Name of Drugs

Rebamipide

Dosage/Route/ Frequency 1 tab NGT TID

Indication Treatment of gastritis, Peptic ulcer.

Contraindication

Side Effects
Rash, pruritus, constipation, diarrhea, nausea.

Action
mucosal protective agent and is postulated to increase gastric blood flow, prostaglandin biosynthesis and decrease free oxygen radicals.

Nursing Considerations

Lactulose

30 cc NGT OD

Constipation

Patients who require low lactulose diet. Galactosaemia or disaccharide deficiency. Intestinal obstruction

Abdominal discomfort associated with flatulence and intestinal cramps. Nausea, vomiting, diarrhea on prolonged use

Causes an influx of fluid in the intestinal tract by increasing the osmotic pressure within the intestinal lumen

Assess patient s condition before therapy and reassess regularly thereafter to monitor drug s effectiveness. Identify cause of constipation :Assess lifestyle in relation to fluids, bulk and exercise. Monitor for possible adverse GI reaction: nausea, vomiting, abdominal cramps, belching, diarrhea, flatulence and distention. Monitor fluid and electrolyte status: UO, hypokalemia or hypernatremia. Assess patient s fever or pain:type of pain, location, intensity, duration, temperature, diaphoresis. Assess allergic reactions: rash, urticaria; if this occur, drug may have to be discontinued. Assess hepatoxicity: dark urine, clay-colored stools, yellowing of skin and sclera. Monitor liver and renal functions: AST, ALT, bilirubin,pro-time, BUN, CREA. Check intake and output ratio: decreasing output may indicate renal failure. Assess patient s condition before therapy and

Paracetamol

500 mg tab NGT Q4 PRN

Relief of mildmoderate pain; treatment of fever.

Hypersensitivity, intolerance to tartrazine(yellow dye #5), alcohol, table sugar, saccharin.

Hypersensitivity,Drowzi ness, nausea, vomiting, abdominal pain, hepatoxicity, renal failure(high, prolonged doses)

Decreases fever by inhibiting the effects of pyrogens on the hypothalamic heat regulating centers and by a hypothalamic action leading to sweating and vasodilation. Limits seizure

y y y y y

Phenytoin

1 cap NGT OD

TONIc-clonic and

Sinus bradycardia,

GI disturbances, ataxia,

psychomotor seizures, seizures occurring during or following neurosurgery.

SA block, AV blocks II and III, AdamsStoke Syndrome.

slurred speech, diplopia, nystagmus and mental confusion with headache, gingival hyperplasia, dizziness.

activity by stabilizes neuronal membranes of hyper excitable cells through decreasing influx of sodium during action potential, influx of calcium is also decreased.

y y y y y y

reassess regularly thereafter to monitor drug s effectiveness. Assess seizure: type, location, duration and character. Assess for and report allergic reaction:red raised rash and increased temperature. Monitor drug level: therapeutic level 7.5-20 mcg/ml, toxic level 30-50 mcg/ml. Monitor possible drug induced adverse reactions Assesss renal studies: urinalysis, BUN, urine creatinine. Monitor liver and renal functions: AST, ALT, bilirubin,pro-time, BUN, CREA. Obtain baseline assessment of iron deficiency before starting therapy. Evaluate hemoglobin, hematocrit, and reticulocyte count during therapy. Monitor for adverse reactions:nausea, epigastric pain, diarrhea, constipation. Assess bowel elimination, increase water, bulk and activity if constipation occurs. Assess diet and nutrition: amount of iron in diet(meat, dark green leafy vegetables, dried beans, dried fruits, eggs) Identify cause of iron loss or anemia(salicylates, sulfonamides, antimalarials, quinidine) Obtain history of GI status, bowel disorder, fluid intake, nutritional status and exercise habits. Assess abdominal pain, rectal bleeding, nausea, vomiting . Monitor frequency and character of stools. Monitor occurrence of adverse reactions.

