NAME OF DRUG Omeprazole 40mg IV BID Classifications : gastrointestina l agent; proton pump inhibitor 1/24

MECHANISM OF ACTION Omeprazole is a selective and irreversible proton pump inhibitor. Omeprazole suppresses gastric acid secretion by specific inhibition of the hydrogenpotassium adenosinetriphosphatas e (H +, K +-ATPase) enzyme system found at the secretory surface of parietal cells. It inhibits the final transport of hydrogen ions (via exchange with potassium ions) into the gastric lumen. Since the H +, K +-ATPase enzyme system is regarded as the acid (proton) pump of the gastric mucosa, omeprazole is known as a gastric acid pump inhibitor. The inhibitory effect is doserelated. Omeprazole inhibits both basal and stimulated acid secretion irrespective of

INDICATION Conditions where inhibition of gastric acid secretion may be beneficial, including aspiration syndromes, dyspepsia, gastroesophageal reflux disease, and peptic ulcer

ADVERSE EFFECT/ SIDE EFFECT CNS:Headache, dizziness, fatigue.

NURSING RESPONSIBLITITIES Encourage patient to avoid

alcohol, aspirin products, GI:Diarrhea, abdominal pain, nausea, mild transient ibuprofen, and foods that increases in liver function may increase gastric tests. secretions during therapy. Urogenital:Hematuria, Because drug can interfere proteinuria. with absorption of vitamin B12, Skin:Rash monitor for anemia. Monitor therapeutic effectiveness and adverse reactions at beginning of therapy and periodically throughout therapy. Assess GI system: bowel sounds every 8hours, abdomen for pain and swelling, appetite loss Assess knowledge/teach appropriate use of this medication, interventions to reduce side effects, and adverse symptoms to report.

Pancreatin 1tab Oral TID Classification: Digestives 1/24

the stimulus. Pancreatin are pancreatic enzymes which hydrolyse fats to glycerol and fatty acids, break down protein into peptides, proteoses and derived substances, and convert starch into dextrins and sugars.

Bloating and flatulence as in pancreatic insufficiency; hepatic, biliary gastric and intestinal disorders

GI: abdominal discomfort, nausea and vomiting.. Colonic strictures may occur, mainly in patients with cystic fibrosis receiving high doses of pancreatin preparations. Hyperuricaemia and hyperuricosuria may occur.

Give dose just before or during a meal to maximize effectiveness. Diet should balance fat, protein, and starch intake properly to avoid indigestion. taken with meals and snacks and a full glass of water Photosensitivity may occur with prolonged exposure to sunlight or tanning equipment; reduce dose in renal impairment Consider drug serum level determinations in prolonged therapy Take doxycycline with a full glass of water. Drink plenty of liquids while you are taking doxycycline. Take this medication for the full prescribed length of time. Your symptoms may improve before the infection is

Doxycycline 100mg Oral BID Classification: Anti-Bacterial Agents 1/24

Doxycycline is lipophilic and can pass through the lipid bilayer of bacteria. Doxycycline blocks the binding of aminoacyl tRNA to the mRNA and inhibiting bacterial protein synthesis. Doxycycline prevents the normal function of the apicoplast of Plasmodium falciparum, a malaria causing organism.

indicated for use in respiratory tract infections cause d by Mycoplasma pneumoniae, Haemophilus influenzae, Streptococcus pneumoniae, Legionella spp., or Klebsiella spp.

Gastrointestinal: Hepatotoxicity, , anorexia, diarrhea, dysphagia, esophagitis, esophageal ulcerations Hematologic: Hemolytic anemia, eosinophilia, neutropenia, thrombocytopenia Renal: Increased BUN Skin: Exfoliative dermatitis, rash, urticaria, and photosensitivity, rash

It is also used for Immune: Hypersensitivity prophylaxis of reactions, including malaria. urticaria, serum sickness,

Doxycycline is indicated for a variety of bacterial infections

pericarditis, and drug rash

completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Should be taken with food or milk to prevent gastric iritation. Patients with history of renal calculi should avoid taking excessive doses for extended periods of time Vitamin C increases the absorption of iron when taken at the same time as iron-rich foods.

Ascorbic acid 500mg Oral BID Classification: Vitamins and Minerals 1/24

Ascorbic acid is a functional and principal in vivo form of vitamin C, an essential watersoluble vitamin which is fundamental in the synthesis of collagen and intercellular materials

Prevention and treatment of ascorbic acid deficiency.

GI: Diarrhea, nausea, vomiting. Genitourinary: Excessive doses over a long period of time may cause precipitation of cystine, oxalate, or urate crystals in kidney

Nystatin gargle Oral Classification: antifungal; anti-infectives TID

Nystatin, a polyene antifungal, binds to ergosterol in the fungal cell membrane. This binding affects the cell wall permeability allowing leakage of cellular contents.

