Mefenamic Acid( me fe nam ik)Pregnancy Category CDrug Class NSAIDMechanism of ActionMefenamic Acid inhibits prostaglandin synthesis. It possesses anti-inflammatory, antipyretic and analgesic effects.IndicationRelief of moderate pain when therapy will not exceed 1 wk. Treatment of primary dysmenorrhea ContraindicationContraindicated with hypersensitivity to mefenamic acid, aspirin or NSAID allergy, and as treatment of peri-operative pain with coronary artery bypass grafting.Use Catiously with asthma, renal or hepatic impairment, peptic ulcer disease, GI bleeding, hypertension, heart failure, pregnancy, lactationevaluation, peripheral sensation; P, edema; R, adventitious sounds; liver evaluation; CBC, clotting times, LFTs, renal function tests; serum electrolytes, stool guaiacInterventionsGive with milk or food to decrease GI upset. Arrange for periodic ophthalmologic examinations during long-term therapy.If overdose occurs, institute emergency procedures supportive therapy and induced emesis, activated charcoal, and/or an osmotic cathartic.Teaching PointsTake drug with food; take only the prescribed dosage; do not take the drug longer than 1 week.Discontinue drug and consult your health care provider if rash, diarrhea, or digestic problems occur.Dizziness or drowsiness can occur (avoid driving and using dangerous machinery).Report sore throat, fever, rash, itching, weight gain, swelling in ankles or fingers; changes in vision; black, tarry stools, severe diarrhea, right upper adominal pain, flulike symptoms, chest pain.

Cefuroxime( se fyoor ox eem)Pregnancy Category BDrug Class AntiobioticCephalosporin (second generation)Mechanism of ActionBactericidal: Inhibits synthesis of bacterial cell wall, causing cell death.IndicationLower respiratory infections caused by S.pneumonia, S.aureus, E.coli, Klebsiella pneuemoniae, H.influenzae, S.pyogenesDermatologic infections caused by S.aureus, S.pyogenes, E.coli, K.pneumoniae, EnterobacterUTIs caused by E.coli, K.pneumoniaeUncomplicated and disseminated gonorrhoea caused by N.gonorrhoeaeSepticemia cause by S. pneumonia , H.influenzae, S.aureus, E.coli, K.pneumoniae, H.influenzae.Meningitis caused by S. pneumonia , H.influenzae, S.aureus, N.meningitidisAdverse EffectsCNS: Headache, dizziness, somnolence, insomnia, fatigue, tiredness, tinnitus, ophthalmic effectsCV: HF, hypertension, tachycardiaDermatologic: Rash, pruritus, sweating, dry mucous membranes, stomatitisGI: Nausea, dyspepsia, GI pain, diarrhea, vomiting, constipation, flatulence, ulcers, GI bleedGU: Dysuria, renal impairmentHematologic: Bleeding, platelet inhibition with higher dose, neutropenia, eosinophilia, leukopenia, pancytopenia, thrombocytopenia, agrunlocytosis, granulocytopenia, aplastic anemia, decreased Hgb or Hct, bone marrow depression, menorrhagiaRespiratory: Dyspnea, hemoptysis, pharyngitis, bronchospasm, rhinitisOther: Peripheral edema, anaphylactoid reactions to anaphylactic shockNursing ConsiderationsAssessmentHistory: Allergies; renal, hepatic, CV, GI conditions; pregnancy; lactationPhysical: Skin color and lesions; orientation, reflexes, ophthalmologic and audiometric

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Ketorolac( kee toe role ak )Pregnancy Category C (1st and 2nd trimester)Pregnancy Category D (3rd trimester)Drug Class AntipyreticNonopioid analgesicNSAIDMechanism of ActionAnti-inflammatory and analgesic activity; inhibits prostaglandins and leukotriene synthesisIndicationShort-term management of pain (up to 5 days)Ophthalmic: Relief of ocular itching due to seasonal conjunctivitis and relief of postoperative inflammation and pain after cataract surgeryContraindicationContraindicated with significant renal impairment, during labor and delivery, lactation; patients wearing soft contact lenses (ophthalmic); aspirin allergy; concurrent use of NSAIDs; active peptic ulcer disease, recent GI bleed or perforation,Bone and joint infections due to S.aureusPerioperative prophylaxisTreatment of acute bacterial maxillary sinusitis in patients 3 mo-12 yrContraindicationContraindicated with allergy to cephalosporins or penicillins. Use cautiously with renal failure, lactation, pregnancy.Adverse EffectsCNS: Headache, dizziness, lethargy, paresthesiasGI: Nausea, diarrhea, vomiting, adominal pain, flatulence, anorexia, pseudo-membranous colitis, hepatotoxicity GU: NephrotoxicityHematologic: Bone marrow depression (decreased WBC, decreased platelets, decreased Hct)Hypersensitivity: Ranging from rash to fever to anaphylaxis; serum sickness reactionLocal: Pain, abcess at injection site, phlebitis, inflammation at IV siteOther: Superinfections, disulfram-like reaction with alcohol

