Classification Histamine Blocker

Indication Treatment and prevention of heartburn, acid indigestion, and sour stomach.

Action Potent anti-ulcer drug that competitively and reversibly inhibits histamine action at H2receptor sites on parietal cells, thus blocking gastric acid secretion. Indirectly reduces pepsin secretion but appears to have minimal effect on fasting and postprandial serum gastrin concentrations or secretion of gastric intrinsic factor or mucus.

Contraindications/ Precautions Contraindicated with allergy to ranitidine, lactation. Use cautiously with impaired renal or hepatic function, pregnancy.

Adverse Reaction CNS: Confusion, dizziness, drowsiness, hallucinations, headache CV: Arrhythmias GI: Altered taste, black tongue, constipation, dark stools, diarrhea, nausea GU: Decreased sperm count, impotence HEMATOLOGY: Agranulocytosis, neutropenia, thrombocytopenia MISC: Hypersensitivity reactions, vasculitis

Patient/ Family Teaching Take drug with meals and at bedtime. Therapy may continue for 4-6 weeks or longer. If you also are using an antacid, take it exactly as prescribed, being careful of the times of administration. Have regular medical follow up care to evaluate your response. Report sore throat, fever, unusual bruising or bleeding, tarry stools, severe headache, muscle or joint pain.

Classification Laxatives, Purgatives

Indication Relief of occasional constipation. For bowel cleansing prior to medical procedures e.g. surgery, x-ray or endoscopic exam.

Action Saline laxative; osmotically mediated water retention which stimulates peristalsis.

Contraindications/ Precautions Impaired renal function, preexisting electrolyte imbalances, and debilitated patients. Rectal bleeding or no bowel movement after use.

Adverse Reaction Transient hyperphosphatemia.

Patient/ Family Teaching Should be taken on an empty stomach (Take on an empty stomach 1 hr before or 2 hr after meals. Dilute recommended dose w/ glass of water, drink & follow w/ 1 full glass of water.).

Classification Second-generation cephalosporins

y y y y y y

Indication Uncomplicated urinary tract infections Respiratory tract infections Uncomplicated gonorrhoea Otitis media Meningitis Renal impairment

Action Cefuroxime binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death. Absorption: Absorbed from the GI tract with peak plasma concentrations after 2-3 hr (oral); may be enhanced by the presence of food. Distribution: Pleural and synovial fluid, sputum, bone and aqueous fluids; CSF (therapeutic concentrations). Crosses the placenta and enters breast milk. Protein-binding: Up to 50%. Metabolism: Rapidly hydrolysed (intestinal mucosa and blood). Excretion: Via the urine by glomerular filtration and renal tubular secretion (as unchanged); via bile (small amounts); 70 min (elimination half-life); prolonged in neonates and renal impairment.

Contraindications/ Precautions y Severe renal impairment; pregnancy, lactation; hypersensitivity to penicillins. y Hypersensitivity to cephalosporins.

Adverse Reaction Large doses can cause cerebral irritation and convulsions; nausea, vomiting, diarrhea, GI disturbances; erythema multiform, StevensJohnson syndrome, epidermal necrolysis. Potentially Fatal: Anaphylaxis, nephrotoxicity, pseudomembranous colitis.

Patient/ Family Teaching Advise patient to immediately report rash or bleeding tendency. Instruct patient to take drug with food every 12 hours as prescribed. Teach patient how to recognize signs and symptoms of super infection. Instruct him to report these right away. Advise patient to report CNS changes. As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.

Classification Anti hemophilic agent

Indication Anti-hemorrhagic and anti-fibrinolytic for effective hemostasis in various surgical and clinical cases, in traumatic injuries, posttooth extraction and other dental procedures.

Action Forms a reversible complex that displaces plasminogen form fibrin resulting in inhibition of fibrinolysis, it also inhibit s the proteolyticactivity of plasmin.

Contraindications/ Precautions Not advisable to use for prolonged periods in patients predisposed to thrombosis. Not recommended for prophylaxis during pregnancy and before delivery. Opthalmic exam before and during therapy required if patient is treated beyond several days; caution in patients with cardiovascular, renal and cerebrovascular disease.

Adverse Reaction GI disorders Nausea, Vomiting CNS Anorexia, Headache, impaired renal insufficiency, hypotension when iv injection is too rapid

Patient/ Family Teaching Dosage modification required in patients with renal impairment. Watch out for any signs of bleeding.a