CP Drug Study

Drug Name Classification

Indication Mechanism of Action Side Effects Nursing Considerations

Ampicillin Sulbactam

Anti-infective, aminopenicillins/beta lactamase inhibitors

This drug is indicated for patients after undergoing surgery to prevent infection of skin and soft-tissue structures

This drug binds to bacterial cell wall, resulting in cell death. The addition of sulbactam increases resistance to beta-lactamases, enzymes produced by bacteria that may inactivate ampicillin

CNS: seizuresGI: pseudomembranous colitis, diarrhea, nausea, vomiting Derm: rashes, urticarialHemat: blood dyscrasiasLocal: pain at IV siteMisc: allergic reactions such as anaphylaxis and serum sickness,superinfection

- Administer skin testing to assess if patient is sensitive to penicillin

- Observe patient for signs and symptoms of anaphylaxis

- Administer drug slowly to prevent irritation

- Monitor for side effects like nausea and vomiting, bleeding or bleeding gums, blood in the stool and urine

- Stop drug if allergic reaction occur and notify doctor on duty

- Advise to increase Vitamin C on diet

Tranexamic Acid

Anti-hemophilic agent, anti-fibrinolytic and anti-hemorrhagic

Treatment of severe hemorrhage associated with excessive fibrinolysis. Abnormal bleeding during operation

Forms a reversible complex that displaces plasminogen fromfibrin resulting in inhibition of fibrinolysis, it also inhibits the proteolyticactivity of plasmin

GI disorders: nausea, vomitingCNS: anorexia, headache may appear,impaired renal insufficiency, hypotension when IV injection is too rapid

- Watch out for any signs of bleeding

- Massive hematuria from the upper urinary tract

- Inform patient about side effects

Omeprazole

Proton pump

Short term treatment

Suppresses gastric secretion by inhibiting

CNS;headache,dizziness,asthenia,verti

- Administer before meals- Administer antacids

inhibitor of active duodenal ulcer, gastroesophageal reflux disease (GERD), including erosive esophagitis and symptomatic GERD. Long term treatment of pathologic hypersecretory condition: to maintain healing of erosive esophagitis. Short term treatment of active benign gastric ulcer

hydrogen/potassium ATP ase enzyme system in the gastric parietal cell: characterize as a gastric acid pump inhibitor, since it block the final step of acid production

go,insomnia,apathy,anxiety, paresthesias,dreamabnormalitiesDermatologic: rash, inflammation, urticaria, pruritus, alopecia, dry skinGI: diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophyRespiratory: URI symptoms, cough, epistaxis

with, if needed- Report severe

headache, worsening of symptoms, fever, chills

Spironolactone

Potassium-sparingdiureticAldosterone antagonist

Adjunctive therapy in the treatment of hepatic cirrhosis, treatment of hypokalemia or prevention of hypokalemia inpatients at high risk if hypokalemia occurs; essential

Mild diuretic that acts on the distal tubule to inhibit sodium exchange for potassium, resulting in increased secretion of sodium and water conservation of potassium. Manifests a slight antihypertensive effect. Interferes with synthesis of testosterone and may increase formation

Dizziness, headache, drowsiness, rash,cramping,diarrhea,hyperkalemia,hirsutism,gynecomastia,deepening of the voice, irregular menses

- Take as directed with a snack or meals to minimize GI upset

- Report if nausea, bloating, anorexia, vomiting or diarrhea persist

- Inform patient of these side effects: drowsiness or uneasy gait

- Report if deep, rapid respirations, headaches or mental slowing

hypertension of estradiol from estrogen thus leading to endocrine abnormalities

occurs; may indicate hyperchloremic metabolic acidosis

- Remind client that intake of Spironolactone may cause breast swelling and diminished sex drive due to reduction of testosterone levels

- Since the drug is metabolized in liver, report jaundice, tremors or mental confusion; may develop hepatic encephalopathy with liver disease

- Weigh yourself on a regular basis, at the same time and in the same clothing, and record the weight on your calendar

Propanolol Anti-anginal, Anti-arrythmic, Anti-hypertensive, non selective beta-adrenergic

