Cebu Normal University College of Nursing Osmenia Blvd.

Cebu City 6000 NAS III Pharmacology, Therapeutics and Diagnostics DRUG STUDY Name of Patient +iagnosis +o0tor ordan !. "anaganag Im,alement In-ury. /e0tum "rade II. S1P 23 !a,. !oo, Colostomy +r. Age Se3 +ate of Admission #$ days old male August #6. 60#7 %eig&t 4eig&t Body Build '()* 60 5g 8esomor,&

+rug +ata "eneri0 Name Am,i0illin 9rade Name Am,i0in Patients +ose #.'g I:99 O+ 8inimum +ose 6' mg 8a3imum +ose 6 grams ;it&in 70 min. Availability

Classifi0ation 9&era,euti0= Antibioti0 P&arma0ologi0 Peni0illin Pregnan0y /is5 Category= B

8e0&anism of A0tion In&ibits ba0terial 0ell ;all synt&esis. 9&e rigid. 0ross< lin5ed 0ell ;all is assembled in several ste,s. Am,i0illin e3erts its effe0ts on sus0e,tible ba0teria in t&e final stage of t&e 0ross<lin5ing ,ro0ess by binding ;it& and ina0tivating ,eni0illin< binding ,roteins >en?ymes res,onsible for lin5ing t&e 0ell ;all strands@. 9&is a0tion 0auses ba0terial 0ell lysis and deat&. P&arma0o5ineti0 A= Un5no;n to I: += Into ,leural. ,eritoneal. and synovial fluidsA lungs. ,rostate. liver. gallbladder midle ear effusions 8= Only ,artial 2= In urine by renal tubular se0retion and glomerular filtration. Onset Oral 70 min I8 #' min I: immediate Pea5 Oral 6 &rs. I8 # &r I: ' min +uration

Ca,sules < 6'0 mg. '00 mg Po;der for oral sus,ension< #6'mg1' ml. 6'0 mg1 'ml Po;der for in-e0tion

/outes of administration= intravenous

Indi0ation "eneral Indi0ations B9o treat "I infe0tions and genitourinary infe0tions >ot&er t&an gonorr&ea@ 0aused by sus0e,tible strains of S&igella. Salmonella ty,&i and ot&er s,e0ies. 2s0&eri0&ia 0oli. Proteus mirabilis. and entero0o00i B9o treat gonorr&ea 0aused by sus0e,tible strains of non ,eni0illinase<,rodu0ing Neisseria gonorr&oeae B9o treat res,iratory tra0t infe0tions 0aused by sus0e,tible strains of non,eni0illinase ,rodu0ing %aemo,&ilus influen?ae. sta,&ylo0o00i. and stre,to0o00i.in0luding Stre,to0o00us ,neumonia Bto treat se,ti0aemia Bto treat listeriosis Patients A0tual Indi0ation 9o ,revent infe0tion in t&e stoma of t&e 0olostomy

Contraindi0ations Contraindi0ations C %y,ersensitivity to any ,eni0illin. 0e,&alos,orins and infe0tion 0aused by ,eni0illinase<,rodu0ing organism Pre0aution Use 0autiously in= C renal im,airment +rug intera0tion drug to drug allopurinol: In0reased ris5 of ras&. ,arti0ularly in &y,eruri0emi0 ,atient aminoglycosides: Possibly ina0tivated a0tion of aminogly0oside and am,i0illin ;&en given toget&er heparin, oral anticoagulants: In0reased ris5 of bleeding oral contraceptives: Possibly redu0ed 0ontra0e,tive effe0tiveness and brea5t&roug& bleeding probenecid: Possibly in0reased serum am,i0illin level and

Adverse /ea0tion CNS: C&ills. fatigue. fever. &eada0&e. 8alaise CV: C&est ,ain. edema. t&rombo,&lebitis NT: 2,ista3is. glossitis. laryngeal stridor. mu0o0utaneous 0andidiasis. stomatitis. t&roat tig&tness G!: Abdominal distention. diarr&ea. diarr&ea related to Clostridium difficile, entero0olitis. flatulen0e. gastritis. nausea. ,seudomembrano us 0olitis. vomiting GU: +ysuria. urine retention. vaginal 0andidiasis " # : Agranulo0ytosis. anemia. eosino,&ilia. leu5o,enia. t&rombo0yto,enia. t&rombo0yto,eni0 ,ur,ura S$!N: 2ryt&ema multiformeA