history of peptic ulcer disease or GI bleeding; hypersensitivity to ketorolac; as prophylactic analgesic before major surgery; treatment of perioperative pain CABG; suspected or confirmed cerebrovascular bleeding; hemorrhagic diathesis, incomplete hemostasis, high risk of bleeding; use with probenecid, pentoxyphylline.Use cautiously with impaired hearing; allergies, hepatic, CV and GI conditionsAdverse EffectsCNS: Headache, dizziness, somnolence, insomnia, fatigue, tinnitus, ophthalmic effectsDermatologic: Rash, pruritus, sweating, dry mucous membranesGI: Nausea, dyspepsia, GI pain, diarrhea, vomiting, constipation, flatulence, gastric or duodenal ulcersGU: Dysuria, renal impairmentHematologic: Bleeding, platelet inhibition with higher dose, neutropenia, eosinophilia, leukopenia, pancytopenia, thrombocytopenia, agrunlocytosis, granulocytopenia, aplastic anemia, decreased Hgb or Hct, bone marrow depression, menorrhagiaRespiratory: Dyspnea, hemoptysis, pharyngitis, bronchospasm, rhinitisNursing ConsiderationsAssessmentHistory: Hepatic and renal impairment, lactation, pregnancyPhysical: Skin status, LFTs, renal function tests, culture of affected area, sensitivity testsInterventionsCulture infection site, and arrange for sensitivity tests before and during therapy if expected response is not seen.Give oral drug with food to decrease GI upset and enhance absorption.Give oral tablets to children who can swallow tablets; crushing the drug results in a bitter, unpleasant taste. Use solution for children who cannot swallow tablets.Have vitamin K available in case hypoprothrombinemia occursDiscontinue if hypersensitivity reaction occurs.Evaluate patient for Clostridium difficile infection if diarrhea occurs.Teaching PointsAvoid alcohol while taking this drug and for 3 days after because severe reactions often occur.Report severe diarrhea, difficulty breathing, unusual tiredness or fatigue, pain at injection site.

Multivitamins w/ IronMechanism of ActionNeeded for adequate metabolismIndicationPrevention and treatment of vitamin deficienciesContraindicationDiverticular disease, ulcer from stomach acid, ulcerated colon, inflammation of the lining of the stomach and intestines, several blood transfusions, iron metabolism disorder causing increased iron storage, increased bodily iron from high RBC destruction, haemolytic anemiaAdverse EffectsConstipation, diarrhea, upset stomach, nausea, vomiting, heartburn, stomach pain, black or dark-colored stools or urine, temporary staining of the teeth, headache, unusual or unpleasant taste in your mouthOther: Peripheral edema, anaphylactoid reactions to anaphylactic shock; local burning, stinging (ophthalmic)Nursing ConsiderationsAssessmentHistory: Renal impairment; impaired hearing; allergies; hepatic, CV, GI conditions; lactation, pregnancyPhysical: Skin color and lesions; orientation, reflexes, ophthalmologic and audiometric evaluation, peripheral sensation; P, edema; BP; R, adventitious sounds; liver evaluation; CBC, clotting times, LFTs, renal function tests; serum electrolytes, stool guaiacInterventionsBe aware that patient may be at increased risk for CV events, GI bleeding, renal toxicity, monitor accordingly.Do not use during labor or delivery or in breast-feeding patients; serious adverse effects to the fetus or baby are possible.May increase risk of bleeding. Do not use with high risk of bleeding or prophylatically before surgery.Discard bottle from nasal spray within 24 hr of opening.

