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DRUG NAME Generic Name: celecoxib Brand Name: Celebrex Dosage: Capsules: 100 mg, 200 mg Classification: Non-Steroidal

Anti-Inflammatory Drugs

ACTION
Thought to inhibit prostaglandin synthesis, impeding cyclooxygenase2 (COX-2), to produce antiinflammatory, analgesic, and antipyretic effects.

INDICATION
Acute pain

CONTRAINDICATION
Contraindicated in patients hypersensitive to drug, sulfonamides, aspirin, or other NSAIDs. Contraindicated in those with severe hepatic impairment. Contraindicated in women in the third trimester of pregnancy. Use cautiously in patients with history of ulcers or GI bleeding, advanced renal disease, dehydration, anemia, symptomatic liver disease, hypertension, edema, heart failure, or asthma and in poor CYP2C9 metabolizers. Use cautiously in elderly or debilitated patients.

SIDE EFFECT
CNS: dizziness, headache, insomnia. CV: peripheral edema. EENT: pharyngitis, rhinitis, sinusitis. GI: abdominal pain, diarrhea, dyspepsia, flatulence, nausea. Metabolic: hyperchloremia. Musculoskeletal: back pain. Respiratory: upper respiratory tract infection. Skin: rash. Other: accidental injury.

NURSING RESPONSIBILITY
>Instruct to take meals before taking the drug to prevent Abdominal pain. >NSAIDs such as celecoxib can cause fluid retention; monitor patient with hypertension, edema, or heart failure. >Instruct patient to promptly report signs of GI bleeding such as blood in vomit, urine, or stool; or black, tarry stools. >Drug may be hepatotoxic; watch for signs and symptoms of liver toxicity. >Advise patient to immediately report rash, unexplained weight gain, or swelling.

DRUG NAME
Generic Name: Brand Name: Rejuvenex Dosage: 1 cap daily Classification:

ACTION

INDICATION
Vit & mineral deficiency, fatigue in mental & physical stress, lack of conc, rapid tiredness & reduced performance. Prophylaxis & treatment of the general symptoms of advancing age.

CONTRAINDICATION

SIDE EFFECT

NURSING RESPONSIBILITY

Vitamins &/or Minerals

DRUG NAME Generic Name: Fe/Lysine/ Methionine/Protein /Vit B6/Vit C Brand Name: Protab Dosage: Classification: Vitamins and Minerals

ACTION

INDICATION

CONTRAINDICATION

SIDE EFFECT

NURSING RESPONSIBILITY

2. cefalexin Brand Name: ApoCephalex, Biocef, Keflex, NovoLexin, NuCephalex Dosage: Tablets: 500 mg cephalexin monohydrate Capsules: 250 mg, 500 mg Oral suspension: 125 mg/5 ml, 250 mg/5 ml Tablets: 250 mg, 500 mg, 1 g Adults: 250 mg to 1 g P.O. q 6 hours or 500 mg q 12 hours. Maximum 4 g daily. Children: 25 to 50 mg/kg/day P.O. in two to four equally divided doses. In severe infections, dose can be doubled. Adjust-a-dose: For adults with impaired renal Classification :

Second-generation cephalosporin that inhibits cell-wall synthesis, promoting osmotic instability causing cell death; bactericidal.

Respiratory tract, GI tract, skin, softtissue, bone, and joint infections and otitis media caused by Escherichia coli and other coliform bacteria, group A beta-hemolytic streptococci, Klebsiella species, Proteus mirabilis, Streptococcus pneumoniae, and staphylococci

Contraindicated in patients hypersensitive to cephalosporins. Use cautiously in patients hypersensitive to penicillin because of possibility of crosssensitivity with other beta-lactam antibiotics. Use cautiously in breast-feeding women and in patients with history of colitis or renal insufficiency.

CNS: dizziness, headache, fatigue, agitation, confusion, hallucinations. GI: pseudomembranous colitis, nausea, anorexia, vomiting, diarrhea, gastritis, glossitis, dyspepsia, abdominal pain, anal pruritus, tenesmus, oral candidiasis. GU: genital pruritus, candidiasis, vaginitis, interstitial nephritis. Hematologic: neutropenia, eosinophilia, anemia, thrombocytopenia. Musculoskeletal: arthritis, arthralgia, joint pain. Skin: maculopapular and erythematous rashes, urticaria. Other: hypersensitivity reactions, serum sickness, anaphylaxis.

