NAME OF DRUG Cefazolin

DATE ORDERED

01-24-12

CLASSIFICATION DOSE FREQUENCY ROUTE Anti-infectives 2gm Q8 IVTT

MECHANISM OF ACTION Bind to bacterial cell wall membrane; active against many gram - + cocci including GABS and S.pneumoniae; penicillinsproducing staphylococci

SPECIFIC INDICATION Skin and Skin structure infections

SIDE EFFECTS

NURSING IMPLICATIONS BEFORE: Assess pt for infection, history of allergic reaction to cephalosporins, check results of C &S DURING: Have the pt state his name, explain the importance of giving the medication and administer cautiously AFTER: Observe pt for S & Sx of anaphylaxis. Discontinue if those occurs and notify physician; keep epinephrine, antihistamine and resuscitation equipment

Diarrhea Nausea Vomiting Cramps Rashes Urticaria Phlebitis at IV site

close in case of anaphylactic reaction; instruct pt to report if fever and diarrhea develop.

NAME OF DRUG Gentamycin

DATE ORDERED

CLASSIFICATION

01-24-12

DOSE FREQUENCY ROUTE Aminoglycosides 80mg Q8 IVTT

MECHANISM OF ACTION Bactericidal: inhibits protein synthesis in susceptible strain of gramnegative bacteria; appears to disrupt functional integrity of bacterial all membrane, causing cell death.

SPECIFIC INDICATION Infections of soft tissues

SIDE EFFECTS

NURSING IMPLICATIONS BEFORE: Check results of C & S and real function; assess V/S (BP, PR, R) DURING: Have the pt state his name, explain the importance of giving the medication and administer cautiously AFTER: Instruct pt to report signs of adverse effects (severe headache, loss of hearing, DOB).

Dizziness Headache Numbness Paresthesia Muscle twitching Palpitations HPN Hypotension Pain fever

NAME OF DRUG Penicillin G

DATE ORDERED CLASSIFICATION DOSE FREQUENCY ROUTE 01-24-12 Antibiotic 500U IVTT q6

MECHANISM OF ACTION Bactericidal: inhibits synthesis of cell wall of sensitive organism, causing cell death.

SPECIFIC INDICATION Severe infections caused by sensitive organisms (streptococci)

SIDE EFFECTS

NURSING IMPLICATIONS BEFORE: Obtain history of hypersensitivity to cephalosporins and other allergies; renal disorder; culture infection; assess V/S (R) ; normal output. DURING: Have the pt state his name, explain the importance of giving the medication and administer cautiously. AFTER: Monitor serum electrolytes and cardiac status ( Na/K preparations have been assoc. with severe electrolyte

Lethargy Abdominal pain Rash Fever Pain phlebitis

imbalances); keep epinephrine, IVF,vasopressors, bronchodilators, O2 and E equipment readily available in case of serious hypersensitivity reaction; notify physician id A/E occurs.

NAME OF DRUG Tramadol

DATE ORDERED

01-24-12

CLASSIFICATION DOSE FREQUENCY ROUTE Centrally acting 50mg analgesic q8 IVTT

MECHANISM OF ACTION Binds to muopioid receptors and inhibits the reuptake of norepinephrine and serotonin; causes many effects similar to opioidsdizziness, somnolence, nausea, constipationbut does not have the

SPECIFIC INDICATION Relief of moderate to severe pain

SIDE EFFECTS

NURSING IMPLICATIONS BEFORE: Obtain history of hypersensitivity to tramadol and opioid addiction; assess V/S (BP, R) and PS. DURING: Have the pt state his name, explain the importance of giving the medication and

Sedation Dizziness Headache Confusion Sweating Anxiety Hypotension Pruritus Rash Urticaria Nausea vomiting

respiratory depressant effects.

administer cautiously. AFTER: Instruct pt to report if he experience severe nausea/ dizziness/ constipation.

NAME OF DRUG Parecoxib

DATE ORDERED

01-24-12

CLASSIFICATION DOSE FREQUENCY ROUTE NSAIDs 40 mg IVTT q 12

MECHANISM OF ACTION

SPECIFIC INDICATION

SIDE EFFECTS

NURSING IMPLICATIONS BEFORE: Assess for presence of GI lesions and bleeding disorders; check results of renal functions, liver studies and platelet. DURING: Have the pt state his name, explain the importance of giving the medication and administer cautiously. AFTER:

Parecoxib is a Management selective antiof postinflammatory, operative pain. meaning that it blocks the enzyme cyclooxygenase2 (COX-2), responsible for prostaglandin (chemicals that play a role in pain and inflammation) synthesis, without affecting the enzyme COX-1, involved in the production of

Indigestion Flatulence Mild swelling Rash

prostaglandins that protect the lining of the stomach against stomach ulcers.

Educate pt about the side effects and report for any adverse effects ( GI bleeding/pain).

