7/29/2019 Drug Study 903
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Drug Data Mechanism of Action Indication Contraindications
Adverse Reaction Nursing Intervention
Generic NameAmpicillin
PharmacologicClass:Penicillin
TherapeuticClass:Antibiotic
Dosage:260 mg ANST
Bactericidal actionagainst sensitiveorganisms; inhibitssynthesis
of bacterialcell wall, causing celldeath.
PharmacokineticsD: Crosses placenta;enters breast milkM:Not
knownE: Urine, unchanged
Drug Half Life1-2 hours
Treatment for acutegastroenteritis causeby bacteria.
Concentrations- Allergies to penicillins,cephalosporins, or
otherallergens
Precaution
- Renal disorders
Drug interactionDrug to drug- Increased ampicillin effectwith
probenecid- Increased risk of rash withallopurinol- Increased
bleeding effectwith heparin, oralanticoagulants- Decreased effect
withtetracyclines,
chloramphenicol- Decreased efficacy ofhormonal
contraceptives,atenolol with ampicillin
Drug to food- Oral ampicillin may be lesseffective with food;
take onempty stomach
Drug to lab test- False-positive Coombs' testif given IV-
Decrease in plasmaestrogen concentrations inpregnant women-
False-positive urine glucosetests if Clinitest, Benedict'ssolution
or Fehling's solutionis used
CNS: Lethargy, hallucinations,seizures
CV: Heart failure
GI: Glossitis, stomatitis,
gastritis, sore mouth, furrytongue, black hairy tongue,nausea,
vomiting, diarrhea,abdominal pain, bloodydiarrhea,
enterocolitis,pseudomembranous colitis,nonspecific hepatitis
GU: Nephritis
Hematologic:Anemia,thrombocytopenia, leukopenia,neutropenia,
prolonged
bleednig time
Hypersensitivity:Rash, fever,wheezing, anaphylaxis
Local: Pain, phlebitis,thrombosis at injection site
Other: Superinfections oraland rectal moniliasis, vaginitis
Before-Observe 15 rights in drugadministration.- 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 useshormonal contraceptive, she should usea second form of
birth control for 1-2weeks while taking this drug.
During- Administer oral drug on an emptystomach, 1 hour before
or 2 hours aftermeals.- Administer with a full glass of water.
Donot give with fruit juice or soft drinks.- Do not give IM
injections in the same
site; atrophy can occur.- For IV administration, give slowly
over3-5 mins.- Use within 1 hour after preparationbecause potency
may decreasesignificantly after that.
After- Dispose of used materials properly.- Educate patient
about side effects.- Instruct to report pain or discomfort atsites,
unusual bleeding or bruising,mouth sores, rash, hives, fever,
itchingsevere diarrhea, difficulty breathing.- Instruct patient not
to use antibiotic toself-treat other infections.- Instruct to take
the full course of drugtherapy.- Do proper documentation.
7/29/2019 Drug Study 903
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Drug Data Mechanism of Action Indication Contraindications
Adverse Reaction Nursing Intervention
Generic NameHydrocortisone
PharmacologicClass:
Adrenal corticalsteroidCorticosteroidGlucocorticosteroid
TherapeuticClass:Hormone
Dosage40 mg ANST
Enters target cells andbinds to cytoplasmicreceptor; initiates
manycomplex reactions thatare responsible for its
anti-inflammatory,immunosuppressive(glucocorticoid),
andsalt-retaining(mineralocorticoid)actions.
Treatment forgastrointestinaldisorders like
acutegastroenteritis.Thishelp reduces cell
damage andinflammation. It isalso used to suppressthe immune
system;and aid in fat, proteinand carbohydratemetabolism.
Concentrations- Allergy to any component ofthe drug- Fungal
infections- Amebiasis
- Hepatitis B- Vaccinia or varicella- Antibiotic-resistant
infections- Immunosuppression
Precaution- Kidney disease- Liver disease- Cirrhosis-
Hypothyroidism- Ulcerative colitis withimpending perforation-
Diverticulitis- Recent GI surgery- Active or latent peptic ulcer-
Inflammatory bowel disease- Hypertension- Heart failure-
Thromboembolic tendencies- Osteoporosis- Convulsive disorders-
Metastatic carcinoma- Diabetes mellitus- TB- Lactation
CNS: Vertigo, headache,paresthesias, insomnia,seizures,
psychosisCV: Hypotension, shock, HPNand heart failure secondary
to
fluid retention,thromboembolism,thrombophlebitis, fatembolism,
cardiac arrhythmiasDermatologic:Thin, fragileskin, petechiae,
ecchymoses,purpura, striae, subcutaneousfat atrophyEENT: Cataracts,
glaucoma,increased IOPEndocrine:Amenorrhea,irregular mens,
growthretardation, decreasedcarbohydrate tolerance andDM,
cushingoid state, HPAsuppression systemic ,hyperglycemiaGI: Peptic
or esophageal ulcer,pancreatitis, abdominaldistention, nausea,
vomiting,increased appetite and weightgainHematologic:Na and
fluidretention, hypocalcemia,increased blood sugar,increased serum
cholesterol,decreased T3 and T4 levels
Hypersensitivity:Anaphylactoid orhypersensitivity
reactionsMusculoskeletal:Muscleweakness, steroid myopathyand loss
of muscle mass,osteoporosis, spontaneousfracturesOther:
Immunosuppression,aggravation or masking ofinfections, impaired
woundhealing
Before- Assess for contraindications.- Assess body weight, skin
color, V/S,urinalysis, serum electrolytes, X-rays,CBC.
- Arrange for increased dosage whenpatient is subject to unusual
stress.- Do not give live vaccines withimmunosuppressive doses
ofhydrocortisone.- Observe the 15 rights of drugadministration.
During- Give daily before 9am to mimic normalpeak diurnal
corticosteroid levels.- Space multiple doses evenlythroughout the
day.- Use minimal doses for minimal durationto minimize adverse
effects.- Do not give IM injections if patient hasthrombocytopenic
purpura.- Taper doses when discontinuing high-
dose or long-term therapy.
After- Monitor client for at least 30 minutes.- Educate client
on the side effects of themedication and what to expect.- Instruct
client to report pain at injectionsite.- Instruct client to take
drug exactly as
prescribed.- Dispose of used materials properly.- Document that
drug has been given.
