Clinical Clerk: Mattus, Miguel Manuel T.

Patient Name: Oxales, Kristoffer

Date of Admission: May 12, 2014
Generic Name
Clonazepam

Brand
Name
Rivotril

Dosage

Class

2 mg/tablet

Anticonvulsant
s

Mechanism of action

Etoricoxib

Arcoxia

30 mg/tablet
60 mg/tablet
90 mg/tablet
120 mg/tablet

Nonsteroidal
AntiInflammatory
Drugs
(NSAIDs)

Adverse Effects

Increases
the
presynaptic
GABA inhibition
and reduces the
monosynaptic
and polysynaptic
reflexes.
Suppresses
muscle
contractions by
facilitating
inhibitory GABA
neurotransmissio
n
and
other
inhibitory
transmitters.

Selectively
inhibits
cyclooxygenase
2 (COX-2)

Somnolence
Ataxia
Depression
Dizziness
Fatigue
Memory Impairment
URTI
Confusion
Dysarthria
Rhinitis
Impotence
Decreased libido

Indications

Fatigue
Dizziness
Dyspepsia
Heartburn,
Nausea
Thrombocytopenia
Hypersensitivity
reactions including
anaphylactic/anaphyl
actoid reactions
Hyperkalemia
Palpitations
Angina
Arrhythmia
Hypertensive crisis
Bronchospasm
Abdominal pain
Oral ulcers
Peptic ulcer
including perforation
or bleeding (elderly),
Vomiting,
Diarrhea
Hepatitis
Stevens-Johnson

Contraindications/Warnings

Seizure Disorders
o
First Line

Typical absences

Atypical absences

Myoclonic seizures

Atonic seizures
o
Second Line

Infantile spasms
o
Third Line

Tonic-clonic seizures

Simple and complex partial

seizures

Secondary generalized tonicclonic seizures

Panic Disorders

Relief of acute pain

Acute & chronic treatment of signs & symptoms of
Osteoarthritis & Rheumatoid arthritis.
Ankylosing spondylitis
Acute gouty arthritis
Primary dysmenorrhea
Moderate to severe acute post-op pain associated w/
dental surgery & abdominal gynecological surgery.

Contraindications
o
Hypersensitivity
to
benzodiazepines
o
Severe
respiratory
insufficiency
o
Severe hepatic insufficiency
o
Pregnant Patients
Warnings
o
The concomitant use of
Rivotril with alcohol and/or
CNS depressants should be
avoided.
o
These increase the clinical
effects of Rivotril possibly
including severe sedation,
clinically
relevant
respiratory
and/or
cardiovascular depression
Contraindications
o
Active peptic ulceration
o
Gastrointestinal bleeding
o
History of bronchospasm,
acute rhinitis, nasal polyps,
angioneurotic
edema,
urticaria or allergic-type
reactions after taking aspirin
or NSAIDs including COX2 inhibitors.
o
Inflammatory bowel disease
o
Congestive Heart Failure
o
Ischemic heart disease
o
Peripheral arterial disease
o
Cerebrovascular disease
o
Uncontrolled Hypertension
o
Pregnancy and Lactation

Tramadol
HCL/Paracetamo
l

Dolcet

Tramadol
HCL
37.5 mg
Paracetamol
325 mg

Opioid
Analgesic/
Non-Opioid
Analgesic

Ranitidine HCL

150mg/tablet

Antacids/Antireflux, &
Antiulcerants

Tramadol - binds
to
mu-opioid
receptors
and
weakly inhibits
the reuptake of
norepinephrine
and serotonin.
Paracetamol
analgesic,
antipyretic and
weak
antiinflammatory
activity

Blocks histamine
H2-receptors in
the stomach and
prevents
histaminemediated gastric
acid secretion.

Source:
Medscape
MIMS - Philippines

syndrome
Renal insufficiency
including renal
failure.
CNS & GI
disturbances.
Nausea
Dizziness
Somnolence
Asthenia,
Fatigue
Hot flushes
Constipation,
Diarrhea
Flatulence
Dry mouth
Pruritus
Increased sweating
Tinnitus
Headache
Abdominal pain
Agitation
Alopecia
Confusion
Constipation
Diarrhea
Dizziness
Hypersensitivity
reaction
Nausea
Vomiting

For moderate to severe pain.

Contraindications
o
Previously
demonstrated
hypersensitivity
to
tramadol, paracetamol and
any other component of
opioids.
o
In
cases
of
acute
intoxication with alcohol,
hypnotics,
narcotics,
centrally-acting analgesics,
opioids or psychotropic
drugs.

Gastroesophageal Reflux Disease

Gastric Ulcer
Erosive Esophagitis
Hypersecretory Conditions
Stress ulcer prophylaxis

Contraindications
o
Hypersensitivity
to
ranitidine
Warnings
o
Use caution in renal
impairment
o
Use caution in hepatic
impairment
o
Avoid in patients with acute
porphyria