DRUG NAME Generic name: Co-amoxiclav Brand name: Amoxcil Classification: Antibiotic

DOSAGE/ FREQUENCY Co-amoxiclav 625mg/tab q12 for 7 days

MECHANISM OF ACTION Co-amoxiclav is an antibiotic that is a combination of a penicillin(amoxicillin) and a substance called clavulanic acid. It kills bacteria, byinterfering with their ability to form cell walls. The bacteria therefore breakup and die.

INDICATION Upper respiratory tract infections (including ENT) - sinusitis, otitis media, recurrent tonsillitis. These infections are often caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pyogenes. Lower respiratory tract infectionsacute exacerbations of chronic bronchitis, bronchopneum onia, urinarytract infections often caused by Streptococcus pneumoniae, Haemophilus influenzae, and

CONTRAINDICATION Co-amoxiclav is contraindicated in patients with a history of allergic reactions to any penicillin. It is also contraindicated in patients with a previous history of amoxicillinpotassium clavulanateassociated cholestatic jaundice/ hepatic dysfunction.

SIDE EFFECTS Diarrhea, loose stools, nausea, skin rashes, vomiting and vaginal infections.

NURSING RESPONSIBILITIES Assess for infection Obtain specimens for culture and sensitivity prior to therapy. First dose may be given before receiving the result Monitor bow function Instruct the patient to take the medication around the clock and to finish the drug completely as directed. Review use and preparation of tablets for oral suspension Instruct female patients taking oral contraceptives to use an alternate or additional nonhormonal method contraception during therapy with amoxicillin and until next menstrual period. Advise the patient to

Moraxella catarrhalis. Genito-urinary tract and abdominal infections in particular cystitis (especially when recurrent or complicated, but not prostatitis) septic abortion, pelvic or puerperal sepsis, and intraabdominal sepsis. These infections are often caused by Enterobacteriac eae (mainly Escherichia coli), Staphylococcus saprophyticus, Enterococcus species. Skin and soft tissues infections in particular, cellulites,

report signs of superinfection ( furry over growth on the tongue, vagina itching or discharge, foulsmelling stools and allergy.

animal bites, and severe dental abscess with spreading cellulites caused by Staphyloccocus aureus, Streptococcus pyogenes and Bacteriodes species.

DRUG NAME Generic name: Ampicillin sulbactam Brand name: Ampisulbactam Classification: Anti-infectives Anti-bacterial Aminopenicillin Pregnancy Category C

DOSAGE/ FREQUENCY Ampicillin sulbactam 150 mg IV q8

MECHANISM OF ACTION Bactericidal action.Active against:Streptococci, Penumococci,Enteroc occi,Haemophilusinfl uenzae. Binds tobacteria cell wall,resulting in cell death,spectrum is broaderthan that of penicillin.Addition of sulbactamincreases resistanceto betalactamase,enzymes produced bybacteria that mayinactivate ampicillin.

INDICATION Treatment of infections caused by susceptible trains of Shigella, Salmonella, E.Coli, Haemophilus influenzae, S.typhosa, N.Gonorrhea, enterococci, gram-positive organisms Meningitis causedby Neisseriamenin gitides

CONTRAINDICATION Contraindicated with allergies to penicillins, cephalosporins, or other allergens. Use cautiously with renal disorders.

SIDE EFFECTS CNS: Lethargy, hallucinations, seizures CV: Heart failure GI:Glossitis,stom atitis, gastritis, soremouth, nausea, vomiting, diarrhea,abdomi nal pain, bloody diarrhea, enterocolitis, pseudomembran ous colitis, nonspecifichepati tis GU: Nephritis Hematology: Anemia, thrombocytopeni a, leukopenia, neutropenia, prolongedbleedin g time Hypersensitivity: Rash, fever, wheezing, anaphylaxis Local: Pain,p hlebitis, thrombosis

NURSING RESPONSIBILITIES Assess patient (vitalsigns), wound appearance,s putum, urine, stool, and WBCs)at beginning and throughout therapy. Obtain a history before initiating therapy to determine previous use of and reactions to penicillins or cephalosporins. Persons with a negative history of penicillin sensitivity may still have an allergic response. Obtain specimens for culture and sensitivity before therapy. First dose may be given before receiving results. Observe patients for signs and symptoms of anaphylaxis (rash,pruritus,larynge al edema, wheezing).Discontinu e the drug and notify the physician immediately if these occur. Keep

epinephrine, an antihistamine, and resuscitation equipment close by in the event of an anaphylactic reaction.

