Generic Name

Brand Name
Classifications
Brand Name:
Decilone
Generic name:
Dexamethasone
Classification:
Anti inflammatory
Glucocorticoid

Prescribed and
Recommended
Dosage,
Frequency, and
route of
Administration
PO: initial, 0.75-9
mg/day;
maintenance,
gradually reduce to
minimum effective
dose (0.5-3 mg/day

Mechanism of
Action
Corticosteroids are
natural substances
produced by the
adrenal
glands located
adjacent to the
kidneys.
Corticosteroids have
potent antiinflammatory
properties by
preventing
phospholipid release,
decreasing
eosinophil action and
a number of other
mechanisms.
Dexamethasone, a
corticosteroid, is
similar to a natural
hormone produced by
your adrenal glands.
I t often used to
replace this chemical
when your body does
not make enough of
it.

Indication
Specific
Adjunctive
treatment in
bacterial
meningitis.
General
Cerebral edema
Allergic and
inflammatory
conditions Shock,
Tuberculosis
meningitis

Contraindication

Adverse Reaction

Nursing
Responsibilities

Hypersensitivity;
active untreated
infections;
ophthalmic use in
viral, fungal
disease of the eye

CNS: euphoria,
insomnia, psychotic
behavior, pseudo tumor
cerebri, vertigo,
headache, paresthesia,
seizures, depression.

A ssess patients on long

term therapy have blood
tests to determine
glucose
levels an electrolyte
balance

CV: hypertension,
edema, arrhythmias,
thromboembolism.

A ssess patients muscles

for weakness and
wasting

EENT: cataracts,
glaucoma.

A ssess for signs and

symptoms of other
diseases because
adrenococorticoids mask
the severity of most
illnesses.

GI: peptic ulceration,

GI irritation, increased
appetite, pancreatitis,
nausea, vomiting.
GU: increase urine
glucose, and calcium
levels
Metabolic:
hypokalemia,
hyperglycemia

Assess if the patient is

sensitive to
other corticosteroids
Monitor BP at least 2
times daily until the
patient is stabilized on a
maintenance
dose. Report increase in


Musculoskeletal:
muscle weakness
Skin: Delayed wound
healing
Other: Susceptibility to
infections.

BP.
Teach patient or family
to take medication with
food, to be careful to
avoid falls
because steroids makes
the bones more
unsusceptible to
fractures, the need to
slowly withdrawing the
drug when therapy is
completed so that the
patients own
adrenal cortex will
gradually be reactivated
to take over the
productions of
hormone, the need to
maintain general
hygiene to prevent
infection because
antibody production is
decreased by
adrenocorticosteroids
Evaluate for
G I bleeding when
patient is on a long term
therapy.
Document the procedure.

Generic Name
Brand Name
Classification
Generic name:
Hydralazine
hydrochloride
Brand name:
Alphapress,
Apresoline
Classification
Antihypertensive

Prescribed and
Recommended Dosage,
Frequency and Route
of Administration
Minimum Dose
5 mg/hr by IV infusion
Maximum Dose
10 mg by IV infusion
Contents
Hydralazine HCl
Availability and color
- Tablets- 10, 25,50, 100
mg- Injection- 20mg/mL
Routes
of administration
Oral
Intramuscular Intraveno
us

Mechanism of
Action
Acts directly on
vascular smooth
muscle to cause
vasodilatation,
primarily arteriolar,
decreasing peripheral
resistance; maintains
or increases renal and
cerebral flow

Indication

Essential
hypertension
To manage
hypertensive
emergencies related
to pregnancy(preeclampsia
or eclampsia)

Contraindication

Adverse Reaction

Concentrations
- HypersensitivityCAD- mitral
valvular rheumatic
heart disease

CNS:
Headache, peripheral
neuritis, dizziness,
tremors, psychotic
reactions, characterized
by depression,
disorientation, anxiety

Precaution
- with CAVs- increased
intracranial pressuresevere hypertension
To manage severe heart with uremia- advanced
failure.
renal damage- slow
acetylators- lactationpregnancy- pulmonary
hypertension
Drug interaction
Drug to drugIncreased
pharmacologic effects
of beta-adrenergic
blockers and
hydralazine when
given concomitantly
Drug to foodIncreased
bioavailability of oral
hydralazine given with

Nursing
Responsibilities

Assess patients BP.

