DRUG Generic: Rivaroxaban Brand: Xarelto Classification: Antiplatelet Dosage:

10 mg tablets:

MODE OF ACTION Xarelto (rivaroxaban) is an orally bioavailable factor Xa inhibitor that selectively blocks the active site of factor Xa and does not require a cofactor (such as Antithrombin III) for activity. Activation of factor X to factor Xa (FXa) via the intrinsic and extrinsic pathways plays a central role in the cascade of blood coagulation.

INDICATION Prevention of venous thromboembolism (VTE) in adult patient undergoing elective hip or knee replacement surgery. Prevention of stroke & systemic embolism in patients w/ non-valvular artrial

CONTRAINDICATION Active pathological bleeding Severe hypersensitivity reaction to XARELTO (eg, anaphylactic reactions)

SIDE EFFECTS Epistaxis, peripheral edema, dizziness, anemia, increase transaminase, postprocedural hemorrhage

Route: Oral Frequency: 1x a day

NURSING RESPONSIBILITY 1.Note condition(s) requiring therapy, onset, estimated duration of therapy. Give initial (po) at least 6 to 10 hr after surgery once hemostasis has been established. Usual duration of therapy is 35 days following hip replacement or 12 days following knee replacement surgery. 2. List drugs prescribed to ensure none interact. Monitor all sites, incisions, orifices for bleeding. Assess mobility and adherence to exercise program.

DRUG Generic: Vitamin C Brand: Ascorbic Acid Classification: Vitamins Dosage:1 tab per day Route: Oral Frequency: 1x a day

MODE OF ACTION Needed for wound healing, collagen synthesis, antioxidant, carbohydrate metabolism, protein, lipid synthesis, prevention of infection

INDICATION Vitamin C is a compound that is necessary for proper growth and health. They are needed in small amounts only and are usually available in the normal foods that are ingested. Ascorbic acid( vitamin C) is necessary for wound healing. Vit C plays a major role in many oxidative and other metabolic reactions

CONTRAINDICATION Tartrazine, sulfite sensitivity; G6PD May be contraindicated in patients with hemolytic anemia

SIDE EFFECTS Nausea, vomiting, diarrhea, anorexia, heartburn ramps Headache, insomnia, dizziness, fatigue, flushing Polyuria, urine acidification, oxalate or urate renal stones, dysuria

NURSING RESPONSIBILITY 1.Assess nutritional status for inclusion of foods high in vit.C: citrus fruits, cantaloupe, tomatoes 2. Assess for vit.C deficiency before, during & after treatment; scurvy (gingivitis, bleeding gums, loose teeth) ; poor bone development 3. Monitor I & O ratio, polyuria; in patients

essential for formation and stabilization of collagens,conversion of folic acid to folinic acid, synthesis of adrenal steroids and catacholamines.It is very important for maintanance of intracellular tissue.

receiving large doses renal stones may occur

DRUG Generic: Multivitamins Brand: Multimeeds Classification: Vitamins Dosage: 1 tab per day Route: Oral Frequency: 1x a day

MODE OF ACTION Needed for adequate metabolism

INDICATION
PO: Treatment and prevention of vitamin deficiencies. Special formulations are available for patients with particular needs, including: o Prenatal multiple vitamins (with larger doses of folic acid), o o o o Preconceptional multiple vitamins, Multiple vitamins with iron, Multiple vitamins with fluoride, Multiple vitamins with other minerals or trace elements. IV: Treatment and prevention of vitamin deficiencies in patients who are unable to ingest oral feedings or vitamins.

CONTRAINDICATION Hypersensitivity to preservatives, colorants, or additives, including tartrazine, saccharin, and aspartame (oral forms) Some products contain alcohol and should be avoided in patients with known intolerance.

SIDE EFFECTS Rare at recommended dosage GU: urine discoloration (preparations with B vitamins) Misc: allergic reactions to preservatives, additives, or colorants

NURSING RESPONSIBILITY 1.Assess patient for vitamin deficiency; usually more than one vitamin deficiency present