Generic Name: Piperacillin Sodium + Tazobactam Sodium

Trade Name: Levepipe

Classification: Antibacterial (Penicillin)

Indications (indicated for the patient): To treat moderate to severe bacterial infections; and to treat
moderately severe community-acquired pneumonia caused by haemophilus influenza.

Mechanism of Action: Inhibits cell-wall synthesis during bacterial multiplication; stops the growth of
bacteria.

Route: IV

Frequency: Q8H ANST

Dosage: 4.5g

Adverse Reactions/Side Effects: Headache, insomnia, fever, dizziness, diarrhea, constipation, nausea
and vomiting, rash

Drug-to-Drug, Food-to-Drug Interaction: Interacts w/ high doses of heparin, oral anticoagulants or other
drugs that affect blood coagulation or thrombocyte function. Prolongs the neuromuscular blockade of
vecuronium and non-depolarising muscle relaxants. Prolongs half-lives w/ probenecid. Increased risk of
methotrexate toxicity.

Nursing Considerations/Patient Teaching:

- Monitor patient for diarrhea and initiate therapeutic measures as needed.
- If rash develops, monitor patient closely and discontinue if lesion progresses.
- Monitor hematologic and coagulation parameters.
- Monitor sodium intake and electrolyte levels.

Reference:

Woods, A. (2023). Piperacillin sodium-tazobactam sodium. In Nursing 2023 Drug Handbook (pp. 1199-
1202). Philadelphia: Wolters Kluwer.
Generic Name: Hydrocortisone

Trade Name: Levecortix

Classification: Corticosteroids

Indications (indicated for the patient): To treat respiratory diseases, severe or intractable allergic states

Mechanism of Action: Not clearly defined. Decreases inflammation, mainly by stabilizing leukocyte
lysososmal membranes, suppresses immune response; stimulates bone marrow; and influences protein,
fat, and carbohydrate metabolism.

Route: IVTT

Frequency: Q8H

Dosage: 100mg

Adverse Reactions/Side Effects: Euphoria, insomnia, vertigo, mood swings, headache, nausea and
vomiting, muscle weakness.

Drug-to-Drug, Food-to-Drug Interaction: Reduced efficacy with concurrent use of carbamazepine,

phenytoin, primidone and barbiturates. Rifampicin reduces corticosteroid activity. Peptic ulcer with
concurrent NSAIDs administration. Dose of antidiabetics and antihypertensives needs to be increased.
Decreases serum concentration of salicylates and antimuscarinic agents.

Nursing Considerations/Patient Teaching:

 Determine whether pt. is sensitive to other corticosteroids.

 Always adjust to lowest effective dose.
 Monitor pt’s. weight, BP, and electrolyte levels.
 Inspect pt’s. skin for petechiae.
 Monitor pt. for cushingoid effects (moon face, central obesity, thinning hair, HTN)
 Tell Px not to stop drug abruptly or without prescriber’s consent.

Reference:

Woods, A. (2023). Hydrocortisone. In Nursing 2023 Drug Handbook (pp. 720-724). Philadelphia: Wolters
Kluwer.
Generic Name: Pantoprazole Sodium

Trade Name: Acicare

Classification: Proton Pump Inhibitor (Antiulcer drugs)

Indications (indicated for the patient): Short-term treatment of erosive esophagitis associated with
GERD; reduces the amount of acid your stomach makes; prevent and treat stomach ulcers

Mechanism of Action: Inhibits proton pump activity by binding to hydrogen-potassium adenosine

triphosphatase, located at secretory surface of gastric parietal cells, to suppress gastric acid secretion.

Route: IVTT

Frequency: Q24H

Dosage: 40mg

Adverse Reactions/Side Effects: Nausea, vomiting, diarrhoea, constipation, flatulence, abdominal pain,
dyspepsia, dry mouth

Drug-to-Drug, Food-to-Drug Interaction: Increased risk of hypomagnesaemia with diuretics. Increased

risk of digoxin-induced cardiotoxic effects. May increase INR and prothrombin time of warfarin. May
increase plasma concentration of methotrexate. May decrease absorption of itraconazole, ketoconazole,
posaconazole, erlotinib.

