Drug Study

Mechanism Indication Contraindication Adverse Reactions Nursing Responsibilities

of Action

Generic Name: Dosage: Inhibition of Ciprofloxacin is  Ciprofloxacin is ♣ Nausea ◙ Instruct patient not to take ciprofloxacin with
contraindicated in dairy products such as milk or yogurt, or with
Ciprofloxacin 500mg topoisomerase used to treat ♣ Vomiting
persons with a calcium-fortified juice. He may eat or drink dairy
(DNA gyrase) infections of the
Frequency: history of ♣ Stomach pain products or calcium-fortified juice with a regular
enzymes, skin, lungs,
meal, but do not use them alone when taking
Brand name: BID which inhibits airways, bones, and hypersensitivity to ♣ Heartburn
ciprofloxacin, any ciprofloxacin. They could make the medication
Quinosyn Route: relaxation of joints caused by
member of the ♣ Diarrhea less effective.
supercoiled susceptible
Per Orem DNA and bacteria. quinolone class of
antimicrobial agents, ♣ Feeling an urgent need to ◙Tell patient that Ciprofloxacin can cause side
Classification: promotes Ciprofloxacin is urinate effects that may impair his thinking or reactions.
breakage of also frequently used or any of the product Tell patient to be careful if he plans to drive or do
Antibacterial double to treat urinary components. ♣ Headache anything that requires him to be awake and alert.
stranded infections caused ♣ Difficulty breathing or ◙Instruct patient to take ciprofloxacin with a full
DNA. by bacteria such as swallowing
 Coadministration glass of water (8 ounces).
E. coli.
Ciprofloxacin is of ciprofloxacin with ♣ Hoarseness or throat ◙ Instruct patient to avoid taking antacids, vitamin
effective in treating other drugs primarily tightness or mineral supplements, sucralfate (Carafate), or
infectious diarrheas metabolized by ♣ Rapid, irregular, or
didanosine (Videx) powder or chewable tablets
caused by E. coli, CYP1A2 results in within 6 hours before or 2 hours after you take
increased plasma pounding heartbeat
Campylobacter ciprofloxacin. These other medicines can make
jejuni, and Shigella concentrations of ♣ Fainting ciprofloxacin much less effective when taken at
bacteria. these drugs and the same time.
could lead to ♣ Fever
clinically significant ◙Inform patient that Ciprofloxacin may cause
♣ Joint or muscle pain
adverse events of the swelling or tearing of a tendon (the fiber that
coadministered drug. ♣ Unusual bruising or connects bones to muscles in the body),
bleeding especially in the Achilles' tendon of the heel.
These effects may be more likely to occur if you
♣ Extreme tiredness are over 60, if you take an oral steroid
 Contraindicated
for the treatment of ♣ Lack of energy of medication, or if you have had a kidney, heart, or
certain sexually
transmitted diseases appetite lung transplant.
by some experts due
♣ Seizures ◙Instruct patient to stop taking ciprofloxacin and
to bacterial
call the doctor at once if he has sudden pain,
resistance. ♣ Dizziness swelling, tenderness, stiffness, or movement
♣ Confusion problems in any of your joints. Also instruct
patient to rest his joint until he receive medical
 Concomitant ♣ Nervousness care or instructions.
administration
with tizanidine is ♣ Restlessness
contraindicated. ♣ Anxiety
♣ Difficulty falling asleep
or staying asleep
♣ Pain in the upper right
part of the stomach
♣ Yellowing of the skin or
eyes
♣ Dark urine
 Drug name Dosage Indication Contraindication Drug Adverse and Nursing Responsibilities
Action Side Effects
• Relief of • Contraindicat • Decreases fever • CNS: • Assess patient’s fever or
Generic name: mild-to- ed with by inhibiting the weakness, pain: type of pain,
Paracetamol moderate allergy to effects of fatigue, location, intensity,
pain acetaminophe pyrogens on the nervousness, duration, temperature
n hypothalamic sedation,
• Temporary heat regulating drowsiness, • Assess allergic reactions:
reduction • Use centers and by a dizziness, rash, urticaria; if these
of fever cautiously hypothalamic depression, occur, drug may have to
Brand Name:
with impaired action leading to tremor, be discontinued
Biogesic sweating and headache,
hepatic
function, vasodilation. seizures
chronic • Assesss for
alcoholism, • Relieves pain by  chronic poisoning:
pregnancy, inhibiting • Dermatologic: rapid, weak pulse
Classification: lactation. prostaglandins pruritus,  dyspnea: cold,
Analgesics synthesis at the urticaria, rash clammy extremities
Antipyretic CNS but does not report immediately to
have anti- prescriber.
inflammatory • GI: Anorexia,
action because nausea,
vomiting, • Give with food or milk if GI
Route and of its minimal
constipation, upset occurs
Dosage: effect on the
peripheral hepatic
prostaglandin insufficiency
synthesis.