Nursing /es,onsibilities Before #. Assess sensitivity of ,t. to t&e drug to avoid life t&reatening side effe0ts. 6. 23,lain to t&e ,atient t&e t&era,euti0 value of drug to de0rease an3iety 7. 4arn about t&e different side effe0t &e may e3,erien0e for ,rom,t referral if side effe0ts are e3,erien0ed D. Assess 5no;ledge about t&e drug and &is 0ondition to 5no; ;&at ne0essary information to be added. '. 8onitor vital signs to obtain baseline information for 0&anges t&at mig&t o00ur t&roug&out t&e 0ourse of t&era,y +uring #. :erify ,t identity to ensure drug is given to t&e rig&t ,atient. 6. Administer t&e drug ;it& t&e rig&t route. time and dosage to avoid un;anted rea0tions 7. Continue monitoring vital signs. D. C&e05 ,aten0y of I: site to ensure drug is ,ro,erly administered '.Advise to re,ort immediately to nurse ;&en adverse effe0ts o00ur to ,rovide ne0essary interventions After #. +o0ument administration of drug to ensure 0ontinuity of 0are 6. 8onitor a,,earan0e of side effe0ts to be addressed immediately 7. Instru0t to re,ort if any of t&e side

Oral 6<E &ours I8< 6<E &ours I:< 6<E &ours +rug &alf<life #<6 &r

am,i0illin to3i0ity tetracyclines: Possibly im,aired a0tion of am,i0illin

eryt&ematous. mildly ,ruriti0 ma0ulo,a,ular ras& or ot&er ty,es of ras&A e3foliative dermatitisA ,ruritusA urti0aria %ther: Ana,&yla3is. fa0ial edema. in-e0tion site ,ain

effe0ts are e3,erien0ed to be addressed immediately D. 8onitor vital signs to obtain baseline information for 0&anges t&at mig&t o00ur t&roug&out t&e 0ourse of t&era,y '. Advi0e to ta5e full 0ourse of drug t&era,y

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Cebu Normal University College of Nursing Osmenia Blvd. Cebu City 6000 NAS III Pharmacology, Therapeutics and Diagnostics DRUG STUDY Name of Patient +iagnosis +o0tor ordan !. "anaganag Im,alement In-ury. /e0tum "rade II. S1P 23 !a,. !oo, Colostomy +r. Age Se3 +ate of Admission #$ days old male August #6. 60#7 %eig&t 4eig&t Body Build '()* 60 5g 8esomor,&

+rug +ata "eneri0 Name 8o3iflo3a0in %Cl 9rade Name Avelo3 Patients +ose D00mg I:99 O+ 8inimum +ose D00mg I:99 O+ 8a3imum +ose D00mg I:99 O+ Availability

Classifi0ation 9&era,euti0= Antibioti0 P&arma0ologi0 FluoroGuinolone Pregnan0y /is5 Category= C

8e0&anism of A0tion In&ibits t&e en?ymes needed for ba0terial +NA re,li0ation. trans0ri,tion. re,air. and re0ombination. P&arma0o5ineti0 A= "ood. += 4ide. About '0H ,rotein<bound. 8= about '0H to ina0tive 0on-ugates 2= about D'H of dose un0&anged in urine and fe0es Onset Oral 70 min I8 #' min I: immediate Pea5 Oral 6 &rs. I8 # &r I: ' min +uration Oral 6<E &ours I8< 6<E &ours I:< 6<E &ours +rug &alf<life #<6 &r

In-e0tion= D00mg 9ablets= D00mg

/outes of administration= Intravenous oral

Indi0ation "eneral Indi0ations BA0ute ba0terial sinusitis 0aused by Stre,to0o00us ,neumonia. %aemo,&ilus influen?ae. or 8ora3ella 0atarr&alis BA0ute ba0terial e3a0erbation of 0&roni0 bron0&itis BCommunity< a0Guired ,neumonia 0aused by multidrug<resistant BUn0om,li0ated slim and s5in< stru0ture infe0tions BCom,li0ated s5in infe0tions BCom,li0ated intra<abdominal infe0tions Patients A0tual Indi0ation 9o ,revent infe0tion in t&e stoma of t&e 0olostomy

Contraindi0ations Contraindi0ations C Contraindi0ated in ,atients &y,ersensitive to drug or any of its 0om,onents. or ot&er fluoroGuinolones Pre0aution Use 0autiously in ,ts ;it& 5no;n or sus,e0ted CNS disorders and in ,ts ;it& ris5 fa0tors t&at may ,redis,ose t&em to sei?ures. +rug intera0tion drug to drug aluminium hydroxide, magnesium hydroxide, calcium carbonate: may de0rease mo3iflo3a0in effe0ts Class IA(procainamide, quinidie) or Class III (amiodarone) antiarrhythmics: may en&an0e adverse C: effe0ts N AI!s: may in0rease ris5 of CNS stimulation and sei?ures. ucralfate: may de0rease absor,tion of mo3iflo3a0in

Adverse /ea0tion CNS: an3iety. ast&enia. 0onfusion. di??iness. &eada0&e. insomnia. malaise. nervousness. ,ain CV: 0&est ,ain. %PN. ,al,itations. ,rolonged I9 interval. ta0&y0ardia G!: abdominal ,ain. anore3ia. 0onsti,ation. diarr&ea. dry mout&. dys,e,sia " # : leu5o,enia. t&rombo0yto,enia. t&rombo0ytosis " P&T!C: 0&olestati0 -aundi0e. liver dysfun0tion #USCU'%: art&ralgia. ba05 ,ain. leg ,ain R SP: dys,nea

