Drug name Arixtra

Drug Classification
Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)

Therapeutic action
Mechanism of Action: Fondaparinux is a synthetic and selective inhibitor of activated factor X (Xa). The antithrombotic activity of fondaparinux is the result of antithrombin III (ATIII)-mediated selective inhibition of factor Xa. By binding selectively to ATIII, fondaparinux potentiates (about 300 times) the innate neutralization of factor Xa by ATIII. Neutralization of factor Xa interrupts the blood coagulation cascade and inhibits both thrombin formation and thrombus development. Fondaparinux does not inactivate thrombin (activated factor II) and has no known effect on platelet function. Pharmacodynamic Effects: At the 2.5 mg dose, fondaparinux does not have a clinically relevant effect on routine coagulation tests eg, activated partial thromboplastin time (aPTT), activated

Indications
Prevention of venous thromboembolic events (VTE) in patients undergoing major orthopedic surgery of the lower limbs eg hip fracture including extended prophylaxis, knee & hip replacement surgery; abdominal surgery at risk of thromboembolic complications, restricted mobility during acute illness who are at risk of thromboembolic complications. Treatment of acute DVT & pulmonary embolism (PE), unstable angina or non-ST segment elevation MI (UA/NSTEMI) acute coronary syndrome for the prevention of death, MI & refractory

Contraindication Adverse effects

Hypersensitivity. Active clinically significant bleeding, acute bacterial endocarditis. Anemia, bleeding, purpura; edema.

Nursing Responsibilities
Do not administer IM. Do not give 24 hr prior to CABG surgery & may be restarted 48 hr post-op. STEMI patients undergoing primary PCI for reperfusion. Monotherapy in UA/NSTEMI & STEMI patients undergoing non-primary PCI. Increased risk of hemorrhage eg congenital or acquired bleeding disorders, active ulcerative GI disease, recent intracranial hemorrhage, shortly after brain, spinal or ophth surgery. Low body wt <50 kg; spinal/epidural anesth or spinal puncture. History of heparininduced thrombocytopenia & latex allergy. Renal (CrCl <20 or 30 mL/min) or severe hepatic impairment. Close monitoring is recommended in patients concomitantly taking products enhancing the risk of hemorrhage. Pregnancy & lactation. Childn <17 yr. Elderly 75 yr.

clotting time (ACT) or prothrombin time (PT)/international normalized ratio (INR) tests in plasma, nor bleeding time or fibrinolytic activity. However, rare spontaneous reports of elevated aPTT have been received at the 2.5 mg dose. Fondaparinux does not cross-react with sera from patients with heparin-induced thrombocytopenia (HIT) type II.

ischemia; ST segment elevation MI (STEMI) acute coronary syndrome for the prevention of death & myocardial reinfarction in patients who are managed w/ thrombolytics or who initially are to receive no other form of reperfusion therapy.

Drug name Humulin R insulin (regular)

Drug Classification Insulin Preparations

Therapeutic action
Pharmacology: The time course of action of any insulin may vary considerably in different individuals or at different times in the same individual. As with all insulin preparations, the duration of action of Humulin is dependent on dose, site of injection, blood supply, temperature and physical activity. Humulin N (NPH): Vial: Humulin N (NPH) contains isophane human insulin of recombinant DNA origin. It is an intermediate-acting

Indications
Treatment of diabetes mellitus for the control of hyperglycemia.

Contraindication Adverse effects

Hypoglycemia. Lipodystrophy, insulin resistance. Local & generalised allergic reactions.

Nursing Responsibilities
Transferring from other insulins. Emotional distress. Infection. Pregnancy.

preparation; onset of action is approximately 1 hr, with a duration of about 14 hrs and peak activity at 2-8 hrs. Cartridge: Humulin N (NPH) is a sterile, crystalline suspension of human insulin with protamine and zinc, providing an intermediate-acting insulin with a slower onset of action and a longer duration of activity (up to 24 hrs) than that of regular insulin. Humulin R (Regular): Humulin R (Regular) is a neutral human insulin of recombinant DNA origin. It is a shortacting preparation; onset of action occurs at approximately 30 min, with a duration of about 5 hrs and peak activity at 1-3 hrs. Humulin 70/30: Humulin 70/30 is an intermediateacting insulin combined with the more rapid onset of action of regular insulin. The duration of activity may last up to 24 hrs following injection.

Drug name Ferrous Sulfate

Drug Classification
Belongs to the class of oral iron bivalent preparations. Used in the treatment of anemia.

Therapeutic action
Antianemic.

Indications
Prophylaxis & treatment of simple Fedeficiency disorders & Fedeficiency anemia.

Contraindication Adverse effects

Anemia not due to Fe deficiency, intolerance to Fe, inability to absorb Fe, regional enteritis, colostomy, ileostomy or hemochromatosis. GI irritation.

Nursing Responsibilities
Should be taken on an empty stomach. Best taken on an empty stomach. May be taken w/ meals to reduce GI discomfort.

Drug name Folic Acid

Drug Classification
Vitamins & Minerals (Pre & Post Natal) / Antianemics

Therapeutic action

Indications
Treatment & prevention of folate deficiency state. Protection against neural tube defects in the offspring of pregnant & women of childbearing potential.

Contraindication Adverse effects

Rarely, GI disturbances & hypersensitivity reactions.

Nursing Responsibilities
Undiagnosed megaloblastic anemia alone or in conjunction w/ inadequate amounts of vit B12. May be taken with or without food.

Drug name Fluimucil

Drug Classification
acetylcysteine ; Belongs to the class of mucolytics. Used in the treatment of wet cough.

Therapeutic action

Indications
Acute & chronic resp tract infections w/ abundant mucus secretions due to acute bronchitis, chronic bronchitis & its exacerbations, pulmonary emphysema, mucoviscidosis & bronchiectasis.

Contraindication Adverse effects

Effervescent tab/Oral soln: Phenylketonurics. Rarely, urticaria, bronchospasm, nausea, vomiting. Inhalant: Rhinitis, stomatitis.

Nursing Responsibilities
Asthmatic patients. Patients w/ history of peptic ulceration. Should be taken with food.