Drug Study Compilation.docx

7/27/2019 Drug Study Compilation.docx

1/9

BSN4A (GROUP 2) 43

XII. Drug Study (Celecoxib)

Name of the Drug Dosage/ Route/

Timing

Mechanism of Action Indication Contraindication Adverse Reaction Nursing

Responsibility

Generic Name:

Celecoxib

Trade Name:

Celebrex

Classification:

Non-steroidal anti-

inflammatoryAnalgesic

(nonopioid)Specific COX-2

enzyme blocker

Dosage:

200gms/ Cap

1 capsule

Route:

Per Orem

Timing:

BID

Reduces inflammationand relieves pain:

Analgesic and anti-inflammatory

activities related toinhibition of COX-2

enzyme, which isactivated in

inflammation to causesigns and symptoms

associated withinflammation; does not

affect the COX-1enzyme, which

protects the lining ofthe GI tract and has

blood clotting andrenal functions.

Management ofacute pain

Contraindicatedwith allergies to

sulfonamides,celexocib,

NSAIDs, or aspirin

CNS: headache,dizziness, insomnia,

fatigue, tiredness,dizziness, tinnitus,

ophthalmologic effects

CV: MI, CVA,

GI:Nausea,abdominal pain,

flatulence, dyspepsia,GI bleed, diarrhea

Hematologic:

Neutropenia,eosiophilia,

leucopenia,pancytopenia,

thrombocytopenia,agranulocytosis,

agranulocytopenia,decreased Hgb or Hct

Others: Peripheral

edema, rash oranaphylactic reactions

Assess for histoor renal

impairment,impaired hearin

and allergies

dysfunction

Assess for skistatus, orientatio

reflexes periphesensation;

peripheral edemR, adventitiou

sounds, serumelectrolytes

Administer druwith foods or af

meals if GI upsoccurs

Establish safetmeasures if CN

or visualdisturbances oc

If overdose occuinstitute

emergencyprocedures--

gastric lavageinduction of

emesis, support


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BSN4A (GROUP 2) 44

therapy

Provide furthecomfort measur

to reduce pain

(e.g., positionindeep breathing

exercises, etc.) ato reduce

inflammation (ePositioning an

rest)

Take only theprescribed dosa

do not increas

dosage

You mayexperience the

side effects:

Dizziness,drowess

Report sore throfever, rash,

itching, weigh

gain swelling iankles or finger

changes in visi


3/9

BSN4A (GROUP 2) 45

Name of the Drug Dosage/ Route/

Timing

Mechanism of Action Indication Contraindication Adverse Reaction Nursing

Responsibility

Generic Name:

Ceftriaxone

sodium

Trade Name:Rocephin

Classification:

AntibioticCephalosporin

(third generation)

Dosage:

2gms

Route:

IVTT

Timing:

OD

Bactericidal: Inhibitssynthesis of bacterial

cell wall, causing celldeath.

Treatment ofsusceptible

infections due to

gram-negative

aerobic organisms,some gram-positive

organisms

including

respiratory tract,

skin, etc.

Contraindicatedwith allergy to

cephalosporins orpenicillins.

CNS: headache,dizziness, lethargy,

paresthesias

GI:Nausea, vomiting,diarrhea, anorexia,

abdominal pain,flatulence,

pseudomembranouscolitis, hepatotoxicity

GU:Nephrotoxicity

Hematologic: Bone

marrow depressiondecreased WBC count,

decreased platelets,decreased Hct

Hypersentivity:Ranging from rash tofever to anaphylaxis;

serum sicknessreaction

Assess for liveand renal

dysfunction

Assess for skistatus, renal

function, culture

affected area ansensitivity tes

Culture infectiohave a sensitivi

test or skin tesbefore and duri

therapy if expecresponse is no

seen.

Protect drug frolight.

Do not mixceftriaxone wi

any other

antimicrobial dr

Refrigeratesuspension aftreconstitution

shake vigorousbefore use an

discard 1 houafter meals.

Discontinue ihypersensitivit

reaction occur


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BSN4A (GROUP 2) 46

Given with meaif GI upset occu

Avoid alcohowhile taking th

drug and for 3days because

severe reactionoften occur.

