Chapter VII

DRUG STUDY
DRUG NAME
Generic Name:
Piperacillin / Ta
zobactam
Brand Name:
Zosyn
CLASSIFICATIO
N
Anti infective ;
Beta-lactam
antibiotic ;
Antipseudomonal
penicillin

MECHANISM
OF ACTION
It is similar to
that of other
penicillins.
Interfere with
bacterial cell
wall synthesis
promotes
loss of membra
ne integrity and
leads to death
of the
organism.

INDICATION
Treatment
of moderate to
severeappendi
citis,uncomplic
atedand compl
icatedskin and
skinstructurein
fections,nosoc
omial orcomm
unityacquiredpneu
moniacausedpi
peracillinresistant,piper
acillin/tazobact
amsusceptible,
betalactamaseproducingbact
eria

DOSAGE
Recommended:
4 g / 0.5
g every
eight
hours
Actual:
4.5 gram
IVTT q8
ANSTC

ADVERSE
REACTION
CNS:
headache,
insomnia,
fever
GI: diarrhea,
nausea,
constipation,
vomiting,
pseudomembr
anous colitis
SKIN:Hypersen
sitivity
reactions,
rash, pruritus

NURSING
RESPONSIBILITIES
Obtain history of hy
persensitivity to
penicillins,
cephalosphorins, or
other
drugs prior to
administration,
Obtain specimen fo
r culture and
sensitivity prior
to first dose of
the drug; start drug
pending results.
Periodic CBC with
differential, platelet
count,Hgb & Hgt, a
nd serum
electrolytes.
Monitor for
hypersensitivity
response;
discontinue drug a
53

nd
notify physician if a
llergic response
noted.
Monitor for
hemorrhagic
manifestations bec
ause
high dose may indu
ce coagulation
abnormalities.
Instruct
family/significant
others to
report significant,
unexplained
diarrhea.
Monitor vital signs
because of cardiac
arrhythmias,
hypertension
and fever as advers
e reactions.
Instruct the mother
not to breast feed
the baby while
taking the drug wit
54

hout consulting
physician

DRUG NAME
Generic Name:
Clindamycin
Brand Name:
Cleocin/Deocin
CLASSIFICATIO
N
Antibiotic

MECHANISM
OF ACTION
Inhibits bacteri
al protein
synthesis
by binding to
50Ssubunit
of ribosome.hinders or kills
susceptible
Bacteria.

INDICATION
infections
caused by
sensitive
staphylococci,
streptococci, p
neumococci, b
acteroides, fusi
bacterium,
clostridium per
fringens, and
other sensitive
aerobic and
anaerobic
organisms.endocarditis pr
ophylaxis
for dental
procedures
in patients
allergic

DOSAGE
Recommended:
300600mg
Actual:
300mg
IVTT q8

ADVERSE
REACTION
CNS: headache
CV:
Thrombophlebitis
EENT: pharyngitis
GI:
abdominal pain,
Anorexia, bloody
or tarry stools,
constipation,
diarrhea,
dysphagia,
esophagitis,
flatulence,
nausea, psuedom
embranuscolitis,
unpleasantor
bitter taste,
vomiting.
GU:

NURSING
RESPONSIBILITIES
-assess patients
infection before
and regularly
through out
therapy
before giving first
dose, obtain
specimen for
culture and
sensitivity test,
begin therapy
pending results.
monitor renal,
hepatic, and
hemato poetic
functions
during prolonged
therapy.
be alert for adverse
reactions and drug
55

to penicillinacne vulgarisbacterial
vaginosispneumocystis j
iroveci
(carinii) pneum
oniatoxoplasmosis(
cerebral or
ocular)immuno
compromised
patients

UTIHEMATOLOGIC
:Eosinophilia,thro
mbocytopenia,tra
nsientleukopenia
SKIN:
maculopapular ra
sh

interactions
if adverse GI
reactions occurs,
monitor patients h
ydration.
teach patient how
to store oral
solution.
tell patient to take
entire
amount prescribed
even after he feels
better.
warn patient that
I.M. injection may
be painful-instruct
patient to report
diarrhea and to
avoid selfthreatening psudo
membranuscolitistell patient
receiving drug I.V.
to report
discomfort at
infusion site.
56

DRUG NAME
Generic Name:
Pantoprazole
Brand Name:
Pantoloc
CLASSIFICATIO
N
Proton Pump
Inhibitor

