1

Generic:
Ordered:
Paracetamol Give 1 tab
by mouth
Brand:
3x a day.
Tylenol
(Tylenol
650 mg tab)
Classification:
Timing:
Analgesics 8 am
( Non1 pm
opioid)
7 pm
Antipyretics
Duration:
4-6 hours

Indications:
Temporary relief
of pain and
discomfort from
headache, fever,
cold, flu, minor
muscular aches,
overexertion,
menstrual cramps,
toothache, minor
arthritic pain.

Mechanism of
Action:
Paracetamol may
Other
cause analgesia by
forms:
inhibiting CNS
>Caplets:
prostaglandin
165 mg,
synthesis. The
500 mg,
mechanism of
650 mg
morphine is
>Caplets
believed to
ER: 650 mg involve decreased
>Capsules: permeability of the
5oo mg
cell membrane to
>Elixir: 80 sodium, which
mg/2.5 mg, results in
80 mg/5 ml, diminished
120 mg/5
transmission of
ml
pain impulses
>Gelcaps:
therefore
500 mg
analgesia.

Adverse Reaction
Hematologic:
hemolytic anemia,
leukopenia,
neutropenia,
pancytopenia,
thrombocytopenia.
Hepatic:
liver damage,
jaundice
Metabolic:
hypoglycemia
Skin: rash, urticuria
Interactions:
Barbiturates,
carbamapezine,
hydantoins,
isoniazid, rifampin,
sulfinpyrazone:
May reduce
therapeutic effect
and enhance
hepatotoxic effects
of acetaminophen
with high doses or
long-term use of
these drugs. Avoid
use together.
Lamotrigine: Serum
lamotrigine
concentrations may

ASSESSMENT
1. Assess patients
pain or temperature
before therapy and
regularly thereafter.
(Students Drug
Handbook, 2009:
101)
2, Asses patients
drug history and
calculate total daily
dosage accordingly.
(Students Drug
Handbook, 2009:
101)
3. Be alert for signs
of reactions
and drug
interactions.
(Students Drug
Handbook, 2009:
101)
4. Assess patients
and familys
knowledge of drug
therapy.
(Students Drug
Handbook, 2009:
101)

1. To indicate
baseline data and
monitor drugs
effectiveness.

2. To prevent over
dosage that could
lead to toxicity
and liver damage.

3. To establish
proper
precautionary
measures and
management for
possible adverse
effects of drug.
4. To determine
the level of
understanding of
the patient and
her family about
the drug therapy

1. Tell patient not

to use drug for
fever thats higher
than 103.1 F,
lasts longer than 3
days, or recurs.
2Warn patient that
high doses or
unsupervised
long-term use can
cause liver
damage.
3. Tell patient to
keep track of
daily drug intake,
including OTC
and prescription
medications.
4. Tell a breastfeeding woman
that drug appears
in breast milk in
levels less than
1% of dose.

Generic &
Brand
Name

>Geltab:
500 mg

be reduced and may

decrease therapeutic
effects.
Warfarin: May
increase
hypoprothrombinemic effect with
long-term use of
high doses. Monitor
PT and INR closely.
Zidovudine: May
increase risk of
bone marrow
suppression because
of impaired
zidovudine
metabolism.
Monitor patient
closely.

Dose,
Indication/
Strength & Mechanisms Of
Formulation Drug Action

Adverse/ Side
Effects Drug
Interactions

Nursing
Responsibilities

Adverse Reaction
CNS: Agitation,
anxiety behavioral
changes, confusion,
dizziness, insomnia.
GI: Abdominal
pain, black hairy
tongue, diarrhea,

ASSESSMENT
1. Assess patients
infection, ask about
past allergic
reactions before
therapy and
regularly thereafter.
(Students Drug

Generic:
Ordered:
CoGive 1 tab
Amoxiclave by mouth
3x a day.
Brand:
(Natravox
Augmentin 625 mg tab)
Classificati-

Timing:

Indications:
Respiratory tract,
GUT, abdominal,
skin and soft
tissues infection.
Mechanism of
Action:

NURSING
DIAGNOSES
Acute pain related
to patients
underlying
condition.
Risk for injury
related to druginduced liver
damage with toxic
doses.
Deficient
knowledge related
to drug therapy.

