DRUG STUDY

Drug Name Classification Mechanism of Action

Dosage, Route Preparation

Indications Contraindications

Adverse Reactions

Nursing Responsibilities

Generic name: Co-Amoxiclav Brand name: Natravox Addex Amoclav Amoclav Forte Demoxil Forte Fimoxy Clav

Antibacterial

Co-amoxiclav is an antibacterial combination consisting of amoxicillin (as sodium) and the beta-lactamase inhibitor, clavulanic acid (as potassium clavulanate). Amoxicillin is the 4-hydroxy analogue of ampicillin. Amoxicillin hinders the cell wall synthesis of sensitive bacteria and is bactericidal against many Gram-positive and Gram-negative bacteria.

Adults and children 40 kg: Oral 500 mg/125 mg dose taken three times a day.

Children < 40 kg:

20 mg/5 mg/kg/day to 60 mg/15 mg/kg/day given in three divided doses.

Availability:

Co-amoxiclav tablets

Suspensions

Pediatric sachets

Lower respiratory tract infections, otitis media, sinusitis, skin & soft tissue infections, UTI, pre& post-surgical procedures, bone & joint, infections, dental infections

History of penicillin hypersensitivity. Superinfections involving Pseudomonas or candida. Pregnancy & lactation

GI: Diarrhea, Nausea and vomiting Hematology: Anemia, Neutropenia Allergic reactions - itching, rashes, wheezing Hepatitis, cholestatic jaundice

Ensure that the patient has adequate fluid intake during any diarrhea attack. Ice chips and crackers to prevent nausea and vomiting The drug must be taken in equal doses around the clock to maintain level in the blood. This could indicate allergy to drug and it should be reported. Dose with caution and monitor hepatic function at regular intervals

DRUG NAME

DRUG CLASS DOSAGE AND FREQUENCY

MECHANISM OF ACTION

INDICATION CONTRAINDICATION SIDE - EFFECTS NURSING RESPONSIBILITIES

Generic Name: Celecoxib Brand Name: Celebrex

Pharmacologic class: Nonsteroidal cyclooxygenase-2 (COX-2 ) inhibitor, anti-inflammatory drug (NSAID) Therapeutic class: Antirheumatic Pregnancy risk category C

400 mg OD p.r.n Exhibits anti-inflammatory, analgesic, and antipyretic action due to inhibition of the enzyme COX-2

Adjunctive treatment to decrease the number of adenomatous colorectal polyps in familial adenomatous polyposis

Hypersensitivity to drug, sulfonamides, or other NSAIDs Severe hepatic impairment History of asthma or urticaria Advanced renal disease Late pregnancy Breastfeeding

CNS: dizziness, drowsiness, headache, insomnia, fatigue CV: peripheral edema EENT: ophthalmic effects, tinnitus, pharyngitis, rhinitis, sinusitis GI: nausea, diarrhea, constipation, abdominal pain, dyspepsia, flatulence, dry mouth, GI bleeding GU: menorrhagia Hematologic: decreased hemoglobin or hematocrit, eosinophilia, epistaxis, bruising,

Before: - Assess pts history of allergic reaction to the drug - Monitor complete blood count, electrolyte levels, creatinine clearance, and occult fecal blood test and liver function test results every 6 to 12 months During: - Instruct patient to take drug with food or milk. - Teach patient to avoid aspirin and other NSAIDs (such as ibuprofen and naproxen) during therapy. After: - Advise patient to immediately report bloody stools, blood in vomit, or signs or symptoms of liver damage (nausea, fatigue, lethargy, pruritus, yellowing of eyes or skin, tenderness on upper right side of abdomen, or flulike symptoms).

DRUG NAME

DRUG CLASS DOSAGE AND FREQUENCY

MECHANISM OF ACTION

INDICATION CONTRAINDICATION SIDE - EFFECTS

NURSING RESPONSIBILITIES

Generic Name: Metoprolol Brand Name: Lopressor

Beta- adrenergic blocking agents

100mg Unknown. A selective beta blocker that selectively blocks beta1 receptors; decreases cardiac output, peripheral resistance, and cardiac oxygen consumption; and depresses rennin secretion.

Hypertension

Acute MI

Angina Pectoris

Hypersensitive to drug.

