DRUG STUDY

Name of drug Indication Action and drug Mechanism of action Side effects and Nursing responsibilities
classification adverse effects

Levofloxacin In oral and Bactericidal Levofloxacin is a bactericidal  nausea.  Arrange culture and sensitivity test
intravenous antibiotic of the antibiotic of the  vomiting. before beginning therapy
Brand name formulations, fluoroquinolone drug fluoroquinolone drug class  diarrhea.  Report to physician immediately any
(loxeva) levofloxacin is class that directly inhibits bacterial  stomach pain. of the following: skin rash or other
indicated in adults for DNA synthesis. Levofloxacin  constipation. signs of a hypersensitivity reaction;
Dosage the treatment of promotes the breakage of cns symptoms such as seizures,
 heartburn.
500 mg/tab various infections DNA strands by inhibiting restlessness, confusion, hallucinations,
1 tab  vaginal itching
caused by susceptible DNA-gyrase in susceptible depression; skin eruption following
and/or
bacteria, including organisms, which inhibits the sun exposure; symptoms of colitis
Route discharge.
infections of the upper relaxation of supercoiled such as persistent diarrhea; joint pain,
Orally respiratory tract, DNA. inflammation, or rupture of a tendon;
lower respiratory hypoglycemic reaction in diabetic on
Frequency tract, skin, skin an oral hypoglycemic agent.
OD PC structures, urinary  Learn important indications for
tract, and prostate. discontinuing drug and immediately
notifying physician.
 Remind patient to consume fluids
liberally while taking levofloxacin.
 Ensure that the patient allows a
minimum of 2 h between drug dosage
and taking any of the following:
Aluminum or magnesium antacids,
iron supplements, multivitamins with
zinc, or sucralfate.
 Ensure that the patient is not exposed
to excess sunlight or artificial UV
light.
 Instruct patient to avoid NSAIDs
while taking levofloxacin, if possible.
 Remind the patient not to breast feed
while taking this drug.
Name of drug Indication Action and drug Mechanism of action Side effects and adverse Nursing responsibilities
classification effects

Paracetamol Paracetamol is a mild Analgesic and Paracetamol has a Side effects from Educate both the patient and family
analgesic and antipyretic drug central analgesic effect paracetamol are rare but of the following:
Dosage antipyretic, and is that is mediated can include:
500 mg 1 tab recommended for the through activation of  allergic reaction  Do not self-medicate adults
treatment of most descending serotonergic (which can cause a for pain more than 10 d (5 d
Route painful and febrile pathways. Debate exists rash and swelling) in children) without
Orally conditions, for about its primary site of  flushing consulting a physician.
example, headache action, which may be  low blood pressure  Do not use this medication
Frequency including migraine, inhibition of without medical direction
 fast heartbeat
Q4h toothache, neuralgia, prostaglandin (PG) for: fever persisting longer
Rare but serious adverse
colds and influenza, synthesis or through an effects include: than 3 d, fever over 39.5° C
sore throat, backache, active metabolite  Hypersensitivity (103° F), or recurrent fever.
rheumatic pain and influencing cannabinoid  Anaphylactic  Do not give children more
dysmenorrhoea receptors. reactions than 5 doses in 24 h unless
prescribed by physician.
 Serious and even
 Do not breast feed while
fatal skin reactions.
taking this drug without
consulting physician.

Name of drug Indication Action and drug Mechanism of action Side effects and adverse Nursing responsibilities
classification effects

Amlodipine Amlodipine is used alone Calcium channel blockers. Amlodipine is a Common side effects:
or in combination with dihydropyridine calcium  swelling of your  Report any rhythm
Dosage other medications to antagonist (calcium ion legs or ankles disturbances or
10mg/tab treat high blood pressure antagonist or slow-channel  tiredness or symptoms of
1 tab in adults and children 6 blocker) that inhibits the extreme sleepiness increased
years and older. It is also transmembrane influx of  stomach pain arrhythmias,
used to treat certain types calcium ions into vascular  nausea including
Route
 Orally of angina (chest pain) and smooth muscle and cardiac  dizziness palpitations, chest
coronary artery disease muscle.  hot or warm pain, shortness of
(narrowing of the blood feeling in your face breath, fainting,
Frequency vessels that supply blood (flushing) and
OD to the heart).  irregular heart rate fatigue/weakness.
(arrhythmia)  Assess blood
 very fast heart rate pressure
(palpitations) periodically, and
 abnormal muscle compare to normal
movements values to help
 tremors document
Serious side effects: antihypertensive
 Low blood pressure. effects.
 More chest pain or
a heart attack:

Name of drug Indication Action and drug Mechanism of action Side effects and adverse Nursing responsibilities
classification effects

Doxofylline Doxofylline is Xanthines The mechanism of action  Nausea  Use with caution in
indicated for the treatment is similar to that of  Vomiting patients with
(Dilatair) of bronchial asthma, theophylline. However,  Epigastric pain hypertension, heart
pulmonary disease with unlike theophylline,  Headache disease,
Dosage spastic bronchial Doxofylline has greatly hypoxemia,
 Cephalagia
400mg component and Chronic decreased affinity towards hyperthyroidism,
 Irritability
½ tab Obstructive Pulmonary adenosine A1 and A2 chrome right
 Insomnia
Disease (COPD). This receptors which explain its ventricular failure,
Route  Tachycardia
product is contraindicated better safety profile. congestive heart
Orally in individuals who have Moreover, it does not  Extrasystole
failure, liver
shown hypersensitivity to interfere with calcium  Tachypnea. disease, renal
its components. influx into the cells nor disease, in those
Frequency antagonize calcium with history of
BID channel blockers. peptic ulcer and in
elderly.
  Contraindicated in
nursing mothers

Name of drug Indication Action and drug Mechanism of action Side effects and adverse Nursing responsibilities
classification effects

Pantoprazole It is used in conditions proton-pump inhibitors The mechanism of action  CNS: headache.  Advise patient to
where inhibition of gastric of pantoprazole is to  GI: abdominal pain, avoid alcohol and
Brand name acid secretion may be inhibit the final step in diarrhea, eructation, foods that may
(antaxid) beneficial, including gastric acid production. In flatulence. cause an increase
gastro-oesophageal reflux the gastric parietal cell of  Endo: hyperglycemia in GI irritation.
Dosage disease, peptic ulcer the stomach, pantoprazole  Instruct patient to
40g disease, for Non-Steroidal covalently binds to the report bothersome
1 tab Anti-Inflammatory Drug H+/K+ ATP pump to or prolonged side
(NSAID)-associated inhibit gastric acid and effects, including
Route ulceration, and in the basal acid secretion. The headache or GI
Orally treatment of pathological covalent binding prevents effects (diarrhea,
hypersecretory states such acid secretion for up to 24 flatulence,
as the Zollinger-Ellison hours and longer belching,
syndrome. abdominal pain).

Name of drug Indication Action and drug Mechanism of Side effects and adverse effects Nursing responsibilities
classification action

Ceftriaxone Treatment of skin and skin Cephalosporin antibiotic Ceftriaxone works  CNS: seizures (high  Instruct patient to notify
structure infections, bone by inhibiting the doses). physician immediately of
 and joint infections, mucopeptide  GI: pseudomembranous signs of superinfection
Brand name complicated and synthesis in the colitis, diarrhea,  Instruct patient and
(keptrix) uncomplicated urinary bacterial cell wall. cholelithiasis, sludging in family/caregivers to
tract infections, The beta-lactam the gallbladder. report other troublesome
Dosage uncomplicated moiety of  DERM: rashes, urticaria. side effects such as
1g gynecologic infections, ceftriaxone binds  HEMAT: bleeding, severe or prolonged
including gonorrhea, to eosinophilia, hemolytic fever, skin problems
lower respiratory tract carboxypeptidases, anemia, leukopenia, (rash, hives), diarrhea, or
Route infections, intra- endopeptidases, signs of gallstones
thrombocytosis.
IV abdominal infections, and Watch for seizures;
 LOCAL: pain at im
septicemia, meningitis, transpeptidases in site, phlebitis at iv site. notify physician
Frequency otitis media. Perioperative the bacterial  MISC: allergic reactions, immediately if patient
Q12h [Link] effects an cytoplasmic including anaphylaxis, develops or increases
ANST adverse effects membrane. These superinfection. seizure activity.
enzymes are  Monitor signs of
involved in cell- pseudomembranous
wall synthesis and colitis
cell division.  Monitor signs of allergic
reactions and
anaphylaxis
 Monitor signs of blood
dyscrasias

