Paracetamol 1 amp Hemostan 500mg Furosemide 20mg Metronidazole 500mg Salbutamol Qualran

Drugs name Classification

Paracetamol 1 amp Non-opiod analgesic and antipyretics

Indication

Acute pain Fever

Action

Through the produce analgesia byblocking pain impulse by inhibitingsynthesis of prostaglandin in cns thatsynthesize pain receptor to stimulation

Contraindication / precautions

Anemia, cardiac & pulmonary disease. Hepatic or severe renal disease. Liver warning & disease. Other medicines containing paracetamol. Concomitant use of warfarin.

Adverse reaction Patient/ family teaching

Allergic skin reactions & gi disturbances. Instruct patient to take with meals Have a plenty of water when taking this drug

Drugs name Classification Indication

Action

Contraindication / precautions

Adverse reaction

Patient/ family teaching

Hemostan 500mg Antihemophilic agent Antihemorrhagic and antifibrinolytic for effective hem ostasis in varioussurgical and clinical cases, in traumatic injuries, post-tooth extraction and other dental procedures Forms a reversible complex that displaces plasminogen formf i b r i n r e s u l t i n g i n i n h i b i t i o n o f f i b r i n o l y s i s , i t a l s o i n h i b i t s t h e p r o t e o l y t i c activity of plasmin. Not advisable to use for prolonged periods in patients predisposed tothrombosis. Not recommended for prophylaxis during pregnancy and befored e l i v e r y . O p h t h a l m i c e x a m b e f o r e a n d d u r ing therapy required if patient istreated beyond several days; caution in patients with cardiovas c u l a r , r e n a l , cerebrovascular disease Gi disorders: nausea, vomiting. Cns: anorexia, headache may appear,impaired renal insufficiency, hypotension when iv injection is too rapid Dosage modification required in patients with renal impairment Watch out for any signs of bleeding

Drugs name Classification Indication

Furosemide 20mg Electrolytic and water balance agent; loop diuretic Edema: furosemide is indicated in adults and pediatric patients for the treatment of edema associated with congestive heart failure, cirrhosis of the liver, and renal disease, including the nephrotic syndrome. Furosemide is particularly useful when an agent with greater diuretic potential is desired. Furosemide is indicated as adjunctive therapy in acute pulmonary edema. The intravenous administration of furosemide is indicated when a rapid onset of diuresis is desired, e.g., in acute pulmonary edema. If gastrointestinal absorption is impaired or oral medication is not practical for any reason, furosemide is indicated by the intravenous or intramuscular route. Parenteral use should be replaced with oral furosemide as soon as practical. Analgesics reduce natriuretic action of furosemide. Antagonises hypoglycaemic agents and drugs used for gout. Hyperglycaemia with antihypertensive agent diazoxide. Antagonises muscle relaxants. Increased risk of ototoxicity when used with aminoglycosides especially in renal impairment. May enhance nephrotoxicity of cephalosporins. Effects of antihypertensives enhanced. Action antagonised by corticosteroids. Phenytoin and indometacin may reduce effects of furosemide. Severe sodium and water depletion, hypersensitivity to sulphonamides and furosemide, hypokalaemia, hyponatraemia, precomatose states associated with liver cirrhosis, anuria or renal failure. Addison's disease. Prostatic hyperplasia. Hepatic or renal impairment, gout, dm, impaired micturition. Infusion rate should not exceed 4 mg/min to reduce the risk of ototoxicity. Monitor fluid and electrolyte balance and renal function. May lower serum levels of calcium and magnesium, thus serum levels should be monitored. Pregnancy and lactation.

Action

Contraindication / precautions

Adverse reaction

Fluid and electrolyte imbalance. Rashes, photosensitivity, nausea, diarrhoea, blurred vision, dizziness, headache, hypotension. Bone marrow depression (rare), hepatic dysfunction. Hyperglycaemia, glycosuria, ototoxicity. Rarely, sudden death and cardiac arrest. Hypokalaemia and magnesium depletion can cause cardiac arrhythmias. Instruct patient to take furosemide as directed. Take missed doses as soon as possible; do not double doses caution patient to change positions slowly to minimize orthostatic hypotension. Caution patient that the use of alcohol, exercise during hot weather, or standing for long periods during therapy may enhance orthostatic hypotension instruct patient to consult health care professional regarding a diet high in potassium (see food sources for specific nutrients) advise patient to contact health care professional of weight gain more than 3 lbs in 1 day advise patient to consult health care professional before taking otc medication or herbal products concurrently with this therapy instruct patient to notify health care professional of medication regimen before treatment or surgery caution patient to use sunscreen and protective clothing to prevent photosensitivity reactions advise patient to contact health care professional immediately if muscle weakness, cramps, nausea, dizziness, numbness, or tingling of extremities occurs Emphasize the importance of routine follow-up examinations advise patients on antihypertensive regimen to continue taking medication even if feeling better. Furosemide controls but does not cure hypertension reinforce the need to continue additional therapies for hypertension (weight loss, exercise, restricted sodium intake, stress reduction, regular exercise, moderation of alcohol consumption, cessation of smoking)

