Name of the Drug Myrin-P Forte

Dosage, Frequency, Preparation 1 tab/15 kg - body wt./day Alternative ly 50 kg - 4 tabs/day 40-49 kg - 3tabs/day.

Classificatio n and Mechanism of Action Anti TB Agents May interfere with synthesis of one or more bacterial metabolites, altering RNA synthesis during cell division.

Indication Tuberculosis and atypical mycobacterial infections caused by Mycobacteriu m tuberculosis

Contraindicati on Hypersensiti vity to drug. In the presence of alcoholism, optic neuritis, impaired hepatic function and severe renal insufficiency , hyperuricem ia and/or gouty arthritis unless the doctor determines that it may be used.

Adverse Reaction CNS: confusion, dizziness EENT: optic neuritis, blurred vision, decreased visual acuity, eye pain, redgreen color blindedness GI: nausea, vomiting, abdominal pain Hematologic: thrombocytop enia Hepatic: hepatitis Metabolic: hyperuricemia Musculosklet al: joint pain, gouty arthritis Respi: bloody sputum Others: anaphylaxis

Nursing Consideration Monitor vital signs (especially blood pressure) Instruct patient to expect side effects of antiTB drugs Instruct patients or relatives to inform any signs of adverse reactions

Each tablet contains ethambuto l HCl 275 mg, rifampicin 150 mg, *pre-breakfast isoniazid *per orem 75 mg and pyrazinami Should be de 400 taken on an mg. empty stomach. Take 1 hr before or 2 hr after meals. If GI irritation occurs, may be taken w/ food or antacids

Name of the Drug Pantopraz ole (Pantoloc)

Dosage, Frequency, Preparatio n 40 mg IV once a day Availability: 40 mg/ vial

Classification and Mechanism of Action Proton Pump Inhibitor Reduces gastric acid secretion and increases gastric mucus and bicarbonate production, creating protective coating on gastric mucosa.

Indication Duodenal ulcer; gastric ulcer; moderate and severe forms of reflux esophagitis.

Contraindicati on Hypersensiti vity to drug. Mild gastrointesti nal complaints e.g., nervous dyspepsia.

Adverse Reaction CNS: headache, dizziness CV: chest pain EENT: rhinitis GI: vomiting, diarrhea, abdominal pain, dyspepsia Metabolic: hyperglycem ia Skin: rash, pruritus Others: injection site reaction

Nursing Consideration Flush IV line with D5W, Normal Saline solution, or lactated Ringers injection, before and after giving the drug. When giving IV over 2 minutes, reconstitute with 10 ml of normal saline injection. Solution may be store up to 2 hours at room temperature. Instruct patient any signs of GI bleeding such as fresh blood in stool or black tarry stool

Name of the Drug Tigecyclin e (Tygacil)

Dosage, Frequenc y, Preparati on 50 mg IV every 12 hours Availabilit y: 50 mg/5 ml in singledose vial

Classification and Mechanism of Action Glycylcycline antibiotic Inhibits protein translation in bacteria by binding to 30S ribosomal subunit and blocking entry of amino-acyl tRNA molecules into ribosomal A site,which in turn prevents incorporation of amino acid residues into elongating peptide chains Classification and Mechanism of

Indication Complicated skin & skin structure infections, including those w/ methicillinresistant Staphylococ cus aureus (MRSA). Complicated intraabdominal infections.

Contraindi cation Hyperse nsitivity to tigecycli ne & tetracycl ine class antibioti cs.

Adverse Reaction CNS: headache, dizziness CV: hypertension, hypotension GI: nausea, vomiting, diarrhea, constipation, abdominal pain, pseudomembrano us colitis, dyspepsia Hematologic: anemia, thrombocytopenia Skin: rash, pruritus

Nursing Consideration Instruct patient to report rash and other signs or symptoms of allergic reaction. Tell patient to complete full course of therapy, even if he feels better.

Name of the Drug

Dosage, Frequenc y,

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Mefenami c acid (Dolfenal)

Preparati on 500 mg/tab 1 tab every 6 hours PRN for pain per orem Availability : TABLETS 100 mg, 250 mg, 500 mg

Action Nonsteroidal Antiinflammatory Drugs (NSAIDS) Binds the prostaglandin synthetase receptors COX-1 and COX-2, inhibiting the action of prostaglandin synthetase. Mild to moderately severe pain associated w/ muscular, rheumatic, traumatic, dental, post-op & postpartum pain, headache, toothache, fever. Active ulceration or GIT inflammati on. Preexisting renal disease. CNS: headache, dizziness, drowsiness EENT: visual disturbances GI: GI disturbances , peptic ulceration & GI bleeding Tell patient that it should be taken with food. Asses patients pain before giving medication Monitor patient for any adverse reaction Advice patient to report persistence or failure to relieve pain

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Dosage, Frequenc y, Preparati on

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Phytomenadio ne (Konakion)

1 ampule every 8 hours Availabilit y: 2 mg/ml aqueous colloidal(I M, IV); aqueous dispersion 10 mg/ml (IM)

Fat-soluble vitamin

Vitamin K malabsorpti on, Needed for hypoprothro adequate mbinemia, blood prevention clotting of (factors II, hypoprothro VII, IX, X) mbinemia caused by oral anticoagula nts.

