DRUG ORDER Generic name: pregabalin Brand name: Lyrica Classification: anti-epileptic drug, anticonvulsant Route: PO Dosage: 75mg

tab Frequency: BID (8am-6pm)

MECHNISM OF ACTION Pregabalin selectively binds to the alpha2deltasubunit protein of voltage-gated calcium channels in various regions of brain and in the superficial dorsal horn of the spinal cord. It acts as a presynaptic inhibitor of the release of excitatory neurotransmitters in stimulated neurons. It reduces influx of calcium into isolated synaptic endings.

INDICATIONS Pregabalin is used for neuropathic pain associated with diabetic peripheral neuropathy or postherpetic neuralgia and in combination with other drugs to treat partial onset seizures in adults.

CONTRAINDICATION ADVERSE EFFECT OF THE DRUG Hypersensitivity to dizziness or pregabalin or one of drowsiness, this components. anxiety; loss of balance or coordination; problems with memory or concentration; dry mouth; skin rash or itching; constipation, stomach pain; increased appetite; or joint or muscle pain.

NURSING RESPONSIBILITY/PRECAUTION Monitor patient closely for adverse reactions. Notify prescriber if significant adverse reactions persist. Monitor patient closely for evidence of suicidal thinking or behavior, especially when therapy starts or dosage changes. PATIENT TEACHING Warn against stopping pregabalin abruptly. Urge patient to avoid hazardous activities until she knows how drug affects her. Instruct patient to notify prescriber if she has changes in vision or unexplained muscle pain, tenderness, or weakness, especially if these muscle symptoms are accompanied by malaise or fever. Alert patient that drug may cause edema and weight gain.

DRUG ORDER Generic name: cefuroxime Brand name: Ambixime Classification: anti-infectives Route: IVTT Dosage:500mg Frequency: q 8 hr (4-12-8)

MECHNISM OF ACTION

INDICATIONS Cefuroxime is used to treat otitis media, respiratory tract, genitourniary tract, gynecologic, skin, and bone infections. It is also used in the treatment of speticemia, bacterial meningitis, gonorrhea, and other gonococcal infections.

CONTRAINDICATION ADVERSE EFFECT OF THE DRUG Hypersensitivity to Discomfort with IM cephalosporins. administration Oral candidiasis (mouth and/or tongue sores) Mild diarrhea Mild abdominal cramping Vaginal candidiasis Nausea Serum sickness reaction (joint pain, fever) Allergic reactions Thrombophlebitis

NURSING RESPONSIBILITY/PRECAUTION allergies, particularly cephalosporins and penicillins. If GI upset occurs give with food or milk. muscular injections must be administered deep IM to minimize discomfort. patches on mucous membranes and tongue. stool consistency carefully. tolerable but increasing severity may indicate onset of antibioticassociated colitis. renal function reports for nephrotoxicity. severe genital or anal pruritus, abdominal pain, severe mouth soreness, moderate to severe diarrhea.

DRUG ORDER Generic name: pregabalin Brand name: Lyrica Classification: anti-epileptic drug, anticonvulsant Route: PO Dosage: 75mg tab Frequency: BID (8am-6pm)

MECHNISM OF ACTION Pregabalin selectively binds to the alpha2deltasubunit protein of voltage-gated calcium channels in various regions of brain and in the superficial dorsal horn of the spinal cord. It acts as a presynaptic inhibitor of the release of excitatory neurotransmitters in stimulated neurons. It reduces influx of calcium into isolated synaptic endings.

INDICATIONS Pregabalin is used for neuropathic pain associated with diabetic peripheral neuropathy or postherpetic neuralgia and in combination with other drugs to treat partial onset seizures in adults.

CONTRAINDICATION ADVERSE EFFECT OF THE DRUG Hypersensitivity to dizziness or pregabalin or one of drowsiness, this components. anxiety; loss of balance or coordination; problems with memory or concentration; dry mouth; skin rash or itching; constipation, stomach pain; increased appetite; or joint or muscle pain.

NURSING RESPONSIBILITY/PRECAUTION Monitor patient closely for adverse reactions. Notify prescriber if significant adverse reactions persist. Monitor patient closely for evidence of suicidal thinking or behavior, especially when therapy starts or dosage changes. PATIENT TEACHING Warn against stopping pregabalin abruptly. Urge patient to avoid hazardous activities until she knows how drug affects her. Instruct patient to notify prescriber if she has changes in vision or unexplained muscle pain, tenderness, or weakness, especially if these muscle symptoms are accompanied by malaise or fever. Alert patient that drug may cause edema and weight gain.

