Physician: Dr.

Sanico Impression: post-operative splenectomy DRUG THERAPEUTIC RECORD

Drug/Dose Frequency/Route

Date: October 17, 2011

Classification/ Mechanism of Action Classification; Opiod analgesic Mechanism of Action: Unknown, centrally acting synthetic agents/ analgesic compound not chemically related to opiods that is thought to bind to opiod receptors and inhibit reuptake of norepinephrine and serotonin. Relieves pain.

Tramadol 50cc IVTT every 6 hours

Principle of Care - for better Indications: analgesic - moderate to moderately severe effect, give pain drug before onset of Contraindications; intense pain - patients hypersensitive to the drug or any of its components - if respiratory - patients with acute rate decreases intoxication from alcohol, or falls below hypnotics, centrally acting 12 breats/min, analgesics withhold dose and notify Side Effects: prescriber CNS: anxiety, asthenia, CNS stimulation, confusion, coordination - need for disturbance, dizziness, euphoria, laxative headache, nervousness therapy since CV: vasodilation constipation is EENT: visual disturbances a common GIT: abdominal pain, anorexia, side effect constipation, diarrhea, dry mouth, dyspepsia

Indications/Contraindications Side Effects

Treatment - instruct patient to take drug exactly as prescribed and not to increase dosage or interval unless instructed by physician - tell ambulatory patient to be careful when getting out of bed and walking -warn patient to refrain from driving or activities requiring mental alertness

Evaluation Patient was able to adhere to medication regimen. Slight dizziness was noted especially during walking to the bathroom.

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Drug/Dose Frequency/Route

Classification/ Mechanism of Action Classification; Aminopenicillin, beta lactamase inhibitor - antibiotic Mechanism of Action: Prevents bacterial cell wall synthesis during replication. Clauvulonic acid increases amoxicillins effectiveness by inactivating beta lactamases, which destroys amoxicillin.

Indications/Contraindications Side Effects Indications: - pre operative and post operative surgical procedure - skin and soft tissue infections Contraindications; - history of penicillin hypersensitivity Side Effects: CNS: headache GIT: abdominal discomfort, diarrhea, flatulence Integumentary skin rashes, urticaria

Amoclav 625 mg PO BID Timing: 8am-6pm

Principle of Care - give drug with food to prevent gastrointestinal distress - give drug at least 1 hour before bacteriostatic antibiotics - do not crush or chew drug, take drug as prescribed

Treatment -tell patient to take drug in its entire quantity - advise patient to report if any side effects occur - notify prescriber if skin rash or urticaria develops

Evaluation Patient was able to adhere to medication regimen. Abdominal discomfort was slightly noted on the 1st dose, but drug is taken before food to prevent GI distress.

Drug/Dose

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Principle of

Treatment

Evaluation

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Frequency/Route

Mechanism of Action

Side Effects Indications: - prophylactic treatment against abdominal, pelvis, orthopedia, cardiac, pulmonary, esophageal and vascular surgery where there is increased risk for infection Contraindications; - hypersensitivity to cephalosporins Side Effects: GIT: abdominal discomfort, nausea and vomiting EENT: pseudomembraneous colitis

Zinacef 750 mg Classification; PO TID -2nd generatin cephalosporin Timing: - antibiotic 8-1-6 Mechanism of Action: Inhibits cell wall synthesis, promoting osmotic instability usually bactericidal. Hinders or kills susceptible bacteria including many gram positive organism and gram negative bacilli.

Care - take with food to enhance drug absorption - inject deep into large muscle mass such as gluteus maximus or lateral aspect of thigh to increase absorption - not considered as drug of choice for meningitis and gonorrheal infections

- assess patients infection before giving medication and regularly thereafter - before giving 1st dose, obtain specimen for culture and sensitivity tests - before giving 1st dose, ask patient about previous reactions to cephalosporin - be alert for adverse reactions and drug interactions - if adverse reaction occurs, notify prescirber immediately

Patient was able to adhere to medication regimen.