Hypersensitiv ity, sever hepatic disease

CNS: headache, brain damage (large doses) GI: nausea, decreased liver function tests Hematology: hemolytic anemia, hemoglobinuri a, hyperbilirubine mia Skin: rash, urticaria

Monitor for bleeding, pulse, and BP Assess for bleeding or bruising: hematuria, black tarry stools, hematemesis Advice patient to avoid hard toothbrush, flossing, electric razor until treatment is terminated. Stress the need for periodic lab tests to monitor coagulation levels.

Name of the Drug Metocloprami de (Plasil)

Dosage, Frequenc y, Preparati on 1 ampule IV stat Availability : Ampule 10mg/2 mL

Classificati on and Mechanism of Action Antiemetic Dopamine antagonist that acts by increasing receptor sensitivity and response of upper GIT tissues to acetylcholine

Indicatio n To prevent post operativ e nausea and vomittin g

Contraindicati on Hypersensiti vity to metoclopra mide and its components Pheochromo cytoma Seizure disorders

Adverse Reaction CNS: Agitation, anxiety, drowsiness, fatigue, headache, insomnia, irritability GI: Constipation, Diarrhea, Nausea Hematology: Agranulocytosis Skin: rash, urticaria

Nursing Consideration Assess patient for any signs of intestinal obstruction, such as abnormal bowel sounds, diarrhea, nausea, vomiting before administering drug Avoid rapid administration of iv preparation for it may cause restlessness, anxiety or drowsiness

Name of the Drug Furosemide (Lasix)

Dosage, Frequenc y, Preparati on 20mg IV bolus stat Availability : 20mg/2ml

Classifica tion and Mechanis m of Action Loop Diuretic Inhibits water and sodium reabsorpti

Indication To reduce edema caused by cirrhosis, heart failure, and renal

Contraindicatio n Anuria unresponsive to furosemide Hypersensitiv ity to

Adverse Reaction CNS: Dizziness, fever, headache, paresthesia, restlessness, vertigo, weakness GI: Abdominal cramps, anorexia,

Nursing Consideration Weigh patient before furosemide therapy to monitor fluid loss

on in the loop of Henle and increases urine formation

diseases including nephritic syndrome

furosemide, sulfonamides or their components

constipation, diarrhea, gastric irritation, indigestion, nausea, pancreatitis and vomiting Hematology: Agranulocytosis(r are), azotemia, hemolytic anemia, leukopenia, thrombocytopenia Skin: erythema multiforme, exfoliative dermatitis, photosensitivity, pruritus, rash, urticaria

Administer drug slowly over 1 to 2 min to prevent ototoxicity Refer to doctor if patient experiences signs of hearing loss, vertigo, buzzing or sense of fullness in ears

Name of the Drug

Dosage, Frequency , Preparatio n

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Indication

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Nursing Consideration

Arcoxia (Etoricoxib)

120mg/tab stat per orem

Nonsteroidal antiinflammatory drugs (NSAIDS) NSAIDs work by blocking the action of a substance in the body called cyclo-oxygenase. Cyclo-oxygenase is involved in producing prostaglandins, in response to injury or certain diseases. These prostaglandins cause pain, swelling and inflammation. Because NSAIDs block the production of these prostaglandins, they are effective at relieving pain and inflammation

Relief of acute pain Moderate to severe acute postoperative pain

Active peptic ulceration or GI bleeding Congestive heart failure Acute arthritis Hypersensiti vity to NSAIDs Cerebrovasc ular disease Inadequatel y controlled HPN

CNS: Dizziness, drowsiness, confusion, anxiety, headache and insomnia GI: Diarrhea, heartburn, vomiting Hematolog y: Decrease in platelet count Skin: rash

Assess patient for any hypersensiti vity to NSAIDs Instruct patient or relatives to report any adverse effects of drug Assess patient for any signs of bleeding

