Name of Drug

Classification

Action

Indication

Side Effects

Intervention and Evaluation

GENTAMICIN SULFATE (jen-ta-mye'sin) Garamycin, Garamycin Ophthalmic, Genoptic

ANTIINFECTIVE; AMINOGLYCOSIDE ANTIBIOTIC

Broad-spectrum aminoglycoside antibiotic derived from Micromonospora purpurea. Action is usually bacteriocidal.

Parenteral use restricted to treatment of serious infections of GI, respiratory, and urinary tracts, CNS, bone, skin, and soft tissue (including burns) when other less toxic antimicrobial agents are ineffective or are contraindicated. Has been used in combination with other antibiotics. Also used topically for primary and secondary skin infections and for superficial infections of external eye and its adnexa.

Special Senses: Ototoxicity (vestibular disturbances, impaired hearing), optic neuritis. CNS: neuromuscular blockade: skeletal muscle weakness, apnea, respiratory paralysis (high doses); arachnoiditis (intrathecal use). CV: hypotension or hypertension. GI: Nausea, vomiting, transient increase in AST, ALT, and serum LDH and bilirubin; hepatomegaly, splenomegaly. Hematologic: Increased or decreased reticulocyte counts; granulocytopenia, thrombocytopenia (fever, bleeding tendency), thrombocytopenic purpura, anemia. Body as a Whole: Hypersensitivity (rash, pruritus, urticaria, exfoliative dermatitis, eosinophilia, burning sensation of skin, drug fever, joint pains, laryngeal edema, anaphylaxis). Urogenital: Nephrotoxicity: proteinuria, tubular necrosis, cells or casts in urine, hematuria, rising BUN, nonprotein nitrogen, serum creatinine; decreased creatinine clearance. Other: Local

Lab tests: Perform C&S

and renal function prior to first dose and periodically during therapy; therapy may begin pending test results. Determine creatinine clearance and serum drug concentrations at frequent intervals, particularly for patients with impaired renal function, infants (renal immaturity), older adults, patients receiving high doses or therapy beyond 10 d, patients with fever or extensive burns, edema, obesity. Repeat C&S if improvement does not occur in 35 d; reevaluate therapy. Note: Dosages are generally adjusted to maintain peak serum gentamicin concentrations of 4 10 g/mL, and trough concentrations of 12 g/mL. Peak concentrations above 12 g/mL and trough concentrations above 2 g/mL are associated with toxicity. Draw blood specimens for peak serum gentamicin concentration 30 min1h after IM administration, and 30 min

irritation and pain following IM use; thrombophlebitis, abscess, superinfections, syndrome of hypocalcemia (tetany, weakness, hypokalemia, hypomagnesemia). Contraindication

after completion of a 3060 min IV infusion. Draw blood specimens for trough levels just before the next IM or IV dose. Use nonheparinized tubes to collect blood.

History of hypersensitivity to or toxic reaction with any aminoglycoside antibiotic. Safe use during pregnancy (category C) or lactation is not established

Name of Drug

Classification

Action

Indication

Side Effects

Intervention and Evaluation

Generic Name Penicillin G Benzathine Trade Name Penadur Minimum Dose 300,000 units IM Maximum Dose 2.4 million units IM weekly for 3 weeks Contents Benzathine benzylpenicillin Availability and color - Injection: 600,000, 1.2 million, 2.4 million units/dose

Penicillin Therapeutic Class Anti-infective, Antibiotic Pregnancy Risk Factor B

Interferes with bacterial cell wall synthesis during active multiplication, causing cell wall death and resultant bactericidal activity against susceptible bacteria. Pharmacokinetics D: Crosses placenta; enters breast milk M: Hepatic E: Urine Drug Half Life 30-60 min

- Severe infections caused by sensitive organisms (streptococci) - URTI caused by sensitive streptococci - Treatment of syphilis, bejel, congenital syphilis, pinta, yaws - Prophylaxis of rheumatic fever and chorea

CNS: Lethargy, hallucinations, seizures GI: Glossitis, stomatitis, gastritis, sore mouth, furry tongue, black hairy tongue, nausea, vomiting, diarrhea, abdominal pain, bloody diarrhea, enterocolitis, pseudomembranous colitis, nonspecific hepatitis GU: Nephritis Hematologic: Anemia, thrombocytopenia, leukopenia, neutropenia, prolonged bleeding itme Hypersensitivity: Rash, fever, wheezing, anaphylaxis Local: Pain, phlebitis, thrombosis at injection site, Jarisch-Herxheimer reaction when used to treat syphilis Other: Superinfections, sodium overload leading to heart failure -Contraindication

Before - Observe 15 rights of drug administration. - Reduce dosage with hepatic or renal failure. - Assess for hypersensitivity to drug. - Assess for any contraindications to the drug. - Educate about side effects of drug. During - Drug is not for IV use. Do not inject or mix with other IV solutions. - Give IM injection in upper outer quadrant of the buttock. - Avoid contact with the needle. - Withdraw needle as quickly as possible to avoid discomfort. - Stay with patient throughout whole duration of administration. After - Monitor client for at least 30 minutes. - Arrange for regular followup, including blood tests, to evaluate effects. - Instruct to report difficulty breathing, rashes, severe pain at injection site, mouth sores, unusual bleeding or bruising.

