: مجموعة متنوعه من الأدوية بشرح كامل لها
Cefazolin
Trade name: Ancef, Kefzol Class: Antibiotic "cephalosporines" FIRST GENERATION Pregnancy: (Category B) Action: Bind to bacterial cell wall membrane, causing cell death Uses Treatment of: Skin and skin structure infections (including burn wounds) Pneumonia Otitis media Urinary tract infections Bone and joint infections Septicemia (including endocarditic) caused by susceptible organisms Perioperative prophylaxis Dose By intramuscular injection or intravenous injection or infusion, 05–1 g every 6–12 hours; CHILD, 25–50 mg/kg daily (in divided doses), increased to 100 mg/kg daily in severe infections Contraindications Hypersensitivity to cephalosporin or Penicillin, renal failure, Pregnancy, Lactation Side effects Nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence, skin rashes super-infection, heartburn, sore mouth, bone marrow depression: (Decrease WBC, decreased platelets, decreased Hct Nephrotoxicity, (pain, abscess at injection site, phlebitis and inflammation at IV site Nursing considerations Infuse over 30 minutes unless otherwise indicated Therapy should be continued for at least 2-3 days after symptoms of infection have disappeared Assess client with a history of hypersensitivity reaction “for penicillin or cephalosporin” Assess client financial status These drugs are usually expensive If GI upset occurs administer Drugs with meals “Should be administered on empty stomach” Obtain liver & renal studies Cefotaxime Trade name: claforan Class: Antibiotic "cephalosporines "(third generation) Pregnancy: Category B Action: Bind to bacterial cell wall membrane, causing cell death Uses Pneumonia – GU tract infections - meningitis, Peritonitis, septicemia, pelvic cellulitis - endometritis Dose by intramuscular or intravenous injection or by intravenous infusion, 1 g every 12 hours increased in severe infections (eg meningitis) to 8 g daily in 4 divided doses; higher doses (up to 12 g daily in 3–4 divided doses) may be required; NEONATE 50 mg/kg daily in 2–4 divided doses increased to 150–200 mg/kg daily in severe infections; CHILD 100–150 mg/kg daily in 2–4 divided doses increased up to 200 mg/kg daily in very severe infections Gonorrhea, 500 mg as a single dose Contraindications Hypersensitivity to cephalosporin or Penicillin Side effects CNS: seizures high doses GI: pseudomembraneous colitis, diarrhea, nausea, vomiting, cramps, pseudolithiasis (ceftriaxone) Derm: rashes, urticaria Hemat: bleeding (increased with cefoperazone), blood dyscrasias, hemolytic anemia Local: pain at IM site, phlebitis at IV site Misc: allergic reactions including anaphylaxis and serum sickness, super infection Nursing considerations Should not be mixed with amino glycosides ( each should be given separately) For IV use, should be mixed with 10 ml sterile water & administer over 3-5 minutes |
Ceftazidime
Trade name: Ceptaz, Fortum, Tazicef, Tazidime Class: Antibiotic "cephalosporines" third-generation Pregnancy: Category B Action : Bind to bacterial cell wall membrane, causing cell death Uses Ceftazidime eliminates bacteria that cause many kinds of infections, including lung, skin, bone, joint, stomach, blood, gynecological, and urinary tract infections Dose by deep intramuscular injection or intravenous injection or infusion, 1 g every 8 hours or 2 g every 12 hours; 2 g every 8–12 hours or 3 g every 12 hours in severe infections; single doses over 1 g intravenous route only; elderly usual max 3 g daily; child up to 2 months 25–60 mg/kg daily in 2 divided doses, over 2 months 30–100 mg/kg daily in 2–3 divided doses; up to 150 mg/kg daily (max 6 g daily) in 3 divided doses if immuno- compromised or meningitis; intravenous route recommended for children Urinary-tract and less serious infections, 05–1 g every 12 hours Pseudomonal lung infection in cystic fibrosis, adult 100–150 mg/kg daily in 3 divided doses; child up to 150 mg/kg daily (max 6 g daily) in 3divided doses; intravenous route recommended for children Surgical prophylaxis, prostatic surgery, 1 g at induction of anesthesia repeated if necessary when catheter removed Contraindications Hypersensitivity to cephalosporin Side effects Diarrhea, stomach pain, upset stomach, vomiting Nursing considerations Infuse over 30 minutes unless otherwise indicated Therapy should be continued for at least 2-3 days after symptoms of infection have disappeared Assess client with a history of hypersensitivity reaction “for penicillin or cephalosporin” Assess client financial status These drugs are usually expensive Obtain liver & renal studies |
