Generic Name: Dynastat

Brand name: Parecoxib

Classification: Non-steroidal anti-inflammatory drugs.

Indication: IIndicated for the short-term treatment of postoperative pain in adults.

Parecoxib has not been studied in patients under 18 years. Therefore, its use is not

recommended in these patients.

Action: NSAIDs inhibit cyclooxygenase (COX) enzymes, which are involved in the

synthesis of prostaglandins and thereby reduce pain and inflammation. Oral NSAIDs are

used post-operatively but when patients are unable to tolerate oral medications or require

a faster onset of analgesia, parenteral administration may be preferred.

Contraindications:

You have or have had any medical conditions, especially the following:

kidney or liver disease

heart problems, heart surgery, or other

blood vessel disease

heart attack

stroke

diabetes

high cholesterol levels

high blood pressure, heart failure or

fluid retention

dehydration

asthma or other allergic conditions

Skin problems with symptoms such as

swelling, blistering, peeling, itching,

reddening or some other abnormality.

Peptic ulcer (ie stomach or duodenal

ulcer), a recent history of one, or have had

peptic ulcers before.

Side Effects:

changes in blood pressure

dizziness or light-headedness due to low

blood pressure

back pain

a reduced sense of touch

stomach upset including nausea (feeling

sick), vomiting, heartburn, indigestion,

cramps

constipation, diarrhoea, pain in the

stomach, wind

sleeplessness

irritability

sore throat

inflammation and pain after a tooth

extraction

skin rash, including hives, raised red, itchy

spots

blistering and bleeding in the lips, eyes,

mouth, nose and genitals

swelling, blistering or peeling of the skin,

which may be accompanied by fever,

chills, headache, sore throat, diarrhoea,

aching joints and muscles

other signs of allergic reaction such

as wheezing, swelling of the face,

lips, mouth, tongue or throat which

may cause difficulty in swallowing

or breathing

slow heart beat

severe or persistent headache, fever,

stiff neck, sensitivity to light and

vomiting

bleeding or bruising more easily than

normal, reddish or purplish blotches

under the skin

signs of anaemia, such as tiredness,

being short of breath, and looking

pale

unusual weight gain, swelling of

ankles or legs

a change in the amount or frequency

of urine passed

infection of any wounds

chest pain or discomfort

Stock dose: 40mg by IM or IV injection, followed every 6 to 12 hours by 20mg or

40mg as required to a maximum of 80mg per day

Nursing responsibilities:

1. You have any allergies to:

any other medicines including aspirin or other NSAID medicines, including

other Coxib medicines

any other substances, such as foods, preservatives or dyes

2. You are pregnant or intend to become pregnant

May affect your developing baby if taken during pregnancy. Use of

DYNASTAT during pregnancy is not recommended.

3. You are breastfeeding or intend to breastfeed

It is not known whether DYNASTAT passes into breast milk or whether your

baby might be affected. Therefore, breastfeeding should be discontinued

during treatment with DYNASTAT.

4. You are taking DYNASTAT together with any medicines used to treat high

blood pressure and some other heart problems such as ACE inhibitors,

angiotensin receptor antagonists and diuretics (also called fluid or water

tablets).When taken together these medicines can cause kidney problems.

5. You are a smoker, stop or restrain from smoking

6. You currently have an infection.

If you are given DYNASTAT while you have an infection, it may hide some of

the signs of an infection.

Generic Name: Aminoglycosides; Gentamicin

Brand name: Cidomycin, Gramycin, G-mycin, Jenamicin

Classification: Therapeutic: Anti-Infectives, Pharmacologic: aminoglycosides

Indication: Treatment of serious gram negative bacillary infection & infectious caused

by staphylococci when Penicillin’s or other are less toxic drugs are contraindicated

Action: Inhibits the protein synthesis bacteria at level of 30 S ribosome’s with

bactericidal action

Contraindications: Hypersensitivity. Most parenteral products contain bisulfates and

should be avoided in patients with known intolerance. Products containing benzyl alcohol

should be avoided in neonates. Cross-sensitivity among aminoglycosides may occur

Side Effects:

an allergic reaction (shortness of

breath; closing of the throat; hives;

swelling of the lips, face, or tongue;

rash; or fainting);

little or no urine;

decreased hearing or ringing in the

ears;

dizziness, clumsiness, or unsteadiness;

numbness, skin tingling, muscle

twitching, or seizures; or

severe watery diarrhea and

abdominal cramps.

increased thirst;

loss of appetite;

nausea or vomiting;

a rash.

