PHARMACOLOGIC MANAGEMENT

ANTI-INFECTIVES
DRUG NAME
EFFICACY
piperacillin inhibits bacterial
cell wall synthesis by binding
Piperacillin
to specific penicillin-binding
/tazobactam
proteins
Tazobactam increases
piperacillin activity against
greatest increase in activity
against B fragilis.
Ticarcillin/
It inhibits biosynthesis of cell
wall mucopeptide and is
clavulanate
effective during the stage of
potassium
active growth.
Binds to one or more of the
penicillin-binding proteins
Cefoxitin
(PBP) located on cell walls of
susceptible organisms.

LEVOFLOXACIN

Inhibits DNA bacterial

topoisomerase II, an enzyme
required for DNA replication,
transcription, repair, and
recombination.
This inhibits third and final
stage of bacterial cell wall
synthesis, thus killing the
bacterium.
Synthetic compound with
direct trichomonacidal and
amebicidal

SAFETY
CNS: Headache, insomnia, fever.
GI: Diarrhea,
constipation,nausea,
vomiting,dyspepsia,pseudomemb
ranous colitis.
Skin: Rash,
pruritus,hypersensitivity
reactions
Hypersensitivity reactions, pain,
burning, swelling at injection site;
phlebitis, thrombophlebitis;
superinfections.
Drug fever, eosinophilia,
superinfections, local reactions:
pain, tenderness, and induration
(IM site), thrombophlebitis (IV
site).
Injection site pain or
inflammation, chest or back pain,
fever, pharyngitis, Rash, pruritus

Pruritus, fever, chills, pain,

induration; phlebitis (IV site).
GI: pseudomembranous colitis
Urogenital: Genital pruritus
Hypersensitivity (rash, urticaria,
Metronidazole
pruritus, flushing), fever, fleeting
joint pains, overgrowth
of Candida.
Meropenem
Inhibits the cell wall synthesis GI: Diarrhea, nausea, vomiting,
of gram-positive and gramconstipation.
negative
CNS: Headache.
Skin: Rash, pruritus, diaper rash.
Other: Inflammation at injection
site
RECOMBINANT HUMAN ACTIVATED PROTEIN C
Inhibits clotting Factor Va and
Hematologic: Bleeding (includi
VIIIa. Inhibits TNF produced by
ng intracranial).
Drotrecogin Alfa monocytes, and limits the
thrombin-induced
inflammatory responses
Ceftriaxone

SUITABILITY
Effective against an
extremely broad spectrum
of gram-positive, gramnegative, and anaerobic
bacteria and greatest
increase is in activity
against B fragilis
Provides coverage against
most gram-positive and
gram-negative organisms,
as well as most anaerobes.
For mixed aerobicanaerobic infections
(e.g., Bacteroides fragilis).
For surgical prophylaxis
Prevents replication of
certain bacteria resistant
to beta-lactam antibiotics.

For intra-abdominal
infections and surgical
prophylaxis
Exhibits antibacterial
activity against obligate
anaerobic bacteria, gramnegative anaerobic bacilli
Effective against both
gram-positive and gramnegative bacteria and for
complicated peritonitis

Anticoagulant,
profibrinolytic and antiinflammatory properties.

NARCOTIC (OPIATE) AGONIST

Morphine
Sulfate

Has agonist
activity by binding
with the same
receptors as
endogenous
opioid peptides.

Hypersensitivity, skeletal muscle flaccidity; cold, clammy

skin, hypothermia.
CNS: disorientation CNS stimulation decreased cough reflex,
drowsiness
Special Senses: Miosis.
CV: Bradycardia, palpitations, orthostatic hypotension
GI: Constipation, dry mouth, biliary colic, nausea, vomiting
Urogenital: Urinary retention or urgency
Respiratory: Severe respiratory depression

BULK LAXATIVE
Psyllium
Highly refined colloid of
Hydrophilic
psyllium seed (Plantago
Mucilloid
ovata) with equal amount
of dextrose
ANTI-EMETIC

Dolasetron

Hematologic: Eosinophilia. GI: Nausea and

vomiting, diarrhea (with excessive use); GI
tract strictures when drug used in dry
form, abdominal cramps.

