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GENERIC NAME: Fondaparinux sodium BRAND NAME: ARIXTRA DRUG CLASS: Selective factor Xa inhibitor MECHANISM: Selective inhibition

of antithrombin III (ATIII), which potentiates the innate neutralization of factor Xa by ATIII. Neutralization of factor Xa interrupts the blood coagulation cascade and inhibits thrombin formation and thrombus development. Indications: Prophylaxis of deep vein thrombosis (DVT) in patients undergoing hipfracture surgery (including extended prophylaxis), hip replacementsurgery, knee replacement surgery, or abdominal surgery. Contraindications: Severe renal impairment (creatinine clearance <30 mL/min) in prophylaxis or treatment of venous thromboembolism. Body weight <50 kg. DOSAGE: - Injection, solution 2.5 mg per 0.5 mL ADVERSE EFFECTS: bleeding complications, Mild local irritation, Anemia, insomnia, increased wound drainage, hypokalemia, dizziness, hypotension, confusion, bullous eruption, hematoma, post-operative hemorrhage, and purpura may occur. NURSING RESPONSIBILITIES: For subcutaneous administration only. Do not mix with other medications or solutions. Closely monitor for signs and symptoms of bleeding

GENERIC NAME: Ramipril BRAND NAME: RAMIPRO DRUG CLASS: ACE inhibitor MECHANISM: ACE inhibitors lower the production of angiotensin II, therefore relaxing arterial muscles while at the same time enlarging the arteries, allowing the heart to pump blood more easily, and increasing blood flow due to more blood being pumped into and through larger passageways. Indications: Hypertension. It is also used to decrease the risk of heart attack and stroke. It is also used to manage heart failure and improve survival after a heart attack Contraindications: Hypersensitivity, bilateral renal artery stenosis, or a single kidney with unilateral renal artery stenosis. Aortic stenosis or outflow tract obstruction. Pregnancy and lactation. DOSAGE: 2.5 5 mg q d ADVERSE EFFECTS: Nausea, vomiting, diarrhoea, dizziness, fatigue, headache, abdominal pain, cough. NURSING RESPONSIBILITIES: Monitor renal function before and during treatment. Use with caution in patients with history of idiopathic or hereditary angioedema. Regular monitoring of WBC in patients with vascular collagen disorders is recommended.

GENERIC NAME: sodium chloride BRAND NAME: DRUG CLASS: electrolyte supplement MECHANISM: Preventing or treating sodium loss due to excessive sweating or dehydration. Indications: prophylaxis of heat prostration or muscle cramps; chloride deficiency due to dieresis or salt restrictions; prevention or treatment of extracellular volume depletion Contraindications: congestive heart failure, severely impaired renal function, hypernatremia, fluid retention DOSAGE: 1 tab TID 6-12-6 ADVERSE EFFECTS: hypernatremia, hypokalemia, acidosis. Fluid and solute overload leading to dilution of serum electrolyte level, CHF, over hydration, acute pulmonary edema NURSING RESPONSIBILITIES: Observe S&S of hypernatremia, flushed skin, elevated temperature, rough dry tongue, and edema. Monitor VS and I&O

GENERIC NAME: SODIUM BICARBONATE BRAND NAME: DRUG CLASS: gastrointestinal agent; antacid; fluid and electrolyte balance agent MECHANISM: increases plasma bicarbonate, neutralizes gastric acid which forms water, sodium chloride, carbon dioxide, and raises blood pH Indications: Treatment of metabolic acidosis, promotion of gastric, systemic and urine alkalinization in the case of intoxication with weak organic acids Contraindications: Hypoventilation, hypocalcemia, increase serum osmolarity, further in all situations where sodium intake must be restricted like cardiac insufficiency, edema hypertension, eclampsia, severe kidney insufficiency. DOSAGE: 650 mg tab TID ADVERSE EFFECTS: irritability, muscle rigidity, weakness, nausea, vomiting, or headache NURSING RESPONSIBILITIES: Monitor patient closely for toxicity and effectiveness. Avoid using NaHCO3 And enteric-coated drugs together

GENERIC NAME: Pizotifen + MVC BRAND NAME: MOSEGOR VITA DRUG CLASS: APPETITE STIMULANT MECHANISM: Enhance sedative effects of CNS depressants, antihistamine, alcohol. Indications: Underweight due to lack of appetite associated w/ vitamin B deficiency secondary to impaired dietary intake or absorption Contraindications: hypersensitivity to the drug, those with glaucoma and prostatic hypertrophy - an overgrowth or enlargement of prostate glands in males. DOSAGE: 1 cap OD ADVERSE EFFECTS: Sedation; rarely dizziness, dry mouth, constipation. NURSING RESPONSIBILITIES: Avoid activities which require concentration. Administer with meals to avoid G.I irritations.