MONSALUD, CAURRINE M.

BSN-2C

DRUG STUDY

1. PENICILLIN
BRAND NAME: Bicillin C-R
GENERIC NAME: Penicillin G procaine
INDICATION:
Indicated in the treatment of serious infections caused by susceptible strains of
the designated microorganisms. Appropriate culture and susceptibility tests
should be done before treatment in order to isolate and identify organisms
causing infection and to determine their susceptibility to penicillin G.
CONTRAINDICATION:
Penicillin is contraindicated for use in patients with penicillin hypersensitivity. It
should be used cautiously in patients with cephalosporin hypersensitivity or
carbapenem hypersensitivity. These patients are more susceptible to cross-
hypersensitivity reactions. Penicillin can cause a variety of hypersensitivity
reactions ranging from mild rash to fatal anaphylaxis. Patients with allergies or
allergic conditions including asthma may have a greater risk for hypersensitivity
reactions to penicillin.
ADVERSE EFFECT:
Skin rashes including maculopapular eruptions and exfoliative dermatitis,
Urticaria, Serum-sickness like reactions (eg, chills, fever, edema, arthralgia, and
prostration), Jarisch-Herxheimer reaction reported when treating syphilis,
Pseudomembranous colitis.
NURSING MANAGEMENT:
 Assessment
History: Allergies to penicillins, cephalosporins, or other allergens; renal
disorders; pregnancy; lactation
Physical: Culture infection; skin color, lesions; R, adventitious sounds; bowel
sounds: CBC, LFTs, renal function tests, serum electrolytes, Hct, urinalysis
 Interventions
Culture infection before beginning treatment; reculture if response is not as
expected.
Continue therapy for at least 2 days after infection has disappeared, usually 7–10
days.
Do not administer oral drug with milk, fruit juices, or soft drinks; a full glass of
water is preferred; this oral penicillin is less affected by food than other penicillin.
 Teaching points
Avoid self-treating other infections with this antibiotic because it is specific for
the infection being treated. Complete the full course of drug therapy.
You may experience these side effects: Nausea, vomiting, diarrhea, mouth sores.
Report difficulty breathing, rashes, severe diarrhea, mouth sores, unusual
bleeding or bruising.

2. SALBUTAMOL
BRAND NAME: Salbutamol Sulfate
GENERIC NAME: Ventolin
INDICATION:
Indicated to prevent or treat bronchospasm inpatients with reversible obstructive
airway disease and to prevent exercise-induced bronchospasm.
CONTRAINDICATION:
Contraindicated in patients hypersensitive to drug or its ingredients. Use
cautiously inpatients with CV disorders (including coronary insufficiency and
hypertension), hyperthyroidism, or diabetes mellitus and those Salbutamol
nebulization q 6°CNS: tremor, nervousness, dizziness, insomnia, headache,
hyperactivity, weakness, CNS stimulation, malaise.CV: tachycardia, palpitation,
hypertension EENT: dry and irritated nose and throat with inhaled form, nasal
congestion, epistaxis, hoarseness. GI: Heartburn, nausea, vomiting, anorexia,
bad taste, increased appetite. Metabolic: hypokalaemia Musculoskeletal: muscle
cramps Respiratory: Bronchospasm.
ADVERSE EFFECT:
The most common adverse effects are fine tremor, anxiety, headache, muscle
cramps, dry mouth, and palpitation. Other symptoms may include tachycardia,
arrhythmia, flushing of the skin, myocardial ischemia (rare), and disturbances of
sleep and behaviour. Rarely occurring, but of importance, are allergic reactions
of paradoxical bronchospasms, urticaria (hives), angioedema, hypotension, and
collapse. High doses or prolonged use may cause hypokalemia, which is of
concern especially in patients with kidney failure and those on certain diuretics
and xanthine derivatives.
NURSING MANAGEMENT:
 Observe 10 rights in giving medications.
 Use minimal doses for minimal periods; drug tolerance can occur with
prolonged used.
 Maintain a – adrenergic blocker ( cardioselectivebeta – blocker, such as
atenolol, should be used with respiratory distress ) on standby in case
cardiac arrhythmias occur

