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Brand name: Hemostan, Fibrinon, Cyklokapron, Lysteda, Transamin Classification: Anti-fibrinolytic, antihemorrhagic Indications: Tranexamic acid is used for the prompt and effective control of hemorrhage in various surgical and clinical areas: Treating heavy menstrual bleeding Hemorrhage following dental and/or oral surgery in patients with hemophilia Management of hemophilic patients (those having Factor VIII or Factor IX deficiency) who have oral mucosal . bleeding, or are undergoing tooth extraction or other oral surgical procedures Surgical: General surgical cases but most especially operative procedures on the prostate, uterus, thyroid, lungs, heart, ovaries, adrenals, kidneys, brain, tonsils, lymph nodes and soft tissues. Obstetrical and gynecological: abortion, post-partum hemorrhage and menometrorrahgia Medical: epistaxis, hemoptysis, hematuria, peptic ulcer with hemorrhage and blood dyscrasias with hemorrhage Effective in promoting hemostasis in traumatic injuries. Preventing hemorrhage after orthopedic surgeries. Mechanism of Action Tranexamic acid is a synthetic derivative of the amino acid lysine. It exerts its antifibrinolytic effect through the reversible blockade of lysine-binding sites on plasminogen molecules. Anti-fibrinolytic drug inhibits endometrial plasminogen activator and thus prevents fibrinolysis and the breakdown of blood clots. The plasminogen-plasmin enzyme system is known to cause coagulation defects through lytic activity on fibrinogen, fibrin and other clotting factors. By inhibiting the action of plasmin (finronolysin) the anti-fibrinolytic agents reduce excessive breakdown of fibrin and effect physiological hemostasis. Contraindications Allergic reaction to the drug or hypersensitivity Presence of blood clots (eg, in the leg, lung, eye, brain), have a history of blood clots, or are at risk for blood clots Current administration of factor IX complex concentrates or anti-inhibitor coagulant concentrates Precautions Pregnancy. Tranexamic acid crosses the placenta. Lactation. Tranexamic acid is distributed into breast milk; concentrations reach approximately 1% of the maternal plasma concentration. Contraceptives, estrogen-containing, oral or Estrogens. Concurrent use with tranexamic acid may increase the potential for thrombus formation. Renal function impairment (medication may accumulate; dosage adjustment based on the degree of impairment is recommended) Hematuria of upper urinary tract origin (risk of intrarenal obstruction secondary to clot retention in the renal pelvis and ureters if hematuria is massive; also, if hematuria is associated with a disease of the renal parenchyma, intravascular precipitation of fibrin may occur and exacerbate the disease) Nursing Responsibilities Unusual change in bleeding pattern should be immediately reported to the physician. For women who are taking Tranexamic acid to control heavy bleeding, the medication should only be taken during the menstrual period. Tranexamic Acid should be used with extreme caution in CHILDREN younger than 18 years old; safety and effectiveness in these children have not been confirmed. The medication can be taken with or without meals. Swallow Tranexamic Acid whole with plenty of liquids. Do not break, crush, or chew before swallowing. If you miss a dose of Tranexamic Acid, take it when you remember, then take your next dose at least 6 hours later. Do not take 2 doses at once. Inform the client that he/she should inform the physician immediately if the following severe side effects occur: Severe allergic reactions such as rash, hives, itching, dyspnea, tightness in the chest, swelling of the mouth, face, lips or tongue Calf pain, swelling or tenderness Chest pain Confusion Coughing up blood

Decreased urination Severe or persistent headache Severe or persistent body malaise Shortness of breath Slurred speech Slurred speech Vision changes 2. Ferrous sulfate Generic Name: Ferrous sulfate Trade Name: Classification: Iron Preparation Dose, Route, PO freq: BID MECHANISM OF ACTION

Elevates the serum iron concentration which then helps to form High or trapped in the reticuloendothelial cells for storage and eventual conversion to a usable form of iron. INDICATIONS Prevention and treatment of iron deficiency anemias. Dietary supplement for iron. CONTRAINDICATIONS Hypersensitivity Severe hypotension. ADVERSE EFFECT Dizziness N&V Nasal Congestion Dyspnea Hypotension CHF MI Muscle cramps Flushing NURSING RESPONSIBILITIES Advise patient to take medicine as prescribed. Caution patient to make position changes slowly to minimize orhtostatic hypotension.