Rationale

Client Teaching

1. To indicate
baseline data and
monitor drugs
effectiveness.

1. Tell patient to
take entire
quantity of drug
exactly as
prescribed, even
after he feels
better.

on:
Penicillins

8 am
1 pm
7 pm
Duration:
6-8 hr
Other
forms:
Chewable
Tablets: 25
mg
amoxicillin,
31.25 mg
clavulanic
acid; 200
mg
amoxicillin,
62.5 mg
clavulanic
ER tablets:
1000 mg
amoxicillin,
62.5
clavulanic
acid
Tablets
(filmcoated):
250 mg
amoxicillin,
125 mg
clavulanic

Prevents bacterial
cell-wall synthesis
during replication.
Clavulanic acid
increase
amoxicillins
effectiveness by
inactivating beta
lactamases, which
destroy
amoxicillin.

enterocolitis,
gastritis, glossitis,
indigestion, nausea.
GU: Vaginal
candidiasis,
vaginitis.
Hematologic:
Agranulocytosis,
anemia,
eosinophilia,
leucopenia.
Other:
Hypersensitivity
reactions,
angioedema,
pruritus, rash,
urticaria.

Interactions:
Drug-drug
Allopurinol: May
cause rash. Monitor
patient.
Probenecid: May
increase level of
amoxicillin and
other penicillins.
Probenecid may be
used for this

Handbook, 2009:
147)
2, Asses patients
drug history and
calculate total daily
dosage accordingly.
(Students Drug
Handbook, 2009:
147)
3. Be alert for signs
of reactions
and drug
interactions.
(Students Drug
Handbook, 2009:
147)
4. Monitor
hydration status if
adverse GI
reactions occur.
(Students Drug
Handbook, 2009:
147)
5. Assess patients
and familys
knowledge of drug
therapy.
(Students Drug

2. Tell patient to
call prescriber if
2. To prevent over rash develops
dosage that could (sign of allergic
lead to toxicity
reaction).
and liver damage.
3. Instruct patient
to take drug with
food to prevent
3. To establish
GI distress.
proper
precautionary
measures and
management for
possible adverse
effects of drug.
4. To prevent
complications
such as diarrhea.
5. To determine
the level of
understanding of
the patient and
her family about
the drug therapy

acid; 500
mg
amoxicillin,
125 mg
clavulanic
acid

purpose.

Handbook, 2009:
147)
NURSING
DIAGNOSES
Ineffective
protection related to
presence of
susceptible
bacteria.
Risk for deficient
fluid volume
related to druginduced adverse GI
reactions.
Deficient
knowledge related
to drug therapy.

Generic:

Cefuroxim
e

Ordered:

Indication:

CEFUROXIM
E

-Serious lower
respiratory
tract infection,
UTI, skin or skin
structure
infections,
bone/ joint
infection,
septicemia
meningitis and
gonorrhea.

250mg
IVTT
q8hrs

Brand:
Ceftin

Timing:
q8 hrs.

Duration:
immediate.

Classificat
ion:
Second
generatio
n
cephalosp
orin,

Other
Form:

Suspension
:
125mg/5ml

-Perioperative
prevention
- Bacterial
exacerbations
of chronic
bronchitis/
secondary
bacterial
infection of
acute
bronchitis
-Acute bacterial
maxillary
sinusitis
-Pharyngitis &

Side Effects:

CNS: dizziness,
headache,
insomnia, stroke
CV: hypertension,
MI, peripheral
edema
EENT: Pharyngitis,
rhinitis, sinusitis
GI: Abdominal
pain, diarrhea,
dyspepsia,
flatulence, nausea,
GI bleeding
METABOLIC:
Hyperchloremia,
hypophosphatemia
MUSCULOSKETETA
L:

-Assess patients
infection before therapy
and regularly
thereafter.

-Before giving the first

dose, obtain specimen
for culture and
sensitivity test.

-To ensure right drug.

-Before giving first

dose, ask patient about
previous reactions to
cephalosporin and
penicillin.

-to avoid cross sensitivity

with other betalactamantibiotics

-Be alert for adverse

reaction and drug
interaction.

-To establish proper

precautionary measures
and management for
possible adverse effects
of the drug.

Back pain
RESPIRATORY:
Upper respiratory
tract infection

-To monitor drugs

effectiveness.

-If GI reactions
occur,monitor patients
hydration.

-To prevent dehydration .

7
antibiotic

, 250 mg/5
ml
Infusion ;
750 mg,
1.5
premixed,
frozen
solution
Injection:
750 mg,
1.5. mg
Capsules;
50 mg, 100
mg, 200
mg, 400
mg:

tonsilities

SKIN:

-Otits media

-Uncomplicated
UTI

Erythema,
multiforme,
exfoliative
dermatitis, rash,
Stevens- Johnson
syndrome, toxic
epidermal
necrolysis

-Uncomplicated
gonorrhea

OTHER:

-Uncomplicated
skin & skinstructure
infection

-Early lyme
disease

Accidental injury

-Impetigo
INTERACTIONS

MECHANISM OF
ACTION;

Chemical
effect: May

Drug-drug
Diuretics ; may
increase risk of
adverse renal
reactions . Monitor
renal function
closely.
Probenecid: may
inhibit excretion &
increase level of

8
selectively
inhibit COX 2
decreasing
prostaglandin
synthesis

Therapeutic
effect; Relieves
pain &
inflammation in
joints and
smooth muscle
tissue.

cefuroxime.
Sometimes used
for this effect.
Drug-food: Any
food: May increase
drug adsorption &
bioavailability of
suspension. Give
suspension with
food. Tablets may
begin without
regard to food.
-Before giving
dose, obtain
specimen for
culture &
sensitivity tests.
Begin therapy
pending test
results.
-Before giving the
first dose, ask the
pt. about previous
reactions to.

