Generic/ Trade Name Mechanism

Generic/ Trade Name Mechanism of Action Dosage/ Frequency Classification Indication Contraindication Side effects Nursing Responsibilities
metronidazole
Medgyl Bactericidal

Inhibits DNA synthesis of specific (obligate) anaerobes

Cell death 500 mg 1 tab TID Antibiotics,
Antiprotozoal, Amebicide, antibacterial * Acute infection with susceptible anaerobic bacteria
* Contraindicated with hypersensitivity to metronidazole * Dry mouth with strange metallic taste
* Dizziness, headache, diarrhea,
* Rash, itching, sore throat, fever, severe stomach pain, vomiting
* Urine may be darker * Administer with food
* Teach the patient to take the full course of drug therapy; alcohols are contraindicated (beverages or preparations containing alcohol, cough syrup) for 24-72 hr of drug use
* Urine may be darker
* Discontinue drug if hypersensitivity reaction occurs.
* Report severe GI upset, dizziness, unusual fatigue or weakness, fever chills, and allergic reactions furosemide

Furosemide Inhibits reabsorption of sodium and chloride
proximal and distal tubules and ascending Loop of Henle

Na, Cl, Kexcretion in urine 20 mg 1 tab OD in am Loop diuretic * Edema associated with heart failure, cirrhosis, renal disease
* contraindicated with allergy to furosemide, sulfonamides
* Severe renal failure
* increased volume and frequency of urination
* dizziness
* feeling faint on arising
* drowsiness
* sensitivity to sunlight
* increased thirst
* loss of potassium * Administer with food and milk
* Reduce dosage if given with other antihypertensives, readjust dosage as BP responds
* Give early in the day so that increased urination will not disturb sleep
* Do not expose to sunlight, which may discolor solution /tablet
* Measure and record weight to monitor fluid changes
* Arrange to monitor serum electrolytes, hydration, liver and renal function
* Arrange for potassium-rich diet or supplemental potassium as needed
* Avoid rapid position changes (when dizziness is experienced)
* Instruct patient to Wear protective clothing and sunglasses when sensitivity to sunlight occurs
* Report loss or gain of more than 3 lbs in 1 day, swelling in ankles or fingers, unusual bleeding or bruising, dizziness, numbness, fatigue, muscle weakness and cramps
Aminogen Synthetic enzyme

Breaks down protein (digestion)

Easier absorption of protein

Nitrogen retention

Muscle and strength

500 cc IV q12 Parenteral nutritional product * Supplement for protein, nutrition & water. * Patients suffering from severe shock, hyperkalemia, severe disturbances of liver or kidney function & disturbance of amino acid metabolism * Septicemia, thrombophlebitis, bacteremia * Patients w/ a tendency to elevated serum K or urea levels. Too rapid infusion leading to renal loss & nausea co-trimoxazole
other name:
trimethoprim-sulfamethoxazole

Cotrimoxazole Sulfathomexazole (SMZ)

Inhibits formation of dihydrofolic acid from PABA
Trimethoprim (TMP)

Inhibits dihydrofolate reductase

Blocking synthesis of tetrahydrofolic acid

Blocks bacterial synthesis of folic acid 500 mg tab BID Antibacterial combinations * Resp tract, GIT and GUT infections * Patients w/ marked liver parenchyma damage, blood dyscrasia, megaloblastic bone marrow, severe renal insufficiency, hypersensitivity. Nausea, vomiting, diarrhea, abdominal pain, headache * Assess patient’s infection before therapy
* Obtain C/S before beginning drug therapy to identify if correct treatment has been initiated
* Assess for possible occurrence of drug induced adverse reaction
* Assess for signs and symptoms of anaphylaxis like wheezing, rales, tachypnea, tachycardia, facial swelling fainting and seizures, if these are seen, discontinue drug
* Monitor renal function
* Administer drug with food Albuterol-Ipratropium

Combivent neb Ipratropium

Inhibits vagally mediated reflex

Antagonize acetylcholine

Anticholinergics prevent increase in intracellular concentration of cyclic guanosine monophosphate

Interaction with muscaranic receptor (bronchial smooth muscle)

Bronchodilation
Salbutamol

Relaxes smooth muscle from trachea to terminal bronchioles

Protects against bronchoconstrictor challenges

Bronchodilation Q8 c/o RT Antiasthmatic
* Management of reversible bronchospasm associated w/ obstructive airway diseases in patients who require more than a single bronchodilator * Hypertrophic obstructive cardiomyopathy or tachyarrhythmia. History of hypersensitivity to soya lecithin or related food products (for MDI only) * Headache, dizziness, nausea, coughing, dry mouth or sinus congestion * Instruct patient to report and seek medical attention immediately when any allergic reactions occur (like rash, itching, swelling, severe dizziness, trouble breathing)
* Provide / assist in Chest-Physio Therpy (CPT) after nebulization to loosen secretions Captopril
Blocks ACE (converting Angiotensin I – Angiotensin !!)

