Metronidazole

Mechanism of Action 

Effective against anaerobic bacteria and protozoa. Specifically inhibits growth of trichomonae and amoebae by binding to DNA, resulting in loss of helical structure, strand breaking, inhibition of nucleic acid synthesis, and cell death.

Contraindication 

 Patients with blood dyscrasias, active organic disease of the CNS, trichomoniasis during the first trimester of pregnancy.

 Lactation Consumtion of alcohol during use. Hypersensitivity.

Indication 

 Serious infections due to susceptible anaerobic bacteria.

 Peritonitis. Intra-abdominal abscess and liver abscess due to B. fragilis and so on.

 Skin and skin structure infections due to Bacteroides species.

 Endometritis, endomyometritis, tube-ovarian abscess, and post surgical vaginal cuff infection due to Bacteroides Species.

 Bacterial vaginosis and symptomatic trichomoniasis in males and females.

 Bacterial septicemia due to bacteroides species.

 Adjunct therapy to treat bone and joint infections due to bacteroides species.

 Meningitis and brain abscess due to Bacteroides species,

 Endocarditis due to Bacteroides species.

 Amebiasis To reduce postoperative anaerobic

infection following colorectal surgery, elective hysterectomy, and emergency appendectomy.

 Hepatic encephalopathy. Crohn’s disease Diarrhea associated with

Clostridium difficile.

Side Effects 

 Headache, vaginitis, nausea, metallic taste, genital (vaginitis) pruritis, bacterial infection, flu-like symptoms.

Nursing Interventions 

 Reduce dosage to patients with hepatic disorder. Discontinue primary IV infusion during infusion of

metronidazole. Monitor CBC, LFTs, and cultures.to patients with amebiasis,

monitor stool number/characteristics. To patients with IV therapy, assess for sodium retention. With pregnancy use the 7-day regimen for trichomoniasis. Administer PO drug with food to reduce GI upset. Instruct patient to take no alcohol until at least 48 hours after

therapy is completed. Encourage patient o avoid vaginal intercourse during

treatment.

 Ampicillin (am-pih-SILL-in)

Mechanism of Action 

Bactericidal action against sensitive organisms; inhibits synthesis of bacterial cell wall, causing cell death.

Indication

Treatment of infections caused by susceptible strains of shigella, salmonella, E. coli, H. influenza, P. mirabilis, N. gonorrhoeae, enterococci, gram-positive organisms.

Meningitis caused by neisseria meningitiditis

Unlabelled use: prophylaxis in cesarean section I certain high-risk patients.

Side Effects 

 Lethargy, hallucinations, seizures, CHF, glossitis, stomatitis, gastritis, sore-mouth, nausea and vomiting, diarrhea, abdominal pain.

Nursing Interventions  

Take drug around the clock. Encourage the patient to take full course of

therapy. Administer drug orally on an empty stomach 1

hour before or 2 hours after meals. Check IV site carefully for signs of thrombosis or

drug reaction when drug is given intravenously.

Assessmentnote

Contraindication 

 Allergies to penicillins, cephalosporins, or other allergens.

 Use cautiously to patients with renal disorder.

Amikacin

Mechanism of Action 

Bactericidal: inhibits protein synthesis in susceptible strains of gram-negative bacteria, and the functional integrity of bacterial cell membrane appears to be disrupted, causing cell death.

Indication 

 Short-term treatment of serious infections caused by susceptible strains of Pseudomonas species, E. coli, indole– positive proteus species, providencia species, klebsiella, enterobacter, and serratia species, acinetobacter species.

Contraindication Patients with allergy to aminoglycosides.Patients with renal or hepatic disorder, preexisting hearing loss, myasthenia gravis, parkinsonism, infant botulism.LactationUse cautiously to elderly patients.

 Confusion, disorientation, depression, lethargy, nystagmus, visual disturbances, headache, fever, numbness, tingling, tremor, paresthesias, muscle twitching, convulsions, muscular weakness.

Nursing Interventions- am-ih-KAY-sin

contraindicationsconcurrent use of nephrotixic agents

 ·Monitor duration of treatment; usually 7-10 days. If clinical response does not occur within 3-5 days, stop

therapy.· Ensure that patient is well hydrated before and during the therapy.

Assessment (note reasons for therapy, onset, characteristics of s&s, c&s results. Assess weight, hydration status U/A,CBC, renal and LFTs; reduce, dose with dysfunction…2) obtain audiometric assessment with high doses or prolonged use 3) note vestibular dysfunction; monitor for 8th CN impairment R/T elevated peak drug levels

· drug is administered parenterally (IV or IM) to treat susceptible infections-report lack of response; adverse side effects. Consume 2-3 liters/day of fluids to ensure to ensure hydration

Tranexamic Acid

Mechanism of Action 

Competitively inhibits activation of plasminogen. Directly inhibits plasmin activity, but higher doses are required than are needed to reduce plasmin formation.

Indication 

 Used after delivery to reduce bleeding.

 Treatment of bleeding. Reduce risk of secondary

hemorrhage outcomes in patients with traumatic hyphema.

Contraindication 

 Allergy to any ingredient in tranexamic acid. Patients with disturbance of color vision. Patients with irregular bleeding of unknown

cause. Conditions that may increase blood clots.

Side Effects 

 Dizziness, fatigue, headache

Nursing Interventions 

 Administer by mouth usually 2-4 times daily or as directed by the physician.

 Dosage must be based on clients weight.

Photos of ranitidine, tramadol,& tranexamic acid