Name of drug Indication Action and Mechanism of Side effects and Nursing responsibilities
drug action adverse effects
classification

Hydrocortisone Indicated to treat Corticosteroids Hydrocortisone  feeling dizzy  Establish baseline and continuing data on
inflammation, status binds to the  headaches BP, weight, fluid and electrolyte balance,
Dosage asthmaticus, acute and glucocorticoid  swollen and blood glucose.
 100g chronic adrenal receptor leading to ankles  Lab tests: Periodic serum electrolytes
insufficiency, and as a downstream effects  feeling weak blood glucose, Hct and Hgb, platelet count,
Route physiologic replacement in such as inhibition of or tired and WBC with differential.
IV pediatric use. phospholipase A2,  infection  Monitor for adverse effects. Older adults
NF-kappa B, other  skin and patients with low serum albumin are
Frequency inflammatory problems especially susceptible to adverse effects.
Q8h transcription factors, such as acne  Be alert to signs of hypocalcemia.
and the promotion of or thin, shiny  Ophthalmoscopic examinations are
anti-inflammatory skin recommended every 2–3 mo, especially if
genes. patient is receiving ophthalmic steroid
Hydrocortisone has a therapy.
wide therapeutic  Monitor for persistent backache or chest
index 8 and a pain; compression and spontaneous
moderate duration of fractures of long bones and vertebrae
action. present hazards.
 Monitor for and report changes in mood
and behavior, emotional instability, or
psychomotor activity, especially with long-
term therapy.
 Be alert to possibility of masked infection
and delayed healing
 Note: Dose adjustment may be required if
patient is subjected to severe stress
 Note: Single doses of corticosteroids or use
for a short period (<1 wk) do not produce
withdrawal symptoms when discontinued,
even with moderately large doses.

Name of drug Indication Action and drug Mechanism of action Side effects and adverse Nursing responsibilities
classification effects

Tamsulosin Tamsulosin is indicated for alpha blockers Tamsulosin is a selective  sleepiness  Avoid using with
the treatment of signs and alpha1A-adrenergic  difficulty falling other alpha-
Dosage symptoms of benign receptor antagonist. The asleep or staying blockers.
400g prostatic hyperplasia. effects of tamsulosin are asleep Tamsulosin is
 1 tab Tamsulosin is also used targeted for the smooth  weakness contraindicated
off label for the treatment muscle receptors of the  back pain with strong
Route of ureteral stones, prostate and urethra.  diarrhea CYP3A4 inhibitors
Orally prostatitis, and female Blocking this receptor  runny or stuffy such as
voiding dysfunction. relaxes the smooth muscle nose ketoconazole.
Frequency of the bladder and urethra  Assess and monitor
 pain or pressure in
OD to improve urine flow. blood pressure,
the face
 sore throat, cough, especially after first
fever, chills, or dose because
other signs of tamsulosin may
infection cause orthostatic
 blurred vision hypotension.
 difficulty
ejaculating
 painful erection of
the penis that lasts
for hours
 rash
 itching
 hives
 swelling of the
eyes, face, tongue,
lips, throat, arms,
hands, feet, ankles,
or lower legs

Name of drug Indication Action and drug Mechanism of Side effects and adverse Nursing responsibilities
classification action effects