• GU:
Hematuria,
glycosuria,
urinary
frequency,
renal colic,
crystaluria,
polyuria
 Other: weight loss,
fever , acidosis

Drug name Dosage Mechanism of Indication Contraindication Adverse Reactions Nursing Responsibilities
 Action
Hidrasec should be Pharmacology: Rehydration is the essential element of the
Known A few cases of
Hidrasec given in Hidrasec is an For the treatment of acute diarrhea in infants. In children
hypersensitivity to drowsiness have been
capsule: conjunction with inhibitor of treatment of >24 months, it shoud be planned automatically.
racecadotril. Renal reported during clinical
oral or parenteral enkephalinase, acute diarrhea The prevention or treatment of dehydration will
Hidrasec 100 or hepatic trials. Nausea and
rehydration the enzyme be done with oral rehydration solution. It is
mg impairment. vomiting, constipation,
therapy in patients responsible for recommended to use solutions intended for this
dizziness and headaches
where dehydration breaking down Special purpose and to follow the instructions for
Hidrasec have also been reported
has occurred or is enkephalins. It is Precaution: reconstitution and use.
powder: rarely. The side effects
suspected. a selective but have been mild, and
reversible The sodium concentration should be between 30
Hidrasec equivalent in nature,
Capsule: Adults: inhibitor and and 60 mmol/L, with solutions with a lower
(infant) 10 mg frequency and intensity
Treatment should protects content (30 mmol/L) being reserved for less
to those reported with
Hidrasec 30 mg be initiated with a endogenous severe dehydration. Provision of chlorine and
placebo. Post-marketing
single 100-mg cap enkephalins potassium is necessary in order to correct
surveillance has indicated
given regardless of which are digestive losses. The recommended glucosae
side effects to be
the time. Further physiologically concentration is between 74 and 110 mmol/L.
extremely rare in general
treatment is given active in the The addition of hydrolyzed proteins or amino
use.
approximately 8- digestive tract. acids does not seem to improve rehydration or
hourly until the nutritional state . It is essential to offer the
cessation of Hidrasec has a child very frequent drinks, every quarter of an
diarrhea. pure intestinal hour for example. As a guideline, the proposed
antisecretory volume of oral rehydratio should be equivalent
The daily dose agent which has to the weight loss ie, 50-100 mL/kg for
should not exceed been shown to dehydration of 5-10% of bodyweight.
300 mg and the have no effect on
duration of gastrointestinal In the case of severe or prolonged diarrhea,
treatment must not motility. It severe vomiting or refusal of food, IV
exceed >7 days. reduces intestinal rehydration should be considered.
hypersecretion of
Powder: The usual water and In the case of infectious diarrhea with clinical
daily dose is electrolytes manifestations suggesting an invasive
determined caused by cholera phenomenon, use antibacterial with good
according to toxin or
bodyweight on the inflammation systemic diffusion.
basis of 1.5 mg/kg without affecting
per dose, with 1 basal secretion. Hidrasec 30 mg: If rehydration by rehydration
initial dose and 3 There is therefore solution is prescribed, the conditions of use and
doses spread over no effect in the the method of reconstitution should be explained
the day. Children normal intestine. clearly and precisely.
>9 years (approx
>27 kg): 2 When given It is not necessary to prescribe such rehydration,
sachets/dose; 30 orally, it is nonetheless necessary to explain clearly the
months - 9 years enkephalinase need to rehydrate the child plentiful salty or
(approx 13-27 inhibition is sweetened drinks in order to make up for the loss
kg): 1 sachet/dose; purely peripheral. of fluid due to the diarrhea (the average daily
9-30 months Racecadotril does ration of water is 2 L).
(approx 9-13 kg): not affect central
2 sachets/dose; 1-9 nervous system Maintain feeding during period of diarrhea:
months: 1 enkephalinase Excluding certain product, especially fruit, green
sachet.dose. activity and has vegetables, spicy food and also iced foods or
not been shown to drinks; giving preferen to grilled meat and rice;
Children: Hidrasec produce withdrawal of milk and dairy products should be
is not habituation or considered in each individual case.
recommended for central nervous
use in children. stimulant or In the case of diabetes, take into account the
sedative effects. quantity of sugar in a sachet ie, about 2.899 g of
Elderly: An sucrose per sachet of 3 g powder. If the quantity
adjustment of dose Pharmacokinetic of sucrose (source of glucose and fructose) in
is not necessary in s: Racecadotril is daily dose of this drug >5 g/day, it should be
elederly subjectcs rapidly absorbed taken into account in the daily ration.
by the oral route.
It is rapidly In the absence of any studies in these situations,
hydrolyzed to Hidrasec should not be used as treatment of first
(RS)-N-(1-oxo-2- intent for acute dysentery with blood in the
(mercaptomethyl) stools or high fever and it should not be used in
-3-phenylpropyl) the case of diarrhea occurring during treatment
glycine, its active
metabolite, which with a broad-spectrum antibiotic.
is in turn
converted into Effects on the Ability to Drive or Operate
inactive Machinery: No adverse effects on the ability to
metabolites which drive or operate machinery have been identified.
are eliminated
through the Use in pregnancy & lactation: Adequate
kidneys, feces human data on use during pregnancy are not
and lungs. available. However, animal studies have not
identified any risk to pregnancy or embryo-fetal
The extent and development. Hidrasec should not be used in
duration of action pregnancy unless the potential benefits outweigh
of racecadotril the risks.
depends on the
dose
administered.

