GENERIC NAME: tetracycline TRADE NAME: achromycin V, panmycin, sumycin
CLASSIFICATION: broad-spectrum antiinfective
USES: syphilis, Chlamydia trachomatis, gonorrhea, lymphogranuloma venereum;
uncommon gram-positive, gram-negative organisms; rickettsial infections
DOSAGE & ROUTE: susceptible gram-positive/gram-negative infections. Adult: PO
250-500 mg q6hr. child >8yr: PO 25-50 mg/kg/day in divided doses q6hr. Chlamydia
trachomatis – adult: PO 500 mg qid x 7 days. Syphilis. Adult/adolescent: PO 500 mg qid x
2 wk; if syphilis duration > 1 yr, must treat 30 days. Brucellosis adult: PO 500 mg q6hr x 3
wk with IM 1g streptomycin bid x 1st wk, then daily x 2nd wk. urethral, endocervical,
rectal infections (C. trachomatis) adult: PO 500 mg qid x 7 days. Acne adult/adolescent:
PO 250 mg q6hr, then 125-500 mg/day or every other day. Renal dose: adult: PO CCr 51-
90 ml/min give dose q8-12hr; CCr 10-50 ml/min give dose q12-24hr; CCr <10 ml/min give
dose q24hr.
SIDE EFFECTS: CNS: fever, headache, paresthesia. CV: pericarditis. EENT: dysphagia,
glossitis, decreased calcification, discoloration of deciduous teeth, oral candidiasis, oral
ulcers. GI: nausea, abdominal pain, vomiting, diarrhea, anorexia, enterocolitis, hepatotxicity,
flatulence, abdominal cramps, epigastric burning, stomatitis, hepatitis, pseudomembranous
colitis. GU: increased BUN, azotemia, acute renal failure. HEMA: eosinophilia,
neutrophenia, thrombocytopenia, leukoctosis, hemolytic anemia. INTEG: rash, urticaria,
GENERIC NAME: Gentamicin TRADE NAME: garamycin, gentamicin sulfate, jenamicin
CLASSIFICATION: antiinfective; aminoglycoside antibiotic
USES: severe systemic infections of CNS, respiratory, GI, urinary tract, bone, sin, soft tissues caused
by susceptible strains of pseudomonas aeruginosa, proteus, klebsiella, serratia, Escherichia coli,
enterobacter, citrobacter, staphylococcus, shigella, salmonella, acinetobacter, bacillus anthracis, acute
PID
DOSAGE & ROUTE: Moderate to Severe Infection. Adult: IV/IM 1.5–2 mg/kg loading dose followed
by 3–5 mg/kg/d in 2–3 divided doses Intrathecal 4–8 mg preservative free q.d. Topical 1–2 drops of
solution in eye q4h up to 2 drops q1h or small amount of ointment b.i.d. or t.i.d. Child: IV/IM 6–7.5
mg/kg/d in 3–4 divided doses Intrathecal >3 mo, 1–2 mg preservative free q.d. Neonate: IV/IM 2.5
mg/kg q12–24h Acute Pelvic Inflammatory Disease Adult: IV/IM 2 mg/kg followed by 1.5 mg/kg q8h
Prophylaxis of Bacterial Endocarditis Adult: IV/IM 1.5 mg/kg 30 min before procedure, may repeat in 8
h Child: IV/IM < 27 kg, 2 mg/kg 30 min before procedure, may repeat in 8 hr
SIDE EFFECTS: CNS: neuromuscular blockade: skeletal muscle weakness, apnea, respiratory;
arachnoiditis 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, thrombocytopenic purpura, anemia. Other:
Local irritation and pain following IM use; thrombophlebitis, abscess, superinfections, syndrome of
hypocalcemia
NURSING CONSIDERATIONS: assess: weight before treatment; calculation of dosage is usually
based on ideal body weight, but may be calculated on actual body weight. I&O ratio, urinalysis daily
for proteinuria, cells, casts; report sudden change in urine output; toxicity is increased in patients with
photosensitivity, increased ptimentation, exfoliative dermatitis, prutitus, angioedema,
Stevens-Johnson syndrome. MISC: increased ICP, candidiasis.
NURSING CONSIDERATIONS: assess: signs of anemia: Hct, Hgb, fatigue. I&O ratio.
Blood studies: PT, CBC, AST, ALT, BUN creatinine. Allergic reactions: rash, itching,
pruritus, angioedema. Nausea, vomiting, diarrhea; administer antiemetic, antacids as
ordered. Overgrowth of infection: fever, malaise, redness, pain, swelling, drainage, perineal
itching, diarrhea, changes in cough or sputum. Administer: after C&S obtained. 2 hr before
or after iron products; hr after antacid products. Should be given on an empty stomach.