Stock dose: Injection 10mg/ml, 40 mg/ml. Premixed injections: 40mg/50 ml, 40mg/100

ml, 60mg/ 50ml, 60mg/100ml, 70mg/ 50ml 70mg/ 100ml, 80 mg/ 50 ml, 80mg /100ml,

90mg/ 50 ml, 90 mg/ 100ml, 100mg/ 80ml, 100mg/ 100 ml, 120mg/ 100ml, 160mg/

100ml, 180mg/ 100ml

Nursing responsibilities:

Assess for the level of infection at the beginning at through out the administration

of the medication

Obtain specimen for culture and sensitivity before initiating therapy 1st dose may

be given even with out the results

Monitor intake and output and daily weight to assess hydration status and renal

function

Assess for the patient’s signs and symptoms of superinfection, report to the

physician early if it occur

Resolution of signs and symptoms of superinfection if it occurs and if no response

is seen within 3-5 days, new cultures should be taken

Generic Name: Naloxone

Brand name: Narcan

Classification: Therapeutic: antidotes. Pharmacologic: opioid antagonist

Indication: Reversal of CNS depression and respiratory depression because of suspected

opioid overdosage. Unlabeled uses: Narcotic induced pruritis. Management of refractory

circulatory shock

Action: competitively blocks the effects of opioids, including CNS and respiratory

depression with out producing any agonist effects. Therapeutic effects: Reversal of signs

of opioid excess

Contraindications: in patients known to be hypersensitive to naloxone hydrochloride or

to any of the other ingredients in Narcan.

Side Effects: Hypertension, hypotension, ventricular fibrillation and ventricular

tachycardia. GI; nausea and vomiting

Stock dose:

Injection: 0.4 mg/ml. Neonatal injection: .02 mg/ml in combination with pentazocine

Nursing responsibilities:

Monitor vitals signs especially respiratory arte, rhythm and depth; pulse, ECG,

and lvel of consciousness frequently for 3-4 hours after the expected peak of

blood concentration.

Assess for signs and symptoms of opioid withdrawal. Symptoms may occur

within few minutes to 2 hours. Severity depends on dose of naloxone, the opioid

involved, and degree of physical dependence

Lack of significant improvement indicates that symptoms are caused by a disease

process or other non-opioid CNS depressant not affected by naloxone

Dosages should be titrated carefully in postoperative patients to avoid interference

with control of postoperative pain

Resuscitation equipment, oxygen, vasopresor and mechanical ventilators should

be available to supplement naloxone therapy as needed

Generic Name: Propofol

Brand name: Diprivan

Classification: General anesthetics

Indication: Propofol is a drug that reduces anxiety and tension, and promotes relaxation

and sleep or loss of consciousness. Propofol provides loss of awareness for short

diagnostic tests and surgical procedures, sleep at the beginning of surgery, and

supplements other types of general anesthetics. Propofol is for injection into a vein. It is

given by trained anesthesia professionals in a controlled environment

Action: short acting hypnotic. Mechanism of action is unknown. Produces amnesia. Has

no analgesic property. Therapeutic: induction and maintenance of anesthesia

Contraindications: Hypersensitive to propofol, soybean oil, egg lecithin, or glycerol.

Labor and delivery

Side Effects:

Side effects that you should report to your prescriber or health care professional as soon

as possible:

difficulty breathing, wheezing, swelling of the throat

fast heartbeat, palpitations

lightheadedness or fainting spells

numbness or tingling in the hands or feet

seizure (convulsion)

skin rash, flushing (redness), or itching

swelling or extreme pain at the injection site

uncontrollable muscle spasm

dizziness

pain or irritation at the injection site

Stock dose: Injection: 10mg/ml in 20-ml ampules, 50- and 100- ml infusion vials

Nursing responsibilities:

Patient should be closely monitored following administration of propofol.

