Generic Name Azithromycin

Brand Name Magbro Healthcare

Classification Antibiotics/Macrolides.

Route Onset Peak Duration

Oral Unknown 2-5 hr Unknown

Action  Azithromycin dihydrate, a macrolide from the azalide

subclass, acts as an antibacterial by binding to the
50s ribosomal subunit of susceptible bacteria and
inhibiting protein synthesis.
 Azithromycin is rapidly absorbed and 40%
bioavailable orally, with peak plasma concentrations
2-3 hours after dose. High concentrations enter white
blood cells, cross placenta, and demethylate in liver.
Indication  Resp-tract infections (including otitis media), skin &
soft-tissue infections, uncomplicated genital
infections. Prophylaxis & as component of regimens
in treatment of Mycobacterium avium complex (MAC)
infections.
Health Teaching  Advise patient not to stop taking drug with-
out first contacting health care provider.
 Tell patient that tablets and suspension can
be taken with or without food. Food may re-
duce GI upset..
 Instruct patient to thoroughly wash hands
before instilling ophthalmic solution.
 Tell patient to avoid contaminating oph-
thalmic applicator tip and not to let tip touch
eye, fingers, or other surfaces.
 Instruct patient how to instill ophthalmic
solution.
 Advise patient to avoid contact lenses when
diagnosed with bacterial conjunctivitis.
 Tell patient to take drug as prescribed, even
after feeling better.
 Advise patient to avoid excessive sunlight
and to wear protective clothing and use sun-
screen when outside.
 Tell patient to report adverse reactions
promptly
 .Instruct parents and caregivers to contact
prescriber if vomiting or irritability with feed-
 ing occurs during or after azithromycin use
in neonates (treatment up to 42 days of life).
Alert: Warn patient to seek immediate med- ical
care for irregular heartbeat, shortness of breath,
dizziness, or fainting.
Contraindications  Azithromycin is contraindicated in patients with known
hypersensitivity to Azithromycin, erythromycin, any
macrolide or ketolide antibiotic. Azithromycin is
contraindicated in patients with a history of cholestatic
jaundice/hepatic dysfunction associated with prior use
of Azithromycin.
Side Effects
 CNS: Fatigue, Headache, Somnolence, dizziness.
 CV: Chestpain, palpitations.
 EENT: Eye irritation
 GI: Abdominal pain, anorexia, diarrhea, nausea,
vomiting, pseudomembranous colitis, dyspepsia,
flatulence, melena.
 GU: Candidiasis, nephritis, vaginitis.
 HEPATIC: Cholestatic juandice
 SKIN: Photosensitivity reactions, rash, pain at
injectionsite.
Nursing Intervention • Monitor patient for superinfection. Drug may cause
overgrowth of nonsusceptible bac- teria or fungi.
Alert: Monitor patient for CDAD, which may range in
severity from mild diarrhea to fatal colitis.
Alert: Consider full risk profile when choosing
appropriate antibiotic therapy. Al- ternative macrolide
or fluoroquinolone class drugs also have the potential
to cause QT- interval prolongation and other
significant adverse effects.

• Monitor patient for allergic and skin reac- tions.

Discontinue drug if reactions occur. Be aware that
allergic symptoms may recur when symptomatic
therapy is discontinued; patient may require
prolonged monitoring and treatment.

• Monitor patient for jaundice, hepatotoxi- city, and

hepatitis. Discontinue drug imme- diately if signs and
symptoms (yellowing of skin or sclera, abdominal
pain, nausea, vomit- ing, dark urine) occur. Alert:
Exacerbation and new onset of myasthenia gravis
have occurred with azithromycin use.
 Generic Name Clopidogrel
Brand Name
Classification Antiplatelet drugs/Platelet aggregation inhibitors

Route Onset Peak Duration

Oral 2 hr 45 mins. 5 days

Action  Clopidogrel selectively and irreversibly inhibits

adenosine diphosphate (ADP) from binding to its
platelet P2Y12 receptor and subsequent ADP-
mediated activation of glycoprotein IIb/IIIa complex,
thus reducing platelet aggregation.
Indication  To treat iron or vitamin deficiencies caused by the
illness, pregnancy, poor nutrition, digestive disorder,
and many other condition
 Prevention and treatment of iron-vitamin deficiency
anemias; used in anemia die to blood loss during
menstruation, infections, surgery, delivery
intoxications, parasitosis, or other causes & anemias
during pregnancy
Health Teaching  Advise patient that it may take longer than usual to
stop bleeding and to refrain from ac- tivities in which
trauma and bleeding may occur. Encourage patient to
wear a seat belt when in a car.