Perform/provide: storage in tight, light-resistant container at room temperature. Evaluate:
therapeutic response: decreased temp, absence of lesions, negative C&S. teach
patient/family: to avoid sun exposure; sunscreen does not seem to decrease photosensitivity.
That all prescribed medication must be taken to prevent superinfection. To avoid milk
products, antacids, or separate by 2 hr; take with a full glass of water. That tooth
discoloration may occur.
decreased renal function if high doses are given. VS during inf; watch for hypotension, change in pulse.
IV site for thrombophlepbitis, including pain, redness, swelling, q30min, change site if needed;
discontinue, apply warm compresses to site. Serum peak, drawn at 30-60 min after IV inf or 60 min
after IM inj, and trough level drawn just before next dose; blood level should be 2-4 times bacteriostatic
level; peak = 4-10 mcg/ml, trough = 0.5-2 mcg/ml. urine pH if product is used for UTI; urine should
Be kept alkaline. Renal impairment by securing urine for CCr testing, BUN, serum creatinene; lower
dosage should be given in renal impairment (CCr <80 ml/min). eighth cranial nerve dysfunction by
audiometric testing; also ringing, roaring ears, vertigo; assess hearing before, during, after treatment.
Dehydration: high specific gravity, decrease in skin turgor, dry mucous membranes, dark urine.
Overgrowth of infection including fever, malaise, redness, pain, swelling, perineal itching, diarrhea,
stomatitis, change in cough or sputum. C&S before starting treatment to identify infecting organism.
Vestibular dysfunction: nausea, vomiting, dizziness, headache; product should be discontinued if severe.
Inj sites for redness, swelling, abscesses; use warm compresses at site. Administer: IM inj in large
muscle mass; rotate inj sites. Product in evenly spaced doses to maintain blood level. Perform/provide:
adequate fluids of 2-3 L/day, unless contraindicated, to prevent irritation of tubules. Supervised
ambulation, other safety measures with vestibular dysfunction. Evaluate: therapeutic response: absence
of fever, draining wounds, negative C&S after treatment. teach patient/family: to report headache,
dizziness, symptoms of overgrowth of infection, renal impairment. To report loss of hearing, ringing,
roaring in ears, or feeling of fullness in head.
GENERIC NAME: ampicillin TRADE NAME: omnipen, principen
CLASSIFICATION: antiinfective – broad spectrum
USES: effective for gram-positive cocci (staphylococcus aureus, streptococcus
pyogenes, streptococcus faecalis, streptococcus pneumonia), gram-negative cocci
(neisseria meningitides), gram-negative bacilli (haemophilus influenza, proteus
mirabilis, salmonella, shigella, listeria monocytogenes), gram-positive bacilli
DOSAGE & ROUTE: systemic infections: adult/child ≥40kg: PO 250-500 mg
q6hr; IV/IM 2-8 g/day in divided doses q4-6hr. child <40kg: PO 50-100 mg/kg/day
in divided doses q6-8hr; IV/IM 100-200 mg/kg/day in divided doses q6-8hr.
bacterial meningitis: adult: IM/IV 500 mg=3g q6hr; max 14 g/day. Child: IM/IV
200-400 mg/kg/day in divided doses q6hr, max 12g/day. Gonorrhea (urethritis):
adult/child: ≥45kg: PO 3.5 g given with 1 g probenecid as a single dose.
Prevention of bacterial endocarditis: adult: IM/IV 2g 30 min before procedure.
Child: IM/IV 50 mg/kg 30 min prior to procedure, max 2g. GI/GU infections
other than caused by N. gonorrhoeae. Adult/child >20kg: PO 250-500 mg q6hr,
may use larger dose for more serious infections. Child ≤20 kg: PO 50-100
mg/kg/day in divided doses q6hr. renal disease–adult/child: CCr 30-50 ml/min
before product therapy; product may be taken as soon as culture is taken. Bowel
pattern before, during treatment. Skin eruptions after administration of penicillin to
1 wk after discontinuing product. Respiratory status: rate, character, wheezing,
tightness in chest. Anaphylaxis: rash, itching, dyspnea, facial swelling; stop
product, notify prescriber, have emergency edirect IV; may be diluted in 50 ml
equipment available. Administer: PO ROUTE on empty stomach, with plenty of
water for best absorption (1-2 hr before meals or 2-3 hr after meals). Shake
suspension well before each dose. IM ROUTE reconstitute by adding 0.9-1.9
ml/250-mg vial; 1.2-1.8 ml/500-mg vial; 2.4-7.4 ml/1-g vial; 68 ml/1g vial. IV
ROUTE after diluting with sterile H2O 0.9-1.2 ml/125 mg product, administer over
3-5 min (up to 500mg), 10-15 min (>500 mg) by or more of D5W, D50.45% NaCl
to concentration of 30 mg/ml or less; IV sol is stable for 1 hr; give at prescribed
rate. Perform/provide: adequate intake of fluids (2L) during diarrhea episodes.