Vasoconstricts

Decreased BP; decreased aldosterone secretion;
increase in serum K, Na and fluid loss;
increased prostaglandin synthesis

antihypertensive action 25 mg / tab PRN for HPN ACE inhibitor
Antihypertensive * Treatment of hypertension alone or in combination with thiazide-type diuretics
* Contraindicated with allergy to captopril, history of angioedema * Cough, GI upset, loss of appetite, change in taste perception, mouth sores, rash, fast heart rate, dizziness, light-headedness * Use cautiously with renal impairment, heart failure, salt or volume depletion,
* Administer 1 hr before meals. Instruct patient to take drug without food.
* Monitor patient for drop BP secondary to reduction in fluid volume (due to excessive perspiration, dehy
dration) excessive hypotension may occur.
* Mouth care for mouth sores
* Report mouth sores, sore throat, fever, chills, swelling of hands, irregular heartbeat., chest pain, swelling of the face, eyes, lips, tongue, and difficulty breathing
Ketorolac decreases the
activity of the
enzyme,
cyclo-oxygenase
results in
decreased
formation of
prostaglandin
precursors

inhibits
prostaglandin
synthesis
30 mg IV q8 ANST (-) analgesic
NSAID) * For short term management of pain not exceeding five (5) days in all routes combined * Contraindicated with significant renal impairment, aspirin allergy, concurrent use of NSAIDs, active peptic ulcer disease, recent GI bleeding, hypersensitivity to ketorolac CNS: drowsiness, dizziness, euphoria, headache

RESP: asthma, dyspnea

CV: edema, pallor, vasodilation

GI: GI Bleeding, abnormal taste, diarrhea, dry mouth, dyspepsia, GI pain, nausea

GU: oliguria, renal toxicity, urinary frequency

DERM: pruritis, purpura, sweating, urticaria

HEMAT: prolonged bleeding time

LOCAL: injection site pain

NEURO: paresthesia * Assess the patient on renal impairment, impaired hearing, allergies.
* Assess skin color and lesions
* Instruct patient to report sore throat, fever, rash, itching, weight gain, swelling in ankles and fingers, changes in vision, black tarry stools, and bruising metformin hydrochloride

Metformin Increases peripheral utilization of glucose

Decreases hepatic glucose production

Alters intestinal absorption of glucose 1 tab TID
Home med Antidiabetic * Adjunct to diet to lower blood glucose with type 2 DM * Contraindicates with allergy to metformin, heart failure, diabetes complicated by fever, sever infections, severe trauma, major surgery, ketosis, acidosis, coma, type 1 diabetes * indigestion, headache, diarrhea, nausea and vomiting, abdominal discomfort * Assess patient on history to metformin, diabetes complicated with fever, sever infections, severe trauma, major surgery, ketosis, acidosis, coma, type 1 diabetes
* Assess skin color and lesions
* Instruct patient the following: do not discontinue this medication without consulting health care provider
* Instruct patient to Swallow ER tablets whole, do not crush or chew
* Instruct patient to report sore throat, fever, unusual bleeding or bruising, dark urine, light-colored stools, hypoglycemic or hyperglycemic reactions Nalbuphine

Binds with opiate receptors in CNS

Ascending pain pathways in limbic system, thalamus, midbrain, hypothalamus

Altering perception of and emotional response to pain

Relieves pain 10mg IV q6 x 2 doses Narcotic analgesic
Opiate analgesic * Relief of moderate to severe pain
* Can be used to as a supplement to balance anesthesia for preoperative and post operative anesthesia * Hypersensitivity to nalbuphine or any component of the formulation * Constipation; dizziness; drowsiness; dry mouth; feeling of a whirling motion; headache; nausea; sweating/clammy skin; vomiting.
* Report if severe reactions occur on patients such as severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; difficulty urinating; fainting; numbness of an arm or leg; seizures; severe headache, dizziness, or vomiting; slow heartbeat; vision changes
* Nalbuphine hydrochloride injection should be administered as a supplement to ge
* neral anesthesia only by persons specifically trained in the use of intravenous anesthetics and management of respiratory effects of potent opioids
Fentanyl Inhibits ascending pathways in CNS

Increases pain threshold

Alters pain receptors by binding to opiate receptors 50 mg IVP Analgesic * Short-term analgesia before, during and after anesthesia * Hypersensitivity to fentanyl or adhesives. * Anxiety; confusion; constipation; difficulty walking; dizziness; drowsiness; dry mouth; headache; indigestion; itching; nausea; vomiting.

