GENERIC NAME: amoxicillin/clavulanate potassium TRADE NAME: augmentin status: rate, character, wheezing, tightness in chest. Anaphylaxis: ;rash, itching, dyspnea,
CLASSIFICATION: broad-spectrum antiinfective facial/laryngeal edema. Administer: PO ROUTE – do not break, crush, or chew XR (ext rel) product.
USES: sinus infections, pneumonia, otitis media, skin infection, UTI; effective for strains of Only as directed, 2 (250 mg tab) not equivalent to 1 (500 mg tab) due to strength of clavulanate. Shake
escherichia coli, proteeus mirabilis, haemophilus influenzae, streptococcus faecalis, streptococcus suspension well before each dose, may be used alone or mixed in drinks, use immediately, discard
pneumoniae, and some β-lactamase-producing organisms unusual portion of susp after 14 days. Give around the clock. Perform/provide: adrenaline, suction,
DOSAGE & ROUTE: adult: PO 250-500 mg q8hr or 500-875 mg q12hr depending on severity of tracheostomy set, endotracheal intubation equipment on unit. Adequate intake of fluids (2L) during
infection. Child ≤40 kg: PO 20-40 mg/kg/day in divided doses q8hr or 25-45 mg/kg/day in divided diarrhea episodes. Scratch test to assess allergy after securing order from prescriber; usually done when
doses q12hr. renal disease - adult: PO CCr <10 ml/min dose q24hr; do not use 875 mg strength or ext penicillin is only product of choice. Storage refrigerated for 10 days. Evaluate: therapeutic response:
rel if CCr <30 ml/min; augmentin XR is contraindicated in renal disease. absence of infection. Teach patient/family: to take as prescribed, not to double dose. All aspects of
SIDE EFFECTS: CNS: headache, fever, seizures. GI: nausea, diarrhea, vomiting, increased AST, ALT, product therapy: need to complete entire course of medication to ensure organism death (10-14 days);
abdominal pain, glossitis, colitis, black tongue, pseudomembranous colitis. GU: oliguria, proteinuria, culture may be taken after completed course of medication. To report sore throat, fever, fatigue (may
hematuria, vaginitis, moniliasis, glomerulonephrintis. HEMA: anemia, bone marrow depressin, indicate superinfection or arganulocytosis). That product must , cramping, blood in stools;
granulocytopenia, leucopenia, eosinophilia, thrombocytopenic purpura. INTEG: rash, urticaria, pseudomembranous colitis may occur. To use alternative contraceptive measures, if using oral
dermatitis, toxic epidermal necrolysis. META: hypo/hyperkalemia, alkalosis, hypernatremia. SYST: contraceptives.
anaphylaxis, respiratory distress, serum sickness, superinfection, Stevens-Johnson syndrome
NURSING CONSIDERATIONS: assess: I&O ratio; report hematuria, oliguria since penicillin in high
doses is nephrotoxic. Any patient with a compromised renal system since product is excreted slowly in
poor renal system function; toxicity may occur. Hepatic studies: AST, ALT. blood studies: WBC,
RBC, Hgh and Hct, bleeding time. Renal studies: urinalysis, protein, blood, BUN, creatinine. C&S
before product therapy; product may be given as soon as culture is taken. Bowel pattern before, during
treatment; diarrhea, cramping, blood in stools, report to prescriber, pseudomembranous colitis may
occur. Skin eruptions after administration of penicillin to 1 wk after discontinuing product. Respiratory
GENERIC NAME: acyclovir TRADE NAME: zovirax NURSING CONSIDERATIONS: assess: signs of infection, anemia. Any patient with compromised
CLASSIFICATION: antiviral renal system since product is excreted slowly in poor renal system function; toxicity may occur rapidly.
