Generic Name: ibuprofen Brand Name: Advil Classification: non-steroidal anti-inflammatory drugs (NSAIDs), analgesics Action: Pain, fever,

and inflammation are promoted by the release in the body of chemicals called prostaglandins. Ibuprofen blocks the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower levels of prostaglandins. As a consequence, inflammation, pain and fever are reduced. Indications Relief of signs and symptoms of rheumatoid arthritis and osteoarthritis Relief of mild to moderate pain Treatment of primary dysmenorrhea Fever reduction Unlabeled uses: Prophylactic for migraine; abortive treatment for migraine Contraindications and cautions Contraindicated with allergy to ibuprofen, salicylates, or other NSAIDs Use cautiously with CV dysfunction, hypertension; peptic ulceration, GI bleeding; pregnancy; lactation; impaired hepatic or renal function. Dosages PEDIATRIC PATIENTS Juvenile arthritis: 3040 mg/kg/day PO in three to four divided doses; 20 mg/kg/day for milder disease. Fever (6 mo12 yr): 510 mg/kg PO q 68 hr; do not exceed 40 mg/kg/day.

Adverse effects Headache, dizziness, somnolence, insomnia, fatigue, tiredness, dizziness, tinnitus, ophthalmologic effects, Rash, pruritus, sweating, dry mucous membranes Nursing Responsibilities: Administer drug with food or after meals if GI upset occurs. Discontinue drug if eye changes, symptoms of liver dysfunction, or renal impairment occur. Institute emergency procedures if overdose occurs: Gastric lavage, induction of emesis, supportive therapy. Teaching points Use drug only as suggested; avoid overdose. Take the drug with food or after meals if GI upset occurs. Do not exceed the prescribed dosage. Avoid over-the-counter drugs. Many of these drugs contain similar medications, and serious overdosage can occur. These side effects may occur: Nausea, GI upset, dyspepsia (take drug with food) Report sore throat, fever, rash, itching, weight gain, swelling in ankles or fingers, changes in vision, black or tarry stools.

Generic Name: b-complex Brand Name: Polynerv Classification: Vitamin B complex Action: Indication: Treatment of vit B deficiencies. Nutritional support in painful neurological manifestations of neuritis & neuropathy eg cervical & shoulder-arm syndrome, lumbago, ischialgia & sciatica. Neuropathies caused by disease states eg diabetes, RA, TB, leprosy & cardiac disorders. Alcoholic neuropathy due to INH or phenothiazine intoxication. Pregnancy, hyperemesis gravidarum. Contraindication: Dosage: Prophylaxis 1-2 tab daily. Therapy 2-4 tab daily Adverse Effects: Nursing Responsibilities: May be taken with or without food (May be taken w/ meals to reduce GI discomfort)

Generic Name: cefuroxime sodium Brand Name: Panaxim Classification: Antibiotic Action: A second-generation cephalosporin that inhibits cell-wall synthesis, promoting osmotic instability; usually bactericidal. Indication: Serious infections of the lower respiratory and urinary tracts; skin and skin-structure infections; bone and joint infections; septicemia; meningitis; gonorrhea; and for perioperative prevention of infection. Contraindication: Contraindicated in patients hypersensitive to drug or other cephalosporins. Use cautiously in patients with history of sensitivity to penicillin and in breast-feeding women. Use cautiously and with reduced dosage in patients with impaired renal function. Monitor renal function.

Adverse Reactions: nausea, anorexia, vomiting, diarrhea, maculopapular and erythematous rashes, urticaria, pain, hypersensitivity reactions, anaphylaxis. Nursing Responsibilities:

Patient teaching Tell patient to take all of the drug as prescribed, even after he feels better. Tell patient to notify prescriber if rash or signs and symptoms of superinfection occur. Inform patient receiving drug I.V. to alert nurse if he has discomfort at I.V. insertion site. Tell patient to notify prescriber if he has loose stools or diarrhea.

