Generic Name: Albuterol Brand Name: Salbutamol, Proventil, Ventolin, Accuneb, airet, Novo-Salbutamol, Proventil HFA, Gen-salbutamol, Ventodisk,

Ventolin HFA, Volmax, VoSpira ER Classification: Bronchodilator (therapeutic); adrenergics (pharmacologic) Indications 1. To control and prevent reversible airway obstruction caused by asthma or chronic obstructive pulmonary disorder (COPD) 2. Quick relief for bronchospasm 3. For the prevention of exercise-induced bronchospasm 4. Long-term control agent for patients with chronic or persistent bronchospasm Mechanism of Action It relieves nasal congestion and reversible bronchospasm by relaxing the smooth muscles of the bronchioles. The relief from nasal congestion and bronchospasm is made possible by the following mechanism that takes place when Salbutamol is administered. 1. First, it binds to the beta2-adrenergic receptors in the airway of the smooth muscle which then leads to the activation of the adenyl cyclase and increased levels of cyclic- 35-adenosine monophosphate (cAMP). 2. When cAMP increases, kinases are activated. 3. Kinases inhibit the phosphorylation of myosin and decrease intracellular calcium. 4. Decreased in intracellular calcium will result to the relaxation of the smooth muscle airways. Contraindications 1. Hypersensitivity to adrenergic amines 2. Hypersensitivity to fluorocarbons Precaution 1. Cardiac disease including coronary insufficiency, a history of stroke, coronary artery diseaseand cardiac arrhythmias 2. Hypertension 3. Hyperthyroidism 4. Diabetes 5. Glaucoma 6. Geriatric patients older individuals are at higher risk for adverse reactions and may require lower dosage 7. Pregnancy especially near term 8. Lactation 9. Children less than 2 years of age because safety of its use has not been established 10. Excess inhaler use which may lead to tolerance and paradoxical bronchospasm Side Effects and Adverse Reactions 1. Nervousness 2. Restlessness 3. Tremor 4. Headache 5. Insomnia 6. Chest pain 7. Palpitations 8. Angina 9. Arrhythmias

10. Hypertension 11. Nausea and vomiting 12. Hyperglycemia 13. Hypokalemia Route and Dosage PO (Adults and Children more than 12 years): 2-4 mg 3-4 times a day or 4-8 mg of extended dose tablets twice a day. PO (Geriatric Patients): initial dose should not exceed 2 mg 34 times a day and may be increased carefully up to 32 mg/day PO (Children 6-12 years old): 2 mg 3-4 times a day or 4 mg as extended-release tablets twice a day; may be carefully increased as needed but not to exceed 24 mg/day PO (Children 2-6 years old): 0.1 mg/kg 3 times a day Inhalation (Adults and children more than 4 years of age): 2 inhalations every 4-6 hours Inhalation (Children 2-12 years old): 0.1-0.15 mg/kg/dose 3-4 times a day Nursing Interventions 1. Assess lung sounds, PR and BP before drug administration and during peak of medication. 2. Observe fore paradoxical spasm and withhold medication and notify physician if condition occurs. 3. Administer PO medications with meals to minimize gastric irritation. 4. Extended-release tablet should be swallowed-whole. It should not be crushed or chewed. 5. If administering medication through inhalation, allow at least 1 minute between inhalation of aerosol medication. 6. Advise the patient to rinse mouth with water after each inhalation to minimize dry mouth. 7. Inform the patient that Albuterol may cause an unusual or bad taste. Albuterol sulfate (Ventolin) is an antiasthmatic that In low doses, acts relatively selectively at beta2-adrenergic receptors to cause bronchodilation and vasodilation; at higher doses, beta2 selectivity is lost, and the drug acts at beta2 receptors to cause typical sympathomimetic cardiac effects. Generic Name & Brand Names Contents [hide] 1 Generic Name & Brand Names 2 Drug classes 3 Therapeutic actions 4 Indications 5 Dosages 6 Adverse effects 7 Contraindications and cautions 8 Nursing considerations o 8.1 Assessment o 8.2 Interventions o 8.3 Teaching points albuterol sulfate (al byoo ter ole) AccuNeb, Novo-Salmol (CAN), Proventil, Proventil HFA, Salbutamol (CAN), Ventodisk (CAN), Ventolin HFA Pregnancy Category C Drug classes Sympathomimetic

