DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATIONS CONTAINDICATIONS SIDE EFFECTS NURSING RESPONSIBILITIES

GENERIC:Telmisartan

BRAND:Micardis

80 mg once a day Angiotensin receptor blockers

This drug works by blocking the hormone angiotensin thereby relaxing blood vessels, causing them to widen.

mild-to-moderate high blood pressure

anyone who is allergic to any of the ingredients of the product

pregnant women

back pain constipation diarrhea difficulty sleeping dizziness eczema or skin rash headache heartburn joint pain rash upper respiratory tract infection

(such as colds or sinus infections)

INSTRUCT THE CLIENT:* not to take a double dose to make up for a missed one.* not to stop taking this medication without consulting your doctor.* to store telmisartan at normal room temperature in a dry place (not in the bathroom) and keep it out of the reach of children. Do not remove tablets from their blister-pack until you are ready to take them.* not to dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATIONS CONTAINDICATIONS SIDE EFFECTS NURSING RESPONSIBILITIES

GENERIC:cefixime

BRAND:Tergecef

Adult: PO Susceptible infections 200-400 mg/day

Cephalosporins Tergecef acts by inhibiting cell wall synthesis. Its mode of action is bactericidal. It has high affinity for penicillin-binding proteins (PBP) 1 (1a, 1b, 1c) and 3, with the site of activity varying according to organisms.

Uncomplicated gonorrhoea

Hypersensitivity to cephalosporin

History of allergy to penicillins

pregnancy lactation renal failure GI disease.

upset stomach diarrhea vomiting mild skin rash headache severe skin rash itching hives difficulty breathing or swallowing wheezing vaginal infection

*Take cefixime with food or milk.*Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.*Shake the liquid well before each use to mix the medication evenly.The tablets should be swallowed whole and taken with a full glass of water.Continue to take cefixime even if you feel well. Do not stop taking cefixime without talking to your doctor.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATIONS CONTAINDICATIONS SIDE EFFECTS NURSING RESPONSIBILITIES

GENERIC:Salbutamol

BRAND:Duavent

*Adult, adolescent >12 yr & elderly Treatment of acute attacks 1-2 pulmoneb. Maintenance: 1 pulmoneb every 6-8 hours. *Children 2-12 yr 3 drops/kg/dose. Max: 2.5 mg of salbutamol every 6-8 hours. MDI Adult & children >12 yr 2 actuations every 6 hours. Max: 12 actuations in 24h

Respiratory/ Drugs for Asthma/COPD/ Anticholinergics

Salbutamol stimulates adenyl cyclase, the enzyme which catalyzes the formation of cyclic-3', 5'-adenosine monophosphate (cAMP) from adenosine triphosphate (ATP). The cAMP thus formed mediates the cellular response eg, bronchial smooth muscle relaxation. In vitro and in vivo pharmacologic studies have demonstrated that salbutamol has a preferential effect on β-adrenergic receptors that are especially found in respiratory tract compared with isoproterenol.

Management of reversible bronchospasm associated w/ obstructive airway diseases eg. bronchial asthma, COPD.

Hypertrophic obstructive cardiomyopathy or tachyarrythmia.

Hypersensitivity to soya lecithin or related food products (for MDI).

Headache pain influenza chest pain nausea Bronchitis Dyspnea coughing pneumonia bronchospasm pharyngitis sinusitis rhinitis

*Patients should avoid spraying the aerosol into the eyes since this may result in precipitation or worsening of narrow-angle glaucoma, eye pain or discomfort, temporary blurring of vision, visual halos or colored images in association of red eyes from conjunctival and corneal congestion.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATIONS CONTAINDICATIONS SIDE EFFECTS NURSING RESPONSIBILITIES

GENERIC:Albuterol

BRAND:Ventolin

*1-2 inhalations every 4-6 hours by aerosol.* The usual nebulizer dose is 0.63 mg, 1.25 mg or 2.5 mg 3-4 times a day. *tablets or syrup is 2 or 4 mg given 3 or 4 times daily *extended release tablets is 4 or 8 mg every 12 hours.

Bronchodilatorbeta II adrenergic agonist

Salbutamol is a beta (2)-adrenergic agonist and thus it stimulates beta(2)-adrenergic receptors. Binding of albuterol to beta(2)-receptors in the lungs results in relaxation of bronchial smooth muscles. Increased intracellular cyclic AMP increases the activity of cAMP-dependent protein kinase A, which inhibits the phosphorylation of myosin and lowers intracellular calcium concentrations and also cause an inhibition of the release of mediators from mast cells in the airways. A lowered intracellular calcium concentration leads to a smooth muscle relaxation..

Ventolin is used to treat or prevent bronchospasm in people with reversible obstructive airway disease. It is also used to prevent exercise-induced bronchospasm.

hypersensitive to drugW/ CAUTION:ischemic heart HTNarrhythmiashypokalemiadiabetes mellitusseizure disorderhyperthyroidismpheochromocytomapregnancyelderly pts

Side effects include nervousness, tremor, headache, palpitations, fast heart rate, elevated blood pressure, nausea, dizziness, and heartburn. Throat irritation and nosebleeds can also occur. Allergic reactions may rarely occur and may manifest as rash, hives, swelling, bronchospasm, or anaphylaxis (shock). Worsening of diabetes and lowering of potassium have also been reported. In rare patients, inhaled albuterol can paradoxically precipitate life-threatening bronchospasm.

*Shake the Ventolin canister well just before each spray.*Uncap the mouthpiece of the inhaler. Breathe out fully. Put the mouthpiece into your mouth and close your lips. Breathe in slowly while pushing down on the canister. Hold your breath for 10 seconds, then breathe out slowly.*If you use more than one inhalation at a time, wait at least 1 minute before using the second inhalation and shake the inhaler again.*Keep your Ventolin inhaler clean and dry, and store it with the cap on the mouthpiece. Clean your inhaler once a week by removing the canister and placing the mouthpiece under warm running water for at least 30 seconds. Shake out the excess water and allow the parts to air dry completely before putting the inhaler back together.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC:Erdosteine

BRAND:Zertin, Biopulmin, Dostol, Ectrin, Edotin, Ilvico, Mucofor, Mucotec, Recustein, Tantong, Vectrine

Capsule:300 mg twice daily Suspension:35mL60mL100mL

Mucolytics Erdosteine is an original derivative of natural mercapto-amino acid in thiolactonic form. Following oral administration erdosteine is rapidly metabolized in the liver. The product acts as a prodrug and its metabolites are mainly responsible for mucolytic activity, due to the presence of free thiol groups which cause the splitting up of the intra- and intermolecular disulfide bridges of several proteins and mucoproteins present in the expectoration, resulting in a reduction of the mucus elasticity and viscosity

Treatment of acute & chronic bronchopulmonary diseases, rhinosinusitis, laryngopharyngitis or exacerbations of these chronic diseases in association w/ mucus production & transport.

Hepatic disorders & abnormalities, renal insufficiency, homocystinuria, phenylketonuria.

