METOCLOPRAMIDE:

MOA: Stimulates motility of upper GI tract without stimulating gastric, billiary, or pancreatic secretions; appears to sensitize tissues to action of acetylcholine; relaxes pyloric sphincter, which, when combined with effects on motility, accelerates gastric emptying and intestinal transit; little effect on gallbladder or colon motility; increases lower esophageal sphincter pressure; has sedative properties; induces release of prolactin INDICATION: Relief of symptoms of acute and recurrent diabetic gastroparesis Short-term therapy for adults with symptomatic GERD who fail to respond to conventional therapy- Prevention of nausea and vomiting associated with emetogenic cancer chemotherapy- Prophylaxis of postoperative nausea and vomiting when nasogastric suction is undesirable- Facilitation of small-bowel intubation whentube does not pass the pylorus with conventional maneuvers- Stimulation of gastric emptying and intestinal transit of barium when delayed emptying interferes with radiologic examination of the stomach or small intestine- Unlabeled uses :Improvement of lactation; treatment of nausea and vomiting of a variety of etiologies :hyperemesis gravidarum, gastric ulcer, anorexia nervosa CONTRAINDICATION; - Allergy to metoclopramide- GI hemorrhage- Mechanical obstruction or perforation- Pheochromocytoma- Epilepsy Precaution - Previously detected breastcancer - Lactation- Pregnancy- Fluid overloadRenal impairment NSG CONSIDERATION Before Observe 15 rights in drugadministration.- Assess for allergy to metoclopramide.- Assess for other contraindications.- Keep diphenhydramine injection readilyavailable in case extrapyramidalreactions occur (50 mg IM).- Have phentolamine readily available incase of hypertensive crisis. During - Monitor BP carefully dring IVadministration.- Monitor for extrapyramidal reactions,and consult physician if they occur.- Monitor diabetic patients.Give direct IV doses slowly over 1-2minutes.- For IV infusion, give over at least 15minutes.

LEVOFLOXACIN
Drug classes: Antibiotic, Fluoroquinolone Therapeutic actions Bactericidal: interferes with DNA by inhibiting DNA synase replication in susceptible gram-negative and gram-positive bacteria, preventing cell reproduction. Indications Treatment of adults with community-acquired pneumonia, acute maxillary sinusitis caused by susceptible bacteria Treatment of acute exacerbation of chronic bronchitis caused by susceptible bacteria Treatment of complicated and uncomplicated skin and skin structure infections caused by susceptible bacteria Treatment of complicated and uncomplicated UTIs and acute pyelonephritis caused by susceptible bacteria Treatment of nosocomial pneumonia due to methicillin-sensitive Staphylococcus aureus, Pseudomonas strains, Serratia, E. coli, Klebsiella, Haemophilus influenzae, Streptococcus pneumoniae Adverse effects Headache, dizziness, insomnia, fatigue, somnolence, blurred vision Nausea, vomiting, dry mouth, diarrhea, abdominal pain (occur less with this drug than with oflaxacin), constipation, flatulence Elevated BUN, AST, ALT, serum creatinine, and alkaline phosphatase; neutropenia, anemia Fever, rash, photosensitivity, muscle and joint tenderness Nursing considerations Arrange for culture and sensitivity tests before beginning therapy. Continue therapy as indicated for condition being treated. Administer oral drug 1 hr before or 2 hr after meals with a glass of water; separate oral drug from other cation administration, including antacids, by at least 2 hr. Ensure that patient is well hydrated during course of therapy. Discontinue drug at any sign of hypersensitivity (rash, photophobia) or at complaint of tendon pain, inflammation, or rupture. Monitor clinical response; if no improvement is seen or a relapse occurs, repeat culture and sensitivity test.

OXYCOTIN
The precise mechanism of the analgesic action is unknown. However, specific CNS opioid receptors for endogenous compounds with opioid-like activity have been identified throughout the brain and spinal cord and are thought to play a role in the analgesic effects of this drug. Indication OxyContin is indicated for the management of moderate to severe pain when a continuous, around-the-clock opioid analgesic is needed for an extended period of time. S/E

Seizures

SAGOBION

Sangobion is organic iron Sangobion is ferrous gluconate and not ferrous sulfate. This organic iron formulation allows for better absorption* inside the body and has less gastrointestinal side effects than ferrous sulfate. *Haler, David (1952). The Therapeutic Response of Secondary Anemias to Organic and Inorganic Iron Salts. British Medial Journal, United Kingdom.

Respiratory depression [see BOXED WARNING, WARNINGS AND PRECAUTIONS, and OVERDOSAGE] CNS depression [see DRUG INTERACTIONS, and OVERDOSAGE] Hypotensive effects [see WARNINGS AND PRECAUTIONS, and OVERDOSAGE] Drug abuse, addiction, and dependence [see Drug Abuse and Dependence] Gastrointestinal Effects [see WARNINGS AND PRECAUTIONS]

Sangobion has Vitamins and Minerals Sangobion is packed with Vitamin C, Folic acid, Vitamin B12, Copper sulfate, and Manganese sulfate. Sangobion contains SORBITOL A common side effect of most iron supplements is constipation. Sangobions Sorbitol component acts as an anti-constipating agent. Sorbitol is naturally found in edible fruits and vegetables