FeSO4

1 cap NGT OD

Prevention and Hypersensitivity to treatment of iron- any ingredient, deficiency anemia. hemosiderosis, hemolytic anemia.

GI irritation, anorexia, nausea, vomiting, diarrhea, constipation, dark stool. Teeth staining with liquid formulation.

Provides or replaces elemental iron, an essential component in formation of hemoglobin in red blood cell development.

y y y y y

y Bisacodyl 1 supp rectum if - BM for 2 days Constipation Nausea, vomiting, or Occasional abdominal other symptoms of discomfort, soreness in appendicitis; acute the anal region. surgical abdomen;fecal impaction; intestinal obstruction; Increases peristalsis and motor activity of the small intestines by muscles. May stimulate colonic y y y y

ulcerative lesions of the colon; renal fissures.

Citicoline

1 cap NGT OD

Ciprofloxacin

500 mg 1 tab NGT BID

Symptoms and signs of cerebral insufficiency i.e., dizziness, headache, poor concentration, memory loss, disorientation. Recent cranial trauma and their sequelae. Infections of the respiratory tract, ears, paranasal sinuses, eyes, kidneys, and/or urinary tract,abdominal cavity, skin and soft tissue, bones and joints,infections or imminent risk of infection in patients whose immune system has been weakened, complicated uti.

Hypertonia of the parasympathetic nervous system.Meclofenoxa te(clophenoxate).

Shock, hypersensitivity, hypotension, insomnia, excitement.Stimulates parasympathetic action and fleeting and discreet hypotensor effect.

Hypersensitivity to quinolones. Concurrent administration with tizanidine. Drugs that inhibit peristalsis.

Nausea, diarrhea, vomiting, rash, transient increase in transaminases.

intramural plexus and promote fluid accumulation in the intestines and colon. Citicoline is a derivative of choline and cytidine involved in the biosynthesis of lecithin. It is claimed to increase blood flow and oxygen consumption in the brain. Inhibits bacterial DNA gyrase thus preventing replication in susceptible bacteria.

y y y y y

Evaluate patient medical history Assess patient condition Monitor blood pressure, pulse, and heart rate Assess allergic reaction like gastrointestinal disturbances. Must not be administered to patients with hypertonia of the parasympathetic nervous system.

y y

y y

Assess patient for previous sensitivity reaction. Assess patients for signs and symptoms of infection before and during treatment: fever earache, characteristics of wounds, sputum, urine, stool and WBC > 10,000/mm3 Assess reaction and anaphylaxis: rash, urticaria, pruritis, chills, fever, wheezing, laryngeal edema or joint pain. Assess renal studies: urinalysis, BUN, urine creatinine. Monitor hematologic, electrolyte and hepatic status if patient is on long term therapy. Hematologic : bleeding, gums, hematuria, stool guaiac, CBC and Hct.Electrolyte: sodium, potassium and chloride Hepatic:AST, ALT, LDH, bilirubin, alkaline phosphates and Coomb s test monthly. Assess for possible adverse reactions: headache,

y Omeprazole 40mg NGT OD Short-term treatment of active duodenal ulcer, GERD, including erosive esophagitis. Hypersensitivity. Angina, tachycardia, bradycardia, palpitation, headache, dizziness, rash, diarrhea, abdominal pain,acid regurgitation, nausea, vomiting, constipation. Supresses gastric secretion by inhibiting hydrogen/pottasiu m.ATPase enzyme system in the gastric parietal cell: characterized as a gastric acid pump inhibitor, since it blocks the final step of acid production. Decreases viscosity of respiratory tract secretions and promote their removal by breaking disulfide bonds. Inhibits bacterial cell wall synthesis, rendering cell wall osmotically unstable, leading to cell death. y y

y y

seizures, nausea, vomiting, diarrhea, joint pain and inflammation. Assess for possible superinfection: perineal itching, fever, malaise, redness, pain, swelling. Assess other medications patients maybe taking for effectiveness and interactions. Monitor therapeutic effectiveness and adverse reactions at beginning of therapy and periodically throughout therapy. Assess GI system: bowel sounds 8 hrly,abdomen for pain and swelling, appetite loss Monitor hepatic enzymes: AST, ALT, increased alkaline phosphatase during treatment.