G.I:Gastric burning, nausea, and rarely diarrhea. Hypersensitivity reactions:Skin rash, urticaria, unexpected hyperpyrexia

In case of appearance of classical hypersensitivity signs and symptoms, the treatment with erdosteine must be immediately suspended.

May be taken with or without food

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC:Ebastine 10mg BRAND:Co-Aleva Betamethasone 500 mcg

Antihistamine Antiallergics

Adult : 1tab twice daily

Ebastine has been shown to produce a rapid and long-lasting inhibition of histamine-induced effect and to have a strong affinity towards H1-receptors. Following oral administration neither ebastine nor its metabolites cross the blood-brain barrier. This characteristic is consistent with the low sedative profile seen in the results of experiments studying the effects of ebastine on the CNS.

Treatment of seasonal/perennial allergic rhinitis and chronic urticaria.

Contraindicated in patients hypersensitive to Ebastine and Betamethasone or any of tablet ingredients. Patients with severe liver insufficiency.

Headache, dry mouth and drowsiness. Pharyngitis, abdominal pain, dyspepsia, asthenia, epistaxis, rhinitis, sinusitis, nausea and insomnia..

Should be taken with foods

Betamethasone should only be used systematically with great caution in the presence of heart failure, recent myocardial infarction or hypertension, in patients with diabetes mellitus, epilepsy, glaucoma, hypothyroidism, hepatic failure, osteoporosis, peptic ulceration, psychoses or severe affective disorders and renal impairment.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC: Children 1 month H2 receptor Competitively inhibits action of Active duodenal Contraindicated in patients CNS: headache, malaise, vertigo Assess patient for abdominal pain. Note presence of

Ranitidine Hydrochloride BRAND:Apo-Ranitidine, Zantac, Zantac-C, Zantac 75, Zantac 150, Zantac EFFERdose Tablets, Zantac 150 GELdose, Zantac 300, Zantac 300 GELdose

to 16 years of age: 2–4 mg/kg twice daily. Maximum 300 mg daily. Adults: 150 mg twice daily.

antagonist Histamine on the H2 at receptor sites of parietal cells, decreasing gastric acid secretion

and gastric ulcer Maintenance therapy for duodenal or gastric ulcer.Pathologic hypersecretory conditions such as Zollinger-Ellison syndrome (ZES)Gastroesophageal reflux disease Erosive esophagitis Heartburn

hypersensitive to drug and those with acute porphyria EENT: blurred vision

Hepatic:Jaundice Other: anaphylaxis, angioedema, burning and itching at injection site.

blood in emesis, stool, or gastric aspirate. Drug may be added to total parenteral nutrition solutions. Don’t confuse ranitidine with rimantadine; don’t confuse Zantac with Xanax or Zyrtec.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC:Amoxicillin BRAND::Ultramox

Tablet:500mg/500mg x 8’s Suspension:60 mL

Penicillin Amoxicillin is a semi-synthetic penicillin which kills bacteria by interfering with the synthesis of the bacterial cell wall. It binds to penicillin-binding proteins (PBPs) on the bacterial cell wall and blocks peptidoglycan synthesis. Peptidoglycan is a heteropolymeric structure that gives the cell wall its mechanical stability. The final stage of the peptidoglycan synthesis involves the completion of the cross-linking with the terminal glycine residue of the pentaglycine bridge linking to the 4th residue of the pentapeptide.

Tonsillitis, pharyngitis, laryngitis,sinusitis, otitis media, tracheobronchitis, pneumonia, bronchopneumoniaIntra-abdominal infections Gynecological infections Urinary tract infections Skin and skin structure infection

History of hypersensitivity to penicillins and/or cephalosporins.The risk-benefit ratio should be carefully evaluated in patients with a history of GI disease, particularly ulcerative colitis, regional enteritis or antibiotic-associated colitis and infectious mononucleosis.

G.I: Nausea, vomiting, dyspepsia, stomatitis, sour mouth and tongue and diarrhea Hypersensitivity reactions: Oral candidiasis, urticaria Renal:Interstitial nephritis and hematuria

Patient w/ history GI disease eg ulcerative colitis, regional enteritis/antibiotic-associated colitis & infectious mononucleosis.Consider pseudomembranous colitis in patients who present w/ diarrhea following administration of antibiotics.Monitor hepatic, renal & hematopoietic functions. Renal impairment. :Young infant <6 mth. Elderly. Pregnancy & lactation.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFEECTS NURSING RESPONSIBILITIES

GENERIC:CEFUROXIME

BRAND: Ecocef (750mg IV) (Xeno Pharmaceuticals),Philippines

*Adults and teenagers—750mg every 6- 8hours usually for5-14 days,IM/IV.*Infants and children 1 monthof age and older—12.5 to 150 mg/ kg of bodyweight every 6-8 hours IM/IV*Newborns—30-100 mg/ kg (ofbody weight very 8-12 hours,IV

Antibiotic Cefuroxime, like the penicillins, is a beta-lactam antibiotic. Bybinding to specific penicillin-binding proteins (PBPs)located inside the bacterial cell wall, it inhibits the thirdand last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cellwall autolytic enzymes such asautolysins; it is possible thatcefuroxime interferes with anautolysin inhibitor.

As for the othercephalosporins,although as a second-generation it is less susceptible to Beta-lactamase and so may have greater activity against Haemophilusinfluenzae, Neisseriagonorrhoeae andLyme disease.

Cefuroxime forInjection USP andDextrose InjectionUSP is contraindicated inpatients with known allergy to the cephalosporingroup of antibiotics.Solutions containing dextrose may becontraindicated inpatients withhypersensitivity to corn products.

Allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Serious Side effects:diarrhea that is watery or bloody; fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;seizure (black-out or convulsions); or jaundice(yellowing of the eyes or skin).

Less SeriousSide Effects:nausea, vomiting, diarrhea, stomach pain;headache, dizziness; fussiness

*Determine history of hypersensitivity reactions to cephalosporins, penicillins,and history of allergies, particularly to drugs, before therapy is initiated. • Inspect IM and IV Injection sites frequently for signs of phlebitis. • Report onset of loose stools or diarrhea. Although pseudomembranous colitis rarely occurs, this potentially life-threatening complication should be ruled out as the cause of diarrhea during and after antibiotic therapy. • Monitor for manifestati ons of hypersensitivity .Discontinue drug and report their appearance promptly. • Monitor I&O rates and patte

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECT NURSING RESPONSIBILITY

GENERIC::Amlodipine

BRAND:Norvasc

PO (Adults): 5-10mg (OD) PO (Geriatric Patients): 2.5mg/day,

Therapeutic: Antihypertensives Pharmacologic: Calcium Channel Blockers

Inhibits the transport of calcium into myocardial and vascular smooth muscle cells, resulting in inhibition of excitation – contraction coupling and subsequent contraction.Therapeutic Effects: Systematic Vasodilation resulting in decreased blood pressure. Coronary Vasodilation resulting in decreased frequency and severity of attacks of Angina

Alone or with other agents in the management of Hypertension, Angina Pectoris, andVasospastic (Prinzmetal’s) Angina.

