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ampicillin (am pi sill' in) ampicillin sodium Oral: Ampicin (CAN), Apo -Ampi (CAN), NovoAmpicillin (CAN), Nu-Ampi (CAN), Penbritin (CAN), Pri ncipen Pregnancy Category B Drug classes Antibiotic Penicillin

Capsules250, 500 mg; powder for oral suspension 125 mg/5 mL, 250 mg/5 mL; powder for injection250, 500 mg, 1, 2 g Dosages Maximum recommended dosage: 8 14 mg/day (14 g should be reserved for serious infections, such as meningitis, septicemia); may be given IV, IM, or PO. Use parenteral ro utes for severe infections, and switch to oral route as soon as possible.

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

Treatment of infections caused by susceptible strains of Shigella, Salmonella, E. coli, H. influenzae, P. mirabilis, N. gonorrhoeae,entero cocci, gram-positive organisms (penicillin G sensitive staphylococci, streptococci, pneum ococci) Meningitis caused by Neisseria meningiti dis Unlabeled use: Prophylaxis in cesarean section in certain high-risk patients

CNS: Lethargy, hallucinations, seizures CV: CHF GI: Glossitis, stomatitis, gastritis, sore mouth, furry tongue, black "hairy" tongue, nausea, vomiting, diarrhea, abdominal pain, bloody diarrhea, enterocolitis, pseu domembranous colitis, nonspecific hepatitis GU: Nephritis Hematologic: Anemia, thrombocytopenia, leukope nia, neutropenia, prolonged bleeding time Hypersensitivity: Rash, fever, wheezing, anaphylaxis Local: Pain, phlebitis, thrombosis at injection site (parenteral) Other: Superinfectionsoral and rectal moniliasis, vaginitis

Contraindicated with allergies to penicillins, cephal osporins, or other allergens. Use cautiously with renal disorders.

Culture infected area before treatment; reculture area if response is not as expected. Check IV site carefully for signs of thrombosis or drug reaction. Do not give IM injections in the same site; atrophy can occur. Monitor injection sites. Administer oral drug on an empty stomach, 1 hr before or 2 hr after meals with a full glass of water; do not give with fruit juice or soft drinks.

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Oxytocin (Pictopin, Syntocinon)

For stimulation of labor: 10 units (1ml) of drug infused in 1L D5LRS before deliver For Reduction of Postpartum bleeding: 1 amp after delivery of placenta

Oxytocin Causes potent and selective stimulation of uterine and mammary gland smooth muscles producing sustained contractions Induces labor and milk ejection and reduces post partum bleeding

Induction of labor at term; control of postpartum bleeding; adjunctive therapy in management of abortion

Cardiovascular: hypertension; increased heart rate, systemic venous return, and cardiac output, and arrhytmias CNS: seizures, coma from water intoxication Gastrointestinal: Nausea, vomiting, GU: titanic uterine contractions, abruption placentae, impaired uterine blood flow, pelvic hematoma Hematologic: afibrinogenemia Respiratory: anoxia, asphyxia

> Contraindicated in patients hypersensitive to the drug or any of its component. > Also contraindicated in cephalopelvic disproportion or delivery that requires conversion, as in tranverse lie; in fetal distress when delivery isnt imminent; in prematurity and in severe toxemia, hypertonic uterine patterns, total placenta previa or vasa previa. > Also contraindicated in fetal distress.

> Contraindicated in patients hypersensitive to the drug or any of its component. > Also contraindicated in cephalopelvic disproportion or delivery that requires conversion, as in tranverse lie; in fetal distress when delivery isnt imminent; in prematurity and in severe toxemia, hypertonic uterine patterns, total placenta previa or vasa previa. > Also contraindicated in fetal distress.

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Hydralazine (Apresoline)

5 mg/dose then 5-10 mg every 20-30 minutes as needed.