Instruct patient to avoid concurrent use of alcohol or OTC medicine without consulting the physician. Advise patient to consult physician if irregular heartbeat, dyspnea, swelling of hands and feet and hypotension occurs. Inform patient that angina attacks may occur 30 min. after administration due reflex tachycardia. Encourage patient to comply with additional intervention for hypertension like proper diet, regular exercise, lifestyle changes and stress management. 3. Clindamycin is a lincosamide antibiotic. It is used to treat infections and anaerobic bacteria. It can be also used to treat some protozoal diseases like malaria and can be useful against some methicillin-resistant Staphylococcus aureus infections. Clindamycin is also common topical treatment for acne. Common brand names are Anerocin, Clindal, Dalacin, Dalacin C, Inprosyn-HP, Klindex, and Zindal. Clindamycin is classified as Lincosamide and Antibiotic. Indication of Clindamycin Treatment of respiratory tract, skin or soft tissue, chronic bone or joint infections; septicemia; intra-abdominal, female genitourinal infections; bacterial vaginosis; endocarditis. Can be used for acne vulgaris. Clindamycin is used for treatment of malaria, otitis media, Pneumocystis carinii pneumonia, and toxoplasmosis. Route and Dosage of Clindamycin IV/IM: ADULTS, ELDERLY: 1.2-1.8 g/day in 2-4 divided doses. CHILDREN: 25-40 mg/kg/day in 3-4 divided doses. Maximum: 4.8 g/day. PO: ADULTS, ELDERLY: 150-450 mg/dose q6-8h. CHILDREN: 10-30 mg/kg/day in 3-4 divided doses. Maximum: 1.8 g/day. Bacterial Vaginosis Intravaginal: ADULTS: One applicatorful at bedtime for 3-7 days or 1 suppository at bedtime for 3 days. PO: ADULTS, ELDERLY: 300 mg 2 times/day for 7 days. Acne Vulgaris Topical: ADULTS: Apply thin layer 2 times/day to affected area. Action of Clindamycin Bacteriostatic. Clindamycin binds to bacterial ribosomal receptor sites. Topically, it decreases fatty acid concentration on skin. It inhibits protein synthesis of bacterial cell wall and prevents outbreak of acne vulgaris. Side Effect and Adverse Reaction of Clindamycin Side Effects of Clindamycin Abdominal pain Nausea and Vomiting Diarrhea Vaginitis and itching Dry scaly skin Phlebitis, thrombophlebitis with IV administration Pain, induration, at the IM injection site Allergic reaction, urticaria, pruritus Headache and dizziness Contact dermatitis Hypersensitivity reaction Adverse Reactions or Toxic Effects of Clindamycin Antibiotic-associated colitis (Severe abdominal pain, tenderness, fever, watery and severe diarrhea) Blood dyscrasias (Leukopenia and thrombocytopenia) Nephrotoxicity (Proteinuria, azotemia, oliguria) Nursing Consideration for Clients Taking Clindamycin Store capsules at room temperature After reconstitution, oral solution is stable for 2 weeks at room temperature. Do not refrigerate oral solution to avoid thickening. Give with 8 oz water. Question patient for history of allergies, particularly to clindamycin, lincomycin, and aspirin. Avoid concurrent use of neuromuscular blocking agents.

Monitor bowel activity, stool consistency; report diarrhea promptly due to potential for serious colitis. Assess skin for rash with topical application. Assess for superinfection: severe diaarhea, genital/anal pruritus, increase fever, and change of oral mucosa. Patient Teaching for Clients Taking Clindamycin Continue therapy for full length of treatment. Doses should be evenly spaced. Oral doses should be taken with 8 oz water. Caution should be used when applying topical clindamycin concurrently with peeling/abrasive acne agents, soaps, alcohol-containing cosmetics to avoid cumulative effect Do not apply topical preparations near eyes, abraded areas. If accidental contact with eyes, rinse with cool tap water. Do not engage in sexual intercourse during treatment. 4. Mefenamic Acid Pronunciation: (MEH-fen-AM-ik acid) Class: NSAID Ads by Google Humidity and Temp Control www.humiditycontrol.com/catalogCabinets, rooms & conditioners. Warranties, maintenance & service. 13 Agriculture Companies EnergyandCapital.com/AgricultureJump in today to take advantage of this emerging bull market in argo. Ask a Doctor Online Now Health.JustAnswer.comA Doctor Will Answer You Now! A Question is Answered Every 9 Sec. Trade Names