* Monitor VS after parenteral route, note muscle rigidity, take dug history after administering drug, check liver, kidney function tests
* Seek medical attention right away if any of these SEVERE side effects occur when using Fentanyl: Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); hallucinations; muscle rigidity; seizures; slow or irregular heartbeat; slowed breathing; trouble breathing; weakness.
Midazolam Increasing the inhibitory neurotransmitter activity of GABA

Depresses the limbic system and reticular formation 2.0 mg + 1.5 mg Anxiolytics, hypnotics and Sedative
anticonvulsant * Insomnia
* Sedation in critical care, minor surgical procedures
* Induction of anesthesia
* Pre-med in surgical procedure * acute narrow-angle glaucoma; coma or patients in shock; acute alcohol intoxication; intrathecal and epidural admin. Acute pulmonary insufficiency or marked neuromuscular respiratory weakness including unstable myasthenia gravis; severe respiratory depression * DOB
* Cardiac arrest
* Arrhythmia
* Hypotension
* Signs of allergic reaction including an unexplained rash, hives, itching, and unexplained swelling * Assess patient’s condition before therapy and regularly thereafter to monitor drug effectivess.
* Monitor blod pressure, HR and rhythm, RR, airway integrity, arterial oxygen saturation (during procedures in patients premedicated with opioids). Emergency equipment should be nearby.
* Monitor for possible drug induced adverse reactions: headache, oversadation, involuntary movements, amnesia, hypotension, PR cardiac arrest, nausea, vomiting, hiccups, bradypnea Propofol
positive modulation of the inhibitory function of the neurotransmitter gama-aminobutyric acid (GABA) through GABAA receptor

decreased pain sensation 2 ml IVP intermittent Anesthetic – Local and General * Induction and maintenance of general anesthesia Electroconvulsive therapy * difficulty breathing, wheezing, swelling of the throat
* fast heartbeat, palpitations
* lightheadedness or fainting spells
* numbness or tingling in the hands or feet seizure (convulsion)
* skin rash, flushing (redness), or itching
* swelling or extreme pain at the injection site
* uncontrollable muscle spasm
* Reduce dose if given with nitrous oxide or halogenated anaesthetics. Increased sedative, anaesthetic and cardiorespiratory effects when used with other CNS depressants ketamine Depresses CNS

Blocking the effects of excitatory neurotransmitter, glutamic acid at the NMDA receptors 50 mg Anesthetic – Local and General * Induction of anesthesia * hypertension, history of cerebrovascular accident. Eye injury, raised ocular and intracranial pressure. Psychotic disorders * Blurred vision; confusion; drowsiness; increased or decreased blood pressure or heart rate; mental or mood changes; nausea; nightmares; vomiting

* Minimise verbal and tactile stimulation during recovery period. Chronic alcoholic and alcohol-intoxicated patients. Preanaesthetic elevated CSF pressure. Dependence and tolerance may develop.

* May impair ability to drive or operate machinery.
* Monitor cardiac function in patients with hypertension or cardiac decompensation. Vit. K 1 amp IV q 8 Haemostatic Drug * Hypoprothrombinemia caused by effects of oral
* Hypoprothrombinemia caused by Vit. K malabsorption, drug therapy, or excessive Vit. A dosage. Contraindicated in patient hypersensitivity to drug CNS: dizziness

CV: flushing, transient hypotension after IV administration, rapid and weak pulse

Skin: diaphoresis, erythema

IV: pain, swelling, and hematoma in injection site * Check brand name levels for administration route restriction.

* If severe bleeding occurs, don’t delay other measures, such as administration of fresh frozen plasma or whole blood.

* Vit. K doesn’t reverse the anticoagulant effects of heparin.