 Instruct patient to notify prescriber if un- usual

bleeding or bruising occurs.

 Tell patient to inform all health care providers,

including dentists, before undergo- ing procedures or
starting new drug therapy, about taking drug.

 Inform patient that drug may be taken with- out regard

to meals.

Contraindications Active pathological bleeding (e.g. peptic ulcer or

intracranial haemorrhage). Severe hepatic
impairment.

Contraindicated in patients hypersensitive to drug or

 its components, in those with a his- tory of
hypersensitivity or hematologic re- action to other
thienopyridines, and in those with pathologic bleeding
(such as peptic ulcer or intracranial hemorrhage).

• Hypersensitivity reactions, including rash,

angioedema, and hematologic reactions, have been
reported.

• Consider discontinuing drug 5 days before elective

surgery, including elective CABG, except in patients
with cardiac stents who haven't completed the full
course of dual an- tiplatelet therapy; discuss patient-
specific sit- uations with cardiologist. Platelet
aggregation won't return to normal for at least 5 days
after drug has been stopped.

• Premature interruption of therapy may re- sult in

stent thrombosis with subsequent fatal or nonfatal MI.
Duration of therapy, in gen- eral, is determined by
type of stent placed (bare metal or drug eluting) and
whether an ACS event was ongoing at the time of
place- ment.

• Use cautiously in patients at risk for in- creased

bleeding from trauma, surgery
Side Effects CNS: confusion, fatal intracranial bleeding,
hallucinations, headache.
CV: hypotension, hemorrhage at any site.
EENT: epistaxis, rhinitis, taste disorder. GI:
hemorrhage, ab- dominal pain, constipation, diarrhea,
dys- pepsia, gastritis, ulcers.
GU: UTI, hema- turia.
Hematologic: thrombotic thrombocy- topenic purpura.
Musculoskeletal: arthral- gia, myalgia, arthritis.
Respiratory: bron- chospasm, interstitial pneumonitis,
respira- tory tract bleeding.
Skin: rash, pruritus, bruis- ing, eczema, erythema
multiforme, urticaria, SJS, toxic epidermal necrolysis.
Other: flu- like syndrome, angioedema, anaphylaxis,
serum sickness.
Nursing Intervention
 Generic Name Spironolactone
Brand Name
Classification Aldosterone antagonists.

Route Onset Peak Duration

Oral/Tab Unknown 3-4 hrs 2-3 days

Action Spironolactone is a steroid with a structure that

resembles natural aldosterone. It competes with
aldosterone for receptor sites in the distal convoluted
renal tubule, thereby increasing the excretion of Na
and water while conserving K and hydrogen ions.
Indication Essential HTN is a short-term pre-operative treatment
for patients with primary hyperaldosteronism,
including severe heart failure. It can also be used to
manage conditions like liver cirrhosis, edema, and
hirsutism.
Health Teaching  Instruct patient to take drug consistently either with or
without food.

 Tell patient to report all adverse reactions.

 Alert: To prevent serious hyperkalemia, warn patient

to avoid excessive ingestion of potassium-rich foods
(such as citrus fruits, tomatoes, bananas, dates, and
apricots), salt substitutes containing potassium, and
potas- sium supplements.

 Caution patient not to perform hazardous activities if

adverse CNS reactions occur.

 Advise patient about possible breast tender- ness or

enlargement.
Contraindications Hypersensitivity. Acute renal insufficiency, significant
renal compromise anuria; Addison's disease;
hyperkalemia. Concomitant use of eplerenone.
Side Effects CNS: headache, drowsiness, lethargy, con- fusion, ataxia.
Gl: diarrhea, gastric bleed- ing, ulceration, cramping,
gastritis, nausea, vomiting.
GU: renal failure, inability to maintain erection, menstrual
 disturbances, postmenopausal bleeding.
Hematologic: agranulocytosis.
Metabolic: hyperkalemia, dehydration, hyponatremia, mild
acidosis.
Skin: urticaria, hirsutism, maculopapular eruptions.
Other: anaphylaxis, gynecomas- tia, breast soreness, drug
fever

Nursing Intervention  Monitor electrolyte levels, fluid intake and output,

weight, and BP closely.

 Monitor elderly patients closely, who are more

susceptible to excessive diuresis.

 Inform laboratory that patient is taking spironolactone

because drug may interfere with tests that measure
digoxin level.

