Name Of Drug Generic Name: Zinc Sulfate(monohy drate) , white vitriol Brand Name: E-Zinc Classifications: Vitamins &

Minerals (Paediatric) / El ectrolytes

Route/ Dosage Minimum Dose Drops: Therapeutic Dose: As an Adjunct in the Management of Acute Diarrhea together with Reduced Osmolarity ORS: Children 6 months: 1 mL; <6 months: 2 mL. To be taken orally once during an acute diarrhea episode. Take for 10-14 days even when diarrhea has already stopped. As Nutritional Supplement: Children 13 years: 0.5 mL; 6-11 months: 0.5 mL. Orally once daily. Missing a Dose: If the patient miss the dose for the day, just take the next dose and the subsequent doses at the usual recommended schedule ie, once a day. Do not double the dose unless recommended. Syrup: Therapeutic Dose:

Indications -Zinc is used for the following conditions: As an adjunct in the management of acute diarrhea; to help boost immune function; to help support optimum physical growth and developmen

Actions E-Zinc contains zinc. Zinc helps the body's natural defense against damaging free radicals (antioxidant effect) and helps boost immune function. Free radicals are highly reactive and unstable chemicals generated during normal body activities that require oxygen (eg, respiration, digestion, blood circulation, immune system response, etc) and after exposure to ultraviolet (UV) light, cigarette smoke and various pollutants. One major effect of zinc is on the ability of cells to properly replicate the deoxyribonucleic acid (DNA), which is

Contr aindic ation Allerg y to any compo nent of EZinc.

Side Effects CNS: Depression. CV:flushing, hypotensio Respiratory: Decreased respiratory rate GI: Gastrointestinal side effects eg, nausea and vomiting are seen with doses of elemental zinc >30 mg. Rare cases of acute zinc poisoning have been reported. The toxicity signs observed after ingestion of high zinc doses (4-8 g) include nausea, vomiting, diarrhea, fever, metallic taste and lethargy (sleepiness).

Nursing Responsibilities Before - Assess for contra indicated conditions.- Observe the 15 rights in drug administration. During - Monitor nausea, vomitin After - Arrange to discontinue administration as soon as levels are within normal limits and desiredclinical response is obtained.- Discontinue if diarrhea orcramping occurs. - Arrange for dietary measures,exercise and environmental controlto return to normal bowel activity. - Report nausea, vomiting, diarrhea, fever, metallic taste and lethargy

As an Adjunct in the Management of Acute Diarrhea together with Reduced Osmolarity ORS: Children 6 months: 5 mL or 1 tsp; <6 months: 2.5 mL or tsp. To be taken orally once during an acute diarrhea episode. Take for 10-14 days even when diarrhea has already stopped. Routes of administration Oral

required for cells to multiply. Hence, zinc is needed for normal growth. Zinc has other known functions/effects: Cofactor of various enzymes in cell division and growth. Required for the normal development and maintenance of the immune system; helps regulate the activity of cells involved in immune function. Functions as an antioxidant by being a cofactor of the enzyme superoxide dismutase, which is involved in the removal of harmful free radicals. Zinc is also recommended by the World Health Organization (WHO) and UNICEF as an adjunct in acute

diarrhea management together with reduced osmolarity oral rehydration salts (ORS). Name Of Drug Generic Name: salbutamol Brand Name: It is marketed by GlaxoSmithKlin e as Ventolin, Ventoline, Ventilan, Aerolin or Ventorlin, depending on the market; by Cipla as Asthalin and Asthavent; by Schering-Plough as Proventil, by Teva as ProAir, by Ad-din Pharma as Ventosol and by Alphapharm as Asmol. Classification: Antiasthmatic & Route/ Dosage Indication Actions s Acute Antihistamine.direc severe t effect on asthma bronchial smooth muscle. Acute bronchos pasm Contraindication Other.Drugs.Diuretics, corticosteroids and xanthines may augment hypokalaemia. CV effects potentiated by MAOIs, TCAs, sympathomimetics. Increases absorption of sulfamethoxazole when used together. May markedly increase heart rate and BP when used with atomoxetine. Reduces serum levels of digoxin. Hypokalaemia induced by salbutamol increases the risk of digitalis toxicity. BP should be closely monitored if linezolid is used concurrently with salbutamol. Nursing Responsibilities The most common Before side effects are fine - Assess for contra tremor, anxiety, indicated headache, muscle conditions.cramps, dry mouth, - Observe the 15 and palpitation.[5] rights in drug Other symptoms may administration. include tachycardia, During arrhythmia, flushing, Check.Breathing myocardial ischemia, After and disturbances of Check.Breathing sleep and behaviour. the maximal effect of [5] Rarely occurring, salbutamol can take but of importance, place within five to are allergic reactions twenty minutes of of paradoxical dosing, though some bronchospasm, relief is immediately urticaria, seen. It can also be angioedema, given orally as an hypotension, and inhalant or collapse. High doses intravenously. may cause -Arrange for hypokalaemia which pyridoxine if patient are of concern in develops symptoms patients with renal of peripheral Side Effects