 Beta 2-selective adrenergic agonist Bronchodilator Antasthmatic Therapeutic actions In low doses, acts relatively selectively at beta2adrenergic receptors to cause bronchodilation and vasodilation; at higher doses, beta2 selectivity is lost, and the drug acts at beta2 receptors to cause typical sympathomimetic cardiac effects. Indications Relief and prevention of bronchospasm in patients with reversible obstructive airway disease Inhalation: Treatment of acute attacks of bronchospasm Prevention of exercise-induced bronchospasm Unlabeled use: Adjunct in treating serious hyperkalemia in dialysis patients; seems to lower potassium concentrations when inhaled by patients on hemodialysis Dosages ADULTS Oral Initially, 2 or 4 mg (12 tsp syrup) tidqid PO; may cautiously increase dosage if necessary to 4 or 8 mg qid, not to exceed 32 mg/day. Inhalation Each actuation of aerosol dispenser delivers 90 mcg albuterol; 2 inhalations q 46 hr; some patients may require only 1 inhalation q 4 hr; more frequent administration or larger number of inhalations not recommended. Prevention of exercise-induced bronchospasm: 2 inhalations 15 min prior to exercise. Solution for inhalation 2.5 mg tid to qid by nebulization. Inhalation capsules One 200 mcg capsule q 46 hr up to two 200 mcg capsules q 46 hr. Prevention of exercise-induced asthma: One 200 mcg capsule inhaled 15 min before exercise. PEDIATRIC PATIENTS Oral, tablets 612 yr: 2 mg tidqid. Do not exceed 24 mg/day. > 12 yr: Use adult dosage. Oral, syrup < 2 yr: Safety and efficacy not established. 26 yr: Initially 0.1 mg/kg tid, not to exceed 2 mg (1 tsp) tid; if necessary, cautiously increase stepwise to 0.2 mg/kg tid. Do not exceed 4 mg (2 tsp) tid. 614 yr: 2 mg (1 tsp) tidqid; if necessary, cautiously increase dosage. Do not exceed 24 mg/day in divided doses. 14 yr: Use adult dosage. Inhalation 212 yr: For child 1015 kg, use 1.25 mg; for child > 15 kg, use 2.5 mg. 12 yr: Use adult dosage. Solution for inhalation 1015 kg: 1.25 mg bid or tid by nebulization.

15 kg: 2.5 mg bid or tid by nebulization. Inhalation capsules > 4 yr: One 200 mcg capsule inhaled q 46 hr. Prevention of exercise-induced asthma: One 200 mcg capsule inhaled 15 min before exercise. Adverse effects CNS: Restlessness, apprehension, anxiety, fear, CNS stimulation, hyperkinesia, insomnia, tremor, drowsiness, irritability, weakness, vertigo, headache CV: Cardiac arrhythmias, tachycardia, palpitations, PVCs (rare), anginal pain Dermatologic: Sweating, pallor, flushing GI: Nausea, vomiting, heartburn, unusual or bad taste in mouth GU: Increased incidence of leiomyomas of uterus when given in higher than human doses in preclinical studies Respiratory: Respiratory difficulties, pulmonary edema, coughing, bronchospasm, paradoxical airway resistance with repeated, excessive use of inhalation preparations Contraindications and cautions Contraindicated with hypersensitivity to albuterol; tachyarrhythmias, tachycardia caused by digitalis intoxication; general anesthesia with halogenated hydrocarbons or cyclopropane (these sensitize the myocardium to catecholamines); unstable vasomotor system disorders; hypertension; coronary insufficiency, CAD; history of CVA; COPD patients with degenerative heart disease. Use cautiously with diabetes mellitus (large IV doses can aggravate diabetes and ketoacidosis); hyperthyroidism; history of seizure disorders; psychoneurotic individuals; labor and delivery (oral use has delayed second stage of labor; parenteral use of beta2-adrenergic agonists can accelerate fetal heart beat and cause hypoglycemia, hypokalemia, pulmonary edema in the mother and hypoglycemia in the neonate); lactation; the elderly (more sensitive to CNS effects). Nursing considerations Assessment History: Hypersensitivity to albuterol; tachyarrhythmias, tachycardia caused by digitalis intoxication; general anesthesia with halogenated hydrocarbons or cyclopropane; unstable vasomotor system disorders; hypertension; coronary insufficiency, CAD; history of CVA; COPD patients who have developed degenerative heart disease; diabetes mellitus; hyperthyroidism; history of seizure disorders; psychoneurotic individuals; lactation Physical: Weight; skin color, T, turgor; orientation, reflexes, affect; P, BP; R, adventitious sounds; blood and urine glucose, serum electrolytes, thyroid function tests, ECG Interventions Use minimal doses for minimal periods; drug tolerance can occur with prolonged use. Maintain a beta-adrenergic blocker (cardioselective betablocker, such as atenolol, should be used with respiratory distress) on standby in case cardiac arrhythmias occur.