Selective serotonin (5-HT3)

receptor antagonist.

Fever, fatigue, pain, chills

CNS: Headache, dizziness
CV: Hypertension.
GI: Diarrhea, abdominal pain.
Genitourinary: Urinary retention.

Controls
severe pain

Bulk-producing laxative
that promotes peristalsis
and natural elimination.

Treatment of
postoperative nausea
and vomiting.

NSAID/ANTIPYRETIC

Celecoxib

P-DRUGS
DRUG
NAME
Piperacillin/
tazobactam

Metronidazole

inhibits prostaglandin
synthesis by inhibiting
cyclooxygenase-2 (COX-2), but
does not inhibit
cyclooxygenase-1 (COX-1)

EFFICACY
inhibits bacterial cell
wall synthesis

Synthetic compound
with direct
trichomonacidal and
amebicidal

Morphine

Drotrecogin

Inhibits clotting Factor

Va , VIIIa and TNF
produced by
monocytes

peripheral edema.
GI: Abdominal pain, diarrhea,
dyspepsia, flatulence, nausea.
CNS: Dizziness, headache, insomnia.
. Skin: Rash.

SAFETY
Headache, insomnia, fever, Diarrhea,
constipation,nausea,vomiting,dyspepsi
a,pseudomembranous, colitis, Rash,
pruritus, hypersensitivity reactions
Hypersensitivity (rash, urticaria,
pruritus, flushing), fever, fleeting joint
pains, overgrowth of Candida.
Hypersensitivity, skeletal muscle
flaccidity; cold, clammy
skin,constipation, respiratory depression
Hematologic: Bleeding (including
intracranial).

anti-inflammatory,
analgesic, and antipyretic
activities

SUITABILITY

COST

anaerobic bacteria and

greatest increase is in
activity against B fragilis

P 330

antibacterial against
obligate anaerobic
bacteria, gram-negative
anaerobic bacilli
Controls severe pain

P 172

Anticoagulant,
profibrinolytic and
antiinflammatory
properties.

P 17

Psyllium

Dolasetron

Celecoxib

Highly refined colloid

of psyllium seed
(Plantago ovata) with
equal amount of
dextrose
Selective serotonin (5HT3) receptor
antagonist

inhibits prostaglandin

Hematologic: Eosinophilia. GI: Nausea

and vomiting, diarrhea (with excessive
use); GI tract strictures when drug used
in dry form, abdominal cramps.

Bulk-producing laxative
that promotes
peristalsis and natural
elimination.

Fever, fatigue, pain, chills

CNS: Headache, dizziness
CV: Hypertension.
GI: Diarrhea, abdominal pain.
Genitourinary: Urinary retention.
Peripheral edema, abdominal pain,
diarrhea, dyspepsia, flatulence,
nausea, dizziness, headache, insomnia,
rash.

Treatment of
postoperative nausea
and vomiting

anti-inflammatory,
analgesic, and
antipyretic activities

P 20

P 18

VI. MONITORING AND FOLLOW-UP

Monitor patients incision site for any separation, bleeding, or signs of infection.
Teach and advice patient how to monitor wound for any signs of infection or other complication.
Instruct patient to drink lots of fluids and maintain high fiber in your diet, such as fresh fruits, vegetables, and
whole grain cereals or breads. To help prevent constipation and normal bowel function, especially after
taking narcotic pain medication.
Monitor vital signs, bowel sounds, signs of bleeding, Intake and Output
Follow up laboratory examination for
1. Complete Blood Count
2. Random Blood Sugar
3. Hematocrit and hemoglobin monitoring
4. U/A
5. Platelets
6. Sodium, potassium
7. BUN, creatinine
8. ALT (SGPT)
9. AST (SGOT)
Check for any adverse reaction of meds