Brand Name: Clexane

Generic Name: Enoxaparin sodium

Indications:

Prevent pulmonary embolism and deep vein thrombosis after hip or knee replacement surgery,
abdominal surgery, patients with acute illness who are at increased risk because of decreased mobility.
To prevent ischemic complications of unstable angina and non-Q-wave MI with oral aspirin theraphy.

Drug Classification: Anticoagulants

Mechanism of Action:

A low moleculer weight heparin derivative that accelerates formation of anti-thrombin III-thrombin
complex and deactivates thrombin, preventing conversion of fibrinogen to fibrin. Has higher anti-factor
Xa to antifactor IIa activity ratio.

Dosage:

Initially at 40mg SC q8 for 10 days.

Special Precaution:

History of Heparin induced thrombocytopenia with or without thrombosis. Do not administer by IM

route. Renal or hepatic insufficiency, History of hepatic ulcer, arterial hypertension, diabetic retinophaty,
shortly after neuro or ophth surgery.

Pregnancy Risk: B

Adverse Reaction:

Hemorrhage. Thrombocytopenia. Local reactions (Small local hematoma). Exceptional cases of skin
necrosis. Rarely cutaneous or systemic allergic reaction. Increase liver enzymes.

Contraindications:

Conditions with high risk of uncontrolled hemorrhage including major bleeding disorders.

Form: Ampules 30mg/0.3 ml, Syringes (prefilled) 30mg/0.3 ml, 40mg/0.4 ml, Vial 300mg/3ml

Nursing Responsibilities:

Monitor pregnant women using the drug

Instruct patient and family to watch for signs of bleeding or abnormal bruising and to notify prescriber
immediately if any occur.

Tell patient to avoid OTC drugs containing aspirin or other salicylates unless ordered by physician.
GENERIC NAME: Pantoprazole

BRAND NAME: Protonix

DRUG CLASS AND MECHANISM: Pantoprazole is in a class of drugs called proton pump inhibitors
(PPI) which block the production of acid by the stomach. Other drugs in the same class include
lansoprazole (Prevacid), omeprazole (Prilosec) and rabeprazole (Aciphex). Proton pump inhibitors are
used for the treatment of conditions such as ulcers, gastroesophageal reflux disease (GERD) and
Zollinger-Ellison Syndrome that are caused by stomach acid. Pantoprazole, like other proton-pump
inhibitors, blocks the enzyme in the wall of the stomach that produces acid. By blocking the enzyme, the
production of acid is decreased, and this allows the stomach and esophagus to heal.

GENERIC AVAILABLE: No

PRESCRIPTION: Yes

PREPARATIONS: Tablets: 40 mg . An intravenous form of pantoprazole is expected soon.

STORAGE: Store at room temperature, 15-30°C (59-86°F). Keep away from moisture.

PRESCRIBED FOR: Although pantoprazole is approved for the treatment of gastroesophageal reflux
disease (GERD), like other PPI's it also is used for treating ulcers of the stomach and duodenum, and the
Zollinger-Ellison Syndrome.

DOSING: For GERD the recommended dose for adults is 40 mg daily for 4-8 weeks.

It generally is recommended that tablets be taken approximately 30 minutes prior to meals for maximal
effectiveness. Tablets should be swallowed whole and should not be crushed, split or chewed.

DRUG INTERACTIONS: Pantoprazole is less likely than omeprazole to interact with other drugs.

The absorption of certain drugs may be affected by stomach acidity, and, as a result, pantoprazole and
other PPIs that reduce stomach acid also reduce the absorption and concentration in blood of
ketoconazole (Nizoral) and increase the absorption and concentration in blood of digoxin (Lanoxin). This
may lead to reduced effectiveness of ketoconazole or increased digoxin toxicity, respectively.

PREGNANCY: Use of pantoprazole in pregnant women has not been adequately evaluated.

NURSING MOTHERS: Pantoprazole has not been studied in nursing women.

SIDE EFFECTS: Pantoprazole like other PPIs is well-tolerated. The most common side effects are
diarrhea, nausea, vomiting, constipation, rash and headaches. Dizziness, nervousness, abnormal heartbeat,
muscle pain, weakness, leg cramps and water retention rarely occur.