He mayexperience sid

effects: Stomac

upset or diarrhe

Report severediarrhea, difficubreathing, unus

tiredness, &fatigue


5/9

BSN4A (GROUP 2) 47

Name of Drug Dosage,

Route,

Timing

Mechanism of Actions Indications Contraindications Adverse Effect Nursing Responsibilities

Generic Name:

Quadmax

Brand Name:Rifampicin/ INH/

Pyrazinamide/EthambutolHCl

Classifications:

Anti-Infectives/Tuberculosis (TB)

Dosage:

4 tablets

Route

Per Orem

Timing

ODHS

Rifampin inhibits DNA-

dependent RNApolymerase activity in

susceptible cells.Rifampin interacts with

bacterial RNApolymerase but does not

inhibit the mammalianenzyme. At therapeutic

levels, rifampin hasdemonstrated

bactericidal activityagainst both intracellular

andextracellular Mycobacter

iumtuberculosis organism.

Rifampin has alsobactericidal activity

against slow andintermittently

growing M.tuberculosis organism.

Rifampin crossresistance has been

shown only with otherrifamycins.

Isoniazid kills actively

growing tubercle bacilli

Treatment of both

pulmonaryand extra

pulmonarytuberculosis in the

intensive initialphase of treatment

Hypersensitivity to

rifampicin,isoniazid,

pyrazinamide orethambutol.

Isoniazid: Previousisoniazid-associated

hepatic injury;severe adverse

reactions toisoniazid eg, fever,

chills and arthritis;acute liver disease

of any etiology, ahistory of previous

hypersensitivityreaction to isoniazid

including drug-induced hepatitis.

CNS: Headache,

drowsiness, fatigue,ataxia, dizziness,

inability toconcentrate, mental

confusion, visualdisturbances,

muscular weakness,pain extremities and

generalizednumbness.

CV: Heartburn,

GIT:epigastric

distress, anorexia,nausea, vomiting,

gas cramps anddiarrhea.

Hema: Elevation in

serum bilirubin,BSP, alkaline

phosphatase, serumtransaminase.

Elevation of BUN.Thrombocytopenia,

transient leukopenia,hemolytic anemia,

eosinophilia and

Patients should have baseline serumacid and liver function determinations

Patients with preexisting liver diseathose patients at increased risk for drug-relhepatitis (eg, alcohol abusers) should b

followed closely. Because it contains

pyrazinamide, Quadmax should be discontand not be resumed if signs of hepatocell

damage or hyperuricemia accompanied byacute gouty arthritis appear. If hyperurice

accompanied by an acute gouty arthritis ocwithout liver dysfunction, the patient shou

transferred to a regimen not containingpyrazinamide.

Rifampicin is not recommended intermittent therapy;. Rifampicin has beobserved to increase the requirements fo

anticoagulant drugs of the coumarin typ

In patients receiving anticoagulantsrifampicin concurrently, it is recommended

the prothrombin time be performed daily ofrequently as necessary to establish and ma

the required dose of anticoagulant.

Instruct patient that urine, feces, sasputum, sweat and tears may be colored r

orange by rifampicin and its metabolite
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BSN4A (GROUP 2) 48

by inhibiting thebiosynthesis of mycolic

acids which are majorcomponents of the cell

wall of M. tuberculosis.

The exact mechanism ofaction by which

pyrazinamide inhibitsthe growth of M.

tuberculosisorganisms isunknown. In vitro and in

vivo studies havedemonstrated that

pyrazinamide is onlyactive at a slightly acidic

pH (pH 5.5).

Ethambutol diffuses intoactively growing M.

tuberculosis such astubercle bacilli.

Ethambutol appears toinhibit the synthesis of

one or more metabolites,thus causing impairment

of cell metabolism,arrest of multiplication,

and cell death{16}

. Nocross resistance with

other availableantimicrobial agents has

been demonstrated.

decreasedhemoglobin.

Agranulocylosis,hemolytic

sideroblastic oraplastic anemia,

thrombocytopenia,eosinophilia.

Integ: Skin eruptions

(morbiliform,maculopapular,

purpuric orexfoliative),

lymphadenopathyand vasculitis,

pyridoxine defiency,pellagra,

Monitor electrolyte levels becautherapeutic levels of rifampicin have been s

to inhibit standard microbiological assays

serum folate and vitamin B12.

