DRUG STUDY

I. GENERIC NAME:  RanitidineBRAND NAME:  ZantacCLASSIFICATION:

Therapeutic: Anti-ulcer agentsPharmacologic: Histamine H2 antagonists

DOSAGE: 1 to 3 mg/kg ROUTE: IVFREQUENCY: q 6˚- 8˚MECHANISM OF ACTION:

Inhibits the action of histamine at the H2 receptor site located primarily in gastric parietal cells, resulting in inhibition of gastric acid secretion.DESIRED EFFECTS:

Blood: neutropenia, thrombocytopeniaCNS: confusion, dizziness, drowsiness, hallucinations, headache

CV: rrhythmias GI: altered taste, black tongue, constipation, dark stools, diarrhea, drug-

induced hepatitis, nauseaHepatic: increases in liver enzymes, jaundiceSkin: rashLocal: burning and itching in injection site

NURSING IMPLICATIONS/RESPONSIBILITIES: Inform the parents or the significant others of the patient that medication may

temporarily cause the stools turn to color black and the tongue appears gray in color.

- so that the parents or the significant others of the patient will not be surprise if the side effects of the drug occur

Advise the parents or the significant others of the patient to report any onset of black or tarry stools; fever, diarrhea; rash; to health care professional promptly.

- so that the health care provider can render an immediate action to prevent any complications that may occur to the infant

Use cautiously in patients with hepatic dysfunction, dosage should be adjusted to patients with impaired renal function.

- to prevent drug tolerance and to promote cumulative effect Inform the parents or the significant others of the patient that infants are more

likely to experience adverse reactions. - due to the decreased renal clearance of infants

II. Generic Name: AmpicillinBrand Name: Omnipen, Novo-Ampicillin, Penbritin, Principen, Polycillin,

TotacillinClassification:

Therapeutic: Anti-infectivesPharmacologic: aminopenicillins

Dosage: 650mgRoute: IVFrequency: q 12˚Mechanism of action: Bactericidal against microorganisms by inhibiting cell-

wall synthesis during active multiplication. Bacteria resist penicillin by producing penicillinases-enzymes that covert penicillin to inactive penicilloic acid.

Desired Effect:Blood: anemia, thrombocytopenia, thrombocytopenic purpura,

eosinophilia, leukopeniaBody as a whole : severe allergic reactions such as rash, headache, fever

and hives. Gastrointestinal: nausea, soreness of the tongue, inflammation in the

mouth, oral candidiasis, vomiting, enterocolitis pseudomembranous colitis and diarrhea. 

Hypersensitivity: anaphylactic shock, redness of skin, skin inflammation, hives and inflammation of blood vessels. 

Liver : jaundice, moderate elevation of SGOT and liver inflammation. Local: pain at injection site, thrombophlebitis

Nursing Responsibility/Rationale: Obtain cultures before giving the first dose.- to know if there is any sensitivity of the patient to the drug Tell the parents or the significant others of the patient to call the doctor or the

nurse if rash, fever or chills develop.- so that the health care provider can render an immediate action to prevent any

complications that may occur to the infant Dosage should be altered in patient with impaired renal functions.- To prevent drug tolerance When giving IV, mix with dextrose 5% in water or a saline solution, don’t mix

with other drugs or solutions- they might be incompatible if there is a combination of other drugs Give IV intermittently, change site every 48 hours.- To prevent vein irritation With prolonged therapy, bacterial or fungal superinfection may occur, especially

on infants with low resistance to infection, close observation is essential.- This is due to immunosuppressives or irradiation

III. Generic Name: GentamicinBrand Name: Alomicin, Cidomycin, Garamycin, JenamicinClassification:

Therapeutic: Anti-infectivesPharmacologic: aminoglycosides

Dosage: 9 mgRoute: IVFrequency: q 10˚Mechanism of Action:

Inhibits protein synthesis by binding directly to the 30S ribosomal subunit. Generally bactericidal.

Desired Effect:CNS: headache, lethargy, neuromuscular blockadeEENT: Ototoxicity (tinnitus, vertigo, hearing loss)GU: Nephrotoxicity (cells or casts in the urine; oliguria; proteinuria;

decreased creatinine clearance; increased BUN,nonprotein nitrogen, and serum creatinine levels)

Nursing Responsibility/Rationale: Lab tests: Perform C&S and renal function prior to first dose and periodically

during therapy; therapy may begin pending test results. Determine creatinine clearance and serum drug concentrations at frequent intervals, particularly for infants with renal immaturity.

- to reduce the development of drug-resistant bacteria and maintain the effectiveness of gentamicin and other antibacterial drugs, gentamicin should beused only to treat or prevent infections that are proven or strongly suspectedto be caused by bacteria

Use cautiously in patients with impaired renal function, in neonates, infants, and elderly person

- to prevent drug tolerance Weigh patient and obtain baseline renal function studies before therapy begins.- to know how much dosage should be given and to prevent drug tolerance Monitor renal function (output,specific gravity, urinalysis, BUN and creatinine

levels and creatinine clearance)- To know if there is any decreased occurrence on renal functions Patient should be well hydrated while taking this drug.- To minimize chemical irritation of the renal tubules Watch for superinfection( continued fever and other signs of new infections,

especially of upper respiratory tract).- To avoid any severe complications