Scratch test to assess allergy after securing order from prescriber; usually done
when penicillin is only product of choice. Evaluate: therapeutic response: absence
of temp, draining wounds, other symptoms of infections. Teach patient/family: that
tabs may be crushed; caps may be opened and mixed with water. To take oral
q6-8hr; CCr 10-30 ml/min dose q8-12hr; CCr <10 ml/min dose q12hr. biliary
tract infection (unlabeled) – adult/adolescent/child ≥20kg: IM/IV 200 mg/kg/day
in equally divided doses q3-4hr, max 14g/day. Shigellosis in AIDS patients –
adult: PO 500 mg qid x 5 days. Typhoid fever - Adult/adolescent/child: IV 100
mg/kg/day divided q6hr x 14 days or more
SIDE EFFECTS: CNS: lethargy, hallucinations, anxiety, depression, twitching,
coma, seizures, GI: nausea, vomiting, diarrhea, pseudomembranous colitis,
stomatitis. GU: oliguria, proteinuria, hemauria, vaginitis, moniliasis,
glomerulonephritis. HEMA: anemia, increased bleeding time, bone marrow
Depression, granulocytopenia, leucopenia, eosinophilia. INTEG: rash, urticaria.
MISC: anaphylaxis, serum sickness, Stevens-Johnson syndrome, toxic epidermal
necrolysis
NURSING CONSIDERATIONS: assess: I&O ratio; report hematuria, oliguria,
since penicillin in high doses is nephrotoxic. Any patient with compromised renal
system, since product is excreted slowly in poor renal system function; toxicity
may occur. Hepatic studies: AST, ALT. blood studies: WBC, RBC, Hgb and Hct,
bleeding time. Renal studies: urinalysis, protein, blood, BUN, creatinine. C&S
ampicillin on empty stomach with full glass of water. To report sore throat, fever,
fatigue, diarrhea (may indicate superinfection); report rash or other signs of allergy.
All aspects of product therapy: need to complete entire course of medication to
ensure organism death (10-14 days); culture may be taken after completed course
of medication. That product must be taken in equal intervals around the clock to
maintain blood levels. To wear or carry emergency ID if allergic to penicillins.
GENERIC NAME: linezolid TRADE NAME: zyvox
CLASSIFICATION: broad-spectrum antiinfective
USES: vancomycin-resistant enterococus faecium infections, nosocomial
pneumonia, uncomplicated or complicated skin and skin structure infections,
community-acquired pneumonia
DOSAGE & ROUTE: vancomycin-resistant enterococus faecium infections –
adult: IV/PO 600 mg q12hr x 14-28 days; max 1200 mg/day. Nosocomial
pneumonia/complicated skin infections/community-acquired
pneumonia/concurrent bacterial infection – adult: IV/PO 600 mg q12hr x 10-14
days; max 1200 mg/day. Child: birth-11yr: PO 10 mg/kg q8hr x 10-14 days.
Uncomplicated skin infections – adult: PO 400 mg q12hr x 10-14 days; max
1200 mg/day. Adolescent: PO 600 mg q12hr x 10-14 days; max 1200 mg/day.
Infant preterm <7 days old: PO 10 mg/kg q12hr x 10-14 days.
SIDE EFFECTS: CNS: headache, dizziness, insomnia. GI: nausea, diarrhea,
pseudomembranous colitis, increased ALT, AST, vomiting, taste change, tongue
color change. HEMA: myelosuppression. MISC: vaginal moniliasis, fungal
infection, oral moniliasis, lactic acidosis.
GENERIC NAME: vancomycin hydrochloride TRADE NAME: Vancocin,
Vancoled
CLASSIFICATION: Miscellaneous Antibiotic
USES: Appears to bind to bacterial cell wall, arresting its synthesis and lysing the
cytoplasmic membrane by a mechanism that is different from that of penicillins
and cephalosporins; may also change permeability of the cytoplasmic membranes
of bacteria, thus inhibiting RNA synthesis; bactericidal for most organisms and
bacteriostatic for enterococci
DOSAGE & ROUTE: PO – 0.5-2 g/day in 3-4 divided doses for 7-10 days OR 125
mg 3-4 times per day for C. difficile may be as effective as 500 mg dosage: IV –
500 mg q 6 hr or 1 g q 12 hr
SIDE EFFECTS: Oxotoxicity (including tinnitus), chills, coughing, drowsiness,
anorexia, nausea & vomiting, weakness, sore throat, fever
NURSING CONSIDERATIONS: assess: CBC with differential weekly, assess for
myelosuppression (anemias, leucopenia, pancytopenia, thrombocytopenia). For
serotonin syndrome. CNS symptoms: headache, dizziness. Hepatic studies: AST,
ALT. allergic reactions: fever, flushing, rash, urticaria, pruritus. For
pseudomembranous colitis, product should be discontinued. For lactic acidosis:
nausea, vomiting, low bicarbonate levels. Administer: PO ROUTE – with or
without food. Store reconstituted oral suspension at room temperature, use within 2
wks. IV ROUTE – 30-120 min; do not use IV inf bag in series connections; do not
use with additives in sol; do not use with another product, administer separately.
