Medication Mechanism of Indication Dosage & Frequency Contraindication Adverse Effects Nursing Considerations

Action
Amoxicillin/Clavulanate Amoxicillin inhibits Treatment of Usual Adult Dosage : Hypersensitivity to Antibiotic- Baseline assessment
bacterial cell wall susceptible PO: ADULTS, ELDERLY: 250 amoxicillin, clavulanate, associated colitis, Question for history of
Pharmacological Class: synthesis. infections due to mg q8h or 500 mg q8–12h or 875 any penicillins; other allergies, esp. penicillins,
penicillins and beta- Clavulanate inhibits streptococci, E. mg q12h or history of cholestatic superinfections cephalosporins, renal
lactamase inhibitors bacterial coli, E. faecalis, 2,000 mg q12h. jaundice or hepatic (abdominal cramps, impairment.
beta-lactamase. P. Usual Pediatric Dosage impairment with severe watery Intervention/evaluation
Therapeutic Class: Therapeutic Effect: mirabilis, beta- PO: CHILDREN OLDER THAN amoxicillin/clavulanate diarrhea, fever) may Promptly report rash,
Antibiotic Amoxicillin is lactamase 3 MOS, WEIGHING 40 KG OR therapy. Augmentin XR result from altered diarrhea (fever,
bactericidal in producing H. MORE: (additional): Severe renal bacterial balance in abdominal pain, mucus
susceptible influenzae, (Mild-Moderate): 500 mg q12h impairment (CrCl less GI tract. Severe and blood in stool
microorganisms. Klebsiella spp., or 250 mg q8h. (Severe): 875 mg than 30 mL/min), hypersensitivity may indicate antibiotic-
Clavulanate protects M. q12h or 500 hemodialysis pt. reactions, including associated colitis). Be
amoxicillin from catarrhalis, and mg q8h. (Extended-Release): Cautions: History of anaphylaxis, acute alert for signs of
enzymatic S. aureus (not 2,000 mg q12h. WEIGHING allergies, esp. interstitial nephritis, superinfection,
degradation. methicillin- LESS THAN 40 cephalosporins; renal occur rarely. including fever,
resistant KG: (Mild-Moderate): 25 impairment, infectious vomiting, diarrhea, black
Staphylococcus mg/kg/day in 2 divided doses or mononucleosis. "hairy" tongue,
aureus 20 mg/kg/day in 3 ulceration or changes
[MRSA]), divided doses. (Severe): 45 of oral mucosa,
including lower mg/kg/day in 2 divided doses or anal/genital pruritus.
respiratory, skin 40 mg/kg/day in 3 Monitor renal/hepatic
and skin divided doses. Maximum Single tests with prolonged
structure, UTIs, Dose: 500 mg. LESS THAN 3 therapy.
otitis MOS: Patient/family teaching
media, sinusitis. Amoxicillin 30 mg/kg/day • Continue antibiotic for
OFF-LABEL: divided q12h using 125 mg/5mL full length of treatment.
Chronic suspension only. • Space doses evenly.
antimicrobial Usual Neonate Dosage • Take with meals if GI
suppression of PO: NEONATES, CHILDREN upset occurs.
prosthetic YOUNGER THAN 3 MOS: 30 • Thoroughly crush or
joint infection. mg/kg/day chew the chewable
(125 mg/5 mL suspension) in tablets before
divided doses q12h. swallowing.
Dosage in Renal Impairment • Notify physician if
Do not use 875-mg tablet or rash, diarrhea, other new
extended-release tablets for symptoms occur.
creatinine
clearance less than 30 mL/min.
Dosage and frequency are
modified based on creatinine
clearance. Creatinine
 clearance 10–30 mL/min: 250–
500 mg q12h. Creatinine
clearance less than
10 mL/min: 250–500 mg q24h.
HD: 250–500 mg q24h, give dose
during and
after dialysis. PD: 250 mg q12h.
Dosage in Hepatic Impairment
Multivitamins Absorption: Well PO: Treatment PO (Adults and Children): 1 dose Contraindicated in: In recommended Assess patient for signs
absorbed from the and prevention of unit Hypersensitivity to doses, adverse of nutritional deficiency
Pharmacological Class: GI tract after oral vitamin (tablet/capsule/dropperful)/day or preservatives, colorants, reactions are before and throughout
Vitamins administration; deficiencies. amount recommended by or additives, including extremely rare GU: therapy.
some processes are Special individual manufacturer. tartrazine, saccharin, and urine discoloration Patients at risk include
Therapeutic Class: active, some are formulations are aspartame (oral forms); (preparations with B geriatric patients and
Vitamins passive. available for IV (Adults and Children): Some products contain vitamins). those who are
patients with Amount sufficient to meet RDA alcohol and should be debilitated, burned, or
Distribution: Widely particular needs, for age group. Usually added to avoided in patients with Misc: allergic unable to take oral
distributed; cross the including: large-volume parenteral or total known intolerance. reactions to nutrition and those with
placenta and enter Prenatal multiple parenteral nutrition preservatives, malabsorption
breast milk. Fat- vitamins (with Use Cautiously in: additives, or syndromes or chronic
soluble vitamins (A, larger doses of Patients with anemia of colorants. alcoholism
D, E, and K) are folic acid), undetermined cause.
stored in fatty Preconceptional
tissues and the liver. multiple
vitamins,
Metabolism and Multiple
Excretion: Utilized vitamins with
in various biologic iron, Multiple
processes. Excess vitamins with
amounts of water- fluoride,
soluble vitamins 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

Ferrous Sulfate
Pharmacological Class:
oral iron bivalent
preparations.
Mefenamic Acid
Pharmacological Class:
anthranilic acid derivative
class of NSAIDs
(fenamates).
Therapeutic Class:
Analgesic, NSAID;
Antipyretic
vitamins.
Ferrous sulfate Oral Adult: As elemental Fe: Haemochromatosis and Significant: Monitor Hb and
facilitates oxygen Treatment: 65-200 mg daily in 2- other Fe overload Hypersensitivity. haematocrit; RBC count
transport from the 3 divided doses. Prevention: 65 syndromes. Blood Gastrointestinal and indices, serum
lungs to tissues via mg daily. disorders (e.g. disorders: ferritin, transferrin
Hb. It is used as an Elderly: As elemental Fe: 15-50 paroxysmal nocturnal Blackening of stool, saturation, total Fe-
Fe source as it mg daily. haemoglobinuria, gastrointestinal binding capacity, serum
replaces Fe found in Child: As elemental Fe: haemolytic anaemia, irritation, nausea, Fe concentration, and
Hb, myoglobin, and Treatment: 3-6 mg/kg daily in 3 haemosiderosis); active vomiting, epigastric erythrocyte
other enzymes. divided doses. Max: 200 mg peptic ulcer, Crohn's pain, diarrhoea, protoporphyrin
daily. Prevention: ≥4 months disease, and ulcerative constipation, concentration.
Exclusively breastfed infants: 1 colitis. Patient receiving flatulence,
mg/kg daily; ≥6 months to <2 frequent blood abdominal
years 10-12.5 mg daily for 3 transfusions. discomfort, tooth
consecutive months in a year; 2- Concomitant parenteral discolouration,
<5 years 30 mg daily for 3 Fe therapy and mouth ulceration.
consecutive months; ≥5 years 30- dimercaprol.
60 mg daily for 3 consecutive
months.
Mefenamic acid, an Mild to moderate Adult: 500 mg tid. Alternatively, Hypersensitivity to Significant: Na and Monitor CBC, occult
anthranilic acid pain, initiate at 500 mg, followed by mefenamic acid; history fluid retention, blood loss, chemistry
derivative, is an Osteoarthritis, 250 mg 6 hourly as necessary, of hypersensitivity diarrhoea, new- profile, and LFTs
NSAID with Rheumatoid usually not more than 1 week. reaction (e.g. asthma, onset or worsening (periodically); renal
analgesic and arthritis, Use the lowest effective dose for rhinitis, angioedema, of hypertension, function (urine output,
antipyretic Menorrhagia, the shortest possible duration. urticaria) to aspirin or hyperkalaemia; serum BUN and
properties. It Primary Elderly: Use the lowest effective other NSAIDs. renal papillary creatinine). Closely
reversibly inhibits dysmenorrhoea, dose for the shortest possible Inflammatory bowel necrosis and other monitor blood pressure
cyclooxygenase-1 Fever. duration. disease, history of renal injury during initiation and
and 2 (COX-1 and Child: As oral susp: >6 months to gastrointestinal bleeding (prolonged use); throughout treatment.
2) enzymes resulting <2 years 25 mg/kg daily in or perforation related to may impair female Observe for signs and
in decreased divided doses or 50 mg 1-3 times previous NSAID therapy, fertility (prolonged symptoms of
formation of daily; 2-<5 years 100 mg 1-3 active gastrointestinal use); aseptic gastrointestinal bleeding.
prostaglandin times daily; 5-<9 years 150 mg 1- ulceration or bleeding, meningitis
precursors. 3 times daily; 9-<12 years 200 history of recurrent (particularly in
mg 1-3 times daily. As tab or cap: peptic ulcer disease or patients with
≥12 years Same as adult dose. haemorrhage (≥2 distinct autoimmune
Use the lowest effective dose for episodes of proven disorders),
the shortest possible duration. ulceration or bleeding), decreased platelet
Max treatment duration: 7 days severe heart failure. Use adhesion and
(except in the treatment of in the setting of CABG aggregation,
systemic onset juvenile chronic surgery. Severe renal and anaemia. Rarely,
arthritis). Treatment hepatic impairment. potentially severe
recommendations may vary Pregnancy (3rd blood dyscrasias
among countries and individual trimester). (e.g.
products (refer to specific agranulocytosis,
product guidelines). thrombocytopenia,
aplastic anaemia).
Cardiac disorders:
Cardiac failure,
palpitations.
Ear and labyrinth
disorders: Ear pain,
vertigo, tinnitus.
Eye disorders:
Blurred vision,
reversible loss of
colour vision, eye
irritation.
Gastrointestinal
disorders: Nausea,
vomiting,
dyspepsia,
constipation,
abdominal pain,
melaena,
haematemesis,
ulcerative
stomatitis,
exacerbation of
Crohn's disease and
colitis, pancreatitis,
steatorrhoea,
enterocolitis.
General disorders
and administration
site conditions:
Fatigue, malaise,
pyrexia.
Investigations:
Elevated LFTs.
Metabolism and
nutrition disorders:
Glucose intolerance
(in diabetic
patients),
hyponatraemia,
anorexia.
Nervous system
disorders:
Headache,
dizziness,
drowsiness,
paraesthesia,
convulsions.
Psychiatric
disorders:
Depression,
confusion,
hallucinations,
nervousness,
insomnia.
Renal and urinary
disorders: Dysuria,
haematuria, cystitis.
Respiratory,
thoracic and
mediastinal
disorders:
Dyspnoea.
Skin and
subcutaneous tissue
disorders: Rash,
pruritus, urticaria,
photosensitivity
reaction, alopecia,
perspiration.
Vascular disorders:
Hypotension.
Potentially Fatal:
CV thrombotic
events (including
MI and stroke),
gastrointestinal
inflammation,
bleeding, ulceration,
or perforation;
bronchospasm (in
patients with
aspirin-sensitive
 asthma). Rarely,
severe anaphylactic-
like reactions, drug
reaction with
eosinophilia and
systemic symptoms
(DRESS) or
multiorgan
hypersensitivity
reactions,
exfoliative
dermatitis, toxic
epidermal
necrolysis, Stevens-
Johnson syndrome,
severe hepatic
reactions (e.g.
fulminant hepatitis,
hepatic necrosis or
failure).
Malunggay Capsule Malunggay Natural health NATALAC: Take one (1) to two N/A N/A N/A
(Moringa oleifera supplement for (2) capsules daily for 2 weeks
Therapeutic Class: Lam.) has gained nursing mothers prior to giving birth and
analgesic, anti- acceptance as food especially those thereafter all throughout the
inflammatory, diuretic, supplement to help with inadequate lactation period.
antihypertensive, stimulate milk let- lactation. NATALAC FORTE: Take one (1)
antioxidant and anti-tumor down, improve milk capsule daily or as recommended
activities flow & milk by health professional.
production due to its
safety and efficacy.
It has been used by
generations of
nursing mothers
especially those
with inadequate
lactation.
Malunggay, known
as a "miracle
vegetable", is an
outstanding
indigenous source of
natural
phytonutrients that
have antibiotic,
hypotensive,
antispasmodic, anti-
ulcer, anti-
inflammatory, anti-
cancer,
hypocholesterolemic
and hypoglycemic
activities.
Malunggay is also
rich in antioxidants.
NATALAC &
NATALAC FORTE
Capsules contains
young malunggay
leaves, which come
from selected high-
quality, healthy,
organically grown
and chemical-free
malunggay trees. It
is rich in iron,
calcium,
phosphorus,
Vitamins A and C,
and proteins. It has
been clinically
proven to increase
the secretion of
breastmilk, which
contains antibodies
that protect the
infant from
infections.