CNS:Headache or insomnia (high doses). Intestinal Allergic reaction: Itching or or oropharyngeal hives, swelling in your face candidiasis or hands, swelling or tingling in your mouth or throat GI: Diarrhea, nausea, vomiting, gastrointestinal upset/disturbances

Shake the oral liquid well just before each dose. Measure your dose with the dropper that comes with the medicine. Keep the medicine in your mouth for as long as possible. Swish it around, gargle, and swallow. Avoid eating for 5-10 minutes after using this

medication. Use this medication regularly in order to get the most benefit from it. Remember to use it at the same times each day. Fish, meat (especially liver), and fortified cereals and breads are good dietary sources of iron; emphasize them in a well-balanced diet. Ferrous sulfate is absorbed better on an empty stomach but may be taken with food if it upsets your stomach. Some foods (eg, eggs, whole grain breads, cereal, dairy products, coffee, tea) may decrease the amount of iron absorbed by your body. Ferrous sulfate may cause darkened or green stools. This is normal and not a cause for concern. if taking medications such as pancreatin and doxycyclines, take it 3 hours after or 2 hours before taking ferrous sulfate. Do not take antacids at the same time as

Ferrous sulfate Oral BID Classification: hematinics

Ferrous sulfate facilitates O2 transport via haemoglobin. It is used as iron source as it replaces iron found in haemoglobin, myoglobin and other enzymes. Iron is an essential component in the physiological formation of hemoglobin, adequate amounts of which are necessary for effective erythropoiesis and the resultant oxygen transport capacity of the blood. A similar function is provided by iron in myoglobin production. Iron also serves as a cofactor of several essential enzymes, including cytochromes that are involved in electron transport. Iron

treat or prevent iron-deficiency anemia,

GI: Nausea, Vomiting, Gastrointestinal irritation, constipation, Diarrhea, stomach pain and dark stools. Urinary: urine discoloration

Sodium Chloride Tab Oral TID Classification: plasma volume expander 1/24 Fluconazole 150mg Oral BID Classification: antifungal; anti-infectives 1/29

is necessary for catecholamine metabolism and the proper functioning of neutrophils. Sodium chloride is the major extracellular cation. It is important in electrolyte and fluid balance, osmotic pressure control and water distribution as it restores sodium ions

ferrous sulfate; take them as far apart as possible because it decreases the absorption of iron. Preventing or treating sodium loss due to dehydration. Hypernatraemia; thirst, reduced salivation and lachrymation, fever, tachycardia, hypertension, headache, dizziness, restlessness, irritability and weakness. Take it with or without food. Take sodium chloride with a full glass of water (8 oz/240 mL) Assess urine specific gravity and serum sodium levels Monitor VS and I&O

Fluconazole interacts with 14- demethylase, a cytochrome P-450 enzyme necessary to convert lanosterol to ergosterol. As ergosterol is an essential component of the fungal cell membrane, inhibition of its synthesis results in increased cellular permeability causing leakage of cellular contents. Fluconazole may also inhibit endogenous respiration, interact with

Treatment of oropharyngeal, esophageal, or vulvovaginal candidiasis in the treatment of other serious systemic candidal infections, for Cryptococcus infections and candidal infections of the skin.

rash, headache, dizziness, nausea, vomiting, abdominal pain, diarrhea, and/or elevated liver enzymes

Low levels of potassium or magnesium i n the blood may increase your risk of QT prolongation. Use hygiene measures to prevent reinfection or spread of infection. Drug may be given orally or IV as needed. The drug will need to be taken for the full course and may need to be taken long term.

Ceftriazide 500mg Oral BID Classification: anti-infectives; 3rd generation cephalosporin 1/29

membrane phospholipids inhibit the transformation of yeasts to mycelial forms, inhibit purine uptake, and impair triglyceride and/or phospholipid biosynthesis. Ceftriaxone works by inhibiting the mucopeptide synthesis in the bacterial cell wall. The beta-lactam moiety of Ceftriaxone binds to carboxypeptidases, endopeptidases, and transpeptidases in the bacterial cytoplasmic membrane. These enzymes are involved in cell-wall synthesis and cell division. By binding to these enzymes, Ceftriaxone results in the formation of of defective cell walls and cell death.

Report rash, changes in stool or urine color, difficulty breathing, increased tears or salivation.

Susceptible infections which include chancroid, endocarditis, gastroenteritis, gonorrhea, septicemia, and syphilis

CNS: Headache, dizziness, if patient develops anemia lethargy, paresthesias while on ceftriaxone, stop antibiotic GI: Nausea, vomiting, Dosage must be adjusted in diarrhea, anorexia, severe renal insufficiency abdominal pain, liver (high dosages may cause toxicity CNS toxicity) Hematologic: Bone marrow Superinfections and depression: decreased WBC, decreased platelets, promotion of nonsusceptible organisms may occur with decreased Hct prolonged use or repeated therapy GU: Nephrotoxicity Hypersensitivity: Ranging from rash to fever to anaphylaxis ; serum sickness reaction Other: Superinfections

Metronidazole 500mg

Unionized metronidazole is

Intestinal amoebiasis,

CNS: seizures, dizziness, headache

Administer with food or milk to minimize GI irritation.

Oral Q8 Classification: anti-infectives; antiprotozoals 1/20

selective for anaerobic bacteria due to their ability to intracellularly reduce metronidazole to its active form. This reduced metronidazole then covalently binds to DNA, disrupt its helical structure, inhibiting bacterial nucleic acid synthesis and resulting in bacterial cell death.

hepatic amoebiasis and Trichomoniasis

GI: diarrhea, nausea, stomach pain, loss of appetite, constipation, changes in taste (metallic taste), and dry mouth Hematologic: leucopenia Skin: rashes, urticaria Urinary: cause urine to darken in color

Instruct patient to take medication exactly as directed evenly spaced times between dose. Do not skip doses or double up on missed doses. Inform patient that medication may cause an unpleasant metallic taste. Inform patient that medication may cause urine to turn dark. Advise patient to consult health care professional if signs and symptoms of superinfection (black furry overgrowth on tongue; loose or foul-smelling stools) develop.