USES: mucotaneous herpes simplex virus, herpes genitalis (HSV-1, HSV-2), varicella infections, Hepatic, reanl studies: AST, ALT; BUN, creatinine before and during treatment. Blood studies: EBC,
herpes zoster, herpes simplex encephalitis RBC, Hct, Hgb, bleeding time; blood dyscrasias may occur; product should be discontinued. Renal
DOSAGE & ROUTE: herpes simplex – adult: PO 200mg q4hr adult/child >12: IV INF 5 mg/kg over studies: urinalysis, protein, BUN, creatinine, CCr, watch for increasing BUN and serum creatinine or
1 hr q8hr x 5 days. Child <12: IV INF 250 mg/m2 or 30 mg/kg/day divided q8hr over 1 hr x 5 days. decreased CCr, may indicate nephrotoxicity; I&O ratio; report hematuria, oliguria, fatigue, wakness;
Neonate: IV INF 20 mg/kg over 8 hr x 14 days. Genital herpes – adult: PO 200 mg/q4hr (5x/day may indicate nephrotoxicity; check for protein in urine during treatment. C&S before product therapy;
while awake) for 5 days to 6 mo depending on whether initial, recurrent or chronic; IV 5 mg/kg q8hr x 5 product may taken as sson as culture is taken; repeat C&S after treatment; determine the presence of
days. Herpes simplex encephalitis - adult: IV 10 mg/kg over 1 hr q8hr x 10 days. Child 3mo-12yr: IV other infections. Bowel pattern before, during treatment; if severe abdominal pain with bleeding occurs,
20 mg/kg q8hr x 10 days. Child birth-3mo: IV 10 mg/kg q8hr x 10 days. Herpes zoster - adult: PO pdouct should be discontinued. Skin eruptions: rash, urticaria, itching. Allergies before treatment,
800 mg q4hr while awake x 7-10 days; IV 10 mg/kg q8hr. varicella-zoster – adult: PO 1000 mg q6hr reaction of each medication; place allergies on chart in bright red letters. Neurologic status in herpes
x 5 days or 600-800 mg q4hr (5x/day while awake); IV 20 mg/kg q8hr x 5 days. Child: PO 10-20 encephalitis. Administer: PO ROUTE – do not break, crush, or chew caps. May give without regard to
mg/kg (max 800 mg) qid x 5 days; IV 500 mg/m2 q8hr or 10 mg/kg q8hr x 7days. Mucosal/cutaneous meals, with 8 oz of water. Shake suspension before use. Lower dose in acute or chronic renal failure.
herpes simplex infections in immunosuppressed patients – adult/child>12: IV 5 mg/kg q8hr x IV ROUTE – increased fluids to 3 L/day to decrease crystalluria. After reconstituting with 10 ml
7days. Child <12: IV 10 mg/kg q8hr x 7days. compatible sol/500 mg of product, concentration of 50 mg/ml, shake, further dilute in 50-100l
SIDE EFFECTS: CNS; tremors, confusion, lethargy, hallucinations, seizures, dizziness, headache, compatible sol; use within 12 hr; give over at least 1 hr (constant rate) by infusion pump to prevent
encephalopathic changes. EENT: gingival hyperplasia. GI: nausea, vomiting, diarrhea, increased ALT, nephrotoxicity; do not reconstitute with sol containing benzyl alcohol in neonates. Perform/provide:
AST, abdominal pain, glossitis, colitis GU: oliguria, proteinuria, hematuria, vaginitis, moniliasis, storage at room temp for up to 12 hr after reconstitution; if refrigerated, sol may show a precipitate that
glomerulonephritis, acute renal failure, changes in menses, polydipsia. HEMA: thrombotic clears at room temperature, yellow discoloration does not affect potency. Adequate intake of fluids (2L)
thrombocytopenia purpura, hemolytic uremic syndrome (immunocompresed patients) INTEG: rash, to prevent deposit in kidneys. Evaluate: therapeutic response: absence of itching, painful lesions;
urticaria, pruritus, pain or phlebitis at IV site, unusual sweating, alopecia. MS; joint pain, leg pain, crusting and healed lesions; decreased symptoms of chickenpox.
muscle cramps.
Teach patient/family: to take as prescribed; if dose is missed, take as soon as GENERIC NAME: antovaquone TRADE NAME: mepron
remembered up to 1 hr before next dose; do not double dose; that product does not CLASSIFICATION: antiprotozoal
cure the condition. That product may be taken orally before infection occurs; USES: pneumocystis jiroveci infections in patients intolerant of
trimethoprimsulfamethoxazole, prophylaxis, toxoplasma gondii, toxoplasmosis
product should be taken when itching or pain occurs, usually before eruptions.