Assess for
contraindicated
conditions.Assess bowel sounds.-

CV:
Palpitations,
tachycardia, angina
pectoris, hypotension,
paradoxical press or
response, orthostatic
hypotension
GI:
Anorexia, nausea,
vomiting, diarrhea,
constipation, paralytic
ileus
GU:
Difficult micturation,
impotence
Hematologic:
Blood dyscrasias
Hypersensitivity:

Assess voiding pattern.

Give oral drug with
food.
Instruct to take drug
exactly as prescribed
Use parenteral drug
immediately after
opening ampule.Discard discolored
solutions.- Arrange for
CBC, LE cell
preparations, and ANA
titers during prolonged
therapy..

food.

Rash, urticaria,
pruritus, fever, chills,
arthralgia, eosinophilia;
rarely, hepatitis,
obstructive jaundice
Other:
Nasal congestion,
flushing, edema,
muscle cramps,
lymphadenopathy,
splenomegaly, dyspnea,
lupus-like syndrome
,possible
carcinogenesis,
lacrimation,
conjunctivitis

Withdraw drug
gradually.- Discontinue
if blood dyscrasias
occur.Arrange for pyridoxine
therapy if patient
develops symptoms
of peripheral neuritis.Monitor for orthostatic
hypotension.
Report persistent or
severe constipation,
unexplained fever
or malaise, muscle or
joint aching, chest pain,
rash, numbness,
tingling.
Do proper
documentation.

Generic Name
Brand Name
Classification
Generic Name:
Ketorolac
Tromethamine
Brand Name:
Toradol
Classification:
Anti-pyreticNSAID

Prescribed and
Recommended
Dosage,
Frequency, and
route of
Administration
Dosage:
30mg (3 doses)
Route:
IVTT
Frequency:
Every 6 hours

Mechanism of
Action
- Inhibits prostaglandin
synthesis, producing
Peripherally mediated
analgesia
- Also have antipyretic and
anti-inflammatory
properties.
-Therapeutic
effect:Decreased pain

Indication

Short term management

of pain(not to exceed
5days total for all routes
combined)

Contraindication

Adverse Reaction

Nursing
Responsibilities

Contraindicated in
patients with
hypersensitivity to
drug, its components,
aspirin, or other
NSAIDs, peptic ulcer
disease, GI bleeding
or perforation,
advance renal
impairment, risk
of renal failure,
increased risk of
bleeding ,suspected or
confirmed
cerebrovascular
bleeding, hemorrhagic
diathesis, incomplete
hemostasis
Prophylactic use
before major
surgery ,intraoperative
use when hemostasis
is critical Labor and
delivery
Breastfeeding

CNS:
drowsiness, headache,
dizziness
CV:
hypertension
EENT:
tinnitus
GI:
nausea, vomiting,
diarrhea, constipation
,flatulence, dyspepsia,
epigastric pain,
stomatitis
Hematologic:
thrombocytopenia
Skin
: rash, pruritus,
diaphoresis

Assess pain (who have

asthma, aspirin-induced
allergy, and nasal polyps are
at increased risk
for developing
hypersensitivity reactions.

Other
: excessive thirst,
edema, injection site
pain

Assess for rhinitis note

type, location, and
intensity) prior to and12 hr following
administration.
Monitor BP upon
administration.
< 90/80never
administers).
Caution patient to avoid
concurrent use of alcohol,
aspirin, NSAIDs,
acetaminophen, or
other OTC drugs
medications without
consulting health care
professional.

Advice patient to
consult if rash, itching,
visual disturbance
tinnitus, weight gain,
edema occur.
Effectiveness of the
therapy can be
demonstrated by
decrease in severity pf
pain. Patients who
dont respond to one
NSAIDS may be
respond to another.
Ketorolac therapy should
always be given initially
by the IM or IV route.
Oral therapy should be
used only as a continuation
of parenteral therapy.Do proper
documentation.

Generic Name
Brand Name
Classification

cefuroxime
cefuroxime axetil
Ceftin cefuroxime
sodiumZinacef
Drug classes
Antibiotic
Cephalosporin
(secondgeneration)

Prescribed and
Recommended
Dosage,
Frequency, and
route of
Administration
PO
Uncomplicated UTI
125 mg twice daily.
Respiratorytract
infections
250-500 mg twicedaily.
Uncomplicated
gonorrhea
W/ oral probenecid: 1 g
as a single dose. IV
Meningitis
3 g 8hrly. IM
Gonorrhea
W/ oral probenecid:1.5
g as a single dose.
IV/IM
Surgical prophylaxis
1.5 g IV per-op, then
750mg IM 8 hrly for up
to 24-48 hr.