Generic Name: salbutamol Brand Name: Ventolin Classification: B2 adrenergic receptor agonist Action: Salbutamol is a selective 2-adrenomimetic agent stimulating mainly the 2-adrenergic receptors and to a lesser extent 1-adrenergic receptors in the myocardium. The stimulation of the 2 receptors leads to adenylate cyclase activation and cAMP accumulation, alterations in the methyl transferase activity, decrease in the calcium ion intracellular concentration. Due to these changes bronchial smooth muscle relaxation and inhibition of mast cell degranulation develop. The antiasthmatic action of Salbutamol is related to the decrease of edema and mucus secretion. The drug has no influence on the heart activity, and there are no tachycardia and blood pressure elevation. Indication: Salbutamol is used in cases of bronchospasm in patients with reversible airway obstruction: mild and moderate attacks of dyspnea in patients suffering from bronchial asthma; mild and moderate bronchoobstruction in patients with chronic bronchitis and lung emphysema Contraindication: Hypersensitivity to some of the drug ingredients. Adverse Effect: Headache, tremor, tachycardia, hypertension, anxiety, rarely nausea, vomiting, and skin rash can be observed. Nursing Responsibilities: .The drug should be used with caution in patients with heart diseases and probable rhythm disorders (advanced high grade valvular diseases, ischemic heart disease, cardiomyopathy, etc.), as well as in patients with diabetes mellitus. Avoid/watch for concurrent administration with MAO-inhibitors or antidepressants, a potentiation of the cardiovascular effects is observed. The -blockers antagonize the action of Salbutamol. In cases of simultaneous

administration with digitalis glycosides, theophylline, oral antidiabetic agents, insulin, sympathomimetics, Salbutamol can increase the toxicity of these agents. Report severe headache, irregular heartbeat, worsening of asthma, difficulty breathing

Generic Name: pregabalin Brand Name: Lyrica Classification: Anticonvulsant Action: Pregabalin increases neuronal GABA levels by producing a dose-dependent increase in glutamic acid decarboxylase activity. Glutamic acid decarboxylase (GAD) is the enzyme that converts the excitatory neurotransmitter glutamate into the inhibitory GABA in a single step. For this reason, pregabalin greatly potentiates benzodiazepines, barbiturates & other depressants. - works by decreasing the number of pain signals that are sent out by damaged nerves in the body. Indication: used for neuropathic pain an adjunct therapy for partial seizures with or without secondary generalization in adults. It has also been found effective for generalized anxiety disorder Contraindication: Pregabalin is contraindicated in patients with known hypersensitivity to pregabalin or any of its components. Adverse Effect: "high" or elevated mood; anxiety, blurred vision, double vision, or other changes in eyesight, difficulty concentrating or paying attention, dizziness, dry mouth ,headache, hives , increased appetite, itching Nursing Responsibilities: Watch for some potential pharmacological interactions with opioids (pregabalin is synergistic with opioids in lower doses)

Generic Name: Paracetamol Brand Name: Tempra Classification: Antipyretic Action: depression of the prostaglandin synthesis by inhibition of the specific cell cyclooxygenase, and depression of the thermoregulatory center in the medulla oblongata. Indication: The preparation is indicated in diseases manifesting with pain and fever: headache, toothache, mild and moderate postoperative and injury pain, high temperature, infectious diseases and chills Contraindication: Paracetamol should not be used in hypersensitivity to the preparation and in severe liver diseases. Dosage: In children: aged from 3 months to1 year - 60-120 mg (2.5-5 ml syrup), 3-4 times daily; 1-6 years - 120-240 mg (510 ml syrup), 3-4 times daily; children older than 6 years - 250-500 mg, 3-4 times daily. Adverse Effect: In rare cases hypersensitivity reactions, predominantly skin allergy (itching and rash), may appear. Longterm treatment with high doses may cause a toxic hepatitis with following initial symptoms: nausea, vomiting, sweating, and discomfort. Occasionally a gastrointestinal discomfort may be seen. Nursing Responsibilities: The preparation should be used with care in patients with liver and renal diseases Paracetamol potentiates effects of the anticoagulant medicines. Be cautious. Concomitant usage of alcohol and medicines harming the liver, enhances the risk of severe liver disorders.