Ponstel - Capsules 250 mg Apo-Mefenamic (Canada) Pharmacology Decreases inflammation, pain, and fever, probably through inhibition of cyclooxygenase activity and prostaglandin synthesis. Indications and Usage Relief of moderate pain lasting less than 1 wk; treatment of primary dysmenorrhea. Unlabeled Uses Treatment of sunburn, migraine (acute attack), PMS. Contraindications Patients in whom aspirin, iodides, or any NSAID has caused allergic-type reactions; preexisting renal disease; active ulceration or chronic inflammation of GI tract. Dosage and Administration Acute Pain Adults and Children (14 yr or age and older) PO 500 mg, followed by 250 mg every 6 h as needed. Usually not used more than 1 wk. Primary Dysmenorrhea

Adults and Children (14 yr of age and older) PO 500 mg, followed by 250 mg every 6 h starting with onset of bleeding and associated symptoms. Storage/Stability Store at room temperature (59 to 86F) in tightly closed, light-resistant container. Ads by Google Stability Storage Equip. Precise humidity controlled rooms and chambers. Browse our catalog. www.humiditycontrol.com/catalog Ask a Doctor Online Now A Doctor Will Answer You Now! Health Answers Today: 87. Health.JustAnswer.com Help For Ulcers, H.Pylori Heal wounds, ulcers, infections Verified by World-Leading Research www.manukahoney.com Drug Interactions Anticoagulants Increased risk of gastric erosion and bleeding. Cyclosporine Nephrotoxicity of both agents may be increased. CYP-450 Exercise caution when coadministering mefenamic acid with drugs known to inhibit the isoenzyme 2C9. Lithium Serum lithium levels may be increased. Methotrexate Increased methotrexate levels. Salicylates Additive GI toxicity. Laboratory Test Interactions May cause prolonged bleeding time or false-positive reaction for urinary bile using diazo tablet test. Adverse Reactions Cardiovascular Edema; weight gain; CHF; altered BP; palpitations; chest pain; bradycardia; tachycardia. CNS Headache; vertigo; drowsiness; dizziness; insomnia. Dermatologic Rash; urticaria; purpura. EENT

Blurred vision; tinnitus; salivation; glossitis. GI Diarrhea; dry mouth; vomiting; abdominal pain; dyspepsia; GI bleeding; nausea; constipation; flatulence. Genitourinary Hematuria; proteinuria; dysuria; renal failure. Hematologic Decreased hematocrit; bleeding; neutropenia; leukopenia; pancytopenia; eosinophilia; thrombocytopenia. Hepatic Mild elevations in LFT results. Respiratory Bronchospasm; laryngeal edema; rhinitis; dyspnea; pharyngitis; hemoptysis; shortness of breath. Miscellaneous Autoimmune hemolytic anemia may occur if used long term. Ads by Google Structure-Based Design CHI Conference June 6-8, 2012, Cambridge, MA www.healthtech.com/sbd Oral Fluid Drug Test Kit 6 Drug+Alcohol test instant result Contact us for samples www.oranoxis.com Improve Kidney Health Probiotics to promote removal of nitrogenous waste for kidney health www.kibowbiotech.com Precautions Warnings NSAIDs may cause an increased risk of serious CV thrombotic events, MI, and stroke, which can be fatal. This risk may increase with length of therapy. Patients with CV disease or risk factors for CV disease may be at greater risk. NSAIDs cause an increased risk of serious GI adverse reactions, including bleeding, inflammation, perforation of the stomach or intestines, and ulceration, which can be fatal. These events can occur any time during use and without warning symptoms. Elderly patients are at greater risk of serious GI events.

Pregnancy Category C . Lactation

Undetermined. Children Not recommended for children younger than 14 yr of age. Elderly Increased risk of adverse reactions. Hypersensitivity May occur; use with caution in aspirin-sensitive individuals because of possible cross sensitivity. Renal Function Acute renal insufficiency, interstitial nephritis, hyperkalemia, hyponatremia, and renal papillary necrosis may occur. Lower doses may be necessary in patients with renal function impairment. Diarrhea If diarrhea occurs, reduce dosage or temporarily discontinue. GI toxicity Bleeding, ulceration, or perforation can occur at any time, with or without warning symptoms. Rash Promptly discontinue if rash develops. Overdosage Symptoms Acute renal failure, coma, grand mal seizures, muscle twitching, status epilepticus. Patient Information Inform patient not to use drug for longer than 1 wk. If given for dysmenorrhea, instruct patient to begin taking drug with onset of bleeding and associated symptoms. Warn patient about potential for bleeding, and advise patient to notify other health care professionals that drug is being taken. Advise patient to discontinue medication if rash develops and to contact health care provider. Instruct patient to report the following symptoms to health care provider: rash, visual problems, dark stools, decreased urinary output, persistent headache or stomach pain and unusual bruising or bleeding. Advise patient to avoid intake of alcoholic beverages. Instruct patient that drug may cause drowsiness and to use caution while driving or performing other activities requiring mental alertness. Caution patient to avoid prolonged exposure to sunlight and to use sunscreen or wear protective clothing to avoid photosensitivity reaction. Instruct patient not to take OTC medications, including aspirin and ibuprofen or other prescription drugs, without consulting health care provider.