Drug/Dose Frequency/Rout

Classification/ Mechanism of Action

Indications/Contraindications Side Effects

Principle of Care

Treatment

Evaluation

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Risek 40 mg IVTT OD

Classification; Antacids, antireflux agents and antiulcerants Mechanism of Action: Omeprazole reduces gastric acid secretion through a unique mechanism of action. Belongs to a new class of antisecretory compounds, the substitutes of benzimidazoles that do not exhibit anti cholinergic or histamine protagonist property. Inhibits secretion of gastric acid by irreversibly blocking the enzyme system of H+, K+, ATPase. Inhibits both basal and stimulated acid secretion irrespective of the stimulus.

Indications: - treatment and prophylaxis of NSAID associated ulcer - helicobacter pylori infection - treatment of symptomatic GERD Contraindications; - patients with known hypersensitivity to any component of Risek or to substitutes of benzimidazoles Side Effects: CNS:, dizziness, headache CV: vasodilation GIT: abdominal pain, flatulence constipation, diarrhea, nausea and vomiting Hepatic: increased liver enzyme Skin: rash, pruritus Hema: leucopenia, thrombocytopenia Indications/Contraindications Side Effects

- give powder for oral suspension at least 1 hour before meal - dont use drug in children younger than 18 years old - lower doses arent needed for patient with renal or hepatic impairment

- explain importance of taking drug exactly as prescribed - explain to patient how to reconstitute powder for oral suspension - explain to patient that over the counter drug isnt intended for immediate relief of heartburn - explain to patient that over the counter drug may require 1-3 days for full effect

Patient was able to adhere to medication regimen.

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Principle of Care

Treatment

Evaluation

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Iberet Folic Acid I tab OD after breakfast

Classification; Multivitamins and Minerals -Antianemics Mechanism of Action: Increases oxygen carrying capacity of hemoglobin to increase oxygen concenration

Indications: - treatment and prevention of iron deficiency and concomitant folic acid - deficiency associated with deficient intake or increased need for vitamin B complex in non-pregnant adults Contraindications; - Thalassemia, hemochromatosis Side Effects: GIT: constipation, diarrhea GU: bright yellow urine discoloration, stone formation, crystalloria, black discoloration of stool Skin: acne formation and eruption

- drug may be taken with an empty stomach - dont crush or chew tablet - drug is best taken with vitamin c for easier absorption

- advise patient to take drug with meals to reduce GI symptoms

Patient was able to adhere to medication regimen. Black stool formation was noted and - assess patients bright yellow serum B12 urine. needs regularly - tell patient that formation of black stools is normal - tell patient to avoid alcohol while drinking medication - advise patient to report any hypersensitive reactions or bleeding difficulty

Drug/Dose Frequency/Route

Classification/ Mechanism of Action Classification;

Indications/Contraindications Side Effects Indications:

Paracetamol

Principle of Care - dont use drug for fever

Treatment

Evaluation

- assess patients Patient was temperature and able to adhere

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(Opigesic) 450mg every 4 hours PRN for fever > 39C

Acetaminophen Mechanism of Action: Blocks pain impulses probably by inhibiting prostaglandin or pain receptor sensitizers. May reduce fever by acting in hypothalamic heat regulating center.

Treatment of mild to moderate < 39C, pain and as antipyretic lasting for 3 days or Contraindications; recurring - Patients with known hypersensitivity to - drug is for paracetamol short term use only Side Effects: Hematologic: anemia, leucopenia, - dont crush, neutropenia, pancytopenia, break or chew thrombocytopenia drug Hepatic: liver damage Metabolic: hypoglycemia - do not Skin: Rash, pruritus mistake oral drug for suppository drug

pain before and during therapy - warn patient that high doses or unsupervised use can cause liver damage - advise patient to not drink drug with alcoholic beverages - warn patient not to exceed recommended dose for it may cause hypertoxicity

to medication regimen.

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