Ranitidine is an oral drug that blocks the production of acid by acid-producing cells in the stomach.

It belongs to a class of drugs called H2 (histamine-2) blockers that also includes cimetidine(Tagamet), nizatidine (Axid), and famotidine (Pepcid). Histamine is a naturallyoccurring chemical that stimulates cells in the stomach (parietal cells) to produce acid. H2-blockers inhibit the action of histamine on the cells, thus reducing the production of acid by the stomach. Since excessive stomach acid can damage the esophagus, stomach, and duodenum and lead to inflammation and ulceration, reducing stomach acid prevents and heals acid-induced inflammation and ulcers. The FDA approved ranitidine in October 1984. DOSING: Ranitidine may be taken with or without food.

Usual oral doses for treating ulcers and GERD are 150 mg twice daily or 300 mg at bedtime. The maintenance dose is 150 mg daily. Erosive esophagitis is treated with 150 mg 4 times daily. Zollinger Ellison syndrome may be treated with as much as 6 g daily. Heartburn is treated with 75 mg or 150 mg once or twice daily 30-60 minutes before consuming meals or beverages that cause heartburn.

Self-medication should not last longer than 2 weeks unless advised by a physician. Minor side effects include constipation, diarrhea, fatigue,headache, insomnia, muscle pain, nausea, and vomiting. Major side effects are rare; they include: agitation, anemia, confusion, depression, easy bruising or bleeding, hallucinations, hair loss, irregular heartbeat, rash, visual changes, and yellowing of the skin or eyes. USES: Ranitidine is used to treat ulcers of the stomach and intestines and prevent them from returning after treatment. This medication is also used to treat and prevent certain stomach and throat (esophagus) problems caused by too much stomach acid (e.g., Zollinger-Ellison syndrome, erosiveesophagitis) or a backward flow of stomach acid into the esophagus (gastroesophageal reflux disease-GERD).Ranitidine is known as an H2 histamine blocker. It works by reducing the amount of acid in your stomach. This helps heal and prevent ulcers and improves symptoms such as heartburn and stomach pain.This medication is also available without a prescription. It is used to prevent and treat heartburn and other symptoms caused by too much acid in the stomach (acid indigestion). If you are taking this medication for self-treatment, it is important to read the manufacturer's package instructions carefully so you know when to consult your doctor or pharmacist. Contradiction:

breast-feeding children elderly gastric cancer

 H2-blocker hypersensitivity infants infection neonatal prematurity neonates phenylketonuria porphyria pregnancy renal disease renal failure renal impairment tobacco smoking

Tramadol is a man-made (synthetic) analgesic (pain reliever). Its exact mechanism of action is unknown but similar morphine. Like morphine, tramadol binds to receptors in the brain (opioid receptors) that are important for transmitting the sensation of pain from throughout the body to. Tramadol, like other narcotics used for the treatment of pain, may be abused. Tramadol is not a nonsteroidal antiinflammatory drug (NSAID) and does not have the increased risk of stomach ulceration and internal bleeding that can occur with NSAIDs. DOSING: The recommended dose of tramadol is 50-100 mg (immediate release tablets) every 4-6 hours as needed for pain. The maximum dose is 400 mg/day. To improve tolerance patients should be started at 25 mg/day, and doses may be increased by 25 mg every 3 days to reach 100 mg/day (25 mg 4 times daily). Thereafter, doses can be increased by 50 mg every 3 days to reach 200 mg day (50 mg 4 times daily). Tramadol may be taken with or without food. Tramadol is generally well tolerated, and side effects are usually transient. Commonly reported side effects include nausea,constipation, dizziness, headache, drowsiness, and vomiting. Less commonly reported side effects include itching, sweating, dry mouth, diarrhea, rash, visual disturbances, and vertigo. Some patients who received tramadol have reported seizures. Abrupt withdrawal of tramadol may result in anxiety, sweating, insomnia, rigors, pain, nausea, diarrhea, tremors, and hallucinations.