is usually given by the inhaled route for direct effect on bronchial smooth muscle. Should be taken on an empty stomach. (Take 1 hr before or 2 hr after meals.) Adult: PO Acute Severe bronchospasm 2-4 mg bronchos (up to 8 mg) 3-4 pasm times/day. Extended release 8 mg twice daily. IV Severe bronchospasm 250 mcg via inj or infusion. Higher doses may be used in respiratory failure. Uncomplicated premature labour Severe bronchospasm 500 mcg 4 hrly if needed. Inhalation Acute bronchospasm As aerosol: 100 or 200 mcg

COPD Preparations / Dr ugs Acting on the Uterus

3-4 times/day. 2 puffs may be given prior to exertion to prevent exercise-induced bronchospasm. Acute severe asthma As MDI: 4-6 inhalations every 1020 mins. Severe bronchospasm Via nebuliser: 2.5-5 mg up to 4 times/day. intravenously.

failure and those on certain diuretics and xanthine derivatives

neuritis.

Name Of Drug Generic Name: Paracetamol (acetaminophe n) Brand Name: Tempra Classification: Pain.Killer.

Indication Actions s Pain,Fever, Paracetamol works Route headache, as a painkiller by Tablet/syrup affecting chemicals ease mild in the body called Adults to prostaglandins. The recommended dosage moderate Prostaglandins are of paracetamol in adults is pain for substances released two 500mg tablets (i.e. example, in response to 1gm paracetamol) every headaches, illness or injury. four to six hours, not sprains, to Paracetamol blocks exceeding eight tablets othache or the production of (4gms) in any 24 hour the prostaglandins, period (1). This dosage symptoms making the body may be continued for of a cold less aware of the several days. If pain relief pain or injury. is required for a longer

Route/ Dosage

Contraindication
(None except hypersensitivity to paracetamol). However, if there is a pre-existing liver insufficiency, paracetamol can be hepatotoxic even in small amounts. Child safe storage is indicated because of the considerable danger of intoxication!

Side Effects
None except hypersensitivity to paracetamol. The antidote acetylcysteine (e.g. fluimucil) must be administered within 8 to 10 hours when there is intoxication: i.v. infusion of 150 mg/kg in 15 minutes, then 50 mg/kg for 4 hours, and then 100 mg/kg for 16 hours in a 5% glucose solution.

Nursing Responsibilities Before - Assess for contra indicated conditions.Observe the 15 rights in drug administration. After Check.Tempreture,an d.pain.symptoms

Paracetamol only

period it should be with the supervision of a doctor.

Children
Children's dosages vary with the age of the child and the type of product, therefore the instructions on the pack should always be followed. In general, children's dosages are based on a single dose of 10mg paracetamol per kilogram bodyweight, which can be repeated 4-6 hourly, not exceeding four doses per 24 hours. On a doctor's recommendation only, paracetamol may be given to a 2 month old child following immunisation as a single dose of 60mg (i.e. 2.5mL paracetamol liquid (oral suspension) at a strength 120mg per 5 mL). For children under 3 months, on a doctor's advice only, the dosage is 10mg paracetamol per

Paracetamol reduces temperature by acting on the area of the brain that is responsible for controlling temperature.

rarely causes gastrointestinal problems or allergic skin reactions. Blood dyscrasia (e.g. thrombocytopenia), methaemoglobinemi a, and hemolytic anemia are very rare. A minority of the subjects with socalled aspirin intolerance responds to paracetamol with bronchospasms. It is not safely established if paracetamol can cause a nephropathy, like drug combinations containing phenacetin.
When metabolized in the liver, small amounts of an intensely active metabolite, which is normally immediately inactivated by glutathione, are produced. An overdose causes a glutathione deficiency; the reactive metabolite may then cause hepatocellular damage and necrosis