Generic
Name
Brand
Name
Butamirate
citrate/
Sinecod
Forte

Classifica
tion

Cough & Cold

Preparations

Mechanisms
Of Action

Act centrally (on

brain, and
specifically the
vagus nerve) or
locally (on the
respiratory tract) to
suppress the cough
reflex

Dose/
Frequenc
y
1 tab TID

Indicati
on

Advers
Nursing
e
Considerations
Reactio
ns

Acute
cough of
any
etiology

CNS:
dizziness.
GI: Nausea
and
vomiting,
diarrhea.
Skin: rash

Assess cough type

and frequency
Monitor the adverse
reactions
Assess patients VS
Assess sleep pattern.

Teach patient:
If cough persist 10
days + fever or chest
pain check with
Doctor.

Dont exceed
recommended dose

10

Drink fluids but not

immediately after
dose.

Since the drug may

cause dizziness or
drowsiness, caution
patient to avoid
driving or other
activities requiring
alertness until
response to
medication is known.
Advise patient to
minimize cough by
avoiding irritants
(cigarette smoke,
fumes, Dust)

Instruct patient to
cough effectively, sit
upright and take
several deep breaths
before attempting.

11

IMMUNOPRO RX (Biomolecular Sciences)

Description
ImmunoPro Rx is a proprietary whey protein concentrate, derived from hormone treatment free milk. It provides
biologically active protein fractions that assist the body in maintaining levels of glutathione (GSH) and support the
immune system. ImmunoPro Rx contains high levels of naturally occurring Lactoferrin, Immunoglobulins and
Bovine Serum Albumin. Lactoferrin has been shown to have anti-microbial, anti-viral and anti-fungal effects. The
protein fractions in ImmunoPro Rx contain exceptional amounts of cysteine and glutamine (glutamate), the
precursors required for the production of intracellular GSH.
KEY FACTS
GSH is a tripeptide composed of the three amino acids glutamate, cysteine and glycine. ImmunoPro Rx is a
primary product, not a by-product of cheese manufacturing. The full range of protein fractions are maintained in
their original conformation. This process enables ImmunoPro Rx to have high levels of cysteine. Cysteine is the
critical amino acid for the efficient intracellular production of GSH.
Lactoferrin is an iron binding and iron modulating protein. Lactoferrin resides in the chemical family called cytokines.
ImmunoPro Rx provides naturally occurring lactoferrin in its most biologically available state.
ImmunoPro Rx can be viewed as a delivery system of both cysteine and lactoferrin.
RECOMMENDED USE
Biologically active protein supplementation may be used to address GSH deficiency, wasting, oxidative stress, iron
deficiency, chemical toxicity, detoxification, protein deficiency and immune suppression. Reduced levels of GSH
have been observed in: AIDS, cancer, CFIDS, catabolic cachexia, hepatitis, radiation poisoning, malnutritive states,
chemotherapy and over training syndrome, and has been associated with numerous neurological disease states.
These clinical pathologies have been associated with oxidative stress and have been published in peer-reviewed
research.

12
Maintenance dose is two servings (10 grams) per day. For mild to moderate health challenges, higher doses are
recommended. Observational studies with AIDS, cancer and CFIDS patients have noted consumption of 20-30 grams
per day without ill effect. ImmunoPro Rx is best administered on an empty stomach or with light food
consumption.
Do not use hot or acidic liquids to mix the product.
SAFETY
ImmunoPro Rx is contraindicated in individuals who have known hypersensitivity to milk proteins.
Each 5 gram serving of ImmunoPro Rx contains 4 grams of protein. Patients on a protein restricted diet need to
take this into account when calculating their daily protein intake. ImmunoPro Rx contains less then 6% lactose and
is generally well-tolerated by lactose-intolerant individuals.
Patients undergoing immunosuppressive therapy should discuss the use of this product with their health
professional.
RECOMMENDED DOSAGE
Maintenance dosage is 5gram BID. For advanced disease states, higher dosages are recommended.
How Supplied
5 grams of milk protein concentrate powder per serving scoop.
60 servings per jar.
Storage: Cool and dry. Refrigeration is not necessary.