Drug Study

D r u g S t u d y

Generic Name: Brand Name: Major Drug Category

Hyoscine Buscopan Anti-spasmodic

Drug Action Uses Side Effects/Adverse

Reactions

Acts as a competitive inhibitor of

post-ganglionic muscarinic

receptor sites of PNS

Acute GI; Biliary and

genitourinary spasm, include

biliary and renal colic,

dysmenorrhea

Tachycardia, urinary retention,

xerostomia, dizziness,

bronchospasm

Significant Drug Interaction Usual Drug Dose Contraindications

TCAD’s, antihistamines,

quinidine, amantadine,

disopyramide, Beta-adrenergic

agents

Adult & children > 6yrs: 10-20mg

3-5 times daily

Myasthenia gravis, megacolon,

hypersensitivity, glaucoma,

tachycardia, mechanical stenosis

of GIT

Nursing Medication Management

1) Assessment 2) Intervention

-Assess for eye pain

-Assess for parkinsonism

-Assess for urinary hesitancy, retention

-Assess for constipation

-Assess mental status

-Monitor I&O ratio (retention commonly causes

decreased urine output)

-Palpate bladder if bladder retention occurs

3) Education 4) Evaluation

-Tell patient to avoid hazardous activities

requiring alertness

-Advise patient to avoid use of alcohol or other

CNS depressants while taking medication

-Decreased secretions

-Absence of motion sickness

DE LA SALLE LIPACOLLEGE OF

NURSING1962 J.P. Laurel National Highway, Lipa City

Tel. (043)756-5555, 756-2491, 756-2391 loc 270

D r u g S t u d y


Ceftriaxone Forgram Antibiotic


Reactions

Inhibits bacterial cell wall

synthesis, rendering cell wall

osmotically unstable, leading to

cell death

Treatment of susceptible

infections including chancroid,

gastroenteritis, lyme disease,

meningitis, syphilis, typhoid

Pain, rash, diarrhea, eosinophilia,

casts in urine, thrombocytosis,

leucopenia


Aminoglycosides and diuretics,

Nephrotoxic antibiotics such as

furosemide

Adult – 1g-2g/day once daily

according to infection severity

Pedia – 50-100mg/kg/day

Hypersensitivity to

cephalosporins, penicillins,

lidocaine and other local

anesthetic product of amide type.



-Assess patient previous sensitivity to

cephalosporins/penicillins

-Assess patient for signs and symptoms of

infection

-Assess for allergic reaction and anaphylaxis

-Assess renal function before and during therapy

-Obtain C&S before beginning therapy to identify if

correct treatment has been initiated

-Monitor hematologic, electrolyte & hepatic status on

long term therapy


-Instruct patient to take medication as prescribed

for the length of time ordered

-Teach patient to report sore throat, bruising,

bleeding and joint pain.

-Absence of signs and symptoms of infection

-Observed and experienced improvements in

symptoms of infection

-Negative C&S

-Absence of drug induced adverse effects



Tel. (043)756-5555, 756-2491, 756-2391 loc 270

D r u g S t u d y


Racecadotril Hidrasec Anti-diarrheals


Reactions

Inhibitor of enkephalinase this

drug antagonise the effect of

enkephalins which is agonist of a

recaptor(opioid) & maintain the c-

AMP level.

Treatment of acute diarrhea Drowsiness, nausea, vomiting,

constipation, dizziness,

headache


Racecadotril does not inhibit or

induce cytochrome P-450 in

animal models.

