OMEPRAZOLE DOSE & FREQUENCY: 40 mg OD IV THERAPEUTIC CLASS: Anti-ulcer drug/ Proton pump inhibitor ACTION Gastric pump inhibitor

that blocks the final step of acid production by inhibiting the H/K ATPase system at the secretory surface of gastric parietal cell. Both basal and stimulated acid secretions are inhibited. Serum gastrin levels are increased during the first 1 or 2 weeks of therapy and are maintained at such levels during the course of therapy. INDICATION For treatment of ulcer disease CONTRAINDICATIONS Use as maintenance therapy for duodenal ulcer disease. OTC use in those who have trouble or pain swallowing food, or vomiting blood. ADVERSE REACTIONS CNS: headache, dizziness, anxiety disorders, abnormal dreams, vertigo, insomnia, nervousness, apathy, paresthesia, somnolence, depression GI; diarrhea, N&V, abdominal pain, swelling, constipation, flatulence, anorexia, fecal discoloration Hepatic: pancreatitis, liver necrosis, hepatic failure, hepatic encephalopathy CV: angina, chest pain, tachycardia, bradycardia, palpitation, elevated BP Respiratory: URI cough Dermatologic: Rash, Steven Johnson Syndrome, erythema, dry skin

GU: UTI, nephritis Hematologic: pancytopenia, anemia Miscellaneous: muscle weakness, cramps, rash, fever, pain, gout DRUG INTERACTIONS Ampicillin/ Possible less absorption of ampicillin r/t increased stomach pH Clarithromycin/ Increased plasma levels of both drugs Ketoconazole/ Possible less ketoconazole absorption Warfarin/ Prolonged rate of warfarin elimination NURSING RESPONSIBILITIES Capsules and powder for oral suspension packets should be stored away from light and moisture, 15 30 degrees Celsius Capsule taken 30 minutes before eating, swallowed whole not chewed Report if diarrhea persists, changes in urinary elimination or pain or discomfort Avoid consumption of alcohol Evaluate for ulcer healing, relief of pain

VITAMIN K PHYTOMENADIONE DOSE & FREQUENCY: 10 mg OD IV THERAPEUTIC CLASS: Anti-ulcer drug/ Proton pump inhibitor ACTION Vit K is required for the formation of several of the proteins, called clotting factors that regulate blood clotting. Vitamin K is also required for the formation of some proteins which are important for the maintenance of healthy bones and teeth and in vivo biosynthesis by gut bacteria/flora. INDICATION For bleeding disorders CONTRAINDICATIONS Those taking anti-coagulants should not take supplements, containing over 100mg Vitamin K except on the advice of a doctor. Hypersensitivity ADVERSE REACTIONS Anaphylaxis, difficulty in breathing Cyanosis, pain, swelling, vein inflammation at the injection site Increased sweating, dizziness, low blood pressure, allergic reactions after SC and IM injection.

DRUG INTERACTIONS

Phylloquinone (K1) or menaquinone (K2) are capable of blocking the blood-thinning action of anticoagulants such as warfarin, which work by interfering with the action of vitamin K. They also reverse the tendency of these drugs to cause arterial calcification in the long term. NURSING RESPONSIBILITIES Watch out for adverse effects Monitor vital signs Monitor APPT and PTT Monitor for possibility of thrombosis