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8/17/2019 Ceftriaxone Omeprazole Ipatropium Salbutamol Aspirin
1/12
DRUG
ORDER
PHARMACOLOGIC ACTION
OF DRUG
INDICATIONS AND
CONTRAINDICATION
ADVERSE EFFECT OF
THE DRUG
DESIRED ACTIO
ON THE CLIEN
8/17/2019 Ceftriaxone Omeprazole Ipatropium Salbutamol Aspirin
2/12
Ceftriaxo
ne
Ceftriaxone inhibits the
snthesis in the ba!teria"
!e"" #a""$ Li%e other
!e&ha"os&orins of the
'thir( )eneration'* it has
a +er broa( anti,
ba!teria" -anti,.i!robia"/0
s&e!tr1. an( it is stab"e
a)ainst .ost 2,
"a!ta.ases$ Ceftriaxone
is hi)h" e3!ient a)ainst
stre&to!o!!i*
Hae.o&hi"1s in41en5ae*
neisseriae* &eni!i""in
resistant strains of
Sta&h"o!o!!1s a1re1s*
.1"tiresistant
enteroba!ters* as #e"" as
other ba!teria$ Its e6e!t
a)ainst Pse1(ono.as
aer1)inosa is "i.ite( an(
it is ine6e!ti+e a)ainst
.ethi!i""in resistant
strains of Sta&h"o!o!!1s
a1re1s* Entero!o!!1s
fae!a"is* C"ostri(i1.
(i3!i"e* an( 7a!teroi(es
fra)i"is$
Indications:
• Perio&erati+e
&ro&h"axis
• Treat.ent of8
9 Res&irator tra!tinfe!tions9 S%in an( s%in
str1!t1re infe!tions9 7one an( :ointinfe!tions9 Urinar tra!t an()ne!o"o)i!infe!tion9 Se&ti!e.ia
Contraindications: H&ersensiti+it to
!e&ha"os&orins
Serio1s
h&ersensiti+it
to &eni!i""ins
CNS: sei51res -hi)h
(oses0$
Gastrointestinal:
&se1(o.e.brano1
s !o"itis* (iarrhea*
na1sea* +o.itin)*
!ra.&s* &se1(o"ithiasis
Dermatologic:
rashes* 1rti!aria$
Hematologic:
b"ee(in)* b"oo(
(s!rasias*
he.o"ti! ane.ia$
Local: &ain at IMsite* &h"ebitisat IV
site$
• Miscellaneous:
a""er)i! rea!tions
in!"1(in)
ana&h"axis an(
ser1. si!%ness*
s1&erinfe!tion$
• For treatin)
&atient;s
&ne1.onia
an(
in4a..atio
of bron!hio"e
(1e to
asth.a
8/17/2019 Ceftriaxone Omeprazole Ipatropium Salbutamol Aspirin
3/12
NURSING RESPONSI7ILITES AND CAUTIONS
• Assess &atient for infe!tion -+ita" si)ns< a&&earan!e of #o1n(* s&1t1.* 1rine* an( stoo"< =7C0 at
be)innin) of an( thro1)ho1t thera&
• 7efore initiatin) thera&* obtain a histor to (eter.ine &re+io1s 1se of an( rea!tions to &eni!i""ins or
!e&ha"os&orins$ Persons #ith a ne)ati+e histor of &eni!i""in sensiti+it .a sti"" ha+e an a""er)i!
res&onse
• Obser+e &atient for si)ns an( s.&to.s of ana&h"axis -rash* &r1rit1s* "arn)ea" e(e.a* #hee5in)0$
Dis!ontin1e the (r1) an( notif the &hsi!ian or other hea"th !are &rofessiona" i..e(iate" if these
s.&to.s o!!1r$ >ee& e&ine&hrine* an antihista.ine* an( res1s!itation e?1i&.ent !"ose b in the e+en
of an ana&h"a!ti! rea!tion
• Ma !a1se in!rease( ser1. AST* ALT* a"%a"ine &hos&hatase* bi"ir1bin* LDH* 7UN* an( !reatinine
• Ma rare" !a1se "e1%o&enia* ne1tro&enia* a)ran1"o!tosis* thro.bo!to&enia* eosino&hi"ia*
".&ho!tosis* an( thro.bo!tosis
• Monitor in:e!tion site fre?1ent" for &h"ebitis -&ain* re(ness* s#e""in)0$ Chan)e sites e+er @B hr to
&re+ent &h"ebitis• In:e!t (ee& into a #e"",(e+e"o&e( .1s!"e .ass< .assa)e #e""
• A(+ise &atient to re&ort si)ns of s1&erinfe!tion -f1rr o+er)ro#th on the ton)1e* +a)ina" it!hin) or
(is!har)e* "oose or fo1",s.e""in) stoo"s0 an( a""er)
• Instr1!t &atient to notif hea"th !are &rofessiona" if fe+er an( (iarrhea (e+e"o&* es&e!ia"" if stoo" !ontain
b"oo(* &1s* or .1!1s$ A(+ise &atient not to treat (iarrhea #itho1t !ons1"tin) hea"th !are &rofessiona"$
• =at!h o1t for &ossib"e (r1),(r1) intera!tions8
Probenecid (e!reases ex!retion an( in!reases b"oo( "e+e"s
If alcohol is in)este( #ithin @B hr of !efa.an(o"e* !ef.eta5o"e* or !efotetan* a (is1"ra.,"i%
8/17/2019 Ceftriaxone Omeprazole Ipatropium Salbutamol Aspirin
4/12
rea!tion .a o!!1r
Cefa.an(o"e* !ef.eta5o"e* an( !efotetan .a &otentiate the e6e!ts of anticoagulants an(
in!rease the ris% of b"ee(in) #ith antiplatelet agents* thrombolytics* NSAIDs* plicamycin* oalproic acid$
DRUG
ORDER
PHARMACOLOGIC ACTION
OF DRUG
INDICATIONS AND
CONTRAINDICATION
ADVERSE EFFECT OF
THE DRUG
DESIRED ACTIO
ON THE CLIEN
8/17/2019 Ceftriaxone Omeprazole Ipatropium Salbutamol Aspirin
5/12
O.e&ra5o"
e @.)