DOSAGE & ROUTE: acute, mild, moderate pneumocystis jiroveci pneumonia –
That sexual partners need to be told that patient has herpes; they can become adult/adolescent 13-16yr: PO 750 mg with food bid for 21 days. Pneumocystis jiroveci
infected; condoms must be worn to prevent reinfections. Not to touch lesions to pneumonia, prophylaxis – adult/adolescent: PO 1500 mg/day with meal
avoid spreading infection to new sites. That product does not cure infection, just SIDE EFFECTS: CNS: dizziness, headache, anxiety, insomnia, asthenia, fever. CV:
controls symptoms and does not prevent infecting others. To report sore throat, hypotension. GI: nausea, vomiting, diarrhea, anorexia, increased AST and ALT, acute
fever, fatigue (may indicate superinfection). That product must be taken in equal pancreatitis, constipation, abdominal pain. HEMA: anemia, leucopenia, neutropenia.
intervals around the clock to maintain blood levels for duration of therapy. To INTEG: pruritus, urticaria, rash, oral monilia, sweating. META: hyperkalemia,
notify prescriber of side effects of bruising, bleeding, fatigue, malaise; may hypoglycemia, hyponatremia. OTHER: cough
indicate blood dyscrasias. To seek dental care during treatment to prevent gingival NURSING CONSIDERATIONS: assess: signs of infection, anemia. Bowel pattern before,
during treatment. Respiratory status: rate, character, wheezing, dyspnea; ABGs, chest films.
hyperplasia. That women with genital herpes are more likely to develop cervical
Allergies before treatment, reaction of each medication. Administer: with high-fat food
cancer; to keep all gynecologic appointments. because of increased absorption of the product and higher plasma concentrations. Oral susp,
shake before using. All contents of foil pouch. Evaluate: therapeutic response: decreased
temp, ability to breathe. Teach: to take with food to increase plasma concentrations.
GENERIC NAME: amantadine TRADE NAME: symmetrel Treatment. Skin eruptions, photosensitivity after administration of product. Respiratory
CLASSIFICATION: antiviral, antiparkinsonian agent status: rate, character, wheezing, tightness in chest. Allergies before initiation of treatment,
USES: prophylaxis or treatment of influenza type A, EPS, parkinsonism, Parkinson’s reaction of each medication. Signs of infection. Livedo reticularis: mottling of t he skin,
disease. usually red. Parkinson’s disease; gait, tremors, akinesia, rigidity. Toxicity: confusion,
DOSAGE & ROUTE: influenza type A – adult/child >12: PO 200 mg/day in single dose behavioral changes, hypotension, seizures. Administer: before exposure to influenza;
or divided bid, max 400 mg/day. Geriatric: PO no more than 100 mg/day. Child 9-12: PO continue for 10 days after contact. At least 4 hr before bedtime to prevent insomnia. After
100 mg bid. Child1-9: 5 mg/kg/day divided bid-tid, not to exceed 150 mg/day. meals for better absorption, to decrease GI symptoms. In divided doses to prevent CNS
Extrapyramidal reaction/parkinsonism – adult: PO 100 mg bid, up to 400 mg/day in disturbances: headache, dizziness, fatigue, drowsiness. Perform/provide: storage in tight,
EPS; give for 1 wk, then 100 mg as needed up to 400 mg in parkinsonism. Renal dose – dry container. Evaluate: therapeutic response: absence of fever, malaise, cough, dyspnea in
adult: PO CCr 40-50 ml/min 100 mg/day; CCr 30 ml/min 200 mg 2x/wk; CCr 20 ml/min infection; tremors, shuffling gait in Parkinson’s disease. Teach patient/family: to change
100 mg 2x/wk; CCr <10 ml/min 100 mg alternating with 200 mg q7days body position slowly to prevent orthostatic hypotension. About aspects of product therapy:
SIDE EFFECTS: CNS: headache, dizziness, drowsiness, fatigue, anxiety, psychosis, need to report dyspnea, weight gain, dizziness, poor concentration, dysuria, behavioral
depression, hallucinations, tremors, seizures, confusion, insomnia. CV: orthostatic changes. To avoid hazardous activities if dizziness, blurred vision occurs. To take product
hypotension, CHF, EENT: blurred vision. GI: nausea, vomiting, constipation, dry mouth, exactly as prescribed; parkinsonian crisis may occur if product is discontinued abruptly; to
anorexia. GU: frequency, retention. HEMA: leucopenia, agranulocytosis. INTEG: not double dose; if a dose is missed, do not take within 4 hr of next dose; caps may be
photosensitivity, dermatitis, livedo reticularis. opened and mixed with food. To avoid alcohol. Not to breastfeed.