* Watch for flushing, weakness, tachycardia, and hypotension, condition may progress to shock. Eugeclav 1 Tablet BID 3xday Antidiabetic Adjunct to diet to lower glucose level in patients with type 2(non-insulin-dependent) diabetes Contraindicated in patients hypersensitivity to drug and in those with diabetic ketoacidosis with or without coma EENT: changes in accommodation or blurred vision

GI: nausea, epigastric fullness, heartburn

HEMATOLOGIC: hemolytic anemia

HEPATIC: cholestatic jaundice

METABOLIC: hypoglycemia

Skin: rash, pruritus, other allergic reactions * instruct patient about nature of disease and importance of following therapeutic regimen, adhering to specific diet, losing weight, getting exercise, following personal hygiene programs, and avoiding infection.

* tell patient not to change drug dosage without prescribers consent and to report abnormal blood or urine glucose test result. diphenhydramine 1 amp. IV now Antihistamine Rhinitis, allergy symptoms, motion sickness Contraindicated in patients hypersensitivity to this drug CNS: fatigue, nervousness, drowsiness, dizziness, tremor, headache, seizures, sleepiness, confusion, restlessness.

GI: nausea, vomiting, constipation, anorexia

GU: dysuria, urine retention, urinary frequency

HEMATOLOGIC: hemolytic anemia

CV: palpitations, hypotension, tachycardia

SKIN: urticaria, photosensitivity, rash
* Warn patient not to take this drug with any other products that contain diphenhydramine because of increase reaction.

* Tell patient to notify prescriber if tolerance develops because a different antihistamine may need to be prescribed. Clindamycin Stops or slows the growth or proliferation of cells
disrupting the processes that lead directly to the generation of new proteins
causing cell death 300 mg IV q 4hr Lincosamide antibiotic Adjunct to surgical treatment of chronic bone and joint infections due to susceptible organisms Allergy to clindamycin; history of asthma or other allergies; hepatic or renal dysfunction
•CV: Hypotension, cardiac arrest (with rapid IV infusion)

•Hypersensitivity: Rashes, urticaria to anaphylactoid reactions

•Local: Pain following injection, indurations and sterile abscess after thrombophlebitis after IV use •Assess for infection (vital signs; appearance of wound, WBC) at beginning and throughout therapy

•Assess for allergy to clindamycin.

•Obtain specimens for culture and sensitivity prior to initiating therapy.

•Do not use for minor bacterial or viral infections.

•Monitor renal and liver function tests, and blood counts with prolonged therapy.
Budesonide Anti-inflammatory effect
Local administration into nasal passages
Maximizes beneficial effects on tissues
While decreasing the likelihood of adverse effects from systemic absorption. Nebulization q 8hr. Corticosteroid Used for management of bronchial asthma and symptomatic management of seasonal or perennial allergic rhinitis •Hypersensitivity to drug or for relief of acute asthma or bronchospasm.
•CNS: Headache, dizziness, fatigue

•Dermatologic: Rash, edema, pruritus, alopecia

•Endocrine: HPA suppression, Cushing’s syndrome with overdosage and systemic absorption

•GI: Nausea, dyspepsia, dry mouth

•Local: Nasal irritation

•Respiratory: Epistaxis, rebound congestion, pharyngitis, cough

•Other: Chest pain, acne, bruising, back pain •Assess for untreated local nasal infections, nasal trauma, septal ulcers, recent nasal surgery, lactation

•Do not use more often than prescribed; do not stop without consulting your health care provider.

•It may take several days to achieve good effects.

•Advice patient to report sore mouth, sore throat, worsening of symptoms, severe sneezing, exposure to chickenpox or measles, eye infections occur. Diamicron Gliclazide is a sulfonylurea
Stimulates insulin secretion by the pancreas
Resulting in a physiological release of insulin
Gliclazide restores glycaemic control throughout 24 hrs.
Normalizes fasting and postprandial blood sugar.
1 tab. BID Oral anti diabetic agent For non-insulin dependent diabetes (type 2), in association with dietary measures and with exercise, when these measures alone are not sufficient. •Contraindicated with Type 1 diabetes, ketoacidosis, diabetic precoma, severe renal or hepatic impairment, pregnancy, lactation. Co-administration with miconazole •Hypoglycemic: sweating, pallor, intense hunger, malaise.

•Dermatologic: urticaria, itching, skin rash

•GI: Nausea, diarrhea, stomach upsets, constipation, hepatitis •Follow as closely possible the diet prescribed by the doctor

•Regularly carry out the laboratory tests as prescribed or recommended by the doctor

•Inform the doctor in the ff. cases: Surgery, trauma, fever or infection, difficulty in eating.

