Drug Study Cefuroxime

DRUG STUDY Contraindication

Mechanism of Action

Side Effects/Adverse Effects

Nursing Considerations

Generic Name: Cefuroxime

Cefuroxime

is

a Allergy to cephalosporins or CV:

Classification:

bactericidal

Anti-infectives

antibiotic,

Route:

exerts

PO

activity by inhibition

vomiting, diarrhea

Indication:

of bacterial cell wall

Hematologic:

Treatment of Upper and

synthesis

neutropenia, eosinophilia,

Lower Respiratory Tract

susceptible species.

hemolytic

Infections, Skin

Cefuroxime

thrombocytopenia

Infections.

good

penicillins,

which lactation, pregnancy

antibacterial

in has

stability

several

renal

to

bacterial

beta-lactamase enzymes consequently,

and, is

active against many resistant strains of susceptible species.

phlebitis,

arrange for sensitivity

failure, thrombophlebitis GI:

- Culture infection,

pseudomembranous

colitis, nausea, anorexia,

tests before and during therapy if expected response is not seen. - Give oral drug with

transient

food to decrease GI upset

and enhance absorption. anemia, - Give oral drug to children who can swallow

Skin: maculopapular and tablets; crushing the drug erythematous

rashes, results in a bitter,

urticaria, pain, induration, unpleasant taste. - Have vitamin K sterile abscesses, available in case temperature elevation, hypoprothrombinemia tissue sloughing at occurs. intramuscular injection - Discontinue if site hypersensitivity reaction Other: hypersensitivity occurs. reactions, serum sickness, anaphylaxis.

Mechanism of Action

DRUG STUDY Contraindication

Side Effects/Adverse Effects

Nursing Considerations

Generic Name: Salbutamol

Relaxes

bronchial, Hypersensitivity

Classification:

uterine, and vascular adrenergic amines

Bronchodilator,

smooth muscle by Hypersensitivity

Adrenergic

stimulating

Route:

receptors.

beta2 fluorocarbons

to CNS: tremor, nervousness, 1. to

dizziness,

insomnia,

headache,

hyperactivity,

weakness, CNS stimulation, malaise CV: tachycardia, palpitations,

Inhalation

hypertension

Indication:

EENT: dry and irritated nose

used

for

relief

bronchospasm

of

2.

3.

and throat with inhaled form, 4. nasal congestion, epistaxis, hoarseness GI:

heartburn,

nausea,

5.

vomiting, anorexia, altered taste, increased appetite Metabolic: hypokalemia Musculoskeletal:

muscle

6.

cramps Respiratory:

bronchospasm,

cough, wheezing, dyspnea, bronchitis, increased sputum

7.

Assess lung sounds, PR and BP before drug administration and during peak of medication. Observe fore paradoxical spasm and withhold medication and notify physician if condition occurs. Administer PO medications with meals to minimize gastric irritation. Extended-release tablet should be swallowed-whole. It should not be crushed or chewed. If administering medication through inhalation, allow at least 1 minute between inhalation of aerosol medication. Advise the patient to rinse mouth with water after each inhalation to minimize dry mouth. Inform the patient that Albuterol may cause an unusual or bad taste.

DRUG NAME GENERIC: Mannitol DOSE: 50mg FREQUENCY and TIME: Every 4 hours ROUTE: IV push CLASSIFICATION: Osmotic Diuretic

MECHANISM OF ACTION In the oliguric phase of acute renal failure, Mannitol increases osmotic pressure (pressure needed to stop the absorption of something or osmosis) of the glumerular filtrate, thereby, promoting diuresis (treating the oliguric phase of renal failure) and excretes toxic materials (management for toxic overdose). It also elevates blood plasma osmolality thus, inhibiting the reabsorption of water and electrolytes (for relief of edema) and mobilizing fluids in the cerebral and ocular spaces (lowers intracranial or intraocular pressure).

ADVERSE REACTION 

Dehydration



Anuria



Intracranial bleeding



Headache



Blurred vision



Nausea and vomiting



Volume expansion



Chest pain



Pulmonary edema



Thirst



Tachycardia



Hypokalemia (increases the risk of digoxin toxicity)



Chronic renal failure

INDICATIONS AND CONTRAINDICATION Indications:  Acute oliguric renal failure  Toxic overdose  Edema  Increased intracranial pressure (ICP)  Intraocular pressure (IOP) Contraindications:  Susceptibility  Dehydration