Nursing ConsiderationsAssessmentAssess patient for vitamin deficiency; usually more than one vitamin deficiency is present.PO routeLiquid multivitamins can be diluted or dropped into patients mouth using dropper provided with some brands.Chew tabs should be chewed, not swallowed wholeIV routeGive by cont inf only after diluting 5-10 ml (multivitamins)/ 500-1000 ml of D5W, D10W, D20W, LR, D5/0.9% NaCl, 0.9% NaCl, 3% NaClDo not use sol with crystals, precipitate or color other than bright yellow.Teaching PointsAdvise patient that adequate nutrition must be maintained to prevent further deficiencies; to comply with treatment regimen.Advise patient to avoid treating flavoured multivitamins as candy, child may overdose.Caution patient to store vitamins out of childrens reach.Keep emergency equipment readily available at time of initial dose, in case of severe hypersensitivity reaction.Protect drug vials from light.Administer every 6 hr to maintain serum levels and control pain.Teaching PointsEvery effort will be made to administer drug on time to control pain; dizziness, drowsiness can occur; burning and stinging on application (ophthalmic)Do not use ophthalmic drops with contact lenses.Report sore throat, fever, rash, itching, weight gain, swelling in ankles or fingers; changes in vision black, tarry stools; easy bruising.

Nursing ConsiderationsAssessmentHistory: Assess pts history of hypersensitivity to methyldopa; hepatic disease, previous methyldopa therapy associated with liver disordersPhysical: Weight, body temperature, skin color and lesions; mucous membranes color, lesions, orientation affect, reflexesInterventionsAdminister IV slowly, monitor injection siteMonitor hepatic function, especially in the first 6-12 weeks of therapy or if unexplained fever appearsMonitor blood counts periodically to direct haemolytic anemia; a direct Coombs test before therapy and 6-12 months later may be helpfulDiscontinue therapy if involuntary choreoathetotic movements occurDiscontinue if edema progresses or signs of CHF occurAdd a thiazide to drug regimen or increase dosage if methyldopa intolerance occursMonitor BP carefully when discontinuing methyldopaRanitidine(ra NI ti deen)Pregnancy Category BDrug ClassGastrointestinal agentAntisecretory ( H2-receptor antagonist )Mechanism of ActionInhibitstheactionofhistamineattheH2-receptor sitelocatedprimarily in gastric parietal cells, resulting in inhibition of gastric acid secretion IndicationDuodenal and gastric ulcer (short-term treatment); pathologic hypersecretory conditions such asZollinger-Ellison syndrome, maintenance therapy for duodenalor gastric ulcer, gastro esophageal reflux disease, erosive esophagitis, Heartburn ContraindicationHypersensitivity to the drug, some products that contain alcohol should be avoided with patients with known intolerance Use cautiously with previous liver disease, renal failure, dialysis, bilateral cerebrovascular disease, pregnancy, lactationAdverse EffectsCNS: Sedation, headache, asthenia, weakness, dizziness, light-headedness, symptoms of cerebrovascular insufficiency, paresthesias, parkinsonism, Bells palsy, decreased mental activity, involuntary choreoathetotic movements, psychic disturbancesCV: Bradycardia, prolonged carotid sinus hypersensitivity, aggravation of angina pectoris, paradoxical pressor response, pericarditis, myocarditis, orthostatic hypotension, edemaDermatologic: Rash as in eczema or lichenoid eruption, toxic epidermal necrolysis fever, lupus like syndromeEndocrine: Breast enlargement, gynecomastia, lactation, hyperprolactenemia, amenorrhea, galactorrhea, impotence failure to ejaculate, decreased libidoGI: Nausea, vomiting, distention, constipation, flatus, diarrhea, colitis, dry mouth, sore or lack tongue, pancreatitis, sialadenitis, abnormal liver function tests, jaundice, hepatitis, hepatic necrosisMethyldopa(methy-ill-DOH-pah)Pregnancy Category BDrug ClassificationAntihypertensive, centrally-actingMechanism of ActionMechanism of action not conclusively demonstrated; probably due to drugs metabolism to - methylnorepinephrine, which lowers arterial blood pressure by stimulating central nervous system 2 adrenergic receptors, which in turn decreases sympathetic outflow from the CNSIndicationHypertensionAcute hypertensive crisis (IV methyldopate); not drug of choice because of slow onset of actionContraindicationHypersensitivity to methyldopa, active hepatic disease, previous methyldopa therapy associated with liver disorders