3. CETIRIZINE
BRAND NAME: Zyrtec
GENERIC NAME: Cetirizine
INDICATION:
Relief of allergic symptoms caused by histamine release including: Seasonal and
perennial allergicrhinitis, Chronicurticaria.
CONTRAINDICATION:
Hypersensitivity to cetirizine, hydroxyzine or any component; Lactation: Excreted
in breast milk; note recommended for use. Use Cautiously in: Patients with
hepatic or renal impairment (dosage reduction recommended if CCr ≤31 mL/min
or hepatic function is impaired); OB/Pedi: Safety note established for pregnant
women of lactating.
ADVERSE EFFECT:
CNS: dizziness, drowsiness (significant with doses > 10mg/day), fatigue. EENT:
pharyngitis. GI: dry mouth.
NURSING MANAGEMENT:
 Check for doctor’s order
 Carefully read product packaging to note strength of solution, dosage/
route of administration.
 Observe 10 R’s in medicine administration
 Assess allergy symptoms (rhinitis, conjunctivitis, hives) before and
periodically during therapy.
 Assess lung sounds and character of bronchial secretions. Maintain fluid
intake of 1500 –2000 mL/day to decrease viscosity of secretions.
 Lab Test Considerations: May cause false-negative result in allergy skin
testing.
 4. AMPICILLIN
BRAND NAME: Principen
GENERIC NAME: Ampicillin
INDICATION:
Intraabdominal, gynecologic, and skin-structure infections caused by susceptible
beta-lactamase-producing strains. Destroy bacteria by inhibiting bacterial cell-
wall synthesis during microbial multiplication. Addition of sulbactam enhances
drug’s resistance to beta-lactamase, an enzyme that can in activate ampicillin.
CONTRAINDICATION:
Hypersensitivity to penicillin, cephalosporin, imipenem, oe other beta-lactamase
inhibitors.
ADVERSE EFFECT:
CNS:lethargy,hallucinations,anxiety,confusion,agitation,depression,fatigue,dizzin
ess,seizureEENT:bluredvision, itchy eyes GI: nausea, vomiting, diarrhea,
abdominal pain, gastritis, stomatitis GU: hematuria, hyaline casts in urine,
vaginitis, nephropathy, interstitial nephritis RESPIRATORY: wheezing, dyspnoeal,
hypoxia, apnea SKIN: rash, urticarial, diaphoresis.
NURSING MANAGEMENT:
 Observe 15 rights in drug administration.
 Assess for allergies to penicillins, cephalosporins, or other allergens.
 Assess for renal disorders or lactation.
 Culture infected area before treatment.
 If patient is a woman and she uses hormonal contraceptive, she should
use a second form of birth control for 1-2 weeks while taking this drug
 Administer oral drug on an empty stomach, 1 hour before or 2 hours after
meals.
 Administer with a full glass of water. Do not give with fruit juice or soft
drinks

5. SULBACTAM
BRAND NAME: Betamp inj
GENERIC NAME: Ampicillin/Sulbactam
INDICATION:
Antibacterial combination consisting of the semisynthetic antibacterial ampicillin
sodium and the beta-lactamase inhibitor sulbactam sodium for intravenous and
intramuscular administration.
CONTRAINDICATION:
Contraindicated for use in patients with a history of cholestasis with jaundice or
other hepatic dysfunction caused by ampicillin; sulbactam. Hepatotoxicity,
including cholestatic jaundice and hepatitis, has been associated with ampicillin;
sulbactam.
ADVERSE EFFECT:
The most frequently reported adverse reactions were diarrhea in 3% of the
patients and rash in less than 2% of the patients.Additional systemic reactions
reported in less than 1% of the patients were: itching, nausea, vomiting,
candidiasis, fatigue, malaise, headache, chest pain, flatulence, abdominal
distension, glossitis, urine retention, dysuria, edema, facial swelling, erythema,
chills, tightness in throat, substernal pain, epistaxis and mucosal bleeding.
NURSING MANAGEMENT:
 Use within 1 hour after preparation because potency may decrease
significantly after that.
 Dispose of used materials properly.
 Educate patient about side effects.
  Instruct to report pain or discomfort at sites, unusual bleeding or bruising,
mouth sores, rash, hives, fever, itching severe diarrhea, difficulty
breathing.
 Instruct patient not to use antibiotic to self-treat other infections.
 Instruct to take the full course of drug therapy.
 Do proper documentation.

6. PARACETAMOL
BRAND NAME: Tylenol, Calpol and Panadol
GENERIC NAME: Parecetamol
INDICATION:
To relieve mild to moderate pain due to things such as headache, muscle and
joint pain, backache and period pains. It’s also used to bring down a high
temperature. For this reason, paracetamol can be given to children after
vaccinations to prevent post-immunization pyrexia (high temperature).
Paracetamol is often in cluded in cough, cold and flu.
CONTRAINDICATION:
Hypersensitivity to acetaminophen orphenacetin; use with alcohol
ADVERSE EFFECT:
Hematologic: haemolytic anemia, leukopenia, neutropenia, pancytopenia
thrombocytopenia. Hepatic: liver damage, jaundice. Metabolic: hypoglycaemia.
Skin: rash, urticuria.
NURSING MANAGEMENT:
 Assess patient’s fever or pain: type of pain, location, intensity, duration,
temperature, and diaphoresis.
 Assess allergic reactions: rash, urticaria; if these occur, drug may have to
bed is continued.
 Teach patient to recognize signs of chronic overdose: bleeding, bruising,
malaise, fever, sore throat.
 Tell patient to notify prescriber for pain/fever lasting for more than 3 days.

