Name of the Drug GENERIC NAME: Calcium Gluconate Name of the Drug BRAND NAME: Calcium Generic: Gluconate

Tranexamic Acid DRUG CLASSIFICATION: replace Brand: minerals and ment of Cyklokapron electrolytes Classification: Hemostatic , systemic; anti-fibrimolytic agent.

Dosage/Route Calcium Gluconate should be administered intravenously either Dosage/Route directly or by infusion. The dose is dependent upon the individual Dosage: requirements of the patient. Oral Calcium Gluconate may also be Short-term management administered by intermittent of haemorrhage infusion at a rate not exceeding Adult: 1-1.5 or by continuous 200 mg/min, g or 15-25 mg/kg 2-4 times. infusion. Child: 25 mg/kg bid or tid. Renal impairment: Adjust dose Adults: 500 mg 2 grams (5-20 based on serum creatinine mL) concentration: 120-250 micromol/l: 15 mg/kg bid daily; Children: 200-500 mg (2-5 mL) 250-500 micromol/l: 15 mg/kg once daily; >500 micromol/l: Infants: not more than 200 mg 7.5 mg/kg once daily or 15 mg/kg (not more than 2 mL) once every 48 hr. Oral Management of hereditary angioedema Adult: 1-1.5 g bid or tid. Child: 25 mg/kg bid or tid. Renal impairment: Adjust dose based on serum creatinine concentration: 120-250 micromol/l: 15 mg/kg bid daily; Drug Classification & Indication 250-500 micromol/l: 15 mg/kg once daily; >500 and Derivative PC: Ergot Alkaloid micromol/l: 7.5 TC: oxytocic, daily or 15 mg/kg mg/kg once lactation stimulant once every 48 hr. Indication: Intravenous Prevention and treatment of Short-term and postabortion management of postpartum hemorrhage caused by uterine haemorrhage atony or subinvolution Adult: 0.5-1 g or 10 mg/kg tid or 25-50 mg/kg daily by continuous infusion. Child: 10 mg/kg bid or tid. Renal impairment: Adjust dose based on the serum-creatinine concentration: 120-250 micromol/l: 10 mg/kg bid daily; 250-500 micromoles/l: 10 mg/kg once daily; >500 micromol/l: 5 mg/kg once daily or 10 mg/kg once every 48 hr.

Action/Classification Replaces calcium and maintains calcium leve l Action/Classification Tranexamic acid is an antifibrinolytic agent that competitively inhibits breakdown of fibrin clots. It blocks binding of plasminogen and plasmin to fibrin, thereby preventing haemostatic plug dissolution.

Indication/ Contraindications INDICATION: Calcium gluconate is used to treat conditions arising Indication/ deficiencies such as from calciumContraindications hypocalcaemia tetany and to Indication: This medication is relieve muscle cramping. used for short-term Contraindiof control CONTRAINDICATION: bleeding in hemophiliacs, cated in patients with ventricular including dental extraction fibrillation or hypercalcemia procedures. when serum calcium levels are Contraindication: Severe renal above normal. failure, active intravascular clotting, thromboembolic disease, colour vision disorders, subarachnoid bleeding.

