DRUG STUDY

NAME OF DRUG (GENERIC INDICATIONS (WHY IS IT GIVEN TO GENERAL MECHANISM OF SIDE EFFECTS AND NURSING RESPONSIBILITIES
AND BRAND NAME) THE PATIENT) CLASSIFICATION ACTION ADVERSE EFFECTS
Generic Name: clindamycin,  Systemic administration: Serious Classification: Lincosamide Assessment
clindamycin hydrochloride, infections caused by susceptible strains antibiotic Clindamycin inhibits
bacterial protein synthesis  Diarrhea, nausea,  History: Allergy to clindamycin, history of
clindamycin palmitate of anaerobes, streptococci,
Pregnancy Category B by binding to 23S RNA of vomiting, abdominal asthma or other allergies, allergy to tartrazine
hydrochloride, clindamycin staphylococci, pneumococci; reserve use
the 50S subunit of the pain; erythema (in 75- and 150-mg capsules); hepatic or renal
phosphate for penicillin-allergic patients or when
bacterial ribosome. It multiforme, contact dysfunction; lactation; history of regional
penicillin is inappropriate; less toxic
Brand Name: impedes both the assembly dermatitis, exfoliative enteritis or ulcerative colitis; history of
antibiotics (erythromycin) should be
of the ribosome and the and vesiculous antibiotic associated colitis
 Oral:  Cleocin, Dalacin C considered
translation process. The dermatitis, urticaria;
(CAN), Cleocin Pediatric molecular mechanism  Physical: Site of infection or acne; skin color,
 Parenteral: Treatment of septicemia eosinophilia; local
through which this occurs lesions; BP; R, adventitious sounds; bowel
 Oral, parenteral, topical caused by staphylococci, streptococci; irritation,
is thought to be due to sounds, output, liver evaluation; CBC, LFTs,
dermatologic solution for acute hematogenous osteomyelitis; thrombophlebitis.
clindamycin's three- renal function tests
acne, vaginal adjunct to surgical treatment of chronic
dimensional structure,  Potentially
preparation: Cleocin bone and joint infections due to Interventions
which closely resembles Fatal: Gasping
Phosphate, Cleocin T, susceptible organisms; do not use to the 3'-ends of L-Pro-Met- syndrome (neonates); Systemic administration
Cleocin Vaginal Ovules, treat meningitis; does not cross the tRNA and deacylated- pseudomembranous
Clinda-Derm (CAN), blood–brain barrier. tRNA during the peptide  Culture infection before therapy.
colitis.
Clindagel, ClindaMax, elongation cycle - in acting
 Topical dermatologic solution:  Administer oral drug with a full glass of water
Clindets, Dalacin C (CAN) as a structural analog of Contraindications
Treatment of acne vulgaris or with food to prevent esophageal irritation.
these tRNA molecules,
 Vaginal preparation: Treatment of clindamycin impairs  Do not give IM injections of more than 600
peptide chain initiation and  Hypersensitivity.
bacterial vaginosis mg; inject deep into large muscle to avoid
may stimulate dissociation
serious problems.
of peptidyl-tRNA from
bacterial ribosomes.8  Do not use for minor bacterial or viral
The mechanism through infections.
which topical clindamycin
treats acne vulgaris is  BLACK BOX WARNING: Be aware that
unclear, but may be related serious to fatal colitis can occur; reserve use,
to its activity and monitor patient closely.
against Propionibacterium
acnes, a bacteria that has  Monitor LFTs and renal function tests, and
been associated with acne blood counts with prolonged therapy.
Topical dermatologic administration
 Keep solution away from eyes, mouth and
abraded skin or mucous membranes; alcohol
base will cause stinging. Shake well before
use.
 Keep cool tap water available to bathe eye,
 mucous membranes, abraded skin
inadvertently contacted by drug solution.
Vaginal preparation
 Give intravaginally, preferably at bedtime.
Teaching points
Systemic administration
 Take oral drug with a full glass of water or
with food.