Acetylcystein

600 mg 1 tab NGT OD

Treatment of respiratory affections characterized by thick and viscous hypersecretions.

Hypersensitivity. Phenylketonuria(co ntains aspartame)

nausea, vomiting and other GI symptoms, generalized urticaria accompanied by mild fever, hypotension, wheezing, dyspnea, and stomatitis. Rash, pruritus, urticaria, nausea, vomiting, diarrhea, headache, fever.

y y

Assess patients history of underlying condition, cough:type, frequency, character. Assess patients respiration and pulmonary secretions , exercise caution on patients with respiratory insufficiency and history of bronchospasm.

Cefepime

1 g x 7 days NGT q8

Treatment of espiratory tract infection, including pneumonia and bronchitis, UTI.

Hypersensitivity to beta-lactam antibiotics.

y y y

Assess patients previous sensitivity reaction to penicillin or other cephalosporins. Assess patient for sign and symptoms of infection before and during treatment Assess reaction and anaphylaxis: rash, urticaria, pruritis, chills, fever, wheezing, laryngeal edema or joint pain. Assess renal studies: urinalysis, BUN, urine creatinine.Monitor for nephrotoxicity.

Monitor hematologic, electrolyte and hepatic status if patient is on long term therapy. Hematologic : bleeding, gums, hematuria, stool guaiac, CBC and Hct.Electrolyte: sodium, potassium and chloride Hepatic:AST, ALT, LDH, bilirubin, alkaline phosphates and Coomb s test monthly. Assess for possible superinfection: perineal itching, fever, malaise, redness, pain, swelling.

Meropenem

1g IV q8

Treatment of infections caused by single or susceptible bacteria sensitive to meropenem.Pneu monia, gynecological and skin and soft tissue infections.

Hypersensitivity to to carbapenems, penicillins and other beta-lactam antibiotics.

Rash, pruritus, urticaria. Abdominal pain, nausea, vomiting, diarrhea, headache, paresthesia.

Bactericidal, it interferes with bacterial cell wall replication of susceptible organisms. It readily penetrates the cell wall of most gram positive and gram negative bacteria to reach penicillinbinding protein targets whereit inhibits cell wall synthesis to render the cell wall osmotically unstable.

y y

Complete Culture and sensitivity tests before beginning drug therapy to identify correct treatment has been initiated. Assess patient for previous sensitivity reaction to carbapenem antibiotics, penicillins, cephalosporins and other beta lactams. Assess patients for signs and symptoms of infection before and during treatment: fever earache, characteristics of wounds, sputum, urine, stool and WBC > 10,000/mm3 Assess reaction and anaphylaxis: rash, urticaria, pruritis, chills, fever, wheezing, laryngeal edema or joint pain. Assess for anemia(fatigue, headache, irritability, faintness and shortness of breath)and bleeding (ecchymosis, bleeding gums, hematuria and stool guaiac).Monitor CBC, Hgb and Hct. Assess for possible superinfection: perineal itching, fever, malaise, redness, pain, swelling. Assess renal and hepatic status.Monitor: urine output,BUN,CREA, AST, ALT, LDH, bilirubin, alkaline phosphates and Coomb s test monthly if patient is on long term therapy.

Mannitol

75 cc IV q6

Reduction of increased intracranial pressure associated with cerebral edema,reductiono of increased intraocular pressure; promoting urinary excretion of toxic substances. Treatment of hypertension alone or in combination with other antihypertensive drugs.

Hypersensitivity.Sev ere renal renal disease, severe dehydration, pulmonary congestion.Severe pulmonary edema.