Adult – 100mg

Child, infant – 1.5mg/kg/dose

with 1 initial dose

Renal & hepatic impairment,

fructose intolerance, glucose and

galactose malabsorption



-Consider severe or prolonged diarrhea

-Assess patient’s weight to determine

appropriate dosage

-Assess clients elimination pattern to determine

effectiveness of drug

-Monitor intake and output

-Monitor for possible signs of drug induced adverse

effects


-Can be taken with or without food

-Maintain feeding during diarrhea, severe

vomiting, refusal of food

-Patient state understanding of drug therapy

-Less occurrence of watery stools after proper length

of treatment



Tel. (043)756-5555, 756-2491, 756-2391 loc 270

D r u g S t u d y


Dextromethorphan/Guaifenesin Mucobron Antitussive


Reactions

Supresses cough reflex by direct

action on the cough center in the

medulla

Relief of cough due to minor

throat & bronchial irritation as

may occur with the common cold,

bronchitis or inhaled irritants

Nausea, drowsiness, dizziness


Monoamine oxidase inhibitors

(MAOI’s), haloperidol, fluoxetine,

quinidine, amiodarone

Adult: 15ml

Pedia: 5-10 ml

-Should not be taken for

persistent/chronic cough

-When coughing accompanied by

excessive secretions



-Obtain patient history of cough before therapy

and reassess after giving the drug

-Assess cough: type, frequency, character

including sputum

-Monitor for possible adverse reactions:

CNS: drowsiness, dizziness

GI: Nausea, vomiting, abdominal pain


-Instruct patient to follow exactly the direction on

medication

-Advice medical consultation for persistent

cough more than 7 days

-Suggest sugarless lozenges to decrease throat

irritation and cough

Relief of dry, irritating cough



Tel. (043)756-5555, 756-2491, 756-2391 loc 270

D r u g S t u d y


Mometasone Nasonex Anti-pruritic/Anti-inflammatory


Reactions

Inhibition of prostaglandin

synthesis and inhibition of

macrophage and leukocyte

migration to site of inflammation

-Prophylaxis and treatment of

symptoms of seasonal and

perennial allergic rhinitis

Paresthesia, pruritus, skin

atrophy, burning, tingling,

folliculitis, acneiform reaction


-no significant drug interaction Adult and Pedia:

-1-2 sprays each nostril per day

-Untreated localized infection

involving the nasal mucosa.

-Recent nasal surgery/trauma



-Document onset, duration and character of

symptoms

-Attempt to identify triggers

-Assess patients family knowledge on drug

therapy

-Monitor for systemic absorption and fever (increased

temperature)

-Monitor for possible drug induced adverse effects

-Prime pump until fine spray appear

-Store protected from sunlight


-Instruct patient to use regularly as directed

-Instruct patient to report failure to improve

condition after 3-5 days therapy

-Teach patient to limit treatment to 14 days

-Instruct to monitor for and report drug induced

adverse reactions

-Absence of severe itching, patches on or flaking of

skin

-Relief of allergic rhinitis

-Patient does not develop injury related to drug

induced adverse reactions.



Tel. (043)756-5555, 756-2491, 756-2391 loc 270

D r u g S t u d y


Isoniazid INH Anti-infectives


Reactions

Inhibits RNA synthesis,

decreases tubercle bacilli

For pulmonary and extra-

pulmonary TB

Fever, lymphadenopathy,

vasculitis, hypersensitivity,

nausea, vomiting, GI

disturbances


Phenytoin, carbamezapine,

cycloserine, ethionamide, BCG

vaccine

Administer before taking antacids

Adult – 300mg OD

Pedia – 5-10ml OD

Should not be given to patients

with drug induced liver disease



-Assess lab exams & sputum, CXR before

treatment

-Assess CNS often: affect, mood, behavioral

changes

-Assess hepatic status,: decreased appetite,

jaundice, dark urine, fatigue

-Monitor liver/renal function: ALT, AST, bilirubin,

increased results may indicate hepatitis

-Give with meals to decrease GI symptoms: 1 hour to

2 hours after meals


-Instruct patient that compliance with dosage

schedule for duration is necessary to gain

-Decreased symptoms of TB

-Culture negative for TB



Tel. (043)756-5555, 756-2491, 756-2391 loc 270

benefits

-Tell patient to report peripheral neuritis:

weakness, tingling/numbness of feet.

