ENOXAPARIN

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(e-nox’a-pa-rin)
Lovenox
Classifications: blood formers, coagulators, and anticoagulants; low molecular weight heparin
Pregnancy Category: B

NURSING IMPLICATIONS

Assessment & Drug Effects

• Lab tests: Baseline coagulation studies; periodic CBC, platelet count, urine and stool for occult blood.
• Monitor platelet count closely. Withhold drug and notify physician if platelet count less than 100,000/mm³.
• Monitor closely patients with renal insufficiency and older adults who are at higher risk for thrombocytopenia.
• Monitor for and report immediately any sign or symptom of unexplained bleeding.

Patient & Family Education

• Report to physician promptly signs of unexplained bleeding such as: pink, red, or dark brown urine; red or dark brown vomitus; bleeding gums or bloody sputum; dark, tarry stools.
• Do not take any OTC drugs without first consulting physician.
• Do not breast feed while taking this drug without consulting physician.

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• PIPERACILLIN SODIUM (pi-per’a-sill-in) Pipracil Classifications: antiinfective; beta-lactam antibiotic; antipseudomonal penicillin Prototype: Mezlocillin Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Obtain history of hypersensitivity to penicillins, cephalosporins, or other drugs prior to administration. Lab tests: C&S prior to first dose of the drug; start drug pending results. Periodic CBC
• AMPICILLIN SODIUM AND SULBACTAM SODIUM (am-pi-sill’in/sul-bak’tam) Unasyn Classifications: antiinfective; antibiotic; aminopenicillin Prototype: Ampicillin Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Determine previous hypersensitivity reactions to penicillins, cephalosporins, and other allergens prior to therapy. Lab tests: Baseline C&S tests prior to initiation of therapy; start drug pending results. Report promptly unexplained
• CELECOXIB (cel-e-cox’ib) Celebrex Classifications: central nervous system agent, analgesic, nsaid, cyclooxygenase-2 inhibitor, antipyretic Pregnancy Category: C first and second trimesters; D third trimester NURSING IMPLICATIONS Assessment & Drug Effects Therapeutic effectiveness is indicated by relief of joint pain. Lab tests: Periodically monitor Hct and Hgb, liver functions, BUN and creatinine, and serum
• DOBUTAMINE HYDROCHLORIDE (doe-byoo’ta-meen) Dobutrex Classifications: autonomic nervous system agent; beta-adrenergic agonist; catecholamine Prototype: Isoproterenol Pregnancy Category: C NURSING IMPLICATIONS Assessment & Drug Effects Correct hypovolemia by administration of appropriate volume expanders prior to initiation of therapy. Monitor therapeutic effectiveness. At any given dosage level, drug takes 10–20 min to produce
• AZITHROMYCIN (a-zi-thro-mye’sin) Zithromax Classifications: antiinfective; macrolide antibiotic Prototype: Erythromycin Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Monitor for and report loose stools or diarrhea, since pseudomembranous colitis (see Appendix F) must be ruled out. Monitor PT and INR closely with concurrent warfarin use. Patient & Family Education Direct sunlight