Hypertension alone or with other drugs, especially diuretics

Competitively blocks beta-adrenergic receptors in the heart and juxtaglomerular apparatus, decreasing the influence of the sympathetic nervous system on these tissues, the excitability of the heart, cardiac workload

Adverse Effects:a. Fever,

rashes, pruritus, shortness of breath

R: Hypersensitivity reactions to the drug

- Monitor the vital signs of the client

- Encourage eat in small frequent feedings if there are episodes of vomiting

- May offer ice chips to reduce nausea

- TSB for fever- Instruct client not to get

blocker and oxygen consumption, and the release of rennin and lowering BP; has membrane-stabilizing (local anesthetic)effects that contribute to its antiarrhythmic action; acts in the CNS to reduce sympathetic outflow and vasoconstrictor tone

b. Bradycardia, heart failure

R: Reduced cardiac oxygen in the heart

up on bed immediately to reduce the occurrence of dizziness

- May be given with food if GI upsets occurs

- Provide environment conducive for rest

Essentiale Forte

Hepatic protectors

Acute, subacute & chronic hepatitis; toxic metabolic liver diseases, intoxications (eg. from drugs); infection, fatty degeneration of the liver due to alcohol, hypernutrition, DM, kwashiorkor, pregnancy; cholestasis; pre- & post-op care, esp in liver/gallbladder surgery

Essential phospholipids normalize liver function and enzymatic activity of liver cells, decrease the level of energy consumption by the liver, promote regeneration of liver cells, convert the neutral fats and cholesterol in the compounds facilitating their metabolism, stabilize the physical and chemical properties of bile. Essentiale normalizes protein metabolism and improves detoxication liver function, inhibit the formation of connective tissue in the liver

Abdominal pain, nausea, diarrhea and allergic reaction(skin rash)

- Inform patient about the possible side effects of the medicine

Lactulose Laxative,Ammonia reduction

Treatment of constipation. Prevention and

Reduces blood ammonia; appears to involve metabolism of lactose to

GI: Flatulence, borborygmi, belching,

- Promote fluid intake (>=1500–2000 mL/d) during drug therapy for

drug treatment if portal-systemic encephalopathy.

organic acids by resident intestinal bacteriaAcidifies colon contents, which retards diffusion of nonionic ammonia (NH3) from colon to blood while promoting its migration from blood to colon. In the acidic colon, NH3 is converted to nonabsorbable ammonium ions (NH4) and is then expelled in feces by laxative action. Decreased blood ammonia in a patient with hepatic encephalopathy is marked by improved EEG patterns and mental state (clearing of confusion, apathy, and irritation). Osmotic effect of organic acids causes laxative action, which moves water from plasma to intestines, softens stools, and stimulates peristalsis by pressure from water content of stool

abdominal cramps, pain, and distention (initial dose);diarrhea (excessive dose ); nausea, vomiting, colon accumulation of hydrogen gas; hypernatremia

constipation; older adults often self-limit liquids. Lactulose-induced osmotic changes in the bowel support intestinal water loss and potential hypernatremia.

- Notify physician if diarrhea (i.e., more than 2 or 3 soft stools/d) persists more than 24–48 h. Diarrhea is a sign of overdosage.

Octreotide Cyclic Octapeptide, Acetate Salt

Used to treat severe watery diarrhea and sudden

Long-acting octapeptide with pharmacologic actions mimicking those of the natural hormone

Nausea, vomiting, loose/oily stools, constipation, stomach upset, gas,

- Inform patient about the side effect of the medication especially dizziness

reddening of the face and neck caused by certain types of tumors (e.g., carcinoid tumors, vasoactive intestinal peptide tumors) that are found usually in the intestines and pancreas. The symptoms occur when these tumors make too much of certain natural substances (hormones). This medication works by blocking the production of these hormones. By decreasing watery diarrhea, octreotide helps to reduce the loss of body fluids and minerals

somatostatin bloating, dizziness, or headache may occur. Pain and irritation at the injection site may also occur.

