V.

DRUGSTUDY Doctors Orders Celecoxib 200 mg 1 cap BID Classification Cephalosporins, 2nd Generation Indication Post-surgical pain Contraindication Known sulfanomides hypersensitivity. Asthma, urticaria or allergic reactions after taking acetyl salicylic acid or other NSAIDs. Renal impairment with creatinine clearance less than 30 mL/min. Sever hepatic impairment, severe heart failure and inflammatory bowel disease, myocardial infarction or stroke, peri-operative period undergoing cardiac or major vascular surgery. Doctors Orders Sultamicillin 250mg 1 cap BID Classification Penicillins Indication Skin and soft tissue infections Contraindication Contraindicated in patients MOA Inhibits cell-wall synthesis during MOA Exhibits antiinflammatory, analgesic, and antipyretic action due to inhibition of the enzyme COX-2. Adverse Reaction Most common: abdominal pain, diarrhea, dyspepsia, flatulence, nausea, dizziness, headache, pharyngitis, rhinitis, sinusitis, upper respiratory tract infection, back pain, insomnia, rash Less common: constipation, dysphagia, esophagitis, gastritis, gastroenteritis, gastroesophageal reflux, hemorrhoids, melena, dry mouth, stomatitis, vomiting, aggravated hypertension, angina pectoris. Adverse Reaction Gastrointestinal disturbances, skin Nursing Considertion Instruct patient to take drug with food or milk. Teach patient to avoid aspirin and other NSAIDs during the therapy. Advise patient to immediately report bloody stools, blood in vomit, or signs and symptoms of liver damage (nausea, fatigue, lethargy, pruritus, yellowing of eyes or skin, tenderness on upper right side of abdomen, or flu like symptoms)

Nursing Considertion Decrease dosage in patient with renal

hypersensitive to drug or other penicillins. Use cautiously with patients with other drug allergies (especially to cephalosporins) because of possible cross-sensitivity and in those with mononucleosis because of high risk maculopapular rash.

bacterial multiplication. Sultamicillin is hydrolyzed during absorption to provide sulbactam and ampicillin in the systemic circulation.

rashes, itching, anaphylaxis

failure. Monitor liver function test results during therapy, especially in patients with impaired liver functions. Monitor for adverse effects. Administer the complete course of drug to use the beneficial effect. Advise patient to report rash, fever or chills. Instruct patient to promptly report signs of enterocolitis, vomiting, diarrhea and nausea.

Doctors Orders Mecobalamin 500mg 1 amp qo8

Classification Vitamin B-complex

Indication Megaloblastic anemia due to vitamin B12

Contraindication Hypersensitivity to drug.

MOA Mecobalamin plays animportant role intransmethylation

Adverse Reaction Infrequently, anorexia, nausea, vomiting, diarrhea,

Nursing Considertion In IMadministration, careshould be exercised by

deficiency and peripheral neuropathies.

as acoenzyme in thesynthesis of methioninefrom homocysteine.The drug is welltransported to nerve cellorganelles, and promotes nucleic acidand protein synthesis(erythrocyte production). Mecobalamin promotesthe synthesis of lecithin,the main constituent of medullary sheath lipids,and increasesmyelination of neurons

pain and induration at IM injection site. Rarely skin rash, headache, sweating or hot sensation.

following theinstructions asfollows to avoidadverse effects ontissues or nerves:Repeated injectionat the same siteshould be avoided If the patientcomplains of asevere pain or if blood reflux occurswhen the syringeneedle is stuck,withdraw itimmediately and tryat a different site.