kilogram body weight (5mg/kg if jaundiced). For a child 3 months to 1 year of age a dose of between 60mg and 120mg (i.e. 2.5mL to 5mL of paracetamol liquid (oral suspension) at a strength of 120mg/5mL) may be repeated every 4-6 hours to a maximum of 4 doses in 24 hours. For a child 1 to 5 years of age 120mg to 250mg (i.e. 5mL to 10mL of paracetamol liquid (oral suspension) at a strength of 120mg/5mL) may be repeated every 4-6 hours to a maximum of 4 doses in 24 hours. For a child 6 to 12 years of age 250mg to 500 mg (i.e. 5mL to 10mL paracetamol liquid (oral suspension) at a strength of 250mg/5mL) may be repeated every 4-6 hours to a maximum of 4 doses in 24 hours.

leading to acute liver failure. Toxic effects have been observed in adults treated with doses of more than 10 g (20 tablets). However, if there is a pre-existing liver insufficiency, paracetamol can be hepatotoxic even in small amounts.

Name Of Drug Generic Name: Oxacillin Brand Name: Bactocill Classification: Oxacillin sodium (trade name Bactocill) is a narrow spectrum beta-lactam antibiotic of the penicillin class.

Route/ Dosage

Indicatio ns

Actions Toxic.to.micro-Organisms. Oxacillin is a penicillinaseresistant -lactam. It is similar to methicillin, and has replaced methicillin in clinical use. Another related compound is nafcillin. Since it is resistant to penicillinase enzymes, such as that produced by Staphylococcus aureus, it is widely used clinically to treat penicillin-resistant Staphylococcus aureus. However, resistant strains called oxacillin-resistant Staphylococcus aureus (MRSA/ORSA) are highly prevalent

Usual Pediatric Dose for Bacterial Bacterial Infection: Infection Neonates: < 7 days, birthweight < 1200 g: 25 mg/kg IV or IM every 12 hours. < 7 days, birthweight 1200 to 2000 g: 25 to 50 mg/kg IV or IM every 12 hours. < 7 days, birthweight > 2000 g: 25 to 50 mg/kg IV or IM every 8 hours. > 7 days, birthweight < 1200 g: 50 mg/kg/day IV or IM in divided doses every 12 hours. > 7 days, birthweight 1200 to 2000 g: 25 to 50 mg/kg IV or IM every 8 hours. > 7 days, birthweight > 2000 g: 25 to 50 mg/kg IV

Contraindi cation A history of a hypersensiti vity (anaphylact ic) reaction to any penicillin is a contraindic ation. Solutions containing dextrose may be contraindic ated in patients with known allergy to corn or corn products.

Side Effects hypersensitivity (anaphylactic) reaction Oxacillin can cause hepatitis. fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; diarrhea that is watery or bloody; fever, chills, body aches, flu symptoms; easy bruising or bleeding, unusual weakness; urinating less than usual or not at all; severe skin rash, itching, or peeling; agitation, confusion, unusual thoughts or behavior; or seizure (black-out or convulsions). Less serious side effects may include:

Nursing Responsibilities Before - Assess for contra indicated conditions.Observe the 15 rights in drug administration. After Check.for.Alergic.rea ction. Skin.Test

or IM every 6 hours. 1 month to 12 years: Mild to moderate infections: Parenteral: 25 to 37.5 mg/kg IV or IM every 6 hours. Oral: 12.5 mg/kg every 6 hours. Severe infections: 150 to 200 mg/kg/day IV or IM in equally divided doses every 4 to 6 hours. Maximum dose: 12 g/day.

nausea, vomiting, stomach pain; vaginal itching or discharge; headache; swollen, black, or "hairy" tongue; or thrush (white patches or inside mouth or throat).

Name Of Drug Generic Name: Ceftriaxone Brand Name: Rocephin Classification:

Route/ Dosage Oral Tablet/solution In children, the ceftriaxone dosing can range depending on body

Indications Bacterial Infection

Actions Like other third-generation cephalosporins, it has broad spectrum activity against Gram-positive and Gramnegative bacteria.

