Generic Name Phytonadione Trade Name Vitamin K Classification fat-soluble vitamins,Antifibrinolytic Agents Dose 10mg Route SQ Time/frequency daily

Peak 3-6 hr Onset 1-2 hr Duration 12-14 hr Normal dosage range 10 mg daily Why is your patient getting this medication Hypoprothrombinemia due to Vitamin K Deficiency IV meds, compatibility with IV drips and/or solutions N/A Mechanism of action and indications(Why med ordered) Required for hepatic synthesis of blood coagulation factors II(prothrombin), VII, IX, and X Nursing Implications (what to focus on)Contraindications/warnings/interactions Hypersensitivity, Hypersensitivity or intolerance to benzyl alcohol(injection only), use cautiously in impaired liver function side effects No known common side effects for this drug with other patient drugs, OTC or herbalmedicines (ask patient specifically) No known interactions for this patient Lab value alterations caused by medicine Prothrombin time (PT) should be monitored prior to and throughoutvitamin K therapy to determine response to and need for further therapy Be sure to teach the patient the following about this medication Instruct patient to take this medication as ordered. If a dose is missed,take as soon as remembered unless almost time for next dose. Notifyhealth care professional of missed doses. Cooking does not destroysubstantial amounts of vitamin K. Patient should not drastically alter diet while taking vitamin K. Caution patient to avoid IM injectionsand activities leading to injury. Use a soft toothbrush, do not floss, andshave with an electric razor until coagulation defect is corrected.Advise patient to report any symptoms of unusual bleeding or bruising(bleeding gums; nosebleed; black, tarry stools; hematuria). Patientsreceiving vitamin K therapy should be cautioned not to take OTCmedications without advice of health care professional. Advise patientto inform health care professional of medication regimen prior totreatment or surgery. Advise patient to carry identification at all timesdescribing disease process. Emphasize the importance of frequent labtests to monitor coagulation factors. Nursing Process- Assessment(Pre-administration assessment) Monitor for frank and occult bleeding (guaiacstools, Hematest urine, and emesis). Monitor pulseand blood pressure frequently; notify physicianimmediately if symptoms of internal bleeding or hypovolemic shock develop. Inform all personnelof patient's bleeding tendency to prevent further trauma. Apply pressure to all venipuncture sitesfor at least 5 min; avoid unnecessary IM injections AssessmentWhy would you hold or not give this med? Toxicity (hemolytic anemia, brain damage),clot formation (e.g., DVT, pulmonary emboli) EvaluationCheck after giving Prevention of spontaneous bleeding or cessation of bleedingin patients withhypoprothrombinemia secondaryto impaired intestinal absorptionor oral anticoagulant, salicylate,or anti-infective therapy.

TERRAMYCIN oxytetracycline HCl with POLYMYXIN B SULFATE OPHTHALMIC OINTMENT STERILE To reduce the development of drug-resistant bacteria and maintain the effectiveness of Terramycin and other antibacterial drugs, Terramycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.

DESCRIPTION Each gram of sterile ointment contains oxytetracycline HCl equivalent to 5 mg oxytetracycline, 10,000 units of polymyxin B sulfate, white petrolatum, and liquid petrolatum.

ACTIONS Terramycin is a widely used antibiotic with clinically proved activity against gram-positive and gram-negative bacteria, rickettsiae, spirochetes, large viruses, and certain protozoa. Polymyxin B Sulfate, one of a group of related antibiotics derived from Bacillus polymyxa, is rapidly bactericidal. This action is exclusively against gram-negative organisms. It is particularly effective against Pseudomonas aeruginosa (B. pyocyaneus), and Koch-Weeks bacillus, frequently found in local infections of the eye. There is thus made available a particularly effective antimicrobial combination of the broad-spectrum antibiotic Terramycin as well as polymyxin B sulfate against primarily causative or secondarily infecting organisms.

INDICATIONS The sterile preparation, Terramycin with Polymyxin B Sulfate Ophthalmic Ointment, is indicated for the treatment of superficial ocular infections involving the conjunctiva and/or cornea caused by Terramycin with Polymyxin B Sulfate-susceptible organisms. It may be administered topically alone, or as an adjunct to systemic therapy. It is effective in infections caused by susceptible strains of staphylococci, streptococci, pneumococci, Hemophilus influenzae, Pseudomonas aeruginosa, Koch-Weeks bacillus, and Proteus. To reduce the development of drug-resistant bacteria and maintain effectiveness of Terramycin and other antibacterial drugs, Terramycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

CONTRAINDICATIONS This drug is contraindicated in individuals who have shown hypersensitivity to any of its components.

PRECAUTIONS As with all antibiotic preparations, use of this drug may result in overgrowth of nonsusceptible organisms, including fungi. If superinfection occurs, the antibiotic should be discontinued and appropriate specific therapy should be instituted.

Prescribing Terramycin in the absence of proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria. Information For Patients Patients should be counseled that antibacterial drugs including Terramycin should only be used to treat bacterial infections. They do not treat viral infections (e.g., the common cold). When Terramycin is prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed. Skipping doses or not completing the full course of therapy may (1) decrease the effectiveness of the immediate treatment and (2) increase the likelihood that bacteria will develop resistance and will not be treatable by Terramycin or other antibacterial drugs in the future.

ADVERSE REACTIONS Terramycin with Polymyxin B Sulfate Ophthalmic Ointment is well tolerated by the epithelial membranes and other tissues of the eye. Allergic or inflammatory reactions due to individual hypersensitivity are rare.

DOSAGE AND ADMINISTRATION Approximately inch of the ointment is squeezed from the tube onto the lower lid of the affected eye two to four times daily. The patient should be instructed to avoid contamination of the tip of the tube when applying the ointment.