D r u g S t u d y


Ampicillin Excillin Anti-infectives


Reactions

Interferes w/ cell wall synthesis of

susceptible organisms,

preventing bacterial multiplication

Treatment of respiratory tract and

soft tissue infections, bacterial

meningitides, septicemia and

gonococcal infections

Thrombophlebitis at injection site,

dizziness, fatigue, insomnia,

reverse hyperactivity,

neurotoxicity


Probenecid interferes/impairs

drug excretion

Allopurinol increases risk for skin

rashes

Adult – 1-2g/day

Pedia – 50-200mg/kg/day

Hypersensitivity to penicillins,

cephalosporins or imipenen



-Obtain patient history of infection before and

during therapy to assess response.


infection, fever, characteristics of wounds,

sputum, urine, stool, earache and WBC count

-Monitor renal function: urine output, urinalysis, protein

and blood, BUN, creatinine

-Monitor blood studies: AST, ALT, CBC, Hct, bilirubin,

LDH, alkaline phosphatase

-Given by direct IV over 3-5mins in lower dosages


-Instruct patient to take all medications

prescribed for the length of time ordered

-Control of infection manifested by absence of

signs/symptoms of infection



Tel. (043)756-5555, 756-2491, 756-2391 loc 270

-Instruct patient to monitor adverse reaction:

sore throat, bruising, bleeding, joint pain

-Instruct patient if diarrhea with blood occurs

-Reported improvement in symptoms of infection

-Patient and family state understanding of drug

therapy

D r u g S t u d y


Cefuroxime Zegen Anti-infectives


Reactions

Binds to bacterial cell wall

membrane which causes death

Treatment of bone and joint

infections, bronchitis and other

LRTIs, gonorrhea, meningitis,

pharyngitis, UTI

Thrombophlebitis, pruritus,

urticarial, diarrhea, nausea,

pseudomembrane colitis


Other antibiotics, probenecid,

water pills

Adult – 750mg-1.5g

Pedia – 500mg-750mg

Hypersensitivity to

cephalosporins and penicillins



-Assess patient history of allergies particularly

cephalosporins and penicillins

-Assess mouth for white patches in mucous

membranes and tongue

-Monitor bowel activity and stool consistency carefully

-Monitor I&O and renal function reports for

nephrotoxicity

-Monitor for drug adverse effects: pruritus, abdominal

pain, mouth sores


-Instruct client that doses should be evenly

spaced

-Instruct client to continue medication therapy for

full length of treatment

-Reported improvements in symptoms of infection

-Control of infection manifested by absence or less

occurrence of signs and symptoms of infection



Tel. (043)756-5555, 756-2491, 756-2391 loc 270

-Inform patient that the drug may cause GI

upset. (may take with food or milk)

D r u g S t u d y


Budesonide & Formoterol Symbicort Turbuhaler Anti-asthma


Reactions

Dose-dependent anti-

inflammatory action in the

airways; rapid & long-lasting

relaxation of bronchial smooth

muscles

Treatment of asthma in

combination with a corticosteroid,

treatment of moderate and

severe COPD

Headache, palpitations, tremor

candida infections, mild throat

irritation, coughing hoarseness


Ketoconazole, Acarbose,

aceclofenac, aclofenac, BCG

Adult and >12yrs – 2 inhalations

320/9mcg

Pedia: 1-2 inhalations 80/4.5mcg

Hypersensitivity to inhaled

lactose



-Assess respiratory function: breathing patterns

and cough sputum

-Assess ability to use the inhaler device and

reassess technique at regular appointments

-Monitor for evidence of allergic reactionsand

paradoxical bronchospasms

-Monitor for adverse reactions at beginning of therapy

and periodically with long term use.