Prepare solution for inhalation by diluting 0.5 mL 0.5% solution with 2.5 mL normal saline; deliver over 515 min by nebulization. Do not exceed recommended dosage; administer pressurized inhalation drug forms during second half of inspiration, because the airways are open wider and the aerosol distribution is more extensive. Teaching points Do not exceed recommended dosage; adverse effects or loss of effectiveness may result. Read the instructions that come with respiratory inhalant. You may experience these side effects: Dizziness, drowsiness, fatigue, headache (use caution if driving or performing tasks that require alertness); nausea, vomiting, change in taste (eat frequent small meals); rapid heart rate, anxiety, sweating, flushing, insomnia. Report chest pain, dizziness, insomnia, weakness, tremors or irregular heartbeat, difficulty breathing, productive cough, failure to respond to usual dosage. Albuterol drug study, ventolin nursing considerations, salbutamol drug study, drug study salbutamol nebulization, yhs-shopathome_001, drug study of salbutamol nebulization, drug study of salbutamol Drug Study: Salbutamol (Ventolin) Classification: Sympathomimetic Action: Stimulates beta-2 receptors of bronchioles by increasing levels of cAMP which relaxes smooth muscles to produce bronchodilation. Also cause CNS stimulation, cardiac stimulation, increased diuresis, skeletal muscle tremors, and increased gastric acid secretion. Longer acting than isoproterenol. Indication: Relief of bronchospasm in bronchial asthma, chronic bronchitis, emphysema and other reversible, obstructive pulmonary diseases. Also useful for treating bronchospasm in patients with co-existing heart disease of hypertension. Adverse Reactions: Fine skeletal muscle tremor, leg ramps, palpitations, tachycardia, hypertension, headache, nausea, vomiting, dizziness, hyperactivity, insomnia, hypotension, peripheral vasodilation, flushing, feeling of tension or nervousness and other emotional upsets. Mouth and throat irritation. Serious hypokalemia. Bronchospasm, cough, bronchitits. Heartburn, epistaxis, cough, gastrointestinal (GI) discomfort, unusual taste, dyspepsia and rash. Nursing Considerations Assessment: Assess cardio-respiratory function: BP, HR, and rhythm and breath sounds Determine history of previous medication (theophylline), and ability to self medicate to prevent additive Monitor for evidence of allergic reactions and paradoxical bronchospasm Planning: PO route Give oral administration with meals to decrease gastric irritation; oral solution for children (no alcohol, sugar) In elderly patients, a spacing device is advised

Do not crush, break, or chew extended release tablets Aerosol route Give after shaking metered dose inhaler; have patient exhale and place mouthpiece in mouth, inhale slowly while depressing inhaler, hold breath, remove inhaler, exhale slowly; allow at least 1 minute between inhalations Store in light-resistance container do not expose to temperature over 86 F ( 30 C) Nebulizer/IPPB Dilute 5 mg/mL solution/2.5 mL 0.9% NaCl for inhalation, other solution do not require dilution for nebulizer O2 flow or compressed air 6-10 L/min Implementation: Instruct patient on dosage and not use more than prescribed. If regular oral dose is missed, do not double dose. Take dose when remembered and adjust other doses on a new time schedule Teach patient to use inhaler; to avoid getting aerosol in eyes or blurring may result; to wash inhaler in warm water and dry 4 times daily; to rinse mouth after using Tell patient not to use OTC medications before consulting physician; excess stimulation may occur Instruct patient to use this medications and allow at least 5 minutes between each to prevent overstimlation Instruct patient to limit caffeine products such as chocolate, coffee, tea, and cola, avoid smoking, smoke filled rooms and persons w/ respiratory infection Tell patient to stop drug immediately of paradoxic bronchospasm occurs and notify physician In elderly patients, a spacing device is advised Evaluation: Relief of dyspnea and wheezing after 1 hour Improved airway exchange Improved ABGs