Hypersensitivity; Blood Pressure <90 mmHg

CNS: headache, dizziness, fatigue CV: Peripheral Edema, Angina, Bradycardia, Hypotension, and PalpitationsGI: Gingival Hyperplasia, NauseaDerm:Flushing

General Info: Monitor blood pressure and pulse before therapy, during dose titration, and periodically during therapy, Monitor ECG periodically during prolonged therapy. Monitor intake and output ratios and daily weight. Assess for signs of CHF. Angina: Assess location, duration, intensity, and precipitating factors of patient’s anginal pain. Lab Test Considerations: Total serum calcium concentrations are not affected by calcium channel blockers

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFEECTS NURSING RESPONSIBILITIES

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECT NURSING RESPONSIBILITY

GENERIC:Metoprolol

BRAND:Apo-Metoprolol (CAN), Betaloc (CAN), Lopresor (CAN), Lopressor, Novometoprol (CAN), Nu-Metop (CAN), Toprol XL Brand Name: Norvasc

ADULTS • Hypertension: 50–100 mg/day PO as 1 dose. • Angina: 100 mg/day PO as 1 dose. • CHF: 12.5–25 mg/day Toprol XL for 2 wk; may then be increased by 25 mg every 2 wk to a maximum of 200 mg. PEDIATRIC PATIENTS Safety and efficacy not established

-Beta1-selective adrenergic blocker

Antihypertensive

Competitively blocks beta-adrenergic receptors in the heart and juxtaglomerularapparatus, decreasing the influence of the sympathetic nervous system on these tissuesand the excitability of the heart, decreasing cardiac output and the release of renin, andlowering BP; acts in the CNS to reduce sympathetic outflow and vasoconstrictor tone.

-Hypertension, alone or with other drugs, especially diuretics • Immediate-release tablets and injection: Prevention of reinfarction in MI patients who are hemodynamically stable or within 3–10 days of the acute MI • Treatment of angina pectoris • Toprol XL only: Treatment of stable, symptomatic CHF of ischemic, hypertensive, or cardiomyopathic origin

-Contraindicated with sinus bradycardia (HR < 45 beats/min), second- or third-degree heart block (PR interval > 0.24 sec), cardiogenic shock, CHF, systolic BP< 100 mm Hg; lactation.• Use cautiously with diabetes or thyrotoxicosis; asthma or COPD; pregnancy

Allergic: Pharyngitis, erythematous rash, fever, sore throat, laryngospasm • CNS: Dizziness, vertigo, tinnitus, fatigue, emotional depression, paresthesias, sleep disturbances, hallucinations, disorientation, memory loss, slurred speech • C V:CHF, cardiac arrhythmias, peripheral vascular insufficiency, claudication, CVA, pulmonary edema, hypotension • Dermatologic: Rash, pruritus, sweating, dry skin • EENT: Eye irritation, dry eyes conjunctivitis, blurred vision • GI: Gastric pain, flatulence, constipation, diarrhea, nausea, vomiting,anorexia,ischemic colitis, renal and mesenteric arterial thrombosis, retroperitoneal fibrosis, hepatomegaly, acute pancreatitis • GU: Impotence, decreased libido, Peyronie's disease, dysuria, nocturia, frequent urination • Musculoskeletal: Joint pain, arthralgia, muscle cramp • Respiratory: Bronchospasm, dyspnea,cough, bronchial obstruction, nasal stuffiness, rhinitis, pharyngitis • Other: Decreased exercise tolerance, development of antinuclear antibodies (ANA), hyperglycemia or hypoglycemia, elevated serum transaminase, alkaline phosphatas

-Do not discontinue drug abruptly after long-term therapy (hypersensitivity to catecholamines may have developed, causing exacerbation of angina, MI, and ventricular arrhythmias). Taper drug gradually over 2 wk with monitoring. • Ensure that patient swallows the ER tablets whole; do not cut, crush, or chew them. • Consult physician about withdrawing drug if patient is to undergo surgery (controversial). • Give oral drug with food to facilitate absorption. • Provide continual cardiac monitoring for patients receiving IV metoprolol.

GENERIC:Citicoline

BRAND: Zynapse

CVD, in acute recovery phase, in signs & symptoms of cerebral vascular insufficiency & in cranial traumatism & their sequelae.

Citicoline activates the biosynthesis of structural phospholipids in the neuronal membrane, increases cerebral metabolism and the level of various neurotransmitters, including acetylcholine and dopamine Furthermore, it has been demonstrated that citicoline restores the activity of mitochondrial ATPase and of membranal Na+/K+ ATPase, inhibits the activation of phospholipase A2 and accelerates the reabsorption of cerebral edema in various experimental models.

CVD, in acute recovery phase, in signs & symptoms of cerebral vascular insufficiency & in cranial traumatism & their sequelae.

Patients with hypertonia of the parasympathetic.

Occasionally, citicoline may exert a stimulating action of the parasympathetic, as well as a fleeting and discrete hypotensive effect.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFEECTS NURSING RESPONSIBILITIES

GENERIC:Glibenclamide

BRAND: Daonil/Euglucon, Diabeta, Glynase,Micronase

5 mg once daily upto a maximum of 15 mg daily

Antidiabetic The drug works by inhibiting ATP-sensitive potassium channels in pancreatic beta cells. This inhibition causes cell membrane depolarization, which causes voltage-dependent calcium channels to open, which causes an increase in intracellular calcium in the beta cell, which stimulates insulin release.

.In type 2 diabetes (non insulin requiring).

Patients with severe kidney and liver damage should not be using Glibenclamide. Patients with porphyra should not be prescribed Glibenclamide.

The common side effects include, nausea, vomiting, diarrhoea and constipation. They may cause disturbance in liver function and skin rashes are also known to occur

*For best result, administer 30 minutes prior to meals.*Review dose and frequency of administration.*Record finger sticks at various times.*Continue regular daily exercise, life style changes, BP control, and dietary restrictions to control cholesterol in addition to drug therapy. *Avoid alcohol and OTC agents without provider approval.*Repost as scheduled for teaching,reinforcement, F/U labs, foot/ eye exams and medication evaluation.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFEECTS NURSING RESPONSIBILITIES

GENERIC:Metformin

BRAND: I-Max

Usual Adult Metformin Dose for Diabetes Mellitus Type II:500 mg orally twice a day (with the morning and evening meal)

Antidiabetic Metformin is an antihyperglycemic agent which improves glucose tolerance in patients with type 2 diabetes, lowering both basal and postprandial plasma glucose. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. With metformin therapy, insulin secretion remains unchanged while fasting insulin levels and day-long plasma insulin response may actually decrease.

*Alone as an adjunct to diet to lower blood glucose in clients having NIDDM * *Extended release form used to treat type 2 diabetes as initial therapy or in combination with a sulfonylurea or insulin in clients aged 17 years and older.