Hydralazine Directly relaxes arteriolar smooth muscle Vasodilaion Lowers Blood Pressure

CNS: peripheral neuritis, headache, dizziness Pre-eclampsia / eclampsia CV: orthostatic hypotension, tachycardia, arrythmias, angina, palpitations. GI: n/v, diarrhea, anorexia Hematologic: neutropenia, leukopenia, agranulocytopenia Metabolic: weight gain, sodium retention Skin: rash

Contraindicated to patients hypersensitive to the drug and any of its component and in those with coronary artery disease or mitral valvular rheumatic heart disease. Use cautiously in patients with suspected cardiac disease, CVA, or severe renal impairment, and in those taking other antihytensives.

>Assess blood pressure before starting therapy and regularly thereafter. >Instruct client to take oral form with meals. >Inform client that orthostatic hypotension can be minimized by rising slowly and not changing position suddenly. >Tell pt. not to abruptly stop taking drug, but to call prescriber if adverse reaction occurs. >Tell client to limit sodium intake.

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Dosage & Route Dosage: 1.8 mg IV q6

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Dexamethasone Classification: Anti inflammatory Glucocorticoid

The patient was given dexamtehasone 1.8 mg through IV every 6 hours to decreases inflammation, mainly by stabilizing leukocyte lysosomal membranes; suppresses immune response; stimulates bone marrow; and influences protein, fat and carbohydrate metabolism.

Specific Adjunctive treatment in bacterial meningitis. General Cerebral edema Allergic and inflammatory conditions Shock Tuberculosis meningitis

CNS: euphoria, insomnia, psychotic behavior, pseudotumor cerebri, vertigo, headache, paresthesia, seizures, depression. CV: hypertension, edema, arrythmias, thromboembolism. EENT: cataracts, glaucoma.

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4. GI: peptic ulceration, GI irritation, increased appetite, pancreatitis, nausea, vomiting. 5. GU: increase urine glucose, and calcium levels Metabolic: hypokalemia, hyperglycemia Musculoskeletal: muscle weakness Skin: Delayed wound healing Other: Susceptibility to infections.

6. 7.

8.

Determine whether patient is sensitive to other corticosteroids Most adverse reactions to corticosteroids are dose-or durationdependent. For better results and less toxicity, give once daily dose in morning. Give oral dose with food when possible. Patient may need drugs to prevent GI irritation. Give I.M injection deeply into gluteal muscle. Rotate injection sites to prevent muscle atrophy. Avoid subcutaneous injection because atrophy and sterile abscesses may occur. Alwats adjust to lowest effective dose Monitor patient weight, blood pressure, and electrolyte levels. Monitor patient for cushingoid effects, including moon face, buffalo hump, thinning of hair.

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Dosage & Route IV 50mg q6

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Cefuroxime Classification: ANTIINFECTIVE; ANTIBIOTIC; SECONDGENERATION CEPHALOSPORIN

It is effective for the treatment of penicillinaseproducing Neisseria gonorrhoea (PPNG). Effectively treats bone and joint infections, bronchitis, meningitis, gonorrhea, otitis media, pharyngitis/tonsillitis, sinusitis, lower respiratory tract infections, skin and soft tissue infections, urinary tract infections, and is used for surgical prophylaxis, reducing or eliminating infection.

Body as a Whole: Thrombophlebitis (IV site); pain, burning, cellulitis (IM site); superinfections, positive Coombs' test. GI: Diarrhea, nausea, antibioticassociated colitis. Skin: Rash, pruritus, urticaria. Urogenital: Increased serum creatinine and BUN, decreased creatinine clearance.

Hypersensitivity to cephalosporins and related antibiotics; pregnancy (category B), lactation.

Determine history of hypersensitivity reactions to cephalosporins, penicillins, and history of allergies, particularly to drugs, before therapy is initiated. Inspect IM and IV injection sites frequently for signs of phlebitis. Report onset of loose stools or diarrhea. Although pseudomembranous colitis. Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes.