Spironolactone It is indicated to treat a Aldosterone receptor Spironolactone  vomiting  Monitor signs of fluid,
number of conditions antagonists. competitively  diarrhea electrolyte, or acid-base
Brand name including heart failure, inhibits aldosterone  stomach pain or cramps imbalances, including
(Spirofar) deem, hyperaldosteronism, dependant sodium  enlarged or painful dizziness, clumsiness,
adrenal hyperplasia, potassium exchange breasts in men or drowsiness, headache,
Dosage
 25g hypertension, and channels in the distal women blurred vision, confusion,
1 tab nephrotic syndrome convoluted tubule.  irregular menstrual hypotension, or muscle
This action leads to periods cramps and weakness.
Route increased sodium  vaginal bleeding in  Report excessive or
Orally and water excretion, post-menopausal ('after prolonged symptoms to the
but more potassium the change of life', the physician
Frequency retention. The end of monthly  Assess blood pressure
OD increased excretion menstrual periods) periodically and compare
of water leads to women to normal values to help
diuretic and also  difficulty maintaining document antihypertensive
antihypertensive or achieving an erection effects.
effects  deepening of voice  Monitor signs of allergic
 increased hair growth reactions, including
on parts of the body pulmonary symptoms or
 drowsiness skin reactions. Notify
physician immediately if
 tiredness
these reactions occur.
 restlessness
 Remind patients to take
medication as directed to
control hypertension and
other cardiac conditions
even if they are
asymptomatic

Name of drug Indication Action and drug Mechanism of Side effects and adverse Nursing responsibilities
classification action effects

Tramadol Tramadol is used to relieve opiate (narcotic) Tramadol modulates  noisy breathing,  Monitor other changes in mood and
moderate to moderately analgesics the descending pain sighing, shallow behavior, including euphoria,
Dosage severe pain. Tramadol pathways within the breathing, confusion, malaise, nervousness,
50 mg extended-release tablets central nervous breathing that and anxiety. Notify physician if
and capsules are only used system through the stops during these changes become problematic.
Route by people who are binding of parent sleep;  Advise patient that centrally acting
IV expected to need and M1 metabolite  a slow heart analgesics are usually more
 medication to relieve pain to μ-opioid receptors rate or weak effective if given before pain
around-the-clock. and the weak pulse; becomes severe; emphasize that
Tramadol is in a class of inhibition of the  a light-headed adequate pain control will allow
medications called opiate reuptake of feeling, like you better participation in physical
(narcotic) analgesics. norepinephrine and might pass out; therapy.
serotonin.  seizure  Educate patient about the dangers
(convulsions); or of overdose; encourage patient to
 low cortisol adhere to proper dosing schedule.
levels – nausea,  Emphasize that the risk of physical
vomiting, loss of addiction (tolerance and
appetite, dependence) is usually minimal
dizziness, during short-term treatment of pain.
worsening Advise patient that addiction is
tiredness or more likely during excessive or
weakness. inappropriate use of centrally acting
analgesics.
 Advise patient to avoid alcohol and
other CNS depressants because of
the increased risk of sedation and
decreased CNS function.
 Advise patient to increase fluid
intake

Name of drug Indication Action and drug Mechanism of action Side effects and Nursing responsibilities
classification adverse effects

Piperacillin Serious susceptible penicillin antibiotics Piperacillin inhibits cell  CNS: Headache,  Obtain history of
infections, including wall synthesis by binding insomnia, fever. hypersensitivity to penicillins,
(Vigocid) lower respiratory tract, to bacterial cell  GI: Diarrhea, cephalosporins, or other drugs
intraabdominal, membranes. Tazobactam constipation, prior to administration.
Dosage septicemia, skin and skin inactivates bacterial beta- nausea, vomiting,  Lab tests: C&S prior to first
4-5gm structure, bone and joint, lactamase. Therapeutic dyspepsia, pseud dose of the drug; start drug
UTIs, gynecological Effect: Piperacillin is omembranous pending results. Monitor
Route infections, and bactericidal in susceptible colitis hematologic status with
IV uncomplicated organisms.  Skin: Rash, prolonged therapy (Hct and
 gonoccocal urethritis. pruritus, Hgb, CBC with differential
Frequency hypersensitivity and platelet count).
Q8h reaction  Monitor patient carefully
during the first 30 min after
initiation of the infusion for
signs of hypersensitivity
Educate patient and family of the
following:
 Report rash, itching, or other
signs of hypersensitivity
immediately.
 Report loose stools or diarrhea
as these may indicate
pseudomembranous colitis.
 Do not breast feed while
taking this drug without
consulting physician.