Propofol is a very short-acting drug, and its effects generally wear off in just a

few hours. However, propofol may affect your ability to drive or operate

machinery for several hours after use. Do not attempt to drive yourself home if

you have received propofol for minor outpatient surgery or diagnostic tests.

Avoid alcohol, mood-altering drugs, or any other medicines for at least 24 hours

after a dose of propofol, unless approved by your prescriber or health care

professional.

Aseptic technique is essential. Solution is capable of rapid growth of bacteria

contaminants. Infections and subsequent dea6hs have been reported

May cause drowsiness or dizziness. Advice patients to request assistance prior to

ambulation and transfer to avoid driving or any kind of activities that requires

alertness until response to medication is known

Generic Name: Acid Ioxitalamique, acid Ioxitalamique

Brand name: Telebrix

Classification: Diagnostic products or other therapeutic products

Indication:

Tomodensitometry

Intravenous urography

Digitized Angiography

Angiocardiography (ventriculographie, coronarography)

Action: binds with the blood stream for better visualization of the parts of the organ that

are being visualized by different diagnostics procedures

Contraindications: Injection by way under-arachnoids

Side Effects:

Benign demonstrations of intolerance can occur precociously or tardily. They can

be isolated or associated and from type:

respiratory: cough, respiratory feeling of oppression ;

digestive: nauseas, vomiting;

neuron sensory: feeling of heat, distresses, agitation, cephalgia;

cutaneous: flush, pruritis, localized or generalized urticaria, rash cutaneous,

palpebral edema.

More serious accidents can follow these minor signs or occur of start:

Reactions allergies: dyspnea, hypotension; more rarely shock anaphylactic

broncho spasm, edema of the larynx, pulmonary edema and exceptionally

edema of Quince.

Cardiovascular disorders: disorders of the rate/rhythm, paleness, cyanosis

being able to lead exceptionally to a cardiovascular collapse.

Neurological disorders: tetany, crisis convulsive, coma.

The accidental extravasations of product of contrast apart from the vascular

way are responsible for painful and inflammatory demonstrations local.

Stock dose: 350 mg iode/ml inject able Solution by intravascular way Box of 1 Bottle (+

micro perfusion + syringe) of 50 ml

Nursing responsibilities:

Advice patient to increase fluid intake before and after the administration of the

said medication to facilitate excretion

Maintain proper hydration status

Assess for any allergic reaction to seafood’s or iodine rich foods

Advice the patient that discoloration on diffident secretions of the body may alter

in color and it is just normal and if the said medication is gone into the body’s

system it will go back to its original state

Advice patient that alteration in taste sensation is normal and will go back as soon

as the medication is excreted

Nursing mothers should wait for 24 hours after contrast material injection before resuming breast-feeding.

Generic Name: Thiopental Sodium

Brand name: Pentobrim, Pentothal Sodium

Classification: Anesthetics General & Local

Indication: Parenteral thiopental also indicated in the treatment of cerebral hypertension,

for narcoanalysis in the treatment of psychiatric disorders, in the treatment of cerebral

ischemia and hypoxia, and to control convulsive states during or following inhalation

anesthesia, local anesthesia, or other causes

Action: Ultra short-acting barbiturate anesthetics depress the central nervous system

(CNS) to produce hypnosis and anesthesia without analgesia.

The exact mechanism by which barbiturate anesthetics produce general anesthesia is not

completely understood. However, it has been proposed that they act by enhancing

responses to gamma-aminobutyric acid (GABA), diminishing glutamate (GLU)

responses, and directly depressing excitability by increasing membrane conductance (an

effect reversed by the GABA antagonist picrotoxin), thereby producing a net decrease in

neuronal excitability to provide anesthetic action.

