Nurs 170 Drug Cards

Front 1

Azithromycin (Zithromax, AxaSite)

Back 1

prototype: Erythromycin

Classification: Macrolide antibiotic

MOA: Inhibition of the steps of protein synthesis; bactericidal

Uses: treat gram-positive and some gram-negative organisms; for clients who are allergic to penicillin; to treat respiratory infections, gonorrhea, and skin infections. AzaSite is given for bacterial conjunctivitis.

Dose:
A: PO: 250–500 mg daily
IV: 500 mg daily
C: PO: 5–10 mg/kg/d

NI: monitor for diarrhea, avoid direct sunlight, magnesium antacids 2 h before drug

Adverse effects: superinfections, vaginitis, urticaria, stomatitis, hearing loss, anorexia, n/v/d, abdominal craps, pruritus

Serious side effects: hepatotoxicity, anaphylaxis

Patient teaching: take full course of drug, side effects

Front 2

Doxycycline (Adoxa, Doxycin)

Back 2

Prototype: Tetracycline

Classification: Tatracycline antibiotic

Uses: Treatment of serious infections cause by gram positive/negative organisms and respiratory infections/disorders, chlamydial, gonorrhea, syphilis, rickettsial, inflammatory papules and pustules r/t rosacea in adults

MOA: inhibition of the steps of protein synthesis; bactericidal

Dose:
A: PO: 100 mg q12h, IV: 100-200 mg q24h
C: >8 y: PO: 4.4 mg/kg/d in 1–2 divided doses
C: >8 y: IV: 4.4 mg/kg/d daily or b.i.d.

NI: watch for painful swallowing, superinfection

Adverse effects: superinfection, n/v/d, rash, flatulence, abdominal discomfort, headache, photosensitivity, pruritus, epigastric distress, heartburn

Serious side effects: superinfection, blood dyscrasias, hepatotoxicity, nephrotoxicity, intracranial hypertension, CNS toxicity

Patient teaching: store away from light/heat, take complete course, no one < 8 should take it, side effects, avoid milk products

Front 3

Aminoglycoside
Gentamicin sulfate (Garamycin)

Back 3

Prototype: Gentamicin

Classification: Aminoglycoside antibiotic

MOA: Inhibition of bacterial protien synthesis; bactericidal

Uses: To treat serious infections caused by gram-negative organisms (e.g., Pseudomonas aeruginosa, Proteus); to treat pelvic inflammatory disease; effective against methicillin-resistant Staphylococcus aureus infections
NI: renal function, draw blood for peak serum gentamicin concentration, baseline weight/vitals, monitor I&O, watch for bacterial overgrowth

Dose:
A: IM: 3 mg/kg/d in 3–4 divided doses
IV: 3–5 mg/kg/d in 3 divided doses
C: IM/IV: 6-7.5 mg/kg q8h
TDM: 5–10 mcg/ml; peak: 10–12 mcg/ml; trough: 0.5-2 mcg/ml

Adverse effects: oliguria, urticaria, palpitation, super infection, n/v, rash, numbness, visual disturbances, tremors, tinnitus, pruitus, muscle cramps/weakness, photosensitivity

Serious side effects: ototoxicity, nephrotoxicity, thrombocytopenia, agranulocytosis, neuromuscular blockade, liver damage

Patient teaching: increase fluid intake, never take leftover antibiotics, side effects

Front 4

Levofloxacin (Levaquin)

Back 4

Prototype: Ciprofloxacin

Classification: quinolone antibiotic

MOA: Interference with the enzyme DNA gyrase (bacteria DNA synthesis); bacterialcidal

Uses: treat lower respiratory tract, renal, bone and joint infections

Dose:
A: PO: 500 mg q24h
IV: 500 mg q24h, infused over 60 min

NI: lab tests: C&S prior to starting, watch for side effects

Adverse effects: stevens-Johnson syndrome, encephalopathy, seizures, pseudomembranous colitis, dysrhythmias, n/v/d, adbdominal cramps, flatulence, headache, dizziness, fatigue, restlessness, insomnia, flushing, tinnitus, photosensitivity

Serious side effects:

Patient teaching: increase fluid intake, avoid caffeinated products, side effects

Front 5

Cefazolin (Ancef, Kefzol)

Back 5

Prototype:

Classification: 1st generation cephalosporin antibiotic

MOA: Inhibition of cell wall synthesis, causing cell death; bactericidal

Uses: To treat respiratory, urinary, and skin infections

Dose:
A: IM/IV: 250 mg-2 g q6-8h; max: 12 g/d

C: IM/IV: 25–100 mg/kg/d in 3 divided doses; max: 4 g/d


NI: drug history, monitor I&O, watch for allergic reaction, report onset of diarrhea