All drugs should be stopped and evaluation of the patient should be made afirst sign of a hypersensitivity reaction

Isoniazid may decrease the excretiophenytoin or may enhance its effects. To aphenytoin intoxication, appropriate adjustm

of the anticonvulsant dose should be ma

Avoid alcohol for daily users aningestion may be associated with a high

incidence of isoniazid-hepatitis; patient w

current chronic liver disease or severe ren

dysfunction. Periodic ophthalmoscopic examinaduring isoniazid therapy is recommended w

visual symptoms occur.

Patients with decreased renal funcneed the dosage reduced as determined by s

levels of ethambutol

Because ethambutol may have adveffects on vision, physical examination shinclude ophthalmoscopy, finger perimetry

testing of color discrimination.

As with any potent drug, period
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BSN4A (GROUP 2) 49

assessment of organ system functions, inclurenal, hepatic and hematopoietic should be

during long-term therapy.


8/9

BSN4A (GROUP 2) 50

Name of Drug Dosage,

Route,

Timing

Mechanism of Actions Indications Contraindicatio

n

Adverse Effect Nursing Responsibilities

Generic Name:

Clindamycin

Brand Name:Cleocin

Classifications:

Antibiotic

Dosage:

300 mg 1cap

Route:

Per Orem

Timing:

Q6h

Semi-synthetic

derivative oflincomycin with a

greater degree ofantibacterial

activity invitro, betterabsorption, and lower

incidence of GI adverseeffects than

lincomycin. Suppressesprotein synthesisby

binding to 50 s subunitsof bacterial ribosomes,

and therefore, inhibitsother antibiotics (e.g.,

erythromycin) thatactat this site.

Anaerobic

infections(empyema, lung

abscesses.Streptococci

andStaphylococci

infections(serious

respiratory)Pneumococci

infections(respiratory

infections)

Hypersensitivity

to ClindamycinCNS: headache

CV: Thrombophlebitis

EENT: pharyngitis

GI: abdominal pain, Anorexia,

bloody or tarry stools,

constipation, diarrhea, dysphagia,

esophagitis, flatulence, nausea,

psuedomembranus colitis,

unpleasant or bitter taste,

vomiting.

GU: UTI

HEMATOLOGIC: eosinophilia,

thrombocytopenia, transient

leukopenia

SKIN:maculopapular rash,

urticaria

OTHER: anaphylaxis, erythema,

pain (I.V. use), induration, pain;sterile abcess (I.M. use)

Take each dose with a full glass of(decreases esophageal iritiatio

M a y b e t a k e nw i t h o u t r e g a r d f o r m e a Monitor BP and pulse after

administration.

Be alert for signs of superinfectioanaphylactoid reactions that req

immediate attention.

C o m p l e t e f u l l c o u r s e o f t hy

Report loose stool or diarrhe Tell your doctor immediately if a

these rare but very serious side efoccur: joint pain/swelling, yellow

eyes/skin, dark urine, and change amount of urine.

Use of this medication for prolongrepeated periods may result in oral

A very serious allergic reaction todrug is rare. However, seek imme

medical attention if you notice symptoms of a serious allergic rea

including: rash, itching/swellin

(especially of the face/tongue/thrsevere dizziness, trouble breath


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BSN4A (GROUP 2) 51

Name of Drug Dosage, Route,

Timing

Mechanism of Actions Indications Contraindicat

ion

Adverse Effect Nursing Responsibilitie

Generic:

Ceftazidime

Trade:Zeptrigen

Classification:

AntibioticCephalosphorin (3rd

generation)

Dosage:

1g

Route:

IVTT

Frequency:

Q8-12 hrs

Third generation

cephalosporin thatinhibits its cell wall

synthesis, promotingosmotic instability;

usually bactericidal.

Serious UTI andlower respiratorytract infection and

CNS infection

Contraindicated inpatient

hypersensitive to

drug or

othercephalosp

orin

GI: pseudo

membranous colitis

Hematologic: bonemarrow depression

Hypersensitivity:

anaphylaxis

Assess liver and kidneydysfunction, skin status,culture of affected area

Arrange for sensitivity tesbefore and during the ther

For direct IV administratireconstitute 1g in 10ml ste

water for injection. Give o3-5mins.

For intermittentadministration, further diluin 500-100mL solution an

administer over 30-60min

Do not add Ceftazidime tosolutions containing amin

glycosides.

Have Vitamin K availablecase of hypothrombinemia

occurs

Discontinue ifhypersensitivity occurs.

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Drug Study Compilation.docx