Name of drug Indication Action and drug Mechanism of action Side effects and Nursing responsibilities
classification adverse effects

Salmeterol+fluticasone Salmeterol is indicated in It is also is used to prevent Beta-2 adrenoceptor  CNS: headache  Monitor and report
the treatment of asthma bronchospasm (breathing stimulation causes , nervousness. signs of CNS toxicity
Brand name with an inhaled difficulties) during relaxation of bronchial  CV: palpitation  Assess any muscle
(seretide) corticosteroid, prevention exercise in adults and smooth muscle, s, tachycardia. cramps or soreness.
of exercise induced children 4 years of age and bronchodilation, and  GI: abdominal Report severe or
bronchospasm, and the older. Salmeterol is in a increased airflow. pain, diarrhea, prolonged
Dosage maintenance of airflow class of medications called Salmeterol is hypothesized musculoskeletal
nausea.
25/250 obstruction and prevention long-acting beta agonists to bind to 2 sites on the symptoms.
 MS: muscle
2 puffs of exacerbations of chronic (LABAs)/ anticholinergic. beta-2 adrenoceptor. The cramps/sorenes  Advise patient not to
obstructive pulmonary It works by relaxing and saligenin moiety binds to s. exceed the
Route disease. opening air passages in the the active site of the beta-2
 Inhalation lungs, making it easier to adrenoceptor. The  Neuro: trembli recommended dose or
Nonprescription breathe. hydrophilic tail of ng. frequency of
Frequency fluticasone nasal spray salmeterol binds to leucine  Resp: paradoxi inhalations. Contact
BID (Flonase Allergy) is Fluticasone oral inhalation residues in the exo-site of cal physician immediately
used to relieve symptoms is used to prevent difficulty the beta-2 adrenoceptor bronchospasm, if bronchospasm is not
of rhinitis such as breathing, chest tightness, almost irreversibly, cough. relieved by medication
sneezing and a runny, wheezing, and coughing allowing salmeterol to or is accompanied by
stuffy, or itchy nose and caused by asthma in adults persist in the active site, diaphoresis, dizziness,
itchy, watery eyes caused and children. It is in a class which is responsible for it's or other symptoms.
by hay fever or other of medications called long duration of action  Instruct patient and
allergies (caused by an corticosteroids. family/caregivers to
allergy to pollen, mold, Fluticasone works report severe or
dust, or pets). by decreasing swelling prolonged headache or
and irritation in the GI problems (nausea,
airways to allow for diarrhea, abdominal
easier breathing. pain).

Name of drug Indication Action and drug Mechanism of action Side effects and adverse Nursing responsibilities
classification effects

Omeprazole Omeprazole is proton-pump It suppresses stomach acid  CNS: dizziness,  Monitor improvements in GI

used to treat inhibitors secretion by specific drowsiness, fatigue, symptoms to help determine if drug
Dosage certain conditions inhibition of the H+/K+- headache, therapy is successful.
40mg where there is too ATPase system found at the weakness.  Assess dizziness that might affect gait,
much acid in the secretory surface of gastric  CV: chest pain. balance, and other functional
Route stomach. It is parietal cells. Because this activities. Report balance problems
IV  GI: abdominal
used to treat enzyme system is regarded and functional limitations to the
pain, acid
gastric and as the acid (proton, or H+) physician, and caution the patient and
Frequency duodenal ulcers, pump within the gastric regurgitation,
family/caregivers to guard against falls
OD erosive mucosa, omeprazole inhibits constipation,
and trauma.
esophagitis, and the final step of acid diarrhea, flatulence,
 Monitor other CNS side effects and
gastroesophageal production nausea, vomiting. report severe or prolonged effects.
 reflux disease  Derm: itching,  Monitor any chest pain and attempt to
(GERD). rash. determine if pain is drug induced or
 Misc: allergic caused by cardiovascular dysfunction
reactions.  Advise patient to avoid alcohol and
foods that may cause an increase in GI
irritation.
 Instruct patient to report bothersome or
prolonged side effects, including skin
problems or GI effects

