ATI (Unit 2) Antiinfectives -

N203 ATI (Unit 2) Antiinfectives -

N203 ATI (Unit 2) Antiinfectives -

N203 ATI (Unit 2) Antiinfectives -

N203 ATI (Unit 2) Antiinfectives -

N203 ATI (Unit 2) Antiinfectives -

N203 ATI (Unit 2) Antiinfectives -

N203 ATI (Unit 2) Antiinfectives -

N203 ATI (Unit 2) Antiinfectives -

N203 ATI (Unit 2) Antiinfectives -

N203 ATI (Unit 2) Antiinfectives -

N203 ATI (Unit 2) Antiinfectives -

Demerol; Meperidine
Analgesic, Narcotic

Route/Dose: Oral, I.M., I.V.: S.C.: 50-150 mg/dose every 3-4 hours PRN Expected Action:

Binds to opiate receptors in the CNS, causing inhibition of ascending pain pathways, altering the perception of and response to pain; produces generalized CNS depression
Therapeutic Uses:

Management of moderate to severe pain; adjunct to anesthesia and preoperative sedation

Adverse Effects:

Hypotension Central nervous system: Fatigue, drowsiness, dizziness. Nausea, vomiting, constipation Weakness. Histamine release. Nervousness, headache, restlessness, malaise, confusion
Implications: If I.V. administration is required, inject very slowly using a diluted solution; administer over at least 5 minutes; intermittent infusion: dilute to 1 mg/mL and administer over 15-30 minutes; dilute to less than or equal to 10 mg/mL for intermittent I.V. use Education:
May cause physical and/or psychological dependence. While using this medication, do not use alcohol and other prescription or OTC medications (especially sedatives, tranquilizers, antihistamines, or pain medications) without consulting prescriber. May cause hypotension, dizziness, drowsiness, impaired coordination, or blurred vision

Ativan; Lorazepam
Classification:Benzodiazepine. Therapeutic class: Anxiolytic

Expected Action: Therapeutic Uses:

Route/Dose: PO-1-3 mg. IM-0.02-0.09mg/kg

Depresses the CNS, probably by potentiating GABA, an inhibitory neurotransmitter

Anxiety disorder (oral). Preoperative sedation (injection). Decreases preoperative anxiety and provides amnesia. Antiemetic prior to chemotherapy Insomnia, panic disorder, as an adjunct with acute mania or acute psychosis

Adverse Effects:
dizziness, drowsiness, lethargy, hangover, headache, ataxia, slurred speech, forgetfulness, confusion, mental depression, rhythmic myoclonic jerking in pre-term infants, paradoxical excitation. Blurred vision. Respiratory depression. Rapid IV use onlyapnea, cardiac arrest, bradycardia, and hypotension. Constipation, diarrhea, nausea, vomiting, weight gain (unusual). Rashes. Physical dependence, psychological dependence, tolerance.

Implications:
Conduct regular assessment of continued need for treatment. Assess geriatric patients carefully for CNS reactions as they are more sensitive to these effects. Assess falls risk. Patients on high-dose therapy should receive routine evaluation of renal, hepatic, and hematologic function.

Education:
Instruct patient to take medication exactly as directed and not to skip or double up on missed doses. If medication is less effective after a few weeks, check with health care professional; do not increase dose Advise patient that lorazepam is usually prescribed for short-term use and does not cure underlying problem Advise patient to taper lorazepam by 0.05 mg q 3 days to decrease withdrawal symptoms; abrupt withdrawal may cause tremors, nausea, vomiting, and abdominal and muscle cramps Teach other methods to decrease anxiety, such as increased exercise, support groups, relaxation techniques. Emphasize that psychotherapy is beneficial in addressing source of anxiety and improving coping skills

Darvocet; Propoxyphene napsylate

Classification: opiod analgesic

Expected Action:

Dose/Route: PO- proxyphene 50-100mg/acetaminophen 325500mg,

Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli, while producing generalized CNS depression.
Therapeutic Uses:

Treatment of mild to moderate pain

Adverse Effects:

Gastrointestinal: Nausea, vomiting. Weakness. Psychologic and physical dependence

Implications:

Monitor pain relief, respiratory and mental status, blood pressure, excessive sedation
Education:

Caution patient to avoid drinking grapefruit juice during propoxyphene therapy. Advise patient to change positions slowly to minimize orthostatic hypotension.