DRUG NAME Generic name: Mefenamic acid Brand name: Ponstel Classification: NSAID Pregnancy Category C

DOSAGE/ FREQUENCY Mefenamic acid 500mg/cap q6 for pain

MECHANISM OF ACTION Anti-inflammatory, analgesic, and antipyretic activities related to inhibition of prostaglandin synthesis; exact mechanisms of action are not known.

INDICATION Relief of moderate pain when therapy will not exceed 1 week. Treatment of primary dysmenorrhea

CONTRAINDICATION Hypersensitivity, ASA allergy, history of aspirin triad, GI tract ulcer/inflammation , CABG, renal disease, late pregnancy (may cause premature closure of ductus arteriosus)

SIDE EFFECTS Headache, dizziness, insomia, fatigue, Rash, pruritus, sweating Nausea, dyspepsia, GI pain, diarrhea, vomiting, constipation, flatulence, ulcers, GI bleed

NURSING RESPONSIBILITIES Give with milk or food to decrease GI upset. Assess patients who develop severe diarrhea and vomiting for dehydration and electrolyte imbalance. Discontinue drug promptly if diarrhea, dark stools, hematemesis, ecchymoses, epistaxis, or rash occur and do not use again. Contact physician. Notify physician if persistent GI discomfort, sore throat, fever, or malaise occur. Do not drive or engage in potentially hazardous activities until response to drug is known. It may cause dizziness and drowsiness. Do not breast feed while taking this drug without consulting physician.

DRUG NAME Generic name: Ferrous sulfate Brand name: Apo-Ferrous Sulfate (CAN), Feosol, Fergen-sol, Fer-In-Sol Classification: Iron preparation Pregnancy Category A

DOSAGE/ FREQUENCY Ferrous sulfate OD

MECHANISM OF ACTION Elevates the serum iron concenrration, and is then converted to Hgb or trapped in the reticuloendothelial cells for storage and eventual conversion to a usable form of iron.

INDICATION Prevention and treatment of iron deficiency anemia. Dietary supplement for iron.

CONTRAINDICATION Contraindicated with allergy to any ingredient;sulfite allergy;hemochroma tosis,hemosiderosis, hemolytic anemia. Use cautiously with normal iron balance; peptic ulcer,regional enteritis, ulcerative colitis.

SIDE EFFECTS CNS: CNS toxicity, acidosis, coma and death with overdose. GI: GI upset, anorexia, nausea, vomiting, constipation, diarrhea, dark stools, temporary staining of the teeth ((liquid preparations).

NURSING RESPONSIBILITIES Advice patient to take medicine as prescribed. Caution patient to make position changes slowly to minimize orhtostatic hypotension. Instruct patient to avoid concurrent use of alcohol or OTC medicine without consulting the physician. Advise patient to consult physician if irregular heartbeat, dyspnea, swelling of hands and feet and hypotension occurs. Inform patient that angina attacks may occur 30 min. after administration due reflex tachycardia. Encourage patient to comply with additional intervention for hypertension like proper diet, regular exercise, lifestyle changes and stress management.

DRUG NAME Generic name: Methylergometrine maleate Brand name: Methergine Classification: Oxytocic Pregnancy Category C

DOSAGE/ FREQUENCY Methylergometr ine maleate tab q8 for 5 days

MECHANISM OF ACTION A partial agonist or antagonist at alpha receptors; as a result, it increases the strength, duration, and frequency of uterine contraction.

INDICATION Prevention andtreatment of postpartum and postabortionhe morrhage caused byuterine atony or subinvolution. Uterine stimulation during 2nd stage of labor following the delivery of the anterior shoulder, under strict medical supervision.

CONTRAINDICATION Contraindicated with allergy to methylergometrine, hypertension, toxemia, lactation, pregnancy. Use cautiously with sepsis, obliterative vascular disease, hepatic or renal impairement.

SIDE EFFECTS CNS: dizziness, headache, tinnitus, diaphoresis CV: hypertension, palpitations, chest pain, dyspnea GI: nausea, vomiting

NURSING RESPONSIBILITIES Be alert for adverse reactions and drug interactions. This drug should be used extremely carefully because of it's potent vasoconstrictor action. I.V. use may induce sudden hypertension accidents. As a last resort, give I.V. slowly over several minutes and monitor blood pressure closely