DRUG NAME MECHANISM OF ACTION INDICATION CONTRAINDICATIONS SIDE EFFECTS/ NURSING
ADVERSE EFFECTS CONSIDERATION
Azithromycin Bacteriostatic or bactericidal in Treatment of lower Contraindicated with ADVERSE EFFECTS BEFORE:
susceptible bacteria, i.e. respiratory infections: hypersensitivity to CNS: Dizziness, 1. Obtain history for
DOCTOR’S ORDER: preventing bacteria from growing Acute bacterial azithromycin, headache, vertigo, Hypersensitivity to
Azithromycin 500mg tab by interfering with their protein exacerbations of COPD erythromycin, or any somnolence, fatigue azithromycin,
I tab OD synthesis. It bind to the 5os due to Haemophilus macrolide antibiotic, mild GI: Diarrhea, abdominal erythromycin, or any
subunit of the bacterial ribosome, influenzae, Moraxella to moderate pneumonia, pain, nausea, dyspepsia, macrolide antibiotic;
BRAND NAME: this inhibiting translation of catarrhalis, cystic fibrosis, bacteremia, flatulence, vomiting, gonorrhea or syphilis,
Zithromax mRNA. Nucleic Acid Synthesis is Streptococcus immunocompromised melena, pseudomembranous
Zmax not affected. pneumoniae;community- patients, elderly patients. pseudomembranous colitis, hepatic or renal
Azicip-500 acquired pneumonia due Use cautiously with colitis impairment, lactation
Azithro 500 to S. pneumoniae, H. gonorrhea or syphilis, Other: Superinfections, 2. Assess the skin color,
Azihawk-500 influenzae, Mycoplasma pseudomembranous angioedema, rash, lesions; orientation, GI
Azipro-500 pneumoniae; colitis, hepatic or renal photosensitivity, output, bowel sounds,
Chlamydophilia impairment, lactation. vaginitis liver evaluation; culture
AVAILABLE FORM: pneumoniae and sensitivity tests of
Tablets–250, 500, 600 Treatment of lower INTERACTIONS infection, urinalysis,
mg; powder for injection respiratory infections: Drug-drug LFTs, renal function
—500 mg; injection— Streptococcal pharyngitis Decreased serum levels tests.
2.5 g; powder for oral and tonsillitis due to and effectiveness of
suspension–100 mg/5 Streptococcus azithromycin with DURING:
mL, 200 mg/5 mL, 1 pyogenesin those who aluminum and 1. Administer on an empty
g/packet; bottles for oral cannot take penicillins magnesium-containing stomach 1 hr before or
suspension—2 g to be Treatment for antacids 2–3 hr after meals. Food
reconstituted with 60 mL strepthroat, skin Possible increased affects the absorption of
water (Zmax) infections, STDs, effects of theophylline this drug.
whooping cough, and Possible increased 2. Prepare Zmax by adding
CLASSIFICATION: bronchitis. anticoagulant effects of 60 mL water to bottle,
Macrolide antibiotic warfarin shake well.
Drug-food AFTER:
Food greatly decreases 1. Take the full course
the absorption of prescribed. Do not take
azithromycin with antacids. Tablets
and oral suspension can
be taken with or without
food.
2. Tell the patients that he
or she may experience
these side effects:
Stomach cramping,
discomfort, diarrhea;
fatigue, headache
(medication may help);
additional infections in
the mouth or vagina
(consul your health care
provider for treatment).
3. Report severe or watery
diarrhea, severe nausea
or vomiting, rash or
itching, mouth sores,
vaginal sores.
DRUG NAME MECHANISM OF ACTION INDICATION CONTRAINDICATIONS SIDE EFFECTS/ NURSING
ADVERSE EFFECTS CONSIDERATION
Prednisone Enters target cells and binds to Short-term management Contraindicated with ADVERSE EFFECTS BEFORE:
intracellular corticosteroid of various inflammatory infections, especially CNS: Vertigo, headache, 1. Obtain history of
DOCTOR’S ORDER: receptors, initiating many and allergic disorders, tuberculosis, fungal paresthesias, insomnia, Infections, renal or liver
Start Prednisone 20mg complex reactions that are such as rheumatoid infections, amebiasis, seizures, psychosis, disease, hypothyroidism,
tab TID po responsible for its arthritis, collagen vaccinia and varicella, and cataracts, increased IOP, ulcerative colitis with
antiinflammatory and diseases (eg, SLE), antibioticresistant glaucoma (long-term impending perforation,
BRAND NAME: immunosuppressive effects. dermatologic diseases infections; lactation. therapy), euphoria, diverticulitis, active or
Apo-Prednisone (CAN) (eg, pemphigus), status Use cautiously with renal depression latent peptic ulcer,
NovoPrednisone (CAN) asthmaticus, and or liver disease, CV: Hypotension, inflammatory bowel
Prednisone Intensol autoimmune disorders. hypothyroidism, ulcerative shock,hypertension and disease, HF,
Concentrate Minimization of colitis with impending HF secondary to fluid hypertension,
Winpred (CAN) inflammation within the perforation, diverticulitis, retention, thromboembolic
bronchial tubes. active or latent peptic thromboembolism, disorders, osteoporosis,
AVAILABLE FORM: ulcer, inflammatory bowel thrombophlebitis, fat seizure disorders,
Tablets—1, 2.5, 5, 10, disease, heart failure, embolism, cardiac diabetes mellitus, hepatic
20, 50 mg; oral solution hypertension, arrhythmias disease, lactation
—5 mg/5 mL, 5 mg/mL thromboembolic disorders, Electrolyte imbalance: 2. Assess the Weight, T,
osteoporosis, seizure Sodium and fluid reflexes and grip
CLASSIFICATION: disorders, diabetes retention,hypokalemia, strength, affect and
Corticosteroid mellitus, hepatic disease, hypocalcemia orientation, P, BP,
(intermediate acting) pregnancy (monitor Endocrine: Amenorrhea, peripheral perfusion,
Glucocorticoid infants for adrenal irregular menses, growth prominence of superficial
Hormone insufficiency). retardation, decreased veins, R, adventitious
carbohydrate tolerance, sounds, serum
diabetes mellitus, electrolytes, blood
cushingoid state (long- glucose
term effect), increased
blood sugar, increased DURING:
serum cholesterol, 1. Administer once-a-day
decreased T3 and doses before 9 AM to
T4levels, HPA mimic normal peak
suppression with corticosteroid blood
systemic therapy longer levels.
than 5 days 2. Increase dosage when
GI: Peptic or esophageal patient is subject to
ulcer, pancreatitis, stress.
abdominal distention, 3. Taper doses when
nausea, vomiting, discontinuing high-dose
increased appetite, or long-term therapy to
weight gain(long-term avoid adrenal
therapy) insufficiency.
Hypersensitivity: 4. Do not give live virus
Hypersensitivity or vaccines with
anaphylactoid reactions immunosuppressive
Musculoskeletal: Muscle doses of corticosteroids.
weakness, steroid
myopathy, loss of AFTER:
muscle mass, 1. Do not stop taking the
osteoporosis, drug without consulting
spontaneous fractures your health care
(long-term therapy) provider; take oncedaily
Other: doses at about 9 AM.
Immunosuppression, 2. Avoid exposure to
aggravation or masking infections.
of infections; impaired 3. Report unusual weight
wound healing;thin, gain, swelling of the
fragile skin; petechiae, extremities, muscle
ecchymoses, purpura, weakness, black or tarry
striae; subcutaneous fat stools, fever, prolonged
atrophy sore throat, colds or other
infections, worsening of
INTERACTIONS the disorder for which
Drug-drug the drug is being taken.
Increased therapeutic
and toxic effects with
troleandomycin,
ketoconazole
Increased therapeutic
and toxic effects of
estrogens, including
hormonal contraceptives
Risk of severe
deterioration of muscle
strength in myasthenia
gravis patients who also
are receiving
ambenonium,
edrophonium,
neostigmine,
pyridostigmine
Decreased steroid blood
levels with barbiturates,
phenytoin, rifampin
Decreased effectiveness
of salicylates
Drug-lab test
False-negative nitroblue
tetrazolium test for
bacterial infection
Suppression of skin test
reactions
DRUG NAME MECHANISM OF ACTION INDICATION CONTRAINDICATIONS SIDE EFFECTS/ NURSING
ADVERSE EFFECTS CONSIDERATION
Tiotropium Competitively antagonistic at Long-term once-daily Contraindicated with ADVERSE EFFECTS BEFORE:
muscarinic receptor sites; causes maintenance treatment of allergy to atropine or its CNS: Blurred vision 1. Obtain history of Allergy
DOCTOR’S ORDER: smooth muscle relaxation, bronchospasm associated derivatives, ipratropium or CV: Edema to atropine or its
Tiotropium 18 mcg cap leading to bronchodilation. with COPD, including any component of the GI: Dry mouth, derivatives, ipratropium,
inhaled OD at HS chronic bronchitis and product. constipation, abdominal or any component of the
emphysema Use cautiously with pain, dyspepsia, product; narrow-angle
BRAND NAME: narrow-angle glaucoma, vomiting glaucoma; prostatic
Spiriva prostatic hyperplasia, Respiratory: Epistaxis, hyperplasia, bladder neck
Braltus bladder neck obstruction, pharyngitis, rhinitis, obstruction, severe renal
Tutast Sanohaler moderate to severe renal sinusitis, URI, cough impairment; pregnancy,
Tiova impairment (creatinine Other: Myalgia, rash, lactation
Bontiair clearance of 50 mL/min or infections, accidents, 2. Assess for Orientation,
Spiolto less), pregnancy, lactation. candidiasis, UTI, flulike vision, IOP; skin
symptoms, arthritis evaluation; cardiac
AVAILABLE FORM: rhythm, bowel sounds;
Powder for inhalation— INTERACTIONS R, adventitious sounds
18 mcg supplied with Drug-drug
Handihalerinhalation 1. Risk of increased DURING:
device adverse effects if 1. Do not use this drug for
combined with other acute respiratory
CLASSIFICATION: anticholinergics; avoid problems.
Anticholinergic this combination 2. Instruct patient in the
Antimuscarinic proper use of the
Bronchodilator Handihaler inhalation
device.
3. Do not use any other
drugs in the Handihaler
inhalation device.
4. Evaluate patient for
glaucoma; discontinue
drug at first sign of
developing glaucoma—
eye pain, blurred vision,
visual halos with red eye
and corneal edema.
5. Have patient void before
using medication if
urinary retention is a
problem.
AFTER:
1. Administer this drug
once daily using the
provided Handihaler
inhalation device. Do not
use this device for any
other drugs. Do not
swallow capsules.
2. Keep the capsule in the
foil blister pack until
ready to use; discard any
capsules inadvertently
opened and left exposed
to the air.
3. Follow the directions that
come with the
Handihaler for proper
administration of the
drug and cleaning of the
device.
4. Avoid getting the
inhalation powder in
your eyes; if this occurs,
gently wash the eye.
5. Use this drug for
maintenance of your
COPD. Do not use it if
you have acute trouble
breathing.
6. Empty your bladder
before using this drug if
you have a problem with
urinary retention.
7. You may experience
these side effects: Dry
mouth (drink plenty of
fluids; suck sugarless
lozenges); constipation
(consult your health care
provider); blurred vision
(avoid driving a car or
operating hazardous
machinery).
8. Report eye pain, eye
discomfort, blurred
vision, visual halos or
colored images along
with red eye (consult
your health care provider
immediately), urinary
retention, difficulty
urinating.
