Drug Study

1. AZITHROMYCIN

500mg/tab 1tab OD

Classification: Macrolide antibiotic

Action: Bacteriostatic or bactericidal in susceptible bacteria.
Indication: Treatment of lower respiratory tract infections: acute bacterial exacerbations of
COPD due to H. influenzae, Moraxella catarrhalis, S. pneumoniae; community-acquired
pneumonia due to S. pneumoniae, H. influenza; treatment of lower respiratory tract
infections: streptococcal pharyngitis/tonsillitis due to Streptococcus pyogenes in those who
cannot take penicillins; treatment of uncomplicated skin infections due
toStaphylococcus aureus, S. pyogenes, Streptococcus agalactiae; treatment
of nongonococcal urethritis and cervicitis due to C.trachomatis; treatment of PID; treatment
of otitis media caused by H. influenzae, M.catarrhalis, S. pneumoniae in children > 6 months;
treatment of pharyngitis/tonsillitis in children > 2 yr who cannot use first-line therapy;
prevention and treatment of disseminated Mycobacteriumavium complex (MAC) in patients
with advanced AIDS
Contraindication: Hypersensitivity to azithromycin, erythromycin, or
any macrolide antibiotic.
Adverse Effects: Dizziness, headache, vertigo, somnolence, fatigue, diarrhea, abdominal
pain, nausea, dyspepsia, flatulence,
vomiting, melena,pseudomembranous colitis, Superinfections, angioedema, rash
Nursing Considerations:
> Culture site of infection before therapy.
>Administer on an empty stomach--1 hr before or 23 hr after meals. Food affects the
absorption of this drug.
>Counsel patients being treated for STDs about appropriate precautions and additional
therapy.
>Take the full course prescribed. Do not take with antacids. Tablets and oral suspension can
be taken with or without food.
2. CO-AMOXICLAV

1g/tab 1tab q12H

Classification: Penicillin
Action: An antibiotic that combines amoxicillin (inhibits bacterial cell wall mucopeptide
synthesis) and clavulanic acid (blocks the chemical defense, known as beta-lactamase found
in some bacteria that are resistant to beta-lactam antibiotics). It destroys bacteria by
disrupting their ability to form cell walls.
Indication: Known or suspected amoxicillin-resistant infections including grespiratory tract,
skin and soft tissue, genitourinary, and ear,nose and throat infections. It is effective against
strains of Escherichia coli, Proteus mirabilis, Haemophilus influenza, Streptococcus faecalis,
Streptococcus pneumoniae and some beta-lactamase producing organisms.
Contraindication: Penicillin hypersensitivity, history of co-amoxiclav-associated or penicillinassociated jaundice or hepatic dysfunction.
Adverse Effects: Lethargy, hallucinations,seizures, glossitis, sore mouth, furry tongue, black
hairy tongue, nausea and vomiting, diarrhea, abdominal pain, bloody diarrhea, enterocolitis
Nursing Considerations:
>Assess bowel pattern before and during treatment as pseudo membranous colitis may
occur.
>Report hematuria or oliguria as high doses can be nephrotoxic.
>Assess respiratory status.
>Observe for anaphylaxis.
>Ensure that the patient has adequate fluid intake during any diarrhea attack.
3. EVENING PRIMROSE OIL
Latin Binomial: Oenothera biennis
Plant Origin: Evening Primrose Plant

Action: The medicinal action of Evening Primrose Oil revolves around the omega-6-fatty acid
portion, linoleic and gamma-linolenic acid, and its relationship with prostaglandin
synthesis. EPO supposedly helps the cervix to soften and efface (get thinned out). Some
believe it can shorten labor duration as well, crediting the linolenic acid, which may trigger a
prostaglandin response in the body. But while its been taken for many years, EPOs
real effect on labor remains relatively unknown.
Indication: Effective for treating rheumatoid arthritis and diabetic nerve disorders, but its
usefulness is not clear in the treatment of a type of eczema, hot flashes, breast pain, or
multiple sclerosis.
Contraindication: Hypersensitivity to evening primrose, bleeding or blood clotting disorder,
pregnancy.
Adverse Effects: Headache, nausea if taken on an empty stomach, upset stomach and
diarrhea only in high doses, may exacerbate temporal lobe epilepsy and mania
Nursing Considerations:
> Inform patient to use it as directed on the package or as directed by the doctor,
pharmacist, or other healthcare provider. Do not use more of this product than is
recommended on the label.
> Inform patient to not use different formulations (e.g., tablets, liquids, and others) of evening
primrose at the same time, unless specifically directed to do so by a health care professional.
Using different formulations together increases the risk of an overdose of evening primrose.
4. FOLIC ACID SUPPLEMENT

1 tab/day

Classification: Vitamin B9
Action: Essential for nucleoprotein synthesis and maintenance of normal erythropoiesis. It
acts against folic aciddeficiency that impairs thymidylate synthesis and results in production
of defective DNA that leads to megaloblast formation and arrest of bone marrow maturation.
Indication: Folate deficiency, macrocytic anemia, and megaloblastic anemias associated
with malabsorption syndromes, alcoholism, primary liver disease, inadequate dietary intake,
pregnancy, infancy, and childhood.
Contraindication: Folic acidalone for pernicious anemia or other vitamin B12 deficiency
states; normocytic, refractory, aplastic, or undiagnosed anemia.
Adverse Effects: Slight flushing and feeling of warmth following IV administration; nausea,
loss of appetite; bloating, gas; bitter or unpleasant taste in your mouth
Nursing Considerations:
>Obtain a careful history of dietary intake and drug and alcohol usage prior to start of
therapy. Drugs reported to cause folate deficiency include oral contraceptives, alcohol,
barbiturates, methotrexate, phenytoin, primidone, and trimethoprim. Folate deficiency may
also result from renal dialysis.
>Keep physician informed of patient's response to therapy.
>Monitor patients on phenytoin for subtherapeutic plasma levels.
5. MEFENAMIC ACID

50mg/tab 1cap q8H PO PC

Classification: Non-steroidal anti-inflammatory drug

Action: Mefenamic acid has analgesic, anti-inflammatory and anti-pyretic properties. It inhibits
the synthesis of prostaglandins. Mefenamic acid shows central and peripheral action and it owes
these properties to its capacity to inhibit cyclooxygenase.
Indication: Used for the relief of mild to moderate pain in acute and chronic conditions including:
pain of traumatic, arthritic or muscular origin; dysmenorrhoea; headache and dental pain. Reduces
blood loss in menorrhagia where menorrhagia is due to ovulatory dysfunctional bleeding
Contraindication: Hypersensitivity to drug; GI inflammation, or ulceration. Safety in children
<14 y, during pregnancy (category C), or lactation is not established.
Adverse Effects: Dyspepsia, upper gastro-intestinal discomfort, gastro-intestinal bleeding,
headache, drowsiness, dizziness, nervousness, visual disturbances
Nursing Considerations:
> Assess patients who develop severe diarrhea and vomiting for dehydration and electrolyte
imbalance.

> Lab tests: With long-term therapy (not recommended) obtain periodic complete blood
counts, Hct and Hgb, and kidney function tests.
> Inform patient not to drive or engage in potentially hazardous activities until response to
drug is known. It may cause dizziness and drowsiness.
> Monitor blood glucose for loss of glycemic control if diabetic.