Patient/ family teaching

Drugs name

Metronidazole 500mg

Classification Indication

Antimicrobial Treatment of serious abdominal infections due to susceptible anaerobic bacteria Treatment of protozoal infections e.g. Amebiasis, giardiasis, trichomoniasis

Action

Metronidazole is converted to reduction products that interact with dna to cause destruction of helical dna structure and strand leading to a protein synthesis inhibition and cell death in susceptible organisms. It is effective against a wide range of organisms including e. Histolytica, t. Vaginalis, giardia, anaerobes e.g. Bacterioides sp, fusobacterium sp, clostridium sp,peptococcus sp and peptostreptococcus sp, and moderately active against gardnerella sp and campylobacter sp. History of hypersensitivity to metronidazole or other nitroimidazole derivatives. Pregnancy (1st trimester) and lactation. Patients with cns diseases; discontinue iv therapy if abnormal neurologic symptoms occur. History of seizure disorder. Evidence or a history of blood dyscrasias; perform total and differential leukocyte counts before and after treatment. Severe hepatic impairment; monitor plasma levels. Predisposition to oedema (inj contains sodium). Prolonged use may result in fungal or bacterial superinfection.

Contraindication / precautions

Adverse reaction

Gi disturbances e.g. Nausea, unpleasant metallic taste, vomiting, diarrhoea or constipation. Furred tongue, glossitis, and stomatitis due to overgrowth of candida. Rarely, antibioticassociated colitis. Weakness, dizziness, ataxia, headache, drowsiness, insomnia, changes in mood or mental state. Numbness or tingling in the extremities, epileptiform seizures (high doses or prolonged treatment). Transient leucopenia and thrombocytopenia. Hypersensitivity reactions. Urethral discomfort and darkening of urine. Raised liver enzyme values, cholestatic hepatitis, jaundice. Thrombophlebitis (iv). advise patient to take drug with food if it causes gi upset. However, instruct him to take extended-release tablets 1 hour before or 2 hours after meals. tell patient with trichomoniasis to refrain from sexual intercourse or to have male partner wear a condom to prevent reinfection. Explain that asymptomatic sex partners should be treated simultaneously. advise patient to report fever, sore throat, bleeding, or bruising. inform patient that drug may cause metallic taste and may discolor urine deep brownishred. tell patient using topical form to clean area thoroughly with mild cleanser before use and then wait 15 to 20 minutes before applying drug. Tell her she may apply cosmetics to skin after applying drug; with topical lotion, instruct her to let skin dry at least 5 minutes before applying cosmetics. tell female patient to consult prescriber if she is pregnant or plans to become pregnant. as appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.

Patient/ family teaching

Drugs name Classificati on

salbutamol Bronchodilator (therapeutic); adrenergics (pharmacologic)

Indication To control and prevent reversible airway obstruction caused by asthma or chronic obstructive pulmonary disorder (COPD) Quick relief for bronchospasm For the prevention of exercise-induced bronchospasm Long-term control agent for patients with chronic or persistent bronchospasm Action It relieves nasal congestion and reversible bronchospasm by relaxing the smooth muscles of the bronchioles. The relief from nasal congestion and bronchospasm is made possible by the following mechanism that takes place when Salbutamol is administered. First, it binds to the beta2-adrenergic receptors in the airway of the smooth muscle which then leads to the activation of the adenyl cyclase and increased levels of cyclic- 35-adenosine monophosphate (cAMP). When cAMP increases, kinases are activated. Kinases inhibit the phosphorylation of myosin and decrease intracellular calcium. Decreased in intracellular calcium will result to the relaxation of the smooth muscle airways. Hypersensitivity to adrenergic amines, Hypersensitivity to fluorocarbons, Cardiac disease including coronary insufficiency, a history of stroke, coronary artery diseaseand cardiac arrhythmias, Hypertension ,Hyperthyroidism,Diabetes, Glaucoma, Geriatric patients older individuals are at higher risk for adverse reactions and may require lower dosage, Pregnancy especially near term, Lactation, Children less than 2 years of age because safety of its use has not been established Excess inhaler use which may lead to tolerance and paradoxical bronchospasm Nervousness, Restlessness, Tremor, Headache, Insomnia, Chest pain, Palpitations, Angina, Arrhythmias, Hypertension, Nausea and vomiting, Hyperglycemia, Hypokalemia

Contraindi cation / precaution s

Adverse reaction

Patient / family teachin g

Tell patient to swallow extended-release tablets whole and not to mix them with food. Teach patient signs and symptoms of hypersensitivity reaction and paradoxical bronchospasm. Tell him to stop taking drug immediately and contact prescriber if these occur. Instruct patient to notify prescriber immediately if prescribed dosage fails to provide usual relief, because this may indicate seriously worsening asthma. Advise patient to limit intake of caffeine-containing foods and beverages and to avoid herbs unless prescriber approves. Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness. Advise patient to establish effective bedtime routine and to take drug well before bedtime to minimize insomnia. As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, foods, and herbs mentioned above.