Evaluate: therapeutic response: decreased symptoms of infection, blood cultures
negative. Teach patient/family: if dizziness occurs, to ambulate, perform activities
with assistance. To complete full course of product therapy. To contact prescriber
if adverse reaction occurs. To inform prescriber if SSRIs or cold products,
decongestants are being used. To inform prescriber if there is a history of
hypertension. To avoid large amounts of high tyramine foods, drinks (provide list).
NURSING CONSIDERATIONS: Reduce dosage in renal disease; dilute each 500
mg vial with 10 mL sterile water (may further be diluted in 200 mL of dextrose or
saline solution and infused over 60 min); intermittent infusion preferred but may
also be administered with continuous IV drip; avoid rapid IV administration (may
result in hypotension, nausea, warmth, generalized tingling); aqueous solution
stable for 2 weeks; assess renal and auditory functions; report adverse drug effects
such as oxotoxicity and nephrotoxicity; during IV administration, ensure peak and
trough levels are performed at prescribed dosing interval (30 min prior and 1 hr
after dosage)
GENERIC NAME: ceftazidime TRADE NAME: Ceptaz, Fortaz, Tazicef,
Tazidime
CLASSIFICATION: Cephalosporin, third generation
USES: Only for IV or IM usage; between 80 and 90% is excreted unused in urine
DOSAGE & ROUTES: Usual infections – IM, IV: 1 g q 8-12 hr; UTIs – IM, IV –
0.25-0.5 g q 12 hr; pneumonia, mild skin infections – 0.5-1 g q 8 hr
SIDE EFFECTS: Nausea & vomiting, diarrhea, yeast infection of mouth or vagina,
abdominal pain, stomach cramps, colitis, thrombophlebitis
NURSING CONSIDERATIONS: For IM, reconstitute in sterile or bacteriostatic
water or 0.5% or 1% lidocaine injection, use large muscle mass and inject deeply;
IV route is preferred with bacterial septicemia, peritonitis, bacterial meningitis, or
other severe/life threatening infections; for direct IV, reconstitute 1 g in 10 mL
sterile water for injection (give over 3-5 min); do not give ceftazidime to solutions
containing aminoglycosides
GENERIC NAME: amoxicillin/clavulanate potassium TRADE NAME: augmentin
CLASSIFICATION: broad-spectrum antiinfective
USES: sinus infections, pneumonia, otitis media, skin infection, UTI; effective for strains of
escherichia coli, proteeus mirabilis, haemophilus influenzae, streptococcus faecalis, streptococcus
pneumoniae, and some β-lactamase-producing organisms
DOSAGE & ROUTE: adult: PO 250-500 mg q8hr or 500-875 mg q12hr depending on severity of
infection. Child ≤40 kg: PO 20-40 mg/kg/day in divided doses q8hr or 25-45 mg/kg/day in divided
doses q12hr. renal disease - adult: PO CCr <10 ml/min dose q24hr; do not use 875 mg strength or ext
rel if CCr <30 ml/min; augmentin XR is contraindicated in renal disease.
SIDE EFFECTS: CNS: headache, fever, seizures. GI: nausea, diarrhea, vomiting, increased AST, ALT,
abdominal pain, glossitis, colitis, black tongue, pseudomembranous colitis. GU: oliguria, proteinuria,
hematuria, vaginitis, moniliasis, glomerulonephrintis. HEMA: anemia, bone marrow depressin,
granulocytopenia, leucopenia, eosinophilia, thrombocytopenic purpura. INTEG: rash, urticaria,
dermatitis, toxic epidermal necrolysis. META: hypo/hyperkalemia, alkalosis, hypernatremia. SYST:
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: nystatin TRADE NAME: nystatin
CLASSIFICATION: vaginal antifungal
USES: vaginal, vulval, vulvovaginal candidiasis (moniliasis)
DOSAGE & ROUTE: adult: 100,000 units daily x 2wk.
SIDE EFFECTS: GU: vulvovaginal burning, itching, pelvic cramps. INTEG: rash,
urticaria, stinging, burning. MISC: headache, body pain
NURSING CONSIDERATIONS: assess: for allergic reaction: burning, stinging,
itching, discharge, soreness. Administer: TOPICAL ROUTE – one full applicator
every night high into the vagina. Storage at room temperature in dry place.