Routes of administration Intramuscular

Concentrations - Allergies to penicillins, cephalosporins, or other allergens

Precaution - Renal disorders - Pregnancy - Lactation Drug interaction Drug to drug - Decreased effectiveness with tetracyclines - Inactivation of parenteral aminoglycosides (amikacin, gentamicin, kanamycin, neomycin, tobramycin) Drug to food - none reported

- Instruct to take medication as directed for the full course of therapy, even if feeling better. - Do proper documentation.

Name of Drug

Classification

Action

Indication

Side Effects

Intervention and Evaluation

AMINOLEBAN Branched chain amino acid Parenteral Nutritional product a group of essential amino acids that play important roles in protein synthesis and energy production.

Improvement of the nutritional state of chronic hepatic insufficiency patients including those with hepatic encephalopath y

Hypersensitivity: rare skin eruptions. If hypersensitivity reactions occur, the solution should be discontinued. Gastrointestinal: occasional nausea and vomiting. Cardiovascular: occasional chest discomfort and palpitation. Others: occasional chills, fever, headache and vascular pain. - Contraindication contraindicate d in patients with severe renal impairment and abnormal amino acid metabolism other than hepatic disorders.palpitation. Others: occasional chills, fever, headache and

Since elderly patients often have reduced physiological function, it is advisable to take such measures as reducing the dose by decreasing the infusion. If the patient develops hypoglycemia, glucose should be administered promptly by intravenous infusion. In addition, appropriate nutrition management is recommended in such patients. If adverse reactions are observed, discontinue the administration, and institute appropriate treatment.

Name of Drug

Classification

Action

Indication

Side Effects

Intervention and Evaluation

Generic Name:Lactulose(laktyoolose) Brand Name:Cephulac, Chronulac ,Movelax,Lilac Pregnancy Category:C Availability 10 g/15 mL solution, syrup

Classifications:gastrointestinal agent; hyperosmotic laxative

Reduces blood ammonia; appears to involve metabolism of lactose to organic acids by resident intestinal bacteria.

Constipation, salmonellosis. Treatment of hepatic encephalopathy.

GI:Flatulence,borborygmi,belching,abdominal cramps,pain,and distention (initial dose);diarrhea (excessive dose); nausea, vomiting, colon accumulation of hydrogen gas; hypernatremia.

Assessment Assess patients condition before therapy and reassess regularly thereafter to monitor drugs effectiveness. Identify cause of constipation: bulk and exercise For patient with hepatic encephalopathy, regularly assess mental condition (clearing

Assess lifestyle in relation to fluids,

of confusion, lethargy, restlessness 70 mg/100 mL). Monitor for possible adverse GI reaction: nausea, vomiting, abdominal cramps, belching, diarrhea, flatulence and distension. Monitor fluid and electrolyte status: urine output, input-output ratio to hypernatremia. Monitor for patients. Assess patients and familys knowledge of drug therapy. - See more at: study-lactulose-duphalaclilac/#sthash.rCkqDN5F.dpuf

irritability) and ammonia level (30-

identify fluid loss, hypokalemia and

increased glucose levels in diabetic

http://www.nursehussein.com/drug

Name of the drug

Classification

Generic Name : Somatostatin

Adult: IV The recommended dose is 250 mcg as a bolus injection, then infuse at 3.5 mcg/kg/hour until bleeding has ceased.

Classification : Hormones

Action This medication is a peptide hormone, prescribed for gastrointestinal hemorrhage.

indication

It is a synthetic cyclic tetradecapeptide having the structure of the hypothalamic hormone that inhibits the release of growth hormone. It is also known as growth hormone-inhibiting hormone(GHIH). Somatostatin (also known as growth hormone-inhibiting hormone (GHIH) or somatotropin releaseinhibiting factor (SRIF)) is a peptide hormone that regulates the endocrine system and affects neurotransmission and cell proliferation

Side Effects Abdominal discomfort, nausea, flushing and slow heart rate.

Intervention

via interaction with Gprotein-coupled somatostatin receptors.