Generic Name: Paracetamol Trade Name: Sinomol Dosage and Route: 150 mg/ml,IM,IV Classification: Antipyretic and Analgesic

ACTION Antipyretic: Reduces fever by acting directly on the hypothalamic heat-regulating center to cause vasodilation and sweating, which helps dissipate heat.

INDICATION Common cold, flu, other viral and bacterial infections with pain and fever

CONTRAINDICATION Contraindicated with allergy to acetaminophen. Use cautiously with impaired hepatic function, chronic alcoholism, pregnancy, lactation.

ADVERSE EFFECTS

NURSING CONSIDERATION Do not exceed the recommended dosage. Avoid using multiple preparations containing acetaminophen. Carefully check all OTC products. Give drug with food if GI upset is noted. Discontinue drug if hypersensitivity reactions occur. Treatment of overdose: Monitor serum levels regularly, N-acetylcysteine should be available as a specific antidote; basic life support measures may be necessary

CNS: Headache CV: Chest pain, dyspnea,

myocardial damage when doses of 58 g/day are ingested daily for several weeks or when doses of 4 g/day are ingested for 1 yr GI: Hepatic toxicity and failure, jaundice GU: Acute kidney failure, renal tubular necrosis Hematologic: Methemoglobinemia cyanosis; hemolytic anemia hematuria, anuria; neutropenia, leukopenia, pancytopenia, thrombocytopenia, hypoglycemia Hypersensitivity: Rash, fever

Generic Name: Metochlopramide Trade Name: Metsil Dosage and Route: 50 mg/1ml, IM,IV Classification: Antiemetics ACTION Stimulate motility of upper gastrointestinal tract, increases lower esophageal sphincter tone, and blocks dopamine receptors at the chemoreceptor trigger zone INDICATION To prevent or reduce nausea and vomiting from emetogenic cancer chemotherapy To facilitate small bowel intubation, to aid in radiologic examination To prevent or reduce post operative nausea and vomiting Delayed gastric emptying secondary to diabetic gastro paresis. Gastroesophageal reflux disease Emesis during pregnancy. CONTRAINDICATION Contraindicated in patients hypersensitive to drug and those with pheochromocytoma or seizure disorders. Contraindicated in patients for whom stimulation of GI motility might be dangerous (those with hemorrhage, obstruction or perforation) ADVERSE EFFECTS CNS: anxiety, drowsiness, dystonic reactions, fatigue, lassitude, restlessness, neurolephtic malignant syndrome, seizures, suicide ideation, akathisia, confusion, depression, dizziness, extrapyramidal symptoms, fever, hallucinations, headache, insomnia, tardive dyskinesia CV: bradycardia, supraventricular tachycardia, hypotension, transient hypertention GI: bowel disorders, diarrhea, nausea GU: incontinence, urinary frequency Hematologic: agranulocytosis, neutropenia Skin: rash, urticaria Other: lost of libido, prolactin secretions NURSING CONSIDERATION Monitor bowel sounds. Safety and effectiveness of drug havent been established for therapy lasting longer for 12 weeks.

Alert! Use 25mg diphenhydramine IV to counteract extra pyramidal adverse effects from high doses.

Generic Name: Atropine Sulfate Trade Name: Anespin Dosage and Route: 1mg/ml,IM,IV,SC Classification: Anticholinergic ACTION Reduces the secretions of many organs, thereby helping to control conditions such as excessive stomach acid production and excessive secretion from the pancreas; to reduce secretions of the nose, lungs, salivary glands, and stomach before surgery; and to help dry up excessive mucus production associated with diseases, infections, and allergies INDICATION >symptomatic bradycardia, bradyarrythmia >antidote for cholinerfevase insecticide poisoning CONTRAINDICATION > to patients with hypersensitivity to drugs > to patients with cardiogenic shock, congenital interval prolongation, heart block ADVERSE EFFECTS CNS: headache, restlessness, ataxia, disorientation, hallucination, delirium, insomnia, dizziness, excitement, agitation, effusion CV: palpitations, bradycardia, tachycardia EENT: photophobia, blurred vision, mydriasis, cycloplegia, increased intraocular pressure GI: dry mouth, thirst, constipation, nausea, vomiting GU:urine retention, impotence NURSING CONSIDERATION > correct electrolyte abnormalities before starting therapy >digitalized patients with atrial fibrillation before starting > in adult, avoid less than 0.5 mg because of the risk of paradoxical bradycardia > Atropine increases the risk of heat stroke because it causes decreased sweating > Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while you are taking atropine.