•The once-daily administration of Diamicron MR must always be followed by a meal.

•Do not take a double dose to compensate for the single dose that was not taken. Sulferazone Bactericidal

Inhibits bacterial cell wall synthesis

Cell death 300 mg IV q 4hr Third generation of Cephalosporins Skin & soft tissue infections •Hypersensitivity to penicillins, sulbactam or cephalosporins, hepatic dysfunction and renal impairment, patients with poor diet, pregnancy and lactation.
•GI: diarrhea, nausea, vomiting, anorexia, abdominal pain, flatulence

•Hypersensitivity: urticaria, pruritus, anaphylactoid reaction / shock

•CNS: Headache,

•CV:
hypotension,
•Assess for hypersensitivity to any cephalosporin.

•Advice patient to report if severe diarrhea with blood, pus or mucus; difficulty of breathing; unusual irritation or itching and unusual bleeding occurs Humulin Increases glucose transport
across muscle ad fat cell membranes
Reduce glucose level
20/30
20 units pre BF

15 pre dinner Antidiabetics Treatment of diabetes mellitus for the control of hyperglycemia. Hypoglycemia Adverse Reaction: Lipodystrophy, insulin resistance. Local and generalized allergic reactions •Dosage is always prescribed in USP units.

•Monitor patient closely.

•Make sure that patient knows that insulin relief pain but does not cure disease.

•Instruct patient to avoid vigorous exercise.

•Teach patient to avoid alcohol use.

•Advice patient to wear or carry medical identification at all times.

Tramadol hydrochloride
Ultram
Unknown a centrally acting synthetic analgesic compound not chemically related to opoids. Thought to bind opioate receptor and inhibit reuptake of nor epinephrine and serotonin 50 mg lV q6 Opioid analgesic Moderate to moderately severe pain. Contraindicated in patients’ hyper sensitive to drugs other opiods, in breast feeding women, and in those w/ intoxication from alcohol, hypnotics, centrally acting analgesics, opioids or psychotropic drugs. Serious hypersensitivity reaction can occur, usually after the first dose. Patients w/ history of anaphylactic reaction to codeine and other opioids maybe at increase risk. Use
cautiously in patients at risk for seizures or respiratory depression; in patients w/ increase intracranial pressure or head injury, acute abdominal condition or renal or hepatic impairment or in patients w/ physical dependence on opioids.
NS: dizziness, vertigo, headaches, somnolence, CNS stimulation, asthenia, anxiety, confusion, coordination dis-turbace, euphoria, nervousness, sleep disorder, seizure, malaise
CV: vasodilation
EENT: visual disturbances.
GI: nausea, constipation, vomiting, dyspepsia, dry mouth, diarrhea, abdominal pain, anorexia, flatulence
GU: urine retention, urinary frequency, menopausal symptoms, proteinuria
Musculoskeletal: hypertonia
Respiratory: respiratory depression
Skin: pruritus, diaphoresis, rash. * reassess patient’s level of pain at least 30 minute after administration.
* monitor cu and respiratory status with hold dose and notify prescriber if respirations decrease or rate is below 12 breaths per minute.
* for better analgesic effect, give drug before on set of intense pain.
* monitor patient at risk for seizures. Drug may reduce seizure threshold.
* in case of an overdose, naloxone may also increase risk of seizures.
* monitor patient for drug dependence. Drug can produce defence similar to that of codeine or dextropropoxyphene and thus has potential for abuse.
* withdrawal symptoms may occur if drug is stopped abruptly reduce dosage gradually
look alike sound, don’t confuse tramadol w/ trazodone or trandolapril.
Cefepime Hydrochloride
Maxipime
Bactericidal

Inhibits bacterial cell wall synthesis

Cell death 500mg, 1 tab OD 3th generation cephalosporin Mild to moderate UTI caused by Escherichia coli, klebsiella pneumonia, proteus minabbilis, including concurrent bacteremia w/ these micro organism.

