RUG Tudy: College of Nursing

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OUR LADY OF FATIMA UNIVERSITY NAME: SECTION: BSN 3Y1-1S GROUP # 3

College of Nursing COURSE: BSN DATE: 10/11/2020


SCHEDULE:

DRUG STUDY Diagnosis: Chronic Obstructive Pulmonary Disease(COPD) Patient’s Initials: HW

DRUG TO DRUG NURSING


MEDICATION ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS
INTERACTION CONSIDERATION
Pharmacodynamics  Infections caused  Contraindicated in patients  Aminoglycoside  CNS: seizures, heada  Piperacillin is usually
Generic Name
Bactericidal. Adheres to by susceptible hypersensitive to drug or antibiotics: Has che, dizziness, given with another
bacterial penicillin-binding organisms. other penicillins. synergistic fatigue. antibiotic such as an
 Tazobac
proteins, thus inhibiting  Prophylaxis of  Use cautiously in patients bactericidal effects  CV: vein irritation, aminoglycoside in
 Piperacillin
bacterial cell wall surgical with other drug allergies against Pseudomon phlebitis. life-threatening
Sodium
synthesis. Extended- infections. (especially to as aeruginosa,  GI: nausea, diarrhea, situations.
spectrum penicillins are cephalosporins), bleeding Escherichia coli, vomiting, pseudome  Patients with cystic
more resistant to tendencies, uremia, or Klebsiella, mbranous colitis. fibrosis are most
Brand Name inactivation by certain hypokalemia. Citrobacter,  GU: interstitial susceptible to fever
beta-lactamases, Enterobacter, nephritis. or rash from
 Zosyn especially those produced Serratia, and  Hematologic: piperacillin.
by gram-negative Proteus (with high  Monitor serum
Classification organisms, but are still mirabilis. However, doses), neutropenia,  electrolytes,
liable to inactivation by drugs are physically eosinophilia, leukop especially
 Antibiotic certain others. Because of and chemically enia, potassium.
the potential for rapid incompatible; thrombocytopenia.  Monitor neurologic
development of bacterial inactivated when  Metabolic: hypokale status. High serum
Dosage & Frequency resistance, drug shouldn’t mixed or given mia, hypernatremia. levels of this drug
be used as a sole drug in together. Don’t  Musculoskeletal:  may cause seizures.
 4.5g thru soluset the treatment of an give together. prolonged muscle  Monitor CBC,
dissolved in PNSS infection.  Clavulanic acid, relaxation. differential, and
90cc x 1hr OD sulbactam,  Skin: pain at platelets. Drug may
ANST Piperacillin’s spectrum of tazobactam: Has injection site. cause
activity includes many synergistic  Other: hypersensitivi thrombocytopeniaO
gram-negative aerobic and bactericidal effect ty reactions (edema, bserve patient
Stock Dose anaerobic bacilli, many against certain carefully for signs of
fever, chills, rash,
gram-positive and gram- beta-lactamase- pruritus, urticaria,  occult bleeding.
 2g, 3g, 4g negative aerobic cocci, producing  Because drug is
anaphylaxis),
and some gram-positive bacteria. May be overgrowth of dialyzable, patients
aerobic and anaerobic used together for nonsusceptible undergoing
bacilli. Piperacillin may be this effect. organisms. hemodialysis may
effective against some  Hormonal need dosage
strains of carbenicillin- contraceptives: De adjustments.
resistant and ticarcillin- creases  Drug may falselyMCALIM2020
resistant gram-negative efficacy. Suggest decrease serum
bacilli. Piperacillin is more other means of aminoglycoside
active contraception. levels; drug may
against Pseudomonas  Methotrexate:  cause positive
aeruginosa than are other Large doses of Coombs’ tests.
extended-spectrum penicillins may
penicillins. interfere with renal
tubular secretion of
Pharmacokinetics methotrexate;
Absorption:  Rapidly and causes delayed
almost completely elimination and
absorbed within the first elevated serum
hour after I.M. levels of
administration. methotrexate. Mon
itor patient for
Distribution: Distributed toxicity.
widely after parenteral  Probenecid: Blocks
administration; penetrates tubular secretion of
minimally into uninflamed piperacillin, raising
meninges and slightly into serum levels of
bone and sputum. 16% to drug. Probenecid
22% protein-bound; may be used for
crosses the placental this purpose.
barrier.  Vecuronium: Prolo
ngs neuromuscular
Metabolism:  None blockade. Monitor
significant. patient closely.

Excretion: 42% to 90%
excreted in urine by renal
tubular secretion and
glomerular filtration; also
excreted in bile and breast
milk. Elimination half-life
in adults is about 1/2 to 1
1/2 hours; in extensive
renal impairment, half-life
extended to about 2 to 6
hours; in combined
hepatorenal dysfunction,
half-life may extend from
11 to 32 hours. Drug is
removed by hemodialysis MCALIM2020
but not by peritoneal
dialysis.

MCALIM2020

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