Contraindication Hypersensitivity;

Nursing Responsibilities Fatigue,headache,so Before mnolence,nervousnes - Assess for contra s, dry mouth, GI indicated disorders (eg: conditions.nausea, gastritis)& Observe the 15 rights

Side Effects

antibiotic.

weight, from 50 to 100 mg per kilogram of body weight per day (mg/kg per day) once only or 1 to 2 times daily for 7 to 14 days. Route/ Dosage The usual recommended adult dose is 10 mg for a 70 kg individual, administered subcutaneously, intramuscularly or intravenously; this dose may be repeated every 3 to 6 hours as necessary. Dosage should be adjusted according to the severity of the pain, physical status of the patient, and other medications which the patient may be receiving. In non-tolerant individuals, the recommended single maximum dose is 20 mg, with a maximum total daily dose of 160 mg. The use of NUBAIN as a Indications Nalbuphine is indicated for the relief of moderate to severe pain. It can also be used as a supplement to balanced anesthesia, for preoperative and postoperativ e analgesia, and for obstetrical analgesia during labor and delivery. Although Nalbuphine

In most cases, it is considered to be equivalent to cefotaxime in terms of safety and efficacy. Ceftriaxone sodium

allergic symptoms eg: rash.

in drug administration. After Check.for.Alergic.rea ction. Skin.Test

Name Of Drug Gerneric.Name Nalbuphine Brand.Name Nubain Classification: Nalbuphine is a semi-synthetic opioid agonistantagonist analgesic of the phenanthrene series.

Actions Nalbuphine is a semisynthetic opioid agonistantagonist analgesic of the phenanthrene series. It is chemically related to both the widely used opioid antagonist, naloxone, and the potent opioid analgesic, oxymorphone.

Contraindication hypersens. to drug/class/compon. caution if opioid dependency caution if head injury caution if pulmonary impairment caution if hepatic impairment caution if biliary surgery or dz caution if hypersens. to sulfites caution if renal impairment caution in

Nursing Responsibilities he most frequent side Before effect in 1066 - Assess for contra patients treated with indicated nalbuphine was conditions.sedation in 381 Observe the 15 rights (36%). in drug Other, less frequent administration. reactions are: feeling After sweaty/clammy 99 Check.for.Alergic.rea (9%), ction. nausea/vomiting 68 (6%), dizziness/vertigo 58 (5%), dry mouth 44 (4%), and headache 27 (3%). Other adverse reactions which may occur (reported incidence of 1% or less) are: CNS effects: Nervousness, depression,

Side Effects

supplement to balanced anesthesia requires larger doses than those recommended for analgesia. Induction doses of NUBAIN range from 0.3 mg/kg to 3.0 mg/kg intravenously to be administered over a 10 to 15 minute period with maintenance doses of 0.25 to 0.50 mg/kg in single intravenous administrations as required. In case of overdose or adverse reaction, the immediate intravenous administration of naloxone (Narcan) is a specific antidote. Oxygen, intravenous fluids, vasopressors and other supportive measures should be used as indicated

possesses opioid antagonist activity, there is evidence that in nondependen t patients it will not antagonize a opioid analgesic administered just before, concurrently, or just after an injection. Therefore, patients receiving an opioid analgesic, general anesthetics, phenothiazin es, or other tranquilizers, sedatives, hypnotics, or other CNS depressants (including

elderly pts caution if pregnancy caution in labor and delivery

restlessness, crying, euphoria, floating, hostility, unusual dreams, confusion, faintness, hallucinations , dysphoria, feeling of heaviness, numbness, tingling, unreality. The incidence of psychotomim etic effects, such as unreality, depersonaliza tion, delusions, dysphoria and hallucinations has been shown to be less than that which occurs with pentazocine. Cardiovascul

alcohol) concomitantl y with Nalbuphine may exhibit an additive effect. When such combined therapy is contemplate d, the dose of one or both agents should be reduced.

ar: Hypertension, hypotension, bradycardia, tachycardia, pulmonary edema. Gastrointestin al: Cramps, dyspepsia, bitter taste. Respiration: Depression, dyspnea, asthma. Dermatologic al: Itching, burning, urticaria. Obstetric: Pseudosinusoidal fetal heart rhythm.

Other possible, but rare side effects include speech difficulty, urinary urgency, blurred vision, flushing and warmth.

Name Of Drug Generic.Name IRON VITAMIN B COMPLEX Brand.Name Ferlin Syrup Classification Mineral/Vitamin s

Route/ Dosage Oral.syrup DOSAGE AND ADMINISTRATION Supplemental (Prophylactic) Dose: Syrup (Oral Drops): Term infants: 1 mg/kg BW/day up to 15 mg/day. To start no later than 4 mos and to continue at least through the remainder of the 1st yr of life. Preterm infants: 2 mg/kg BW/day up to15 mg/day. To start no later than 2 mos of age and to continue at least through the remainder of the first yr of life.