 Take full prescribed course of oral drug. Do
not stop taking without notifying health care
provider.
 You may experience these side effects:
Nausea, vomiting (eat frequent small meals);
superinfections in the mouth, vagina (use
frequent hygiene measures; request treatment
if severe).
 Report severe or watery diarrhea, abdominal
pain, inflamed mouth or vagina, skin rash or
lesions.
Topical dermatologic administration
 Apply thin film of acne solution to affected
area twice daily, being careful to avoid eyes,
mucous membranes, abraded skin; if solution
contacts one of these areas, flush with lots of
cool water.
 Report abdominal pain, diarrhea.
Vaginal preparation
 Use vaginal preparation for 7 or 3 consecutive
days, preferably at bedtime. Refrain from
sexual intercourse during treatment with this
product.
 Report vaginal irritation, itching; diarrhea, no
improvement in complaint being treated.
Generic Name :  gentamicin Parenteral  Aminoglycoside  Dizziness or vertigo; Assessment
sulfate Pregnancy Category D Aminoglycosides like acute renal failure,
Brand Name:  Serious infections caused by susceptible gentamicin "irreversibly" interstitial nephritis,  History: Allergy to any aminoglycosides; renal
 Parenteral, strains of Pseudomonas aeruginosa, Proteus bind to specific 30S- acute tubular necrosis; or hepatic disease; preexisting hearing loss;
intrathecal: Alcomicin species, Escherichia coli, Klebsiella- subunit proteins and 16S electrolyte imbalances; active infection with herpes, vaccinia, varicella,
(CAN), Garamycin, Pediatric Enterobacter-Serratia species, Citrobacter, rRNA. Specifically transient elevation of fungal infections, myobacterial infections
Gentamicin Sulfate Staphylococcus species gentamicin binds to four serum bilirubin and (ophthalmic preparations); myasthenia gravis;
 Topical dermatologic  Serious infections when causative nucleotides of 16S rRNA aminotransferases; parkinsonism; infant botulism; lactation,
cream, ointment: Garamycin organisms are not known (often in and a single amino acid of purpura; nausea, pregnancy
 Ophthalmic: Garamycin, conjunction with a penicillin or protein S12. This interferes vomiting; convulsions,  Physical: Site of infection; skin color, lesions;
Gentacidin, Gentak, cephalosporin) with decoding site in the mental depression, orientation, reflexes, eighth cranial nerve
Genoptic, Genoptic S.O.P.  Unlabeled use: With clindamycin as vicinity of nucleotide 1400 hallucinations. Atrophy function; P, BP; R, adventitious sounds; bowel
 Gentamicin impregnated alternative regimen in PID in 16S rRNA of 30S or rat necrosis at inj sounds, liver evaluation; urinalysis, BUN, serum
PMMA beads: Septopal Intrathecal subunit. This region sites. creatinine, serum electrolytes, LFTs, CBC
 Gentamicin Liposome interacts with the wobble  Potentially Fatal: Interventions
 Gram-negative infections
injection: Maitec  Serious CNS infections, such as base in the anticodon of Nephrotoxicity,  Give by IM route if at all possible; give by
meningitis, ventriculitis, infections caused tRNA. This leads to ototoxicity and deep IM injection.
by susceptible Pseudomonas species interference with the neuromuscular blockade  Culture infected area before therapy.
Ophthalmic preparations initiation complex, (may unmask or  Use 2 mg/mL intrathecal preparation without
misreading of mRNA so aggravate myasthaenia preservatives, for intrathecal use.
 Treatment of superficial ocular incorrect amino acids are gravis).  Avoid long-term therapies because of
infections due to strains of microorganisms inserted into the Contraindications increased risk of toxicities. Reduction in dose
susceptible to gentamicin polypeptide leading to may be clinically indicated.