tab* tab
o( &o
!her" Class: anti1"!er
a)ents
Pharm" Class: &roton
&1.& inhibitors
7in(s to an en5.e on
)astri! &arieta" !e""s in the
&resen!e of a!i(i! )astri!
&H* &re+entin) the na"
trans&ort of h(ro)en ions
into the )astri! "1.en
Thera&e1ti! E6e!ts8
9 Di.inishe(
a!!1.1"ation of a!i( in the
)astri! "1.en #ith"essene( )astroeso&ha)ea"
re41x
9 Hea"in) of (1o(ena"
1"!ers
Indications:
• Mana)e.ent
of GERD
• Mana)e.ent
of (1o(ena"
1"!ers -#ith
or #itho1t
anti,infe!ti+es for
H$ &"ori0
• Treat.ent of
&atho"o)i!
h&erse!reto
r
!on(itions*
in!"1(in)
o""in)er,
E""ison
sn(ro.e
Contraindications:
H&ersensiti+it
• CNS: (i55iness*
(ro#siness* fati)1e*
hea(a!he*
#ea%ness$
• C#: !hest &ain$
• GI: ab(o.ina" &ain*
a!i( re)1r)itation*
!onsti&ation*
(iarrhea* 4at1"en!e*
na1sea* +o.itin)$
• Derm: it!hin)* rash$
Misc: a""er)i!
rea!tions$
Pre+ent sto.a!
1"!ers
NURSING RESPONSI7ILITES AND CAUTIONS
8/17/2019 Ceftriaxone Omeprazole Ipatropium Salbutamol Aspirin
6/12
=at!h o1t for the fo""o#in) (r1),(r1) intera!tions
O.&era5o"e is .etabo"i5e( b the CJP@K en5.e sste. an( .a !o.&ete #ith other a)ents
.etabo"i5e( b this sste.
De!reases .etabo"is. an( .a in!rease e6e!ts of dia$epam* %ura$epam* tria$olam* cyclosporine
disul&ram* phenytoin* an( 'ar(arin
Ma interfere #ith absor&tion of (r1)s re?1irin) a!i(i! )astri! &H* in!"1(in) esters of ampicillin* iron
salts* digo)in* cyanocobalamine* an( *etocona$ole
Has been 1se( safe" #ith antacids• Assess &atient ro1tine" for e&i)astri! or ab(o.ina" &ain an( fran% or o!!1"t b"oo( in the stoo"* e.esis* or )astri!
as&irate$
• A(.inister (oses before .ea"s* &referab" in the .ornin)$ Ca&s1"es sho1"( be s#a""o#e( #ho"e< (o not !r1sh*
o&en* or !he#$
• Ma be a(.inistere( !on!1rrent" #ith anta!i(s$
• Instr1!t &atient to ta%e .e(i!ation as (ire!te( for the f1"" !o1rse of thera&* e+en if fee"in) better$ If a (ose is
.isse(* it sho1"( be ta%en as soon as re.e.bere( b1t not if a".ost ti.e for next (ose$ Do not (o1b"e (oses$
• Ma !a1se o!!asiona" (ro#siness or (i55iness$ Ca1tion &atient to a+oi( (ri+in) or other a!ti+ities re?1irin)a"ertness 1nti" res&onse to .e(i!ation is %no#n$
• A(+ise &atient to a+oi( a"!oho"* &ro(1!ts !ontainin) as&irin or NSAIDs* an( foo(s that .a !a1se an in!rease in G
irritation$
• A(+ise &atient to re&ort onset of b"a!%* tarr stoo"s< (iarrhea< ab(o.ina" &ain< or &ersistent hea(a!he to hea"th !a
&rofessiona" &ro.&t"
DRUG
ORDER
PHARMACOLOGIC ACTION
OF DRUG
INDICATIONS AND
CONTRAINDICATION
ADVERSE EFFECT OF
THE DRUG
DESIRED ACTIO
ON THE CLIEN
8/17/2019 Ceftriaxone Omeprazole Ipatropium Salbutamol Aspirin
7/12
I&ratro&i1. sa"b1ta.o"
Phar.a!o"o)i! !"ass8Anti!ho"in
er)i!