NURSING RESPONSIBIILITIES >Assessment – Monitor the following: 1. Vital signs 2. Intake and output 3. Central venous pressure >Pulmonary artery pressure >Signs and symptoms of dehydration (e.g. poor skin turgor, dry skin, fever, thirst) >Signs of electrolyte imbalance/deficit (e.g. muscular weakness, paresthesia, numbness, confusion, tingling sensation of extremity and excessive thirst) > (for increase ICP) Neurologic status and intracranial pressure readings. > (for increase IOP) Elevating eye pain or decreased visual acuity. Laboratory Tests >Renal function (BUN and Creatinine) >Serum Electrolyte (Sodium and Potassium)

DRUG NAME GENERIC: Pantoprazole DOSE: 40mg FREQUENCY and TIME: Once daily ROUTE: IV push CLASSIFICATION: Antisecretory agent Proton pump inhibitor

MECHANISM OF ACTION

Gastric acid-pump inhibitor: Suppresses gastric acid secretion by specific inhibition of the hydrogen-potassium ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid production.

ADVERSE REACTION



CNS: Headache, dizziness, asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, dream abnormalities



Dermatologic: Rash, inflammation, urticaria, pruritus, alopecia, dry skin



GI: Diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophy



Respiratory: URI symptoms, cough, epistaxis



Other: Cancer in preclinical studies, back pain, fever

INDICATIONS AND CONTRAINDICATION

NURSING RESPONSIBIILITIES

Indications:  Oral: Short-term (< 8 wk) and longterm treatment of GERD  IV: Short-term (7– 10 days) treatment of GERD in patients unable to continue oral therapy  Treatment of pathological hypersecretory conditions associated with Zollinger-Ellison syndrome and other neoplastic conditions  Unlabeled uses: Treatment of peptic ulcer

Assessment: >History: Hypersensitivity to any proton pump inhibitor or any drug components; pregnancy; lactation >Physical: Skin lesions; T; reflexes, affect; urinary output, abdominal examination; respiratory auscultation

Contraindications:  Contraindicated with hypersensitivity to any proton pump inhibitor or any drug components.  Use cautiously with pregnancy

Interventions: >Administer once or twice a day. Caution patient to swallow tablets whole; not to cut, chew, or crush them. >WARNING: Arrange for further evaluation of patient after 4 wk of therapy for gastroreflux disorders. Symptomatic improvement does not rule out gastric cancer; gastric cancer did occur in preclinical studies. >Maintain supportive treatment as appropriate for underlying problem. >Switch patients on IV therapy to oral dosage as soon as possible. >Provide additional comfort measures to alleviate discomfort from GI effects and headache.

DRUG NAME

GENERIC: Rosuvastatin DOSE: 10mg FREQUENCY and TIME: Once during bedtime ROUTE: PO CLASSIFICATION: Cardiovascular agent; Anti-lipemic; HMG-COA Reductase Inhibitor (Statin)

MECHANISM OF ACTION

Rosuvastatin is a potent inhibitor of HMG-CoA reductase, an enzyme that catalyzes the conversion of HMG-CoA to mevalonic acid, an early and ratelimiting step in cholesterol biosynthesis. Interference with this enzyme's activity reduces the quantity of mevalonic acid, a precursor of cholesterol.

ADVERSE REACTION









  

Body as a Whole: Asthenia, back pain, flu syndrome, chest pain, infection, pain, peripheral edema. CNS: Headache, dizziness, insomnia, hypertonia, paresthesia, depression, anxiety, vertigo, neuralgia. CV: Hypertension, angina, vasodilatation, palpitations. GI: Diarrhea, dyspepsia, nausea, abdominal pain, constipation Endocrine: Diabetes. Hematologic: Anemia, ecchymosis. Musculoskeletal: Myalgia, arthritis, arthralgia, rhabdomyolysis (especially with dose >40 mg).

INDICATIONS AND CONTRAINDICATION

NURSING RESPONSIBIILITIES

Indications:  Adjunct to diet for the reduction of LDL cholesterol and triglycerides in patients with primary hypercholesterolemi a and mixed dyslipidemia

Assessment & Drug Effects: >Monitor for and report promptly S&S of myopathy (e.g., skeletal muscle pain). >Withhold drug and notify physician if CPK levels are markedly elevated (10xULN) or if myopathy is diagnosed or suspected. >Lab tests: CPK levels for S&S of myopathy; periodic LFTs; more frequent INR values with concomitant warfarin therapy. >Monitor CV status, especially with a known history of hypertension or heart disease. >Monitor diabetics for loss of glycemic control.

Contraindications:  Hypersensitivity to any component of the product, active liver disease, pregnancy (category X), women of childbearing potential not using appropriate contraceptive measures, lactation.

Patient & Family Education: >Do not take antacids within 2 h of taking this drug. >Do not breast feed while taking this drug. >Females should use reliable means of contraception while taking this drug to prevent pregnancy.