DRUG STUDY

DRUG NAME: Mecobalamin (Methycobal) DATE ORDERED: December 2, 2011 (10am) DOSE & FREQUENCY: 1 tab BID P.O. CLASSIFICATION: Vit. B12 ACTION: Neurologically active form of vit. B12 and occurs as a water-soluble vitamin in the body. It is a cofactor in the enzyme methionine synthase, which functions to transfer methyl groups for the regeneration of methione from homocystein. INDICATION: 1. Treatment for pt. with peripheral neuropathies 2. Vit. B12 deficiency ADVERSE REACTION: nausea and vomiting, dizziness, skin rash, sweating, anorexia and headache. NURSING CONSIDERATIONS: Asses for gastrointestinal complaints such as nausea, vomiting and constipation Asses the patient abdomen for bloating Ask the significant others if the patient is experiencing headache Report severe GI upset, dizziness , unusual fatigue or weakness, fever & chills

DRUG NAME: Calvit DATE ORDERED: November 30, 2011 DOSE & FREQUENCY: 3 scoops OD P.O. CLASSIFICATION: Calcium supplements ACTION: Calcium is the most abundant mineral in the human body. It is probably most recognized for its important role in maintaining bone health and allows the individual to achieve their peak bone mass. The skeleton not only provides structural support for muscles, but also protects vital organs and serves as a storage for calcium. INDICATION: 1. Dietary supplement for adolescents and young adults during periods of rapid growth and development. Prevention ofosteoporosis and calcium insufficiency and as dietary supplement during pregnancy and lactation, pre- and post menopause. ADVERSE REACTION: nausea and vomiting, dizziness, skin rash, sweating, anorexia and headache. NURSING CONSIDERATIONS: Asses for gastrointestinal complaints such as nausea, vomiting and constipation Asses the patient abdomen for bloating Ask the significant others if the patient is experiencing headache Report severe GI upset, dizziness , unusual fatigue or weakness, fever & chills Remind 3 checks before giving the supplement Remind the 10 rights of the patient before giving the medication

DRUG NAME: Humulin R (Novolin R) DATE ORDERED: December 2,2011 DOSE & FREQUENCY: 15 u SQ once daily before breakfast CLASSIFICATION: anti-diabetic ACTION: increases synthesis of glycogen in the liver. INDICATION: 1. Diabetic coma 2. diabetic acidosis 3. clients suffering from labile diabetes CONTRAINDICATION: Hypersensitivity to the drug/insulin. ADVERSE REACTION: Hypoglycemia, hypokalemia, injection site reaction pruritus and rashes. NURSING CONSIDERATIONS: Note disease, onset, level of control or understanding of disease. Previouse agents trialed, outcome. Monitor vital signs, complete blood count, urinalysis microalbumin, renal and liver function tests. Tell client to report adverse effects or lack of sugar control. Continue diet, exercise and weight control.

DRUG NAME: Castor Oil (Xenaderm) DATE ORDERED: December 2,2011 DOSE & FREQUENCY: 30 CLASSIFICATION: anti-diabetic CONTRAINDICATION: Hypersensitivity to the drug/insulin. ACTION: The kinetics of digoxin were affected by coadministration of the castor oil derivative polyoxyl 35 castor oil. Oral cremophor delayed and enhanced absorption of an oral dose of digoxin 0.5 mg in healthy adults. The increase in plasma digoxin concentrations did not result in clinical effects. 17Experimental interactions with IV doxorubicin and doxorubicinol and oral saquinavir also have been observed, with proposed action via interference with the efflux pump P-glycoprotein membrane transporter. Interactions with other drugs with relatively low bioavailability, such as amiodarone and phenytoin, are theoretically possible INDICATION: Castor oil is used to treat constipation. It may also be used to clean out the intestinesbefore a bowel examination/surgery. Castor oil is known as a stimulant laxative. It works by increasing the movement of the intestines, helping the stool to come out.CONTRAINDICATION: Hypersensitivity to the drug/insulin. ADVERSE REACTION: Stomach/abdominal pain or cramping, nausea, diarrhea, or weakness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. NURSING CONSIDERATIONS: Before taking castor oil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which

can cause allergic reactions or other problems. Talk to your pharmacist for more details. Remind 3 checks before giving the supplement Remind the 10 rights of the patient before giving the medication

o o o o o o

DRUG NAME: Metformin HCl DATE ORDERED: No exact date. Perhaps on December 3,2011. DOSE & FREQUENCY: PO: ADULTS, ELDERLY: Initially, 500 mg twice daily (with morning and evening meals). May increase dosage in 500-mg increments every week, in divided doses. Can be given twice daily up to 2,000 mg/day. If 2,500 mg/day dose is required give 3 times/day with meals. Maximum dose/day: 2,500 mg/day. CHILDREN 10-16 YRS.: Initially, 500 mg 2 times/day. May increase by 500 mg/day at weekly intervals. Maximum 2,000 mg/day. CLASSIFICATION: anti-diabetic ACTION: Decreases liver production of glucose, decreases absorption of glucose, improves insulin sensitivity. Therapeutic Effect: provides improvement in glycemic control, stabilizes/decreases body weight, improves lipid profile. INDICATION It is the first-line drug of choice for the treatment of type 2 diabetes. Common brand names for Metformin are Formet, Fornidd, Glucoform, Glucophage, Glucopres, and Humamet. Metformin is classified as an Antihyperglycemic and Antidiabetic. CONTRAINDICATION: Hypersensitivity to the drug/insulin. ADVERSE REACTION: Gastrointestinal disturbances are transient and resolve spontaneously during therapy (diarrhea, nausea, vomiting, abdominal bloating, flatulence, anorexia). Rare: Unpleasant or metallic taste (resolves spontaneously during therapy). NURSING CONSIDERATIONS: Inform the patient of potential risks/advantages of therapy and of alternative modes of therapy. Assess Hemoglobin, hematocrit, red blood cellsm and serum creatinine prior to initiation of therapy. Monitor fasting blood glucose, hemoglobin a, and renal function. Monitor renal function test for evidence of early lactic acidosis. If patient is on oral sulfonylureas, assess for hypoglycemia. Be alert to conditions that alter glucose requirements: fever, increased activity or stress, surgical procedure.