Topical dermatologic preparation nonfunctional or toxic  History of
hypersensitivity to  Patients with edema or ascites may have lower
peptides and the breakup of peak concentrations due to expanded
 Infection prophylaxis in minor skin polysomes into aminoglycoside;
abrasions and treatment of superficial pregnancy; hepatic extracellular fluid volume.
nonfunctional monosomes.  Cleanse area before application of
infections of the skin due to susceptible impairment, perforated
organisms amenable to local treatment ear drum. dermatologic preparations.
Gentamicin-impregnated PMAA beads on  Ensure adequate hydration of patient before
surgical wire and during therapy.
 BLACK BOX WARNING: Monitor hearing
 Orphan drug use: Treatment of chronic with long-term therapy; ototoxicity can occur.
osteomyelitis of posttraumatic,  BLACK BOX WARNING: Monitor renal
postoperative, or hematogenous origin function tests, CBCs, serum drug levels during
Gentamicin liposome injection long-term therapy. Consult with prescriber to
adjust dosage.
 Orphan drug use: Treatment of Teaching points
disseminated Myobacterium avium-
intracellulare infection  Apply ophthalmic preparations by tilting head
back; place medications into conjunctival sac and
close eye; apply light pressure on lacrimal sac for
1 minute. Cleanse area before applying
dermatologic preparations; area may be covered
if necessary.
 You may experience these side effects:
Ringing in the ears, headache, dizziness
 (reversible; use safety measures if severe);
nausea, vomiting, loss of appetite (eat frequent
small meals, perform frequent mouth care);
burning, blurring of vision with ophthalmic
preparations (avoid driving or performing
dangerous activities if visual effects occur);
photosensitization with dermatologic
preparations (wear sunscreen and protective
clothing).
 Report pain at injection site, severe headache,
dizziness, loss of hearing, changes in urine
pattern, difficulty breathing, rash or skin lesions;
itching or irritation (ophthalmic preparations);
worsening of the condition, rash, irritation
(dermatologic preparation).

Generic Name : metronidazole Therapeutic actions Classification: Antibiotic, A The exact mechanism of  GI disturbances e.g. Assessment
Brand Name: Apo-Metronidazole ntibacterial, Amebicide, Ant action of metronidazole has nausea, unpleasant
(CAN), Flagyl, Flagyl 375, Flagyl  Metronidazole is converted to reduction iprotozoal not been fully established, metallic taste, vomiting,  History: CNS or hepatic disease; candidiasis
ER, Flagyl IV, MetroGel, products that interact with DNA to cause however, it is possible that diarrhoea or (moniliasis); blood dyscrasias; pregnancy;
MetroGel-Vaginal, NidaGel destruction of helical DNA structure and Pregnancy Category B  an intermediate in the constipation. Furred lactation
(CAN), Noritate, Protostat strand leading to a protein synthesis reduction of metronidazole tongue, glossitis, and  Physical: Reflexes, affect; skin lesions, color
inhibition and cell death in susceptible which is only made by stomatitis due to (with topical application); abdominal
organisms. It is effective against a wide anaerobic bacteria and overgrowth of Candida. examination, liver palpation; urinalysis, CBC,
range of organisms including E. histolytica, protozoa, binds Rarely, antibiotic- LFTs
T. vaginalis, Giardia, anaerobes e.g. deoxyribonucleic acid and associated colitis. Interventions
Bacterioides sp, Fusobacterium sp, electron-transport proteins Weakness, dizziness,
Clostridium sp, Peptococcus sp and  BLACK BOX WARNING: Avoid use unless
of organisms, blocking ataxia, headache, necessary. Metronidazole may be carcinogenic.
Peptostreptococcus sp, and moderately nucleic acid drowsiness, insomnia,
active against Gardnerella sp and  Administer oral doses with food.
synthesis. After changes in mood or  Apply topically (MetroGel) after cleansing the
Campylobacter sp. administration, mental state. Numbness
Indications area. Advise patient that cosmetics may be used
metronidazole enters cells or tingling in the over the area after application.