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Dosage, Frequenc

Classificatio n and

Indicatio

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Nursing

y, Preparati on Tramadol hydrochlori de (Ultram) 50 mg IV

Mechanism of Action Analgesic

n Moderate to severe pain

n Hypersensi tivity to drug Acute intoxication with alcohol, sedativehypnotics, or opioid analgesics

Reaction CNS: headache, dizziness, drowsiness CV: vasodilation EENT: visual disturbances GI: nausea, vomiting, diarrhea GU: urinary retention and frequency Resp: respiratory depression

Consideration Assess patients response to drug 30 minutes after administrati on Monitor respiratory status. Withhold drug and contact prescriber if RR become shallow or slower than 12 breaths/min

-Every 6 hours x 6 doses -PRN for pain

Inhibits reuptake of serotonin and norepinephrin e in CNS

Name of the Drug

Dosage, Frequency , Preparatio

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Indication

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n Tramadol hydrochlori de + Paracetamo l (Dolcet) Tramadol hydrochlori de 37.5 mg + Paracetamo l 325 mg/ tab Analgesic and Antipyretic Moderate to severe pain Hypersen sitivity to drug Acute intoxicati on with alcohol, hypnotics, or narcotics CNS: dizziness EENT: tinnitus GI: nausea, constipation , diarrhea, flatulence Skin: increased sweating, pruritus Assess for level of pain relief and administer dose as needed but not to exceed the recommende d total daily dose Discontinue drug and notify the physician if s/sx of hypersensitivi ty occur

-Every 6 hours - for pain

Acts centrally through binding to the opioid receptors and via a tricyclic-like mechanism whereby it inhibits neuronal reuptake of serotonin and norepinephrine within the CNS.

Name of the Drug

Dosage, Frequency Classification and , Mechanism of Preparatio Action n

Indication

Contraindicati on

Adverse Reaction

Nursing Consideration

Paracetam ol (Aeknil)

900 mg IV

Analgesic and Antipyretic

-Every 6 hours RTC x 6 doses

Decreases fever by inhibiting the effects of pyrogens on the hypothalamus heat regulating centers & by a hypothalamic action leading to sweating & vasodilatation. Relieves pain by inhibiting prostaglandin synthesis at the CNS but does not have anti-inflammatory action because of its minimal effect on peripheral prostaglandin synthesis.

Relief of mild-tomoderate pain; treatment of fever.

Hyperse nsitivity to drug

CNS: drowsiness

EENT: allergy to tinnitus acetamin GI: nausea, ophen vomiting, intoleran abdominal pain ce to tartrazin e (yellow dye #5), alcohol, table sugar, sacchari n Skin: rash, urticaria

Assess patients fever or pain: type of pain, location, intensity, duration, temperature, and diaphoresis. Assess allergic reactions: rash, urticaria; if these occur, drug may have to be discontinued. Teach patient to recognize signs of chronic overdose: bleeding, bruising, malaise, fever, sore throat.

Name of the Drug

Dosage, Frequency , Preparatio n 500 mg IV

Classification and Mechanism of Action Anti-fibrinolytic, antihemorrhagic

Indicatio n

Contraindicati on

Adverse Reaction

Nursing Consideration

Tranexami c acid (Trenaxin)

-Every 8 hours x 3 doses

Exerts its antifibrinolytic effect through the reversible blockade of lysine-binding sites on plasminogen molecules; Inhibits endometrial plasminogen activator and thus prevents fibrinolysis and the breakdown of blood clots

For the prompt and effective control of hemorrhag e

Hypersen sitivity to drug Presence of blood clots (e.g., in the leg, lung, eye, brain), have a history of blood clots, or are at risk for blood clots

CNS: Severe or persistent headache Resp: dyspnea, tightness in the chest, coughing up blood Skin rash, hives, itching, swelling of the mouth, face, lips or tongue

Unusual change in bleeding pattern should be immediately reported to the physician.

Name of the Drug

Dosage, Frequency , Preparatio n 100 mg/tab 1 tab

Classification and Mechanism of Action Antacid

Indication

Contraindicati on

Adverse Reaction

Nursing Consideration

Mucosta (Rebamipid e)

-thrice a day

A mucosal protective agent and is postulated to increase gastric blood flow, prostaglandin biosynthesis and decrease free oxygen radicals

Treatment of gastric mucosal lesions (erosion, bleeding, redness & edema) in acute gastritis & exacerbation of chronic gastritis; gastric ulcer. Prevention of NSAID-induced gastropathy.

Hypersen sitivity to drug Presence of blood clots (e.g., in the leg, lung, eye, brain), have a history of blood clots, or are at risk for blood clots

GI: nausea, diarrhea, constipation Skin rash, pruritus

Assess patient for any hypersensit ivity to the drug Monitor for any adverse reaction