1.

) generic name : mefenamic acid trade name : Ponstel Capsules 250 mg dosage: Acute Pain Adults and Children (14 yr or age and older) PO 500 mg, followed by 250 mg every 6 h as needed. Usually not used more than 1 wk.

Primary Dysmenorrhea Adults and Children (14 yr of age and older) 500 mg, followed by 250 mg every 6 h starting with onset of bleeding and associated symptoms. Storage/Stability: Store at room temperature (59 to 86F) in tightly closed, light-resistant container. classification: NSAID Indication: Relief of moderate pain lasting less than 1 wk; treatment of primary dysmenorrhea. contraindication: Patients in whom aspirin, iodides, or any NSAID has caused allergic-type reactions; preexisting renal disease; active ulceration or chronic inflammation of GI tract. side effects: Cardiovascular Edema; weight gain; CHF; altered BP; palpitations; chest pain; bradycardia; tachycardia.

CNS Headache; vertigo; drowsiness; dizziness; insomnia.

Dermatologic Rash; urticaria; purpura.

EENT

Blurred vision; tinnitus; salivation; glossitis.

GI Diarrhea; dry mouth; vomiting; abdominal pain; dyspepsia; GI bleeding; nausea; constipation; flatulence.

Genitourinary Hematuria; proteinuria; dysuria; renal failure.

Hematologic Decreased hematocrit; bleeding; neutropenia; leukopenia; pancytopenia; eosinophilia; thrombocytopenia.

Hepatic Mild elevations in LFT results.

Respiratory Bronchospasm; laryngeal edema; rhinitis; dyspnea; pharyngitis; hemoptysis; shortness of breath.

Miscellaneous Autoimmune hemolytic anemia may occur if used long term. nursing responsibilities: Inform patient not to use drug for longer than 1 wk. If given for dysmenorrhea, instruct patient to begin taking drug with onset of bleeding and associated symptoms. Warn patient about potential for bleeding, and advise patient to notify other health care professionals that drug is being taken. Advise patient to discontinue medication if rash develops and to contact health care provider.

Instruct patient to report the following symptoms to health care provider: rash, visual problems, dark stools, decreased urinary output, persistent headache or stomach pain and unusual bruising or bleeding. Advise patient to avoid intake of alcoholic beverages. Instruct patient that drug may cause drowsiness and to use caution while driving or performing other activities requiring mental alertness. Caution patient to avoid prolonged exposure to sunlight and to use sunscreen or wear protective clothing to avoid photosensitivity reaction. Instruct patient not to take OTC medications, including aspirin and ibuprofen or other prescription drugs, without consulting health care provider.

2.) generic : cephalexin cap trade name: keflex dosage : Adults The adult dosage ranges from 1 to 4 g daily in divided doses. The 333 mg and 750 mg strengths should be administered such that the daily dose is within 1 to 4 grams per day. The usual adult dose is 250 mg every 6 hours. For the following infections, a dosage of 500 mg may be administered every 12 hours: streptococcal pharyngitis, skin and skin structure infections, and uncomplicated cystitis in patients over 15 years of age. Cystitis therapy should be continued for 7 to 14 days. For more severe infections or those caused by less susceptible organisms, larger doses may be needed. If daily doses of Keflex greater than 4 g are required, parenteral cephalosporins, in appropriate doses, should be considered.

Pediatric Patients The usual recommended daily dosage for pediatric patients is 25 to 50 mg/kg in divided doses. For streptococcal pharyngitis in patients over 1 year of age and for skin and skin structure infections, the total daily dose may be divided and administered every 12 hours.

In severe infections, the dosage may be doubled.

In the therapy of otitis media, clinical studies have shown that a dosage of 75 to 100 mg/kg/day in 4 divided doses is required.

In the treatment of -hemolytic streptococcal infections, a therapeutic dosage of Keflex should be administered for at least 10 days. classification: semisynthetic cephalosporin antibiotic / antibacterial drug indication: Keflex is indicated for the treatment of the following infections when caused by susceptible strains of the designated microorganisms:

Respiratory tract infections caused by Streptococcus pneumoniae and Streptococcus pyogenes (Penicillin is the usual drug of choice in the treatment and prevention of streptococcal infections, including the prophylaxis of rheumatic fever. Keflex is generally effective in the eradication of streptococci from the nasopharynx; however, substantial data establishing the efficacy of Keflex in the subsequent prevention of rheumatic fever are not available at present.)