>preoperatively to diminish & block cardiac vagal reflex >use cautiously or avoid, if possible to patient with heart failure >adjunct treatment of peptic ulcer disease; functional GI disorders such as irritable bowel syndrome, colitis, spastic bladder, diverticulitis, infant colic, renal and biliary colic, peptic ulcer, and irritable bowel syndrome > to treat the rigidity, tremor, excessive salivation, and sweating caused by Parkinson's disease

Generic Name: Ranitidine Trade Name: Raxine Dosage and Route: 25mg/ml,IM,IV Classification: Histamine2 (H2) antagonist ACTION Competitively inhibits the action of histamine at the histamine2 (H2) receptors of the parietal cells of the stomach, inhibiting basal gastric acid secretion and gastric acid secretion that is stimulated by food, insulin, histamine, cholinergic agonists, gastrin, and pentagastrin. INDICATION Treatment of heartburn, acid indigestion, sour stomach CONTRAINDICATION Contraindicated with allergy to ranitidine, lactation. Use cautiously with impaired renal or hepatic function, pregnancy. ADVERSE EFFECTS NURSING CONSIDERATION Administer oral drug with meals and hs. Decrease doses in renal and liver failure. Provide concurrent antacid therapy to relieve pain. Administer IM dose undiluted, deep into large muscle group. Arrange for regular follow-up, including blood tests, to evaluate effects.

CNS: Headache, malaise,

dizziness, somnolence, insomnia, vertigo CV: Tachycardia, bradycardia, PVCs (rapid IV administration) Dermatologic: Rash, alopecia GI: Constipation, diarrhea, nausea, vomiting, abdominal pain, hepatitis, increased ALT levels GU: Gynecomastia, impotence or decreased libido Hematologic: Leukopenia, granulocytopenia, thrombocytopenia, pancytopenia Local: Pain at IM site, local burning or itching at IV site Other: Arthralgias

Generic Name: Clonidine Trade Name: Catapres Dosage and Route: 150 mcg/ml, SC,IM,IV Classification: : Centrally acting alpha agonist, Antihypertensive ACTION Unknown. Thought to stimulate alpha2 receptors and inhibit the central vasomotor centers, decreasing sympathetic outflow to the heart, kidneys, and peripheral vasculature, and lowering peripheral vascular resistance, blood pressure, and heart rate. INDICATION Essential and renal hypertension Severe cancer pain that is unresponsive to epidural or spinal opiate analgesia or other more conventional methods of analgesia Migraine prophylaxis Dysmenorrhea Opiatedependence,Alcohol dependence Epidural form is contraindicated in patients receiving anticoagulant therapy, in those with bleeding diathesis, in those with an injection site infection, and in those who are hemodynamically unstable or have severe CV disease. Use cautiously in patients with severe coronary insufficiency, conduction disturbances, recent MI, cerebrovascular disease, CONTRAINDICATION Contraindicated in patients hypersensitive to drug. Transdermal form is contraindicated in patients hypersensitive to any component of the adhesive layer of transdermal system. ADVERSE EFFECTS CNS: drowsiness, dizziness, fatigue, sedation, weakness, malaise, agitation, depression. CV: orthostatic hypotension, bradycardia, severe rebound hypertension. GI: constipation, dry mouth, nausea, vomiting, anorexia. GU: urine retention, impotence. Metabolic: weight gain. Skin: pruritus, dermatitis with transdermal patch, rash. Other: loss of libido. Elderly patients may be more sensitive than younger ones to drug's hypotensive effects. Observe patient for tolerance to drug's therapeutic effects, which may require increased dosage. Noticeable antihypertensive effects NURSING CONSIDERATION Drug may be given to lower blood pressure rapidly in some hypertensive emergencies. Monitor blood pressure and pulse rate frequently. Dosage is usually adjusted to patient's blood pressure and tolerance.

chronic renal failure, or impaired liver function.

of transdermal clonidine may take 2 to 3 days. Oral antihypertensive therapy may have to be continued in the interim. Remove transdermal patch before defibrillation to prevent arcing. Stop drug gradually by reducing dosage over 2 to 4 days to avoid rapid rise in blood pressure, agitation, headache, and tremor. When stopping therapy in patients receiving both clonidine and a beta blocker, gradually withdraw the beta blocker several days before gradually stopping clonidine to minimize adverse reactions. Don't stop drug before surgery. >The injection form concentrate containing 500 mcg/ml must be diluted before use in normal saline injection to yield 100 mcg/ml. >When drug is given epidurally, carefully monitor infusion pump, and inspect catheter tubing for obstruction or dislodgment.