Drug Name Classification and Indications and Side Effects and Adverse Effects Special Precautions Nursing Responsibilities

Mechanism of Action Contraindications

Generic Name: Classifications: Indications: Check the Doctor’s order before

Side Effects: Patient risk factors for administering the medication.
Esomeprazole Belongs to the class of Intravenous reduced vitamin B12
proton pump inhibitors. Headache, Diarrhea, Constipation, Flatulence absorption, at risk of
Prophylaxis of osteoporosis-related Follow the 10 Rights of
rebleeding of duodenal fractures. Hepatic and
Trade/Brand Name: Administering Medications.
Actions: ulcer, Prophylaxis of severe renal impairment.
rebleeding of gastric Adverse Reactions
Nexium
Esomeprazole, the S-isomer ulcer
of omeprazole, is a Significant: Hypomagnesaemia (prolonged use),
substituted benzimidazole osteoporosis-related fractures of the hip, wrist, and
Dosage: Monitoring Parameters
proton pump inhibitor (PPI) spine (particularly in high doses and prolonged use),
Contraindications:
40mg that blocks the final step in Monitor for rebleeding in
gastric acid secretion by Vertigo.
Concomitant use with patients with peptic ulcer bleed.
specific inhibition of Consider further follow-up and
nelfinavir or rilpivirine. Peripheral oedema. Rarely, hyponatraemia.
Route: H+/K+-ATPase enzyme diagnostic testing in patients
system present on the Insomnia. Rarely, agitation, confusion, depression. with suboptimal response or
IV secretory surface of the early symptomatic relapse
gastric parietal cells. Potentially Fatal: Very rarely, severe cutaneous following completion of therapy.
adverse reactions (e.g. Stevens-Johnson syndrome, Rule out malignancy in case of
Frequency and toxic epidermal necrolysis, drug reaction with any alarm symptoms (e.g.
Timing: eosinophilia and systemic symptoms, acute significant unintentional weight
OD (5:30) generalised exanthematous pustulosis). loss, recurrent vomiting,
dysphagia, melaena or
haematemesis).
Drug Name Classification and Mechanism of Action Indications and Contraindications Side Effects and Special Precautions Nursing Responsibilities
Adverse Effects

Generic Name: Classifications: Indications: Check the Doctor’s order

Side Effects: Super-infections with non- before administering the
Ceftriaxone + Third-generation cephalosporins Ceftriaxone-Sulbactam is used in the susceptible microorganisms may medication.
Sulbactam treatment of infections caused by Nausea, vomiting, occur. Since pseudomembranous
Actions:
susceptible organisms including diarrhea, loss of colitis has been reported to occur
sepsis, meningitis, abdominal appetite with ceftriaxone, it is important to
Ceftriaxone is a third-generation Follow the 10 Rights of
infections (e.g. peritonitis, infections consider this diagnosis in patients
Trade/Brand cephalosporin antibiotic with a broad Administering
of the biliary tract), infections of the who present with diarrhea prior to
Name: spectrum of activity against both gram- Medications.
bones, joints, soft tissue, skin and of the administration of Ceftriaxone-
positive and gram-negative bacteria.Its
wounds, renal and urinary tract Adverse Sulbactam. Ceftriaxone, if given at
Sultrex mechanism of action involves inhibition of
infections, respiratory tract infections, Reactions: higher than standard doses, may
bacterial cell wall synthesis. Ceftriaxone
particularly pneumonia, and ear, nose, get precipitated as its calcium salt
binds to penicillin-binding proteins (PBPs) Elevations of
and throat infections and in the gall bladder, the shadows of Monitoring Parameters
Dosage: located on the bacterial cell membrane, SGOT/SGPT,
uncomplicated gonorrhea. which seen under sonography,
specifically PBPs involved in hemolytic anemia
l.5ml peptidoglycan synthesis.By binding to could be mistaken for gallstones.
Ceftriaxone-Sulbactam may also be and bleeding,
PBPs, ceftriaxone prevents the cross- used for pre-operative prophylaxis of However, it is largely Monitor culture and
allergic
linking of peptidoglycan chains, which are infections. A single dose given pre- asymptomatic and shadows susceptibility tests; consult
dermatitis,
Route: essential for the structural integrity of the operatively may reduce chances of disappears on discontinuation of recommendations before
pruritus, urticaria
bacterial cell wall.As a result, bacterial cell postoperative infection. therapy or in due completion of treatment initiation due to
IVTT and edema.
walls become weakened and susceptible to therapy. antibiotic resistance risks.
osmotic pressure, leading to cell lysis and Contraindications: Monitor prothrombin
death. time/INR, renal function
Frequency and Ceftriaxone-Sulbactam is
tests, and LFTs; CBC
Timing: Sulbactam is a beta-lactamase inhibitor that contraindicated in patients with a
regularly during prolonged
works by inhibiting the activity of beta- history of allergy to cephalosporins,
Q8H use. Assess for signs and
lactamase enzymes produced by certain penicillins and other components of
symptoms of
8-4-12 bacteria. the drug.
hypersensitivity reactions
(especially anaphylaxis)
Beta-lactamases are enzymes that during the 1st dose,
hydrolyze the beta-lactam ring present in hemolytic anemia, and
many antibiotics, including penicillins and
 pancreatitis.
cephalosporins. This hydrolysis inactivates
the antibiotics, rendering them ineffective
against the bacteria. Fall risk precautions.
Sulbactam irreversibly binds to beta-
lactamase enzymes, blocking their active
sites and preventing them from hydrolyzing
beta-lactam antibiotics.

By inhibiting beta-lactamases, sulbactam

restores the activity of ceftriaxone and
other beta-lactam antibiotics, allowing
them to exert their bactericidal effects on
susceptible bacteria.

The combination of ceftriaxone and

sulbactam works synergistically to treat
bacterial infections by inhibiting cell wall
synthesis (cefrtriaxone) and by countering
bacterial resistance mechanisms such as
beta-lactamase production (sulbactam).
This combination therapy provides broader
coverage against a wider range of bacteria
and helps to overcome resistance, making it
an effective treatment option for various
infections.

Drug Name Classification and Mechanism of Action Indications and Side Effects and Adverse Effects Special Precautions Nursing
Contraindications Responsibilities

Generic Name: Classifications:

Indications: Side Effects: Patients should not expose Check the Doctor’s
Salbutamol + ● Anti-Asthmatic the eyes to the nebulized order before
 ● Adrenergic with anticholinergic
Ipratropium For the management Headache, hoarseness of voice, fast or solution of Ipratropium- administering the
bromide of reversible irregular heartbeat, tremors Salbutamol since this may medication.
Actions: bronchospasm result in temporary pupillary
Trade/Brand associated with dilation, precipitation or Follow the 10 Rights
Name: Ipratropium bromide is an anticholinergic obstructive airway worsening of narrow-angle of Administering
diseases (e.g., Adverse Reactions glaucoma, eye pain or Medications.
Duavent bronchodilator that reduces the formation of cyclic
guanosine monophosphate (cGMP), a mediator of bronchial asthma). discomfort, blurred vision,
Flu-like symptoms, flushing, reduced visual halos or colored Monitoring Parameters
bronchospasm, thereby relaxing the smooth muscles
appetite, insomnia, central nervous images in association with
of the bronchi and bronchioles. It is a potent
Dosage: system stimulation, dry mouth, throat, red eyes from conjunctival Monitor peak flow,
bronchodilator, particularly in large bronchial
Contraindications: and tongue, mucosal ulcers, thirst, and corneal congestion. and/or other pulmonary
1 nebule per airways; some evidence suggests that Ipratropium
diarrhea, dyspepsia, gastrointestinal Proper nebulizer techniques function tests; blood
nebulization bromide also has bronchodilator activity in small
Patients with distress, constipation, paralytic ileus, should be assured, pressure, heart rate,
airways.
hypertrophic nausea, vomiting, arthralgia, pain, particularly if a mask is serum glucose, and
obstructive back pain, leg cramps, used. Consult a physician if serum K. Observe for
Route: Salbutamol is a selective short-acting beta2-
cardiomyopathy or asthenia/muscle weakness, myalgia, any combination of these signs and symptoms of
adrenergic agonist with preferential effect on beta2-
Nasal Route tachyarrhythmia. muscle cramps, urinary symptoms develops. glaucoma,
adrenergic receptors found in the respiratory tract. It
retention/difficulty, otitis media, hypersensitivity
stimulates adenyl cyclase, the enzyme which
Patients with known tinnitus, fatigue. reactions, urinary
catalyzes the conversion of adenosine triphosphate
hypersensitivity to retention, shortness of
Frequency and (ATP) to cyclic-3',5'-adenosine monophosphate
any ingredient in the breath, and CNS
Timing: (cAMP). cAMP mediates cellular responses such as
product or to atropine stimulation.
bronchial smooth muscle relaxation resulting in
Q6H and its derivatives.
bronchodilation.
6-12-6-12
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. Simultaneous
administration of both an anticholinergic
(Ipratropium bromide) and a beta2-agonist
(Salbutamol) produces a greater bronchodilator effect
than when either drug is used alone.

Bronchodilation occurs within 15 to 30 minutes with

peak effect seen approximately 1 to 2 hours after oral
inhalation via nebulization of 400 to 600 mcg of
Ipratropium bromide. Bronchodilation generally
persists for 4 to 5 hours, but may last up to 7 to 8
hours in some patients.