The i&ratro&i1. in)re(ientis an anti!ho"iner)i! (r1)#hi!h re"axes s.ooth.1s!"e in the "1n)$
The sa"b1ta.o" in)re(ientis a beta, a)onist #hi!hsti.1"ates beta, sites in
the "1n)s to re"ax thebron!hi$
TE8 Re"ie+esbron!hos&as.s$
In(i!ations8
7ron!ho(i"ator for
.aintenan!e thera&
of bron!hos&as.$
Contrain(i!ations8
Contrain(i!ate( #ith
h&ersensiti+it toatro&ine or its
(eri+ati+es$
CNS8 (i55iness* b"1rre(+isionGI8 na1sea* (r .o1thRes&i8 (s&nea*bron!hos&as.s*horsenessCV8 &a"&itations* !hest&ain
To re"ie+ebron!hos&as.san( o&enair#as$
NURSING RESPONSI7ILITES AND CAUTIONS
8/17/2019 Ceftriaxone Omeprazole Ipatropium Salbutamol Aspirin
8/12
Monitor the &atient;s +ita" si)ns* notin) h&otension an( an irre)1"ar or abnor.a" &1"se$ Maintain a ?1iet* !o.fortab"e en+iron.ent to .ini.i5e anxiet an( &erha&s (e!rease &a"&itations$
Tea!h the &atient &1rse(,"i& breathin)* (ia&hra).ati! breathin)* an( !hest s&"intin)$
DRUG
ORDER
PHARMACOLOGIC ACTION
OF DRUG
INDICATIONS AND
CONTRAINDICATION
ADVERSE EFFECT OF
THE DRUG
DESIRED ACTIO
ON THE CLIEN
8/17/2019 Ceftriaxone Omeprazole Ipatropium Salbutamol Aspirin
9/12
As&irin De!reases &"ate"et
a))re)ation$ Exhibits
anti&reti!* anti,
in4a..ator an(
ana")esi! e6e!ts$ The
anti&reti! e6e!t is (1e to
an a!tion on the
h&otha"a.1s* res1"tin) inheat "oss b +aso(i"ation of
&eri&hera" b"oo( +esse"s$
Anti,in4a..ator e6e!ts
are .e(iate( b a
(e!rease in &rosta)"an(in
snthesis$ It a"so
Indications:
• For &ain on
inte)1.entar
str1!t1res*
.a")ia*
ne1ra")ia*
hea(a!he*
(s.enorrhea*)o1t$
• Arthritis* SLE*
a!1te rhe1.ati!
fe+er
Contraindications:
• H&ersensiti+it
to sa"i!"ates*
se+ere ane.ia*
histor of b"oo(
!oa)1"ation
(efe!ts* +ita.in >
(e!ien!* #ee%
before an( after
s1r)er*
&re)nan! in the
"ast tri.ester
GI: (s&e&sia*
heartb1rn* anorexia*
na1sea* e&i)astri!
(is!o.fort*
&otentiation of &e&ti!
1"!er
Allergic:
7ron!hos&as.*asth.a,"i%e s.&to.s*
ana&h"axis* s%in
rashes* 1rti!aria
Hematologic:
&ro"on)ation of
b"ee(in) ti.e*
thro.bo!to&enia*
"e1!o&enia*
+ther: Thirst* fe+er*(i.ness of +ision
Pre+ent b"oo(
!oa)1"ation (1e
to h&ertension
-narro# b"oo(
+esse"s .a
!a1se b"oo( to
a))re)ate0
NURSING RESPONSI7ILITES AND CAUTIONS
8/17/2019 Ceftriaxone Omeprazole Ipatropium Salbutamol Aspirin
10/12
• Assess for &ain8 t&e* "o!ation an( &attern
• Note for asth.a
• Monitor rena"* LFTs an( C7C
• Deter.ine histor of &e&ti! 1"!ers or b"ee(in) ten(en!ies$
Precautions:
• Do not 1se in !hi"(ren #ith !hi!%en &ox or 41 s.&to.s
• La!tation
• Mi"( (iabetes* erosi+e )astritis* b"ee(in) ten(en!ies* "i+er or %i(ne (isease$
8/17/2019 Ceftriaxone Omeprazole Ipatropium Salbutamol Aspirin
11/12
8/17/2019 Ceftriaxone Omeprazole Ipatropium Salbutamol Aspirin
12/12