* Renal disease or renal dysfunction (e.g., as suggested by serum creatinine levels ≥ 1.5 mg/dL [males], ≥ 1.4 mg/dL [females] or abnormal creatinine clearance) which may also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction, and septicemia .*Known hypersensitivity to metformin hydrochloride.*Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma. Diabetic ketoacidosis should be treated with insulin.

Metabolic: Lactic Acidosis GI: Diarrhea, N&V, abdominal

bloating, flatulence, anorexi, unpleasant or metallic taste, abnormal stools, taste disorder.

CNS: Lightheadedness, headache Hematologic: Asymptomatic

subnormal serum Vitamin B12 levels.

Body as a whole: Asthenia, rash, chills, flu syndrome, flushing, increases sweating.

Miscellaneous: Hypoglycemia, myalgia, dyspnea, nail disorder, chest discomfort, palpitation.

*Document age at diabetes onset, previous therapies, utilized, and the outcome*Monitor BP, CBC, BS, Electrolytes, HbA1c, urinalysis, micro albumin, liver and renal function studies. Assess for liver or renal failure.*Monitor known or suspected alcoholics carefully for decreased liver function.*Monitor cardiopulmonary status throughout course of therapy; cardiopulmonary insufficiency may predispose to lactic acidosis.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC NAME:levocetirizine dihydrochloride

BRAND NAME:Xyzal

Oral administration: 5 mg tablet

Antihistamine The active component of Xyzal, Levocetirizine dihydrochloride, is the R enantiomer of cetirizine hydrochloride, a racemic compound with antihistaminic properties. It is an orally active and selective H1-receptor antagonist. Histamines act on H1 receptors, causing the symptoms commonly seen in allergic reactions. Xyzal inhibits these H1 receptors.

Relief of symptoms associated with allergic rhinitis (seasonal and perennial) in adults and children 6 years of age and older

Treatment of the uncomplicated skin manifestations of chronic idiopathic urticaria in adults and children 6 years of age and older

Children 6 months to 11 years of age with impaired kidney function should not take XYZAL

Adverse events associated with the use of Xyzal in adult and pediatric subjects aged 12 years and older may include, but are not limited to, the following:

SomnolenceNasopharyngitisFatigueDry MouthPharyngitis

Adverse events associated with the use of Xyzal in pediatric subjects aged 6 to 12 years may include, but are not limited to, the following:

PyrexiaCoughSomnolenceEpistaxis

Do not take XYZAL if you are allergic to XYZAL, cetirizine or ZYRTEC®

Taking XYZAL with alcohol or sedatives should be avoided

Patients taking XYZAL should avoid operating machinery or driving a motor vehicle

Do not increase the dose due to increased risk of sleepiness.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSINGRESPONSIBILITY

GENERIC NAME:Ceftriaxone

BRAND NAME:Pneumoslov

Adult 1-2 g daily as a single dose or in 2 divided doses.

Childn & infant 20-50 mg/kg body wt once daily..

Neonate Max dose: 50 mg/kg IV over 60 min.

Anti-infectives/ Antibiotics/ Cephalosporins/ 3rd Generation Cephalosporin

Ceftriaxone usually is bactericidal in action. Like other cephalosporins, the antibacterial activity of the drug results from inhibition of mucopeptide synthesis in the bacterial cell wall

Treatment of susceptible infections eg chancroid, endocarditis, gastroenteritis, gonorrhea, Lyme disease, meningitis, septicemia, surgical infection, syphilis, typhoid fever & Whipple's disease.

History of previous allergic reactions (anaphylaxis) to penicillins or cephalosporins. History of GI disease esp ulcerative colitis, regional enteritis or antibiotic-associated colitis. Renal function impairment.

Superinfections, anaphylaxis, diarrhea, local reactions, blood dyscrasias, rash, fever, pruritus, elevated transaminases & alkaline phosphatase, leucopenia, neutropenia. Potentially fatal: Pseudomembranous colitis,nephrotoxicity.

Assess for allergy to cephalosporins

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC NAME:Clarithromycin

BRAND NAME:klaricid

1 tab once or bid. More severe infections: 2 tab once or bid

Anti-Infective Klaricid, a macrolide antibiotic similar to erythromycin and azithromycin, is effective against Mycobacterium avium complex (MAC) and is used for the treatment of Helicobacter pylori-associated peptic ulcer disease, community-acquired pneumonia, sinusitis, and chronic bronchitis. Klaricid is also used to treat respiratory tract, sexually transmitted, otitis media, and AIDS-related infections

*Tx of upper and lower respiratory infections such as acute tonsillopharyngitis , otitis media, acute sinusitis, acute exacerbation of chronic bronchitis and community acquired pneumonia.*Skin and soft tissue infections

Decreased kidney function

Decreased liver function

Abnormal heart rhythm seen on the heart monitoring trace (ECG) as a 'prolonged QT interval', or people at risk of this (your doctor will know).

Nausea, dyspepsia, abdominal pain & diarrhea, headache & skin rash.

Consider cross-sensitivity with other macrolides

Monitor serum levels of theophyline and carbamazepine

Instruct client not to take antijistamines.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC Lactic acid, sodium

Apply to the affected area bid-qid.

Hydrocortisone Hydrocortisone is a corticosteroid used for its anti-inflammatory and

LactiCare is indicated for the symptomatic

Skin lesions caused by viral, fungal or bacterial infections.

Occasionally a transient mild stinging sensation may occur. Should prolonged irritation develop when used on abraded

Keep away from the eyes and mucous membranes.

pyrrolidone carboxylate

BRAND lacticare

immunosuppressive effects. Its anti-inflammatory action is due to the suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It may also be used as replacement therapy in adrenocortical insufficiency.

relief of hyperkeratotic and other chronic dry skin conditions, and for dry skin conditions caused by low humidity or the use of detergents.

or inflamed skin, discontinue use. Should contact with the eyes occur, remove with water.

Keep out of the reach of children.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC Nubain

BRAND Nalbuphine

nalbuphine hydrochloride 10 milligram in 1 milliliter

Analgesic NUBAIN is a potent analgesic. Its analgesic potency is essentially equivalent to that of morphine on a milligram basis. Receptor studies show that NUBAIN binds to mu, kappa, and delta receptors, but not to sigma receptors. NUBAIN is primarily a kappa agonist/partial mu antagonist analgesic.

for the relief of moderate to severe pain

if you have asthma or other breathing disorder, liver or kidney disease, gallbladder disease, mental illness, or a history of drug or alcohol addiction

weak or shallow breathing; fast or slow heart rate; cold, clammy skin; confusion, hallucinations, unusual

thoughts or behavior; severe weakness or dizziness; or feeling like you might pass out.