7. ZINC DROPS
BRAND NAME: OraZinc and Zincate
GENERIC NAME: Zinc Sulfate
INDICATION:
Replacement and supplementation therapy in patients who are at risk for zinc
deficiency.
CONTRAINDICATION:
Hypersensitivity or allergy to any components in the formulation. Use cautiously
in renal failure.
ADVERSE EFFECT:
High doses above the recommended amounts might cause fever, coughing,
stomach pain, fatigue, and many other problems. Taking more than 100 mg of
supplemental zinc daily or taking supplemental zinc for 10 or more years doubles
the risk of developing prostate cancer. There is also concern that taking large
amounts of a multivitamin plus a separate zinc supplement increases the chance
of dying from prostate cancer. Taking 450 mg or more of zinc daily can cause
problems with blood iron. Single doses of 10-30 grams of zinc can be fatal.
NURSING MANAGEMENT:
 Monitor progression of zinc deficiency symptoms during therapy.
 Encourage patient to comply with the diet recommendation.
 Ask the patient to notify any of the healthcare team if the he feels nausea,
vomiting, abdominal pain or tarry stools occur
 Emphasize the importance follow-up exams
 8. HYDROCORTISONE
BRAND NAME: Hydrocort, Alphosyl, Aquacort, Cortef, Cortenema, and
SoluCortef.
GENERIC NAME: Hydrocortisone
INDICATION:
It is indicated for severe inflammation and hematologic Disorder. Enters target
cells and binds to cytoplasmic receptors; initiates many complex reactions that
irresponsible for anti-inflammatory actions.
CONTRAINDICATION:
It is contraindicated for patients who have/ has inactive tuberculosis, herpes
simplex, infection of the eye, intestinal infection caused by the roundworm,
Strongyloides, pheochromocytoma, a condition with low thyroid hormone levels,
diabetes, insufficiency of the hypothalamus and pituitary gland, low amount of,
potassium in the blood, psychotic disorder, brain injury, a disease with shrinking
and weaker muscles called myopathy.
ADVERSE EFFECT:
Nausea, heartburn, headache, dizziness, menstrual period changes, trouble
sleeping, increased sweating, or acne may occur. Use of this medication for
prolonged or repeated periods may result in oral thrush or a yeast infection.
NURSING MANAGEMENT:
 Note degree of involuntary movements, muscle spasm/rigidity and
drooling
 Provide patient safety when vertigo is present
 Monitor for consistency, colour, and amount of stool
 If the patients has developed urinary hesitancy, assess for bladder
distension.

9. ALBUTEROL
BRAND NAME: AccuNeb, Novo-Salmol (CAN), Proventil, Proventil HFA,
Salbutamol (CAN), Ventodisk (CAN), Ventolin HFA
GENERIC NAME: Albuterol Sulfate
INDICATION:
Relief and prevention of bronchospasm in patients with reversible obstructive
airway disease, Inhalation: Treatment of acute attacks of bronchospasm,
Prevention of exercise-induced bronchospasm, Unlabelled use: Adjunct in
treating serious hyperkalaemia in dialysis patients; seems to lower potassium
concentrations when inhaled by patients on haemodialysis.
CONTRAINDICATION:
Contraindicated with hypersensitivity to albuterol; tachyarrhythmias, tachycardia
caused by digitalis intoxication; general anesthesia with halogenated
hydrocarbons or cyclopropane (these sensitize the myocardium to
catecholamines); unstable vasomotor system disorders; hypertension; coronary
insufficiency, CAD; history of CVA; COPD patients with degenerative heart
disease.
ADVERSE EFFECT:
CNS: Restlessness, apprehension, anxiety, fear, CNS stimulation, hyperkinesia,
insomnia, tremor, drowsiness, irritability, weakness, vertigo, headache. CV:
Cardiac arrhythmias, tachycardia, palpitations, PVCs (rare), anginal pain.
Dermatologic: Sweating, pallor, flushing. GI: Nausea, vomiting, heartburn,
unusual or bad taste in mouth. GU: Increased incidence of leiomyomas of uterus
when given in higher than human doses in preclinical studies.
NURSING MANAGEMENT:

 Use minimal doses for minimal periods; drug tolerance can occur with
prolonged use.
  Maintain a beta-adrenergic blocker (cardioselective beta-blocker, such as
atenolol, should be used with respiratory distress) on standby in case
cardiac arrhythmias occur.
 Prepare solution for inhalation by diluting 0.5 mL 0.5% solution with 2.5
mL normal saline; deliver over 5–15 min by nebulization.
 Do not exceed recommended dosage; administer pressurized inhalation
drug forms during second half of inspiration, because the airways are open
wider and the aerosol distribution is more extensive.
 Do not exceed recommended dosage; adverse effects or loss of
effectiveness may result. Read the instructions that come with respiratory
inhalant.
 You may experience these side effects: Dizziness, drowsiness, fatigue,
headache (use caution if driving or performing tasks that require
alertness); nausea, vomiting, change in taste (eat frequent small meals);
rapid heart rate, anxiety, sweating, flushing, insomnia.
 Report chest pain, dizziness, insomnia, weakness, tremors or irregular
heartbeat, difficulty breathing, productive cough, failure to respond to
usual dosage

10.DIPHENHYDRAMINE
BRAND NAME: Allerdyl
GENERIC NAME: Diphenhydramine
INDICATION:
Relief of allergic symptoms caused by histamine release including: Anaphylaxis,
Seasonal and perenial allergic rhinitis, Allergic dermatoses. Parkinson's disease
and dystonic reactions from medicactions. Mild nightime sedation. Prevention of
motion sickness.
CONTRAINDICATION:
Hypersensitivity; Acute attacks of asthma; Lactation; Known alcohol intolerance
(some liquid products). Use Cautiously in: Severe liver disease; Angleclosure
glaucoma; Seizure disorders; Prostatic hyperplasia; Peptic ulcer.
ADVERSE EFFECT:
CNS: drowsiness, dizziness, headache. EENT: blurred vision, tinnutus. CV:
hypotension, palpitations. GI: anorexia, dry mouth, constipation, nausea. GU:
dysuria, frequency, urinary retention. Derm: photosensitivity. Resp: chest
tightness, thickened bronchial secretions, wheezing. Local: pain at IM site.
NURSING MANAGEMENT:
 Determine why the medication was ordered and asses symptoms that
apply to the individual patient.
 Assess for uticaria and for patency of airway.
 Assess degree of nasal stuffness, rhinorrhea, and sneezing.
 Assess movement disorder before and after administration.
 Assess sleep paterns.
 Assess nausea, vomitting, bowel sounds, and abdominal pain.
 Assess frequency and nature of cough, lung sounds, and amount and type
of sputum produced. Unless contraindicated, maintain fluid intake of 1500-
2000 ml daily to decrease viscousity of bronchial secretions.
 Assess degree of itching, skin rash, and inflamation.
 Diphenhydramine may decrease skin response to allergy tests.
Discontinue days before skin testing.
 Caution patient to avoid use of alcohol and other CNS depressants
concurrently with this medication.
  Teach sleep hygine techniques (dark room, quiet, bedtime ritual, limit
daytime napping, avoidance of nicotine and caffine) to patients taking
diphen hydramine to aid sleep.
 Advise patient to use sunscreen and protective clothing to prevent
photosensitivity reactions.
 Do not confuse Benadryl (diphenhydramine) with Benylin
(dextromethorpan), desipramine (Norpramin) or with dimenhydrinate
(Dramamine).

References:
 "Salbutamol". Drugs.com. Archived from the original on 2016-03-30.
Retrieved April 11, 2016.
 Garnett WR (February 2016). "Diphenhydramine". American Pharmacy.
NS26 (2): 35–40. doi:10.1016/s0095-9561(16)38634-0. PMID 396284
 Mehta, Sweety (25 August 2012). "Metabolism of Paracetamol
(Acetaminophen), Acetanilide and Phenacetin". PharmaXChange.info.
Archived from the original on 28 October 2019. Retrieved 27 October 2019
 Penicillin G - FDA prescribing information, side effects and uses".
www.drugs.com. Archived from the original on 20 December 2016.
Retrieved 10 December 2016.
 Portnoy JM, Dinakar C (2004). "Review of cetirizine hydrochloride for the
treatment of allergic disorders". Expert Opin Pharmacother. 5 (1): 125–35.
doi:10.1517/14656566.5.1.125. PMID 14680442.
 "Ampicillin". Drug Information Portal. U.S. National Library of Medicine
 Totir MA, Helfand MS, Carey MP, et al. (August 2007). "Sulbactam forms
only minimal amounts of irreversible acrylate-enzyme with SHV-1 beta-
lactamase". Biochemistry. 46 (31): 8980–7. doi:10.1021/bi7006146. PMC
2596720. PMID 17630699
 Dieter M. M. Rohe; Hans Uwe Wolf (2005). "Zinc Compounds". Ullmann's
Encyclopedia of Industrial Chemistry. Weinheim: John Wiley & Sons.
doi:10.1002/14356007.a28_537. ISBN 978-3527306732.
 "Albuterol - Drug Usage Statistics". ClinCalc. 1 December 1981. Retrieved
11 April 2020.
 "Hydrocortisone". Drugs.com. American Society of Health-System
Pharmacists. February 9, 2015. Archived from the original on 20
September 2016. Retrieved 30 August 2016.