Compazine; Prochlorperazine
Classification: antiemetic, antipsychotic pharm.- phenothiaizine

Expected Action:

Dose/Route: PO: 5-10mg. IM: 5-10mg. IV: 2.5-10mg

Alters the effects of dopamine in the CNS. Possesses significant anticholinergic and alpha-adrenergic blocking activity. Depresses the chemoreceptor trigger zone in the CNS.

Therapeutic Uses:

Management of nausea and vomiting. Treatment of psychoses. Treatment of anxiety.

Adverse Effects:

extrapyramidal reactions, blurred vision, dry eyes, dry mouth, constipation, rashes, discoloration of urine, neuroleptic malignant syndrome, agranulocytosis
Implications:

Avoid skin contact with oral solution or injection, contact dermatitis has occurred; observe for extrapyramidal symptoms
Education:

Take exact amount as prescribed. Do not change brand names. Do not crush or chew tablets or capsules. Avoid skin contact with drug; wash immediately with warm soapy water. You may experience appetite changes; small frequent meals may help. Maintain adequate fluid intake (2-3 L/day of fluids unless instructed to restrict fluid intake). May cause dizziness, tremors, or visual disturbance; use caution when driving or engaging in tasks that require alertness until response to drug is known. Do not change position rapidly

Colace; docusate sodium docusate calcium

Classification: laxative, stool softener

Dose/Route: PO: 50-400mg Rectal(Adults):50-100mg or 1 unit containing 283 mg Expected Action:

docusate sodium, soft soap, and glycerin
Promote incorporation of water not stool, resulting in softer fecal mass. May also promote electrolyte and water secretion into colon

Therapeutic Uses:
Soften stool, prevent constipation

Adverse Effects:
Throat irritation, mild cramps, rashes, abdominal pain, nausea, or vomiting, especially associated with fever or other signs of an acute abdomen

Implications:
Assess for abdominal distention, presence of bowel sounds, and usual pattern of bowel funcition. Assess color, consistency, and amount of stool produced.

Education:
Dont use for long-term, encourage patients to use other forms of bowel regulation, do not use laxatives when abdominal pain, nausea, vomiting, or fever is present, do not take within 2 hours of other laxatives.If cardiac patient- do not strain during bowel movements, teach about other forms of bowel regulation

Ciprofloxacin; Cipro
Classification Therapeutic: anti-infectives Pharmacologic: fluoroquinolones

Expected Action:

Dose/Route: PO: 500750 mg q 12 hr. IV: 400 mg q 12 hr. Bactericidal by inhibition of enzyme needed for DNA

Therapeutic Uses:
Urinary tract and gynecologic infections, including cystitis, gonorrhea, and prostatitis, Respiratory tract infections including acute sinusitis, acute exacerbations of chronic bronchitis, and pneumonia, Skin and skin structure infections , Bone and joint infections , Infectious diarrhea , Complicated intra-abdominal infections (with metronidazole), Typhoid fever. Post-exposure prophylaxis of inhalational anthrax. Cutaneous anthrax.

Adverse Effects:
SEIZURES, dizziness, drowsiness, headache, insomnia agitation, confusion. PSEUDOMEMBRANOUS COLITIS, abdominal pain, diarrhea, abnormal liver enzymes, nausea. GU: vaginitis. Photosensitivity, rash. Hyperglycemia, hypoglycemia. Eosinophilia. Local: phlebitis at IV site. MS: tendinitis, tendon rupture. Peripheral neuropathy. Hypersensitivity reactions including: ANAPHYLAXIS.

Implications:
Instruct patient to notify health care professional if fever and diarrhea develop, especially if stool contains blood, pus, or mucus. Advise patient not to treat diarrhea without consulting health care professional. Instruct patient to notify health care professional immediately if rash, jaundice, signs of hypersensitivity, or tendon (shoulder, hand, Achilles, and other) pain, swelling, or inflammation occur. If tendon symptoms occur, avoid exercise and use of the affected area. Increased risk in >65 yrs old, kidney, heart and lung transplant recipients, and patients taking corticosteroids concurrently. Therapy should be discontinued.

