Warfarin

Generic name: Warfarin

Brand Names: Coumadin®
Pharmacological category: Anticoagulant
Indications/ uses: Prophylaxis and treatment of venous thrombosis,
pulmonary embolism and thromboembolic disorders; atrial fibrillation
with risk of embolism and as an adjunct in the prophylaxis of systemic
embolism after myocardial infarction
Mechanism of action: Interferes with hepatic synthesis of vitamin K-
dependent coagulation factors (II, VII, IX, X)
side effects
 unusual bruising, such as: unexplainable bruises. bruises that grow in
size.
 Nose bleeds.
 bleeding gums.
 bleeding from cuts that takes a long time to stop.
 heavier than normal menstrual or vaginal bleeding.
 pink or brown urine.
 red or black stools.
 coughing up blood.

Adverse reactions:

 Cardiovascular: Vasculitis, edema, hemorrhagic shock

 Central nervous system: Fever, lethargy pain, headache, dizziness,
stroke
 Dermatologic: Rash, dermatitis, alopecia
 Gastrointestinal: Anorexia, nausea, vomiting, stomach cramps,
abdominal pain, diarrhea, flatulence, gastrointestinal bleeding,
mouth ulcers
 Genitourinary: hematuria
  Hematologic: Hemorrhage, leukopenia, unrecognized bleeding
sites
 Neuromuscular & skeletal: osteoporosis

.Warnings/precautions
Cautious use in severe Hepatic disease, Hemorrhage is the most
serious risk. Women may be at risk of developing ovarian hemorrhage
at the time of ovulation. Use with caution in traumas, infection
(antibiotics and fever may alter affects), renal insufficiency, prolonged
dietary insufficiencies (vitamin K deficiency), moderate-severe
hypertension, vasculitis, open wound, active TB. Use with caution in
protein C deficiency.
Pregnancy Category: X

Dose:

 Infants and Children: 0.05-0.34 mg/kg/day

Adults: 5-15 mg/day for 2-5 days

 Omeprazole

Generic name: omeprazol

Brand names
Parenterals: Capsules:
 Risek 20/40mg
 Risek 40mg IV Infusion in 10ml dilution
 Omezole 20/40mg
 Omezole40mgIV Infusion in 10ml dilution

Therapeutic Category
 Antacid
Pharmacologic class:
 Proton pump inhibitor

Use\ Indications
 Short-term treatment of symptomatic gastro-esophageal reflux
disease (GERD); treatment of heartburn and other symptoms
associated with GERD; pathological hypersecretory conditions;
peptic ulcer disease; gastric ulcer therapy; maintenance of healing
of erosive esophagitis; approved for combination use in the
eradication of H. pylori in patients with active duodenal ulcer.
Pharmacological Effects
 Suppresses gastric acid secretion by inhibiting the parietal cell
H+/K+ ATP pump

Adverse Reaction
 Central nervous system: Headache, dizziness
 Dermatologic: Rash
 Gastrointestinal: Diarrhea, abdominal pain, nausea, vomiting,
constipation, taste perversion
 Neuromuscular & skeletal: Weakness, back pain
 Respiratory: Upper respiratory infection, cough

Precautions/Warnings/Contraindication
 An increased risk for the development of tumors in humans
receiving long-term therapy. Bioavailability may be increased in the
elderly.
Pregnancy category: C

Interactions:
 CYP2C8, 2C9, 2C18, 2C19, and 3A3/4 enzyme substrate;
CYP1A2 enzyme inducer; CYP2C19, 2C8, 2C9, and 2C19 enzyme
inhibitor, CYP3A3/4 enzyme inhibitor (weak)
 Increased toxicity: Diazepam may increase half-life; increased
digoxin, increased phenytoin, increased warfarin

Dosing

Adults: Oral:

GERD or erosive esophagitis: 20 mg/day for 4-8 weeks

Pathological hypersecretory conditions: 60 mg once daily to start;

doses up to 120 mg 3 times/day have been administered; administer
daily doses >80 mg in divided doses

Helicobacter pylori: Combination therapy with bismuth subsalicylate,

tetracycline, and clarithromycin; or with clarithromycin alone. Adult dose:
Oral: 20 mg twice daily

Gastric ulcers: 40 mg/day for 4-8 weeks

 Ceftriaxone

Generic Name: ceftraxone

Brand Names:
Parentral
 Rocephin 500mg/1g
 Cefxone 250/500mg/1g
 Oxidil 500mg
 Aventriax 500mg/1g
 Carazone 1g

Therapeutic class:
 Antibiotic
Pharmacologic class:
 Third-generation Cephalosporin

Use\ Indications
Uncomplicated gonococcalvulvovaginitis, UTI; lower respiratory tract,
gynecologic, bone or joint, intra-abdominal, skin, or skin structure
infection; septicemia, Meningitis, Perioperative prevention, Acute
bacterial otitis media

Pharmacological Effects
Inhibits bacterial cell-wall synthesis, promoting osmotic instability;
usually bactericidal.

Adverse Reactions
GI: pseudomembranous colitis, diarrhea.
Hematologic: eosinophilia, thrombocytosis, leukopenia.
Skin: pain, induration, tenderness at injection site, rash.
Other: hypersensitivity reactions, serum sickness, anaphylaxis.

Precautions/Warnings/Contraindication
 Contraindicated in patients hypersensitive to drug or other
cephalosporins.
  Increase alkaline phosphatase, ALT, AST, bilirubin, BUN, and LDH
levels.
 May increase eosinophil and platelet counts. May decrease WBC
count.

Pregnancy category: B

Breast-feeding: use cautiously

Interactions:
 Amino glycosides: May cause synergistic effect against some
strains
 Probenecid: High doses (1 or 2 g daily) enhance hepatic clearance
of ceftriaxone

Dosing
Adult: 1 to 2 g I.M. or I.V. daily or in equally divided doses every 12
hours, Max. 4g/day
Children: 50 mg/kg I.M. as a single dose, Max. 1 g.