Tramadol(TRAM ah dol)Pregnancy Category CDrug ClassAnalgesicMechanism of ActionBinds with opiate receptors in the CNS causing inhibition of ascending pain pathways, altering the perception of and response to pain; also inhibits the reuptake of norepinephrine and serotonin, which may account for tramadols analgesic effectIndicationTo relieve moderate to moderately severe painContraindicationAlcohol intoxication; excessive use of central-acting analgesics, hypnotics, opioids or other psychotropic drugs; hypersensitivity to tramadol or its components; use within 14 days of MAO inhibitor therapyAdverse EffectsCNS: Dizziness, CNS stimulation, somnolence, headache, anxiety, confusion, euphoria, seizures, hallucinations, flushing, sedationCV: Vasodilation, Orthostatic hypotension, tachycardia, hypertension, abnormal ECGGI: Nausea, vomiting, constipation, dry mouth, diarrhea, abdominal pain, anorexia, flatulence, GI bleedingGU: Urinary retention or frequency, menopausal symptoms, dysuria, menstrual disorderNursing ConsiderationsAssessmentAssess pain: location, type, character; give before pain becomes extremeAssess for increased side effects in renal hepatic diseaseAssess need for productInterventionsMonitor I & O ratio: check for decreasing output; may indicate urinary retentionMonitor CNS changesDetermine allergic reactions: rash, urticariaDo not break, crush, or chew ER productGive with antiemetic for nausea, vomitingAdminister when pain is beginning to returnAdverse EffectsConstipation, Diarrhea, Fatigue, Headache, Insomnia, Muscle Pain, Nausea, Vomiting, Agitation, Anemia, Confusion, Depression, Easy bruising or bleeding, Drowsiness, Malaise, Blurred Vision, Rash, Fever, Tachycardia, BradycardiaNursing ConsiderationsAssessmentAssess patient with ulcers or suspected ulcers: epigastric and abdominalpain, hematemesis, occult blood in stools, blood in gastric aspiratebefore and throughout treatment, monitor gastric pH (5 should be maintained)InterventionsMonitor I & O ratio, BUN, Creatinine, CBC with differential monthly.Monitor heart rate after administering the drug.Teaching PointsInstruct patient to avoid alcohol and follow diet as prescriber recommends.Advisepatienttoreportbruising,fatigue,malaiseblood dyscrasias may occur.Teaching PointsTeach patient to report any symptoms of CNS changes; allergic reactionsTeach patient that drowsiness, dizziness and confusion may occur; to call for assistanceInstuct patient to make position changes slowly; orthostatic hypotension may occurTell patient to avoid OTC medication and alcohol unless approved by prescriber

During infusion protect solution from lightThe powder for suspension expires 12 months from date of issueTeaching PointsMay take with food; take caps with a full glass of water to prevent esophageal ulceration and remain upright for 45 min. Take 1 hr before or 2 hr after meals with a full glass of water. May take 2 hr before or 2 hr after antacids containing aluminum, calcium, or magnesium, preparations containing iron or zinc, or dairy products (e.g. cheese, milk, ice cream)Take entire prescription; do not stop if symptoms subside. Stop drug and report if skin rash, hives, itching, SOB, headache, or blurred vision occur.Avoid direct exposure to sunlight and wear protective clothing and sunscreens when exposed.ContraindicationAllergy to tetracyclines, renal or hepatic dysfunction, pregnancy, lactationProphylaxis of malaria in pregnant individuals and in children less than 8 years oldAdverse EffectsAnorexia, Nausea, Vomiting, Diarrhea, Dizziness, Headache, Rashes, Sensitivity to sunlightNursing ConsiderationsAssessmentNote reasons for therapy, onset, and characteristics of S&SObtain C&S when indicated. Monitor vital signs, CBC, renal and LFTsCheck for any allergic or hypersensitivity reactions; note expiration date as expired tetracycline products are nephrotoxicInterventionsAdminister the oral medicatoin without regard to food or meals; if GI upset occurs, give with meals, patients being treated for periodontal disease should receive tablet at least least 1 hr before morning and evening mealsAvoid rapid administration. Duration of IV infusion may vary with the dose; usually 1-4 hr.Doxycycline(dox-ih-SYE-kleen)Pregnancy Category DDrug ClassAntibiotic, tetracyclineMechanism of ActionBacteriostatic: inhibits protein synthesis of susceptible bacteria, causing cell deathIndicationInfections caused by Ricketssiae, M.pneumoniae, agents of psittacosis, ornithosis, lymphogranuloma venerum, and granuloma inguinale; B.recurrentis, H.duereyi, P.pestis; S.aureusT.pertenue, L.monocytogenes, Clostridium, B.anthracids; adjunct to amebicides in acute intestinal amebiasisAdjunct therapy for severe acneReduce incidence of anthraxProphylaxis of malariaAmpicillin(am-pih-SILL-in)Pregnancy Category BDrug ClassificationAntibiotic, penicillinMechanism of ActionBactericidal action against sensitive organisms; inhibits synthesis of bacterial cell wall, causing cell deathIndicationTreatment 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 meningitiditisUnlabelled use: prophylaxis in cesarean section I certain high-risk patients.ContraindicationHypersensitivity to penicillin