Education:
Instruct patient to take medication as directed at evenly spaced times and to finish drug completely, even if feeling better. Encourage patient to maintain a fluid intake of at least 15002000 ml/day to prevent crystalluria. Advise patient that antacids or medications containing calcium, magesium, aluminum, iron, or zinc will decrease absorption and should not be taken within 4 hr before and 2 hr after taking this medication. May cause dizziness and drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.

Aspirin; Acetylsalicylic acid

Classification: antipyretics, nonopioid analgesics Pharmacologic: salicylates

Expected Action:
Decrease platelet aggregation.

Dose/Route: PO: 81mg-975mg. Suppository: 60mg-1.2g

Therapeutic Uses:
arthritis, osteoarthritis, mild to moderate pain, Fever. with other NSAID's, bleeding disorders, thrombocytopenia, perioperative pain. Prophylaxis of transient ischemic attacks and MI from coronary artery bypass graft surgery.

Adverse Effects:
Hearing loss, tinnitus, GI bleeding, dyspepsia, epigastric Decreased platelet aggregation. distress, heartburn, nausea, abdominal pain, anorexia, hepatotoxicity, vomiting Analgesia, reduction of inflammation, reduction of fever, Exfoliative dermatitis, Stevens-Johnson syndrome, Toxic epidermal necrolysis.decreased incidence of transient ischemic attacks and MI anemia, hemolysis, increased bleeding time. Allergic reactions including anaphylaxis and laryngeal edema. Non cardiogenic pulmonary edema.

Implications:
Instruct patient to take salicylates with a full glass of water and to remain in an upright position for 1530 min after administration. Advise patient to report tinnitus; unusual bleeding of gums; bruising; black, tarry stools; or fever lasting longer than 3 days. Caution patient to avoid concurrent use of alcohol with this medication to minimize possible gastric irritation; 3 or more glasses of alcohol per day may increase the risk of GI bleeding. Caution patient to avoid taking concurrently with acetaminophen or NSAIDs for more than a few days, unless directed by health care professional to prevent analgesic nephropathy.

Education:

Instruct patient to take salicylates with a full glass of water and to remain in an upright position for 1530 min after administration. Advise patient to report tinnitus; unusual bleeding of gums; bruising; black, tarry stools; or fever lasting longer than 3 days. Caution patient to avoid concurrent use of alcohol with this medication to minimize possible gastric irritation; Renal damage limited by infusing 1 L NS on day of amphotericin infusion

Ancef; Cefazolin
Classification: anti-infectives

Expected Action: Therapeutic Uses:

Dose/Route: IM or IV: 250mg-2g

Binds to bacterial cell wall membrane, causing cell death. Bactericidal action against susceptible bacteria. Treatment of the following infections due to susceptible organisms: Skin and skin structure infections (including burn wounds), Pneumonia, Urinary tract infections, Biliary tract infections, Genital infections, Bone and joint infections,

Adverse Effects:
Seizures (high doses), Pseudomembranous colitis, diarrhea, nausea, vomiting, cramps, Interstitial nephritis, Rashes, urticarial, Blood dyscrasias, hemolytic anemia, Pain at IM site, phlebitis at IV site, Allergic reactions including Anaphylaxis and Serum sickness, superinfection

Implications:
Observe patient for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Discontinue drug and notify health care professional immediately if these problems occur. Keep epinephrine, an antihistamine, an resuscitation equipment close by in case of an anaphylactic reaction. Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of pseudomembranous colitis. May begin up to several weeks following cessation of therapy

Education:
This drug is administered I.V. or I.M. Drink 2-3 L fluid/day. If diarrhea occurs, yogurt or buttermilk may help. May interfere with oral contraceptives; additional contraceptive measures are necessary. Report severe, unresolved diarrhea; vaginal itching or drainage; sores in mouth; blood, pus, or mucus in stool or urine; easy bleeding or bruising; unusual fever or chills; rash; or respiratory difficulty.