What is Ambroxol? Ambroxol is a clinically proven systemically active mucolytic agent. When administered orally onset of action occurs after about 30 minutes. The breakdown of acid mucopolysaccharide fibers makes the sputum thinner and less viscous and therefore more easily removed by coughing. Although sputum volume eventually decreases, its viscosity remains low for as long as treatment is maintained. Ambroxol Indications All forms of tracheobronchitis, emphysema with bronchitis pneumoconiosis, chronic inflammatory pulmonary conditions, bronchiectasis, bronchitis with bronchospasm asthma. During acute exacerbations of bronchitis it should be given with the appropriate antibiotic. Ambroxol Contraindications There are no absolute contraindications but in patients with gastric ulceration relative caution should be observed.

What is Sinupret Forte used for? LEVOPRONT Content: Product category: Levodropropizine Respiratory/ Cough, Cold, & Other Nasal Preparations/ Cough Suppressants (Antitussives) Yes (please see your doctor for proper supervision) Symptomatic relief of cough. For dosage information of prescription medicine, please consult with your doctor. Syr 30 mg/5 mL x 60 mL , 120 mL. Metro Pharma Phils., Inc. Sinupret Forte is recommended for the relief of sinusitis and sinus pain and the symptomatic relief of mild upper respiratory tract infections. Symptoms that may be improved with Sinupret Forte include: Blocked nose Upper respiratory tract congestion Sinus pain A feeling of pressure over the sinuses Frontal headaches Clinical trials have shown that Sinupret Forte:1-6 Unblocks sinuses improving drainage, reducing swelling and congestion Relieves sinus pain reducing inflammation, swelling and headaches Clears the head clearing congestion Sinupret Forte assists the bodys natural defences. It can be used in conjunction with antibiotic and decongestant therapy, as it has demonstrated a benefit when used together with these medications.2 Safety & efficacy Clinical trials and research evidence have demonstrated Sinupret Fortes action on the symptoms of sinusitis and mild upper respiratory tract infections. Sinupret Forte is a non-drowsy formulation. Over 30 years of research has shown that Sinupret Forte has no known drug interactions and is very well tolerated.5 Sinupret Forte's unique formulation Sinupret Forte contains a unique formulation that is clinically proven, it is the exact product used in clinical trials. This is very important for natural medicines as there can be great variance between products, even if they appear to use the same active ingredients. This is due to the part of the plant that is used, growing methods, harvesting processes and manufacturing methods. The outcomes of clinical studies for natural medicines may therefore only apply to the exact product that has been tested. Each Sinupret Forte tablet contains the following plant extracts: Rumex crispus (Yellow Dock) flower & fruit Verbena officinalis Vervain flower Sambucus nigra (Elder flower) flower Primula veris (Cowslip) flower Gentiana lutea (Gentian) root Directions & dosage Adults and adolescents 12 years and over: 1 tablet three times daily Symptomatic improvement can be expected soon after commencing Sinupret Forte and continued dosing is recommended for 1-2 weeks.

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Sinupret The unique powerful combination of herbal ingredients in Sinupret acts rapidly and reliably against the symptoms and causes of rhinitis and inflammation of paranasal sinuses. Did you know that there are over 200 different types of cold viruses? No wonder there is almost always someone around you who has a runny nose. Colds are lurking almost everywhere and at all times of the year. On average, adults get a cold or a runny nose between two and five times a year, children even more often: four to eight times a year! This means that a 75-year-old person has spent two to three years of his or her life with a runny nose, assuming that the symptoms of the cold last for five to six days each time. Although harmless, a cold is unpleasant and can fairly rapidly develop into a painful inflammation of the paranasal sinuses (= sinusitis). In such cases, fast and focused help is required. Sinupret loosens the mucus, clears and relieves Sinupret acts reliably against rhinitis as well as acute and chronic inflammations of the paranasal sinuses through its unique combination of the medicinal plants cowslip, gentian, common sorrel, elder and vervain. The thick mucus is rapidly dissolved, the swelling of the mucous membranes is reduced, you can breath freely again. Potential associated headache eases. However, Sinupret does not only act against the unpleasant and painful symptoms of the infection, but also against the causes by combating the pathogens (viruses and bacteria). Sinupret No. 1* Its high efficacy and good tolerability make Sinupret to the No.1 in Germany: the highest sales in Germany, equally appreciated by physicians, pharmacists and patients. * Source: 2011 IMS OTC Report based on turnover Sinupret loosens mucus opens the nose clears the head

