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Brand name: Hemostan, Fibrinon, Cyklokapron, Lysteda, Transamin

CIassification: Anti-fibrinolytic, antihemorrhagic

Tranexamic acid is used for the prompt and effective control of hemorrhage in
various surgical and clinical areas:
Treating heavy menstrual bleeding
Hemorrhage following dental and/or oral surgery in patients with hemophilia
Management of hemophilic patients (those having Factor V or Factor X
deficiency) who have oral mucosal bleeding, or are undergoing tooth
extraction or other oral surgical procedures

Surgical: General surgical cases but most especially operative procedures on
the prostate, uterus, thyroid, lungs, heart, ovaries, adrenals, kidneys,
brain, tonsils, lymph nodes and soft tissues.
Obstetrical and gynecological: abortion, post-partum hemorrhage and
Medical: epistaxis, hemoptysis, hematuria, peptic ulcer with hemorrhage and
blood dyscrasias with hemorrhage
Effective in promoting hemostasis in traumatic injuries.
Preventing hemorrhage after orthopedic surgeries.
Mechanism of Action
Tranexamic acid is a synthetic derivative of the amino acid lysine. t exerts its
antifibrinolytic effect through the reversible blockade of lysine-binding sites on
plasminogen molecules. Anti-fibrinolytic drug inhibits endometrial plasminogen
activator and thus prevents fibrinolysis and the breakdown of blood clots. The
plasminogen-plasmin enzyme system is known to cause coagulation defects
through lytic activity on fibrinogen, fibrin and other clotting factors. By inhibiting
the action of plasmin (finronolysin) the anti-fibrinolytic agents reduce excessive
breakdown of fibrin and effect physiological hemostasis.
1. Allergic reaction to the drug or hypersensitivity
2. Presence of blood clots (eg, in the leg, lung, eye, brain), have a history of blood
clots, or are at risk for blood clots
3. Current administration of factor X complex concentrates or anti-inhibitor
coagulant concentrates
1. Pregnancy. Tranexamic acid crosses the placenta.
2. Lactation. Tranexamic acid is distributed into breast milk; concentrations reach
approximately 1% of the maternal plasma concentration.
3. Contraceptives, estrogen-containing, oral or Estrogens. Concurrent use with
tranexamic acid may increase the potential for thrombus formation.
4. Renal function impairment (medication may accumulate; dosage adjustment
based on the degree of impairment is recommended)
5. Hematuria of upper urinary tract origin (risk of intrarenal obstruction
secondary to clot retention in the renal pelvis and ureters if hematuria is
massive; also, if hematuria is associated with a disease of the renal
parenchyma, intravascular precipitation of fibrin may occur and
exacerbate the disease)
Nursing Responsibilities
1. Unusual change in bleeding pattern should be immediately reported to the
2. For women who are taking Tranexamic acid to control heavy bleeding, the
medication should only be taken during the menstrual period.
3. Tranexamic Acid should be used with extreme caution in CHLDREN younger
than 18 years old; safety and effectiveness in these children have not
been confirmed.
4. The medication can be taken with or without meals.
5. Swallow Tranexamic Acid whole with plenty of liquids. Do not break, crush, or
chew before swallowing.
6. f you miss a dose of Tranexamic Acid, take it when you remember, then take
your next dose at least 6 hours later. Do not take 2 doses at once.
7. nform the client that he/she should inform the physician immediately if the
following severe side effects occur:
Severe allergic reactions such as rash, hives, itching, dyspnea, tightness in the
chest, swelling of the mouth, face, lips or tongue
Calf pain, swelling or tenderness
Chest pain
Coughing up blood
Decreased urination
Severe or persistent headache
Severe or persistent body malaise
Shortness of breath
Slurred speech
Slurred speech
Vision changes

eneric Ingredient(s): Amoxicillin, Clavulanic acid, Co-amoxiclav
LegaI CIass: POM
rug CIass:
How SuppIied: Amoxicillin/clavulanic acid (co-amoxiclav)
Price: 250/125mg tab, 21=2.11; 100=12.82.
500/125mg tab, 21=2.53.
How SuppIied: Amoxicillin/clavulanic acid (co-amoxiclav)
Price: 250/125mg disp tab, 21=10.22.
Indications: Known or suspected amoxicillin-resistant infections of the respirato
tract, ENT, skin and soft tissue, urinary tract.
AduIts: 375mg three times daily at start of meals for up to 14 days, then
review. Severe infections, 625mg three times daily.
Dental infections, 375mg three times daily for 5 days.
ChiIdren: Use susp.
How SuppIied: Amoxicillin/clavulanic acid (co-amoxiclav)
Price: 125/31mg per 5ml sugar-free oral susp, 100ml=1.98.
250/62mg per 5ml sugar-free oral susp, 100ml=2.11.
ChiIdren: Under 1 year, 25 mg/kg daily; 16 years, 5 ml three times daily a
start of meals. All for up to 14 days, then review.
eneraI Warnings for Co-amoxicIav
Contraindications: Hypersensitivity to penicillins, cephalosporins or other beta-lactam
Precautions: Hepatic dysfunction, renal impairment (CrCl<30ml/min), infectious
mononucleosis. Risk of crystalluria with high doses; patients shou
well hydrated. Pregnancy, lactation.
Interactions: Anticoagulants, allopurinol, probenecid, oral contraceptives,
methotrexate. Non-enzymatic urine glucose testing, Coombes test
Side Effects: Hypersensitivity reactions, G upset, mucocutaneous candidiasis.
Rarely hepatitis, cholestatic jaundice, interstitial nephritis, toxic
epidermal necrolysis, blood dyscrasias, CNS effects, antibiotic
associated colitis.

Manufacturer Morishita-Seggs
Distributor Metro Drug
Contents 5-oxyanthranilic acid 0.2 mg, Ca pantothenate 5 mg, folic acid 0.2 mg, L
mg, L- leucine 18.3 mg, L- L-lysine HCl 25 mg, L-methionine 18.4 mg, n
threonine 4.2 mg, L- valine 6.7 mg, vit A 2,000 iu, vit B
5 mg, vit B
1 m
D 200 iu, vit E 1 mg
ndications Malnutrition, protein & vit deficiencies, anemia, convalescence, restorat
pregnancy & lactation, adjuvant in the therapy of peptic ulcer & TB.
Dosage Adult 1-2 cap/day. Childn 1 cap/day.
Administration May be taken with or without food (May be taken w/ meals for better ab
Special Precautions May color urine yellow.
Adverse Drug Reactions Hypervitaminosis (large dose).
View ADR Monitoring Website
MMS Class Vitamins &/or Minerals
ATC Classification A11AB - Multivitamins, other combinations ; Used as dietary supplemen
Poison Schedule

eneric Name: Butamirate Citrate

Brand Name: Sinecod
CIassification: Antitussive
Mode of Action: Act centrally on brain, and specifically the vagus nerve or
locally on the respiratory tract to suppress the cough reflex.
Indications: Acute cough of any etiology. Pre and Post op cough sedation for
surgical procedures and bronchoscopy.

Contraindications: Hypersensitivity to drug
Side effects/Adverse effects:
CNS: dizziness.
G: Nausea and vomiting, diarrhea.
Skin: rash
Nursing #esponsibiIities:
Assess cough type and frequency.1. Monitor the adverse reactions2. Assess
patient's VS3. Assess sleep
Teach patient:
4. f cough persist 10 days + fever or chest pain check with Doctor.
5. Don't exceed recommended dose
6. Since the drug may cause dizziness or drowsiness, caution patient to avoid
driving or other activities requiring alertness until response to medication is
7. Advise patient to minimize cough by avoiding irritants (cigarette smoke, fumes,
8. nstruct patient to cough effectively, sit upright and take several deep breaths
before attempting.

Generic Name: rifampicin/rifampin
rand Name: Rifadin, Rimactane
General Action: Antibiotic, Antituberculotic (first line)
Stock Dose: Capsules-150,300mg; powder-600mg
Specific Action:
Inhibits DNA-dependent RNA polymerase activity in susceptible
bacterial cells.
Indications of #ifampicin
%reatment of !:lmonary T in conjunction with at least one other
effective antituberculotic.
Neisseria meningitidis carriers, for asymptomatic carriers to
eliminate meningococci from nasopharynx; not for treatment of
&nlabeled uses: nfections caused by Staphylococcus aureus and
Staphylococcus epidermis, usually in combination therapy;
gram-negative bacteremia in infancy; Legionella pneumophilia,
not responsive to erythromycin; leprosy (in combination with
dapsone); prophylaxis of meningitis caused by Haemophilis
Contraindications of #ifampicin
. Contraindicated with allergy to any rifamycin, acute hepatic
disease, lactation.
5. &se cautiously with pregnancy (teratogenic effects have been
reported in preclinical studies; safest antituberculous regimen for
use in pregnancy is condidered to be rifampin, isoniazid, and
Adverse Effects of #ifampicin
6. NS: headache, drowsiness, fatigue, dizziness, inability to
concentrate, mental confusion, generalized numbness, muscle
weakness, visual disturbances.
7. Dermatologic: Rash, pruritus, urticaria, flushing, reddish
discoloration of body fluids-tears, saliva, urine, sweat, sputum.
8. G: heartburn, distress, anorexia, vomiting gas, cramps,
diaarhea, hepatitis, pancreatitis.
9. GU: hemoglobinuria, hematuria, renal insufficiency, acute renal
failure, menstrual disturbances.
10. ematologic: eosinophilia, thrombocytopenia, transient
leucopenia, hemolytic anemia, decreased Hgb, hemolysis.
11. ther: pain in extremities, osteomalacia, myopathy, fever,
flulike symptoms.
Nursing #esponsibiIities of #ifampicin
8. Administer on an empty stomach, 1 hr before or 2 hr after
9. Administer in a single daily dose.
10. Consult pharmacist for rifamoin suspension for patients unable
to swallow capsules.
11. Prepare patient for the reddish-orange coloring of body fluids
(urine, sweat, sputum, tears, feces, saliva); soft contact lenses
may be permanently stained; advise patients not to wear them
during therapy.
12. arning: arrange for follow-up visits for liver and renal function
tests, CBC, and ophthalmic examinations.
HeaIth Teachings uring #ifampicin Therapy
%each client to take drug in a single daily dose. %ake on an empty
stomach, 1 hr before or 2 hrs after meals.
Inform client to take this drug regularly; avoid missing any doses; do
not discontinue this drug without consulting the health care
%ell client to have periodic medical checkups, including eye
examinations and blood test, to evaluate the drug effects.
Inform client that he may experience the drugs side effects
(especially the red colored secretion)
Instruct client to see his physician if he experience fever, chills,
muscle and bone pain, excessive tiredness or weakness, loss of
appetite, N/V, yellowing of eyes/skin, unusual bleeding or
bruising, skin rash or itching.
Instruct client to remove contact lenses as they may discolor