Use cautiously in elderly patients, children, pregnant women, and during lactationAdverse EffectsCNS: Hyperkinesia, excitement, nervousness, tension, tremor, dizziness, vertigo, weakness, drowsiness, restlessness, headache, insomnia, malaise, fatigue, lightheadedness,disturbed sleep, aggresiveness behavior, irritabilityCV: Palpitations, tachycardia, BP changes, hypertension, tight chest, chest pain or discomfort, anginaHypersensitivity: Urticaria, angioedema, rash, bronchospasmGI: Diarrhea, dry mouth, appetite loss or stimulation, epigastric painMiscellaneous: Flushing, sweating, bad or unusual taste, change in smell, muscle cramps, oropharyngeal edema, difficult urinationNursing ConsiderationsAssessmentObtain history; assess EKG and CNS status. Avoid use with cardiac tachyarrhythmiasDocument PFTs, CXR, oxygen sats and lung sounds. Monitor pulmonary status (i.e. breath sounds, VS, peak flow, or ABGs)Determine if able to self-administer medication. Observe for allergic responses.Adverse EffectsRash, Urticaria, Anemia, Increased bleeding time, Bone marrow depression, Granulocytopenia, Nausea, Vomiting, Diarrhea, Enterocolitis, Glossitis, Pseudomembranous colitis, Oliguria, Proteinuria, Hematuria, Vaginitis, Glomerulonephritis, Lethargy, Hallucinations, Anxiety, Depression, Twitching, Coma, Convulsions, Anaphylaxis, Abdominal painNursing ConsiderationsI&O ratio; report hematuria, oliguria, since penicillin in high doses is nephrotoxicLiver studies: AST, ALTBlood studies: WBC, RBC, Hgb & Hct, bleeding timeRenal studies: Urinalysis, Protein, Blood, BUN, CreatinineCulture & sensitivity before drug theraphy; drug may be taken as soon as culture is takenEncourage 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

InterventionsThe aerosol and inhalation powder are indicated for children 4 years and older; the solution for inhalation is indicated for children 2 years and older.When given by nebulization, use either face mask or mouthpiece.If administering medication through inhalation, allow at least 1 minute between inhalation of aerosol medication.Teaching PointsTake as directed; do not exceed prescribed doseMaintain calm, reassuring approach. Do not leave client/ child unattended if acute short of breath; should improve 30-60 min after therapyAlbuterol(al-BYOU-ter-ohl)Albutamol ( Salbutamol )Pregnancy Category CDrug ClassSympathomimeticMechanism of ActionRelaxes smooth muscles by stimulating beta-2 receptors of the bronchi, leading to bronchodilationIndicationProphylaxis and relief of bronchospasm in reversible obstructive airway diseaseAcute attacks of bronchospasm (inhalation solution)Prophylaxis of exercise-induced bronchospasmContraindicationsHypersensitivity to the drugUse cautiously in patients with cardiac disease, hypertension, diabetes mellitus, glaucoma, seizure disorder, hyperthyroidism, exercise-induced bronchospasm