NURSING CONSIDERATIONS: assess: I&O ratio; report frequency, hesitancy; serum
BUN, creatinine baseline. Hematologic status for leucopenia, agranulocytosis. CHF
(weight gain, jugular venous distention, dyspnea, crackles). Bowel pattern before, during
GENERIC NAME: zidovudine TRADE NAME: AZT, retrovir, azidothymidine NURSING CONSIDERATIONS: assess: blood counts q2wk; watch for decreasing
CLASSIFICATION: antiretroviral granulocytes, Hgb; if low, therapy may have to be discontinued and restarted after
USES: used in combination with other antiretrovirals for HIV-1 infection, human T- hematologic recovery; blood transfusions may be required; viral load, CD4 counts baseline
lymphotropic virus type 1 (HILV-I). and throughout. Administer: by mouth; capsules should be swallowed whole. Bid or tid.
DOSAGE & ROUTE: adult :PO 600 mg/day in divided doses, either 200 mg tid or 300 mg Trimethoprim-sulfamethoxazole, pyrimethamine, or acyclovir as ordered to prevent
bid in combination with other antiretrovirals; IV 1-2 mg/kg q4hr, initiate PO as soon as opportunistic infections; if these products are given, watch for nerotoxicity. IV ROUTE –
possible up to 1000 mg. child 6 wk-12yr: PO 160 mg/m2 q8hr (480 mg/m2/day, max 200 mg after diluting each 1 mg/0.25ml or more D5W to 4 mg/ml or less; give over 1 hr.
q8hr) in combination with other antiretrovirals; IV same as adult. Neonate: PO 2-3 perform/provide: storage in cool environment; protect from light. evaluate: blood
mg/kg/dose q6hr; IV 1.5 mg/kg infused over 30 min q6hr. prevention of HIV following dyscrasias (anemia, granulocytopenia): bruising, fatigue, bleeding, poor healing. Teach
needle-stick – adult: PO mg tid plus lamivudine 150 mg bid, plus a protease inhibitor for patient/family: that GI complaints and insomnia resolve after 3-4 wk of treatment. That
high-risk exposure; begin within 2 hr of exposure product is not cure for AIDS but will control symptoms. To notify prescriber of sore throat,
SIDE EFFECTS: CNS: fever, headache, malaise, diaphoresis, dizziness, insomnia, swollen lymph nodes, malaise, fever; other infections may occur. That patient is still
paresthesia, somnolence, chills, tremor, twitching, anxiety, confusion, depression, lability, infective, may pass AIDS virus on to others. That follow-up visits must be continued since
vertigo, loss of mental acuity, seizures. EENT: taste change, hearing loss, photophobia. GI: serious toxicity may occur; blood counts must be down q2wk. that product must be taken
nausea, vomiting, diarrhea, anorexia, cramps, dyspepsia, constipation, dysphagia, flatulence, bid or tid. That serious product interactions may occur if OTC products are ingested; check
rectal bleeding, mouth ulcer, with prescriber before taking aspirin, acetaminophen, indomethacin. That other products
abdominal pain. GU: dysuria, polyuria, urinary frequency, hesitancy. HEMA: may be necessary to prevent other infections. That product may cause fainting or dizziness.
granulocytopenia, anemia. INTEG: rash, acne, pruritus, urticaria. MS: myalgia, arthralgia,
muscle spasm. RESP: dyspnea
GENERIC NAME: ethambutol TRADE NAME: myambutol Appetite, jaundice, dark urine, fatigue. C&S, including sputum, before treatment.
CLASSIFICATION: antitubercular Visual status: decreased activity, altered color perception. Administer: with meals
USES: pulmonary TB, as an adjunct, other myobacterial infections to decrease GI symptoms. Antiemetic if vomiting occurs. After C&S is completed;
DOSAGE & ROUTE: adult/child >13yr: PO 15-25 mg/kg/day as a single dose or q mo to detect resistance. 2 hr before antacids. Evaluate: therapeutic response:
50 mg/kg 2x/wk or 25-30 mg/kg 3x/wk. renal disease – CCr 10-50 ml/min dose decreased symptoms of TB, decrease in acid-fast bacteria. Teach patient/family:
24-36hr; CCr <10 ml/min dose q48hr. retreatment - adult: PO 25 mg/kd/day as to avoid alcohol products. That compliance with dosage schedule, duration is
single dose x2 mo with at least 1 other product, then decrease to 15 mg/kd/day as necessary. That scheduled appointments must be kept or relapse may occur. To
single dose, max 2.5 g/day. Child: PO 15 mg/kg/day report any visual changes, rash, hot, swollen, painful joints, numbness or tingling
SIDE EFFECTS: CNS: headache, confusion, fever, malaise, dizziness, of extremities to prescriber
disorientation, hallucinations. EENT: blurred vision, optic neuritis, photophobia,
decreased visual acuity. GI: abdominal distress, anorexia, nausea, vomiting.