Ask patient about past reaction to cephalosporin or penicillin therapy before giving first dose. Obtain specimen for culture and sensitivity tests before giving first dose. To prepare oral suspension: Add required amount of water to powder in two portions. Shake well after each addition. After mixing, store in refrigerator. Mixture will remain stable for 14 days. Keep tightly closed and shake well before using. If large doses are given or if therapy is prolonged, monitor patient for superinfection, especially if patient is high risk. Treat group A beta-

Antibacterial

hemolytic streptococcal infections for a minimum of 10 days. Alert: Don't confuse drug with other cephalosporins that sound alike. Tell patient to take drug exactly as prescribed, even after he feels better. Instruct patient to take drug with food or milk to lessen GI discomfort. If patient is taking suspension form, instruct him to shake container well before measuring dose and to store in refrigerator.

Tell patient to notify prescriber if rash or signs and symptoms of superinfection develop.

Vitamin C is recommended for the prevention and treatment of scurvy. Its parenteral administration is desirable for patients with an acute deficiency or for those whose absorption of orally ingested ascorbic acid is uncertain. Symptoms of mild deficiency may include faulty bone and tooth development, gingivitis, bleeding gums, and loosened teeth. Febrile states, chronic illness, and infection (pneumonia, whooping cough, tuberculosis, diphtheria, sinusitis, rheumatic fever, etc.) increase the need for ascorbic acid. Hemovascular disorders, burns, delayed fracture and wound healing are indications for an increase in the daily intake. DOSAGE AND ADMINISTRATION Ascorbic acid is usually administered orally. When oral administration is not feasible or when malabsorption is suspected, the drug may be administered IM, IV, or subcutaneously. When given parenterally, utilization of the vitamin reportedly is best after IM administration and that is the preferred parenteral route. For intravenous injection, dilution into a large volume parenteral such as Normal Saline, Water for Injection, or Glucose is recommended to minimize the adverse reactions associated with intravenous injection. The average protective dose of vitamin C for adults is 70 to 150 mg daily. In the presence of scurvy, doses of 300 mg to 1 g daily are recommended. However, as much as 6 g has been administered parenterally to normal adults without evidence of toxicity. To enhance wound healing, doses of 300 to 500 mg daily for a week or ten days both preoperatively and postoperatively are generally considered adequate, although considerably larger amounts have been recommended. In the treatment of burns, doses are governed by the extent of tissue injury. For severe burns, daily doses of 1 to 2 g are recommended. In other conditions in which the need for vitamin C is increased, three to five times the daily optimum allowances appear to be adequate. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever the solution and container permit. HOW SUPPLIED Ascorbic Acid Injection, USP, 250 mg/mL is available in 2 mL ampules, in cartons of 25. PROTECT FROM HEAT AND LIGHT. Store at controlled room temperature 15- 30 C (59- 86 F). Pressure may develop within the ampule upon long storage. Precautions should be taken to wrap the container in a protective covering while it is being opened. CAUTION: Federal law prohibits dispensing without prescription. Transient mild soreness may occur at the site of intramuscular or subcutaneous injection. Too-rapid intravenous administration of the solution may cause temporary faintness or dizziness.

DRUG INTERACTIONS Limited evidence suggests that ascorbic acid may influence the intensity and duration of action of bishydroxycoumarin.

Diabetics, patients prone to recurrent renal calculi, those undergoing stool occult blood tests, and those on sodium-restricted diets or anticoagulant therapy should not take excessive doses of vitamin C over an extended period of time. PRECAUTIONS General Precautions Too-rapid intravenous injection is to be avoided. Laboratory Tests Diabetics taking more than 500 mg vitamin C daily may obtain false readings of their urinary glucose test. No exogenous vitamin C should be ingested for 48 to 72 hours before amine-dependent stool occult blood tests are conducted because possible false-negative results may occur. Usage in Pregnancy Pregnancy Category C.' Animal reproduction studies have not been conducted with Ascorbic Acid Injection. It is also not known whether Ascorbic Acid Injection can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Ascorbic Acid Injection should be given to a pregnant woman only if clearly needed. Nursing Mothers Caution should be exercised when Ascorbic Acid Injection is administered to a nursing woman. CONTRAINDICATIONS Contraindicated in those persons who have shown hypersensitivity to any component of this preparation. CONTRAINDICATIONS Contraindicated in those persons who have shown hypersensitivity to any component of this preparation. In humans, an exogenous source of ascorbic acid is required for collagen formation and tissue repair. Ascorbic acid is reversibly oxidized to dehydroascorbic acid in the body. These two forms of the vitamin are believed to be important in oxidation-reduction reactions. The vitamin is involved in tyrosine metabolism, conversion of folic acid to folinic acid, carbohydrate metabolism, synthesis of lipids and proteins, iron metabolism, resistance to infections, and cellular respiration. Ascorbic acid deficiency results in scurvy. Collagenous structures are primarily affected, and lesions develop in bones and blood vessels. Administration of ascorbic acid completely reverses the symptoms of ascorbic acid deficiency.
Last updated on RxList: 10/3/2008