Evaluate: therapeutic outcome: decrease in itching or white discharge (vaginal).
Teach: about asepsis (hand washing) before, after each application. To apply with
applicator only; to avoid use of any other vaginal product unless directed by
prescriber; sanitary napkin may prevent soiling of undergarments. To abstain from
sexual intercourse until treatment is completed; reinfection and irritation may
occur. To notify prescriber if symptoms persist.
status: rate, character, wheezing, tightness in chest. Anaphylaxis: ;rash, itching, dyspnea,
facial/laryngeal edema. Administer: PO ROUTE – do not break, crush, or chew XR (ext rel) product.
Only as directed, 2 (250 mg tab) not equivalent to 1 (500 mg tab) due to strength of clavulanate. Shake
suspension well before each dose, may be used alone or mixed in drinks, use immediately, discard
unusual portion of susp after 14 days. Give around the clock. Perform/provide: adrenaline, suction,
tracheostomy set, endotracheal intubation equipment on unit. Adequate intake of fluids (2L) during
diarrhea episodes. Scratch test to assess allergy after securing order from prescriber; usually done when
penicillin is only product of choice. Storage refrigerated for 10 days. Evaluate: therapeutic response:
absence of infection. Teach patient/family: to take as prescribed, not to double dose. All aspects of
product therapy: need to complete entire course of medication to ensure organism death (10-14 days);
culture may be taken after completed course of medication. To report sore throat, fever, fatigue (may
indicate superinfection or arganulocytosis). That product must , cramping, blood in stools;
pseudomembranous colitis may occur. To use alternative contraceptive measures, if using oral
contraceptives.
GENERIC NAME: acyclovir TRADE NAME: zovirax
CLASSIFICATION: antiviral
USES: mucotaneous herpes simplex virus, herpes genitalis (HSV-1, HSV-2), varicella infections,
herpes zoster, herpes simplex encephalitis
DOSAGE & ROUTE: herpes simplex – adult: PO 200mg q4hr adult/child >12: IV INF 5 mg/kg over
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.
Neonate: IV INF 20 mg/kg over 8 hr x 14 days. Genital herpes – adult: PO 200 mg/q4hr (5x/day
while awake) for 5 days to 6 mo depending on whether initial, recurrent or chronic; IV 5 mg/kg q8hr x 5
days. Herpes simplex encephalitis - adult: IV 10 mg/kg over 1 hr q8hr x 10 days. Child 3mo-12yr: IV
20 mg/kg q8hr x 10 days. Child birth-3mo: IV 10 mg/kg q8hr x 10 days. Herpes zoster - adult: PO
800 mg q4hr while awake x 7-10 days; IV 10 mg/kg q8hr. varicella-zoster – adult: PO 1000 mg q6hr
x 5 days or 600-800 mg q4hr (5x/day while awake); IV 20 mg/kg q8hr x 5 days. Child: PO 10-20
mg/kg (max 800 mg) qid x 5 days; IV 500 mg/m2 q8hr or 10 mg/kg q8hr x 7days. Mucosal/cutaneous
herpes simplex infections in immunosuppressed patients – adult/child>12: IV 5 mg/kg q8hr x
7days. Child <12: IV 10 mg/kg q8hr x 7days.
SIDE EFFECTS: CNS; tremors, confusion, lethargy, hallucinations, seizures, dizziness, headache,
encephalopathic changes. EENT: gingival hyperplasia. GI: nausea, vomiting, diarrhea, increased ALT,
AST, abdominal pain, glossitis, colitis GU: oliguria, proteinuria, hematuria, vaginitis, moniliasis,
glomerulonephritis, acute renal failure, changes in menses, polydipsia. HEMA: thrombotic
thrombocytopenia purpura, hemolytic uremic syndrome (immunocompresed patients) INTEG: rash,
urticaria, pruritus, pain or phlebitis at IV site, unusual sweating, alopecia. MS; joint pain, leg pain,
muscle cramps.
Teach patient/family: to take as prescribed; if dose is missed, take as soon as
remembered up to 1 hr before next dose; do not double dose; that product does not
cure the condition. That product may be taken orally before infection occurs;
product should be taken when itching or pain occurs, usually before eruptions.
That sexual partners need to be told that patient has herpes; they can become
infected; condoms must be worn to prevent reinfections. Not to touch lesions to
avoid spreading infection to new sites. That product does not cure infection, just
controls symptoms and does not prevent infecting others. To report sore throat,
fever, fatigue (may indicate superinfection). That product must be taken in equal
intervals around the clock to maintain blood levels for duration of therapy. To
notify prescriber of side effects of bruising, bleeding, fatigue, malaise; may
indicate blood dyscrasias. To seek dental care during treatment to prevent gingival
hyperplasia. That women with genital herpes are more likely to develop cervical
cancer; to keep all gynecologic appointments.
