AREA: GSDH WARD Inclusive Date:

Patient: Juan Dela cruz Attending Physician: DR. SHAUN MURPHY Student Name:
Age and Sex: 56/MALE Diagnosis: ADENOCARCINOMA OF THE COLON Year and Section:
Chief Complain: Abdominal Pain Group:

DRUG DOSAGE
(Brand Name and Generic CLASSIFICATION MECHANISM OF ACTION INDICATION (Recommended and ADVERSE REACTION NURSING RESPONSIBILITIES
Name) Actual)
Brand Name: Ceftin Therapeutic: Antibiotic Cefuroxime is primarily -Perioperative prophylaxis. Recommended: Adults: 1.5 CV: phlebitis, -Inform patient of potential
bactericidal; it also may be -Serious lower respiratory, g I.V. 30 to 60 minutes thrombophlebitiswith I.V. adverse reactions.
Generic Name:
Pharmacological: bacteriostatic. Activity urinary tract, skin, and skin- before surgery; then 750 injection. -For patients on sodium
Cefuroxime
Second-generation depends on the organism, structure infections; bone mg I.M. or I.V. q 8 hours GI: pseudomembranous restriction, note that
Cephalosporin tissue penetration, dosage, and joint infections; intraoperatively for a colitis, nausea, anorexia, cefuroxime sodium contains
and rate of organism septicemia; meningitis prolonged procedure. vomiting, diarrhea. 2.4 mEq of sodium per gram
multiplication. It acts by caused by susceptible Hematologic: transient of drug.
adhering to bacterial organisms. Actual: 750 mg IVTT 1 hour neutropenia, eosinophilia, -Check solutions for
penicillin-binding proteins, -Pharyngitis, tonsillitis, lower before the surgery hemolytic anemia, particulate matter and
thereby inhibiting cell wall respiratory tract infection, thrombocytopenia, discoloration. Solution may
synthesis. urinary tract infection. decreased hemoglobin and range in color from light
-Otitis media, impetigo. hematocrit. yellow to amber without
- Skin: maculopapular and affecting potency.
erythematous rash, urticaria, -For direct intermittent I.V.,
pain, induration, sterile inject solution slowly into vein
abscesses, temperature over 3 to 5 minutes or slowly
elevation, tissue sloughingat through tubing of free-
injection site. running, compatible I.V.
Reference: Other: hypersensitivity solution.
https://www.glowm.com/r
reactions (serum sickness, -With large doses or
esources/glowm/cd/pages
/drugs/c037.html anaphylaxis). prolonged therapy, monitor
patient for superinfection,
especially if high-risk.
-Avoid alcohol while taking
 this drug and for 3 days after
because severe reactions
often occur.

Brand Name: Foxitin Therapeutic: Cefoxitin is primarily -Perioperative prophylaxis, Recommended: CV: hypotension, • For I.V. use, reconstitute 1 g
β-lactam antibiotic bactericidal; it also may be use in contaminated surgery. Adults: 2 g I.V. 30 to 60 thrombophlebitis. of cefoxitin with at least 10 ml
Generic Name: Cefoxitin bacteriostatic. Activity -Serious respiratory, GU, minutes before surgery; GI: pseudomembranous of sterile water for injection,
Pharmacological: depends on the organism, gynecologic, skin, soft-tissue, then 2 g I.V. q 6 hours for colitis, nausea, vomiting, or 2 g of cefoxitin with 10 to
Second-generation tissue penetration, dosage, bone, joint, blood, and intra- 24 hours postoperatively. diarrhea. 20 ml. Solutions of D5W and
Cephamycin and rate of organism abdominal infections caused Children older than age 3 GU: acute renal failure. normal saline solution for
multiplication. It acts by by susceptible organisms. months: 30 to 40 mg/kg I.V. Hematologic: transient injection can also be used.
adhering to bacterial -Uncomplicated gonorrhea. 30 to 60 minutes before neutropenia, eosinophilia, • After reconstituting, shake
penicillin-binding proteins, -Pelvic inflammatory disease. surgery; then 30 mg/kg I.V. hemolytic anemia, anemia, vial and then let stand until
thereby inhibiting cell wall q 6 hours for 24 hours thrombocytopenia, clear to ensure complete drug
synthesis. postoperatively. For leukopenia, bone marrow dissolution. Solution is stable
Cefoxitin is active against contaminated surgery, 1 to suppression. for 24 hours at room
many gram-positive 2 g I.V. q 6 hours with or Respiratory: dyspnea with temperature, for 1 week if
organisms and enteric without I.V. gentamicin (1.5 I.V. injection. refrigerated, or 26 weeks if
gram-negative bacilli, mg/kg q 8 hours) for 5 Skin: maculopapular and frozen.
including Escherichia coli days. erythematous rash, toxic • Solution may range from
 and other coliform epidermal necrolysis, colorless to light amber and
bacteria, Staphylococcus Actual: urticaria, pruritus, exfoliative may darken during storage.
aureus (penicillinase- and 1 g IVq 8 dermatitis, pain, induration, Slight color change doesn’t
non-penicillinase- sterile abscesses, tissue indicate loss of potency.
producing), Staphylococcus sloughingat injection site. • Cefoxitin has been linked to
References:
epidermidis, streptococci, Other: hypersensitivity thrombophlebitis. Frequently
https://www.glowm.com/r
esources/glowm/cd/pages Klebsiella, Haemophilus reactions (serum sickness, assess I.V. site for signs of
/drugs/c031.html influenzae, and Bacteroides anaphylaxis), elevated infiltration or phlebitis.
https://www.mims.com/p species (including B. temperature.
hilippines/drug/info/foxiti
n fragilis). Enterobacter,
Pseudomonas, and
Acinetobacter species are
resistant to cefoxitin.
Brand Name: ConZip Therapeutic: It’s a centrally acting Tramadol is approved for the Recommended: CNS: dizziness, vertigo, • Assess type, location, and
Opiod Analgesic and synthetic analgesic management of moderate to Adjust up to50 to 100 mg headache, somnolence, CNS intensity of pain before and 2-
Generic Name: Tramadol
Serotonin/norepinephri compound that isn’t severe pain in adults. P.O. q 4 to 6 hours, p.r.n. stimulation, asthenia, 3 hr (peak) after
ne reuptake-inhibitor chemically related to Maximum dose is 400 mg anxiety, confusion, administration.
opiates but is thought to daily. coordination disturbance, • Assess BP & RR before and
Pharmacological: bind to opioid receptors = Dosage adjustment. For euphoria, nervousness, periodically during
Synthetic derivative and inhibit reuptake of patients with creatinine sleep disorder, seizures, administration. Respiratory
norepinephrine and clearance of less than 30 malaise. depression has not occurred
serotonin. ml/minute, increase dosing CV: vasodilation. with recommended doses.
interval to q 12 hours, to EENT: visual disturbances. • Assess bowel function
maximum of 200 mg daily. GI: nausea, constipation, routinely. Prevention of
For patients with cirrhosis, vomiting, dyspepsia, dry constipation should be
recommended dosage is 50 mouth, diarrhea, abdominal instituted with increased
mg q 12 hours. pain, anorexia, flatulence. intake of fluids and bulk and
GU: urine retention, urinary with laxatives to minimize
Actual: 50 mg/ml q 6 frequency, increased constipating effects.
creatinine clearance, • Assess previous analgesic
proteinuria, menopausal history. Tramadol is not
 symptoms. recommended for patients
Musculoskeletal: hypertonia. dependent on opioids or who

Reference: Respiratory: respiratory have previously received

https://www.drugbank.ca/ depression. opioids for more than 1
drugs/DB00193 Skin: pruritus, diaphoresis, wk;may cause opioid
https://www.healthline.co
rash. withdrawal symptoms
m/health/tramadol-oral-
tablet
Brand Name: Hemostan Therapeutic: Inhibits plasminogen For use in patients with Recommended: CNS: dizziness, malaise, • Avoid rapid I.V. infusion to
Fibrinolysis inhibitor activators; to a lesser hemophilia for short term Adults: 4 to 5 g I.V. or P.O. headache, delirium, seizures, minimize risk of CV adverse
Generic Name:
Tranexamic Acid degree, it blocks use (two to eight days) to over first hour, followed hallucinations, weakness. reactions, such as
antiplasmin activity by reduce or prevent with constant infusion of 1 CV: hypotension, hypotension, bradycardia, and
Pharmacological: inhibiting fibrinolysis. hemorrhage and reduce the g/hour for about 8 hours or bradycardia, arrhythmias arrhythmias; use infusion
Carboxylic acid need for replacement until bleeding is controlled. (with rapid I.V. infusion), pump to ensure constancy of
derivative therapy during and following Maximum dose is 30 g over generalized thrombosis. infusion.
tooth extraction. It can also 24 hours. EENT: tinnitus, nasal • Monitor coagulation studies,
be used for excessive Children: 100 mg/kg I.V., or congestion, conjunctival heart rhythm, and blood
bleeding in menstruation, 3 g/m2 I.V. first hour, suffusion. pressure. Long-term use of
surgery, or trauma cases. followed by constant GI: nausea, cramps, drug requires routine creatine
infusion of 33.3 diarrhea. kinase determinations.
mg/kg/hour or 1 GU: acute renal failure. • Monitor patient for muscle
g/m2/hour. Maximum dose Hepatic: liver dysfunction. weakness. Rhabdomyolysis
is 18 g/m2 over 24 hours. Metabolic: hyperkalemia. has occurred with prolonged
Musculoskeletal: myopathy. use.
Actual: Skin: rash. • Be alert for signs of
1 amp IV q 8 phlebitis. If skeletal myopathy
Reference: occurs, consider
https://www.webmd.com/
drugs/2/drug-32677- cardiomyopathy.
1331/tranexamic-acid- • To prepare an I.V. infusion,
oral/tranexamic-acid-650- use normal saline solution,
milligram-tablet-
D5W, or lactated Ringer’s
oral/details
injection for dilution. Dilute
 doses up to 5 g with 250 ml of
solution, doses of 5 g or
greater with at least 500 ml.
• Advise patient to change
positions slowly to minimize
dizziness.
• Tell patient that routine CK
determinations will be
necessary with long-term use.
• Teach patient signs and
symptoms of
thrombophlebitis, and advise
him to report them promptly.
Brand Name: Endocone Therapeutic Oxycodone acts on opiate Moderate to severe pain. Recommended: CNS: sedation, somnolence, • Oxycontin is potentially
classification: analgesic receptors, providing Adults: 5 mg P.O. q 6 clouded sensorium, addictive and abused as much
Generic Name: Oxycodone
Hydrochloride analgesia for moderate to hours. Or, 1 to 3 euphoria, dizziness, light- as morphine.
Pharmacologic moderately severe pain. suppositories P.R. daily, as headedness,seizures. • Drug may obscure signs and
classification: opioid Acute pain, rather than needed.For patients not CV: symptoms of an acute
chronic pain, appears to be currently receiving opiates, hypotension,bradycardia. abdominal condition and it
more responsive. who need a continuous, GI: nausea, vomiting, may worsen gallbladder pain.
around-the-clock analgesic constipation. • Consider prescribing a stool
for an extended period, GU: urine retention. softener for patients receiving
give 10 mg (sustained- Respiratory: respiratory long-term therapy.
release tablet) P.O. q 12 depression. • The 80-mg sustained-release
References: hours. May increase dose q Skin: diaphoresis, pruritus, tablets are for opioid-tolerant
https://www.glowm.com/r
1 to 2 days as needed. The rash. patients.
esources/glowm/cd/pages
/drugs/o017.html 80-mg formulation is for Other: physical dependence. • Patients being transferred
opioid-tolerant patients from 5- to 25-mg daily
only. conventional dose should
≡ Dosage adjustment. For receive 10 to 20 mg q 12
patients with impaired hours of the sustained-release
hepatic function, begin preparation. If conventional
sustained-release tablets at dose is 30 to 45 mg or 50 to
33% to 50% of the usual 60 mg daily, the sustained-
dosage and adjust release dose is 20 to 30 mg q
carefully. 12 hours or 30 to 40 mg q 12
hours, respectively.
Actual: 1 Capsule q 8 • Chewing, crushing, snorting,
or injecting the sustained-
release preparation can lead
to overdose and death.