MECHANISM
OF ACTION
Inhibits both
basal and
stimulated
gastric acid
secretion by
suppressing the
final step in
acids productio
n, through the
inhabitation
of the proton
pump
by binding to
and inhibiting
hydrogen- pota
ssium
adenosine
triphosphatase,
the enzyme
system located

INDICATION
Duodenal and
gastric ulcer,
moderate and
severe reflux
esophagitis.
Eradication of
H. pylori in
patient with
peptic
ulcers, patholo
gical hyper
secretory
conditions.
Symptomatic
improvement
and healing of
mild reflux
esophagitis.
Prevention of
gastro-

DOSAGE

ADVERSE
REACTION
Recom-
Occasionally
mended:
headache
40mg
or diarrhea.
Isolated cases of
Actual:
edema, blurred
40mg IV
vision, fever,
OD
dizziness,
thrombophlebitis,
depression
or myalgia
subsiding after
termination of
therapy.

NURSING
RESPONSIBILITIES
Assess underlying
condition before
therapy and
thereafter to
monitor drug
effectiveness.
Assess GI
symptoms:
epigastric/abdomin
al pain, bleeding
and anorexia.
Monitor
for possible drug
induced adverse
reaction

57

DRUG NAME
Generic Name:
Rosuvastatin
Brand Name:
Torus
CLASSIFICATIO
N
Antihyperlipide
mic drug

at the secretory
surface of the
gastric parietal
cell

duodenal
ulcers induced
by NSAID
in patients at
risk with a
need
for continuous
NSAID
treatment

MECHANISM
OF ACTION
A fungal
metabolitethat
inhibits
theenzyme
(HGM-CoA)that
catalyzes
thefirst step in
thecholesterol
synthesispathw
ay, resulting ina
decrease in
serumcholester

INDICATION
an adjunct to
diet inthe
treatment
ofelevated
totalcholestero
l,
mixeddyslipide
mia,atheroscle
rosis

DOSAGE
Recommended:
10mg
Actual:
10mg
1tab OD

ADVERSE
REACTION
Nausea,
dyspepsia,diarrhe
a,constipation,vo
miting,
rhinitis,sinusitis,
cough,dyspnea,
pneumonia

NURSING
RESPONSIBILITIES
Monitor
patientclosely for
signs ofmuscle
injury,especially
higherdoses Provide
comfortmeasures
to dealwith
headache,muscle
cramps, ornausea
Instruct patient to
58

ol, serumLDLs
(associated
withincreased
risk ofcoronary
arterydisease)
and either
anincrease or
no changein
serum
HDLs(associate
d
withdecreased)

DRUG NAME
GENERIC
NAME:
IVABRADINE
BRAND NAME:
CORALAN
CLASSFICATIO
N
Antibiotic

MECHANISM
OF ACTION
Ivabradine is a
pureheart rateloweringagent,
acting
byselective
andspecific
inhibitionof the
cardiac pacema
ker

INDICATION

DOSAGE

Symptomatictr
eatmentof chro
nic
stableangina p
ectorisincorona
ry
arterydisease
patients
w/normal

Recomme
nded:
5mg/7.5
mg

Actual:
5mg
tab BID

ADVERSE
REACTION
Cardiovascular
: bradycardia,
palpitations,su
praventricular
extrasystoles
GI:
nausea,constip
ation

store drug at room

temperature and to
keep container
tightly sealed.
Inform patient to
report adverse
reaction without
delay

NURSING
RESPONSIBILITIES
Monitor BP and
pulse before therapy,
duringdosage
titration,
and periodicallythroug
hout therapy.
Assess for signs
of CHF
( peripheraledema,
59

I
sinusrhythm
f
currentthat
controls
thespontaneous
diastolicdepolar
isation inthe
sinus node
andregulates
heart rate.The
cardiac
effectsare
specific to
thesinus node
with noeffect
on intraatrial,atrioventr
icular
or intraventricul
ar conduction
times,nor on
myocardialcont
ractility
or ventricular re
polarisation

crackles,dyspnea,
weight gain, jugular
venousdistention)
Angina:
Assesslocation,
duration,intensity
and precipitating
factorsof patient's
anginal pain.
Hypertension:
Check frequency of
refills tomonitor
adherence.
Monitor
serum potassium peri
odically.Hypokalemiain
creases the risk
of arrhythmias
andshould be
corrected

60

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