*discuss to patient that this may cause drowsiness or dizziness,advice the patient to have assistance and to avoid driving*assess blood pressure pulse and respirations before and periodically during administration cause it may affect the respiratory rate of the patient.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC Metronidazole

BRAND Flagyl

PO 7.5 mg/kg q6hr (not to exceed 4g/day)

Anti-infectives,

Anti-protozoals

• Disrupts DNA and protein synthesis in susceptible organisms• Bactericidal, or amebicidal action

Indicated for intestinal and extraintestinal amebiasis as well as infections with Trichomonas vaginalis and Giardia lamblia

hypersensitivity •CNS: seizures, dizziness, headache• GI: abdominal pain, anorexia, nausea, diarrhea, dry mouth, furry tongue, glossitis, unpleasant taste, vomiting• Hematologic: leukopenia• Skin: rashes, urticaria

• Administer with food or milk to minimize GI irritation. Tablets may be crushed for patients with difficulty swallowing.• Instruct patient to take medication exactly as directed evenly spaced times between dose, even if feeling better. Do not skip doses or double up on missed doses. If a dose is missed, take as soon as remembered if not almost time for next dose.•May cause dizziness or light-headedness. Caution patient or other activities requiring alertness until response to medication is known.• Inform patient that medication may cause an unpleasant metallic taste.• Inform patient that medication may cause urine to turn dark.• Advise patient to consult health care professional if no improvement in a few days or if signs and symptoms of superinfection (black furry overgrowth on tongue; loose or foul-smelling stools develop).

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC Diclofenac sodium

BRAND : Voltaren

Tablets (delayed release): 25, 50, and 75 mg. Tablets (immediate release): 50 mg. Tablets (extended

Anti-inflammatory-Analgesic

The exact mechanism of action is not entirely known, but it is thought that the primary mechanism responsible for its anti-inflammatory/antipyretic/analgesic action is inhibition of prostaglandin synthesis by inhibition of cyclooxygenase (COX).

Diclofenac is used for musculoskeletal complaints, especially arthritis, rheumatoid arthritis, polymyositis,

Hypersensitivity against diclofenac

History of allergic reactions (bronchospasm, shock, rhinitis, urticaria) following the use of Aspirin or another NSAID

gastrointestinal adverse events including inflammation, bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal

Monitor BP for hypertension and blood sugar for hyperglycemia.

Monitor diabetics closely for loss of diabetic control.

Monitor for increased serum sodium and potassium in patients receiving potassium-sparing diuretics.

Monitor weight and report gains greater than 1 kg (2 lb)/24 h.

release): 100mg

Diclofenac, it seems, may also be a unique member of the NSAIDs. There is some evidence that diclofenac inhibits the lipooxygenase pathways, thus reducing formation of the leukotrienes (also pro-inflammatory autacoids).

dermatomyositis, osteoarthritis, dental pain, TMJ, spondylarthritis, ankylosing spondylitis, gout attacks,[8] and pain management in cases of kidney stones and gallstones- An additional indication is the treatment of acute migraines

Third-trimester pregnancy

Active stomach and/or duodenal ulceration or gastrointestinal bleeding

Inflammative intestinal disorders such as Crohn's disease or ulcerative colitis

Monitor for signs and symptoms of GI irritation and ulceration.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERICMefenamicacid

BRAND:Dolfenal

Adult: startwith 75-150mcgBID

SevereHPN300mg BID

. Analgesics Non-Narcotic AnalgesicsNSAIDs

Aspirin-like drugthat hasanalgesic,antipyretic, & anti-inflammatoryactivities

Relief of painIncluding muscular,rheumatic,traumatic,dental, post-op andpostpartumpain,headache,migraine,fever,dysmenorrhea

Pregnancy & lactation,hypersensitivity,active ulcerationor chronic inflammation ofeither upper or lower GIT, blood disorders, poorplatelet function, kidney or liver impairment, children < 14 yr

GI discomfor,diarrhea or constipation, gas pain, nausea, vomiting, drowsiness

> assess pt.’s pain before therapy

>monitor for possible drug Induced adverse reactions

>advice pt. not to take drug for more than 7 days

>advice pt. to reportImmediately persistence or failure to relieve pain

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC:Cephalexin

BRAND:Keflex

Adult: PO Susceptible infections 1-2 g/day in div. doses. Up to 6 g/day in moreserious infections. Prophylaxis against recurrent UTI 125 mg/day at night

Anti-bacterial Agents

Cephalosporins

Cephalexin, like the penicillins, is a beta-lactam antibiotic. By binding to specific penicillin-binding proteins PBPs) located inside the bacterial cell wall, itinhibits the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated bybacterial cell wallautolytic enzymes such as autolysins; it is possible that cephalexin interferes with an autolysininhibitor.

For the treatment of respiratory tract infections caused by StreptococcuspneumoniaeandStreptococcuspyogenes

For the treatment ofrespiratory tract infections caused by StreptococcuspneumoniaeandStreptococcus pyogenes

Pain at injection site;hypersensitivity; GI disturbances; eosinophilia, neutropenia, leucopenia,thrombocytopenia

Potentially Fatal: Anaphylacticreactions; nephrotoxicity

>The drug should be taken with or without food. (May be taken with meals to reduce GI discomfort)

>Before administration, ask patient if he is allergic to penicillins or cephalosporins.

>Tell patient to take entire amount of drug exactly as prescribed, even after he feels better.

>Advise patient to notify prescriber if rash develops or signs and symptoms ofsuperinfection appear.

>Inform patient not to crush, cut or chew extended-release tablets.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC:Augmentin

BRAND:Co-Amoxiclav

Infants <3 m: 30 mg/kg/day div q 12h using the 125 mg/5 mL suspensionChildren >=3 m and <40 kg: 20-90 mg/kg/day div q 8-12 h

Broad-spectrum penicillin

An antibiotic that combines amoxicillin and clavulanic acid. It destroys bacteria by disrupting their ability to form cell walls.

Clavulanic acid blocks the chemical defence, known as beta-lactamase, that some bacteria have against penicillins. l Co-amoxiclav is active against bacterial infections that have

Known or suspected amoxicillin resistant infections including respiratory tract, skin and soft tissue, genitourinary, and ear, nose and throat infections.

Effective against strains of

Penicillin hypersensitivity.

History of co-amoxiclav-associated or penicillin-associated jaundice or hepatic dysfunction.

> Hepatitis.>Cholestatic jaundice.> Erythema multiforme (including Stevens-Johnson syndrome).> Toxic epidermal necrolysis.> Exfoliative dermatitis.> Vasculitis.> Dizziness.> Headache.> Convulsions (especially in high doses or in renal impairment).

- Assess bowel pattern before and during treatment as pseudomembranous colitis may occur.

- Report haematuria or oliguria as high doses can be nephrotoxic.

- Assess respiratory status.

- Observe for anaphylaxis.

Children >40 kg and Adults: 250-500 mg q 8h or 875 mg q 12hSkin abscess: 875 mg q12h

become resistant to amoxicillin. Escherichia coli, Proteus mirabilis, Haemophilus influenzae, Streptococcus faecalis, Streptococcus pneumoniae and some beta lactamase-producing organisms.