Ceftriaxone
Trade name: Rocephin Class: Antibiotic "cephalosporines" third-generation Pregnancy: Category B Action: Bind to bacterial cell wall membrane, causing cell death Uses Pneumonia, UTI, infections of skin, bone & abdomen Meningitis, bacterial septicemia, pre-op prophylaxis Dose by deep intramuscular injection, or by intravenous injection over at least 2–4 minutes, or by intravenous infusion, 1 g daily; 2–4 g daily in severe infections; intramuscular doses over 1 g divided between more than one site Neonate by intravenous infusion over 60 minutes, 20–50 mg/kg daily - max 50 mg/kg daily Infant and child under 50 kg, by deep intramuscular injection, or by intravenous injection over 2–4 minutes, or by intravenous infusion, 20–50 mg/kg daily; up to 80 mg/kg daily in severe infections; doses of 50 mg/kg and over by intravenous infusion only; 50 kg and over, adult dose Uncomplicated gonorrhea, by deep intramuscular injection, 250 mg as a single dose Surgical prophylaxis, by deep intramuscular injection or byintravenous injection over at least 2–4 minutes, 1 g at induction; colorectal surgery, by deep intramuscular injection or by intravenous injection over at least 2–4 minutes or by intravenous infusion, 2 g at induction; intramuscular doses over 1 g divided between more than one site Contraindications Hypersensitivity to cephalosporin or Penicillin ,renal failure Side effects Nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence, skin rashes super-infection, heartburn, sore mouth, bone marrow depression Nursing considerations IM injection should be deep into the body of large muscle IV injection should be diluted For stability of solution the package insert should be checked carefully Dosage should be maintained for at least 2 days after symptoms of infection have disappeared (usual course is 4-14 days |
Cefuroxime
Trade name: Zinacef Class: Antibiotic "cephalosporines" (second generation) Pregnancy: Category B Action: Bind to bacterial cell wall membrane, causing cell death Uses Pharyngitis, tonsillitis , Otitis media ,Lower respiratory tract infections, UTIs Dermatologic infections, Treatment of early Lyme disease ,Lower respiratory tract infections, influenza, Septicemia, Meningitis Bone and joint infections, Perioperative prophylaxis Dose : by mouth (as cefuroxime axetil), 250 mg twice daily in most infections including mild to moderate lower respiratory-tract infections (eg bronchitis); doubled for more severe lower respiratory-tract infections or if pneumonia suspected Urinary-tract infection, 125 mg twice daily, doubled in pyelonephritis Gonorrhea, 1 g as a single dose Child over 3 months, 125 mg twice daily, if necessary doubled inchild over 2 years with otitis media ContraindicationsAllergy to cephalosporin or penicillins, renal failure, lactation, pregnancy Side effects CNS: Headache, dizziness, lethargy, paresthesias GI: Nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence, pseudo membranous colitis, liver toxicity Hematologic: Bone marrow depression: decreased WBC, decreased platelets, decreased Hct GU: Nephrotoxicity Hypersensitivity: Ranging from rash to fever to anaphylaxis, serum sickness reaction Nursing considerations Culture infection, arrange for sensitivity tests before and during therapy if expected response is not seen Give oral drug with food to decrease GI upset and enhance absorption Give oral drug to children who can swallow tablets; crushing the drug results in a bitter, unpleasant taste Have vitamin K available in case hypoprothrombinemia occurs Discontinue if hypersensitivity reaction occurs |
Chloramphenicol