INTEG: dermatitis, pruritus, toxic epidermal necrolysis. META: elevated uric acid,
acute gout, impaired hepatic function. MISC: thrombocytopenia, joint pain, bloody
sputum, anaphylaxis.
NURSING CONSIDERATIONS: Assess: hepatic studies q wk x 2 wk, then q2mo:
ALT, AST, bilirubin. Signs of anemia: Hct, Hgb, fatigue. Mental status often:
affect, mood, behavioral changes; psychosis may occur. Hepatic status: decreased
GENERIC NAME: amphotericin B desoxycholate TRADE NAME: fungizone NURSING CONSIDERATIONS: assess: VS q15-30min during first infusion; note changes in pulse,
CLASSIFICATION: antifungal B/P. I&O ration; watch for decreasing urinary output, change in specific gravity; discontinue product to
USES: histoplasmosis, blastomycosis, coccidioidomycosis, cryptococcosis, aspergillosis, prevent permanent damage to renal tubules. Blood studies: CBD, K, Na, Ca, Mg q2wk, BUN,
creatinine weekly. Weight weekly; if weight increases over 2 lb/wk, edema is present; renal damage
zygomycosis, candidiasis, sporotrichosis, cryptococcal meningitis; mucomycosis caused by
should be considered. For renal toxicity: increasing BUN, serum creatinine; if BUN is >40 mg/dl or if
mucormycosis, rhizopus, absidia, entomorphthora, basidiobolus serum creatinine >3 mg/dl, product may be discontinued or dosage reduced. For hepatotoxicity:
DOSAGE & ROUTE: adult: IV give test dose of 1 mg (not required); then 0.25 mg/kg, increasing AST, ALT, alk phos, bilirubin. For allergic reaction: dermatitis, rash; product should be
increase daily slowly to 0.5 mg/kg, may give 1 mg/kg/day or 1.5 mg/kg/day, alternate-day discontinued, antihistamines (mild reaction) or epinephrine (severe raction) administered. For
dosing may be used. Child: IV 0.25 mg/kg infused initially, increase by 0.25 mg/kg every hypokalemia: anorexia, drowsiness, weakness, decreased reflexes, dizziness, increased urinary output,
other day to max of 1 mg/kg/day. Adult/child: TOP apply 2-4 x/day. Adult/child: PO 1 ml increased thirst, paresthesias. For ototoxicity: tinnitus (ringing, roaring in ears) vertigo, loss of hearing
(100 mg) qid (rare). Administer: do not confuse four different types; these are not interchangeable: conventional
SIDE EFFECTS: CNS: headache, fever, chills, peripheral neuropathy, seizures, dizziness. amphotericin B, amphotericin B cholesteryl, amphotericin B lipid complex, amphotericin B liposome.
IV ROUTE: product only after C&S confirms organism, product needed to treat condition; make sure
EENT: tinnitus, deafness, diplopia, blurred vision. GI: nausea, vomiting, anorexia, diarrhea,
product is used in life-threatening infections. After diluting 50 mg/10ml steril water (no preservatives)
cramps, hemorrhagic gastroenteritis, acute liver failure. GU: hypokalemia, azotemia, (5mg/1ml), shake, dilute with 500 ml of D5@ to concentration of 0.1 mg/ml. test dose of 1 mg/20ml
hyposthenuria, renal tubular acidosis, nephrocalcinosis, permanent renal impairment, anuria, D5@; give over 10-30 min. perform/provide: acetaminophen and diphenhydramine 30 min prior to
oliguria. HEMA: normochromic, normocytic anemia, thrombocytopenia, agranulocytosis, infusion to reduce fever, chills, headache. Storage protected from moisture and light; diluted solution is
leucopenia, eosinophilia,) hypokalemia, hyponatremia, hypomagnesemia. INTEG: burning, stable for 24hr at room temperature. Evaluate: therapeutic response: decreased fever, malaise, rash,
irritation, pain, necrosis at inj site with extravastion, flushing, dermatitis, skin rash (topical negative C&S for infecting organism. Teach: that long-term therapy may be needed to clear infection
route). MS: arthralgia, myalgia, generalized pain, weakness, weight loss. SYST: Stevens- (2wk-3mo depending on type of infection). To notify prescriber of bleeding, bruising, or soft tissue
Johnson syndrome, toxic epidermal neurolysis, exfoliative dermatitis. swelling
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS: