Question

1) Drug template of any of this drugs:

ANTIMYCOBACTERIALS, MACROLIDES, MONOBACTAMS, AMOXICILLIN, COTRIMOXAZOLE, DOXYCYCLINE, ISONIAZID, ERYTHROMYCIN

-Complications
-Therapeutic use
-expected pharmacological Action
-Medications administration
,-contraindication/precaution
-nursing interventions
-interactions
-client education
-evaluation of medecation effectiveness

Answer 1

AMOXICILLIN

Drug class: Penicillin like antibiotic, antibacterial

Indications/therapeutic use: Bacterial infections of ear,respiratory tract,G.I tract, Skin. It is used in combination with Calvulanic acid to treat community acquired pneumonia,bacterial sinusitis, bacterial otitis media and UTI.

Expected pharmacological Action: It has bactericidal action. Amoxicillin inhibits the synthesis of bacterial cell wall by inhibiting the penicillin binding proteins and up regulation of autolytic enzymes. Reactions of Glycosyltransferase and transpeptidase are catalyzed by the penicillin binding proteins and causes cross-linking of D-alanine and D-aspartic acid in bacterial cell wall. In the absence of penicillin binding proteins, bacteria are unable to build or repair their cell wall.

Complications/Side effects: GI disturbances(Nausea,Vomiting,diarrhea), Prolonged use may cause oral or vaginal fungal infections, allergic reactions like skin rash,itching. Rare but serious complications associated with amoxicillin are dark urine ,persistent GI problems, abdominal pain,easy bruising or bleeding, yellow discoloration of skin and eye, persistent sore throat or fever.

Contraindication/precautions: hypersensitivity to beta lactam drugs, patients with allergic conditions like asthma, urticaria or hay fever

Medications administration: It comes in form of capsule, tablet, chewable tablets, oral suspension and in powdered form for injection(IM/IV)

Drug interactions: Few drugs that interact with amoxicillin are:

Acetaminophen, Aceclofenac, Abacavir, Acarbose,Aspirin- may decrease its excretion leading to high serum concentration

Alcuronium- this drug have increased therapeutic effect when used in combination with amoxicillin

Amoxicillin can cause false positive urine test in diabetes screening

Nursing interventions:

• Ask for known allergies to other beta lactam antibiotics
• Administer test dose before injection
• Check for contraindications before administration
• Assess for side effects including diarrhea, blood in urine, mucus in stool
• Use universal precautions and isolation techniques as indicated
• Follow aseptic techniques of injection administration

Client education:

• Teach about common side effects
• Advice to follow the drug regimen and not to discontinue the treatment without completing the full course
• Advice to report of super added infections like white coating on the tongue, foul smelling stool or vaginal irritation, itching and abnormal discharge if occur
• Advice to report bothering side effects like persistent diarrhea or itching
• Advice not to take any live attenuated vaccines (typhoid vaccine) while taking this drug unless instructed by physician
• Advice not to take this drug during pregnancy unless its necessary
• Instruct to inform the lab personnel about amoxicillin intake if going for blood or urine test for diabetes screening

Evaluation of medication effectiveness can be done by:

• Physical examination findings: reduced body temperature, no signs of super added infection and relief from signs and symptoms indicates that drug is being effective
• Lab values: culture reports showing reduced bacterial count when compared to pre treatment values
• Improvement in patient's general condition is an indicator towards recovery.