DRUG NAME Cefuroxime

CLASSIFICATION -Antibiotic -Cephalosporin (second generation)

INDICATIONS .To prevent against susceptible bacterias causing infections of the middle ear, tonsillitis, throat infections, laryngitis, bronchitis, and pneumonia. It is also used in treating urinary tract infections, skin infections, and gonorrhea. Additionally, it is useful in treating acute bacterial bronchitis in patients with chronic obstructive pulmonary disease (COPD).

ACTION OF THE DRUG Interferes with bacterial cell-wall synthesis and division by binding to cell wall, causing cell to die. Active against gramnegative and gram-positive bacteria, with expanded activity against gramnegative bacteria. Exhibits minimal immunosuppr essant activity.

ADVERSE REACTION CNS: headache, hyperactivity, hypertonia, seizures GI: nausea, vomiting, diarrhea, abdominal pain, dyspepsia, pseudomembranous colitis GU: hematuria, vaginal candidiasis, renal dysfunction, acute renal failure Hematologic: hemolytic anemia, aplastic anemia, hemorrhage Metabolic: hyperglycemia Skin: toxic epidermal necrolysis, erythema multiforme, StevensJohnson syndrome Other: allergic reaction, drug fever, superinfection, anaphylaxis

CONTRAINDI CATION Hypersensiti vity to cephalospori ns or penicillins -Carnitine deficiency

NURSING RESPONSIBILITIES -Monitor patient for lifethreatening adverse effects, including anaphylaxis, StevensJohnson syndrome, and pseudomembranous colitis. -Monitor neurologic status, particularly for signs of impending seizures. -Advise patient to immediately report rash or bleeding tendency. -Instruct patient to take drug with food every 12 hours as prescribed. -Teach patient how to recognize signs and symptoms of superinfection. Instruct him to report these right away. -Advise patient to report CNS changes. -As appropriate, review all other significant and lifethreatening adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.

DRUG NAME

CLASSIFICATION

INDICATIONS -Indicated for shorttermmanageme ntof moderateto severepostopera tivepain

Ketorolac -Antipyretic Tromethamine -NSAID

ACTION OF THE DRUG -Antiinflammatory andanalgesic activity

CONTRAINDI CATION CNS:drowsiness,dizzines Hypersensiti vity and s,euphoria,headache cross sensitivity RESP:asthma,dyspnea toother -inhibits NSAIDs prostaglandins CV: edema,pallor, and vasodilation leukotrienesy nthesis GI: GIBleeding,abnormaltas te,diarrhea, drymouth,dyspepsia, GIpain, nausea GU: oliguria,renal toxicity,urinaryfrequenc y DERM:pruritis,purpura,s weating,urticaria HEMA: prolongedbleeding time LOCAL:injection sitepain NEURO:paresthesia

ADVERSE REACTION

NURSING RESPONSIBILITIES -Be aware thatpatient may be atrisk for CV events,GI bleeding, renaltoxicity, monitor accordingly. -Do not use duringlabor, delivery, or while nursing. -Keep emergency equipment readily available at time of initial dose, in caseof severe hypersensitivity reaction -Protect drug vials from light. - Administer every6 hrs to maintain serum levels and control pain.

DRUG NAME Celecoxib

CLASSIFICATION Antirheumatic

INDICATIONS Adjunctivetreat mentto decreasethe numberof adenomatouscol orectalpolyps infamilialadeno matouspolyposi

ACTION OF THE DRUG Exhibits antiinflammatory, analgesic,and antipyreticacti on due toinhibitionof the enzymeCOX2

CONTRAINDI CATION CNS:dizziness,drowsines Hypersensiti s,headache,insomnia,fat vity to drug, sulfonamides igue , or other NSAIDs CV:peripheraledema -Severe EENT:ophthalmic effects,tinnitus,pharyngi hepatic impairment tis, rhinitis,sinusitis GI:nausea,diarrhea,cons tipation,abdominalpain, dyspepsia,flatulence,dry mouth, -Advanced renal disease GU:menorrhagia -Late Hematologic:decreased pregnancy hemoglobinorhematocri t,eosinophilia, bruising, -Breast feeding epistaxis -History of asthma or urticaria

ADVERSE REACTION

NURSING RESPONSIBILITIES -Assess pts history of allergic reaction to the drug -Monitor complete blood count, electrolyte levels, creatinine clearance, and occult fecal bloodtest and liver function test results every 6 to 12months -Instruct patient to take drug with food or milk. -Teach patient to avoid aspirin and other NSAIDs (suchas ibuprofen andnaproxen)during therapy. -Advise patient to immediately report bloody stools, blood in vomit, or signs or symptoms of liver damage(nausea, fatigue,lethargy, pruritus,yellowingof eyes or skin,tenderness onupper right side of abdomen, or flulikesymptoms).

DRUG NAME

CLASSIFICATION Antirheumatic

INDICATIONS Adjunctivetreat mentto decreasethe numberof adenomatouscol orectalpolyps infamilialadeno matouspolyposi

ACTION OF THE DRUG Exhibits antiinflammatory, analgesic,and antipyreticacti on due toinhibitionof the enzymeCOX2

CONTRAINDI CATION CNS:dizziness,drowsines Hypersensiti s,headache,insomnia,fat vity to drug, sulfonamides igue , or other NSAIDs CV:peripheraledema -Severe EENT:ophthalmic effects,tinnitus,pharyngi hepatic impairment tis, rhinitis,sinusitis GI:nausea,diarrhea,cons tipation,abdominalpain, dyspepsia,flatulence,dry mouth, -Advanced renal disease GU:menorrhagia -Late Hematologic:decreased pregnancy hemoglobinorhematocri t,eosinophilia, bruising, -Breast feeding epistaxis -History of asthma or urticaria

ADVERSE REACTION

NURSING RESPONSIBILITIES -Assess pts history of allergic reaction to the drug -Monitor complete blood count, electrolyte levels, creatinine clearance, and occult fecal bloodtest and liver function test results every 6 to 12months -Instruct patient to take drug with food or milk. -Teach patient to avoid aspirin and other NSAIDs (suchas ibuprofen andnaproxen)during therapy. -Advise patient to immediately report bloody stools, blood in vomit, or signs or symptoms of liver damage(nausea, fatigue,lethargy, pruritus,yellowingof eyes or skin,tenderness onupper right side of abdomen, or flulikesymptoms).