Pt. with sinus bradycardia, cardiogenic shock and heart failure

CV: hypotension GI: nausea and vomiting Respi: dyspnea Skin: rash

1. Always check patients apical pulse 2. Monitor BP 3. Store drug at room temperature. 4. Inform patient about the side effects and adverse effects of the medication. 5. Advise patient to take it with meals. 6. Tell patient to report if he/she feels shortness of breath. 7. Tell patient that metoprolol is not advisable to breastfeeding mothers. 8. Advise not to withdrawn drug abruptly.

DRUG NAME

DRUG CLASS DOSAGE AND FREQUENCY

MECHANISM OF ACTION

INDICATION CONTRAINDICATION SIDE - EFFECTS

NURSING RESPONSIBILITIES

Generic Name: Cetirizine Brand Name: Zyrtec, Zyrtec Allergy, Zyrtec Hives

Non-sedating antihistamine

ADULTS 510 mg daily PO; maximum dose 20 mg/day.

Potent histamine (H1) receptor antagonist; inhibits histamine release and eosinophil chemotaxis during inflammation, leading to reduced swelling and decreased inflammatory response

Management of seasonal and perennial allergic rhinitis Treatment of chronic, idiopathic urticarial Treatment of year-round allergic rhinitis and chronic idiopathic urticaria in infants > 6 mo

Contraindicated with allergy to any antihistamines, hydroxyzine.

Use cautiously with narrow-angle glaucoma, stenosing peptic ulcer, symptomatic prostatic hypertrophy, asthmatic attack, bladder neck obstruction, pyloroduodenal obstruction (avoid use or use with caution as condition may be exacerbated by drug effects); lactation

CNS: Somnolence, sedation CV: Palpitation, edema GI: Nausea, diarrhea, abdominal pain, constipation Respiratory: Bronchospasm, pharyngitis Other: Fever, photosensitivity, rash, myalgia, arthralgia, angioedema

Assessment History: Allergy to any antihistamines, hydroxyzine; narrow-angle glaucoma, stenosing peptic ulcer, symptomatic prostatic hypertrophy, asthmatic attack, bladder neck obstruction, pyloroduodenal obstruction; lactation Physical: Skin color, lesions, texture; orientation, reflexes, affect; vision examination; R, adventitious sounds; prostate palpation; renal function tests Interventions

Give without regard to meals.

Provide syrup form or chewable tablets for pediatric use if needed.

Arrange for use of humidifier if thickening of secretions, nasal dryness become bothersome; encourage adequate intake of fluids.

Provide skin care for urticaria.

Teaching points

Take this drug without regard to meals.

You may experience these side effects: Dizziness, sedation, drowsiness (use caution if driving or performing tasks that require alertness); thickening of bronchial secretions, dryness of nasal mucosa (humidifier may help).

Report difficulty breathing, hallucinations, tremors, loss of coordination, irregular heartbeat.

DRUG NAME

DRUG CLASS DOSAGE AND FREQUENCY

MECHANISM OF ACTION

INDICATION CONTRAINDICATION SIDE - EFFECTS

NURSING RESPONSIBILITIES

Generic Name: Losartan Potassium Brand Name: Cozaar

Anti-hypertensive

For Hypertension: Adults- Initially 25-50mg PO daily, For Nephropahty: Adults-50mg PO OD.

Inhibits vaso-constrictive and aldosterone-secreting action of angiotensin II by blocking angiotensin II receptor on the surface of vascular smooth muscle and other tissue cells.

Hypetension, Nephepatically in type 2 daibetic patients, to reduce risk of CVA in patients with hypertension and left ventricular hypertrophy

Patients hypersensitive to drug, breast-feeding is not recommended, causes fetal and neonatal morbidity and death when administered in the 2nd and 3rd trimester of pregnancy.

CNS-dizziness, asthenia, fatigue, headache, insomia. CV-edema, chest pain. EENT-nasal congestion, sinusitis, pharyngitis, sinus disorder. GI-Abdominal pain, nausea, diarrhea, dyspepsia. Musculoskeletal-muscle cramps, myalgia, back or leg pain. Respiratory-cough, upper respiratory infection.

Monitor patients BP.

Monitor patients who are also taking diuretics for symptomatic hypotension.

Assess patients renal function

Tell patient to avoid salt substitutes