Generic Name: Dynastat

Brand name: Parecoxib

Classification: Non-steroidal anti-inflammatory drugs.

Indication: IIndicated for the short-term treatment of postoperative pain in adults.

Parecoxib has not been studied in patients under 18 years. Therefore, its use is not
recommended in these patients.

Action: NSAIDs inhibit cyclooxygenase (COX) enzymes, which are involved in the
synthesis of prostaglandins and thereby reduce pain and inflammation. Oral NSAIDs are
used post-operatively but when patients are unable to tolerate oral medications or require
a faster onset of analgesia, parenteral administration may be preferred.

Contraindications:

You have or have had any medical conditions, especially the following:

• kidney or liver disease • high blood pressure, heart failure or fluid

• heart problems, heart surgery, or other retention
blood vessel disease • dehydration
• heart attack • asthma or other allergic conditions
• stroke • Skin problems with symptoms such as
• diabetes swelling, blistering, peeling, itching,

• high cholesterol levels reddening or some other abnormality.

• Peptic ulcer (ie stomach or duodenal
ulcer), a recent history of one, or have
had peptic ulcers before.

Side Effects:

• changes in blood pressure chills, headache, sore throat,

• dizziness or light-headedness due to low diarrhoea, aching joints and muscles

blood pressure • other signs of allergic reaction such

• back pain as wheezing, swelling of the face,

lips, mouth, tongue or throat which
• a reduced sense of touch
may cause difficulty in swallowing
• stomach upset including nausea (feeling
or breathing
sick), vomiting, heartburn, indigestion,
• slow heart beat
cramps
• severe or persistent headache, fever,
• constipation, diarrhoea, pain in the
stiff neck, sensitivity to light and
stomach, wind
vomiting
• sleeplessness
• bleeding or bruising more easily than
• irritability
normal, reddish or purplish blotches
• sore throat
under the skin
• inflammation and pain after a tooth
• signs of anaemia, such as tiredness,
extraction
being short of breath, and looking
• skin rash, including hives, raised red, itchy pale
spots
• unusual weight gain, swelling of
• blistering and bleeding in the lips, eyes, ankles or legs
mouth, nose and genitals • a change in the amount or frequency
• swelling, blistering or peeling of the skin, of urine passed
which may be accompanied by fever,
• infection of any wounds
• chest pain or discomfort
Stock dose: 40mg by IM or IV injection, followed every 6 to 12 hours by 20mg or
40mg as required to a maximum of 80mg per day

Nursing responsibilities:

1. You have any allergies to:

• any other medicines including aspirin or other NSAID medicines, including

other Coxib medicines

• any other substances, such as foods, preservatives or dyes

2. You are pregnant or intend to become pregnant

• May affect your developing baby if taken during pregnancy. Use of

DYNASTAT during pregnancy is not recommended.

3. You are breastfeeding or intend to breastfeed

• It is not known whether DYNASTAT passes into breast milk or whether your
baby might be affected. Therefore, breastfeeding should be discontinued
during treatment with DYNASTAT.

4. You are taking DYNASTAT together with any medicines used to treat high
blood pressure and some other heart problems such as ACE inhibitors,
angiotensin receptor antagonists and diuretics (also called fluid or water
tablets).When taken together these medicines can cause kidney problems.

5. You are a smoker, stop or restrain from smoking

6. You currently have an infection.

If you are given DYNASTAT while you have an infection, it may hide some of
the signs of an infection.
Generic Name: Aminoglycosides; Gentamicin
Brand name: Cidomycin, Gramycin, G-mycin, Jenamicin
Classification: Therapeutic: Anti-Infectives, Pharmacologic: aminoglycosides
Indication: Treatment of serious gram negative bacillary infection & infectious caused
by staphylococci when Penicillin’s or other are less toxic drugs are contraindicated
Action: Inhibits the protein synthesis bacteria at level of 30 S ribosome’s with
bactericidal action
Contraindications: Hypersensitivity. Most parenteral products contain bisulfates and
should be avoided in patients with known intolerance. Products containing benzyl alcohol
should be avoided in neonates. Cross-sensitivity among aminoglycosides may occur

Side Effects:

• an allergic reaction (shortness of • numbness, skin tingling, muscle

breath; closing of the throat; hives; twitching, or seizures; or
swelling of the lips, face, or tongue; • severe watery diarrhea and
rash; or fainting); abdominal cramps.
• little or no urine; • increased thirst;
• decreased hearing or ringing in the • loss of appetite;
ears; • nausea or vomiting;
• dizziness, clumsiness, or unsteadiness; • a rash.
Stock dose: Injection 10mg/ml, 40 mg/ml. Premixed injections: 40mg/50 ml, 40mg/100
ml, 60mg/ 50ml, 60mg/100ml, 70mg/ 50ml 70mg/ 100ml, 80 mg/ 50 ml, 80mg /100ml,
90mg/ 50 ml, 90 mg/ 100ml, 100mg/ 80ml, 100mg/ 100 ml, 120mg/ 100ml, 160mg/
100ml, 180mg/ 100ml

Nursing responsibilities:
• Assess for the level of infection at the beginning at through out the administration
of the medication
• Obtain specimen for culture and sensitivity before initiating therapy 1st dose may
be given even with out the results
• Monitor intake and output and daily weight to assess hydration status and renal
function
• Assess for the patient’s signs and symptoms of superinfection, report to the
physician early if it occur
• Resolution of signs and symptoms of superinfection if it occurs and if no response
is seen within 3-5 days, new cultures should be taken
Generic Name: Naloxone
Brand name: Narcan
Classification: Therapeutic: antidotes. Pharmacologic: opioid antagonist
Indication: Reversal of CNS depression and respiratory depression because of suspected
opioid overdosage. Unlabeled uses: Narcotic induced pruritis. Management of refractory
circulatory shock

Action: competitively blocks the effects of opioids, including CNS and respiratory
depression with out producing any agonist effects. Therapeutic effects: Reversal of signs
of opioid excess

Contraindications: in patients known to be hypersensitive to naloxone hydrochloride or

to any of the other ingredients in Narcan.

Side Effects: Hypertension, hypotension, ventricular fibrillation and ventricular

tachycardia. GI; nausea and vomiting

Stock dose:
Injection: 0.4 mg/ml. Neonatal injection: .02 mg/ml in combination with pentazocine

Nursing responsibilities:
• Monitor vitals signs especially respiratory arte, rhythm and depth; pulse, ECG,
and lvel of consciousness frequently for 3-4 hours after the expected peak of
blood concentration.

• Assess for signs and symptoms of opioid withdrawal. Symptoms may occur
within few minutes to 2 hours. Severity depends on dose of naloxone, the opioid
involved, and degree of physical dependence

• Lack of significant improvement indicates that symptoms are caused by a disease

process or other non-opioid CNS depressant not affected by naloxone

• Dosages should be titrated carefully in postoperative patients to avoid interference

with control of postoperative pain

• Resuscitation equipment, oxygen, vasopresor and mechanical ventilators should

be available to supplement naloxone therapy as needed
Generic Name: Propofol

Brand name: Diprivan

Classification: General anesthetics

Indication: Propofol is a drug that reduces anxiety and tension, and promotes relaxation
and sleep or loss of consciousness. Propofol provides loss of awareness for short
diagnostic tests and surgical procedures, sleep at the beginning of surgery, and
supplements other types of general anesthetics. Propofol is for injection into a vein. It is
given by trained anesthesia professionals in a controlled environment

Action: short acting hypnotic. Mechanism of action is unknown. Produces amnesia. Has
no analgesic property. Therapeutic: induction and maintenance of anesthesia

Contraindications: Hypersensitive to propofol, soybean oil, egg lecithin, or glycerol.

Labor and delivery

Side Effects:
Side effects that you should report to your prescriber or health care professional as soon
as possible:
• difficulty breathing, wheezing, swelling of the throat
• fast heartbeat, palpitations
• lightheadedness or fainting spells
• numbness or tingling in the hands or feet
• seizure (convulsion)
• skin rash, flushing (redness), or itching
• swelling or extreme pain at the injection site
• uncontrollable muscle spasm
• dizziness
• pain or irritation at the injection site
Stock dose: Injection: 10mg/ml in 20-ml ampules, 50- and 100- ml infusion vials
Nursing responsibilities:
• Patient should be closely monitored following administration of propofol.