6. MV + Fe

1 tab OD PO AC

Classification: Multivitamins
Action: An essential mineral found in hemoglobin,myoglobin, and many enzymes. Enters the
bloodstream and is transported to theorgans of the reticuloendothelial system (liver, spleen, bone
marrow) where it is separated out and becomes part of iron stores
Indication: Prevention and treatment of iron-vitamin and dietary deficiency anemias. Used in
anemia due to blood loss during menstruation, infections, surgery, delivery, intoxications,
parasitosis or other causes and anemias during pregnancy.
Contraindication: Hemochromatosis,hemosiderosis, or other evidence of iron overload; anemias not
due to iron deficiency; some products contain alcohol, tartrazine or sulfites and should be
avoided in patients with known intolerance or hypersensitivity
Adverse Effects: seizures, dizziness, headache, syncope, hypotension, hypertension, tachycardia,
nausea, constipation, dark stools, diarrhea, epigastric pain, GI bleeding, taste disorder, vomiting,
flushing, urticaria
Nursing Considerations:
> Monitor blood studies of patient.
> Assess for intake of other multivitamin products within 2 hours, may result to vitamin
overdose.
> Most effectively absorbed if administered 1 hr before or 2 hrs after meal.
> Avoid using antacids, coffee, tea, dairy products, eggs within 1 hr after administration.
>Inform patient about dark, green or black stools to avoid panic.
>Instruct patient to report immediately any signs & symptoms of severe adverse effects that
should arise for prompt intervention.
7. VITAMIN C

1 tab/day

Classification: Vitamin
Action: Water-soluble vitamin essential for synthesis and maintenance of collagen and
intercellular ground substance of body tissue cells, blood vessels, cartilage, bones, teeth,
skin, and tendons.
Indication: Prophylaxis and treatment of scurvy and as a dietary supplement. It increases
protection mechanism of the immune system, thus supporting wound healing and is also
necessary for wound healing and resistance to infection.
Contraindication: . Use of sodium ascorbate in patients on sodium restriction; use of
calcium ascorbate in patients receiving digitalis. Safety during pregnancy(category C) or
lactation is not established.
Adverse Effects: Nausea, vomiting, heartburn, diarrhea, acute hemolyticanemia (patients
with deficiency of G6PD); sickle cell crisis, headache (high doses), urethritis, dysuria
,crystalluria (high doses, mild soreness at injection site, dizziness and temporary faintness with
rapid IV administration
Nursing Considerations:
>Lab tests: Periodic Hct & Hgb, serum electrolytes.
>Monitor for S&S of acute hemolytic anemia, sickle cell crisis.
>High doses of vitamin C are not recommended during pregnancy.
>Take large doses of vitamin C in divided amounts because the body uses only what is
needed at a particular time and excretes the rest in urine. Megadoses can interfere with
absorption of vitamin B12.
> Vitamin C increases the absorption of iron when taken at the same time as iron-rich foods.

Discharge Plan

Medication:

Advised to take full compliance with medications prescribed by the physicians.

Advised to take the medication at the right time and with the right dosage as ordered by the
physician.
Instructed patient not to take over-the-counter medications without consulting with a physician.
Informed patient of possible adverse effects of medications taken.

Environment:
Instructed patient and SO to keep the environment clean and safe.`
Encouraged patient and SO to have a quiet and calm environment conducive for sleep, rest and
relaxation.
Encouraged patient and SO to provide a clean, dry and well-ventilated environment.
Advised SO to lessen stimuli by dimming the room and minimizing the noise to facilitate
recuperation.

Treatment:
Instructed patient and SO to follow the health teachings given.
Instructed patient to ambulate, with assistance if needed, and to perform non-strenuous
exercises
Reminded patient of follow-up checkups given by the physician.

Health Teachings:
Instructed patient to observe proper hygiene to prevent infection.
Encouraged patient to do perineal care daily with the use of waiter and mild soap.
Instructed patient to clean genital are from front to back.
Informed the patient of the risks and complications that could possibly arise from teenage
pregnancy.
Provided the client and the SO sensitive and factual information about the loss.

Observable signs and symptoms:

Instructed patient to report immediately any signs of infection such as swelling, redness,
presence of discharges around the episiotomy site.

Diet:
Encouraged patient to eat foods rich in Vitamin C such as guava and citrus fruits and foods rich
in protein such as meat and boiled egg to help boost immune system and to promote wound
healing.
Encouraged patient to eat meals at the right time of the day to promote proper nutrition.
Encouraged SO to increase patient's intake of oral fluids for rehydration.

Spirituality, Safe, Security:

Encouraged patient to express feelings and to release pent up emotions by talking to family,
friends and significant others.
Encouraged patient to release stress through recreational activities of her choice.
Encouraged patient to pray to the Almighty Father always for protection and good health.