DRUG STUDY NAME lanzoprazole classification: anti ulcer agents Brand Name: prevacid ACTION Binds to an enzyme in the

presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen. INDICATION Erosive esophagitis Duodenal ulcers Active benign gastric ulcers Short term treatment of symptomatic GERD Healing and risk reducyion of enzyme associated gastric ulcer Pathologic hypersecretory conditions, including Zollinger- Ellison syndrome CONTRAINDICA TION Contraindicatedhyp ersensitivity. Use cautiously in geriatric patients, severe hepatic impairment (not to exceed 30 mg per day in this patients) ADVERSE EFFECT CNS:dizziness, headache GI: diarrhea, abdominal pain , nausea, DERM: rash NURSING RESPONSIBILITIES

Assess patient routinely for epigastric or abdominal pain or for prank or occult blood in stool, emesis, or gastric aspirate. Laboratory test considerations may cause abnormal liver function test, including increase AST, ALT, alkaline phosphatase and bilirubin. May cause increase serum creatinine and increase or decrease electrolyte levels. May alter RBC, WBC, and platelet levels. May also cause increase gastrin levels, abnormal A/G ratio, hyperlpidemia, increase or decrease cholesterol. Monitor INR and protrombin time in patients taking warfarin.

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ACTION

INDICATION

CONTRAINDICA

ADVERSE EFFECT

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TION Generic Name: tramadol Classification: analgesic (centrally acting) Brand name: ultram Binds to mu-opiod receptors. Inhibits reuptake of serotonin and noripeniphrine in the CNS Moderate to moderately severe pain. Contraindicated in hypersensitivity. Cross sensitivity with opiods may occur. Patients are acute intoxicated with alcohol, sedatives/ hypnotics, centrally acting analgesics, opiods analgesics, or psychotropic agents. Patients who are physically dependent on opiod analgesics. CNS: seizures, dizziness, headache, anxiety, CNS stimulation, confusion. EENT: visual disturbances CV: vasodilation GI: constipation, nausea, diarrhea, dry mouth, vomiting GU: urinary retention/ frequency DERM: pruritus, sweating NEURO: hypertonia. Assess type, location and intensity of pain before 2 to 3 hr. (peak after administration. Assess blood pressure and respiratory rate before and periodically during administration. respiratory depression has not occurred in recommended doses. Assess bowel function routinely Assess previous analgesic history Prolonged used may lead to physical or psychological dependence and tolerance. Monitor patients for sseizures

NAME Generic Name: ciftriaxone Classification: anti infectives

ACTION Binds to the bacterial cell wall membrane, causing cell death

INDICATION Treatment of skin, and skin structure infections bone and joint infections

CONTRAINDICA TION Contraindicated in hypersensitivity to cephalosphorins. Serious hypersensitivity to penicillin.

ADVERSE EFFECT CNS: seizures, (high doses ). GI: colitis, diarrhea, nausea and vomiting, cramps, jaundice,

NURSING RESPONSIBILITIES Assess for infection ( vital signs, appearance of wound, sputum, urine and stool, WBC) at beginning and of throughout therapy Before initiating, obtain a history to determine previous used of and

Brand Name: rocephin

urinary infections Single dose treatment of acute bacterial otitis media Meningitis Perioperative prophylaxis Lyme disease

Hypersensitivity to L arginine, inborn errors of metabolism

pseudolithiasis DERM: rashes, urticaria HEMAT: bleeding blood dyscracias hemolytic anemia

reactions of penicillin to cephalosphorin Obtain specimen for culture and sensitivity before initiating therapy Observe patient for signs and symptoms for anaphylaxis Discontinue the drug and notify the physician or other health care professional immediately if this symptoms occur.