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DRUG ACTION INDICATION CONTRAINDICATION ADVERSE / SIDEEFFECTS

NURSINGRESPONSIBILITIES

Imipenem

Classification:Anti-infectives

*Binds to thebacterial cellwall, resultingin cell death,combinationwith cilastatinprevents renal

inactivation of impipenemresists theactions of manyenzymes thatdegeneratemost otherpenicillins &penicillin leikeanti-infectives

*Treatment of :lowerrespiratoryinfection,urinary tractinfection,abdominal

infection,gynecologicinfection, skin &skin structuteinfection, bone& jointinfection,bacteremia,endocarditis,polymicrobicinfection

*Hypersensitivity:Cross-sensitivity mayoccur w/ penicillin &cephalosporins

CNS: seizures, dizzinessCV: hypotensionGI:pseudomembranous,colitis, diarrhea,nausea & vomitingDERM: rash, pruritus,

sweating, urticariaHEMAT: eosinophiliaLOCAL: phlebitis at IVsiteMISC: allergic reactionincluding anaphylaxis,fever, superinfection

Observe patientsreceivingparenteral drugcarefully; closelymonitor BP andvital signs.

Sudden deathfrom cardiacarrest has beenreported. Monitor BPduring periods of diuresis andthrough period of dosageadjustment. Observe olderadults closelyduring period of brisk diuresis.Sudden alterationin fluid and

electrolytebalance mayprecipitatesignificantadversereactions. Reportsymptoms to

physician.

DRUG ACTION INDICATION CONTRAINDICATION ADVERSE / SIDEEFFECTS

NURSINGRESPONSIBILITIES

Enalpril

Classification:Antihypertensive,ACE inhibitor

Angiotensin-convertingenzymeinhibitorsreduce theactivity of

the renin-angiotensin-aldosteronesystem.

Treatment of hypertension alone or incombination withother antihypertensives,especially thiazide-typediuretics

Treatment of acute andchronic CHF Treatment of asymptomatic leftventricular dysfunction(LVD) Unlabeled use: Diabeticnephropathy

Contraindicated withallergy to enalapril.

Use cautiously withimpaired renalfunction; salt or

volumedepletion(hypotensionmay occur); lactation,pregnancy

CNS: Headache,dizziness, fatigue, insomnia,paresthesias

CV: Syncope, chestpain, palpitations,hypotension insalt- or volume-depleted patients GI: Gastric irritation,nausea, vomiting,diarrhea,

*Alert surgeon, andmark patient's chartwith notice thatenalapril is beingtaken; theangiotensin II

formationsubsequentto compensatoryrenin release duringsurgery will beblocked; hypotensionmay be reversed withvolume expansion.*Monitor patients ondiuretic therapy forexcessivehypotension after

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abdominal pain,dyspepsia,elevatedliver enzymes GU: Proteinuria, renalinsufficiency, renalfailure,polyuria, oliguria,

urinaryfrequency,impotence Hematologic: Decreased hematocrit and hemoglobin Other: Cough, muscle cramps,hyperhidrosis

the first few doses of enalapril.*Monitor patientclosely in anysituation that maylead to a drop inBPsecondary toreduced fluid volume(excessive

perspiration anddehydration,vomiting,diarrhea) becauseexcessivehypotension mayoccur.*Arrange for reduceddosage in patientswith impaired renalfunction.*Monitor patientcarefully becausepeak effect may notbe seen for 4 hr. Donot administersecond dose until BPhas been checked.