Indications
anemia iron deficiency

Actions
For the prevention and treatment of iron deficiency anemia in infants and children

Contraindication
Who should not take Ferlin Syrup? Patients with primary hemochromatosis, peptic ulcer, regional enteritis or ulcerative colitis. Do not use iron to treat hemolytic anemias unless an iron deficient state also exists. Do not administer therapeutic iron doses longer than six months except under the supervision of a physician. Do not administer parenteral iron together with oral iron to avoid iron overload. Do not administer iron to patients receiving repeated blood transfusions, since there is considerable amount of iron in the hemoglobin or transfused erythrocytes. Folic acid should be administered with caution to patients with undiagnosed anemia since it may obscure the diagnosis of pernicious anemia

Side Effects may cause temporary staining of teeth. Stools may appear darker in color. Prolonged folic acid therapy may cause a decrease in vitamin B12 serum concentration.

Nursing Responsibilities Before - Assess for contra indicated conditions.Observe the 15 rights in drug administration. After Check.Stools.

resulting to progression or neurologic complications. Concurrent administration of antacids with oral iron may decrease iron absorption. When take concomitantly, absorption of both iron salts and tetracyclines is diminished. Reponses to iron may be delayed when receiving concomitant chloramphenicol therapy. Iron salts have also been reported to decrease absorption and thus reduce the bioavailability and clinical effect of levodopa with carbidopa, methyldopa, penicillamine, and some quinolones (ciprofloxacin, norfloxacin, ofloxacin). Oral iron preparations should not be ingested concomitantly with or within two hours of a dose of these medications.

Name Of Drug Generic.Name Multivitamin (Per 5 mL: Calcium pantothenate 5 mg, folic acid 250 mcg, Llysine monoHCl 200 mg, nicotinamide 20 mg, vitamins A 2500 I.U., B1 2.5 mg, B12 4 mcg, B2 2.5 mg, B6 2.5 mg, C 60 mg, D 500 I.U. ) Brand.Name Macrobee Syrup Classification Dietary/ Dietary Drugs (registered as Drugs w/ FDA)/ Vitamins & Minerals (registered as Drugs)/ Pediatric Vitamins & Minerals (reg. as Drugs)

Route/ Dosage Oral.syrup Childn 7-12 yr 2-3 tsp, 3-6 yr 1-2 tsp, 1-2 yr 1/21 tsp. Doses taken daily. May be taken with or without food (May be taken w/ meals for better absorption or if GI discomfort occurs.).

Indications

Actions

Contraindication Hypersensitivity to any component of the product.

Side Effects none

Lack of Restores.bodies.vitamin.balan appetite & ce. underweightt ; infections; vitamin deficiencies. Supplements restrictive or deficient diet.

Nursing Responsibilities Before - Assess for contra indicated conditions.Observe the 15 rights in drug administration. After Check.Stools.

Name Of Drug Generic.Name ASCORBIC ACID (Vitamin.C) Brand.Name Ceelin Syrup Classification

Route/ Dosage Oral Each mL syrup (oral drops) contains: Sodium.Ascorbate (Vitamin C) 100 mg . once daily. Birth to <6 months 0.3 mL 6 11 months 0.6 mL 1 2 years 1 mL 2 6 years 5 mL (1 teaspoonful) 7 12 years 5 10 mL (1 2 teaspoonsful)

Indications Lack.of.Viti min.C.

Actions Restores.Bodies.Vitamin.C.B alance

Nursing Responsibilities allergic to any Prolonged intake of Before - Assess for contra ingredient in the Vitamin C in indicated product. excess of 2 g/day conditions.may lead to Prolonged intake nausea, abdominal Observe the 15 rights in drug of Vitamin C in cramps, diarrhea, administration. excess of 2 g/day and nose bleeds. After may lead to Check.Stools. nausea, abdominal cramps, diarrhea, and nose bleeds.

Contraindication

Side Effects

Name Of Drug Generic.Name probiotic Oral

Route/ Dosage

Indications After.Antibi otic.course.

Actions

Contraindication

Side Effects none

Restores.Bodies.Natural.bacte Probiotics are ria.within.the.digestive.syste generally regarded

Nursing Responsibilities Before - Assess for contra

Brand.Name Probiokid Classification Probiotic

m.after.Antibiotics.for.exampl e.

as safe and well tolerated. Some probiotics may be contraindicated in patients who are immunocompromise d or have severe underlying illness, as they have been reported to cause fungaemia and bacteraemia.

indicated conditions.Observe the 15 rights in drug administration. After Check.Stools.