Adverse Effects/ Side Effects

Nursing Responsibilities Assess for cutaneous burning sensations and peripheral vasodilation, with moderate Nursing Responsibilities fall in BP, during direct IV injection. - Monitor ECG during IV administration to 1. Assess baseline BP and pulse before detect evidence of hypercalcemia: decreased starting IV, patient frequently for hypotension QT interval associated with inverted T wave. -during IVIVinfusion which may indicate the Observe site closely. Extravasation infusion is to fast. Slow the and necrosis. may result in tissue irritationIV and repot to the -physician. hypocalcemia and hypercalcemia Monitor for 2. Observe Symptoms, Appendix F). (see Signs & patient for signs and symptoms of thrombosis, such levels Lab tests: Determineas leg ofpain, respiratory calcium and distress, o (tend to vary inversely) phosphoruschest pain and report. and 3. Anticipate reduced during in patients magnesium frequently, dosage sustained with impaired renal function. therapy. Deficiencies in other ions, 4. Stress magnesium, frequently coexist particularlythe importance of opthalmological examinations at regular intervals during withcalcium ion depletion therapy. 5. Report immediately any swelling, pain, or burning at infusion site. 6. Report any changes in vision, unusual pain or difficulty breathing, nausea or vomiting, changes in urinary pattern, or other adverse reactions. 7. Patient should not receive this medication if you are allergic to tranexamic acid, if you are color blind, if you have a history of bleeding in your brain, or if you have recently had a blood clot. Contraindication 8. Do not take if you have kidney disease or blood in the urine. in patients hypersensitive to > contraindicated 9.methylergonovine or any component caution This drug may make you dizzy. Use of the formulation. while driving, using machinery, or doing any >ergot alkaloids are contraindicated with activity that requires alertness. Limit alcoholic potent inhibitors of CYP3A4 (includes protease beverages. azole antifungals, and some inhibitors, macrolide antibiotics); hypertension; toxemia; pregnancy

Generic Name (Brand Name) Methergine (methylergonovine maleate)

Dosage, Route, Frequency IV: 0.2 mg after delivery of anterior shoulder, after delivery of placenta, or during puerperium; may be repeated as required at intervals of 2-4 hours

SIDE EFFECTS: nausea or vomiting, decreased appetite, Adverse Effects/ Side Constipation, dry mouth or Effects increased thirst, increased Side Effect: urination Diarrhoea, nausea, Cardiac ADVERSE EFFECTS: vomiting, disturbances arrhythmias arrest, Cardiacin colour vision, dizziness, hypotension DRUG INTERACTIONS: (after rapid IV inj), thromboembolic DRUG-DRUG events - Inactivates Drug Interaction: Antitetracycline antibiotics. inhibitor Coagulant at the Should not be given Complex: Antifibrinolytic Agents may same time orally nor should enhance the thrombogenic they be mixed for effect of Anti-inhibitor Coagulant Complex. Risk parenteral administration.X: Avoid combination. Fibrinogen Concentrate (Human): Antifibrinolytic Agents may enhance the adverse/toxic effect of Fibrinogen Concentrate (Human). Specifically, the risk for thrombosis may be increased. Fibrinogen Concentrate (Human) may enhance the adverse/toxic effect of Antifibrinolytic Agents. Specifically, the risk for thrombosis may be increased. Risk C: Monitor therapy. Tretinoin (Systemic): Mechanism of Action Adverse Reaction May enhance the thrombogenic effect of Methergin Cardiovascular: hypertension, Antifibrinolytic Agents. Risk C: temporary chest pain, Stimulates uterine smooth muscles Monitor therapy palpitation producing sustained contractions CNSHallucinations, dizziness, seizure, headache thereby shortens the third stage of labor Gastrointestinal: Nausea, vomiting, diarrhea, foul taste Local: Thrombophlebitis Otic: Tinnitus Renal: Hematuria Respiratory: Dyspnea, nasal congestion Miscellaneous: Diaphoresis

DRUG NAME

CLASSIFICATION

INDICATION

ACTION

DOSAGE

SIDE EFFECTS

CONTRAINDICATION

NURSING RESPONSIBILITY

Generic Name Diosmin Hesperidin

G.I /hepatobiliary drugs

organic and functional chronic venous insuffiency

Daflon 500mg is a phlebotonic drug and a vascular protecting agent. it reinforces venous tone by prolonging the activity of parietal noradrenaline. It decreases venous distentibility and venous emptying time.

usually 2 tabs. daily with meals. acute hemorrhoidal attacks: 6 tabs daily for 4 days. 4 tabs daily for 3 days then 2 tabs daily.

minor GI and neurovegetative disorders.

breast feeding is not recommended during treatment.