Trade name: Chloromycetin Class: antibiotic Pregnancy: Category C Action: it inhibits protein synthesis in bacteria by binding to ribosome Uses Not to be used for trivial infections as prophylaxis of infection Cold, throat infections or flu Treatment of choice for typhoid fever not for carrier state Meningitis due to hemophilus influenza, pneumocoeoi or Miningococei Skin infections (topically) Brain abscesses Dose : by mouth or by intravenous injection or infusion, 50 mg/kg daily in 4 divided doses (exceptionally, can be doubled for severe infections such as septicemia and meningitis, providing high doses reduced as soon as clinically indicated); Child, haemophilus epiglottitis and pyogenic meningitis, 50–100 mg/kg daily in divided doses (high dosages decreased as soon as clinically indicated); Infants under 2 weeks 25 mg/kg daily in 4 divided doses 2 weeks–1 year 50 mg/kg daily in 4 divided dose Contraindications Hypersensitivity to chloramphenicol Pregnancy Nursing mothers Renal and hepatic failure Side effectsA plastic anemia, pancytopnea, nausea, vomiting abdominal distention, “progressive pallid cyanoses, ashen gray color, tachypnea , vasomotor collapse & death”, Gray syndrome in infants, super infections Nursing considerations Administer IV as 10% solution over at least 1 min Note any history of hypersensitivity & other contraindications, & if Client takes antidiabetic or other medications that cause bone marrow depression Neonates should be observed closely (greater hazards of toxicity) Arrange for further hematologic studies to be conducted every 2 days to detect early signs of bone marrow depression The drug should be taken at regular intervals to be most effective The drug should be taken 1 hr before or 2 hr after meals - if GI upset Occurs it could be taken with the food |
Chlorpromazine
Trade name: Largactil Class: Antipsychotic, phenothiazine Pregnancy: Category C Action: Act by blocking dopamine receptors It has significant antiemetic effect, hypoteinsive, sedative & anticholenergic effect Uses Acute & chronic psychosis (such as schizophrenia, mania & manic Depression Preanasthetic Intractable hiccoughs Nausea & vomiting Dose : by mouth psychomotor agitation, excitement, and violent or dangerously impulsive behavior initially 25 mg 3 times daily (or 75 mg at night), adjusted according to response, to usual maintenance dose of 75–300 mg daily Intractable hiccup, oral 25–50 mg 3–4 times daily By deep intramuscular injection, (for relief of acute symptoms, 25–50 mg every 6–8 hours; Child, 1–5 years 05 mg/kg every 6–8 hours (max 40 mg daily); 6–12 years 05 mg/kg every 6–8 hours (max 75 mg daily) Induction of hypothermia (to prevent shivering), by deep intramuscular injection, 25–50 mg every 6–8 hours; Child 1–12 years, initially 05–1 mg/kg, followed by maintenance 05 mg/kg every 4–6 hours Contraindications Sever depression, coma Bone marrow depression Patients with history of seizures & on anticonvulsant therapy Hepatic & renal diseases Prostatic hypertrophy Dehydration - glaucoma, measles Side effects Depression, dizziness, seizures, gynecomastia Orthostatic hypotension, bronchospasm, larlynyospasm tardive dyskinesia, photosensitivity, leukopnea, aplastic anemia, and dry mouth Nursing considerations Shouldn’t be used to treat nausea & vomiting in children less than 6 months of age Should avoid getting solution on hands or clothing - it will cause dermatitis Solutions with marked discoloration should be discarded Note any history of seizures Take liver & kidney function test periodically ******** & rotate injection sites Report side effects immediately Determine age of male patients & assess for prostatic hypertrophy |
Ciprofloxacin Hydrochloride
