Ceftriaxone Drug Class: Antibiotic, Cephalosporin Therapeutic Action: Bactericidal, inhibits synthesis of bacterial cell wall causing death.

Indications: Perioperative prophylaxis for patients undergoing potentially contaminated surgical procedures Contraindication Allergy to cephalosporins or penicillins Adverse Effects Nausea and vomiting, diarrhea, anorexia, abdominal pain, flatulence, rash-fever, pain at injection site. Nursing Interventions Culture infection and arrange for sensitivity tests before and during therapy is expected response is not seen. Reconstitute for IM use with sterile water for injection; 0.9% sodium chloride solution, 5% dextrose solution, inject deeply into a large muscle group. Protect drug from light. Do not mix with any other antimicrobial drug. Have vitamin K in case hypo thrombinemia occurs. Stomach upset and diarrhea is expected normal side effects of the drug. Report severe severe diarrhea, difficulty breathing, unusual fatigue or pain at injection site. Metoclopramide Drug Class: Anti-emetic, dopaminergic blocker, GI stimulant Therapeutic Actions: Stimulates motility of GI tract without stimulating gastric, biliary and pancreatic secretions, sensitize action of acetylcholine, relaxes pyloric sphincter accelerates gastric emptying and intestinal transit, increases lower esophageal sphincter pressure, with sedative effects induces release of prolactin. Indications Facilitationn of intubation and gastric emptying when NGT is undesirable. Adverse Effects Restlessness, drowsiness, fatigue, lassitude, nausea and diarrhea. Nursing Interventions Monitor BP during IV administration Monitor extrapyramidal reactions, consult physician if this occurs. Keep diphenyhydramine injection if extrapyramidal reactions occur Have phentolamine readily available in case of hypertensive crisis. Take drug RTC Report involuntsry movement of the face, eyes or limbs, severe depression, severe diarrhea. Ibuprofen Drug Class: Analgesic, NSAID

Therapeutic actions Anti-inflammatory, analgesi and antipyretic activities largely related to inhibition of prostaglandin synthesis. Indications Relief of signs and symptoms of rheumatoid arthritis and osteoarthritis. Relief of moderate pain. Fever reduction Contraindications Allergy to ibuprofen, salicylates, NSAIDS Give dose every 6-8 hour interval according to weight of the patient but no morethan QID. *22-26 kg- 200 mg Fever (6months -12 years old) 10 mg . kg PO every 6-8 hour. Adverse effects Headache, dizziness, insomnia, rash, nausea, dyspepsia, constipation Nursing Intervention Administer drug with meals Discontinue drug if eye changes, hepatic impairment, renal impairment occur. Report sore throat fever rash, itching weight gain, swelling of ankles or fingers, changes in vision, balck or tarry stools. Ranitidine Histamine antagonist Therapeutic Actions: inhibits action of histamine at the H2 receptors of the parietal cells of the stomach, inhibiting basal gastric secretions and gastric secretions stimulated by food, insulin, histamine, cholinergic agonists, gastrin and pentagastrin. Indications Short term treatment of active duodenal ulcer / active gastric ulcer Maintenance therapy for duodenal ulcer/ benign gastric ulcer at reduced dosage