>check patient for symptoms of irritable bowel syndrome. (abdominal cramping, constipation/diarrhea and mucus stools. >assess patient routinely for abdominal distention >auscultate for bowel sounds. >monitor I and O.

Brand Name Daflon 500

of lower limbs with symptoms of heavy legs, pain, nocturnal cramps. Reduces swelling and restoring normal vein function in Hemorrhoids.

DRUG NAME Generic Name Isoxuprine HCL Brand Name Duvadilan Pervadil Duvaprine

CLASSIFICATION aminophenylethanol derivatives agents. peripheral vasodilators.

INDICATION peripheral and cerebral vascular insufficiency with spastic component showing symptom (dizziness, confusion,visual, auditory and speech abnormalities,coldness and numbnessof limbs. Cerbrovascular insufficiency. Uterine hypermotility disorders, dysmenorrhea, premature labor.

ACTION chemically similar to sympathomimetic amines and often described as beta adrenergic agonist. However, the drug appear to be a musculotropicvasodilator and its effects are not blocked by propanolol.

DOSAGE taken with food. Adults: 10-20mg 3- 4x daily. circulatory disturbances: 2 tabs. 3-4x a day after meals. or 1 retard capsule 2x a day or 1 -2ml 3x a day Uterine hypermotility: 0.2-0.5 mg IV infusion or 1 retard capsule 2x a day

SIDE EFFECTS transient flushing , hypotension, rashes, GI disturbances. Maternal pulmonary edema fetal tachycardia.

CONTRAINDICATION recent arterial hemorrhages, heart disease, severe anemia. should not administered immediately postpartum. premature labor.

NURSING RESPONSIBILITY >assess patient's condition before therapy. >Monitor for possible drug induced adverse reaction: hypotension, tachycardia,nausea, vomiting, dizziness and severe rash. >inform patient and family that the utility of vasodilator drugs in reversing or delaying deletirious effects acute or chronic cerebrovascular insufficiency is controversial. >tell the patient that direct acting vasodilator drugs can increase blood flow in normal resting

skeletal muscles and brain but in unlikely that any vasodilator can significantly increase blood flow related to physical occlusion. Generic name Chloramphenicol Brand name Biomycetin Chloromyecetin Vamcetin Penachlor antibiotic antimicrobial typhoid fever, meningeal infection, bacteremia, meningitis or other serious infections caused by susceptible strains of Salmonella or Chlamydia. inhibits protein synthesis in bacteria. Acts pimarily by binding reversibly to the 50s ribosomal subunit. Give with a full glass of watrer on an empty stomach, at least 1 hour before or 2 hours after a meal to achieve optimum blood levels. Adult: Capsule 250-500 mg every 6 hours or as prescribed. Pedia: Capsule 125-250 mg every 6 hours or as prescribed. Suspension: 7-12yrs. 1 tsp 2-6 yrs. 1/2 tsp infants:1/4-1/2 tsp every 6 hours daily after feeding time. blurring of vision GI reactions diarrhea headache mild depression nausea vomiting mild depression history of hypersensitivity and toxic reactions. infants <1 month and in pregnant women with 1 month prior to delivery. Blood diseases. Lactation. Concurrent therapy with other bone marrow depression, tuberculous affections. >assess patient for previous sensitivity reactions to other anti-infectives; cross-sensitivity between penicillins and cephalosporins is common. >assess patient for signs and symptoms of infection including characteristics of wounds, sputum, urine,stool,WBC,fever obtain baseline information and during treatment. >obtain specimen culture and sensitivity testing before drug therapy to identify if correct treatment has been initiated. >Monitor presence of anemia. >Monitor drug level in impaired hepatic renal systems. >monitor blood studies: platelets every 2 days CBC >assess bowel pattern everyday. >monitor for bleeding >Teach patient all aspects of drug therapy need to complete entire course of medication, even if feeling better. >Advise patient to report sore throat, fever, fatigue, unusual bleeding, or bruising(could indicate bone marrow depression.