Trade name: ciproxin Class: Antibacterial, quinolone derivative Pregnancy: Category C Action: is a synthetic quinolone with broad- spectrum bactericidal activity, inhibits the synthesis of bacterial DNA by inhibiting the enzyme DNA gyrase Uses UIT, infectious diarrhea Infection of lower respiratory tract, bone, joints & skin Dose : by mouth, respiratory-tract infections, 250–750 mg Twice daily, Urinary-tract infections, 250–500 mg twice Daily (100 mg twice daily for 3 days in acute uncomplicated cystitis in women Chronic prostatitis, 500 mg twice daily for 28 days Gonorrhea, 500 mg as a single dose Pseudomonal lower respiratory-tract infection in cystic fibrosis, 750 mg twice daily; CHILD 5–17 years, up to 20 mg/kg twice daily Most other infections, 500–750 mg twice daily Surgical prophylaxis, 750 mg 60–90 minutes before procedure Prophylaxis of meningococcal meningitis, [not licensed for this indication] 500 mg as a single dose; Child 5–12 years 250 mg By intravenous infusion (over 30–60 minutes; 400 mg over 60 minutes), 200–400 mg twice daily, Child 20 mg/kg daily in 2 divided doses Pseudomonal lower respiratory-tract infection in cystic fibrosis, 400 mg twice daily; CHILD 5–17 years, up to 10 mg/kg 3 times daily (max 12 g daily) Child not recommended but where benefit outweighs risk, by mouth, 10–30 mg/kg daily in 2 divided doses or by intravenous infusion, 8–16 mg/kg daily in 2 divided doses Anthrax (treatment and post-exposure prophylaxis, see notes above), by mouth, 500 mg twice daily; child 30 mg/kg daily in 2 divided doses Contraindications Hypersensitivity - children - lactation Side effects Nausea vomiting Dysphasia, crystalluria, Hematuria, Rashes, bad taste, GI bleeding, Headache, insomnia Nursing considerations Give medication 2 hr after meals Stress importance of drinking increased amounts of fluids to keep urine acidic & to minimize the risk of crystalluria |
Clindamycin phosphate
Trade name: Dalacin Class: antibiotic, clindamycin Pregnancy: Category B Action: suppress protein synthesis by microorganisms by binding to ribosomes It is both bacteriostatic & bactericidal Uses Serious respiratory tract infections (lung abscess, pneumonia) Serious skin infections Septicemia Osteomyelitis caused by staphylococci Used topically for inflammatory acne vulgaris Dose : by mouth, 150–300 mg every 6 hours; up to 450 mg every 6 hours in severe infections; CHILD, 3–6 mg/kg every 6 hours NB Patients should discontinue immediately and contact doctor if diarrhea develops; capsules should be swallowed with a glass of water By deep intramuscular injection or by intravenous infusion, 06–27 g daily (in 2–4 divided doses); life-threatening infection, up to 48 g daily; single doses above 600 mg by intravenous infusion only; single doses by intravenous infusion not to exceed 12 g CHILD over 1 month, 15–40 mg/kg daily in 3–4 divided doses; severe infections, at least 300 mg daily regardless of weight Contraindications Hypersensitivity Minor bacterial infections Pregnancy Side effects Nausea, vomiting, diarrhea, abdominal pain, tenesmus Loss of weight, pseudo membranous colitis, skin rashes Hypotension Thrombophlebitis following IV use Nursing considerations Give parenteral drug to hospitalized client only Dilute IV injections If IM, inject medication deeply Don’t refrigerate solution because it becomes thick Before use, take full history & not signs of allergy Be prepared to manage colitis which can occur 2-9 days or several weeks after initiation of therapy Which includes: fluids, electrolytes, Protein supplement, corticosteroids, and Vancomycin as ordered During IV administration, observe for signs of hypotension Administer only on an empty stomach With a full glass of water to prevent esophageal ulceration |
Cloxacillin
Trade name: Orbenin Class: antibiotic - penicillinase-resistant penicillins Pregnancy: Category B Action: Inhibit bacterial cell wall synthesis Uses Infections caused by penicillinase- producing staphylococci, streptococci, pneumococci Osteomylitis pneumonia infected wounds & burns Septic arthritis Dose : by mouth, 250–500 mg every 6 hours, at least 30 minutes before food; Child under 2 years quarter adult dose; 2–10 years half adult dose By intramuscular injection, 250–500 mg every 6 hours; Child under 2 years quarter adult dose; 2–10 years half adult dose By slow intravenous injection or by intravenous infusion, 025–2 g every 6 hours; Child under 2 years quarter adult dose; 2–10 years half adult dose Endocarditis 12 g daily in 