DRUG Name Generic: Amlodipine Brand: Norvasc Class: Calcium antagonist/ antianginal drugs Route: Oral

MECHANISM OF ACTION Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells; inhibits transmembrane calcium flow, which results in the depression of impulse formation in specialized cardiac pacemaker cells; these effects lead to decreased cardiac work, decreased cardiac oxygen consumption, and in patients with angina, increased delivery of oxygen to cardiac cells.

INDICATION HTN, angina, myocardial ischemia. Reduce the risk of coronary revascularization, fatal CHD, nonfatal MI & stroke.

CONTRAINDICATION Hypersensitivity to amlodipine

ADVERSE REACTIONS - headache, dizziness, fatigue - peripheral edema, angina, bradycardia, hypotension, palpitations - gingival hyperplasia, nausea - flushing

SIDE EFFECTS The 2 most common side effects are headache and edema (swelling) of the lower extremities. Less common side effects include dizziness, flushing, fatigue, nausea and palpitations.

NURSING CONSIDERATIONS -Monitor blood pressure and pulse before therapy, during dose titration, and periodically during therapy. -Monitor intake and output ratios and daily weight.

DRUG Name Generic: Pregabalin Brand: Lyrica Class: Neuropathic pain/ anticonvulsant Route: Oral

MECHANISM OF ACTION Pregabalin binds to calcium channels on nerves and may modify the release of neurotransmitters. Reducing communication between nerves may contribute to pregabalins effect on pain and seizures.

INDICATION Treatment of neuropathic pain & generalized anxiety disorders in adults; as adjunctive therapy for partial seizures with or without secondary generalization in adults; management of fibromyalgia

CONTRAINDICATION Hypersensitivity

ADVERSE REACTIONS -Dizziness & somnolence. -Increased appetite -confusion, disorientation, irritability, euphoric mood, decreased libido, insomnia, ataxia, -abnormal coordination, balance disorder, amnesia, attention disturbance, memory impairment, tremor

SIDE EFFECTS Dizziness, drowsiness, dry mouth, edema , blurred vision, weight gain, and difficulty concentrating.

NURSING CONSIDERATIONS -Can be given with or without meals -instruct client to avoid drinking alcohol when taking this medication as it can increase certain side effects of drug -instruct client not to drive when taking the drug

DRUG Name Generic: Tramadol Brand: dolcet Class: analgesic Route: Oral

MECHANISM OF ACTION Decreases pain by inhibiting the uptake of norepinephrine & serotonin in the CNS. May produce opioid-like effects, but causes less respiratory depression than morphine.

INDICATION Management of moderate to severe pain.

CONTRAINDICATION - Acute intoxication w/alcohol, hypnotics, narcotics, centrally-acting analgesics, opioids or psychototropic drugs. -Hypersensitivity

ADVERSE REACTIONS -CNS & GI disturbances. -Nausea, dizziness, somnolence. -Asthenia, fatigue, hot flushes, constipation, diarrhea, flatulence, dry mouth, pruritis, diaphoresis, tinnitus.

SIDE EFFECTS Nausea, vomiting, constipation, lightheadedness, dizziness, drowsiness, or headache may occur.

NURSING CONSIDERATIONS -assess for level of pain relief -assess BP & RR -assess bladder &bowel function -monitor for respiratory depression &seizures -to be taken w/meals to avoid GI upset. -encourage coughing & deep breathing q 2 hrs to prevent atelactasis &pneumonia