NURSING CONSIDERATIONS: assess: signs of infection, anemia. Any patient with compromised
renal system since product is excreted slowly in poor renal system function; toxicity may occur rapidly.
Hepatic, reanl studies: AST, ALT; BUN, creatinine before and during treatment. Blood studies: EBC,
RBC, Hct, Hgb, bleeding time; blood dyscrasias may occur; product should be discontinued. Renal
studies: urinalysis, protein, BUN, creatinine, CCr, watch for increasing BUN and serum creatinine or
decreased CCr, may indicate nephrotoxicity; I&O ratio; report hematuria, oliguria, fatigue, wakness;
may indicate nephrotoxicity; check for protein in urine during treatment. C&S before product therapy;
product may taken as sson as culture is taken; repeat C&S after treatment; determine the presence of
other infections. Bowel pattern before, during treatment; if severe abdominal pain with bleeding occurs,
pdouct should be discontinued. Skin eruptions: rash, urticaria, itching. Allergies before treatment,
reaction of each medication; place allergies on chart in bright red letters. Neurologic status in herpes
encephalitis. Administer: PO ROUTE – do not break, crush, or chew caps. May give without regard to
meals, with 8 oz of water. Shake suspension before use. Lower dose in acute or chronic renal failure.
IV ROUTE – increased fluids to 3 L/day to decrease crystalluria. After reconstituting with 10 ml
compatible sol/500 mg of product, concentration of 50 mg/ml, shake, further dilute in 50-100l
compatible sol; use within 12 hr; give over at least 1 hr (constant rate) by infusion pump to prevent
nephrotoxicity; do not reconstitute with sol containing benzyl alcohol in neonates. Perform/provide:
storage at room temp for up to 12 hr after reconstitution; if refrigerated, sol may show a precipitate that
clears at room temperature, yellow discoloration does not affect potency. Adequate intake of fluids (2L)
to prevent deposit in kidneys. Evaluate: therapeutic response: absence of itching, painful lesions;
crusting and healed lesions; decreased symptoms of chickenpox.
GENERIC NAME: antovaquone TRADE NAME: mepron
CLASSIFICATION: antiprotozoal
USES: pneumocystis jiroveci infections in patients intolerant of
trimethoprimsulfamethoxazole, prophylaxis, toxoplasma gondii, toxoplasmosis
DOSAGE & ROUTE: acute, mild, moderate pneumocystis jiroveci pneumonia –
adult/adolescent 13-16yr: PO 750 mg with food bid for 21 days. Pneumocystis jiroveci
pneumonia, prophylaxis – adult/adolescent: PO 1500 mg/day with meal
SIDE EFFECTS: CNS: dizziness, headache, anxiety, insomnia, asthenia, fever. CV:
hypotension. GI: nausea, vomiting, diarrhea, anorexia, increased AST and ALT, acute
pancreatitis, constipation, abdominal pain. HEMA: anemia, leucopenia, neutropenia.
INTEG: pruritus, urticaria, rash, oral monilia, sweating. META: hyperkalemia,
hypoglycemia, hyponatremia. OTHER: cough
NURSING CONSIDERATIONS: assess: signs of infection, anemia. Bowel pattern before,
during treatment. Respiratory status: rate, character, wheezing, dyspnea; ABGs, chest films.
Allergies before treatment, reaction of each medication. Administer: with high-fat food
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
CLASSIFICATION: antiviral, antiparkinsonian agent
USES: prophylaxis or treatment of influenza type A, EPS, parkinsonism, Parkinson’s
disease.
DOSAGE & ROUTE: influenza type A – adult/child >12: PO 200 mg/day in single dose
or divided bid, max 400 mg/day. Geriatric: PO no more than 100 mg/day. Child 9-12: PO
100 mg bid. Child1-9: 5 mg/kg/day divided bid-tid, not to exceed 150 mg/day.
Extrapyramidal reaction/parkinsonism – adult: PO 100 mg bid, up to 400 mg/day in
EPS; give for 1 wk, then 100 mg as needed up to 400 mg in parkinsonism. Renal dose –
adult: PO CCr 40-50 ml/min 100 mg/day; CCr 30 ml/min 200 mg 2x/wk; CCr 20 ml/min
100 mg 2x/wk; CCr <10 ml/min 100 mg alternating with 200 mg q7days
SIDE EFFECTS: CNS: headache, dizziness, drowsiness, fatigue, anxiety, psychosis,
depression, hallucinations, tremors, seizures, confusion, insomnia. CV: orthostatic
hypotension, CHF, EENT: blurred vision. GI: nausea, vomiting, constipation, dry mouth,
anorexia. GU: frequency, retention. HEMA: leucopenia, agranulocytosis. INTEG:
photosensitivity, dermatitis, livedo reticularis.