Generic Name: acyclovir Brand Name: Herpex Classification: Antiviral Action: Antiviral activity; inhibits viral DNA replication Indication: Initial and recurrent mucosal and cutaneous HSV 1 and 2 and varicella zoster infections in immunocompromised patients Severe initial and recurrent genital herpes infections in selected patients Herpes simplex encephalitis in patients > 6 mo Acute treatment of herpes zoster (shingles) and chickenpox Ointment: Initial HSV genital infections; limited mucocutaneous HSV infections in immunocompromised patients Contraindication: Contraindicated with allergy to acyclovir, seizures, CHF, renal disease Dosage: 200 mg q 4 hr while awake Adverse Effect: Headache, vertigo, depression, tremors, inflammation or phlebitis at injection sites, rash, hair loss, nausea, vomiting, diarrhea, anorexia Nursing Responsibilities: Assess for allergy to acyclovir Complete the full course of oral therapy, and do not exceed the prescribed dose. Report difficulty urinating, rash, increased severity or frequency of recurrences.

Generic Name: Paracetamol Brand Name: Tempra Classification: Antipyretic Action: depression of the prostaglandin synthesis by inhibition of the specific cell cyclooxygenase, and depression of the thermoregulatory center in the medulla oblongata. Indication: The preparation is indicated in diseases manifesting with pain and fever: headache, toothache, mild and moderate postoperative and injury pain, high temperature, infectious diseases and chills Contraindication: Paracetamol should not be used in hypersensitivity to the preparation and in severe liver diseases. Dosage: In children: aged from 3 months to1 year - 60-120 mg (2.5-5 ml syrup), 3-4 times daily; 1-6 years - 120-240 mg (510 ml syrup), 3-4 times daily; children older than 6 years - 250-500 mg, 3-4 times daily. Adverse Effect: In rare cases hypersensitivity reactions, predominantly skin allergy (itching and rash), may appear. Longterm treatment with high doses may cause a toxic hepatitis with following initial symptoms: nausea, vomiting, sweating, and discomfort. Occasionally a gastrointestinal discomfort may be seen. Nursing Responsibilities: The preparation should be used with care in patients with liver and renal diseases Paracetamol potentiates effects of the anticoagulant medicines. Be cautious. Concomitant usage of alcohol and medicines harming the liver, enhances the risk of severe liver disorders.

Generic Name: cefuroxime sodium Brand Name: Zegen Classification: Antibiotic Cephalosporin (2nd generation) Action: A second-generation cephalosporin that inhibits cell-wall synthesis, promoting osmotic instability; usually bactericidal. Indication: Serious infections of the lower respiratory and urinary tracts; skin and skin-structure infections; bone and joint infections; septicemia; meningitis; gonorrhea; and for perioperative prevention of infection. Contraindication: Contraindicated in patients hypersensitive to drug or other cephalosporins. Use cautiously in patients with history of sensitivity to penicillin and in breast-feeding women. Use cautiously and with reduced dosage in patients with impaired renal function. Monitor renal function.

Adverse Reactions: nausea, anorexia, vomiting, diarrhea, maculopapular and erythematous rashes, urticaria, pain, hypersensitivity reactions, anaphylaxis. Nursing Responsibilities:

Patient teaching Tell patient to take all of the drug as prescribed, even after he feels better. Tell patient to notify prescriber if rash or signs and symptoms of superinfection occur. Inform patient receiving drug I.V. to alert nurse if he has discomfort at I.V. insertion site. Tell patient to notify prescriber if he has loose stools or diarrhea.

Generic Name: Paracetamol Brand Name: Tempra Classification: Antipyretic Action: depression of the prostaglandin synthesis by inhibition of the specific cell cyclooxygenase, and depression of the thermoregulatory center in the medulla oblongata. Indication: The preparation is indicated in diseases manifesting with pain and fever: headache, toothache, mild and moderate postoperative and injury pain, high temperature, infectious diseases and chills Contraindication: Paracetamol should not be used in hypersensitivity to the preparation and in severe liver diseases. Dosage: In children: aged from 3 months to1 year - 60-120 mg (2.5-5 ml syrup), 3-4 times daily; 1-6 years - 120-240 mg (510 ml syrup), 3-4 times daily; children older than 6 years - 250-500 mg, 3-4 times daily. Adverse Effect: In rare cases hypersensitivity reactions, predominantly skin allergy (itching and rash), may appear. Longterm treatment with high doses may cause a toxic hepatitis with following initial symptoms: nausea, vomiting, sweating, and discomfort. Occasionally a gastrointestinal discomfort may be seen. Nursing Responsibilities: The preparation should be used with care in patients with liver and renal diseases Paracetamol potentiates effects of the anticoagulant medicines. Be cautious. Concomitant usage of alcohol and medicines harming the liver, enhances the risk of severe liver disorders.

