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OMEPRAZOLE

Indications :

Shot-term treatment for erosive esophagitis and symptomatic gastroesophageal


reflux disease (GERD) poorly responsive to other treatment. Omeprazole is used
for the long-term treatment of pathologic hypersecretory conditions and active
duodenal cancer. It is a maintenance healing of erosive esophagitis. Omeprazole
can also be used in the treatment of H. pylori associated with duodenal ulcer and
active benign gastric ulcers. It is also used in the prevention and treatment of
NSAID-induced ulcers.

Routes and Dosage of Omeprazole

Erosive Esophagitis, Poorly Responsive GERD, Active Duodenal Ulcer,


Prevention or Treatment of NSAID-Induced Ulcers
PO: ADULTS, ELDERLY: 20 mg per day.

Action of Omeprazole

Omeprazole is converted to active metabolites that irreversibly bind and inhibit


H+-K+-ATPase (an enzyme on the surface of gastric parietal cells). It inhibits
transport of hydrogen ions into the gastric lumen. Omeprazole increases the
gastric pH and reduces gastric acid formation.

Side Effects of Omeprazole

• Headache
• Diarrhea
• Abdominal pain
• Nausea
• Dizziness
• Asthenia (loss of strength)
• Vomiting
• Constipation
• Upper respiratory tract infection
• Back pain
• Rash
• Cough

Adverse Reactions of Omeprazole


Abdominal pain, headache, dizziness, nausea, vomiting, back pain, constipation.

Nursing Considerations for Clients Taking Omeprazole

• Give before meals


• Do not crush or chew tablets, swallow whole
• Evaluate for therapeutic response like relief of Gastrointestinal symptoms
• Question if Gastrointestinal discomfort, nausea, and diarrhea occurs.
PARACETAMOL

Brand name : biogesic

Classification : para-aminophenol derivative/anti-pyretic

Dosage : 500mg/1tab PO

Mechanism of action : decreases fever by inhibiting the effects of


pyrogens on the hyphothalamic action leading to sweating and
vasodilation.

Indications : relief of mild to moderate pain; treatment of fever.

Contraindications : hypersensitivity, intolerance to tartrazine, alcohol,


table sugar, saccharin.

Adverse reactions : stimulation, drowsiness, nausea, vomiting, abdominal


pain, hepatotoxicity, heapatic seizure, renal failure, leukopenia,
hypersensitivity, cyanosis, anemia, jaundice, CNS stimulation.

Nursing consideration :

 assess allergic reactions


 give with food to decrease gastric symptoms give 30 mins. Before
2hours after meals.
 Advise patient to avoid alcohol.
 Tell patient to notify prescriber for pain or fever lasting for more
than 3 days.
Generic name : cetrizine

Brand name : alnix

Classification : anti-histamine

Dosage : 1 tab OD route : PO

Mechanism of action : long-acting non sedating anti-histamine that


selectively inhibits peripheral H1 receptors.

Indications : treatment of chronic: idiophatic urticaria, pruritis, eczema,


dermatitis, perennial allergic rhinitis and allergic conjunctivitis.

Contraindications : hypersensitivity, cardiac disease,

Adverse reactions : fatigue, drowsiness, headache, gastrointestinal


discomfort, vomiting, diarrhea.

Nursing consideration:

• Assess for respiratory status and increase bronchial secretions,


wheezing.
• Instruct patient to use medication as directed. Teach all aspects of
medication.
• Instruct patient to take 1 hour before or 2 hours after a meal to
facilitate absorption.
Examination Result Reference value
Hemoglobin 14.0 12.0-16.0 g/dl
Hematocrit 44.0 38-47%
RBC 5.48 4.0-6.0 10^g/dl
Mean corpuscular 25.5 26-34 pg
haemoglobin
Mean corpuscular 80.3 80-100 fl
volume
Mean corpuscular 31.8 31-37 g/dl
hgb. Conc.
Wbc 2.55 4.55-11.0 10^3 /ul
Neutrophil 0.40 0.45-0.65
Lymphocyte 0.58 0.20-0.35
Monocyte 0.01 0.02-0.06
Eosinophil 0.01 0.02-0.04
Platelet 195 150-350 10^3/UL

Examination Result Reference value


Hemoglobin 13.5 12.0-16.0 g/dl
Hematocrit 41.2 38-47%
RBC 5.22 4.0-6.0 10^g/dl
Mean corpuscular 25.9 26-34 pg
haemoglobin
Mean corpuscular 78.9 80-100 fl
volume
Mean corpuscular 32.8 31-37 g/dl
hgb. Conc.
Wbc 0.96 4.55-11.0 10^3 /ul
Neutrophil 54.2 0.45-0.65
Lymphocyte 35.4 0.20-0.35
Monocyte 10.4 0.02-0.06
Eosinophil 0.0 0.02-0.04
Basophil 0.0 0.0-5.0%
Platelet 150 150-350 10^3/UL

Examination Result Reference value


Rbc count 5.37 x10/L 4.5-5.5
Hgb 14.30 g/dl 12-14
Hct 0.43 L/L 0.37-0.47
Mcv 81.6 fl 82-92
Mch 26.6 pg 27-33
Mchc 32.6% 32-38
Platelet count 106 x10 /c 150-450
Wbc 1.70 x10/c 5-10
Reticulocyte
ESR