> Superficial teeth staining when using the suspension.> Phlebitis at injection site.

- Ensure that the patient has adequate fluid intake during any diarrhoea attack.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC:Clopidogrel

BRAND:Platexan, Plavix

Adult: PO Prophylaxis of thromboembolic events 75 mg once daily.

.Antiplatelet agents Clopidogrel is a potent, non-competitive inhibitor of adenosine diphosphate- (ADP) induced platelet aggregation, irreversibly inhibiting the binding of ADP to its platelet membrane receptors. Consequently, platelets exposed to clopidogrel are affected for the remainder of their lifespan (approximately 7–10 days). The inhibition is specific and does not significantly affect cyclo-oxygenase (COX) or arachidonic acid metabolism. It can also indirectly inhibit platelet aggregation induced by agonists other than ADP by blocking the amplification of platelet activation by released ADP: ADP binding is necessary for activation of the GPIIb/IIIa receptor, which is the binding site for fibrinogen. Fibrinogen links different platelets together to form the platelet aggregate. it thus ultimately inhibits the activation of the GPIIb/IIIa receptor, its binding to fibrinogen and further platelet aggregation.

>Treatment ofpatients at risk forischemic eventshistory of MI,ischemic stroke,peripheral arterydisease

>Treatment ofpatients withacute coronarysyndrome

Contraindicatedwith allergy toclopidogrel, activepathologicalbleeding such aspeptic ulcer orintracranialhemorrhage,lactation.

CNS:Headache,dizziness, weakness, syncope, flushing

CV: Hypertension, edema

Dermatologic:Rash,pruritus

GI: Nausea, GI distress, constipation, diarrhea, GI bleed

Other:Increasedbleeding risk

>Assess for symptoms of stroke, MI duringtreatment

>Monitor liver function studies: AST, ALT,bilirubin, creatinine if patient is on ong-termtherapy

>Monitor blood studies: CBC,Hgb, Hct,protime, cholesterol if the patient is onlong-term therapy; thrombocytopenia andneutropenia may occur.

DRUG NAME DOSAGE CLASSIFICATION

MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC:Lagundi leaf (Vitex negundo L.)

BRAND:Ascof Forte

Tablet:Adult:300-600 mg tid-qid. Children: 7-12 yr 300 mg tid-qid. Syrup:Adult:300-600 mg (5-10 mL) 1-2 tsp tid-qid. Children:15 mg/kg/dose tid, >40 kg 2 tsp tid, 6-12 yr (20-40 kg) 1½ tsp

. Cough & Cold Preparations. Natural antiviral

Antiviral activity; inhibits the secretion of mucous secretions to expectorate easily.

Relief of cough due to common colds & flu. Treatment of bronchospasm in acute bronchial asthma, chronic bronchitis & other bronchopulmonary disorders. Relief of reversible, mild to moderate bronchospasm (prophylactic/maintenance medication) in adults & childn w/ obstructive airway disease.

No known contraindication

Itchiness, nausea and vomiting, tachycardia, diarrhea, drowsiness and body malaise

Give drug with food or after meals.

Encourage client to cough to expectorate the secretions.

Take note color and consistency of secretion.

Encourage to drink liquids especially water. If cough is longer than two weeks, ask client to visit a physician.

tid, 4-6 yr (15.5-20 kg) 1 tsp tid, 2-4 yr (10-15.5 kg) ½ tsp tid.

DRUG NAME DOSAGE CLASSIFICATION

MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC:Ambrolex

BRAND:Ambroxol HCl

Tablet/syrup:Adults: daily dose of 30 mg)to 120) taken in 2 to 3 divided dosesChildren up to 2 years: half a tsp twice dailyChildren 2 - 5 years: half a tsp 3 x dailyChildren over 5 years: One tsp 2-3 x daily.

Antiasthmatic, Mucolytic agent

Mucolytic which changes the structure of Bronchial secretions by reduction and fragmentation of the Mucopolysaccharide fibers, leading to reduce viscosity of Mucous, thus expectoration is facilitated.

Acute and Chronic disorders of the respiratory tract associated with Pathologically thickened mucus and impaired mucus transport.

This medicine should not be used if you are allergic to one or any of its ingredients

Mild GI side effects, Rash *The patient should be instructed to swallow the tablet whole and not chew to prevent choking or reduced effectiveness. *Encourage the patient to spit into a tissue rather than swallow the sputum. *Take note of the color and consistency and report any changes to the physician. *Suctioning equipment to clear the airways of excess mucus should be kept nearby.*Prior to administering and immediately after, listen to the patient's lung sounds and note any abnormalities. *Regularly assess these sounds to ensure the medication is working properly.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION

INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC:Fluticasone propionate and Salmeterol xinafoate

BRAND:Seretide Accuhaler, Seretide Evohaler

InhalationAsthmaAdult 100/250/500 mcg/dose of inhalation powder: 1 inhalation bid. 50/125/250 mcg/dose of pressurised inhalation: 2 inhalation bid.Child: 4-12 yr: 100 mcg/ dose of inhalation powder: 1 inhalation bid

. Antiasthmatic & COPD Preparations

Seretide contains salmeterol and fluticasone propionate which have different modes of action. Salmeterol protects against symptoms, fluticasone propionate improves lung function and prevents exacerbations of the condition.

Regular treatment of reversible obstructive airways disease (ROAD), including asthma where use of combination therapy (bronchodilator & inhaled corticosteroid) is appropriate. Maintenance treatment of COPD including chronic bronchitis & emphysema.

Contraindicated in patients with hypersensitivity to any of the active substances or to the excipient. Also, other acute attacks of asthma.

Mouth and throat candidiasis, throat irritation, hoarseness/dysphonia, nasopharyngitis, lower respiratory tract infections (e.g. pneumonia and bronchitis), hypokalaemia, headache, tremors, palpitation, muscle cramps. Prolonged high dose use may cause Cushing's syndrome, Cushingoid features, adrenal suppression, retardation of growth in children and adolescents, bone mineral density decrease, cataract and glaucoma.Potentially Fatal: Paradoxical bronchospasm.

*Pulmonary tuberculosis, severe cardiovascular disorders, diabetes, hypokalaemia, thyrotoxicosis. Paradoxical bronchospasm; discontinue immediately. *Prolonged treatment with high doses increases risk of adrenal suppression and systemic effects; monitor adrenal function. *Monitor height of children on prolonged therapy. *Should not be initiated during an exacerbation or if patients have significantly worsening or acutely deteriorating asthma.*Consider additional steroid therapy during stress or surgery. *Pregnancy, lactation. Withdraw gradually.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION

INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC:Aspirin

BRAND:Aspergum, Bayer, Easpirin

oral and suppository forms.,chewable tablet, gums, enteric coated, SR and buffered preparations. Adults:SR: 1300mg, then 650-1300mg q 8hGum: chew 454mg q 4 h.Children:10-15mg/kg/dose q 4h.