Mechanism of
Action
Cefuroxime binds to
one or more of the
penicillin-binding
proteins(PBPs) which
in hibits the final
transpeptidation step
of peptidoglycan
synthesis in bacterial
cell wall, thus inhibiting
biosynthesis and
arresting cell wall
assembly resulting in
bacterial cell death.
Absorption:
Absorbed from the GI
tract with peak plasma
concentrations after 2-3
hr (oral); may be
enhanced by the
presence of food.
Distribution:
Pleural and synovial
fluid, sputum, bone and
aqueous fluids; CSF
(therapeutic

Indication

Oral (cefuroxime axetil)

Pharyngitis, tonsillitis
caused by
Streptococcus pyogenes

Otitis media caused by

Streptococcus pneumon
iae,
S. pyogenes,Haemophil
usinfluenzae,
Moraxellacatarrhalis

Lower respiratory
infections caused by
S. pneumoniae,Haemop
hilus parainfluenzae,
H.influenzae

UTIs caused
by Escherichia
coli,Klebsiella
pneumoniae

Uncomplicated
gonorrhea (urethral and
endocervical)

Contraindication

Adverse Reaction

Nursing
Responsibilities

Contraindicated:
* Contraindicated in
patients hypersensitive
to drug.

Large doses can cause

cerebral irritation and
convulsions; nausea,
vomiting, diarrhea,

* Use cautiously in
patients
hypersensitive to
penicillin because of
possibility of crosssensitivity with other
beta-lactam
antibiotics.* Use with
caution in breastfeeding women and
inpatients with history
of colitisor renal
sufficiency.

GI disturbances;
erythema multiforme,
StevensJohnsonsyndrome,
epidermalnecrolysis.

Potentially Fatal:
Anaphylaxis,
nephrotoxicity
,pseudomembranous
colitis

Assessment
History:
Hepatic and renal
impairment, lactation,
pregnancy

Physical:
Skin status, LFTs, renal
function tests, culture
of affected area,
sensitivity tests
Interventions

Culture infection, and

arrange for sensitivity
tests before and during
therapy if expected
response is not seen.

Give oral drug with

food to decrease GI
upset and enhance
absorption.

Give oral drug to

children who can
swallow tablets;

Susceptible infections
750 mg 8hrly, up to 1.5
g 6-8hrly for severe
infections.

concentrations).Crosses
the placenta and enters
breast milk. Proteinbinding: Up to 50%.
Metabolism:
Rapidly hydrolyzed
(intestinal mucosa and
blood).
Excretion:
Via the urine by
glomerular filtration
and renal tubular
secretion (as
unchanged); via
bile(small amounts);
70min (elimination
half-life); prolonged in
neonates and renal
impairment.

Dermatologic
infections, including
impetigo caused by
Streptococcus aureus,S.
pyogenes

Treatment of early
Lyme disease
Parenteral
(cefuroximesodium)

Lower respiratory
infections caused by
S.pneumoniae, S.
aureus,E. coli,
Klebsiella,
H.influenzae, S.
pyogenes

Dermatologic infections
caused by S. aureus,
S.pyogenes, E.
coli,Klebsiella,
Enterobacter

UTIs caused by E.
coli,Klebsiella

Uncomplicated and
disseminated gonorrhea
caused by
N.gonorrhoeae

crushing the drug

results in a
bitter, unpleasant taste.

Have vitamin K
available in case
hypoprothrombine may
occurs.

Discontinue
if hypersensitivity
reaction occurs.
Teaching points
Oral drug

Take full course

of therapy even if you
are feeling better
Document procedure
properly.


Septicemia caused by S.
pneumoniae, S.aureus,
E. coli,Klebsiella, H.
influenzae

Meningitis caused by
S.pneumoniae,
H.influenzae, S.
aureus,N. meningitidis

Bone and joint

infections caused by S.
aureus

Preoperative
prophylaxis

Treatment of acute
bacterial maxillary
sinusitis in patients
3mo12 yr