Amikacin(am-ih-KAY-sin)Pregnancy Category DDrug ClassAntibiotic, aminoglycosideMechanism of ActionBactericidal: 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.IndicationShort-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.ContraindicationsPatients with allergy to aminoglycosides, renal or hepatic disorder, preexisting hearing loss, myasthenia gravis, parkinsonism, infant botulism, lactation. Use cautiously in elderly patientshyoscine-N-butylbromidePregnancy Category CDrug ClassAntispasmodicsMechanism of ActionActs by interfering with the transmission of nerve impulses by acetylcholine in the parasympathetic nervous systemIndicationIndicated for the relief of spasm of the genitourinary tract or gastrointestinal tract and for the symptomatic relief of Irritable Bowel SyndromeContraindicationsMyasthenia gravies, megacolon, hypersensitivity to drug contents, narrow angle glaucoma, prostate hypertrophy with urinary retention, mechanical stenosis in the GI tract, tachycardia Adverse EffectsCNS: Dizziness, anaphylactic reactions/ shock, increased ICP, disorientation, restlessness, irritability, drowsiness, headache, confusion, hallucination, delirium, impaired memoryCV: Hypotension, tachycardia, palpitations, flushingGI: Dry mouth, constipation, nausea, epigastric distressDermatologic: Flushing, dyshidrosisGU: Urinary retention, urinary hesistancyRespiratory: Dyspnea, bronchial plugging, depressed respirationEENT: Mydriasis, dilated pupils, blurred vision, photophobia, increased intraocular pressure, difficulty of swallowingNursing ConsiderationsDrug compatibility should be monitored closely in patients requiring adjunctive therapyAvoid driving and operating machinery after parenteral administrationAvoid strict heatRaise side rails as a precaution because some patients become temporarily excited or disoriented and some develop amnesia or become drowsyAdverse EffectsConfusion, disorientation, depression, lethargy, nystagmus, visual disturbances, headache, fever, numbness, tingling, tremor, paresthesias, muscle twitching, convulsions, muscular weaknessNursing ConsiderationsAssessmentNote reasons for therapy, onset, characteristics of S&S, C&S results. Assess weight, hydration status U/A, CBC , renal and LFTs; reduce dose with dysfunctionObtain audiometric assessment with high doses or prolonged useNote vestibular dysfunction; monitor for 8th CN impairment R/T elevated peak drug levelsInterventionsMonitor 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.Assess I&O ratio, report for sudden change in urine outputTake vital signs during infusion; watch for hypotension, change in pulse

Tranexamic Acid(tran-eks-am-ik)Pregnancy Category BMechanism of ActionCompetitively inhibits activation of plasminogen. Directly inhibits plasmin activity, but higher doses are required than are needed to reduce plasmin formation.IndicationUsed after delivery to reduce bleeding.Treatment of bleeding.Reduce risk of secondary hemorrhage outcomes in patients with traumatic hyphema.ContraindicationAllergy 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.

Bacterial vaginosis and symptomatic trichomoniasis in males and femalesBacterial septicemia due to bacteroides species.Adjunct therapy to treat bone and joint infections due to bacteroides speciesMeningitis and brain abscess due to Bacteroides speciesEndocarditis due to Bacteroides speciesAmebiasisTo reduce postoperative anaerobic infection following colorectal surgery, elective hysterectomy, and emergency appendectomyHepatic encephalopathyCrohns diseaseDiarrhea associated with Clostridium difficileAdverse EffectsHeadache, dizziness, confusion, irritability, restlessness, ataxia, depression, fatigue, drowsiness, insomnia, paresthesia, peripheral neuropathy, convulsions, incoordination, depression, blurred vision, sore throat, retinal edema, dry mouth, metallic taste, furry tongue, glossitis, stomatitis, nausea, vomiting, diarrhea, epigastric distress, polyuria, abdominal cramps, darkened urine, vaginal dryness, cystitis, incontinence, rash, pruritis, urticaria, flushingMetronidazole(met-ro-ni-da-zole)Pregnancy Category BDrug ClassMechanism of ActionEffective 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.IndicationSerious 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.

Adverse EffectsHeadache, fatigue, abdominal pain, hallucinationsNursing ConsiderationsAdminister by mouth usually 2-4 times daily or as directed by the physician.Dosage must be based on clients weight.

Nursing ConsiderationsReduce 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 to avoid vaginal intercourse during treatment.