This medication is used to help relieve moderate to moderately severe pain. Tramadol is similar to narcotic analgesics. It works in the brain to change how your body feels and responds to pain.

abrupt discontinuation ethanol intoxication opiate agonist hypersensitivity breast-feeding children driving or operating machinery elderly GI disease head trauma hepatic disease increased intracranial pressure labor pregnancy renal impairment respiratory depression seizure disorder substance abus

Generic Name: Cefazolin Brand Name: Ancef Dosage: 250 mg CLASSIFICATIONS Therapeutic: Anti-infectives Pharmacologic: First generation cephalosphorins ACTIONS Bind to bacterial cell wall membrane, causing cell death. Active against many gram-positive cocci including: Streptococcus pneumoniae, Group A beta-hemolytic streptococci; Penicillinas-producing staphylococci. INDICATION Treatment of: Skin & skin structure infections; pneumonia; urinary tract infections; bone & joint infections CONTRA INDICATIONS Contraindicated in: Hypersensitivity to cephalosphorins. Serious hypersensitivity to penicillin. Use Cautiously in: Renal impair- ment History of GI disease, especially colitis

Geriatric patients (consider age-related decrease in body mass, renal/hepatic/ cardiac function, concurrent medications and chronic disease states) Pregnancy or Lactation SIDE EFFECTS/ ADVERSE EFFECTS CNS: Seizures (high doses) GI: Pseudomembranous colitis, diarrhea, nausea, vomiting, cramps GU: Interstitial nephritis DERM: Rashes, urticaria HEMAT: Blood dyscrasias, hemolytic anemia LOCAL: Pain at IM site, phlebitis at IV site MISC: Allergic reactions including Anaphylaxis and Serum sickness, superinfection

Ketorolac is a member of a class of drugs called nonsteroidal antiinflammatory drugs (NSAIDs) that is used for treating inflammation and pain. Other drugs in this class include ibuprofen(Motrin) and naproxen (Naprosyn, Aleve), but ketorolac is more effective than other NSAIDs in reducing pain from both inflammatory and non-inflammatory causes. Ketorolac reduces the production of prostaglandins, chemicals that cells of the immune system make that cause the redness,fever, and pain of inflammation and that also are believed to be important in the production of non-inflammatory pain. It does this by blocking the enzymes that cells use to make prostaglandins (cyclooxygenase 1 and 2). As a result, pain as well as inflammation and its signs and symptoms - redness, swelling, fever, and pain - are reduced. The FDA approved ketorolac in November 1989. Treatment should be started with ketorolac injection. Tablets are used only if treatment is continued after patients begin to eat and drink. The total duration of therapy should not exceed 5 days because of the potential for gastrointestinal bleeding and other side effects. The recommended adult intravenous single dose is 15 to 60 mg. Multiple intravenous doses of 15 or 30 mg every 6 hours, not to exceed 60 or 120 mg a day, also may be used. Following intravenous therapy, the recommended dose is one or two tablets initially followed by 1 tablet every 4-6 hours, not to exceed 40 mg daily. The smaller dose is used for patients with poor kidney function or those older than 65 years. Common side effects from ketorolac include rash, ringing in the ears, headaches, dizziness, drowsiness, abdominal pain, nausea,diarrhea, constipation, heartburn, and fluid retention. NSAIDs reduce the ability of blood to clot and therefore increase bleeding after an injury. Ketorolac may cause ulcers and bleeding in the stomach and intestines, particularly with use for more than five days. Sometimes, stomach ulceration and intestinal bleeding can occur without any abdominal pain. Black tarry stools, weakness, and dizziness upon standing may be the only signs of the bleeding. NSAIDs reduce the flow of blood to the kidneys and impair function of the kidneys. The impairment is most likely to occur in patients with preexisting impairment of kidney function or congestive heart failure, and use of NSAIDs in these patients should be done cautiously. Liver failure has also been

associated with ketorolac. People who are allergic to aspirin and other NSAIDs should not use ketorolac. Individuals with asthma or nasal polyps are more likely to experience allergic reactions to NSAIDs. Indication
Short-term management of moderate to severe postoperative pain Ocular itching associated with seasonal allergic conjunctivitis Prevention and relief of postoperative eye inflammation

Contraindications

hypersensitivity to Ketorolac tromethamine. patients with active peptic ulcer disease, in patients with recent gastrointestinal bleeding or perforation and in patients with a history of peptic ulcer disease or gastrointestinal bleeding. patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic-like reactions to NSAIDs have been reported in such patients prophylactic analgesic before any major surgery the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery patients with advanced renal impairment or in patients at risk for renal failure due to volume depletion labor and delivery because, through its prostaglandin synthesis inhibitory effect, it may adversely affect fetal circulation and inhibit uterine contractions, thus increasing the risk of uterine hemorrhage. nursing mothers because of the potential adverse effects of prostaglandin-inhibiting drugs on neonates patients with suspected or confirmed cerebrovascular bleeding, hemorrhagic diathesis, incomplete hemostasis and those at high risk of bleeding inhibits platelet function patients currently receiving aspirin or NSAIDs because of the cumulative risks of inducing serious NSAID-related adverse events The concomitant use of Ketorolac tromethamine and probenecid is contraindicated.