Generic Name: INH + pyridoxine Brand Name: Comprilex Classification: Antitubercular Action: Isoniazid kills actively growing tubercle bacilli by inhibiting the biosynthesis of mycolic acids which are the major components of the bacterial cell wall of Mycobacterium tuberculosis Indication: Prevention and treatment of pulmonary and extrapulmonary tuberculosis in children in conjunction with at least one other antituberculosis drug Contraindication: Dosage: Available in 120 and 250mL Syrup. Each 5mL (1tsp) contains: 200mg of Isoniazid and 12mg of Pyrodoxine HC1 (Vitamin B6). Adverse Effect: In rare cases hypersensitivity reactions, predominantly skin allergy (itching and rash), may appear. Longterm treatment with high doses may cause a toxic hepatitis with following initial symptoms: nausea, vomiting, sweating, and discomfort. Occasionally a gastrointestinal discomfort may be seen. Nursing Responsibilities: Assess for allergy to Comprilex Do not give if patient is hypersensitive to the drug

Generic Name: rifampicin Brand Name: Rifadin, Rofact Classification: antitubercular Action: Inhibits RNA synthesis by blocking RNA transcription in susceptible organisms (mycobacteria and some grampositive and gram-negative bacteria) Indication: tuberculosis Contraindication: Hypersensitivity to drug or other rifamycin derivatives Dosage: 10 to 20 mg/kg/day (up to 600 mg/day) P.O. or I.V. infusion as a single dose Adverse Effect: confusion, drowsiness, fatigue, headache, conjunctivitis, nausea, vomiting, diarrhea, abdominal cramps, discolored urine Nursing Responsibilities: Use cautiously in: porphyria history of hepatic disease concurrent use of other hepatotoxic drugs Monitor kidney and liver function tests, CBC, and uric acid level. Watch for signs and symptoms of bleeding tendency, especially DIC. Assess for signs and symptoms of hepatic impairment. Monitor bowel movements for diarrhea Patient teaching Advise patient to take oral dose 1 hour before or 2 hours after meals. If drug causes significant GI upset, instruct him to take it with meals. To further minimize GI upset, teach him to eat small, frequent servings of food and drink plenty of fluids.

 Instruct patient to immediately report easy bruising or bleeding, fever, malaise, appetite loss, nausea, vomiting, or yellowing of skin or eyes. Tell patient drug may color his tears, urine, and other body fluids reddish or brownish orange. Instruct him not to wear contact lenses during therapy, because drug may stain them permanently. As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.

Generic Name: pyrazinamide Brand Name: Tebrazid Classification: Antitubercular Action: Unknown. Thought to exert bacteriostatic activity. Indication: It is prescribed in combination chemotherapy in the treatment of tuberculosis of hospitalized patients who fail to respond to other medications. Tuberculosis Contraindication: Hypersensitivity to drug Severe hepatic disease Acute gout Dosage: 15 to 30 mg/kg/day P.O., not to exceed 2 g/day; or 50 to 70 mg/kg P.O. twice weekly, up to a maximum of 4 g/dose; or 50 to 70 mg/kg/dose P.O. three times weekly, up to a maximum of 3 g/dose Adverse Effect: headache, nausea, vomiting, diarrhea, peptic ulcer, abdominal cramps, anorexia, hepatotoxicity, hyperuricemia, gout, joint pain Nursing Responsibilities: Monitor CBC, uric acid level, and liver and kidney function tests. Assess for signs and symptoms of gout, hepatic failure, and hemolytic anemia. Discontinue at first sign of hepatic impairment or hyperuricemia accompanied by acute gouty arthritis. Patient teaching

 Advise patient to take regularly with other antituberculars, as prescribed. Teach patient to recognize and immediately report signs and symptoms of gout and liver impairment. As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.