Analgesic (nonopioid)Anti-inflammatoryAntiplateletAntipyreticNSAID

Inhibit the synthesis of prostaglandins, which are important mediators of inflammation.

Mild to moderate pain, fever, inflammatory condition (rheumatic fever, rheumatoid arthritis, osteoarthritis, juvenile rheumatoid arthritis), reduction of risk of recurrent TIAs or CVA in patient with history of TIA.

Contraindicated with allergy to salicylates or NSAIDs, allergy to tartrazine; hemophilia, bleeding ulcers, hemorrhagic states, blood coagulation defects, hypoprothrombinemia, Vitamin K deficiency.

Acute aspirin toxicity: Respiratory alkalosis, tachypnea, hemorrhage, confusion, excitement, pulmonary edema, seizures, tetany, metabolic acidosis, feverAspirin intolerance: exacerbation of bronchospasm, rhinitisGI: nausea, dyspepsia, heartburn, epigastric discomfort, anorexiaHematologic: occult blood loss, hemostatic defectsSalicylism: dizziness, tinnitus, difficulty hearing, nausea, vomiting, diarrhea, mental confusion.

Give drug with food or after meals if GI upset occurs.

Give drug with full glass of water to reduce risk of tablet or capsule lodging in the esophagus.

Do not crush, and ensure that patient does not chew SR preparations.

Do not use aspirin that has strong vinegar like odor.

Drug Name Classification Dosage Mode of Action Indication Contraindication Side Effects Nursing Responsibility

Brand : Bicillin L-A, Permapen

Generic Name: Penicillin G

AntibioticPenicillin antibiotic

Injection: 600,000, 1.2 million, 2.4 million unit/dose

Bactericidal: Inhibits synthesis of cell wall of sensitive organisms, causing cell death

Severe infections caused by sensitive organisms (streptococci)URI caused by sensitive streptococciTreatment of syphilis, bejel, congenital syphilis, pinta yawsProphylaxis of rheumatic fever and chorea

Contraindicated with allergies to penicillins, cephalosporins, or other allergens.Use cautiously with renal disorders, pregnancy lactation (may cause diarrhea or candidiasis in the infant).

*CNS: lethargy, hallucinations, seizures*GI: glossitis, stomatitis, gastritis, sore mouth, furry tongue, black”hairy” tongue, nausea, vomiting, diarrhea, abdominal pain, bloody diarrhea, enterocolitis, pseudomem-branous colitis, non-specific hepatitis*GU: Nephritis*Hematologic: anemia, thrombo-cytopenia, neutropenia, prolonged bleeding time (more common than with other penicillinase-resistant penicillins)*Hypersensitivity: rash, fever, wheezing, anaphylaxis*Local: pain, phlebitis, thrombosis at injection site, Jarisch-Herxheimer reaction when used to treat syphilis*Other: superinfections, sodium overload, leading to heart failure

Culture infection before giving treatment; reculture if response is not as expected.Give by IM route only.Continue therapy for atleast 2 days after an infection has disappeared, usually 7-10 days.Give IM injection upper outer quadrant of the buttocks. In infants and small children, the midlateral aspect of the thigh may be preferred.

Drug Name Classification Dosage Action Indication Contraindication Side Effects Nursing Responsibility

Brand: Losec(CAN)

Generic: Omepron

Antisecretory DrugProton pump inhibitor

DR capsules; 10, 20, 40 mgDR tablets: 20mg(OTC)

Gastric acid-pump inhibitor: suppresses gastric acid secretion by specific inhibition of the hydrogen-potassium ATPase enzyme system at the secretory surface of the gastric parietal cells blocks the final step of acid production.

Short term treatment of active duodenal cancerTreatment of heartburn or symptoms of GERDShort term treatment of active benign gastric ulcer GERD, severe erosive esophagitis, poorly responsive symptomatic GERDLong term treatment of pathologic hypersecretory conditions. Eradication of helicobacter pylori with amoxicillin or metronidazole and clarithromycin

Contraindicated with hypersensitivity to omepron or its components.Use cautiously with pregnancy and lactation.

*CNS: headache, dizziness asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, dream abnormalities*Dermatologic: rash, inflammation, urticaria, pruritus, alopecia, dry skin*GI: diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophy.*Respiratory: URI symptoms, cough, epistaxis*Other: cancer in preclinical studies, back pain, fever

Administer before meals.Caution patient to swallow capsule whole---not to open, chew or crush them.Administer abtacids with, if needed.If patient can’t swallow combine it with 1 tablespoon applesauce.

Drug Name Classification Dosage Action Indication Contraindication Side Effects Nursing Responsibility

Brand: Catapres

Generic: Clonidine

Antihypertensive Central Analgesic Symphatolytic (centally acting)

Initial dose is 0.1mg BID

Stimulates CNS alpha2-adrenergic receptors, inhibits sympathetic cardio accelerator and vasoconstrictor centers, and decreases sympathetic outflow of the CNS.

Hypertension, use alone or as part of combination therapy.Treatment of severe pain in cancer patients in combination with opiates; epidural more effective with neuropathic pain

Contraindicated with hypersensitivity to clonidine or any adhesive layer components of the transdermal system.Use cautiously with severe coronary insufficiency, recent MI, cerebrovascular disease, chronic renal failure, pregnancy, lactation.

*CNS: drowsiness, sedation, dizziness, headache, fatigue that ends to diminish within 4-6wks, dreams, nightmares, insomnia, hallucinations, delirium, nervousness, restlessness, anxiety, depression, retinal degeneration*CV: heart failure, orthostatic hypotension, palpitations, tachycardia, bradycardia, Raynaud’s phenomenon, ECG abnormalities*Dermatologic: resh, angioneurotic edema, hives, urticaria, hair thinning and alopesia, pruritus, dryness, itching or burning of the eyes, pallor*GI: dry mouth, constipation, anorexia, malaise, nausea, vomiting, parotid pain, parotitis

Do not discontinue, use abruptly.Continue oral clonidine therapy 4hrs after surgery then resume as soon as possible there after.Store epidural injection at room temperature; discard any unused portions.Reevaluate therapy if clonidine tolerance occurs.Use caution with alcohol. Your sensitivity may increase while using this drug.

*GU: impotence, sexual dysfunction, nocturia, difficulty micturition, urinary retention*Other: weight gain, transient hyperglycemia, gynecomastia, weakness, muscle or joint pain, cramps of the lower limbs, dryness of nasal mucosa, fever

Drug Name Classification Dosage Action Indication Contraindication Side Effects Nursing Responsibility

Brand: Serc

Generic: Betahistine dihydrochloride

Anti emetics Anti vertigo

Adults: 24-48 mg divided over the day8 mg tablets- 1-2 tablets, 3 times/day16 mg tablets: 1 tablet, 3 times/day

Betahistine was found to have a histamine-like action in animals. Since parenteral histamine has been used in the treatment of Meniere's disease, studies were conducted to test the action of betahistine in this condition. Unlike some other anti-vertigo drugs, testing with nystagmus induced by caloric and rotational stimulation has demonstrated that betahistine does not decrease the vestibular response, as recorded by electronystagmography. In addition, the absorption, metabolism and action of betahistine when administered by the oral route are not known. may be useful in reducing the vertigo of Meniere's disease.