Activity against
plasma
enkephalinase
starts within 30
min, with peak
activity
corresponding to
75% inhibition
for a dose of 100
mg, occurring 1-3
hrs after
administration.
The biological
half-life of
racecadotril is 3
hrs. For a dose of
100 mg, the
duration of
activity against
plasma
enkephalinase is
about 8 hrs.

(RS)-N-(1-oxo-2-
(mercaptomethyl)
-3-phenylpropyl)
glycine, the active
metabolite of
racecadotril, is
90% bound to
plasma proteins,
mainly albumin.
Tissue
distribution only
affects about 1%
of the
administered
dose.The
pharmacokinetic
properties of
racecadotril are
not changed by
repeated
administration or
in elderly
subjects. The
bioavailability of
racecadotril is not
affected by food
but the peak
activity is delayed
 by 1½ hrs

Drug name Indication Contraindication Drug Adverse and Nursing

Action Side Effects Responsibilities
 Known hypersensitivity No specific studies in A few cases of drowsiness
Hidrasec to racecadotril. Renal or humans have been have been reported during
hepatic impairment performed. clinical trials. Nausea and
Racecadotril does not vomiting, constipation,
Special precautions: inhibit or induce dizziness and headaches
cytochrome P-450 in have also been reported
animal models rarely. The side effects
have been mild, and
equivalent in nature,
frequency and intensity to
those reported with
placebo. Post-marketing
surveillance has indicated
side effects to be extremely
rare in general use.