Bactidol Oral antiseptic

Minor sore throat; halitosis, general oral

Protection against oral bacterial and fungal infection to give fast relief

No available data - Instruct patient not to swallow the medication.

- Caution the patient that

hygiene, Improves appearance of mouth tissue, protects toothe surfaces afaints formation of decay acids

from sore throat and mouth ulcers. First, bactidol quickly reduces bacteriain the affected areas to help relieve and prevent soreness, then hexetidinecontains adheres to affected areas for extended period of time, giving long-lasting protection

the solution may be too harsh to taste.

- Assess for any lesions in the mouth of the patient.

Diphenhydramine

Anti-allergy It is used for the symptomatic relief of allergic conditions including urticarial and angioedema. Diphenhydramine is used for its abtimiscarinic properties in the control of parkinsonism and drug-induced extrapyramidal disorder

Action on blood vessel, GI, respiratory tract by antagonizing the effects of histamine for H1-Receptor site decreases allergic response by blocking histamine caused increased heart rate, vasodilation secretions; significant CNS depressant and anticholinergic

Orthostatic hypotension,Palpitations,Drowsiness,Sedation,Disturbed coordination

- Assess respiratory status: rate, rhythm and increase in bronchial secretions wheezing and chest tightness: provide fluids to 2L day to decrease secretion thickness

- Inform patient that drug may cause dry mouth; frequent oral rinses, good oral hygiene and sugarless gum or candy may minimize the effect

Furosemide

electrolytic and water balance agent; loop diuretic,

Treatment of edema associated with CHF, cirrhosis of liver, and kidney

Inhibits reabsorption of sodium and chloride primarily in loop of Henle and also in proximal and distal renal tubules; an

CV: Postural hypotension, dizziness with excessive diuresis, acute hypotensive

- Observe patients receiving parenteral drug carefully; closely monitor BP and vital signs. Sudden death

antihypertensive

disease, including nephrotic syndrome. May be used for management of hypertension, alone or in combination with other antihypertensive agents.

antihypertensive that decreases edema and intravascular volume. Reportedly less ototoxic than ethacrynic acid.

episodes, circulatory collapse.Metabolic: Hypovolemia, dehydration, hyponatremia, hypokalemia, hypochloremia metabolic alkalosis, hypomagnesemia, hypocalcemia (tetany), hyperglycemia, glycosuria, elevated BUN, hyperuricemia;GI: Nausea, vomiting, oral and gastric burning, anorexia, diarrhea, constipation, abdominal cramping, acute pancreatitis, jaundice.Urogenital: Allergic interstitial nephritis, irreversible renal failure, urinary frequency.Hematologic: Anemia,

from cardiac arrest has been reported.

- Monitor BP during periods of diuresis and through period of dosage adjustment.

- Observe older adults closely during period of brisk diuresis. Sudden alteration in fluid and electrolyte balance may precipitate significant adverse reactions. Report symptoms to physician.

- Lab tests: Obtain frequent blood count, serum and urine electrolytes, CO2, BUN, blood sugar, and uric acid values during first few months of therapy and periodically thereafter.

- Monitor for S&S of hypokalemia .

- Monitor I&O ratio and pattern. Report decrease or unusual increase in output. Excessive diuresis can result in dehydration and hypovolemia,

leukopenia, thrombocytopenic purpura; aplastic anemia, agranulocytosis (rare).SpecSenses: Tinnitus, vertigo, feeling of fullness in ears, hearing loss (rarely permanent), blurred vision.Skin: Pruritus, urticaria, exfoliative dermatitis, purpura, photosensitivity, porphyria cutanea tarde, necrotizing angiitis (vasculitis).BodyWhole: Increased perspiration; paresthesias; activation of SLE, muscle spasms, weakness; thrombophlebitis, pain at IM injection site.

circulatory collapse, and hypotension. Weigh patient daily under standard conditions.

- Monitor urine and blood glucose & HbA1C closely in diabetics and patients with decompensated hepatic cirrhosis. Drug may cause hyperglycemia.

Note: Excessive dehydration is most likely to occur in older adults, those with chronic cardiac disease on prolonged salt restriction, or those receiving sympatholytic agents.