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Generic name: Isoxsuprine

Brand Name: Duvadilan

Chemically similar to sympathomimetic amines and often described as beta adrenergic agonist. However, the drug appears to be a musculotropic vasodilator and its effects are not blocked by propanolol.

Peripheral and cerebral vascular insufficiency with spastic component showing symptoms: Dizziness Forgetfulness Confusion Visual, auditory and speech abnormalities Coldness and numbness of limbs Color changes and ischemic ulcers Raynaud disease

Transient flushing Hypotension Rashes

recent arterial hemorrhage, heart disease, severe anemia should not be administered immediately post partum and premature labor. Avoid parenteral administration to patients with hypotension, tachycardia, premature detachment of placenta or immediate post partum.

Assess patients condition before therapy. Assess potential benefits from drug therapy. Monitor for possible drug induced adverse reactions: Hypotension Tachycardia Nausea Vomiting Dizziness Severe rash Inform the patient about possible side effects , adverse symptoms to report.

Gastrointestinal (GI) disturbances Maternal pulmonary edema Fetal tachycardia Transient palpitations Dizziness

Uterine hypermotility disorders Threatened abortion Premature labor Dysmenorrheal

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Adverse Effects CNS: Weakness, drowsiness, dizziness, fainting, sweating Respiratory: Decreased respiratory rate CV: Palpitations GI: Excessive bowel activity, perianal irritation Metabolic: Magnesium intoxication, hypocalcemia with tetany

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Generic Name Magnesium Sulfate Trade Name Martham Pharmacologic Class Mineral, Electrolyte Therapeutic Class Antiepileptic, Laxative; Mineral, electrolyte replacement Pregnancy Risk Factor A B (Laxative)

Minimum Dose 1-2 g qH by IV infusion Maximum Dose 4-6 g qH by IV infusion Contents Magnesium sulfate Availability and color - Granules- 40 mEq/5 g - Injection- 0.325, 0.65, 1, 4 mEq/mL Routes of administration Oral Intramuscular Intravenous

Cofactor of many enzyme systems involved in neurochemical transmission and muscular excitability; prevents or controls seizures by locking the neuromuscular transmission; attracts and retains the water in the intestinal lumen and distends the bowel to promote mass movement and relieve constipation.

General Indications - Constipation - Torsades de pointes - Muscle stimulating effects of barium poisoning - Reduction of cerebral oedema. Hypomagnesaemia - Seizures associated with epilepsy, glomerulonephritis or hypothyroidism. - Toxemias of pregnancy - Boils and carbuncles

Concentrations - Allergy to magnesium products - Abdominal pain - Nausea - Vomiting - Acute surgical abdomen - Fecal impaction - Intestinal and biliary tract obstruction - Hepatitis - Myocardial damage - Heart blocks - 2 hr preceding delivery Precaution - Renal insufficiency Drug interaction Drug to drug - Potentiation of neuromuscular blockade produced by nondepolarizing neuromuscular relaxants Drug to food - none reported

Before - Assess for contraindicated conditions. - Monitor knee-jerk reflex before repeated parenteral administration. - Give as laxative as temporary measure. - Reserve IV use in eclampsia for lifethreatening situations. - Observe the 15 rights in drug administration. During - Give IM route by deep IM injection. - Monitor serum magnesium levels. - Do not give oral MgSO4 with abdominal pain, nausea, or vomiting. - Do not administer if knee-jerk reflexes are suppressed - Monitor bowel function. After - Arrange to discontinue administration as soon as levels are within normal limits and desired clinical response is obtained. - Discontinue if diarrhea or cramping occurs. - Arrange for dietary measures, exercise and environmental control to return to normal bowel activity. - Report sweating, flushing, muscle tremors or twitching, inability to move extremities. - Maintain urine output at a level of 100 mL every 4 hr during parenteral administration.

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