Brand Name (Generic Name) Dosage 1.Polynerve Tab (Pharma Nutria) 500 mg O.D.

BID

Drug Class Mechanism of Action Drug Class: Dietary Supplement

Indication and Contraindication Indication: Treatment of Vit. B Deficiencies. Nutritional support in painful Neurological manifestation of neuritis and neuropathy. Contraindication: Do not use for the treatment of megaloblastic anemia of pregnancy.

Side Effects and Adverse Reaction Rash and allergic reaction.

Nursing Consideration May be taken with or without food Patients with Renal and Hepatic Failure should use it with Precaution.

2. Dexamethasone 10 mg IV T.I.D

Drug Class: Antiinflammatory Gluccocorticoid MOA: decreases inflammation mainly by stabilizing leukocyte lysosomal membrane suppresses immune reponse; stimulates bone marrow; and influences protein , fat and carbohydrate metabolism.

Indication: Inflammation, Cerebral Edema, Shock, Allergic Conditions, Altitude Sickness, Spinal Cord Compression. Contraindication: Systemic Fungal infection, Hypersensitivity, Cerebral malaria.

CNS: euphoria, insomnia, psychotic behavior, pseudotumor cerebri, vertigo ,headache, paresthesia ,seizures, depression CV: hypertension, edema ,arrhythmias ,thrombo embolism. EENT: cataracts, glaucoma GI: peptic ulceration, GI irritation, increased appetite, pancreatitis, nausea ,vomiting. GU: increase urine glucose ,and calcium level Metabolic: hypokalemia, hyperglycemia Musculoskeletal: muscle weakness Skin: Delayed wound

Determine whether patient is sensitive to other corticosteroi ds Most adverse reactions to corticosteroids are dose-or durationdependent For better results and less toxicity, give once daily dose in morning Advise not to stop drug abruptly or without prescrib ers consent Teach patient signs and symptoms of adrenalin sufficiency Warn patient on long term therapy about cushingoid effects(moon face, buffalo hump)

healing Other: Susceptibility to infections 3. Vitamin B Complex 1 tab B.I.D Class: Vitamins and Mineral MOA: A Coenxyme that stimulate metabolic function and is needed for cell replication and hematopoiesis and necloprotein and myelin synthesis. Indication: Pernicious Anemia

CV: peripheral vascular thrombosis, heart failure. Contraindication: GI: transient diarrhea. Hypersensitivity to Respi: pulmonary edema. Vitamin B12 or Skin: itching, transitory cobalt; early exanthema, urticaria. Lebers Disease Other: anaphylaxis, anaphylactoid

4. Omeprazole 40 mg P.O. O.D.

Drug Class: Gastric acidpump inhibitor MOA: Suppresse s gastric acid secretion by

INDICATIONS: Short-term treatment of active duodenal ulcer; First-line therapy in treatment of

CNS: Headache, dizziness, asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, dream abnormalities Dermatologic: Rash,

Warn patient about easy bruising Advise patient to avoid exposure to infections Determine reticulocyte count, hct, Vit. B12, iron, folate levels before beginning therapy Obtain a sensitivity test history before administration Avoid I.V. administration bec. faster systemic elimination will reduce effectiveness of vitamin Dont give large doses of vitamin B12 routinely Dont mix parenteral preparation in same syringe with other drugs Protect Vit. B12 from light. Dont refrigerate or freeze. Monitor patient for hypokalemia for first 48 hours, as anemia correct itself. Give potassium supplements, as needed. Administer before meals. Caution patient to swallow capsules wholenot to open, chew, or crush them.

specific inhibition of the hydrogenpotassi um ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid production.

heartburn or symptoms of gastroesophageal reflux disease (GERD); Shortterm treatment of active benign gastric ulcer; GERD, severe erosive esophagitis, poorly responsive symptomatic GERD; Long-term therapy: Treatment of pathologic hypersecretory conditions (Zollinger-Ellison syndrome, multiple adenomas, systemic mastocytosis); Eradication of H. pylori with amoxicillin or metronidazole and clarithromycin; Prilosec OTC: Treatment of frequent heartburn (2 or more days per wk); Unlabeled use: Posterior laryngitis; enhance efficacy of pancreatin for the treatment of steatorrhea in cystic fibrosis CONTRAINDICATI ONS: Contraindicated with

inflammation, urticaria, pruritus, alopecia, dry skin GI: Diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophy Respiratory: URI symptoms, cough, epistaxis Other: Cancer in preclinical studies, back pain, fever

Arrange for further evaluation of patient after 8 wk of therapy for gastroreflux disorders; not intended for maintenance therapy. Symptomatic improvement does not rule out gastric cancer, which did occur in preclinical studies. Administer antacids with omeprazole, if needed. Have regular medical follow-up visits. These side effects may occur: Dizziness (avoid driving or performing hazardous tasks); headache (request medications); nausea, vomiting, diarrhea (maintain proper nutrition); symptoms of upper respiratory tract infection, cough (do not selfmedicate; consult with your health care provider if uncomfortable). Report severe headache, worsening of symptoms, fever, chills.

5. Lactulose 30 cc syrup OD

Drug Class: Gastrointestinal agent, hyperosmotic laxative MOA: The drug passes unchanged into the colon where bacteria break it down to organic acids that increase the osmotic pressure in the colon and slightly acidify the colonic contents, resulting in an increase in stool water content, stool softening, laxative action. This also results in migration of blood ammonia into the colon contents with subsequent trapping and expulsion of feces.

hypersensitivity to omeprazole or its components; Use cautiously with pregnancy, lactation. Indication: Treatment of constipation;Prev ention and treatment of portal-systemic encephalopathy Contraindication: Contraindicated with allergy to lactulose, lowgalactose diet. Use cautiously with diabetes, pregnancy, and lactation.

Abdominal fullness, flatulence, belching. GI Transient flatulence, distention, intestinal cramps, belching, diarrhea, nausea. Other Acid-base imbalances

Allergy to lactulose, lowgalactose diet,diabetes, pregnancy, and lactation. Assess for Abdominal examination, bowel sounds, serum electrolytes, serum ammonia levels. Do not freeze laxative form. Ask patient to report diarrhea, severe belching, abdominal fullness