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5.Ascorbic Acid ( Vitamin C ) Pronunciation: (as-KORE-bik AS-id) Class: Vitamin Ads by Google Premium Apricot Kernels www.nu-gen.netExtremely Bitter Raw Apricot Seeds. On Sale. Vitamin D3 10,000 IU Gels www.ClinicalNutraceuticals.comLimited Time Offer. Buy 2 Bottles & Get 3rd Free. Order Now & Save Big! Humidity and Temp Control www.humiditycontrol.com/catalogCabinets, rooms & conditioners. Warranties, maintenance & service. Trade Names Ascor L 500 - Injection 500 mg/mL Cecon - Solution, oral 100 mg/mL Cenolate - Injection 500 mg/mL Cevi-Bid - Tablets 500 mg Chewable Vitamin C - Tablets, chewable 250 mg vitamin C as sodium ascorbate and ascorbic acid - Tablets, chewable 500 mg vitamin C as sodium ascorbate and ascorbic acid Dull-C - Powder, oral 1,060 mg/tsp Fruit C 500 - Tablets, chewable 500 mg vitamin C as calcium ascorbate and ascorbic acid Fruit C 100 - Tablets, chewable 100 mg vitamin C as calcium ascorbate and ascorbic acid Fruit C 200 - Tablets, chewable 200 mg vitamin C as calcium ascorbate and ascorbic acid N'ice Vitamin C Drops - Lozenges 60 mg Sunkist Vitamin C - Tablets, chewable 60 mg vitamin C as sodium ascorbate and ascorbic acid - Tablets, chewable 250 mg vitamin C as sodium ascorbate and ascorbic acid - Tablets, chewable 500 mg vitamin C as sodium ascorbate and ascorbic acid Vicks Vitamin C Drops - Lozenges 25 mg vitamin C as sodium ascorbate and ascorbic acid Vita-C - Crystals, oral 1,000 mg per tsp Proflavanol (Canada) Revitalose-C-1000 (Canada) Timedose Vitamin C (Canada) Pharmacology Essential vitamin believed to be important for synthesis of cellular components, catecholamines, steroids, and carnitine. Pharmacokinetics

Absorption Absorbed almost completely from distal small intestine. Distribution Distributed throughout water-soluble compartments. Adrenal cortex, leukocytes, platelets, and pituitary gland contain high concentrations. Elimination Excreted in the urine. Indications and Usage Prevention and treatment of ascorbic acid deficiency. Unlabeled Uses Treatment of idiopathic methemoglobinemia; combination therapy with methenamine to increase acidity of urine. Although not proven scientifically, prevention of common colds and treatment of cancer, asthma, atherosclerosis, burns, and other wounds. Topical vitamin C may photoprotect against UV radiation because of its antioxidant and anti-inflammatory properties. Contraindications Hypersensitivity to any component of the product. Dosage and Administration Recommended Daily Allowances 19 y of age and older Men 90 mg/day. Women 75 mg/day. Pregnant 85 mg/day. Breast-feeding 120 mg/day 14 to 18 y of age Male adolescents 75 mg/day. Female adolescents 65 mg/day. Pregnant 80 mg/day. Breast-feeding 115 mg/day. 9 to 13 y of age 45 mg/day. 4 to 8 y of age 25 mg/day. 1 to 3 y of age 15 mg/day. 30 days to 1 y of age 6 mg/kg/day. Nicotine use Adults The RDA for smokers is 100 mg/day because of an increased utilization of vitamin C. Deficiency IV/IM/subcutaneous 100 to 250 mg once or twice daily. If deficiency is severe, give 1 to 2 g/day. Up to 6 g/day has been administered without toxicity. In other conditions in which the need is increased, 3 to 5 times the RDA appears to be adequate. Burns IV/IM/subcutaneous 200 to 500 mg/day. For severe burns, give 1 to 2 g/day. Surgery IV/IM/subcutaneous 300 to 500 mg/day for 7 to 10 days, both pre- and postoperatively to enhance wound healing. 1 to 2 g/day for 4 to 7 days preoperatively has been used in gastrectomy patients.

