DRUG GENERIC NAME: OMEPRAZOLE

DOSE 40 mg OD 15 minutes pre breakfa st

ROU TE Oral

INDICATIONS y

BRAND NAME: Mepraz CLASS: Benzimidazole Gastric acid pump inhibitor Proton Pump inhibitor

CONTRAINDIC ATIONS Short term Contraindicated treatment of with patients who duodenal have ulcer hypersensitivity Short-term to omeprazole treatment for and its erosive components esophagitis and Use cautiously gastroesopha with pregnancy, lactation geal reflux disease Contraindicated (GERD) with poorly responsive to Patients with Atrophic Gastritis, other Broken Bone, treatment. Short term Low Amount of treatment of Magnesium in the active benign Blood gastric ulcer Maintenance therapy for duodenal ulcer at reduced dosage Pathologic secretory conditions

ACTION Gastric-acid pump inhibitor: suppresses gastric acid secretion by specific inhibition of the hydrogenpotassium ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid production. It is converted to active metabolites that irreversibly bind and inhibit H+-K+-ATPase (an enzyme on the surface of gastric parietal cells). It inhibits transport of hydrogen ions into the gastric lumen and increases the gastric pH and reduces gastric

SIDE EFFECTS CNS: Headache Dizziness Asthenia Vertigo Insomnia Apathy Anxiety paresthesia dream abnormalities Dermatologic: Rash Inflammation urticaria, pruritus alopecia dry skin GI: diarrhea abdominal pain nausea vomiting constipation dry mouth tongue atrophy

NURSING CONSIDERATIONS Assessment: 1. History: hypersensitivity to omeprazole or any of its components; pregnancy lactation 2. Physical: 3. Skin lesions, reflexes 4. Urinary output Abdominal examination; Respiratory auscultation Interventions: 1. Administer before meals 2. Have regular medical follow-up visits. 3. Report severe headache, worsening of symptoms, fever and chills 4. Do not crush or chew tablets, swallow whole. 5. Evaluate for therapeutic response like relief of Gastro-intestinal symptoms 6. Question if Gastrointestinal discomfort, nausea, and diarrhea occurs

(ZollingerEllison syndrome) It is also used in the prevention and treatment of NSAIDinduced ulcers. used to treat symptoms of gastroesopha geal reflux disease (GERD) and other conditions caused by excess stomach acid

acid formation. Respiratory: URI symptoms cough epistaxis

DRUG GENERIC NAME: CIPROFLOXACIN

DOSE 500 mg BID

ROUTE Oral

INDICATIONS CONTRAINDICATIONS For the treatment of infections caused by susceptible gram-negative bacteria, including E. coli, P. mirabilis, K. pneumoniae, Enterobacter cloacae, P. vulgaris, P. rettgeri, M. morganii, P. aeruginosa, Citrobacter freundii, S. aureus, S. epidermidis, group D streptococci It is used in the treatment of chronic bacterial prostatitis. It is also used in the treatment of skin or skin Contraindicated with allergy to ciprofloxacin, norfloxacin, pregnancy, lactation.

ACTION Bactericidal; interferes with DNA replication in susceptible gram-negative bacteria preventing cell reproduction.

SIDE EFFECTS Nausea Diarrhea Dyspepsia Vomiting Constipation Flatulence Confusion Crystalluria Burning Crusting in the corner of eye Abdominal pain or discomfort Headache Rash Bad taste Redness of the eyelid Confusion Hallucination Hypersensitivity reaction Insomnia Dry mouth Paresthesia Adverse Effects: Superinfection (especially

NURSING CONSIDERATIONS Assessment: 1. Question for history of hypersensitivity to Ciprofloxacin or Quinolones. 2. Arrange for culture and sensitivity tests before beginning therapy. Interventions: 1. May be given without regards to meals. Preferred dosing time 2 hours after meals. 2. Do not administer antacids within 2 hours of Ciprofloxacin. 3. Encourage cranberry juice or citrus fruits. 4. Evaluate food

BRAND NAME: Cipritor CLASS: Synthetic chemotherapeutic antibiotic from the fluoroquinolone drug class Antibacterial

structure, GI tract, bone or joint, lower respiratory tract, and urinary tract infections.

enterococcal and tolerance. fungal) 5. Determine Nephropathy pattern of bowel Cardiopulmonary activity. arrest 6. Check for Cerebral dizziness, thrombosis may headache, visual occur difficulties, and Arthropathy may tremors. occur if given to 7. Observe children <18 therapeutic years. response. Sensitization may contraindicate later systemic use of Ciprofloxacin

DRUG GENERIC NAME: TRAMADOL CLASS: Central Acting Tramadol

DOSE 50 mg PRN for pain

ROUTE Oral

INDICATIONS Moderate to moderately severe pain

CONTRAINDICATIONS y Hypersensitivity to tramadol, opioids, or any component of the formulation; opioid-dependent patients acute intoxication with alcohol,hypnotics, centrally-acting analgesics,opioids, or psychotropic drugs

ACTION Binds to opiate receptors in the CNS causing inhibition of ascending pain pathways, altering the perception of and response to pain; also inhibits the reuptake of norepinephrine and serotonin, which also modifies the ascending pain pathway

SIDE EFFECTS y y y y y y y y y y y y Dizziness Nausea Drowsiness Dry mouth Constipation Headache Sweating Vomiting Itching Rash Visual disturbances Vertigo

NURSING CONSIDERATIONS Assessment: 1. Assess type, location, and intensity of pain before and 2-3 hr (peak) after administration. 2. Assess BP & RR before and periodically during administration. Respiratory depression has not occurred with recommended doses. 3. Assess bowel function routinely. Prevention of constipation should be instituted with increased intake of fluids and bulk and with laxatives to minimize

constipating effects. 4. 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. 5. 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 drugs that decrease the seizure threshold.

Interventions: 1. Tell patient that driving or operating machinery should be avoided until the effect of drug wears off. 2. Inform client that medication may cause CNS depression and/or respiratory depression, particularly when combined with other CNS depressants 3. Encourage patient to cough and breathe deeply every 2 hr to prevent atelactasis and pneumonia. 4. Instruct client to report any adverse reaction to the physician or nurse.