NAME OF DRUG Ranitidine

DATE ORDERED

01-24-12

CLASSIFICATION DOSE FREQUENCY ROUTE Histamine2 50 mg (H2) antagonist q 8 once NPO IVTT

MECHANISM OF ACTION Ranitidine blocks histamine H2receptors in the stomach and prevents histaminemediated gastric acid secretion. It does not affect pepsin secretion, pentagastrinstimulated factor secretion or serum gastrin.

SPECIFIC INDICATION

SIDE EFFECTS

NURSING IMPLICATIONS BEFORE: Assess history of allergy to ranitidine; check renal or hepatic function. DURING: Have the pt state his name, explain the importance of giving the medication; Administer oral drug with meals. AFTER: Educate pt

constipation diarrhea fatigue headache insomnia muscle pain nausea vomiting

about the side effects of drug; Report sore throat, fever, unusual bruising or bleeding, tarry stools, confusion, hallucinations, dizziness, severe headache, muscle or joint pain.

NAME OF DRUG Clindamycin

DATE ORDERED 01-25-12

CLASSIFICATION DOSE FREQUENCY ROUTE Lincosamide 600 mg antibiotic q8 IVTT

MECHANISM OF ACTION Inhibits protein synthesis in susceptible bacteria, causing cell death.

SPECIFIC INDICATION It is used to o treat o infections and o anaerobic o bacteria o

o

SIDE EFFECTS

NURSING IMPLICATIONS BEFORE: Assess history of allergy to clindamycin and others: check results of renal function and C & S. DURING: Have the pt state his name, explain the importance of giving the

o o o o o

Abdominal pain Nausea Vomiting Diarrhea Dry scaly skin Phlebitis thrombophlebitis with IV administration urticaria pruritus Headache dizziness

medication and administer cautiously. AFTER: Educate pt about the side effects; report severe or watery diarrhea, abdominal pain, inflamed mouth, skin rash or lesions.

NAME OF DRUG Paracetamol

DATE ORDERED 01-26-12

CLASSIFICATION DOSE FREQUENCY ROUTE Antipyretics 300 mg >37.5 prn IVTT

MECHANISM OF ACTION Paracetamol exhibits analgesic action by peripheral blockage of pain impulse generation. It produces antipyresis by inhibiting the hypothalamic heat-regulating centre. Its weak anti-

SPECIFIC INDICATION fever.

SIDE EFFECTS

NURSING IMPLICATIONS BEFORE: Assess temperature, administer if >37.5; check for renal function. DURING: Have the pt state his name, explain the importance of giving the medication and administer

Side effects from paracetamol are rare but can include: -a rash; -blood disorders, such as thrombocytopenia (low platelet count) and leukopenia (low number

inflammatory activity is related to inhibition of prostaglandin synthesis in the CNS.

of white blood cells); -hypotension (low blood pressure) when given in hospital by infusion (a continuous drip of medicine into a vein in your arm) ; -liver and kidney damage, when taken at higher-thanrecommended doses.

cautiously. AFTER: Educate pt about the side effects and report to physician if it worsens.

NAME OF DRUG Ceftriaxone

DATE ORDERED

02-02-12

CLASSIFICATION DOSE FREQUENCY ROUTE Antibiotic 1 gm q8 IVTT

MECHANISM OF ACTION Bactericidal: inhibits synthesis of bacterial cell wall, causing cell death.

SPECIFIC INDICATION Skin and skin structure infections caused by P. Mirabilis

SIDE EFFECTS

NURSING IMPLICATIONS BEFORE: Check C & S test before therapy. DURING: Have the pt state his name, explain the importance of

Headache Dizziness Nausea Vomiting Diarrhea Anorexia Flatulence Pain Inflammation

at IV site

giving the medication and administer cautiously; administer slowly. AFTER: Educate pt about the side effects; report severe diarrhea, DOB, unusual tiredness or fatigue.

NAME OF DRUG Ciprofloxacin

DATE ORDERED

02-02-12

CLASSIFICATION DOSE FREQUENCY ROUTE Antibacterial 1 gm OD if not on NPO P.O

MECHANISM OF ACTION Bactericidal: interferes with DNA replication in susceptible bacteria preventing cell reproduction.

SPECIFIC INDICATION For the treatment of infections caused by susceptible gram-negative bacteria, including proteus mirabilis.

SIDE EFFECTS

NURSING IMPLICATIONS BEFORE: Assess history of allergy to ciprofloxacin, norfloxacin or other Quinolones; check C & S result. DURING: Have the pt state his name, explain the importance of

Headache Dizziness Fatigue Insomnia Nausea Vomiting Dry mouth diarrhea

giving the medication and administer cautiously; Instruct pt not to crush, cut/ chew the tablet. AFTER: Educate pt about the side effects; report rash, visual changes, severe GI problems, weakness, and tremors.