Otitis media due to Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Streptococcus pyogenes, and Moraxella catarrhalis

Skin and skin structure infections caused by Staphylococcus aureus and/or Streptococcus pyogenes

Bone infections caused by Staphylococcus aureus and/or Proteus mirabilis

Genitourinary tract infections, including acute prostatitis, caused by Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae contraindication: Keflex is contraindicated in patients with known allergy to the cephalosporin group of antibiotics. side effects: diarrhea that is watery or bloody; seizure (convulsions); fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; pale or yellowed skin, dark colored urine, fever, confusion or weakness; easy bruising or bleeding, unusual weakness; confusion, agitation, hallucinations (seeing things that are not there); or

urinating less than usual or not at all. mild nausea, vomiting, diarrhea; dizziness, tired feeling; joint pain; or vaginal itching or discharge. nursing responsibilities:

3.) generic name: ferrous sulfate trade name: dosage: Oral Iron-deficiency anaemia Adult: Treatment: 400-600 mg daily in divided doses. Prevention: 200 mg daily. Child: Treatment: <6 yr or <22 kg: Not recommended. 6-12 yr: >22 kg: 200 mg daily; >44 kg: 200 mg bid >66 kg: 200 mg tid. classification: Vitamins & Minerals (Pre & Post Natal) / Antianemics indication: Iron-deficiency anaemia. contraindication: Patients receiving repeated blood transfusions; anaemia not due to iron deficiency. side effects: GI irritation, abdominal pain and cramps, nausea, vomiting, constipation, diarrhoea, dark stool and discoloration of urine; heartburn. nursing responsibility: 4.) generic: ascorbic acid 5.) cefoxitin Parenteral Treatment and prophylaxis of anaerobic and mixed bacterial infections Adult: 1-2 g deep IM, slow IV over 3-5 minutes or by intermittent or continuous IV infusion every 4-8 hr. Up to 12 g/day in severe infections.

Child: and neonates: 20-40 mg/kg every 12 hr (neonates up to 1 wk), every 8 hr (neonates 1-4 wk), every 6-8 hr (for child and older infants). Up to 200 mg/kg/day in severe infections. Renal impairment: Loading dose: 1-2 g. Maintenance dose: According to CrCl. Haemodialysis patients: Repeat loading dose after each dialysis session. CrCl (ml/min) Dosage Recommendation

30-50 1-2 g every 8-12 hr. 10-29 1-2 g every 12-24 hr. 5-9 <5 0.5-1 g every 12-24 hr. 0.5-1 g every 24-48 hr.

Intramuscular Uncomplicated urinary tract infections Adult: 1 g bid. Renal impairment: Loading dose: 1-2 g. Maintenance dose: According to CrCl. Haemodialysis patients: Repeat loading dose after each dialysis session. CrCl (ml/min) Dosage Recommendation

30-50 1-2 g every 8-12 hr. 10-29 1-2 g every 12-24 hr. 5-9 <5 0.5-1 g every 12-24 hr. 0.5-1 g every 24-48 hr.

Intramuscular Uncomplicated gonorrhoea Adult: 2 g as a single dose with probenecid 1 g given orally. Parenteral Prophylaxis of surgical infections Adult: 2 g IM or IV 30-60 min prior to procedure then every 6 hr, usually not for >24 hr.

Child: and infants: 30-40 mg/kg at the same time intervals as adults. Neonates: 30-40 mg/kg at 8-12 hr intervals. Intravenous Prophylaxis of endometritis at caesarean section Adult: Single 2-g dose to the mother as soon as umbilical cord is clamped. If necessary, dose may be repeated at 4 and 8 hr after initial dose. contraindi: Hypersensitivity to cephalosporins. classification: Cephalosporins side effects: Nausea; vomiting; diarrhoea; hypersensitivity reactions; nephrotoxicity; convulsions; CNS toxicity; hepatic dysfunction; haematologic disorders; pain at Inj site (IM); thrombophloebitis (IV infusion); superinfection with prolonged use. Headache. Potentially Fatal: Pseudomembranous collitis. 6.) Brand Name: TRAMADOL

CLASSIFICATIONS Therapeutic: Analgesics (centrally acting) dosage: Adult: PO Moderate to severe pain 50-100 mg 4-6 hrly. Max: 400 mg/day. Extended-release 50100 mg 1-2 times/day. Max: 300 mg/day. IV/IM Moderate to severe pain 50-100 mg 4-6 hrly. Post-op pain Initial: 100 mg, then 50 mg every 10-20 mins if needed, up to 250 mg for the 1st hr. Maintenance: 50-100 mg 4-6 hrly. Max: 600 mg/day. Rectal Moderate to severe pain As 100 mg supp: 1 supp up to 4 times/day. INDICATION: Moderate to moderately severe pain contraindication: Suicidal patients, acute alcoholism; head injuries; raised intracranial pressure; severe renal impairment; lactation. side effects: Sweating, dizziness, nausea, vomiting, dry mouth, fatigue, asthenia, somnolence, confusion, constipation, flushing, headache, vertigo, tachycardia, palpitations, miosis, insomnia, orthostatic hypotension, seizures, CNS stimulation e.g. hallucinations. Potentially Fatal: Respiratory depression.

NURSING CONSIDERATIONS Assess type, location, and intensity of pain before and 2-3 hr (peak) after administration. Assess BP & RR before and periodically during administration. Respiratory depression has not occurred with recommended doses. Assess bowel function routinely. Prevention of constipation should be instituted with increased intake of fluids and bulk and with laxatives to minimize constipating effects. Assess previous analgesic history. Tramadol is not recommended for patients dependent on opioids or who have previously received opioids for more than 1 wk; may cause opioid withdrawal symptoms. Prolonged use may lead to physical and psychological dependence and tolerance, although these may be milder than with opioids. This should not prevent patient from receiving adequate analgesia. Most patients who receive tramadol for pain d not develop psychological dependence. If tolerance develops, changing to an opioid agonist may be required to relieve pain. Tramadol is considered to provide more analgesia than codeine 60 mg but less than combined aspirin 650mg/codeine 60 mg for acute postoperative pain. Monitor patient for seizures. May occur within recommended dose range. Risk increased with higher doses and inpatients taking antidepressants (SSRIs, tricyclics, or Mao inhibitors), opioid analgesics, or other durgs that decrese the seizure threshold. Overdose may cause respiratory depression and seizures. Naloxone (Narcan) may reverse some, but not all, of the symptoms of overdose. Treatment should be symptomatic and supportive. Maintain adequate respiratory exchange. Encourage patient to cough and breathe deeply every 2 hr to prevent atelactasis and pneumonia. 7.) GENERIC NAME: Ketorolac BRAND NAME: Toradol CLASSIFICATION: Nonsteroidal anti-inflammatory agents, nonopioid analagesics DOSAGE: 30mg/amp1 amp IM MECHANISM OF ACTION:

- Inhibits prostaglandin synthesis, producing peripherally mediated analgesia - Also has antipyretic and anti-inflammatory properties. - Therapeutic effect:Decreased pain INDICATION: Short term management of pain (not to exceed 5 days total for all routes combined) CONTRAINDICATIONS: - Hypersensitivity - Cross-sensitivity with other NSAIDs may existPre- or perioperative use - Known alcohol intoleranceUse cautiously in: 1) History of GI bleeding 2) Renal impair-ment (dosage reduction may be required) 3) Cardiovascular disease SIDE EFFECTS/ ADVERSE EFFECTS: - CNS: 1) drowsiness 2) abnormal thinking 3) dizziness 4) euphoria 5) headache- RESP: 1) asthma 2) dyspnea - CV: 1) edema 2) pallor

3) vasodilation - GI: 1) GI Bleeding 2) abnormal taste 3) diarrhea 4) dry mouth 5) dyspepsia 6) GI pain 7) nausea - GU: 1) oliguria 2) renal toxicity 3) urinary frequency - DERM: 1) pruritis 2) purpura 3) sweating 4) urticaria - HEMAT: 1) prolonged bleeding time - LOCAL: 1) injection site pain - NEURO: 1) paresthesia - MISC:

1) allergic reaction, anaphylaxis NURSING IMPLICATIONS/RESPONSIBILITIES: - Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reactions. Assess for rhinitis, asthma, and urticaria. - Assess pain (note type, location, and intensity) prior to and 1-2 hr following administration. - Ketorolac therapy should always be given initially by the IM or IV route. Oral therapy should be used only as a continuation of parenteral therapy. - Caution patient to avoid concurrent use of alcohol, aspirin, NSAIDs, acetaminophen, or other OTC medications without consulting health care professional. - Advise patient to consult if rash, itching, visual disturbances, tinnitus, weight gain, edema, black stools, persistent headche, or influenza-like syndromes (chills,fever,muscles aches, pain) occur. - Effectiveness of therapy can be demonstrated by decrease in severity of pain. Patients who do not respond to one NSAIDs may respond to another. 8.) GENERIC NAME: Ranitidine BRAND NAME: Zantac

CLASSIFICATION Therapeutic: Anti-ulcer agents Pharmacologic: Histamine H2 antagonists

DOSAGE 20 mg IV q8h MECHANISM OF ACTION Inhibits the action of histamine at the H2 receptor site located primarily in gastric parietal cells, resulting in inhibition of gastric acid secretion.

In addition, ranitidine bismuth citrate has some antibacterial action against H. pylori. INDICATION Treatment and prevention of heartburn, acid indigestion, and sour stomach.

CONTRA INDICATIONS Contraindicated in: Hypersensitivity, Cross-sensitivity may occur; some oral liquids contain alcohol and should be avoided in patients with known intolerance. Use Cautiously in: Renal impair- ment Geriatric patients (more susceptible to adverse CNS reactions) Pregnancy or Lactation

SIDE EFFECTS/ ADVERSE EFFECTS CNS: Confusion, dizziness, drowsiness, hallucinations, headache CV: Arrhythmias GI: Altered taste, black tongue, constipation, dark stools, diarrhea, drug-induced hepatitis, nausea GU: Decreased sperm count, impotence ENDO: Gynecomastia HEMAT:

Agranulocytosis, Aplastic Anemia, neutropenia, thrombocytopenia LOCAL: Pain at IM site MISC: Hypersensitivity reactions, vasculitis NURSING IMPLICATIONS/RESPONSIBILITIES Assess patient for epigastric or abdominal pain and frank or occult blood in the stool, emesis, or gastric aspirate. Nurse should know that it may cause false-positive results for urine protein; test with sulfosalicylic acid. Inform patient that it may cause drowsiness or dizziness. Inform patient that increased fluid and fiber intake may minimize constipation. Advise patient to report onset of black, tarry stools; fever, sore throat; diarrhea; dizziness; rash; confusion; or hallucinations to health car professional promptly. Inform patient that medication may temporarily cause stools and tongue to appear gray black.

9.) co-amoxiclav dosage: Tab Adult & childn >12 yr Mild to moderate infection: 1 tab (375 mg) 3 tds or 1 tab (625 mg) bd. Severe infection: 2 tab (375 mg) tds or 1 tab (1 g) bd. Susp Childn 25 mg/kg/day in divided doses 8 hrly, 1-6 yr (10-18 kg) 5 mL tds, <1 yr 25 mg/kg/day. Dosage may be increased up to 50 mg/kg/day in divided doses 8 hrly. classification: penicillins indications: Upper & lower resp tract, skin & soft tissue, GUT, bone & joint infections. contraindication: Hypersensitivity to penicillins or -lactamase inhibitors. Previous history of amoxycillinclavulanate or penicillin-associated jaundice/hepatic dysfunction. side effects: GI disturbances. Rarely, hepatitis & cholestatic jaundice. 9.) ascorbic acid dosage: Adult: PO Scurvy Prevention: 25-75 mg/day; treatment: 250 mg/day. Thalassaemia W/ desferrioxamine: 100-200 mg/day.

classification: vitamin c indication: Vitamin C is recommended for the prevention and treatment of scurvy. Its parenteral administration is desirable for patients with an acute deficiency or for those whose absorption of orally ingested ascorbic acid is uncertain.

Symptoms of mild deficiency may include faulty bone and tooth development, gingivitis, bleeding gums, and loosened teeth. Febrile states, chronic illness, and infection (pneumonia, whooping cough, tuberculosis, diphtheria, sinusitis, rheumatic fever, etc.) increase the need for ascorbic acid.

Hemovascular disorders, burns, delayed fracture and wound healing are indications for an increase in the daily intake contraindication: Contraindicated in those persons who have shown hypersensitivity to any component of this preparation. side effects: Diarrhea, GI disturbances. May cause acidification of the urine; precipitation of urate, cystine or oxalate stones, or drugs in the urinary tract.