Drug Study

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Generic Name: Celecoxib

Brand Name:
Dosage: 200mg 1 cap BID
Classification: Nonsteroidal Anti-Inflammatory Drugs
Indication: Treatment of osteoarthritis, pain, rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing
spondylitis. Reduction of the number of colorectal polyps.
Contraindication: Allergies to sulphonamides, celecoxib, NSAIDs, or aspirin; significant renal
impairment. Hypersensitivity to celecoxib and sulfonamides.
Mode of Action: Celecoxib is a selective cyclooxygenase-2 (COX-2) inhibitor primarily responsible to
reduce mediators of pain and inflammation. Its action is due to inhibition of
prostaglandin synthesis via inhibition of COX-2.
Adverse Effects: Sinusitis, upper resp tract infection, UTI, allergy aggravated, insomnia, dizziness,
hypertonia, MI, pharyngitis, rhinitis, cough, dyspnoea, vomiting, diarrhoea, dyspepsia,
abdominal pain, flatulence, dysphagia, rash, pruritus, flu-like symptoms, peripheral
oedema/fluid retention, jaundice, liver necrosis
Nursing Responsibility: May be taken with or without meals. Advise patient to report signs or symptoms
of GI toxicity (abdominal pain, black stools) or hepatotoxicity (nausea, fatigue,
flu-like symptoms)

Generic Name: Calcium + Vitamin D


Brand Name:
Dosage: 1 tab OD
Classification: Calcium with Vitamins / Antacids, Antireflux Agents & Antiulcerants / Electrolytes
Indication: Hyperphosphataemia in patients with chronic renal failure. Hyperacidity
Contraindication: Patients with Ca renal calculi or history of renal calculi; hypercalcaemia;
hypophosphataemia. Patients with suspected digoxin toxicity.
Mode of Action: Calcium carbonate can neutralise gastric acid rapidly and effectively. However, it
may adversely activate Ca dependent processes, leading to secretion of gastric and
hydrochloric acid. It can induce rebound acid secretion and, prolonged high doses
may cause hypercalcemia, alkalosis and milk-alkali syndrome.
Side Effects: Constipation, flatulence; hypercalcaemia; metabolic alkalosis; milk-alkali syndrome, tissue-
calcification. Gastric hypersecretion and acid rebound (with prolonged use).
Nursing Responsibility: Monitor VS especially BP and PR. Obtain ECG result. Asses for heartburn,
indigestion, abdominal pain. Monitor serum calcium before treatment. Assess for
nausea and vomiting, anorexia, thirst, severe constipation
Generic Name: Benzydamine Hydrochloride
Brand Name:
Dosage: 2 sprays TID
Classification: NSAID with analgesic, anti-pyretic and anti-inflammatory
Indication: Treatment of pain minor infection and inflammation common to uncomplicated sore
throat, oral surgery, minor mouth infections and dental procedures.
Contraindication: Known sensitivity to any of the active ingredients or the excipients. Known sensitivity
to other local anaesthetic agents. This product is contraindicated in
phenylketonurics, since it contains aspartame, which is metabolised in the GIT to
phenylalanine.
Mode of Action: Benzydamine hydrochloride is a non-steroid anti-inflammatory drug that has
analgesic, antipyretic and anti-inflammatory actions. It is used for the relief of
inflammatory conditions of the mouth and throat
Side Effects: Sensitisation can occur to anaesthetics due to prolonged use, over use or inappropriate
use. The most common side effects when large quantities of isomalt are ingested are
gastrointestinal disturbance. Excess consumption of the lozenges will result in excessive
isomalt intake and can cause laxative effects.

Generic Name: Co-Amoxiclav


Brand Name:
Dosage: 1 gm IV BID
Classification: Antibacterial
Indication: Known or suspected amoxicillin-resistant infections including respiratory tract, skin and soft
tissue, genitourinary, and ear, nose and throat infections. Effective against strains of
Escherichia coli, Proteus mirabilis, Haemophilus influenza, Streptococcus faecalis,
Streptococcus pneumoniae and some beta- lactamase-producing organisms
Contraindication: History of penicillin hypersensitivity. Superinfections involving Pseudomonas or
candida
Mode of Action: Co-amoxiclav is an antibacterial combination consisting of amoxicillin (as sodium)
and the beta-lactamase inhibitor, clavulanic acid (as potassium clavulanate).
Amoxicillin is the 4- hydroxy analogue of ampicillin. Amoxicill in hinders the cell wall
synthesis of sensitive bacteria and is bactericidal against many Gram-positive and
Gram-negative bacteria
Side Effects: Lethargy, hallucinations, seizures, glossitis, sore mouth, furry tongue, black “hairy tongue”,
nausea and vomiting, diarrhea, abdominal pain, bloody diarrhea, enterocolitis
Nursing Responsibility: Assess bowel pattern before and during treatment as pseudo membranous
colitis may occur. Report hematuria or oliguria as high doses can be
nephrotoxic. Assess respiratory status. Observe for anaphylaxis. Ensure that the
patient has adequate fluid intake during any diarrhea attack
Generic Name: Difflam Throat Spray
Brand Name:
Dosage: 2 sprays TID
Classification: Non- steroidal anti- inflammatory drug; analgesic
Indication: Relief of painful conditions of the oral cavity including tonsillitis, sore throat, radiation
mucositis, aphthous ulcers, post-orosurgical & periodontal procedures, pharyngitis, swelling
& inflammatory conditions. Antiseptic.
Contraindication: There are no known contraindications except for hypersensitivity
Mode of Action: It selectively binds to inflamed tissues (Prostaglandin synthetase inhibitor) and is
normally free of adverse systemic effects. Unlike other NSAIDs, it does not inhibit
cyclooxygenase or lipooxygenase, and is not ulcerogenic
Side Effects: Oral numbness; dryness or thirst, tingling, warm feeling in mouth, altered sense of taste.
Nursing Responsibility: Spray directly onto the sore/inflammed area & swallow gently.