6 divided doses for 4 weeks Osteomyelitis up to 8 g daily in 3–4 divided doses Contraindications Hypersensitivity to penicillins & cephalosporin Side effects Allergic: skin rashes, pruritis, wheezing, fever… Diarrhea, abdominal cramps pain, nausea, vomiting Psendomembranous colitis, thrombocytopenia, leucopenia Thrombophlebitis + Electrolytes imbalance following IV use Hepatotoxicity Nursing considerations Administer on an empty stomach Refrigerate reconstituted solution & discard remaining amount after 14 days NB: To prepare oral suspension, add amount of water stated on label and shake well Shake the bottle well before each use |
Dexamethasone
Trade name: dexacort Class: adrenocorticosteroid –synthetic, glucocorticoid type Pregnancy: Category C/D if used in 1st trimester Action• They are a group of natural hormones produced by the adrenal cortex They are used for a variety of therapeutic purposes Many slightly modified synthetic variants are available today Some patients respond better to one substance than to another These hormones influence many ****bolic pathways & all organ systems & are essential for survival The release of corticosteroids is controlled by hormones such as corticotropin- releasing factor produced by the hypothalamus & ACTH produced by the anterior pituitary Uses Replacement therapy: adrenal insufficiency (Addison’s disease) Rheumatic disorders: rheumatoid arthritis & osteoarthritis Collagen diseases: systemic lapus erythematosus, rheumatic cardiac • Allergic diseases: drug hypersensitivity, urticarial transfusion reaction Respiratory diseases: bronchial asthma, rhinitis Ocular diseases : allergic & inflammatory conjunctivitis, keratitis Dermatological diseases: psoriasis, contact dermatitis, urticaria Diseases of the GIT: ulcerative colitis Nervous system: Myasthenia gravis Malignancies: leukemia, lymphoma Nephrotic syndrome• Hematologic diseases: hemolytic anemia, thrombocytopenic purpura Miscellaneous: septic shock, liver cirrhosis, stimulation of surfactant Production, prevention of organ rejection Dose By mouth, usual range 05–10 mg daily; by intramuscular injection or slow intravenous injection or infusion (as dexamethasone phosphate), initially 05–20 mg; CHILD 200–500 micrograms/kg daily Cerebral edema (as dexamethasone phosphate), by intravenous injection, 10 mg initially, then 4 mg by intramuscular injection every 6 hours as required for 2–10 days Shock (as dexamethasone phosphate), by intravenous injection or infusion, 2–6 mg/kg, repeated if necessary after 2–6 hours Note Dexamethasone 1 mg = dexamethasone phosphate 12 mg = dexamethasone sodium phosphate 13 mg Contraindications If infection is suspected (Mask signs & symptoms) Peptic ulcer Acute glomerulonephritis Cushing’s syndrome Congestive heart failure Hypertension Hyperlipidemia Side effects Edema, alkalosis, hypokalemia, hypertension, CHF muscle wasting, weakness, osteoporosis, nausea & vomiting Headache, hypercholesterolemia, hirsutism, amenorrhea, depression Redistribution of body fats: thin extremities and fat trunk, moon-like face, buffalo hump Nursing considerations Administer oral forms with food to minimize ulcerogenic effect For chronic use, give the smallest dose possible Corticosteroids should be discontinued gradually if used chronically ******** baseline weight, BP, Pulse & temperature Frequently take BP, monitor body weight - signs of Na+ & H2O retention Periodic serum electrolytes, blood sugar monitoring Report signs & symptoms of side effects - Cushing-like syndrome Discuss with female client potentials of menstrual difficulties Instruct the client to take diet high in protein & potassium Instruct the client to avoid falls & accidents - osteoporosis causes Pathological fracture Remind the client to carry a card identifying the drug being used Stress the need for regular medical supervision Advice the client to delay any vaccination while taking these medications Weakened immunity Explain the need to maintain general hygiene & cleanliness to prevent Infection |
الساعة الآن 10:26 PM |
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