DRUG Generic name: Celecoxib Brand name: Celebrex Route/site/ dosage: Oral,mouth, 400mg/cap,1 cap OD for pain

ACTION

CONTRAINDICATION Analgesic and -Acute and long term -Contraindicated antitreatment of signs w/ allergies to inflammatory and symptoms of sulfonamides,cel activities rheumatoid arthritis ecoxib,NSAIDs, related to and osteoarthritis or aspirin inhibition of the -Reduction of the ;significant renal COX-2 number of colorectal impairment; enzyme,which polyps in familial perioperative is activated in adenomatous pain post CABG inflammation to polyposis . surgery;pregnanc cause the signs -management of y(3rd trimester); and symptoms acute pain. lactation. associated with -treatment of primary inflammation;d dysmenorrhea oes not affect -Relief of signs and the COX-1 symptoms of enzyme, which ankylosing protects the spondylitis. lining of the GI -Relief of signs and tract and has symptoms juvenile blood clotting rheumatoid arthritis and renal function.

INDICATION

ADVERSE EFFECT -CNS: headache, dizziness,somnolen ce,insomnia, fatigue, tiredness, Tinnitus,opthalmog ic effects e -CV: MI,CVA -Dermatologic: Rash,pruritus,sweet ing, dry mucus membrane,stomatiti s -GI: nausea, abdominal pain, dyspepsia, flatulence, GI bleed -Hematologic Neutropenia eosinophilia,leucop enia.decrease Hgb or Hct

NURSING IMPLICATION -Administer drug with food or after meals if GI upset occur. -Established safety measures if CNS or visual disturbances occurs. -Arrange for periodic ophthalmologic examination during long term theraphy. -Provide further comfort measures to reduce pain and to reduce inflammation

DRUG Generic name: Cefuroxime Brand name: Cefuroxime axetel Cefuroxime sodium Route/site/d osage: Oral& parenteral, mouth & IV,750mg,1 50mg ,and 25mg

ACTION Bactericidal:inh ibits synthesis of bacterial cell wall,causing cell death

INDICATION

CONTRAINDICATION Oral Contraindicated -UTIs caused by w/ allery to Escherichia cephalosporins coli,klebsiellapneumo and penicillins ne, -skin and skin structure infections,including impetigo caused by streptoccus aureus,s.pyogenes -treatment of early lyme disease Perenteral -perioperative prophylaxis -lower respiratory infection caused by klebsiellapneumoniae H Influenzae E coli. -uncomplicated and disseminated gonorrhea caused by N.gonorhoeae -bone and joint infection caused by S.aureus

ADVERSE EFFECT CNS headache,dizziness/ lethargy,paresthesia s GI nausea,vomiting,dia rrhea,anorexia abdominal pain, flatulence,pseudo membranous colitis Hepatotoxicity GU nephrotoxity, Hematologic bone marrow depression Hypersensitivity ranging from rash to fever to anaphylaxis;serum sickness reaction Local pain absess at injection site phlebitis,inflammati on at IV site

NURSING IMPLICATION Culture infection site, and arrange for sensitivity tests before and during theraphy and expected response is not seen -give oral drug w/ food to decrease GI upset and enhance absorption -have vit.K available n case hypoprothrombinemia -discontinue hypersensitivity occurs

DRUG Generic name: ketorolac Brand name:Acular LS,acular PF Route/site /dosage parenteral IV 30mg

ACTION Anti inflammatory and analgesic activity ; inhibits prostaglandins and leukotriene synthesis

INDICATION short management of pain (up to 5 days) ophthalmic relief itching due to seasonal conjunctivitis and relief of post operative inflammation after cataract surgery

CONTRAINDICATION Contraindicated w/significant renal impairment,durin g labor and delivery, lactation aspirin allergy history of peptic ulcer disease or GI bleeding,hyperse nsitivity to ketorolac;as prophylactic analgesic before major surgery

ADVERSE EFFECT CNS headache dizziness som nolence insomnia fatigue tinnitus opthalmogic effects GI nausea dyspepsia GI pain rhea vomiting constipation gastric or duodenal ulcers GU dysuria,renal impairment Hematologic bleeding platelet inhibition,w/ higher dosage neutropenia Eosinophilia decreased Hgb or Hct Respiratory dyspnea bronchospasm hemoptysis rhinitis

NURSING IMPLICATION Protect drug vials from light Administer every 6 hour to maintain serum level and control pain

DRUG Generic name: Prantroprazo le Brand name: Panto IV(CAN), Pantoloc ( CAN) Route/site/d osage: Parenteral,I V,40mg OD.

ACTION Gastric acid pump inhibitor;supres sess gastric acid secretion by specific inhibition of the hydrogen potassium ATPase enzyme system at the secretory surface of the gastric parietal cells;blocks the final step of acid production

INDICATION IV short term(710days) treatment of GERD in patient in oral therapy -IV treatment of pathological hypersecretory condition associated w/ zollinger-ellison syndrome and other neuroplastic condition

CONTRAINDICATION Contraindicated w/ hypersensitivity to any proton pump inhibitor or any drug components

ADVERSE EFFECT CNS headache dizziness insomnia anxiety y vertigo parestisias dream abnormalities Dermatologic rasg inflammation urticaria pruritus alopecia dry skin GI diarrhea abdominal pain nausea and vomiting Respiratory URI symptoms cough epestaxis and pneumonia

NURSING IMPLICATION Maintan supportive treatment appropriate for underlying problem switch patient on IV theraphy to oiral dosage as soon as possible provide additional comfort measures to alleviate discomfort from GI effects and headache

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