Gener|c name 1ranexamlc acld 8rand name nemostan llbrlnon Cyklokapron LysLeda 1ransamln

C|ass|f|cat|on AnLlflbrlnolyLlc anLlhemorrhaglc

Ind|cat|ons
1ranexamlc acld ls used for Lhe prompL and effecLlve conLrol of hemorrhage ln varlous surglcal and cllnlcal areas
1reaLlng heavy mensLrual bleedlng
Pemorrhage followlng denLal and/or oral surgery ln paLlenLs wlLh hemophllla
ManagemenL of hemophlllc paLlenLs (Lhose havlng lacLor vlll or lacLor lx deflclency) who have oral mucosal bleedlng or are undergolng LooLh exLracLlon or oLher oral surglcal procedures
Surglcal Ceneral surglcal cases buL mosL especlally operaLlve procedures on Lhe prosLaLe uLerus Lhyrold lungs hearL ovarles adrenals kldneys braln Lonslls lymph nodes and sofL Llssues
CbsLeLrlcal and gynecologlcal aborLlon posLparLum hemorrhage and menomeLrorrahgla
Medlcal eplsLaxls hemopLysls hemaLurla pepLlc ulcer wlLh hemorrhage and blood dyscraslas wlLh hemorrhage
LffecLlve ln promoLlng hemosLasls ln LraumaLlc ln[urles
revenLlng hemorrhage afLer orLhopedlc surgerles
Mechan|sm of Act|on
1ranexamlc acld ls a synLheLlc derlvaLlve of Lhe amlno acld lyslne lL exerLs lLs anLlflbrlnolyLlc effecL Lhrough Lhe reverslble blockade of lyslneblndlng slLes on plasmlnogen molecules AnLl
flbrlnolyLlc drug lnhlblLs endomeLrlal plasmlnogen acLlvaLor and Lhus prevenLs flbrlnolysls and Lhe breakdown of blood cloLs 1he plasmlnogenplasmln enzyme sysLem ls known Lo cause
coagulaLlon defecLs Lhrough lyLlc acLlvlLy on flbrlnogen flbrln and oLher cloLLlng facLors 8y lnhlblLlng Lhe acLlon of plasmln (flnronolysln) Lhe anLlflbrlnolyLlc agenLs reduce excesslve
breakdown of flbrln and effecL physlologlcal hemosLasls
Contra|nd|cat|ons
Allerglc reacLlon Lo Lhe drug or hypersenslLlvlLy
resence of blood cloLs (eg ln Lhe leg lung eye braln) have a hlsLory of blood cloLs or are aL rlsk for blood cloLs
CurrenL admlnlsLraLlon of facLor lx complex concenLraLes or anLllnhlblLor coagulanL concenLraLes
recaut|ons
regnancy 1ranexamlc acld crosses Lhe placenLa
LacLaLlon 1ranexamlc acld ls dlsLrlbuLed lnLo breasL mllk concenLraLlons reach approxlmaLely 1 of Lhe maLernal plasma concenLraLlon
ConLracepLlves esLrogenconLalnlng oral or LsLrogens ConcurrenL use wlLh Lranexamlc acld may lncrease Lhe poLenLlal for Lhrombus formaLlon
8enal funcLlon lmpalrmenL (medlcaLlon may accumulaLe dosage ad[usLmenL based on Lhe degree of lmpalrmenL ls recommended)
PemaLurla of upper urlnary LracL orlgln (rlsk of lnLrarenal obsLrucLlon secondary Lo cloL reLenLlon ln Lhe renal pelvls and ureLers lf hemaLurla ls masslve also lf hemaLurla ls assoclaLed wlLh
a dlsease of Lhe renal parenchyma lnLravascular preclplLaLlon of flbrln may occur and exacerbaLe Lhe dlsease)
Nurs|ng kespons|b|||t|es
unusual change ln bleedlng paLLern should be lmmedlaLely reporLed Lo Lhe physlclan
lor women who are Laklng 1ranexamlc acld Lo conLrol heavy bleedlng Lhe medlcaLlon should only be Laken durlng Lhe mensLrual perlod
1ranexamlc Acld should be used wlLh exLreme cauLlon ln CPlLu8Ln younger Lhan 18 years old safeLy and effecLlveness ln Lhese chlldren have noL been conflrmed
1he medlcaLlon can be Laken wlLh or wlLhouL meals
Swallow 1ranexamlc Acld whole wlLh plenLy of llqulds uo noL break crush or chew before swallowlng
lf you mlss a dose of 1ranexamlc Acld Lake lL when you remember Lhen Lake your nexL dose aL leasL 6 hours laLer uo noL Lake 2 doses aL once
lnform Lhe cllenL LhaL he/she should lnform Lhe physlclan lmmedlaLely lf Lhe followlng severe slde effecLs occur Severe allerglc reacLlons such as rash hlves lLchlng dyspnea LlghLness ln Lhe
chesL swelllng of Lhe mouLh face llps or Longue Calf paln swelllng or Lenderness ChesL paln Confuslon Coughlng up blood uecreased urlnaLlon Severe or perslsLenL headache
Severe or perslsLenL body malalse ShorLness of breaLh Slurred speech Slurred speech vlslon changes


Gener|c Name Pydralazlne 8rand Name Apresollne
C|ass|f|cat|on AnLlhyperLenslve vasodllaLor
Ind|cat|ons
ModeraLe Lo severe hyperLenslon (wlLh a dlureLlc) Lowerlng hlgh blood pressure helps prevenL sLrokes hearL aLLacks and kldney problems
CPl unresponslve Lo convenLlonal Lherapy wlLh ulgoxln and dlureLlcs
Mechan|sm of Act|on
Pydralazlne ls a vasodllaLor LhaL works by relaxlng Lhe muscles ln Lhe blood vessels Lo help Lhem dllaLe (wlden) 1hls lowers blood pressure and allows blood Lo flow more easlly Lhrough Lhe
velns and arLerles
Contra|nd|cat|ons
PypersenslLlvlLy Severe Lachycardla ulssecLlng aorLlc aneurysm PearL fallure wlLh hlgh cardlac ouLpuL Cor pulmonale Myocardlal lnsufflclency due Lo mechanlcal obsLrucLlon
Coronary arLery dlseas ldlopaLhlc SLL aLlenLs wlLh recenL Ml
Use caut|ous|y |n
Cardlovascular or Cerebrovascular dlsorders lschemlc hearL dlsease rheumaLlc hearL dlsease affecLlng Lhe mlLral valve Severe renal and hepaLlc dlsease regnancy
LacLaLlon Chlldren
Adverse 8eacLlons and Slde LffecLs
ulzzlness urowslness Peadache 1achycardla Anglna
ArrhyLhmlas Ldema CrLhosLaLlc hypoLenslon ularrhea nausea and vomlLlng 8ashes Sodlum reLenLlon ArLhralglas ArLhrlLls erlpheral neuropaLhy urug lnduced lupus syndrome
Nurs|ng kespons|b|||t|es
MonlLor Lhe cllenL's blood pressure and pulse frequenLly durlng lnlLlal dosage ad[usLmenL and perlodlcally LhroughouL Lherapy 8eporL slgnlflcanL changes Lo Lhe physlclan
MonlLor frequency of prescrlpLlon refllls Lo deLermlne adherence
rlor Lo and perlodlcally durlng prolonged Lherapy Lhe followlng lab values should be monlLored C8C elecLrolyLes LL Cell rep and AnA LlLer
1he nurse musL be aware LhaL Pydralazlne may cause a poslLlve dlrecL Coomb's LesL resulL
lM or lv rouLe should be used only when Lhe drug cannoL be glven orally
Pydralazlne may be admlnlsLered concurrenLly wlLh dlureLlcs or beLa blockers Lo permlL lower doses and mlnlmlze slde effecLs


Gener|c Name uexameLhasone 8rand Name CorLasLaL ualalone uecadrol ueca[ecL ueronll uexacorLen uexameLh uexasone uexone Pexadrol rlmeLhasone Solurex
C|ass|f|cat|on Long acLlng corLlcosLerold
Ind|cat|ons
ManagemenL of cerebral edema ulagnosLlc agenL ln adrenal dlsorders 8elleves lnflammaLlon Allerglc dlsorders AsLhma ArLhrlLls
Mechan|sm of Act|on
uexameLhasone suppresses lnflammaLlon and Lhe normal lmmune response lL prevenLs Lhe release of subsLances ln Lhe body LhaL causes lnflammaLlon
Contra|nd|cat|ons
PypersenslLlvlLy AcLlve unLreaLed lnfecLlon LacLaLlon SysLemlc fungal lnfecLlon
Use Caut|ous|y |n
Chlldren (chronlc use may resulL ln decreased growLh) SLress (surgery or lnfecLlons) oLenLlal lnfecLlons as dexameLhasone may mask Lhe slgns of lnfecLlon such as fever and lnflammaLlon
regnancy (safeLy ls noL esLabllshed wlLh Lhe sue of Lhe drug durlng pregnancy)
S|de Lffects
Acne uecreased wound heallng uepresslon vomlLlng Lasy brulslng Peadache lncreased halr growLh lnsomnla 8esLlessness SLomach lrrlLaLlon lrregular or absenL mensLruaLlon
ulzzlness
Adverse react|ons
lf Lhese slgns and sympLoms wlll be noLed lnsLrucL Lhe paLlenL Lo call or noLlfy Lhe physlclan lmmedlaLely
Skln rash Swollen face legs or ankles (fluld reLenLlon) vlslon problems ( uexameLhasone may cause caLaracLs and lncreased lnLraocular pressure) Cold or lnfecLlon LhaL lasL for a long Llme
Muscle weakness 8lack or Larry sLool (suggesLlve of pepLlc ulceraLlon caused by uexameLhasone use)
Nurs|ng Intervent|ons
MonlLor lnLake and ouLpuL of paLlenL
Cbserve Lhe paLlenL for perlpheral edema sLeady welghL galn rales or crackles or dyspnea noLlfy Lhe physlclan lmmedlaLely lf Lhese cllnlcal manlfesLaLlons are noLed
erlodlc growLh evaluaLlon for chlldren should be done Llme Lo Llme
lor paLlenLs wlLh cerebral edema assess Lhen for level of consclousness changes and headache durlng Lhe Lherapy
CualacLesL sLools should be carrled ouL CualacposlLlve sLools should be reporLed Lo Lhe physlclan lmmedlaLely
AdmlnlsLer wlLh meals Lo mlnlmlze Cl lrrlLaLlon
lnsLrucL paLlenL Lo avold people wlLh known lnfecLlon and conLaglous lllnesses as corLlcosLerolds causes lmmunosuppresslon and may mask sympLoms of lnfecLlon