Name of drug Indication Action and drug Mechanism of action Side effects and adverse Nursing responsibilities
classification effects

Acetylcysteine is mucolytic agents A number of possible Common side effects:  Monitor signs of bronchospasm
N-Acetylcysteine (NAC) indicated for mechanisms for the  inflammation of the and respiratory irritation, including
mucolytic therapy mucolytic activity of mouth, wheezing, cough, dyspnea,
Brand name and in the acetylcysteine have been  nausea, increased secretions, and tightness
(Fluimucil) management proposed.  vomiting, in the chest and throat.
of acetaminophen Acetylcysteine's  fever,  Report excessive or prolonged
Dosage overdose. NAC sulfhydryl groups may respiratory problems to the
600mg in ½ glass water  runny nose,
can help prevent hydrolize disulfide bonds  drowsiness, physician.
side effects caused within mucin, breaking  During IV infusion, carefully
Route  clamminess,
by drug reactions down the oligomers, and monitor for fluid overload and
Orally  chest tightness,
and toxic making the mucin less signs of hyponatremia (i.e.,
chemicals, and viscous. Acetylcysteine  coughing,
Frequency changes in mental status).
helps break down has also been shown to  wheezing, or
OD  Monitor for S&S of aspiration of
mucus in the body reduce mucin secretion in  shortness of breath.
 rat models.  It is an Serious side effects: excess secretions, and for
antioxidant in its own  chest tightness, bronchospasm (unpredictable);
right but is also  bronchoconstriction, withhold drug and notify physician
deacetylated to cysteine, and immediately if either occurs.
which participates in the  bleeding.  Lab tests: Monitor ABGs,
synthesis of the pulmonary functions and pulse
antioxidant oximetry as indicated.
glutathione. The  Have suction apparatus
antioxidant activity may immediately available. Increased
also alter intracellular volume of respiratory tract fluid
redox reactions, may be liberated; suction or
decreasing endotracheal aspiration may be
phosphorylation of necessary to establish and maintain
EGFR and MAPK, an open airway. Older adults and
which decrease debilitated patients are particularly
transcription of the gene at risk.
MUC5AC which
produces mucin.

Name of drug Indication Action and drug Mechanism of action Side effects and adverse effects Nursing responsibilities
classification

Hyoscine-N- indicated for antispasmodics Scopolamine  CNS: dizziness, anaphylactic  Drug compatibility
Butylbromide the treatment of butylbromide binds to reactions, anaphylactic shock, should be monitored
abdominal pain muscarinic M3 increased ICP, closely in patients
Brand name associated with cramps receptors in the disorientation, restlessness, requiring adjunctive
(buscopan) induced by gastrointestinal tract. irritability, dizziness, drowsiness, therapy
gastrointestinal (GI) This prevents headache, confusion,  Raise side rails as a
Dosage spasms. acetycholine from
1 amp hallucination, delirium, precaution because some
binding to and
impaired memory patients become
activating the
Route receptors which would  CV: hypotension, tachycardia, temporarily excited or
IVTT result in contraction of palpitations, flushing disoriented and some
the smooth muscle.  GI: Dry mouth, constipation, develop amnesia or
 The inhibition of nausea, epigastric distress become drowsy.
contraction reduces  DERM: flushing, dyshidrosis  Reorient patient, as
spasms and their  GU: Urinary retention, urinary needed, Tolerance may
related pain during hesitancy develop when therapy  is
abdominal cramping.  Resp: dyspnea, bronchial prolonged
plugging, depressed respiration  Keep emergency
 EENT: mydriasis, dilated pupils, equipment available
blurred vision, photopobia,  Remind patient to Avoid
increased intraocular driving & operating
pressure, difficulty of machinery after
swallowing. parenteral administration.