Dizziness, headache, convulsions, rebound increase ICP, confusion, seizures, and fever.thrombophlebitis edema, hypotension, hypertension,chest pain, blurred vision.Nausea, vomiting.

Increases the osmotic pressure of glumerular filtrate, which inhibits tubular reabsorption of water and electrolytes and increases urinary output.

y y

y y y

Tranexamic acid

500 mg IV q6

Hypersensitivity to to tradolapril, or ACE inhibitors.

Dizziness, headache, fatigue, syncope, depression, anxiety, Nausea, vomiting, constipation, hyperkalemia, hyponatremia, hypocalcemia.

Celecoxib

200 mg 1 cap NGT OD

Acute or chronic use of in the treatment of the signs and symptoms of osteoarthritis,

Known sulfonamide hypersensitivity.Ast hma, urticaria, or allergic type reactions after taking aspirins or

Constipation, diverticulitis, dysphagia, esophagitis, gastritis, GERD, hiatal hernia, melena, dry mouth, vomiting,

ACE inhibitors that leads to vasodilation and selectively suppresses renninangiotensinaldosterone system.Interupts conversion sequences which leads to angiotensin II from angiotensin I. Inhibits prostaglandin synthesis by selectively inhibiting cyclooxygenase-

y y y y

Assess patient s condition before therapy and regularly thereafter to monitor drug effectiveness. Assess neurologic status if drug is given for increased ICP: LOC, ICP reading, pupil size and reaction. Assess patient for tinnitus, hearing loss and ear pain. Assess for possible drug induced adverse reactions. Assess fluid volume status, hypovolemia or hypervolemia: urine output ratio, skin turgor, peripheral edema, breath sounds, thirst and hypotension.Monitor VS. Obtain patient history Obtain patients hypersensitivity to any drugs Monitor BP closely after initiation of therapy and also during the first 2 weeks. Monitor for any signs of hypersensitivity including angioedema involving swelling of the face, tongue and lips. Monitor lab tests: Monitor BP and cardiac status, serum potassium and sodium, creatinine, and ALT/SGPT and WBC.

Assess for appropriateness of therapy for pain:rheumatoid arthritis, osteoarthritis and inflammation of joints. Use cautiously in patients with history of GI bleeding, hypertension, heart failure or asthma. Check range of motion. Monitor blood counts during therapy: watch for

rheumatoid athritis

other NSAIDS.

Clindamycin

300 mg IV q6

Serious anaerobic infections especially those caused by Bacteroides fragilis. Alternative to penicillin in some severe staphylococcal and streptococcalinfec tions, including staphylococcal osteomyelitis.

Hypersensitivity to lincosamides. Patients with colitis and diarrhea.

hypertension, headache, dizziness, chest pain, fatigue, fever, earache, coughing, blurred vision. GI disorders: nausea,vomiting, abdominal cramps, abnormal taste, diarrhea.

2.Relieves pain and inflammation.

decreasing platelets; if low, therapy may need to be discontinued, restarted after hematologic recovery; and for blood dyscrasias leeding, poor healing., bruising, fatigue, b

Inhibits bacterial protein synthesis by binding to the 5os subunit of the ribosomes.

Assess patients for signs and symptoms of infection including characteristics of wounds, sputum, urine, stool and WBC > 10,000/mm3 ,fever. Assess complete culture and sensitivity testing before start of drug therapy; to identify correct treatment to be initiated. Assess patient with poor renal function; drug is excreted slowly in poor renal system function; toxicity may occur rapidly. Assess for allergic reactions: rash, urticaria, pruritis, chills, fever, wheezing, laryngeal edema or joint pain. Monitor urine output; if decreasing, notify physician (may indicate nephrotoxicity); also check for BUN and creatinine levels. Monitor blood studies: AST, ALT, CBC, Hct, bilirubin, LDH, alkaline phosphates,and Coomb s test monthly if patient is on long term therapy.

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