Name of Drug

Generic Name: Mefenamic Acid

Indications
Short-term relief of mild to moderate pan inluding flank pain

Action
Anthranilic acid derivative. Like ibuprofen inhibits prostaglandin synthesis and affects platelet function. No evidence that it is superior to aspirin

Contraindication
contraindicated in patients with known hypersensitivity to mefenamic acid. Should not be given to patients who have experienced asthma, urticaria, or allergictype reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic-like reactions to NSAIDs have been reported in such patients Contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery Contraindicated in patients with acute active ulceration or chronic inflammation of either the upper or lower gastrointestinal tract. Should not be used in patients with preexisting renal disease.

Side effects
Bloody urine bloody, black, or tarry stools decreased frequency or amount of urine heartburn increased bleeding time increased blood pressure increased thirst indigestion itching skin loss of appetite lower back or side pain nausea pale skin rashes severe abdominal pain, cramping, or burning stomach bloating swelling swelling of the face, fingers, feet, or lower legs trouble breathing with or without exertion unusual bleeding or bruising unusual tiredness or weakness vomiting weight gain weight loss

Adverse Side Effects

Bleeding gums blood in vomit blurred vision burning feeling in the chest or stomach chest pain clay-colored stools cloudy urine confusion constipation cough or hoarseness dark urine difficult or labored breathing difficult, burning, or painful urination difficulty in swallowing dilated neck veins dizziness extreme fatigue fainting fast, pounding, or irregular heartbeat or pulse frequent urge to urinate headache increased volume of pale, dilute urine irregular breathing irregular heartbeat large, flat, blue, or purplish

Nursing Management
Assess patients who develop severe diarrhea and vomiting for dehydration and electrolyte imbalance. Lab test: with long-term therapy (not recommended) obtain periodic complete blood counts, Hct and Hgb, and kidney function test. 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.

Name of Drug
Generic Name: Ciprofloxacin

Indications
Susceptible infections, including lower respiratory tract, skin and skin structures, bone and joint, acute sinusitis, complicated intraabdominal (w. metronidazole), UTIs, chronic bacterial prostatitis. Postexposure prophylaxis and treatment of anthrax. Infectious diarrhea, typhoid fever, uncomplicated cervical and urethral gonorrhea: oral form only.

Action
Inhibits DNAgyrase in susceptible organism; inhibits relaxation of supercolloid DNA and promotes breakage of double-stranded DNA.

Contraindication
Contraindicated in persons with a history of hypersensitivity to ciprofloxacin, any member of the quinolone class of antimicrobial agents, or any of the product components.

Side effects
nausea, vomiting; dizziness or drowsiness; blurred vision; feeling nervous, anxious, or agitated; or

Adverse Side Effects

GI upset, headache, CNS disturbances (eg, convulsions, dizziness, nervousness, insomnia, nightmares, paranoia), rash, eosinophilia, elevated liver enzymes, photosensitivity, Stevens-Johnson syndrome, myalgia, tendinitis/rupture, joint-related disorders (children), local reactions (inj); rare: increased intracranial pressure, toxic psychosis; peripheral neuropathy, C. difficile-associated diarrhea.

Nursing Management
Report tendon inflammation or pain. Cipro needs to be discontinued. Lab tests: Culture and sensitivity tests should be done prior to initial dose. Treatment may be implemented pending results. Monitor urine pH; it should be less than 6.8, especially in the older adult and patients receiving high dosages of ciprofloxacin, to reduce the risk of crystalluria. Monitor I&O ratio and patterns: Patients should be well hydrated; assess for S&S of crystalluria. Monitor plasma theophylline concentrations, since drug may interfere with half-life. Administration with theophylline derivatives or caffeine can cause CNS stimulation. Assess for S&S of GI irritation (e.g., nausea, diarrhea, vomiting, abdominal discomfort) in clients receiving high dosages and in older adults. Monitor PT and INR in patients receiving coumarin therapy

sleep problems (insomnia or nightmares).

Name of Drug
Generic Name: Cotrimoxazol e

Indications
This medication is a combination of trimethoprim and sulfamethoxaz ole, prescribed for certain types bacterial infections. It is also used to treat travelers diarrhea. It eliminates bacteria that cause various infections.

Action
inhibits bacterial synthesis of dihydrofolic acid by competing with PABA. Trimethoprim blocks production of tetrahydrofolic acid by inhibiting the enzyme dihydrofolate reductase. This combination blocks 2 consecutive steps in bacterial biosynthesis of essential nucleic acids and proteins and is usually bactericidal.

Contraindication
Hypersensitivity to trimethoprim or sulfonamides; megaloblastic anemia caused by folate deficiency; pregnancy; lactation; infants younger than 2 mo of age; marked hepatic damage or severe renal insufficiency when renal function status cannot be monitored.

Side effects
diarrhoea headaches nausea overgrowth of microorganisms that are not affected by Sulfamethoxazole/Trim ethoprim skin rash or rashes seek immediate medical advice if you develop a rash abnormal laboratory test results allergic reactions anaphylactic reactions angioedema balance or coordination problems

Adverse Side Effects

Apathy, aseptic meningitis, ataxia, convulsions, depression, fatigue, hallucinations, headache, insomnia, nervousness, peripheral neuritis, vertigo, weakness. Abdominal pain, anorexia, diarrhea, elevation of serum transaminase and bilirubin, emesis, glossitis, hepatitis

Nursing Management
Advise patient to complete full course of therapy. Encourage patient to maintain adequate fluid intake. Advise patient to take tablet with full glass of water. Educate patient and family to report any signs of superinfection, such as fever, vaginitis, oral candidiasis, and fatigue. Instruct patient to report the following symptoms to health care provider: fever, skin rash, sore throat, unusual bruising or bleeding. Caution patient to avoid exposure to sunlight and to use sunscreen or wear protective clothing to avoid photosensitivity reaction. Instruct patients to contact their health care provider as soon as possible if they develop watery and bloody stools, with or without stomach cramps and fever, even as late as 2 mo after taking their last dose of this medicine.

Name of Drug
Generic Name: Paracetamol

Indications
Temporary relief of pain and discomfort from headache, fever, cold, flu, minor muscular aches, overexertion, menstrual cramps, toothache, minor arthritic pain.

Action
Paracetamol may cause analgesia by inhibiting CNS prostaglandin synthesis. The mechanism of morphine is believed to involve decreased permeability of the cell membrane to sodium, which results in diminished transmission of pain impulses therefore analgesia.

Contraindication
Renal insufficiency, anemia. Clients with cardiac or pulmonary disease are more susceptible to acetaminophen toxicity.

Side effects
low fever with nausea, stomach pain, and loss of appetite; dark urine, claycolored stools; or jaundice (yellowing of the skin or eyes)

Adverse Side Effects

Hematologic: hemolytic anemia, leukopenia, neutropenia, pancytopenia, thrombocytopenia. Hepatic: liver damage, jaundice Metabolic: hypoglycemia Skin: rash, urticuria

Nursing Management
Assess patients pain or temperature before therapy and regularly thereafter. Asses patients drug history and calculate total daily dosage accordingly. Be alert for signs of reactions and drug interactions. Assess patients and familys knowledge of drug therapy.