Name of Drug
Levofloxacin Levaquin
Dose/ Therapeutic Dose
Classification
Action and Indication
ADULTS Antibiotic Action: Bactericidal: Interferes \u2022 with DNA by Pneumonia: 500 Fluoroquinolone inhibiting DNA synase mg daily PO or replication in IV for 7\u201314 susceptible days. gram-negative and gram-positive bacteria, preventing cell reproduction. Indications: Treatment of adults with communityacquired pneumonia, acute maxillary sinusitis caused by susceptible bacteria
Contraindication
Contraindicated with allergy to fluoroquinolones, lactation. Use cautiously with renal dysfunction, seizures, pregnancy.
Adverse Reaction
CNS: Headache, dizziness, insomnia, fatigue, somnolence, blurred vision GI: Nausea, vomiting, dry mouth, diarrhea, abdominal pain (occur less with this drug than with oflaxacin), constipation, flatulence Hematologic: Elevated BUN, AST, ALT, serum creatinine, and alkaline phosphatase; neutropenia, anemia Other: Fever, photosensitivity, muscle and tendernes
rash, joint
Nursing Responsibilities
Arrange for culture and sensitivity tests before beginning therapy. Continue therapy as indicated for condition being treated. Administer oral drug 1 hr before or 2 hr after meals with a glass of water; separate Oral drug from other cation administration, including antacids, by at least 2 hr. Ensure that patient is well hydrated during course of therapy. Discontinue drug at any sign of hypersensitivity (rash, photophobia) or at complaint of tendon pain, inflammation, or rupture. Monitor clinical response; if no improvement is seen or a relapse occurs, repeat Culture and sensitivity test.
Name of Drug
Clopidogrel Plavix
Dose/ Therapeutic Dose ADULTS Recent MI or stroke: 75 mg PO daily. Acute coronary syndrome: 300 mg PO loading dose, then 75 mg/day PO with aspirin, given at a dose from 75\u2013325 mg once daily
Classification
Action and Indication
Adenosine Therapeutic action: diphosphate Inhibits platelet (ADP) receptor aggregation by antagonist blocking ADP receptors on platelets, Antiplatelet preventing clumping of platelets. Indications
Treatment of patients at risk for ischemic events\u2014history of MI, ischemic stroke, peripheral artery disease Treatment of patients with acute coronary syndrome
Contraindication
Adverse Reaction
Contraindicated with allergy to clopidogrel, active pathological bleeding such as peptic ulcer or intracranial hemorrhage, lactation.
CNS: Headache, dizziness, weakness, syncope, flushing
Nursing Responsibilities
Use cautiously with bleeding disorders, recent surgery, hepatic impairment, pregnancy.
C V:Hypertension, edema Dermatologic:Rash ,pruritus GI: Nausea, GI distress, constipation, diarrhea, GI blee
Provide small, frequent meals if GI upset occurs (not as common as with aspirin). Provide comfort measures and arrange for analgesics if headache occurs.
Name of Drug
lansoprazole Prevacid
Dose/ Therapeutic Dose Active duodenal ulcer: 15 mg PO daily before eating for 4 wk.
For maintenance, 15 mg PO daily. Gastric ulcer: 30 mg/day PO for up to 8 wk.
Classification
Antisecretory agent Proton pump inhibitor
Action and Indication
Contraindication
Adverse Reaction
Contraindicated CNS:Headache, Action: Gastric acid-pump with dizziness, asthenia, inhibitor: Suppresses hypersensitivity to vertigo, insomnia, gastric acid secretion lansoprazole or any anxiety, by specific inhibition of its components. paresthesias, of the dream hydrogen\u2013potass Use cautiously with abnormalities ium ATPase enzyme pregnancy, system at the secretory lactation. Dermatologic: surface of the gastric Rash, parietal cells; blocks inflammation, the final step of acid urticaria, pruritus, production. alopecia, dry skin, acne Indications Short-term treatment GI: Diarrhea, (up to 4 wk) of active abdominal pain, duodenal ulcer nausea, vomiting, constipation, dry Short-term treatment mouth (up to 8 wk) of gastric ulcers Respiratory: URI symptoms, cough, Short-term treatment epistaxis (up to 8 wk) of gastroesophageal Other: Gastric reflux disease cancer in (GERD) preclinical studies, back pain, fever
Nursing Responsibilities
Administer before meals. Caution patient to swallow capsules whole, not to open, chew, or crush. If patient has difficulty swallowing, open capsule and sprinkle granules on apple sauce, Arrange for further evaluation of patient after 4 wk of therapy for acute gastro reflux disorders if symptomatic improvement does not rule out gastric cancer, which did occur in preclinical studies.
Name of Drug
Fluimucil Acetylcysteine
Dose/ Therapeutic Dose Dosage: Adults: 1 sachet of Acetylcysteine 200 mg or 2 sachets of Acetylcysteine1 00 mg, 2-3 times a day1 Acetylcysteine 600 mg effervescent tablet daily ( preferably in the evening)
For the prevention of exacerbation, the use of FLUIMUCIL 200 mg sachets is recommended.
Classification
Mucolytic agent
Action and Indication
Contraindication
Adverse Reaction
Contraindication: Indication: Treatment of MAO inhibitor respiratory affections therapy within 14 characterized by thick days initiating and viscous hyper therapy; severe secretions: acute hypertension; bronchitis, chronic severe. Coronary bronchitis and its artery disease, exacerbations; hypersensitivity to pulmonary pseudo edephrine, emphysema, acrivastine or any mucoviscidosis and component; renal bronchiectasis. impairment.
Hypersensitivity reactions have been reported in patients receiving acetylcysteine, including bronchospasm, angioedema, rashes and pruritus may occur. Other adverse effects reported include nausea and vomiting, fever, syncope, sweating, arthralgia, blurred vision, disturbances of liver function.
Mechanism of Action: Exerts mucolytic action through its free sulfhydryl group which opens up the disulfide bonds in the mucoproteins thus lowering mucous viscosity. The exact mechanism of action in acetaminophen toxicity is unknown. It is thought to act by providing substrate for conjugation with the toxic metabolite.
Nursing Responsibilities
Monitor effectiveness of therapy and advent of adverse/allergic effects. Instruct patient in appropriate use and adverse effects to report.
Name of Drug
Classification
Salmetrol+Fluti casone
Anti-asthmatic
Seretide
Action and Indication Indication: Regular treatment of reversible obstructive airway disease, including asthma where use of combination therapy is appropriate.
Maintenance treatment for COPD including chronic bronchitis and emphysema. Mechanism of Action: Selectively activates beta 2adrenergic receptors, which results in bronchodilation and blocks the release of allergic mediators from the mast cells in the respiratory tract
Contraindication
Contraindication: Contraindicated to patients with hypersensitivity to drug or any of its components. Caution to patients who are unusually responsive to sympathomimetic and patients with coronary artery insufficiency.
Adverse Reaction
Tremor, subjective palpitations and headache, cardiac arrhythmias, arthralgia, hypersensitivity reactions, oropharyngeal irritation, hoarseness, oral candidiasis, paradoxical bronchospasm.
Nursing Responsibilities
Assess patient respiratory condition before starting therapy. Assess peak flow readings before starting therapy and periodically thereafter. Be alert for adverse reactions and drug reactions Don’t give drug for acute bronchospasm. Tell patient to take the drug at about 12-hour intervals even if he is feeling better.