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
CLASSIFICATION: antiretroviral
USES: used in combination with other antiretrovirals for HIV-1 infection, human T-
lymphotropic virus type 1 (HILV-I).
DOSAGE & ROUTE: adult :PO 600 mg/day in divided doses, either 200 mg tid or 300 mg
bid in combination with other antiretrovirals; IV 1-2 mg/kg q4hr, initiate PO as soon as
possible up to 1000 mg. child 6 wk-12yr: PO 160 mg/m2 q8hr (480 mg/m2/day, max 200 mg
q8hr) in combination with other antiretrovirals; IV same as adult. Neonate: PO 2-3
mg/kg/dose q6hr; IV 1.5 mg/kg infused over 30 min q6hr. prevention of HIV following
needle-stick – adult: PO mg tid plus lamivudine 150 mg bid, plus a protease inhibitor for
high-risk exposure; begin within 2 hr of exposure
SIDE EFFECTS: CNS: fever, headache, malaise, diaphoresis, dizziness, insomnia,
paresthesia, somnolence, chills, tremor, twitching, anxiety, confusion, depression, lability,
vertigo, loss of mental acuity, seizures. EENT: taste change, hearing loss, photophobia. GI:
nausea, vomiting, diarrhea, anorexia, cramps, dyspepsia, constipation, dysphagia, flatulence,
rectal bleeding, mouth ulcer,
abdominal pain. GU: dysuria, polyuria, urinary frequency, hesitancy. HEMA:
granulocytopenia, anemia. INTEG: rash, acne, pruritus, urticaria. MS: myalgia, arthralgia,
muscle spasm. RESP: dyspnea
Treatment. Skin eruptions, photosensitivity after administration of product. Respiratory
status: rate, character, wheezing, tightness in chest. Allergies before initiation of treatment,
reaction of each medication. Signs of infection. Livedo reticularis: mottling of t he skin,
usually red. Parkinson’s disease; gait, tremors, akinesia, rigidity. Toxicity: confusion,
behavioral changes, hypotension, seizures. Administer: before exposure to influenza;
continue for 10 days after contact. At least 4 hr before bedtime to prevent insomnia. After
meals for better absorption, to decrease GI symptoms. In divided doses to prevent CNS
disturbances: headache, dizziness, fatigue, drowsiness. Perform/provide: storage in tight,
dry container. Evaluate: therapeutic response: absence of fever, malaise, cough, dyspnea in
infection; tremors, shuffling gait in Parkinson’s disease. Teach patient/family: to change
body position slowly to prevent orthostatic hypotension. About aspects of product therapy:
need to report dyspnea, weight gain, dizziness, poor concentration, dysuria, behavioral
changes. To avoid hazardous activities if dizziness, blurred vision occurs. To take product
exactly as prescribed; parkinsonian crisis may occur if product is discontinued abruptly; to
not double dose; if a dose is missed, do not take within 4 hr of next dose; caps may be
opened and mixed with food. To avoid alcohol. Not to breastfeed.
NURSING CONSIDERATIONS: assess: blood counts q2wk; watch for decreasing
granulocytes, Hgb; if low, therapy may have to be discontinued and restarted after
hematologic recovery; blood transfusions may be required; viral load, CD4 counts baseline
and throughout. Administer: by mouth; capsules should be swallowed whole. Bid or tid.
Trimethoprim-sulfamethoxazole, pyrimethamine, or acyclovir as ordered to prevent
opportunistic infections; if these products are given, watch for nerotoxicity. IV ROUTE –
after diluting each 1 mg/0.25ml or more D5W to 4 mg/ml or less; give over 1 hr.
perform/provide: storage in cool environment; protect from light. evaluate: blood
dyscrasias (anemia, granulocytopenia): bruising, fatigue, bleeding, poor healing. Teach
patient/family: that GI complaints and insomnia resolve after 3-4 wk of treatment. That
product is not cure for AIDS but will control symptoms. To notify prescriber of sore throat,
swollen lymph nodes, malaise, fever; other infections may occur. That patient is still
infective, may pass AIDS virus on to others. That follow-up visits must be continued since
serious toxicity may occur; blood counts must be down q2wk. that product must be taken
bid or tid. That serious product interactions may occur if OTC products are ingested; check
with prescriber before taking aspirin, acetaminophen, indomethacin. That other products
may be necessary to prevent other infections. That product may cause fainting or dizziness.