 Acute infection with susceptible by passive diffusion. extremities, epileptiform  Reduce dosage in hepatic disease.
anaerobic bacteria Following this, ferredoxin seizures (high doses or Teaching points
 Acute intestinal amebiasis or flavodoxin reduce its prolonged treatment).
 Amebic liver abscess nitro group to nitro Transient leucopenia  Take full course of drug therapy; take the drug
 Trichomoniasis (acute and partners of radicals. The redox and thrombocytopenia. with food if GI upset occurs.
patients with acute infection) potential of the electron Hypersensitivity  Do not drink alcohol (beverages or
 Preoperative, intraoperative, transport portions of reactions. Urethral preparations containing alcohol, cough syrups);
postoperative prophylaxis for patients anaerobic or discomfort and severe reactions may occur.
undergoing colorectal surgery microaerophilic darkening of urine.  Your urine may be a darker color than usual;
 Topical application: Treatment of microorganisms renders Raised liver enzyme this is expected.
inflammatory papules, pustules, and metronidazole selective to values, cholestatic  Refrain from sexual intercourse during
erythema of rosacea these organisms, which hepatitis, jaundice. treatment for trichomoniasis, unless partner
 Unlabeled uses: Prophylaxis for patients cause nitro group Thrombophlebitis (IV). wears a condom.
undergoing gynecologic, abdominal reduction, leading to the  Potentially Fatal:  Apply the topical preparation by cleansing the
 surgery; hepatic encephalopathy; Crohn’s production of toxic Anaphylaxis. area and then rubbing a thin film into the affected
disease; antibiotic-associated metabolites. These include Contraindications area. Avoid contact with the eyes. Cosmetics
pseudomembranous colitis; treatment of N-(2-hydroxyethyl) oxamic may be applied to the area after application.
Gardnerella vaginalis, giardiasis (use acid and acetamide, which  History of  You may experience these side effects: Dry
recommended by the CDC) may damage DNA of hypersensitivity to mouth with strange metallic taste (frequent
replicating organisms. metronidazole or other mouth care, sucking sugarless candies may help);
nitroimidazole nausea, vomiting, diarrhea (eat frequent small
derivatives. Pregnancy meals).
(1st trimester) and  Report severe GI upset, dizziness, unusual
lactation. fatigue or weakness, fever, chills.

Generic Name: celecoxib Therapeutic actions Classification: NSAID, The exact mechanism of  Abdominal pain, CLINICAL ALERT! Name confusion has occurred
Brand Name: Celebrex Analgesic (nonopioid), action of metronidazole has diarrhea, nausea, edema, between Celebrex (celecoxib), Celexa (citalopram),
 Celecoxib has COX-2 specific inhibitory Specific COX-2 enzyme not been fully established, dizziness, headache, Xanax (alprazolam), and Cerebyx (fosphenytoin); use
activity. It inhibits the conversion of blocker however, it is possible that insomnia, upper caution.
arachidonic acid to prostaglandins while Pregnancy Category C an intermediate in the respiratory tract
Assessment
having no effect on the formation of (first and second trimester) reduction of metronidazole infections; rash.
 History: Renal impairment, impaired hearing,
prostaglandins that mediate the normal Pregnancy Category D which is only made by  Potentially
allergies, hepatic and CV conditions, lactation,
homeostasis in the GI tract, kidneys and (third trimester)  anaerobic bacteria and Fatal: Serious skin
pregnancy
platelets catalyzed by COX-1. protozoa, binds reactions such as
 Physical: Skin color and lesions; orientation,
 Absorption: Absorbed from the deoxyribonucleic acid and exfoliative dermatitis,
reflexes, ophthalmologic and audiometric
GI tract (oral); peak plasma electron-transport proteins Stevens-Johnson
evaluation, peripheral sensation; P, edema; R,
concentrations after 3 hr. of organisms, blocking syndrome, and toxic
adventitious sounds; liver evaluation; CBC,
 Distribution: Protein-binding: nucleic acid synthesis. epidermal necrolysis.