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Always read the label. Use only as directed. If symptoms persist, or the condition recurs, it is important to speak with a healthcare professional. Frequently asked questions How does Sinupret Forte differ from other sinusitis medicines? Sinupret Forte is clinically proven, it is the exact product used in numerous clinical trials for over 30 years. This is very important for natural medicines as there can be great variance between products, even if they appear to use the same active ingredients. This is due to the part of the plant that is used, growing methods, harvesting processes and manufacturing methods. The outcomes of clinical studies for natural medicines may therefore only apply to the exact product that has been tested. Other herbal combinations for sinusitis cannot be expected to deliver the same results that Sinupret Forte has demonstrated in the research. - See more at: http://www.flordis.com.au/product/sinupretforte#sthash.bZS4OP3q.dpuf Content: Gentianae radix 6 mg, Primulae flos 18 mg, Rumicus herba 18 mg, Sambuci flos 18 mg, Verbenae herba 18 mg Respiratory/ Cough, Cold, & Other Nasal Preparations/ Cough & Cold Preparations, Other Yes (please see your doctor for proper supervision) Acute and chronic inflammation of the sinuses and respiratory tract. Supplementary measure in antibacterial therapy. For dosage information of prescription medicine, please consult with your doctor. Hypersensitivity to one of the active and inactive ingredients of the product. Patients with rare hereditary problems of fructose and galactose intolerance, lactase deficiency or glucose-galactose malabsorption or sucraseisomaltase insufficiency should not take Sinupret dragees. Gastrointestinal disorders: Stomach ache, nausea. Hypersensitivity reactions: Exanthema, erythema, pruritus, angioedema, dyspnea, face edema. Dragees x 100's. A. Menarini Philippines, Inc.

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ceftriaxone sodium Rocephin Pharmacologic class: Third-generation cephalosporin Therapeutic class: Anti-infective Pregnancy risk category B Action Interferes with bacterial cell-wall synthesis and division by binding to cell wall, causing cell to die. Active against gram-negative and gram-positive bacteria, with expanded activity against gram-negative bacteria. Exhibits minimal immunosuppressant activity. Adverse reactions CNS: headache, confusion, hemiparesis, lethargy, paresthesia, syncope, seizures CV: hypotension, palpitations, chest pain, vasodilation EENT: hearing loss GI: nausea, vomiting, diarrhea, abdominal cramps, oral candidiasis, pseudomembranous colitis, pancreatitis, Clostridium difficileassociated diarrhea GU: vaginal candidiasis Hematologic: lymphocytosis, eosinophilia, bleeding tendency, hemolytic anemia, hypoprothrombinemia, neutropenia, thrombocytopenia, agranulocytosis, bone marrow depression Hepatic: jaundice, hepatomegaly Musculoskeletal: arthralgia Respiratory: dyspnea Skin: urticaria, maculopapular or erythematous rash Other: chills, fever, superinfection, pain at I.M. injection site, anaphylaxis, serum sickness Patient monitoring 2Monitor for extreme confusion, tonic-clonic seizures, and mild hemiparesis when giving high doses. Monitor coagulation studies. Assess CBC and kidney and liver function test results. Monitor for signs and symptoms of superinfection and other serious adverse reactions. Be aware that cross-sensitivity to penicillins and cephalosporins may occur. Patient teaching Instruct patient to report persistent diarrhea, bruising, or bleeding. Caution patient not to use herbs unless