Nursing Considerations/Patient Teaching:

- Monitor the patient for any signs of bleeding, such as dark stools or vomiting blood.
- Monitor bowel function.
- Instruct patient to notify the physician of any side effects.
- Instruct Px to take exactly as prescribed and at about the same time every day.
- Encourage compliance with the treatment plan.

Reference:

Woods, A. (2023). Pantoprazole sodium. In Nursing 2023 Drug Handbook (pp. 1151-1154). Philadelphia:
Wolters Kluwer.
Generic Name: Azithromycin Dihydrate

Trade Name: Berzimax

Classification: Antibacterial (Macrolide Antibiotics)

Indications (indicated for the patient): Treatment for community acquire pneumonia; infections from
respiratory pathogens (S. pneumoniae, M. pneumonia, H. influenzae)

Mechanism of Action: Binds to the 50S subunit of bacterial ribosomes, blocking protein synthesis;
bacteriostatic or bactericidal, depending on concentration.

Route: IV drip

Frequency: Q24H

Dosage: 500mg

Adverse Reactions/Side Effects: fatigue, headache, dizziness, palpitations, nausea and vomiting, rash,
photosensitivity reactions

Drug-to-Drug, Food-to-Drug Interaction: Increased risk of prolonged QT interval with class IA (e.g.
quinidine, procainamide) and class III (e.g. dofetilide, amiodarone, sotalol) antiarrhythmics; pimozide
cisapride and terfenadine. Increased serum concentrations of digoxin, colchicine, and ciclosporin. May
potentiate the effects of oral anticoagulants (e.g. warfarin).

Nursing Considerations/Patient Teaching:

- Monitor Px for superinfection and for allergic and skin reactions. Discontinue if reactions occur.
- Advise Px to avoid excessive sunlight and to wear protective clothing and use sunscreen when outside.

Reference:

Woods, A. (2023). Azithromycin. In Nursing 2023 Drug Handbook (pp. 185-188). Philadelphia: Wolters
Kluwer.
Generic Name: Acetylcysteine

Trade Name: Exflem

Classification: Mucolytics

Indications (indicated for the patient): Used for its mucolytic activity in respiratory disorders associated
with productive cough and thick viscous hypersecretion such as acute bronchitis, chronic bronchitis and
its exacerbation, pulmonary emphysema, cystic fibrosis, and bronchiectasis.

Mechanism of Action: Reduces the viscosity of pulmonary secretions by splitting disulphide linkages
between mucoprotein molecular complexes. Also restores liver stores of glutathione to treat
acetaminophen toxicity; liquefies mucous to make it easier to cough out.

Route: PO

Frequency: BID

Dosage: 600mg sachet in ½ glass H2O

Adverse Reactions/Side Effects: Fever, nausea, vomiting, drowsiness, tachycardia, chest tightness,
dyspnea, chills.

Drug-to-Drug, Food-to-Drug Interaction: Activated charcoal: May limit acetylcysteine’s effectiveness.

Avoid using activated charcoal before or with oral acetylcysteine.

Nursing Considerations/Patient Teaching:

- Monitor cough type and frequency.
- Monitor pt. for bronchospasm, especially if pt. has asthma.
- Warn pt. that drug may have a foul taste or smell.

Reference:

Woods, A. (2023). Acetylcysteine. In Nursing 2023 Drug Handbook (pp. 76-78). Philadelphia: Wolters
Kluwer.
Generic Name: CM-Glucan

Trade Name: ImmunoMax Forte

Classification: (Food) Supplements & Adjuvant Therapy

Indications (indicated for the patient): Enhances immune function and helps in reducing susceptibility to
infection. It may be given as adjuvant to antimicrobial, antiviral and antifungal agents. Helps reduce
severity and duration of allergic rhinitis and asthma or as an adjunct to antiasthma medications.