Meniere’s disease, Meniere-like syndrome (with symptoms of vertigo,tinnitus and sensorineural deafness) and vertigo of peripheral origin.

Hypersensitivity to any component of the product

Occasionaly patients have experienced gastric upset, nausea and headache.

Avoid contact of oral solution or injection with skin Raise bed rails, institute safety measures, supervise ambulation

DRUG NAME CLASSIFICATION DOSAGE MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

BRAND:Ansimar

GENERIC: Doxofylline

Antiasthmatic & COPD Preparations

Tab Adult 1 tab bid-tid. Syr Childn >12 yr 10 mL once-tid, <12 yr 6-9 mg/kg

Adrenergic bronchodilators and phosphodiesterase inhibitors bothwork by increasing intracellular level of cyclic-3’,5’- adenosine monophosphate(cAMP); adrenergics by increasing production and phosphodiesterase inhibitorsby decreasing breakdown. Increased levels of cAMP produce bronchodilation.Corticosteroids act by decreasing airway inflammation. Anticholinergics(ipratropium) produce brondhodilation by decreasing intracellular levels ofcyclic guanosine monophosphate (cGMP).

Bronchial asthma & pulmonary disease w/ spastic bronchial component.

Acute MI, hypotension, lactation.

Nausea, vomiting, epigastric pain, cephalalgia, irritability, insomnia, tachycardia, extrasystole, tachypnea, hyperglycemia, albuminuria.

> Use with caution in patients with hypoxemia, hyperthyroidism, liver disease, renal disease, in those with history of peptic ulcer and in elderly. Frequently, patients with CHF have markedly prolonged drug serum levels following discontinuation of Ansimar.

> assess for allergic reaction> assess for breath sounds>should be given to a pregnant woman only if clearly needed.

Leukotriene receptor antagonists andmast cell stabilizers decrease the release of substances that can contribute tobronchospasm

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION

INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

Brand:Co-aleva

Generic:Betamethasone, ebastine

. Antihistamines & Antiallergics

View Co-Aleva mechanism of action for pharmacodynamics and pharmacokinetics details.

Treatment of seasonal/perennial allergic rhinitis & chronic urticaria.

Severe liver insufficiency. Lactation.

Headache, dry mouth, drowsiness. Less common are pharyngitis, abdominal pain, dyspepsia, asthenia, epistaxis, rhinitis, sinusitis, nausea & insomnia.

Systemic use Give daily dose before 9 AM to miminormal peak corticosteroid blood levels. Increase dosage when patient is subject to stress. Taper doses when discontinuing high-dose or long-term therapy. Do not give live virus vaccines with immunosuppressive doses of corticosteroids.

Topical dermatologic preparations Examine area for infections, skin integrity before application.Administer cautiously to pregnant patients; topical corticosteroids have caused teratogenic effects and can be absorbed from systemic site. WARNING: Use caution when occlusive dressings or tight diapers cover affected area; these can increase systemic absorption of the drug.Avoid prolonged use near eyes, in genital and rectal areas, and in skin creases.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION

INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

Brand:Myonal

Generic:Eperisone

1 tab tid . Muscle relaxants Eperisone is centrally-acting skeletal muscle relaxant used to improve myotonic symptoms.\

Spastic paralysis in cerebrovascular diseases, spastic spinal paralysis, cervical spondylosis, postop sequelae (including cerebrospinal tumor), sequelae to trauma (spinal trauma, head injury), amyotrophic lateral sclerosis, cerebral palsy, spinocerebellar degeneration, spinal vascular diseases, other encephalomyelopathies. Improvement of myotonic symptoms in cervical syndrome,periarthritis of the shoulders & lumbago, tension-type headache.

Eperisone is contraindicated in patients with known hypersensitivity to the drug.[8] Side Effects: ‘very rare’ excessive relaxation, stomachache, nausea, vertigo, anorexia, drowsiness, skin rashes, diarrhoea, vomiting, indigestion, GI disturbances, insomnia, headache, constipation etc.[9]

Weakness, dizziness, insomnia, drowsiness, numbness in the extremities, hepatic & renal dysfunction, hematological changes, rashes, GI disturbances, urinary disorders

1. Careful Administration (MYONAL should be administered with care in the following patients.)(1)Patients with a history of drug hypersensitivity(2) Patients with hepatic function disorder 2. Important PrecautionsWeakness, light-headedness, sleepiness or other symptoms may occur. In the event of such symptoms, the dosage should be reduced or treatment discontinued. Patients should be cautioned against engaging in potentially hazardous activities requiring alertness, such as operating machinery or driving a car. [USE IN THE ELDERLY]Since the elderly often have a physiological hypofunction, it is advisable to take measures, such as reduction in dosage under careful supervision. [PREGNANCY AND LACTATION]

1. Use During Pregnancy MYONAL should only be used in pregnant women or women suspected of being pregnant, if the expected therapeutic benefits are evaluated

to outweigh the possible risk of treatment.

2. Use During Lactation It is advisable to avoid the administration of MYONAL to nursing mothers. When MYONAL must be used, breast feeding should be discontinued during treatment

3. [PEDIATRIC USE]Safety in children has not been established.

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION

INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

Brand: Klonopin

Generic: rivotril or clonazepam

Adult:1.5 mg P.Odaily in threedivided doses.Children:0.01 to 0.03mg P.O daily intwo or threedivided doses

BenzodiazepineAntiepileptic.

Probably facilitates the effects of the nhibitoryneurotransmitter GABA.

-Lennox-Gaustat syndrome,atypical absence seizures,akinetic and mycolonicseizures.-Panic disorder-Acute manic episodes ofbipolar disorder-Adjunct treatment forschizophrenia-Periodic leg movementsduring sleep-Parkinsonian dysarthria.

-Contraindicated in patients hypersensitiveto benzodiazepinees and in those with significant hepaticUse cautiously in patients with mixed type seizuresbecause drug may causegeneralized tonic-clonicseizures.-Use cautiously in children and in patients with chronicrespiratory disease or open-angle glaucoma.

anxiety increased heart rate tremor general unwell feeling Behavior problems drowsiness lack of muscular coordination an allergic reaction (difficulty

breathing; closing of the throat; swelling of

hallucinations or severe confusion

yellowing of the skin or eyes

Watch for behavioral disturbances esp. in children.-Don’t stop drug abruptly because this may worsen seizures. Call prescriber at once if adverse reactions develop.-Assess elderly patient’s response closely.-Monitor patient for oversedation.-Monitor CBC and liverfunction tests.-Withdrawal symptoms are similar to those ofbarbiturates

DRUG NAME DOSAGE CLASSIFICATION MECHANISM OF ACTION INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITY

GENERIC:

BRAND:

.