Generic Name: Hexetidine Gargle


Brand Name:
Dosage: 10mL TID after meals
Classification: Oral antiseptic
Indication: Minor sore throat; halitosis, general oral hygiene. Improves appearance of mouth tissue,
protects tooth surfaces afaints formation of decay acids.
Contraindication: Lesions and ulcerations of oral/buccal mucosa
Mode of Action: Protection against oral bacterial and fungal infection to give fast relief from sore
throat and mouth ulcers. First, bactidol quicly reduces bacteria in the affected areas
to help relieve and prevent soreness, then hexetidine contains adheres to affected
areas for extended period of time, giving long lasting protection.
Side Effects: Taste disturbances, transient anaesthesia, irritation, sensitization
Nursing Responsibility: Assess for lesions. Instruct patient to swallow the medication
Generic Name: Cefuroxime
Brand Name:
Dosage:
Classification: Cephalosporins
Indications: Susceptible infections. Uncomplicated UTI. Respiratory tract infections. Lyme disease.
Uncomplicated gonorrhoea. Susceptible infections. Pneumonia. Acute exacerbations of
chronic bronchitis. Prophylaxis of surgical infections. Meningitis. Gonorrhoea
Contraindication: Hypersensitivity to cefuroxime or to other cephalosporins.
Mode of Action: Cefuroxime inhibits bacterial cell wall synthesis by binding to one 1 or more of the
penicillin-binding proteins (PBPs) which in turn inhibit the final transpeptidation step of
peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis and
arresting cell wall assembly resulting in bacterial cell death.
Side Effects: Body as a Whole: Thrombophlebitis (IV site); pain,burning, cellulitis (IM site); superinfections,
positive Coombs'test. GI: Diarrhea, nausea, antibiotic-associated colitis. Skin: Rash,
pruritus, urticaria. Urogenital: Increased serum cretonne and BUN, decreased creatinine
clearance
Nursing Responsibility: Determine history of hypersensitivity reactions to cephalosphorins, penicillins and
history of allergies particularly to drugs before therapy is initiated. Instruct to
report onselt of loose stools. Absorption of cefuroxime is enhanced by food.
Notify prescriber about rashes or superinfections.

Generic Name: Ketomed


Brand Name:
Dosage:
Classification: Non-steroidal Anti-inflammatory Drugs (NSAID)
Indication: Short-term management of moderate to severe acute post-op pain.
Contraindication: Hypersensitivity to ketorolac tromethamine, other NSAIDs, aspirin or other
prostaglandin synthesis inhibitors induce allergic reactions (severe anaphylactic-like
reactions). History of asthma. History of or active peptic ulceration or GI bleeding;
suspected or confirmed cerebrovascular bleeding, hemorrhage diatheses including
coagulation disorders; complete or partial syndrome of nasal polyps, angioedema or
bronchospasm. Moderate or severe renal impairment (serum creatinine >160
mmol/L). Pregnancy (labor & delivery) & lactation. Inj: Hypovolemia (any cause or
dehydration). Patients who undergone operations w/ a high risk of hemorrhage or
incomplete hemostasis.
Mode of Action: Reversibly inhibits cyclooxygenase -1 and -2 (COX-1 and -2) enzymes, which result in
decreased formation of prostaglandin precursors. It exhibits minimal anti-inflammatory
effect at its analgesic dose.
Side Effects: Nausea, dyspepsia, GI pain & bleeding; abdominal discomfort, hematemesis, gastritis,
esophagitis, diarrhea, eructation, constipation, flatulence, fullness, melena, peptic ulcer,
nonpeptic GI ulceration, rectal bleeding, ulcerative stomatitis.
Nursing Responsibility: Monitor BP upon administration. < 90/80 never administer. Refer to doctor. Assess
pain (note type, location, and intensity) prior to and 1-2 hr following administration. Caution
patient to avoid concurrent use of alcohol, aspirin.

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