LFTs, renal function tests; serum electrolytes
97%. After administration, Contraindications
Interventions
 Metabolism: Hepatic; converted metronidazole enters cells
 Hypersensitivity  BLACK BOX WARNING: Be aware that
to inactive metabolites. by passive diffusion.
including those in whom patient may be at increased risk for CV events,
 Excretion: Feces and urine (as Following this, ferredoxin
attacks of angioedema, GI bleeding; monitor accordingly.
metabolites and unchanged drug); 11 or flavodoxin reduce its
rhinitis and urticaria  Administer drug with food or after meals if GI
hr (elimination half-life). nitro group to nitro
have been precipitated upset occurs.
Indications radicals. The redox
by aspirin, NSAIDs or  Establish safety measures if CNS, visual
potential of the electron
 Acute and long-term treatment of signs sulfonamides. Severe disturbances occur.
transport portions of
and symptoms of rheumatoid arthritis and hepatic impairment;  Arrange for periodic ophthalmologic
anaerobic or
osteoarthritis severe heart failure; examination during long-term therapy.
microaerophilic
 Reduction of the number of colorectal inflammatory bowel  WARNING: If overdose occurs, institute
microorganisms renders
polyps in familial adenomatous polyposis disease; peptic ulcer; emergency procedures—gastric lavage, induction
metronidazole selective to
(FAP) renal impairment (CrCl of emesis, supportive therapy.
these organisms, which
 Management of acute pain <30 ml/min); pregnancy  Provide further comfort measures to reduce
cause nitro group
 Treatment of primary dysmenorrhea and lactation. pain (eg, positioning, environmental control) and
reduction, leading to the
 Relief of signs and symptoms of to reduce inflammation (eg, warmth, positioning,
production of toxic
anklylosing spondylitis and rest).
metabolites. These include
 Relief of signs and symptoms of juvenile Teaching points
N-(2-hydroxyethyl) oxamic
rheumatoid arthritis  Take drug with food or meals if GI upset
acid and acetamide, which
occurs.
may damage DNA of
 Take only the prescribed dosage; do not
replicating organisms.
increase dosage.
  You may experience these side effects:
Dizziness, drowsiness (avoid driving or the use
of dangerous machinery while taking this drug).
 Report sore throat, fever, rash, itching, weight
gain, swelling in ankles or fingers; changes in
vision.

Generic Name: acetaminophen Therapeutic actions Classification: Antipyretic, Assessment

(N-acetyl-p-aminophenol) Analgesic (nonopioid) According to its FDA  CNS: Headache
Brand Name:  Antipyretic: Reduces fever by acting Pregnancy Category B labeling, acetaminophen's  CV: Chest pain,  History: Allergy to acetaminophen, impaired
 Suppositories: Abenol directly on the hypothalamic heat- exact mechanism of action dyspnea, myocardial hepatic function, chronic alcoholism, pregnancy,
(CAN), Acephen regulating center to cause vasodilation and has not been fully damage when doses of lactation
 Oral: Aceta, Apacet, sweating, which helps dissipate heat. establishedl - despite this, it 5–8 g/day are ingested  Physical: Skin color, lesions; T; liver
Atasol (CAN), Genapap,  Analgesic: Site and mechanism of action is often categorized daily for several weeks evaluation; CBC, LFTs, renal function tests
Genebs, Liquiprin, Mapap, unclear. alongside NSAIDs or when doses of 4 Interventions
Panadol, Tapanol, Indications (nonsteroidal anti- g/day are ingested for 1  Do not exceed the recommended dosage.
