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 heart attack stroke diabetes high cholesterol levels conditions Skin problems with symptoms such as swelling, blistering, peeling, high blood pressure, heart dehydration asthma or other allergic

failure or fluid retention

surgery, or other blood vessel disease

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 back pain a reduced sense of touch stomach upset including nausea 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,

low blood pressure

(feeling sick), vomiting, heartburn, indigestion, cramps constipation, diarrhoea, pain in the sleeplessness irritability sore throat inflammation and pain after a tooth skin rash, including hives, raised red, blistering and bleeding in the lips, swelling, blistering or peeling of the stomach, wind

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 a change in the amount or infection of any wounds chest pain or discomfort ankles or legs frequency of urine passed

extraction itchy spots eyes, mouth, nose and genitals skin, which may be accompanied by fever,

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 Penicillins or other are less toxic drugs are contraindicated Action: Inhibits the protein synthesis bacteria at level of 30 S ribosomes 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 patients 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 Neurological disorders: tetany, crisis convulsive, coma. The accidental extravasations of product of contrast apart from the being able to lead exceptionally to a cardiovascular collapse.

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 seafoods 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 bodys 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: InductionDosage must be individualized by physician; however, as a general guideline: Intravenous, 4 to 6 mg per kg of body weight. MaintenanceDosage 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 NSAIDS 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 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, fever, sore throat, and headache with a severe blistering, peeling, and red skin bruising, severe tingling, numbness, pain, muscle weakness; or Fever, headache, neck stiffness, chills, increased sensitivity to light, purple spots

balance;

jaundice (yellowing of the skin or eyes); rash;

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