Mechanism of Action: The process of carboxymethylation transform β-Glucan to CM-Glucan

(carboxymethyl-glucan or carboxymethylated Beta (1,3-glucan) into a highly soluble glucan that can be
readily absorbed by the body. As a result, CM-Glucan triggers and enhances phagocytosis that sets off
the entire immune system cascade.

Route: PO

Frequency: OD

Dosage: 30 mg 1 capsule

Adverse Reactions/Side Effects: Absence of adverse effects.

Drug-to-Drug, Food-to-Drug Interaction: Safe to use with other vitamins, supplements, or medicines

Nursing Considerations/Patient Teaching:

- Take one capsule once a day or as recommended by a healthcare professional.

Reference:

MIMS. BIBLIOGRAPHY ImmunoMax 10/ImmunoMax Forte 30 Capsule. Retrieved from:

https://www.mims.com/philippines/drug/info/immunomax%2010-immunomax%20forte
%2030%20capsule?type=full
Generic Name: Paracetamol

Trade Name: Biogesic

Classification: Analgesic/antipyretic drugs

Indications (indicated for the patient): For mild pain or fever

Mechanism of Action: Thought to produce analgesia by inhibiting prostaglandin and other substances
that sensitize pain receptors. Drug may relieve fever through central action in the hypothalamic heat-
regulating center.

Route: PO

Frequency: Q4H PRN for fever

Dosage: 500 mg 1 tab

Adverse Reactions/Side Effects: fatigue, headache, insomnia, pyrexia, hypotension, nausea and
vomiting, oliguria, rash

Drug-to-Drug, Food-to-Drug Interaction: Cholestyramine resin (may decrease acetaminophen

absorption); Imatinib, mipomersen (may increase hepatoxic effects of these drugs); Isoniazid (may
increase risk of acetaminophen adverse effects); Alcohol use (may increase risk of hepatic damage)

Nursing Considerations/Patient Teaching:

- Advise Px that drug is only for short-term use (adults no longer than 10 days).
- Tell Px to consult prescriber for fever lasting longer than 3 days.
- Warn Px to stop drugs and seek immediate medical attention if rash or other reactions occur.

Reference:

Woods, A. (2023). Acetaminophen. In Nursing 2023 Drug Handbook (pp. 71-74). Philadelphia: Wolters
Kluwer.
Generic Name: Ipratropium Bromide + Salbutamol

Trade Name: Duavent

Classification: Antiasthmatic & COPD Preparations

Indications (indicated for the patient): Management of reversible bronchospasm associated with
obstructive airway diseases (e.g., bronchial asthma). For use in patients with COPD on a regular inhaled
bronchodilator who continue to have evidence of bronchospasm and who require a second
bronchodilator.

Mechanism of Action: Ipratropium bromide-Salbutamol combination maximizes the response to

treatment in patients with bronchial asthma and chronic obstructive pulmonary disease (COPD) by
increasing bronchodilation through two distinctly different mechanisms, i.e., anticholinergic
(parasympatholytic) and beta2-agonist (sympathomimetic) effects. They work by relaxing and opening
up the air passages, making breathing easier and improving shortness of breath, chest tightness and
wheezing.

Route: Inhalation/Respiratory

Frequency: Q6H

Dosage: 1 nebule

Adverse Reactions/Side Effects: urticaria, angioedema, rash, anaphylaxis, bronchospasm, blurred vision,
dry mouth, nausea, headache.

Drug-to-Drug, Food-to-Drug Interaction: Increased adverse adverse effects with corticosteroids,

xanthine derivatives, diuretics.

Nursing Considerations/Patient Teaching:

- Inform Px to avoid spraying into the eyes.
- Caution Px this drug may cause dizziness and blurred vision, if affected, do not drive or operate
machinery.
- Report rash, eye pain, difficulty voiding, palpitations, and vision changes.
- Instruct pt. to rinse mouth after treatment to prevent dry mouth and throat irritation

Reference:

MIMS. Ipratropium Bromide + Salbutamol. Retrieved from:

https://www.mims.com/philippines/drug/info/ipratropium%20bromide%20+%20salbutamol?
mtype=generic