The mechanism by which thiopental reduces intracranial pressure and protects the brain

from cerebral ischemia and hypoxia is not completely understood. However, it is related

to thiopental's anesthetic action and results in increased cerebral vascular resistance with

a decrease in cerebral blood flow and cerebral blood volume, and decreased cerebral

metabolic rate for oxygen. Various mechanisms of action have been proposed, including

a reduction of cerebral metabolic rate, a decrease in the functional activity of the brain, an

inhibition of the brain stem neurogenic mechanism of vasoparalysis, a sealing effect on

membranes, and a scavenging of free oxygen radicals

Contraindications: Absence of suitable veins, status asthmaticus; porphyria

Side Effects:

Drowsiness; tolerance, dependence with withdrawal side effects including seizures

Stock dose:

Rectal, 30 mg per kg of body weight

For parenteral dosage form only

A test dose of 25 to 75 mg (1 to 3 mL of a 2.5% solution) may be administered to

determine tolerance or unusual sensitivity to thiopental; patient reaction should be

observed for at least 60 seconds. In pediatric patients, a test dose of 0.5 mg per kg

of body weight may be used.

A 2 or 2.5% concentration of thiopental solution is used for intermittent

intravenous administration.

A 3.4% concentration of thiopental in sterile water for injection is isotonic;

concentrations less than 2% in sterile water for injection should not be used

because they cause hemolysis.

Children up to 15 years of age:

Induction—Dosage must be individualized by physician; however, as a general

guideline:

Intravenous, 4 to 6 mg per kg of body weight.

Maintenance—Dosage must be individualized by physician; however, as a

general guideline: Intravenous (intermittent), about 1 mg per kg of body weight as

required.

Nursing responsibilities:

Avoid alcohol intake at least 24 hours without advice of the health care

professional

Inform patient that medication will decrease mental recall of the procedure

mood-altering drugs, or any other CNS depressant medicines for at least 24 hours

without advice of the health care professional

Aseptic technique is essential. Solution is capable of rapid growth of bacteria

contaminants. Infections and subsequent dea6hs have been reported

May cause drowsiness or dizziness. Advice patients to request assistance prior to

ambulation and transfer to avoid driving or any kind of activities that requires

alertness until response to medication is known

Generic Name: diclofenac (dye KLOE fen ak)

Brand name: Cataflam, Voltaren, Voltaren-XR

Classification: nonopioid analgesics, nonsteroidal, anti-inflammatory agents

Indication: Management of inflammatory disorder including: Rheumatoid arthritis,

osteoarthritis, ankylosing spondylitis. Relief of mild to moderate pain of dysmenorrheal,

acute pain. Topical: treatment of actinic Kerasotes

Action: inhibits prostaglandin synthesis. Therapeutic effects: suppression of pain and

inflammation

Contraindications: Hypersensitivity to disclofenac or other components of formulation

of Cross-sensitivity may occur with other NSAID’S including aspirin. Active GI bleeding

and ulcer disease

Side Effects:

upset stomach, mild heartburn or stomach pain, diarrhea, constipation;

bloating, gas;

dizziness, headache, nervousness;

skin itching or rash;

blurred vision; or

Ringing in your ears.

chest pain, weakness, shortness of breath, slurred speech, problems with vision or

balance;

black, bloody, or tarry stools;

coughing up blood or vomit that looks like coffee grounds;

swelling or rapid weight gain;

urinating less than usual or not at all;

nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools,

jaundice (yellowing of the skin or eyes);

fever, sore throat, and headache with a severe blistering, peeling, and red skin

rash;

bruising, severe tingling, numbness, pain, muscle weakness; or

Fever, headache, neck stiffness, chills, increased sensitivity to light, purple spots

on the skin, and/or seizure (convulsions).

Stock dose: Diclofenac sodium delayed release (enteric coated) tablets: 25 mg, 50 mg,

75 mg. Diclofenac sodium extended-release tablets: 75 and 100 mg. Suppositories: 50

and 100 mg. In combination with: 200 mcg Misoprostol.

Nursing responsibilities:

Remember, keep this and all other medicines out of the reach of children, never

share your medicines with others, and use this medication only for the indication

prescribed.

Administration of higher that the recommended dose does not provide more relief

and effectiveness but may cause increased side effects, Use lowest effective does

for shortest period of time

Instruct patient to take diclofen with afull galss of water and to remain in an

uprigtyht posityion for 15-30 minutes afgter adminitration.

Take missed dose as soon as possible within 1-2 hours if taking once or twice a

day or unless almost most of the time for the next dose if taking more than twice

per day. Do not double doses.

May cause drowsiness or dizziness. Caution patient to avoid any kind of activities

that requires alertness until response to medication is known