Name of drug Indication Action and drug classification Mechanism of action Side effects and Nursing responsibilities
adverse effects
Cefixime Treatment of Binds to bacterial cell
Like all beta-lactam Side Effects: BASELINE ASSESSMENT
susceptible membranes, inhibits cell wall
antibiotics, cefixime Frequent: Oral
Dosage infections due to synthesis. Therapeutic
binds to specific candidiasis (thrush),  Obtain CBC, renal function tests.
400mg S. pneumoniae, S. Effect: [Link]-binding mild diarrhea, mild  Question for hypersensitivity to
pyogenes, M. proteins (PBPs) located abdominal cramping, cefixime or other cephalosporins,
Route catarrhalis, H. PHARMACOTHERAPEUTIC: inside the bacterial cell vaginal candidiasis. penicillins.
PO influenzae, E. coli, Third-generation wall, causing the
P. mirabilis, cephalosporin. inhibition of the third Occasional: Nausea, INTERVENTION/EVALUATION
Frequency including otitis CLINICAL: Antibiotic and last stage of serum sickness–like
1 Tab Noon After media, acute bacterial cell wall reaction (arthral-  Assess oral cavity for white
Meals x7day bronchitis, synthesis. gia, fever; usually occurs patches on mucous membranes,
acute exacerbations after second tongue (thrush).
of chronic course of therapy and  Monitor daily pattern of bowel
bronchitis, resolves after drug activity, stool consistency. Mild
pharyngitis, is discontinued). GI effects may be tolerable
 tonsillitis, Rare: Allergic reaction (increasing severity may indicate
uncomplicated (rash, pruritus, urticaria). onset of antibiotic-associated
UTI.. colitis).
 Monitor renal function tests for
Adverse Effects: evidence of nephrotoxicity.
Antibiotic-associated  Be alert for superinfection: fever,
colitis, other vomiting, diarrhea, anal/genital
superinfections pruritus, oral mucosal changes
(abdominal cramps, (ulceration, pain, erythema).
severe watery diarrhea,
fever) may result from PATIENT/FAMILY TEACHING
altered bacterial balance
in GI tract. • Continue medication for full length
Nephrotoxicity may treatment; do not skip doses.
occur, esp. in pts with
preexisting renal disease. • Dose should be evenly spaced.
Pts with history
of penicillin allergy are • May cause GI upset (may take with
at increased risk food or milk).
for developing a severe
hypersensitivity • Report persistent diarrhea.
reaction (severe pruritus,
angioedema,
bronchospasm,
anaphylaxis).
Methylprednisolone Anti-inflammatory Anti-inflammatory: Suppresses By reversing capillary SIDE EFFECTS INTERVENTION/EVALUATION
(Mepresone) or immunosuppres- migra- permeability, Frequent: Insomnia,
sant in the tion of polymorphonuclear suppressing the heartburn, anxiety,  Monitor I&O, daily weight;
Dosage treatment of leukocytes, migration of fibroblasts abdominal distention, assess for edema. Monitor daily
16mg 1Tab hematologic, reverses increased capillary and polymorphonuclear diaphoresis, acne, pattern of bowel activity, stool
allergic, neoplastic, permeability. leukocytes, controlling mood swings, increased consistency.
Route dermatologic, Exerts effects on modulating the rate of protein appetite, facial  Check vital signs at least twice
PO endo- carbohy- synthesis, and stabilizing flushing, GI distress, daily. Be alert for infection (sore
crine, GI, nervous drate, protein, lipid lysosomes at the cellular delayed wound throat, fever, vague symptoms).
Frequency system, metabolism. Maintains level, healing, increased  Monitor serum electrolytes,
Evening ophthalmic, fluid/electrolyte hemostasis. methylprednisolone may susceptibility to including B/P, glucose.
renal, or rheumatic Influences CV, control or prevent infection, diarrhea,  Monitor for hypocalcemia
disorders. immunologic, endocrine, inflammation through constipation. (muscle twitching, cramps,
OFF-LABEL: musculoskel- these actions as well.
 Acute spinal cord etal, neurologic physiology. Occasional: Headache, positive Trousseau’s or
injury. Therapeutic edema, tachycardia, Chvostek’s signs), hypokalemia
Effect: Decreases inflammation change in skin color, (weakness, muscle cramps,
frequent urination, numbness, tingling [esp. lower
PHARMACOTHERAPEUTIC: depression. extremities], nausea/vomiting,
Adrenal corticosteroid. irritability, ECG changes).
CLINICAL: Antiinflammatory. Rare: Psychosis,  Assess emotional status, ability
increased blood to sleep. Check lab results for
coagulability, blood coagulability, clinical
hallucinations. evidence of thromboembolism.