• Propofol is a very short-acting drug, and its effects generally wear off in just a
few hours. However, propofol may affect your ability to drive or operate
machinery for several hours after use. Do not attempt to drive yourself home if
you have received propofol for minor outpatient surgery or diagnostic tests.

• Avoid alcohol, mood-altering drugs, or any other medicines for at least 24 hours
after a dose of propofol, unless approved by your prescriber or health care
professional.

• Aseptic technique is essential. Solution is capable of rapid growth of bacteria

contaminants. Infections and subsequent dea6hs have been reported

• May cause drowsiness or dizziness. Advice patients to request assistance prior to

ambulation and transfer to avoid driving or any kind of activities that requires
alertness until response to medication is known
Generic Name: Acid Ioxitalamique, acid Ioxitalamique

Brand name: Telebrix

Classification: Diagnostic products or other therapeutic products

Indication:
• Tomodensitometry
• Intravenous urography
• Digitized Angiography
• Angiocardiography (ventriculographie, coronarography)

Action: binds with the blood stream for better visualization of the parts of the organ that
are being visualized by different diagnostics procedures
Contraindications: Injection by way under-arachnoids
Side Effects:
Benign demonstrations of intolerance can occur precociously or tardily. They can
be isolated or associated and from type:
• respiratory: cough, respiratory feeling of oppression ;
• digestive: nauseas, vomiting;
• neuron sensory: feeling of heat, distresses, agitation, cephalgia;
 • cutaneous: flush, pruritis, localized or generalized urticaria, rash cutaneous,
palpebral edema.
More serious accidents can follow these minor signs or occur of start:
• Reactions allergies: dyspnea, hypotension; more rarely shock anaphylactic
broncho spasm, edema of the larynx, pulmonary edema and exceptionally
edema of Quince.
• Cardiovascular disorders: disorders of the rate/rhythm, paleness, cyanosis
being able to lead exceptionally to a cardiovascular collapse.
• Neurological disorders: tetany, crisis convulsive, coma.
• The accidental extravasations of product of contrast apart from the vascular
way are responsible for painful and inflammatory demonstrations local.
Stock dose: 350 mg iode/ml inject able Solution by intravascular way Box of 1 Bottle (+
micro perfusion + syringe) of 50 ml
Nursing responsibilities:
• Advice patient to increase fluid intake before and after the administration of the
said medication to facilitate excretion
• Maintain proper hydration status
• Assess for any allergic reaction to seafood’s or iodine rich foods
• Advice the patient that discoloration on diffident secretions of the body may alter
in color and it is just normal and if the said medication is gone into the body’s
system it will go back to its original state
• Advice patient that alteration in taste sensation is normal and will go back as soon
as the medication is excreted
• Nursing mothers should wait for 24 hours after contrast material injection before
resuming breast-feeding.
Generic Name: Thiopental Sodium
Brand name: Pentobrim, Pentothal Sodium
Classification: Anesthetics General & Local
Indication: Parenteral thiopental also indicated in the treatment of cerebral hypertension,
for narcoanalysis in the treatment of psychiatric disorders, in the treatment of cerebral
ischemia and hypoxia, and to control convulsive states during or following inhalation
anesthesia, local anesthesia, or other causes
Action: Ultra short-acting barbiturate anesthetics depress the central nervous system
(CNS) to produce hypnosis and anesthesia without analgesia.
The exact mechanism by which barbiturate anesthetics produce general anesthesia is not
completely understood. However, it has been proposed that they act by enhancing
responses to gamma-aminobutyric acid (GABA), diminishing glutamate (GLU)
responses, and directly depressing excitability by increasing membrane conductance (an
effect reversed by the GABA antagonist picrotoxin), thereby producing a net decrease in
neuronal excitability to provide anesthetic action.
The mechanism by which thiopental reduces intracranial pressure and protects the brain
from cerebral ischemia and hypoxia is not completely understood. However, it is related
to thiopental's anesthetic action and results in increased cerebral vascular resistance with
a decrease in cerebral blood flow and cerebral blood volume, and decreased cerebral
metabolic rate for oxygen. Various mechanisms of action have been proposed, including a
reduction of cerebral metabolic rate, a decrease in the functional activity of the brain, an
inhibition of the brain stem neurogenic mechanism of vasoparalysis, a sealing effect on
membranes, and a scavenging of free oxygen radicals
Contraindications: Absence of suitable veins, status asthmaticus; porphyria
Side Effects:
Drowsiness; tolerance, dependence with withdrawal side effects including seizures
Stock dose:
Rectal, 30 mg per kg of body weight
For parenteral dosage form only