GENERIC NAME: ethambutol TRADE NAME: myambutol
CLASSIFICATION: antitubercular
USES: pulmonary TB, as an adjunct, other myobacterial infections
DOSAGE & ROUTE: adult/child >13yr: PO 15-25 mg/kg/day as a single dose or
50 mg/kg 2x/wk or 25-30 mg/kg 3x/wk. renal disease – CCr 10-50 ml/min dose
24-36hr; CCr <10 ml/min dose q48hr. retreatment - adult: PO 25 mg/kd/day as
single dose x2 mo with at least 1 other product, then decrease to 15 mg/kd/day as
single dose, max 2.5 g/day. Child: PO 15 mg/kg/day
SIDE EFFECTS: CNS: headache, confusion, fever, malaise, dizziness,
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
CLASSIFICATION: antifungal
USES: histoplasmosis, blastomycosis, coccidioidomycosis, cryptococcosis, aspergillosis,
zygomycosis, candidiasis, sporotrichosis, cryptococcal meningitis; mucomycosis caused by
mucormycosis, rhizopus, absidia, entomorphthora, basidiobolus
DOSAGE & ROUTE: adult: IV give test dose of 1 mg (not required); then 0.25 mg/kg,
increase daily slowly to 0.5 mg/kg, may give 1 mg/kg/day or 1.5 mg/kg/day, alternate-day
dosing may be used. Child: IV 0.25 mg/kg infused initially, increase by 0.25 mg/kg every
other day to max of 1 mg/kg/day. Adult/child: TOP apply 2-4 x/day. Adult/child: PO 1 ml
(100 mg) qid
SIDE EFFECTS: CNS: headache, fever, chills, peripheral neuropathy, seizures, dizziness.
EENT: tinnitus, deafness, diplopia, blurred vision. GI: nausea, vomiting, anorexia, diarrhea,
cramps, hemorrhagic gastroenteritis, acute liver failure. GU: hypokalemia, azotemia,
hyposthenuria, renal tubular acidosis, nephrocalcinosis, permanent renal impairment, anuria,
oliguria. HEMA: normochromic, normocytic anemia, thrombocytopenia, agranulocytosis,
leucopenia, eosinophilia,) hypokalemia, hyponatremia, hypomagnesemia. INTEG: burning,
irritation, pain, necrosis at inj site with extravastion, flushing, dermatitis, skin rash (topical
route). MS: arthralgia, myalgia, generalized pain, weakness, weight loss. SYST: Stevens-
Johnson syndrome, toxic epidermal neurolysis, exfoliative dermatitis.
Appetite, jaundice, dark urine, fatigue. C&S, including sputum, before treatment.
Visual status: decreased activity, altered color perception. Administer: with meals
to decrease GI symptoms. Antiemetic if vomiting occurs. After C&S is completed;
q mo to detect resistance. 2 hr before antacids. Evaluate: therapeutic response:
decreased symptoms of TB, decrease in acid-fast bacteria. Teach patient/family:
to avoid alcohol products. That compliance with dosage schedule, duration is
necessary. That scheduled appointments must be kept or relapse may occur. To
report any visual changes, rash, hot, swollen, painful joints, numbness or tingling
of extremities to prescriber
NURSING CONSIDERATIONS: assess: VS q15-30min during first infusion; note changes in pulse,
B/P. I&O ration; watch for decreasing urinary output, change in specific gravity; discontinue product to
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
should be considered. For renal toxicity: increasing BUN, serum creatinine; if BUN is >40 mg/dl or if
serum creatinine >3 mg/dl, product may be discontinued or dosage reduced. For hepatotoxicity:
increasing AST, ALT, alk phos, bilirubin. For allergic reaction: dermatitis, rash; product should be
discontinued, antihistamines (mild reaction) or epinephrine (severe raction) administered. For
hypokalemia: anorexia, drowsiness, weakness, decreased reflexes, dizziness, increased urinary output,
increased thirst, paresthesias. For ototoxicity: tinnitus (ringing, roaring in ears) vertigo, loss of hearing
(rare). Administer: do not confuse four different types; these are not interchangeable: conventional
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
product is used in life-threatening infections. After diluting 50 mg/10ml steril water (no preservatives)
(5mg/1ml), shake, dilute with 500 ml of D5@ to concentration of 0.1 mg/ml. test dose of 1 mg/20ml
D5@; give over 10-30 min. perform/provide: acetaminophen and diphenhydramine 30 min prior to
infusion to reduce fever, chills, headache. Storage protected from moisture and light; diluted solution is
stable for 24hr at room temperature. Evaluate: therapeutic response: decreased fever, malaise, rash,
negative C&S for infecting organism. Teach: that long-term therapy may be needed to clear infection
(2wk-3mo depending on type of infection). To notify prescriber of bleeding, bruising, or soft tissue
swelling
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:
GENERIC NAME: TRADE NAME:
CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS:

GENERIC NAME: TRADE NAME:

CLASSIFICATION:
USES:
DOSAGE & ROUTE:
SIDE EFFECTS:
NURSING CONSIDERATIONS: