Name of drug

Mechanism of action

Indication

Contraindicati on

Adverse effect

Nursing alert

Omeprazole

Classification: Benzimidazole and a Gastric acid pump inhibitor.

Dosage

PO: 40 mg tab OD

Omeprazole 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. Omeprazole increases the gastric pH and reduces gastric acid formation

This medication was given to our patient Because his on NPO Diet which means the stomach of our patient continuously producing hydrochloric acid so to stop it the physician ordered omeprazole.

Contraindicated with hypersensitivity to omeprazole or its components

CNS: He a da c he , dizziness, asthenia, vertigo,insomnia, apathy,anxiety, paresthesias,drea m abnormalities Dermatologic: Rash,inflammation , urticaria, pruritus,alopecia, dry skin GI: Diarrhea, abdominal pain, nausea, vomiting, constipation, drymouth,

- Give before meals Rationale: to avoid stomach upset - Do not crush or chew tablets, swallow whole Rationale: chewed tablets and opened capsules decreased the effectiveness of drugs - Evaluate for therapeutic response like relief of Gastrointestinal symptoms Question if Gastrointestinal discomfort, nausea, and diarrhea occurs. Rationale: The patient is continually
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tongueatrophy Respiratory: URI symptoms, c ough, epistaxis

evaluated for therapeutic response and the occurrence of drug side effects for evaluation of both the effectiveness and toxicity of the drug - when taking omeprazole be careful while driving or operating machinery because Dizziness may occur (avoid driving or performing hazardous tasks);headache (request medications); nausea,vomiting, diarrhea (maintain proper nutrition);symptoms of upper respiratory tract infection,cough (do not selfmedicate; consult with your health care provider if
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Prescribed given: September 17, 2011

uncomfortable). Rationale: Omeprazole generally does not cause any problems with your ability to drive a car or operate machinery. However, as with many other medicines, it could be dangerous if you were not fully alert

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Name of drug

Mechanism of action

Indication

Contraindicatio n

Adverse effect

Nursing alert

Paracetamol

Classification : antipyretics, nonopioid analgesics

Dosage

PO: 500 mg q4 hours PRN for fever

Inhibits prostaglandi n synthesis in the CNS and blocks the pain impulse through a peripheral action. It acts on the hypothalamic heatregulating center, producing peripheral vasodilation. It results in antipyresis

This medication was given to our patient to Temporarily relieve pain and discomfort from fever, minor muscular aches, overexertion,

Paracetamol is contraindicated in hypersensitivity, analgesic nephropathy, renal and hepatic impairment.

Early signs of toxicity: Anorex ia, nausea, diaphoresis (excessive sweating), generalized weakness within the first 12-24 hours.

- Assess patients pain or temperature before therapy and regularly thereafter Rationale: To indicate baseline data and monitor drugs effectiveness - Asses patients drug history and calculate total daily dosage accordingly Rationale: To prevent over dosage that could lead to toxicity and liver damage. - Be alert for signs of reactions and drug
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Late signs of toxicity: Vomiti ng, right upper quadrant tenderness, elevated liver function tests within 48-72

and produces analgesic effect.

hours after ingestion. Antidote: Acetylcysteine.

interactions. Rationale: To establish proper preca utionary measures and management for possible adverse effects of drug. -Assess patients and familys knowledge of drug therapy.

Prescribed given: August 13,2011

Rationale: To determine the level of understanding of the patient and her family about the drug therapy

Name of drug

Mechanism of action

Indication

Contraindication

Adverse effect

Nursing alert

Ascorbic acid

Assists in collagen formation, tissue repair; involved in oxidation reduction

Vitamin C is used boosting our patients

Previous hypersensitivity; products containing

GI: Nausea,

-May give without regard to food. -Assess for clinical

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Classification: reactions, other metabolic Vitamin reactions. Vitamin C is involved in metabolism; carbohydrate utilization; Dosage synthesis of lipids, PO: 500 mg BID proteins, carnitine. It also preserves blood vessel integrity.

immune system.

alcohol, aspartame, saccharin, sugar, or tartrazine (FDC yellow dye #5) should be avoided in patients who have hypersensitivity or intolerance to these compounds.

vomiting, heartburn, diarrhea. Hematologic: Acute hemolytic anemia (patients with deficiency of G6PD); sickle cellcrisis. CNS: Headache (high doses). Urogenital: Arthritis, dysuria, crystalluria (high doses)

improvement (improved sense of well-being and sleep patterns). -Observe for reversal of deficiency symptoms (gingivitis, bleeding gums, poor wound healing, digestive difficulties, joint pain). Patient Teachings for Clients Taking Vitamin C -Abrupt vitamin C withdrawal may produce rebound deficiency. - Take large doses of vitamin C in divided amounts Rationale: the body uses only what is needed at a particular time and excretes the rest in urine
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Prescribed given: August 15, 2011

Name of drug

Mechanism of action

Indication

Contraindication

Adverse effect

Nursing alert

Tramadol

Tramadol binds to -opiate receptors and inhibits Classification: reuptake of norepinephrine Analgesic. and serotonin. It reduces intensity

Tramadol is prescribed to our patient to treat moderate to moderately

should not be administered to patients who have previously demonstrated hypersensitivity to tramadol, any

agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting,

* For ambulatory patients: Be careful in rising and walking. Avoid driving and other potentially hazardous activities that require mental
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of pain stimuli incoming from sensory nerve endings, altering pain perception and emotional response to pain. Dosage

severe pain.

other component of this product or opioids.

diarrhea, loss of coordination, fainting; seizure (convulsions); a red, blistering, peeling skin rash; or shallow breathing, weak...

alertness until drugs CNS effects are known. * Avoid giving tramadol to patients with acute abdominal conditions Rationale: because it may mask evidence and disrupt assessment of the abdomen. * Monitor patient for drug dependence. Rationale: Drug can produce dependence similar to that of codeine or dextropropoxyphene and thus has potential for abuse.

PO: 50mg q12 hours

Prescribed given August 23, 2011

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Name of drug

Mechanism of action

Indication

Contraindicatio n

Adverse effect

Nursing alert

Ketorolac

Classification: :Antipyretic NS AID

Anti-inflammatory and analgesic activity; inhibits prostaglan dins and leukotrienesynthes is

Short-term management of pain (up to 5days)

Contraindicated with significant renal impairment, during labor and delivery , lactation, aspirin allergy, recent GI bleed or

CNS: headache, dizziness, somnolence, insomnia, fatigue,

- Patients who have asthma, aspirininduced allergy, and nasal polyps are at increased risk for developing hypersensitivity reactions. Assess for rhinitis, asthma, and
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perforation

dizziness, tinnitus ,ophthalmologic effects

Dosage 30g I.V q8 hours

Prescribed given: August 12, 2011

urticaria. - 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. - 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.

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Name of drug

Mechanism of action

Indication

Contraindicatio n

Adverse effect

Nursing alert

Cefuroxime

Classification: secondgeneration cephalosporin and antibiotic

Cefuroxime binds to bacterial membranes. It inhibits synthesis of bacterial cell wall.

Cefuroxime is used to our patient to prevent infection due to the Gunshot Wound.

*Contraindicated in patients hypersensitive to drug. * Use cautiously in patients hypersensitive to penicillin because of possibility of cross-sensitivity with other beta-

CV: phlebitis, thrombophlebitis GI: pseudomembran ous colitis, nausea, anorexia, vomiting, diarrhea Hematologic: transient

-Question for history of hypersensitivity to this drugs , particularly cephalosporins and penicillins. Rationale: to avoid allergy -Give without regards
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lactam antibiotics.

Dosage

IV: 750 mg every 8 hours post operative

Prescribed given: August 12, 2011

neutropenia, eosinophilia, hemolytic anemia, thrombocytopeni a Skin: maculopapular and erythematous rashes, urticaria, pain, induration, sterile abscesses, temperature elevation, tissue sloughing at intramuscular injection site Other: hypersensitivity reactions, serum sickness, anaphylaxis.

to meals. If GI upset occurs give with food or milk. -Avoid crushing tablets due to bitter taste. Rationale: chewed tablets decreased the effectiveness of drugs - Intramuscular injections must be administered deep IM rationale: to minimize discomfort. -Discomfort may occur with IM injection. -Doses should be evenly spaced. -Continue antibiotic therapy for full length of treatment.

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Name of drug

Mechanism of action

Indication

Contraindica tion

Adverse effect

Nursing alert

Ciprofloxacin

Classification: Fluoroquinolon e and an Antiinfective

Ciprofloxacin inhibits DNA enzyme in susceptible microorganisms . It interferes with bacterial DNA replication. Ciprofloxacin is also bactericidal.

Ciprofloxacin is used to prevent infection to our patient

Dosage PO: 500 mg 1 tab BID

Ciprofloxacin should be avoided by pregnant women as well as by lactating mothers since it could harm the baby. This drug is contraindicate d in patients who have shown hypersensitivit y to ciprofloxacin or to any other quinolones.

-severe dizziness, fainting, fast or pounding heartbeats -sudden pain, snapping or popping sound, bruising, swelling, tenderness, stiffness, or loss of movement in any of your joints; -diarrhea that is watery or bloody; -confusion, hallucinations, depression, unusual thoughts or behavior; -seizure (convulsions);

-Patients taking ciprofloxacin usually develop sensitivity of the skin to direct sunlight therefore these patients need to avoid direct exposure to the sun. -The medication should also be used with strict precautions in patients with history of seizures Rationale: it has been reported that this drug causes seizures.

Prescribed given:

-pale or yellowed skin, dark colored

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Name of drug

Mechanism of action

Indication

Contraindicatio Adverse effect n

Nursing alert

28

Methylcobal

Classification: Nootropics & Neurotonics/ Neurotrophics

Methycobal is a mecobalamin drug, a co-enzyme of Vitamin B that transpires in the blood and the cerebrospinal fluid. It is utilized by the nerve tissue more broadly than other homologues of vitamin B12.

Methycobal Tablets are administere d for treating peripheral neuropathie s.

Dosage

PO: 500 mg 1 tab TID

The drug is contraindicated to patients who has a known allergy to Mecobalamin. The drug is not recommended also with persons whoa re taking multiple medications. In such cases, it may be taken cautiously or unless if the drug is prescribed by your physician.

-Headache -Heat sensation -Feeling warm (general). -Pain around the intramuscular injection site -Pain at the intramuscular injection site -induration at the intramuscular injection site -A hardened mass forms within the muscle at the intramuscular injection site.

- While taking the drug Mecobalamin, it is not advised by the doctor to drink any alcoholic beverages because of the effects it produces on the drug. Patients with pernicious anemia may have to take the drug for the rest of his/her life to -Avoid irrevocable damage to the spinal cord. It is necessary to check your blood every three to six months to monitor progress.

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Prescribed given: Setember 14, 2011

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Name of drug

Mechanism of action

Indication

Contraindicati on

Adverse effect

Nursing alert

Etoricoxib

The mechanism of action of this drug is a COX-2 selective Classification: inhibitor. This drug selectively inhibits Analgesic isoform 2 of cyclooxyginase enzymes /NSAID (COX-2). This reduces the generation of prostaglandins (PGs) from Dosage arachidonic acid. PO: 120 mg 1 Among the different cap OD for functions exerted by pain PGs, their role in the inflammation cascade should be highlighted. This drug non-steroidal anti-inflammatory drugs (NSAIDs). Prescribed COX is involved in given: producing prostaglandins, in August 23, response to certain 2011 diseases and injury.

-This medication is a nonsteroidal antiinflammator y drug (NSAID), prescribed for osteoarthriti s, rheumatoid arthritis and gouty arthritis. -relief of chronic musculoskel etal pain -relief of acute pain

Contraindicated in patients with peptic ulcer, severe heart disease, stroke, and hypersensitivity.

Central Nervous Systemnervousness, depression, drowsiness, insomnia, vertigo and ringing in the ear. Heart- Chest pain, high blood pressure and fluid retention. Metabolic- Taste disturbances, mouth ulcer, loss of appetite and weight loss. MiscellaneousKidney damage, fever, GI disorders, muscle pain and influenza-like syndrome.

-Administer with foods rationale: to prevent GI upset. -Use cautiously in patients with renal/liver dysfunction Rationale: to monitor for hepatic Failure and impair renal function -advice patient to avoid alcohol intake Rationale: GI upset or Gastric ulcer may result. -Instruct the patient to report occurrences of side effects. Rationale: To establish proper prec autionary measures

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