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Ranitidine Hydrochloride

Generic Name Ranitidine hydrochloride Brand Name Novo-Ranitiide Zantac Drug Classification Histamine2 (H2) antagonist Anti-ulcer agent Dosages Therapeutic Actions Inhibits the action of histamine at the H2 receptors of the parietal cells of the stomach inhibiting basal gastric acid secretion and gastric acid secretion that is stimulated by food, insulin, histamine, cholinergic agonists, gastrin, and pentagastrin. Contraindications > Contraindicated with allergy to ranitidine, lactation > Use cautiously with impaired renal or hepatic function. Indications > Short-term treatment of active duodenal ulcer. > Maintenance therapy for duodenal ulcer at reduced dosage. > Short-term treatment of active, benign gastric ulcer. > Pathologic hypersecretory conditions. > Treatment of erosive esophagitis. > Treatment of heartburn, acid indigestion, sour stomach. Side Effects CNS: headache, malaise, dizziness, somnolence, insomnia, vertigo CV: tachycardia, bradycardia, PVCs (rapid lV administration) Dermatologic: rash, alopecia Gl: constipation, diarrhea, nausea, vomiting, abdominal pain, hepatitis. Local: pain at lM site, local burn or itching at lV site Nursing Actions > Administer drugs with meals and hs. > Decrease dosage in renal and liver failure. > Provide concurrent antacid therapy to relieve pain. > Administer lM dose undiluted, deep into large muscle group. > Arrange for regular follow-up including blood tests to evaluate effects.

Ulcer: 150mg PO bid 300mg PO hs or 50mg lV q6-8h GERD: 300mg PO bid Dyspepsia: 75mg PO daily-bid

Tramadol Hydrochloride
Generic Name Tramadol hydrochloride Brand Name Ultram Drug Classification Centrally acting analgesic Dosages Therapeutic Actions Binds to mu-opioid receptors and inhibits the reuptake of norepinephrine and serotonin. Contraindications > Contraindicated with allergy to tramadol or opioids or acute intoxication with alcohol opioids or psychoactive drugs. > Use cautiously in pregnancy, lactation, seizures, concomitant use of CNS depressants or MAOls, renal dysfunction or hepatic impairment. Indications > Relief of moderate to moderately severe pain. Side Effects CNS: sedation, dizziness, or vertigo, headache, confusion, dreaming, sweating, anxiety, seizures. CV: hypotension, tachycardia, bradycardia. Dermatologic: sweating, pruritus, rash, pallor, urticaria. Gl: nausea, vomiting, dry mouth, constipation, flatulence, Nursing Actions > Culture infection, and arrange for sensitivity tests before and during therapy if expected response is not seen. > Give oral drug with food to decrease Gl upset and enhance absorption. > Crushing the drug results in a bitter unpleasant taste. > Have Vit. K available in case hypothrombinemia occurs. > Discontinue if hypersensitivity reactions occurs. > instruct patient to take full course of therapy even if you are feeling better.

50=100mg PO q4-6h PRN; do not exceed 400mg/day

Other: potential for abuse

Cefuroxime
Generic Name Cefuroxime Brand Name Ceftin (PO) Zinacef (parenteral) Drug Classification Antibiotic Cephalosporin (2nd gen) Dosages Therapeutic Actions Bactericidal: inhibits synthesis of bacterial cell wall, causing cell death. Indications > Pharyngitis tonsillitis caused by Streptococcus pyogenes. > Otitis media caused by S.pneumoniae, H.influenzae, Moraxella catarrhalis, S.pyogenes > Lower respiratory infections caused by S. pneumoniae, H. influenza > UTls caused by E.coli, klebsiela pneumonia > Uncomplicated gonorrhea Contraindications > Contraindicated with allergy to cephalosphorins or penicillins > Use cautiously with impaired renal or hepatic function. paresthesia. Gl: nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence, liver toxicity Hematologic: bone marrow depression (decreased WBC, platelets and Hct) Hypersensitivity: rash, fever, anaphylaxis Local: pain, abscess, at injection site, phlebitis, inflammation at lV site. Side Effects CNS: headache, dizziness, lethargy, Nursing Actions > Administer drugs with meals and hs. > Decrease dosage in renal and liver failure. > Provide concurrent antacid therapy to relieve pain. > Administer lM dose undiluted, deep into large muscle group. > Arrange for regular follow-up including blood tests to evaluate effects.

750mg -1.5g lV q6h or 250-500mg PO bid

Mefenamic Acid
Generic Name Mefenamic acid Brand Name Ponstel Drug Classification Non-steroidal anti inflammatory drug (NSAlD) Dosages Therapeutic Actions Anti-inflammatory, analgesic, and antipyretic activities related to inhibition of prostaglandin synthesis. Contraindications > Contraindicated with hypersensitivity to mefenamic acid > Use cautiously with asthma, renal or liver dysfunction, peptic ulcer disease, Gl bleeding, hypertension, CHF, pregnancy or lactation. Indications > Relief of moderate pain when therapy will not exceed 1wk. > Treatment of primary dysmenorrhea. Side Effects CNS: headache, malaise, dizziness, somnolence, insomnia, fatigue, tiredness, dizziness, tinnitus Dermatologic: rash, pruritus, sweating, dry mucus membranes Gl: nausea, dyspepsia, Gl pain, diarrhea, vomiting, constipation GU: dysuria, renal impairement Hematologic: bleeding, decreased Hgb or Hct Respiratory: dyspnea, hemoptysis, pharyngitis, bronchospasm, rhinitis Other: anaphylactic shock Nursing Actions > Give with milk or food to decrease Gl upset > If overdose occurs, institute emergency procedures gastric lavage, induction of emesis and supportive therapy. > instruct patient that dizziness or drowsiness may occur (avoid driving and using dangerous machinery).

500mg PO initially followed by 250mg q6hr PRN.

Carbocisteine
Generic Name Carbocisteine Brand Name Solmux Drug Classification Mucolytic Dosages Therapeutic Actions Reduces viscosity of the sputum and so can be used to help relieve the symptoms of COPD and bronchiectasis by allowing the patient to bring up the sputum easily. Contraindications > Contraindicated with hypersensitivity to carbocisteine. > Avoid carbocisteine in patients with active stomach or intestinal ulcer. Indications > Relief of cough characterized by excessive of sticky sputum or phlegm to help treat respiratory tract disorders such as acute or chronic bronchitis and COPD. > Treatment of otitis media with effusion and glue ear. Side Effects Gl: stomach and intestinal discomfort Nursing Actions > Give the medicine with care on patients with stomach or intestinal ulcer and Gl bleeding. > instruct the patient to seek medical attention if skin rashes or stomach/ intestinal bleeding occurred.

Dermatologic: rash

Oral: 500mg capsule PO q8hr