PATIENT/FAMILY TEACHING
ADVERSE
EFFECTS/TOXIC • Take oral dose with food, milk.
REACTIONS
Long-term therapy: • Do not change dose/schedule or stop
Hypocalcemia, taking drug; must taper off gradually
hypokalemia, muscle under medical supervision.
wasting (esp. in arms,
legs), osteoporosis, • Report fever, sore throat, muscle
spontaneous fractures, aches, sudden weight gain or loss,
amenorrhea, cataracts, edema, loss of appetite, fatigue.
glaucoma, pep-
tic ulcer, HF. Abrupt • Maintain strict personal hygiene; avoid
withdrawal exposure to disease, trauma.
after long-term therapy:
• Severe stress (serious infection,
Anorexia, nausea,
surgery, and trauma) may require
fever, headache, severe
increased dosage.
arthralgia, rebound
inflammation, fatigue,
• Follow-up visits, lab tests are
weakness, lethargy,
necessary.
dizziness, orthostatic
hypotension.
Salbutamol For the Salbutamol: Salbutamol is a It stimulates adenyl Side effects from this  Assess lung sounds, PR and BP
+ symptomatic selective short-acting beta2- cyclase, the enzyme drug are rare but can before drug administration and
Carbocisteine treatment of adrenergic agonist with which catalyzes the include: during peak of medication.
(Solmux Broncho) productive cough preferential effect on beta2- conversion of Salbutamol  Observe fore paradoxical spasm
associated with adrenergic receptors found in adenosine triphosphate  trembling, and withhold medication and
 Dosage acute and chronic the respiratory tract. It (ATP) to cyclic-3',5'- particularly in the notify physician if condition
500mg obstructive airways stimulates adenyl cyclase, the adenosine hands. occurs.
disease, such as enzyme which catalyzes the monophosphate  nervous tension.  Administer PO medications with
Route acute and chronic conversion of adenosine (cAMP). cAMP  headaches. meals to minimize gastric
PO bronchitis, triphosphate (ATP) to cyclic- mediates cellular  suddenly irritation
bronchial asthma 3',5'-adenosine monophosphate responses such as noticeable  Do not increase the dose or
Frequency and bronchiectasis. (cAMP). cAMP mediates bronchial smooth muscle heartbeats frequency of administration.
cellular responses such as relaxation resulting in (palpitations)  Paradoxical
bronchial smooth muscle bronchodilation.  muscle cramps. bronchospasm: Paradoxical
relaxation resulting in bronchospasm, a potentially life-
bronchodilation. Carbocisteine threatening event, has been
Carbocisteine: Carbocisteine, a  nausea observed with salbutamol. If it
derivative of Acetylcysteine, is  vomiting occurs, discontinue use of the
a mucoregulating agent. Its  diarrhoea product immediately.
major action is thought to be on  Metabolic Effects: As with other
 stomach
the metabolism of mucus- beta2-agonists, salbutamol can
discomfort.
producing cells. The mucus induce reversible metabolic
produced under the influence of changes (e.g., increased blood
Carbocisteine has an increased Adverse Reactions sugar levels). The diabetic
content of the less viscous Salbutamol: The most patient may be unable to
sialomucin and a reduced frequent adverse compensate for this; and thus,
content of the highly viscous reactions of oral result in the development of
fucomucin. Sialomucins Salbutamol include ketoacidosis.
influence the rheological tremors (particularly of
properties of mucus and may the hands), nervousness,
also, through the inhibition of headache, dizziness,
kinins, reduce or prevent sleeplessness or
bronchial inflammation and insomnia, weakness,
bronchospasm. drowsiness, restlessness,
irritability, tachycardia,
palpitation, peripheral
vasodilation, flushing,
chest discomfort, nausea,
dyspepsia, difficulty in
micturition, and rarely
muscle cramps.

Carbocisteine adverse
effects include:
headache, nausea,
vomiting, gastric
discomfort and bleeding,
diarrhea, and rash.