• A test dose of 25 to 75 mg (1 to 3 mL of a 2.5% solution) may be administered to

determine tolerance or unusual sensitivity to thiopental; patient reaction should be
observed for at least 60 seconds. In pediatric patients, a test dose of 0.5 mg per kg
of body weight may be used.
• A 2 or 2.5% concentration of thiopental solution is used for intermittent
intravenous administration.
• A 3.4% concentration of thiopental in sterile water for injection is isotonic;
concentrations less than 2% in sterile water for injection should not be used
because they cause hemolysis.

Children up to 15 years of age:

• Induction—Dosage must be individualized by physician; however, as a general
guideline:
• Intravenous, 4 to 6 mg per kg of body weight.
• Maintenance—Dosage must be individualized by physician; however, as a
general guideline: Intravenous (intermittent), about 1 mg per kg of body weight as
required.
Nursing responsibilities:

• Avoid alcohol intake at least 24 hours without advice of the health care
professional

• Inform patient that medication will decrease mental recall of the procedure
 • mood-altering drugs, or any other CNS depressant medicines for at least 24 hours
without advice of the health care professional

• Aseptic technique is essential. Solution is capable of rapid growth of bacteria

contaminants. Infections and subsequent dea6hs have been reported

• May cause drowsiness or dizziness. Advice patients to request assistance prior to

ambulation and transfer to avoid driving or any kind of activities that requires
alertness until response to medication is known

Generic Name: diclofenac (dye KLOE fen ak)

Brand name: Cataflam, Voltaren, Voltaren-XR

Classification: nonopioid analgesics, nonsteroidal, anti-inflammatory agents

Indication: Management of inflammatory disorder including: Rheumatoid arthritis,

osteoarthritis, ankylosing spondylitis. Relief of mild to moderate pain of dysmenorrheal,
acute pain. Topical: treatment of actinic Kerasotes

Action: inhibits prostaglandin synthesis. Therapeutic effects: suppression of pain and

inflammation
Contraindications: Hypersensitivity to disclofenac or other components of formulation
of Cross-sensitivity may occur with other NSAID’S including aspirin. Active GI bleeding
and ulcer disease

Side Effects:
• upset stomach, mild heartburn or stomach pain, diarrhea, constipation;
• bloating, gas;
• dizziness, headache, nervousness;
• skin itching or rash;
• blurred vision; or
• Ringing in your ears.
• chest pain, weakness, shortness of breath, slurred speech, problems with vision or
balance;
• black, bloody, or tarry stools;
• coughing up blood or vomit that looks like coffee grounds;
• swelling or rapid weight gain;
• urinating less than usual or not at all;
• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools,
jaundice (yellowing of the skin or eyes);
• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
• bruising, severe tingling, numbness, pain, muscle weakness; or
• Fever, headache, neck stiffness, chills, increased sensitivity to light, purple spots on
the skin, and/or seizure (convulsions).

Stock dose: Diclofenac sodium delayed release (enteric coated) tablets: 25 mg, 50 mg,
75 mg. Diclofenac sodium extended-release tablets: 75 and 100 mg. Suppositories: 50
and 100 mg. In combination with: 200 mcg Misoprostol.

Nursing responsibilities:
• Remember, keep this and all other medicines out of the reach of children, never
share your medicines with others, and use this medication only for the indication
prescribed.

• Administration of higher that the recommended dose does not provide more relief
and effectiveness but may cause increased side effects, Use lowest effective does
for shortest period of time

• Instruct patient to take diclofen with afull galss of water and to remain in an
uprigtyht posityion for 15-30 minutes afgter adminitration.

• Take missed dose as soon as possible within 1-2 hours if taking once or twice a
day or unless almost most of the time for the next dose if taking more than twice
per day. Do not double doses.

• May cause drowsiness or dizziness. Caution patient to avoid any kind of activities
that requires alertness until response to medication is known