General Advice Parenteral dosing used in acute deficiency or when oral absorption is uncertain. Avoid rapid IV administration. For IV injection, dilute into a large volume parenteral, such as normal saline or glucose, to minimize adverse reactions associated with IV injection. Taper vitamin C prior to discontinuing supplementation. Pressure may develop in vial or ampule upon storage; exercise caution and relieve pressure by inserting a sterile, empty syringe into vial. Take precautions to wrap the ampule in a protective covering while it is being opened. Storage/Stability Ascor L 500 and Cenolate Store in refrigerator at 36 to 46F. Do not allow to stand at room temperature before use. Oral formulations Store at room temperature. Ads by Google Premium Omega3 Salmon Oil Pure, Deep-Sea Omega-3 Salmon Oil Gelcaps. On Sale, lowest $10.95/btl nu-gen.net Vitamin D3 10,000 IU Gels Limited Time Offer. Buy 2 Bottles & Get 3rd Free. Order Now & Save Big! www.ClinicalNutraceuticals.com Omega-3 Food Ingredients MARIS OMEGA-3: Perfect taste for your functional food project www.maris-omega3.com Drug Interactions Amygdalin Risk of life-threatening cyanide toxicity to amygdalin may be increased. Although the FDA has banned the use of the synthetic form of amygdalin, laetrile, for cancer treatment, amygdalin has been used as alternative medicine by some patients. Avoid concurrent use. Disulfiram On occasion, ascorbic acid has been used as a specific antidote for symptoms resulting from the interaction between ethanol and disulfiram; it may be expected that the coadministration of ascorbic acid will interfere with the effectiveness of disulfiram given to patients to encourage abstention from alcohol. Drugs affected by urinary acidification (eg, amphetamine, mexiletine) Acidification of the urine by ascorbic acid may cause precipitation of cysteine, urate, or oxalate stones and will alter the excretion of certain other drugs administered concurrently. Elimination of certain drugs may be enhanced by urinary acidification. Monitor the clinical response of the patient. If an interaction is suspected, it may be necessary to discontinue ascorbic acid or adjust the dose of the drug altered by urinary acidification. Warfarin Large ascorbic acid doses interfere with the anticoagulant effect of warfarin. Monitor coagulation parameters in patients receiving ascorbic acid 5 g or more daily and adjust the warfarin dose as needed. Laboratory Test Interactions Because ascorbic acid is a strong reducing agent, it interferes with numerous laboratory tests based on oxidationreduction reactions. Diabetic patients taking more than 500 mg/day of ascorbic acid may obtain false readings of their urinary glucose test. No exogenous ascorbic acid should be ingested for 48 to 72 hours before aminedependent stool occult blood tests are conducted because false negative results may occur. Adverse Reactions CNS Faintness or dizziness may occur with rapid IV administration. GI Diarrhea, nausea, vomiting. Genitourinary Excessive doses over a long period of time may cause precipitation of cystine, oxalate, or urate crystals in kidney. Miscellaneous

Injection-site irritation may occur with IM or subcutaneous administration. Ads by Google Zinc Citrate USP29 Iso Haccp Kosher Halal Certified. www.reephos.com Clarocet UK & Europe Authorized Clarocet distributor for UK and European customers. www.clarocet.co.uk/ On-Site Drug Tests Immediate, Fast & Easy Results Test 12 Drugs at Once - Buy Online! www.AlfaScientific.com Precautions Pregnancy Category C (in doses exceeding the RDA); Category A (in doses up to RDA). Lactation Excreted in breast milk. Tartrazine Sensitivity Some injectable products contain tartrazine, which can precipitate breathing difficulties in sensitive individuals. Sulfite Sensitivity Some injectable products contain sulfites, which may precipitate a reaction in sensitive individuals. Aluminum toxicity Some injectable products contain aluminum, which may lead to CNS and bone toxicity. Excessive doses Diabetic patients, patients prone to renal calculi, patients on sodium-restricted diets, and those taking anticoagulants should not take excessive doses (more than 5 g/day) over extended periods of time. Patient Information Explain that taking this product with foods high in iron will enhance absorption of iron. Explain to any patient scheduled for glucose studies that product should not be taken for at least 48 to 72 h before test. Inform patient that abruptly stopping high-dose therapy may lead to loosening of teeth and bleeding gums.