Adverse effects: superinfection, urticaria, anorexia, n/v/d, abdominal cramps, fever

Serious side effects: seizures, anaphylaxis

Patient teaching: childproof, avoid dairy, side effects

Front 6

Ganciclovir (Cytovene)

Back 6

Prototype: Acyclovir

Classification: antiviral agent

MOA: inhibits remplication of CMV DNA (cytomegalovirus)

Uses: CMV retinitis, prophylaxis and treatment of systemic CMV infections in immunocompromised patients including HIV positive and transplant patients.

Dose:
A: IV 5mg/kg/q12 h

NI: assess neutrophil & platelet count, inspect IV site,

Adverse effects: fever, n/d, thrombocytopenia, granulocytopenia, eosinophilia, leukopenia

Serious side effects: bone marrow suppression

Patient teaching: increase fluid intake, frequent meatologic monitoring

Front 7

diphenhydramine (Benadryl)

Back 7

Prototype:

Classification: antihistamine centrally acting cholinergic antagonist H1 receptor antagonist

MOA: Blocks histamine1 thereby decreasing allergic response; affects respiratory system, blood vessels, and GI system

Uses: To treat allergic rhinitis, itching; to prevent motion sickness; sleep aid; antitussive

Adverse Reaction: cause drowsiness, dry mouth, and other anticholinergic symptoms, whereas second-generation antihistamines have fewer anticholinergic effects and a lower incidence of drowsiness. decreased secretions, making them useful in treating rhinitis caused by the common cold. Antihistamines also decrease the nasal itching and tickling that cause sneezing.

NI: teaching client: avoid alcohol or CNS depressants, don't drive if drowsy, take as prescribed

Front 8

pseudoephedrine (Novafed, Sudafed)

Back 8

Prototype: Epinephrine

Classification: decongestant, alpha & beta adrenergic receptor agonist

MOA: stimulate the alpha-adrenergic receptors

Uses: Symptomatic relief of nasal congestion associated with rhinitis, coryza, and sinusitis and for eustachian tube congestion.

Dose:
A: PO 60 mg q 4-6 h
C: PO 15 mg q 4-6 h
G: PO 30-60 mg q6h

TR: vascular constriction (vasoconstriction) of the capillaries within the nasal mucosa. The result is shrinking of the nasal mucous membranes and a reduction in fluid secretion (runny nose).

Adverse Reaction: can result in tolerance and rebound nasal congestion (rebound vasodilation instead of vasoconstriction). Rebound nasal congestion is caused by irritation of the nasal mucosa. Might cause stroke, hypertension, renal failure, and cardiac dysrhythmias.

NI: client teaching regarding drug interactions and avoiding large amounts of caffeine (coffee, tea), because it can increase restlessness and palpitations caused by decongestants.

Front 9

beclomethasone (Beconase, Vancenase, Vanceril)

Back 9

Prototype: anti inflammatory, corticosteroid

Classification: Hydrocortisone

MOA: steroids, they have an antiinflammatory action

Uses:oral inhalation to treat steroid-dependent asthma nasal inhalation for the management of the symptoms of seasonal or perennial rhinitis

Dose:
A: 2 inhalations tid or quid
C: 1-2 inhalations per day

TR: decreasing the allergic rhinitis symptoms of rhinorrhea, sneezing, and congestion.

Adverse Reaction: dryness of the nasal mucosa may occur, short term use

NI: oral inhalation and nasal inhalation products are not to be used interchangeably

Front 10

epinephrine (Adrenalin)

Back 10

Prototype:

Classification: vasopressor, cardiac stimulant, cardiovascular agent, α- and β-adrenergic agonist

MOA: stimulates α- and β-adrenergic receptors.

Uses: temporary relief of bronchospasm, acute asthmatic attack, mucosal congestion, hypersensitivity and anaphylactic reactions

Dose:
A: SC 0.1-0.5 mg q 10-15 min
C: SC 0.01 ml/kg of 1:1000 q 10-15 min

TR: Stimulation of the α-adrenergic receptors causes vasoconstriction of peripheral blood vessels. β-Receptor stimulation relaxes bronchial smooth muscles.

AR:

NI: the nurse must carefully document vital signs and intake and output as ordered. The action of epinephrine lasts only a few minutes. For the treatment of anaphylaxis, the drug must be given parenterally (usually subcutaneously).