Tempra,Tylenol inflammatory drugs) due to yr  Consult physician if needed for children < 3
 Analgesic-antipyretic in patients with its ability to inhibit the  GI: Hepatic toxicity yr; if needed for longer than 10 days; if continued
aspirin allergy, hemostatic disturbances, cyclooxygenase (COX) and failure, jaundice fever, severe or recurrent pain occurs (possible
bleeding diatheses, upper GI disease, gouty pathways. It is thought to  GU: Acute kidney serious illness).
arthritis exert central actions which failure, renal tubular  Avoid using multiple preparations containing
 Arthritis and rheumatic disorders ultimately lead to the necrosis acetaminophen. Carefully check all OTC
involving musculoskeletal pain (but lacks alleviation of pain  Hematologic: products.
clinically significant antirheumatic and symptoms. Methemoglobinemia—  Give drug with food if GI upset occurs.
anti-inflammatory effects) One theory is that cyanosis; hemolytic  Discontinue drug if hypersensitivity reactions
 Common cold, flu, other viral and acetaminophen increases anemia—hematuria, occur.
bacterial infections with pain and fever the pain threshold by anuria; neutropenia,  Treatment of overdose: Monitor serum levels
 Unlabeled use: Prophylactic for children inhibiting two isoforms of leukopenia, regularly, N-acetylcysteine should be available as
receiving DPT vaccination to reduce cyclooxygenase, COX-1 pancytopenia, a specific antidote; basic life support measures
incidence of fever and pain and COX-2, which are thrombocytopenia, may be necessary.
involved in prostaglandin hypoglycemia Teaching points
(PG) synthesis.  Hypersensitivity:  Do not exceed recommended dose; do not take
Prostaglandins are Rash, fever for longer than 10 days.
responsible for eliciting Contraindications  Take the drug only for complaints indicated; it
pain is not an anti-inflammatory agent.
sensations. Acetaminophen  Contraindicated with  Avoid the use of other over-the-counter
does not inhibit allergy to preparations. They may contain acetaminophen,
cyclooxygenase in acetaminophen. and serious overdosage can occur. If you need an
peripheral tissues and,  Use cautiously with over-the-counter preparation, consult your health
therefore, has no peripheral impaired hepatic care provider.
anti-inflammatory effects. function, chronic  Report rash, unusual bleeding or bruising,
Though acetylsalicylic acid alcoholism, pregnancy, yellowing of skin or eyes, changes in voiding
(aspirin) is an irreversible lactation. patterns.
inhibitor of COX and
directly blocks the active
site of this enzyme, studies
 have shown that
acetaminophen
(paracetamol) blocks COX
indirectly. Studies also
suggest that acetaminophen
selectively blocks a variant
type of the COX enzyme
that is unique from the
known variants COX-1 and
COX-2. This enzyme has
been referred to as COX-3.
The antipyretic actions of
acetaminophen are likely
attributed to direct action
on heat-regulating centers
in the brain, resulting in
peripheral vasodilation,
sweating, and loss of body
heat. The exact mechanism
of action of this drug is not
fully understood at this
time, but future research
may contribute to deeper
knowledge

References
RN Pedia. (n.d.). acetaminophen (N-acetyl-p-aminophenol) Nursing Considerations & Management. Retrieved from RN Pedia Complete Nursing Notes and Community: https://www.rnpedia.com/nursing-notes/pharmacology-drug-study-
notes/acetaminophen-n-acetyl-p-aminophenol/

RN Pedia. (n.d.). celecoxib Nursing Considerations & Management. Retrieved from RN Pedia Complete Nursing Notes and Community: https://www.rnpedia.com/nursing-notes/pharmacology-drug-study-notes/celecoxib/

RN Pedia. (n.d.). clindamycin Nursing Considerations & Management. Retrieved from RN Pedia Complete Nursing Notes and Community: https://www.rnpedia.com/nursing-notes/pharmacology-drug-study-notes/clindamycin/

RN Pedia. (n.d.). gentamicin sulfate Nursing Considerations & Management. Retrieved from RN Pedia Complete Nursing Notes and Community: https://www.rnpedia.com/nursing-notes/pharmacology-drug-study-notes/gentamicin-sulfate/

RN Pedia. (n.d.). metronidazole Nursing Considerations & Management. Retrieved from RN Pedia Complete Nursing Notes and Community: https://www.rnpedia.com/nursing-notes/pharmacology-drug-study-notes/metronidazole/