-Instruct the patient to use the inhaler at regular

intervals

-Relief of dyspnea and wheezing



Tel. (043)756-5555, 756-2491, 756-2391 loc 270

-Ensure patients know never to use the

medication to treat acute attack

-Improved airway exchange

D r u g S t u d y


Hydrocortisone Solu-cortef Corticosteroids


Reactions

Glucocoorticoid with anti-

inflammatory effect because of

its ability to inhibit prostaglandins

synthesis

Treatment of primary and

secondary adrenal cortex

insufficiency, allergic states,

allergic and inflammatory

ophthalmic processes

Depression, flushing, sweating,

headache, mood changes,

hypertension, thrombophlebitis,

embolism, tachycardia


May decrease effects of the

anticholinesterase in treatment of

myasthenia gravis

-Alkaline antiseptics

Adult – 100-250mg

Pedia – 0.186-1mg/kg 2x-3x/day

Systemic fungal infections, IM

use in idiopathic

thrombocytopenic purpura and

administration of live vaccines in

patient receiving

immunosuppressive

corticosteroid doses



-Assess patient’s condition before starting

therapy and reassess regularly

-Assess mental status and affect, mood,

behavioral changes, aggression

-Assess for signs of infection

-Monitor patients weight, BP, glucose and electrolyte

levels

-Monitor for possible drug induced adverse effects

-Monitor I&O ratio, urine output and increasing edema



Tel. (043)756-5555, 756-2491, 756-2391 loc 270


-teach patient all aspects of drug usage, the

danger of stopping abruptly after long term

therapy and signs of early adrenal insufficiency

-Warn patient receiving long term therapy about

cushingoid symptoms (weight gain and swelling)

-Patient’s condition improves

-Serious drug induced complications does not develop

-Patient does not develop serious infection

-Patient and family state understanding of drug

therapy

D r u g S t u d y


Cefixime Ultraxime Anti-infectives


Reactions

Inhibits bacterial cell wall

synthesis, rendering cell wall

osmotically unstable, leading to

cell death

Bronchitis, secondary infections

of the respiratory tract,

pneumonia, otitis media,

sinusitis, bronchiectasis

Shock, granulocytopenia,

anaphylactoid symptoms, lyell’s

syndrome, hematologic disorders


Co-administration with warfarin

Probenecid, Inhibition of renal

excretion of cefixime

Adult-12yrs&up : 400mgOD

Pedia: 5-10ml OD

Hypersensitivity, history of shock

due to any ingredient to this

product



-Assess patient’s previous sensitivity reaction to

penicillin or other cephalosporins


infection

-Obtain C&S before beginning therapy to identify if

correct treatment has been initiated

-Monitor hematologic, electrolyte and hepatic status

-Assess for allergic reactions and anaphylaxis


-Instruct patient to take medication as prescribed

for the length of time ordered even if he feels

-Absence signs and symptoms of infection

-Observed and experienced improvement in



Tel. (043)756-5555, 756-2491, 756-2391 loc 270

better

-Teach patient to report sore throat bruising,

bleeding and joint pain

symptoms of infection

-Negative C&S

-Absence of drug induced adverse reaction

D r u g S t u d y


Rifampicin Rifamax Anti-infectives


Reactions

Inhibits DNA-dependent

polymerase, decreases

replication

Maintenance phase treatment of

pulmonary and extra-pulmonary

TB.

GI disturbances, nausea,

vomiting, diarrhea, anorexia,

shortness of breath, shock, GI

bleeding


Corticosteroids, digitoxin

derivatives, methadone, oral

contraceptives

Adult: 10mg/kg – 600mg max

Pedia: 10/kg

Jaundice associated with

reduced bilirubin excretions. 1st

trimester of pregnancy



-Assess lung sounds and character of sputum

periodically during therapy

-Perform mycobacterial studies and

susceptibility tests prior to and periodically

during therapy to detect possible resistance.

-Assess periodic results of lab tests and CXR on a

regular basis during theraoy

-Monitor patient compliance with the treatment

regimen


-Do not take any new medication during therapy

without consulting a physician

-Decreased symptoms of TB



Tel. (043)756-5555, 756-2491, 756-2391 loc 270

-Take rifampin on an empty stomach, 1 hour

before or 2 hours after meals

-Instruct client to complete the full course of

therapy and not skip doses

Drug Study

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