prescriber approves. As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above. ciprofloxacin hydrochloride Ciloxam, Cipro, Cipro I.V., Cipro XR, Ciproxin Pharmacologic class: Fluoroquinolone Therapeutic class: Anti-infective Pregnancy risk category C Action Inhibits bacterial DNA synthesis by inhibiting DNA gyrase in susceptible gram-negative and gram-positive organisms Contraindications Hypersensitivity to drug or other fluoroquinolones Comcomitant administration of tizanidine Precautions Use cautiously in: cirrhosis, renal impairment, underlying CNS disease elderly patients pregnant or breastfeeding patients children younger than age 18. Adverse reactions CNS: agitation, headache, restlessness, confusion, delirium, toxic psychosis CV: orthostatic hypotension, vasculitis EENT: nystagmus; with ophthalmic useblurred vision; burning, stinging, irritation, itching, tearing, and redness of eyes; eyelid itching, swelling, or crusting; sensitivity to light GI: nausea, vomiting, diarrhea, constipation, abdominal pain or discomfort, dyspepsia, dysphagia, flatulence, pancreatitis, pseudomembranous colitis GU: albuminuria, candiduria, renal calculi Hematologic: methemoglobinemia, agranulocytosis, hemolytic anemia Hepatic: jaundice, hepatic necrosis Metabolic: hyperglycemia, hyperkalemia Musculoskeletal: myalgia,myoclonus, tendinitis, tendon rupture Skin: rash, exfoliative dermatitis, toxic epidermal necrolysis, erythema multiforme Other: altered taste, anosmia, exacerbation of myasthenia gravis, overgrowth of nonsusceptible organisms,

hypersensitivity reactions including anaphylaxis and Stevens-Johnson syndrome Patient monitoring In patients with renal insufficiency, assess creatinine level before giving first dose and at least once a week during prolonged therapy.Monitor drug blood level closely. Watch for signs and symptoms of serious adverse reactions, including GI problems, jaundice, tendon problems, and hypersensitivity reactions. Patient teaching Tell patient to take drug 2 hours after a meal. Advise patient not to take drug with dairy products alone or with caffeinated beverages. Instruct patient to swallow microcapsules in oral suspension whole without chewing. Advise patient to drink 8 oz of water every hour while awake to ensure adequate hydration. 2Instruct patient to stop taking drug and notify prescriber at first sign of rash or tendon pain, swelling, or inflammation. Advise patient taking hormonal contraceptives to use supplemental birth control method, such as condoms, because drug reduces contraceptive efficacy. Inform breastfeeding patient that drug is excreted in breast milk and can affect infants bone growth. Advise her to consult prescriber before using drug. Teach patient how to use eye ointment or solution. Tell patient not to touch eye dropper tip to any surface, to avoid contamination. Caution patient with bacterial conjunctivitis not to wear contact lenses. As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, and herbs mentioned above. levofloxacin Iquix, Levaquin, NovoLevofloxacin_, Oftaquix , Quixin, Tavanic Pharmacologic class: Fluoroquinolone Therapeutic class: Anti-infective

Pregnancy risk category C Action Inhibits the enzyme DNA gyrase in susceptible gram-negative and gram-positive aerobic and anaerobic bacteria, interfering with bacterial DNA synthesis Adverse reactions CNS: dizziness, headache, insomnia, seizures CV: chest pain, palpitations, hypotension EENT: photophobia, sinusitis, pharyngitis GI: nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia, flatulence, pseudomembranous colitis GU: vaginitis Hematologic: lymphocytopenia Metabolic: hyperglycemia, hypoglycemia Musculoskeletal: back pain, tendon rupture, tendinitis Skin: photosensitivity Other: altered taste, reaction and pain at I.V. site, hypersensitivity reactions including Stevens-Johnson syndrome Patient monitoring Check vital signs, especially blood pressure. Too-rapid infusion can cause hypotension. Closely monitor patients with renal insufficiency. Monitor blood glucose level closely in diabetic patients. 2Assess for severe diarrhea, which may indicate pseudomembranous colitis. 2Watch for hypersensitivity reaction. Discontinue drug immediately if rash or other signs or symptoms occur. 2Watch for signs and symptoms of tendinitis or tendon rupture. Patient teaching 2Tell patient to stop taking drug and contact prescriber if he experiences signs or symptoms of hypersensitivity reaction (rash, hives, or other skin reactions) or severe diarrhea (which may indicate pseudomembranous colitis). 2Instruct patient to stop taking drug and notify prescriber immediately if tendon pain, swelling, or inflammation occurs. Instruct patient not to take with milk, yogurt,multivitamins containing zinc or iron, or antacids containing aluminum or magnesium. Teach patient proper use of eye drops. Tell him to avoid touching

applicator tip to eye, finger, or any other object. Caution patient to avoid driving and other activities that require mental alertness until CNS effects of drug are known. As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, herbs, and behaviors mentioned above.