 Drug is less potent than thiazide and loop diuretics

and is useful as an adjunct to other diuretic therapy.
Diuretic effect is delayed 2 to 3 days when used alone.

 Maximum antihypertensive response may be delayed

for up to 2 weeks.

 Watch for hyperchloremic metabolic aci- dosis,

especially in patients with hepatic cirrhosis.

 Look alike-sound alike: Don't confuse Aldactone with

Aldactazide
Generic Name Acetylcysteine
Brand Name
Classification

Route Onset Peak Duration

PO Unknown 1-3 ½ hrs Unknown

Action Acetylcysteine, an N-acetyl derivative of L-cysteine, reduces

mucous viscosity and may benefit patients with ocular mucus
abnormalities. It also acts as a hepatoprotective agent in
paracetamol poisoning by maintaining glutathione levels.
Indication Adjunctive therapy for abnormal viscid or thickened mucous
secretions in patients with pneumonia, bronchitis,
bronchiecta- sis, primary amyloidosis of the lung, TB, cystic
fibrosis, emphysema, atelectasis, pul- monary complications
of thoracic surgery, or CV surgery
Health Teaching  Warn patient that drug may have a foul taste
or smell that may be distressing.
 For maximum effect, instruct patient to cough to clear
airway before aerosol admin- istration
Contraindications  Contraindicated in patients hypersensitive to drug.

 Alert: Serious anaphylactoid reactions, including rash,

hypotension, dyspnea, and wheezing, have been
reported. Reactions usu- ally occur 30 to 60 minutes
after start of in- fusion and may require treatment and
drug discontinuation.

 Use cautiously in elderly or debilitated pa- tients with

severe respiratory insufficiency. Use IV form
cautiously in patients with asthma or a history of
bronchospasm, in those weighing less than 40 kg, and
in patients re- quiring fluid restriction.
Side Effects CNS: fever, drowsiness.
CV: chest tightness. flushing, tachycardia, edema.
EENT: rhinor- rhea, pharyngitis, throat tightness.
Gl: nausea, stomatitis, vomiting.
Respiratory: chospasm, cough, dyspnea, rhonchi.
Skin: clamminess, pruritus, rash, urticaria.
Nursing Intervention  Monitor cough type and frequency.

 Alert: Monitor patient for bronchospasm, especially if

patient has asthma.

 Ingestion of more than 150 mg/kg of acet- aminophen

may cause hepatotoxicity. Mea- sure acetaminophen
level 4 hours after inges- tion to determine risk of
hepatotoxicity. See manufacturer's information for
nomogram for estimating potential for hepatotoxicity
from acute acetaminophen ingestion and need for
acetylcysteine therapy.

 Alert: Drug is used for acetaminophen overdose

within 24 hours of ingestion. Start drug immediately;
don't wait for results of acetaminophen level. Give
within to hours of
 You sent
 acetaminophen ingestion to minimize hepatic injury.

 For suspected acetaminophen overdose, obtain

baseline INR and AST, ALT, biliru- bin, BUN,
creatinine, glucose, and electrolyte levels.

Generic Name Trimetazidine

Brand Name
Classification Anti-Anginal Drugs
Route Onset Peak Duration

Action Trimetazidine hydrochloride (ANGIREL MR) is a

medication that inhibits beta oxidation of fatty acids,
enhancing glucose oxidation, which is crucial for
maintaining proper energy metabolism during
ischemia. It also acts as a metabolic agent in patients
with ischemic heart disease, preserving high-energy
phosphate intracellular levels.
Indication Add-on therapy for the symptomatic treatment of
patients w/ stable angina pectoris who are
inadequately controlled by or intolerant to 1st-line
antianginal therapies in adults.

Trimetazidine is indicated for the symptomatic

treatment of stable angina pectoris in patients
inadequately controlled or intolerant to first line
therapies.9
Health Teaching .
Contraindications Hypersensitivity. Parkinson disease, parkinsonian
symptoms, tremors, restless leg syndrome & other
related movement disorders; severe renal impairment
(CrCl <30 mL/min).
Side Effects  Dizziness
 Headache
 Stomach pain
 Diarrhea
 Indigestion
 Feeling sick overall
 Vomiting
 Rash
 Itching
 Hives
 Feeling of weakness
Nursing Intervention
Generic Name
 Brand Name
Classification

Route Onset Peak Duration

Action
Indication
Health Teaching
Contraindications
Side Effects  CNS:
 EENT:
 CV:
 GI:

Nursing Intervention 