Nursing /es,onsibilities Before #. Assess sensitivity of ,t. to t&e drug to avoid life t&reatening side effe0ts. 6. Obtain &istory of ,atient(s 0ondition. 7. Assess level of infe0tion. D. Assess 5no;ledge about t&e drug and &is 0ondition to 5no; ;&at ne0essary information to be added. '. Obtain s,e0imen for 0ulture and sensitivity. as indi0ated. +uring #. :erify ,t identity to ensure drug is given to t&e rig&t ,atient. 6. "ive anta0id at least D &ours before or E &ours after t&e administration of drug. 7. C&e05 I: ,aten0y. 8aintain sterility. D. "ive at t&e same time ea0& day to ,rovide 0onsistent absor,tion. '. Instru0t to ta5e drug only on0e a day. at t&e same time ea0& day. After #. +o0ument administration of drug to ensure 0ontinuity of 0are 6. 8onitor a,,earan0e of side effe0ts to be addressed immediately 7. Instru0t to re,ort if any of t&e side effe0ts are e3,erien0ed to be addressed immediately D. 9ell ,t to avoid &a?ardous a0tivities. su0& as driving '. Advi0e to ta5e full 0ourse of drug t&era,y

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Cebu Normal University College of Nursing Osmenia Blvd. Cebu City 6000 NAS III Pharmacology, Therapeutics and Diagnostics DRUG STUDY Name of Patient +iagnosis +o0tor ordan !. "anaganag Im,alement In-ury. /e0tum "rade II. S1P 23 !a,. !oo, Colostomy +r. Age Se3 +ate of Admission #$ days old male August #6. 60#7 %eig&t 4eig&t Body Build '()* 60 5g 8esomor,&

+rug +ata "eneri0 Name Albuterol 9rade Name Salbutamol Patients +ose Salbutamol neb ,rior to O/ 8inimum +ose # neb daily 8a3imum +ose # neb G& Availability Aerosol in&aler= $0m0g1metered s,ray Solution for in&alataion= 0.0E7H. 0.'H. 0.67mg17ml. #.6'mg17ml /oute of administration In&alation

Classifi0ation 9&era,euti0= Bro0&odilator

Indi0ation Contraindi0ations Adverse /ea0tion "eneral Indi0ations Contraindi0ations CNS Used as bron0&odilator %y,ersensitivity to Nervousness to 0ontrol and ,revent adrenergi0 amines. /estlessness reversible air;ay &y,ersensitivity to P&arma0ologi0 obstru0tion 0aused by fluoro0arbons 9remors Sele0tive beta ast&ma COP+ %eada0&e adrenergi0 +/U"<+/U" agonist 9&era,euti0 2ffe0t= Patients A0tual IN92/AC9ION= Insomnia Im,roves ventilation. Indi0ation Con0urrent use ;it& Pregnan0y /is5 For bron0&odilation in ot&er adrenergi0 agents C: Category= P&arma0o5ineti0s ,atients undergoing ;ill &ave adrenergi0 C&est ,ain C %A!F<!IF2= o,eration ;it& general side effe0ts Pal,itation D&ours anest&esia ONS29= Angina '<#'min Arr&yt&mias P2AJ= #<# K &our +U/A9ION= "I 7<D &ours Nausea

8e0&anism of A0tion C&emi0al 2ffe0t= /ela3es bron0&ial and uterine smoot& mus0le by a0ting on beta6<adrenergi0 re0e,tors

Nursing /es,onsibilities Before

%ands s&ould be ;as&ed ;it& soa, L

;ater.

Assess 0ondition. Assess res,iratory status. Aus0ultate

lung sounds.

Assess ,atient(s and SO(s 5no;ledge of

t&era,y.

8onitor ,ulmonary fun0tion before

t&era,y. +uring

After

:erify ,atient(s name. Pre,are t&e rig&t medi0ation.

Aerosol form may ,res0ribed for use #' minutes before a0tivity. Administer ;it& t&e rig&t drug. route. and timing. Administer ;it& rig&t dose. +o0ument medi0ation administration.

2N+O

:omiting

F and 2

%y,ergly0emia

%y,o5alemia

4arn mot&er to sto, drug immediately if ,arado3i0al bron0&os,asms o00ur. Avoid giving t&e 0&ild fluids and foods ;it& 0affeine. 0ola and 0&o0olate. Advise to re,ort any adverse rea0tion immediately. 9ea0& mot&er &o; to administer using a nebuli?er to ,romote inde,enden0e.

SOU/C2= Bro;nell. et. al. 600$. Nursing 2009 Student Drug Handbook. #0t& 2d. !i,,in0ott 4illiams and 4il5ins= Ambler. PA ,,. ##'<##)