* patient w/ hypersensitive to drugs, cephalosporin, beta-lactam antibiotics, or penicillin.
* use cautiously in patients’ hypersensitivity to penicillin because of possibility of cross sensitivity w/ other beta-lactamantibiotics
* use cautiously in breast feeding women and in patients w/ history of colitis or renal insufficiency. CNS: fever, headaches
CV: phlebitis
GI: colitis, diarrhea, nausea, vomiting, ural candidiasis
SKIN: rash, pruritus uticaria
OTHER: pain inflammation, hypersensitivity reactions anaphy laxis. * before giving drug ask patients if he/she is allergic to penicillin or cephalosporin.
* obtain culture and sensitivity test.
* adjust dosage in pt. w/ renal function.
* monitor patients for super infection.
* look alike sound alike.
Do not confuse drug w/ cephalosporin that sound alike.
Piperacillin tazabacttam
Zosyn

Bactericidal

Inhibits bacterial cell wall synthesis

Cell death 2.25g lV q8
(-) ANST Anti infectives Moderate to severe infections from piperacillin resistant, piperacillin tazobactam- susceptible beta-lactamase producing strains of microorganism in appendicitis and peritonitis caused by escherichia coli, bacteroides fragills, B. Ovactus, B thetaiotaomicron, b vulgates, skin and skin structure infections caused by straphylococcus aureus; postpartium endometritis of pelvic inflammation disease caused by e. coli; moderately to severe community acquired pneumonia caused by haemophilus influenzae Contraindicated in patients hypersensitive to drug on other pencillins.
* Use cautiously in patients with bleeding tendencies, urenia, hypokalemia, and allergies to other drug, especially cephalosponins, because of possible cross sensitivity CNS: fever , headaches, insomnia, agitation, dizziness, anxiety, seizures.
CV: hypertension, tachycardia, chest pain, edema
EENt: rhinitis
GI: diarrhea, nausea, constipation, vomiting, dyspepsia, stool changes, abdominal pain, pseudomen branous colitis.
GU: interstitial nephritis, candidiasis.
HEMATOLOGIC: leukopenia, anemia eosinophilia, thrombocy topenia, neutropena.
Respiratory: dsypnea
SKIN: rash, pruritus
OTHERS: pain, anaphylaxis, inflammation, phlebitis, at IV site, hypersensitivity reaction. * Before giving drug ask patient about allergic reaction to penicillin
* obtain specimen for culture and sensitivity test before bacteriostatic antibiotic
* give tecarcillin at least II hour before bacteriostatic antibiotic
* monitor potassium and sodium levels
* check cbc and platelet counts frequently.
* drug is typically used as another antibiotic, such as gentamicin
* if large doses are given or if therapy is prolonged, bacterial or fungal super infection may occur, especially in elderly, debilitated or immunusuppressed patients. levofloxacin
Loxeva Bactericidal: Interferes with DNA by inhibiting DNA synase replication in susceptible
gram-negative and gram-positive bacteria, preventing cell reproduction
500mg tab od antibiotic Treatment of adults with community-acquired pneumonia, acute maxillary
sinusitis caused by susceptible bacteria
•Treatment of acute exacerbation of chronic bronchitis caused by susceptiblebacteria
•Treatment of complicated and uncomplicated skin and skin structure infections
caused by susceptible bacteria
•Treatment of complicated and uncomplicated UTIs and acute pyelonephritis
caused by susceptible bacteria
•Treatment of chronic bacterial prostatitis due to Escherichia coli, Enterococcus
faecalis, Staphylococcusspec ies
•Treatment of nosocomial pneumonia due to methicillin-sensitiveStaphylococcus
aureus, Pseudomonasstrains, Serratiaspec ies, Escherichia coli, Klebsiella
species, Haemophilus influenzae, Streptococcus pneumoniae
Contraindications and cautions
•Contraindicated with allergy to fluoroquinolones, lactation.
•Use cautiously with renal dysfunction, seizures, pregnancy.
CNS:Headache,dizziness, insomnia, fatigue, somnolence, blurred vision
•GI:Nausea, vomiting, dry mouth, diarrhea, abdominal pain (occur less with this
drug than with oflaxacin), constipation, flatulence
•Hematologic: Elevated BUN, AST, ALT, serum creatinine, and alkaline
phosphatase; neutropenia, anemia
•Other: Fever, rash, photosensitivity, muscle and joint tenderness
1.Arrange for culture and sensitivity tests before beginning therapy.
•Continue therapy as indicated for condition being treated.
•Administer oral drug 1 hr before or 2 hr after meals with a glass of water; separate
oral drug from other cation administration, including antacids, by at least 2 hr.
•Ensure that patient is well hydrated during course of therapy.
•Discontinue drug at any sign of hypersensitivity (rash, photophobia) or and complaint of tendon pain, inflammation, or rupture.
•Monitor clinical response; if no improvement is seen or a relapse occurs, repeat
culture and sensitivity test.