DRUG ORDER Generic name: acetylsalisilic acid

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o

reducing the levels of prostaglandins, Brand name: chemicals that Bayer aspirin are released when there is Classification: inflammation and nonsteroidal that cause pain antiinflammatory and fever. drug (NSAID) NSAIDs block the enzyme that Route:PO makes prostaglandins Dosage: 80mg (cyclooxygenase), resulting in lower Frequency: after concentrations of lunch prostaglandins. As a consequence, inflammation, pain, and fever are reduced. Inhibition of prostaglandins also reduces the function of platelets and the ability of blood to clot.

effective in treating fever, pain, and inflammation in the body. It also prevents blood clots (i.e., is antithrombotic). As a group, NSAIDs are non-narcotic relievers of mild to moderate pain of many causes, includingheadaches, injury, menstrual cramps, arthritis, and other musculoskeletal conditions.

aspirin should not be taken by people who are allergic to ibuprofen or naproxen,[76][77] or who have salicylate intolerance[78][79] or a more generalized drug intolerance to NSAIDs, and caution should be exercised in those with asthma or NSAIDprecipitated bronchospasm. People with kidney disease, hyperuricemia, or gout should not take aspirin because it inhibits the kidneys' ability to excrete uric acid, and thus may exacerbate these conditions. Aspirin should not be given to children or adolescents to control cold or influenza symptoms, as this has been linked with Reye's syndrome.[5]

involve the gastrointestinal system and ringing in the o ears. With respect to the gastrointestinal system, it can cause ulcerations, abdominal burning, pain, o cramping, nausea, gastritis, and even serious gastrointestinal bleeding and liver toxicity. o Sometimes, ulceration and bleeding can occur without any abdominal pain. Blacko tarry stools, weakness, and dizziness upon standing may be the only o signs ofinternal bleeding.

NURSING RESPONSIBILITY/PRECAUTION Assess type, location, duration of pain, and inflammation. Inspect appearance of affected joints for immobility, deformities, and skin condition. Therapeutic serum level for antiarthritic effect is 20-30 mg/dL, note that toxicity occurs if levels are more than 30 mg/dL. Monitor urinary pH (pH from 6.5 to 5.5), may result in toxicity. Assess skin for evidence of bruising. When given as an antipyretic, assess body temperature before and 1 hour after giving medication. Do not crush or chew sustainedrelease or enteric coated form. Report ringing in the ears or persistent gastrointestinal pain.

o o

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Generic name: OMEPRAZOLE Brand name OMEPRON Classification PROTON PUMP INHIBITOR Dosage: 40mg Route: IVTT Frequency: q24h

proton-pump inhibitors, blocks the enzyme in the wall of the stomach that produces acid. By blocking the enzyme, the production of acid is decreased

prevention of upper gastrointestinal bleeding in critically ill patients

Malignant neoplasm of stomach Adverse reaction to proton pump inhibitors

Headache Dizziness Dry cough Dry mouth Fatigue Disturbances of the gut such as dia rrhoea,constipation, nausea, vomiting, indigestion or abdominal pain Pain in the muscles or joints Chest pain (angina). Pins and needles sensations (paraesthesia) Feeling of weakness (asthenia) Low blood pressure (hypotension)

Take the drug befor meals. Swallow whole capsule. Do not chew, open, or crush them. Instruct to take Omeprazole 30 minutes apart from Atacids because of possible antagonistic interactions Tell the patient that he may experience the said side effects

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Generic Name: Senna Concentrate Brand Name: Senokot Classification: Laxatives Dosage: 50mg

Active components of senna (sennosides) alter water and electrolyte transport in the large intestine, resulting in accumulation of water and increased peristalsis.

Treatment of constipation, particularly when associated with constipating drugs

Hypersensitivity; abdominal pain of unknown cause, especially if associated with fever.

GI: cramping, diarrhea, nausea GU: pink-red or brown-black discoloration of urine F and E: Electrolyte abnormalities (chronic use or dependence) MISC: laxative dependence

Route: PO Frequency: TID Timing: 8am-1pm6pm

Advice patient that laxatives should be used only for short-term therapy. Long-term therapy may cause electrolyte imbalance and dependence. Encourage patient to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid intake and increasing mobility Inform patient that this medication may cause a change in urine color to pink, red, violet, yellow, or brown

DRUG ORDER

MECHANISM OF ACTION Citicoline is an interneuronal communication enhancer. It increases the neurotransmission levels because it favors the synthesis and production speed of dopamine in the striatum, acting then as a agonist thru the inhibition of tyrosine hydroxylase.

INDICATIONS

CONTRAINDICATIONS

ADVERSE EFFECTS GI disorders

NURSING RESPONSIBILITIES/ PRECAUTIONS

Generic Name: Citicoline Brand Name: Somazine Classification: CNS stimulants Dosage: 50g Route: PO Frequency: TID Timing: 8am1pm-6pm

CVD in acute Parasympathetic and recovery hypertonia phase, symptoms and signs of cerebral insufficiency