Name of Drugs Dosage Mode of Action Indication

Plogrel 75 mg 1 tab OD
Furosemide 40 mg 2 tab OD Loop Diuretic: Hypertension and ascites due to renal
Inhibits reabsorption of sodium and chloride from the proximal and failure
distal tubules and ascending limb of the loop of Henle, leading to
sodium-rich dieresis.
Omeprazole 20 mg 1 tab HS Proton Pump Inhibitor:
40 mg IV OD Binds to an enzyme on gastric parietal cells in the presence of acidic
gastric pH, preventing the final transport of hydrogen ions into the
gastric lumen.
Ciprofloxacin 200 mg BID x 7 Fluoroquinolones:
days Inhibit bacterial DNA synthesis by inhibiting gyrase.
Zynapse 1 g/tab BID
Vascoride 1 tab OD
Amlodipine 10 mg/tab OD Ca Channel Blockers:
Inhibits the transport of calcium into myocardial and vascular
smooth muscle cells, resulting in inhibition of excitation-contraction
coupling and subsequent contraction.
Sangobion 1 cap BID
Ectrin 1 cap TID Mucolytic:

Sodium 650 mg/tab TID Anti- ulcer:

Bicarbonate Acts as an alkalinizing agent by releasing bicarbonate ions. Oral
administration, releases bicarbonate, which is capable of
neutralizing gastric acid.
Ketosteril 600 mg/2 tab Multivitamins and Amino Acids
TID
Apresoline 25 mg/tab BID Vasodilators:
Direct –acting peripheral arteriolar vasodilator. Lowering of blood
pressure in antihypertensive patients and decreased afterload in
patients with CHF
Catapres 150 mg SL q 6° Ca Channel Blockers:
BP 160/100 and Inhibits the transport of calcium into myocardial and vascular
above smooth muscle cells, resulting in inhibition of excitation-contraction
 coupling and subsequent contraction.
Bactidol Oral swab TID
Citicholine 1 g IV q 6°
Furosemide 40 mg IV q 8° Loop Diuretic:
Inhibits reabsorption of sodium and chloride from the proximal and
distal tubules and ascending limb of the loop of Henle, leading to
sodium-rich dieresis.
Sodium 2 vials slow IV Anti- ulcer:
Bicarbonate push q 6 ° Acts as an alkalinizing agent by releasing bicarbonate ions. Oral
administration, releases bicarbonate, which is capable of
neutralizing gastric acid.
Lifezar 50 mg tab OD Angiotensin II receptor Antagonist:
(losartan) Blocks vasoconstrictor and aldosterone-producing effects of
angiotensin II at receptor sites, including vascular smooth muscle
and adrenal glands.
Lowering blood pressure.
Cefuroxime 750 mg IV q 8° Second-generation cephalosporins:
Bind to bacterial cell wall membrane, causing cell death.
Bactericidal action against susceptible bacteria.
Ketorolac 1 amp IV PRN for NSAID, Nonopioid analgesics:
pain Inhibits prostaglandin synthesis, producing peripherally mediated
analgesia. Also has an antipyretic and anti-inflammatory property.
Decreased pain.
Mannitol 75 cc q 8° Osmotic Diuretics:
50 cc q 4° Increases the osmotic pressure of the glomerular filtrate, thereby
inhibiting reabsorption of water and electrolytes. Causes excretion.
Nubain 1 amp IV STAT Opioid analgesic:
Binds to opiate receptors in the CNS. Alters the perception of and
response to painful stimuli while producing generalized CNS
depression.
Kefox 750 mg IV q 8°
Celebrex 200 mg BID NSAID: COX 2 inhibitor
Inhibits the enzyme COX-2. This enzyme is required for the
synthesis of prostaglandins.
Vascorf 10 mg OD
Aldezide BID
Dulcolax 4 tab @ HS Laxatives:
Stimulates peristalsis. Alters fluid and electrolyte transport,
producing fluid accumulation in the colon. Evacuation of the colon.
Diazepam ½ amp IV now Antianxiety agents, anticonvulsants, skeletal muscle relaxants:
Depresses the CNS, probably by potentiating GABA, an inhibitory
neurotransmitter. Produces skeletal muscle relaxation by inhibiting
spinal polysynaptic afferent pathways. Has anticonvulsant
properties due to enhanced presynaptic inhibition.
Ensure 5 scoops IV 200
cc H2O q 6°

Laboratories:

Laboratories Significance

URANALYSIS: 9/11/10 Urinalysis is a diagnostic test to determine the condition of the urinary or even the male genital
Color: yellow system due to the same duct.
Appearance: turbid
pH: acidic The color determines the substances present in the urine and the condition of filtration and
specific gravity: 1.015 concentrating the urine. Colorless to pale yellow indicates dilute urine due to diuretics, alcohol
Pus cells: 1-3/hpf consumption, diabetes insipidus, glycosuria, excess fluid intake, renal disease. The yellow to milky
RBC: too numerous to count
white color indicates infection. Bright yellow is caused by multiple vitamin ingestion. Pink to red
Protein: (+)(+)(+)(+) positive indicates haemoglobin breakdown, red blood cells and gross blood. Orange to amber implies that the
Bacteria: Moderate urine is may be concentrated due to dehydration, fever and presence of excessive bilirubin.
Amorphous urates: few
Cast: Broad Granular Cast:0-2/hpf RBC casts indicates a renal origin of blood. More than three red blood cells per high-power field(HPF)
indicates trauma, infectious processes, toxicity, calculus, and benign and and malignant neoplasms.

Pus cells are normally 0-5/hpf and indicate infection when elevated.

The pH of the urine is normally at the range of 5.5-6.5 which categorize it as weak acid. Lower than 5.5
 indicates metabolic or respiratory acidosis and renal tubular acidosis type II. Higher than 7.5 indicates
presence of urea-splitting organism(Proteus), renal tubular acidosis type I. Specific gravity is normally
at 1.010-1.030. If the specific gravity is decreased, it indicates increased fluid intake,use of diuretics,
decreased renal concentration, diabetes insipidus. Increased specific gravity indicates dehydration,
diabetes mellitus, increased ADH secretion, iodine contrast.

Protein in the urine is normally less than 20 mg/dl. Proteinuria or persistent elevation of protein in the
urine, may be glomerular, tubular or overflow in origin. Glomerular proteinuria occurs with
immunoglobulin A nephropathy or diabetes mellitus. Tubular proteinuria results from failure to
reabsorb immunoglobulin because of defective tubular function. Overflow proteinuria is due to
increase in abnormal immunoglobulins and is often seen with multiple myeloma. Prolonged fever and
excessive physical exercise can cause proteinuria.

Presence of bacteria in the urine is abnormal and indicates Urinary Tract infection.

Casts are formed in the distal tubules and collecting ducts of the kidneys and they signify renal disease
when found in the urine. Granular casts often represent disintegrated epithelial cells, leukocytes, or
protein associated with renal tubular disease.

Implication: these results indicate a renal disease which impairs the glomerular filtration function of
the kidney. The destruction of the glomerulus can have bleeding inside the renal system which is
indicated by the presence of RBC. The protein which are large enough not to pass easily at the
glomerulus now abnormally go through it and becomes present in the urine. The destruction causes
the presence of pus cells and epithelial cells(granular cast) in the urine.

CREATININE:9/11/10 Measures the effectiveness of renal function. The kidney is the only organ in the body that can excrete
256.36 mmol/L Creatinine thus it is the most effective determinant of renal disease. Creatinine is the end product of
muscle energy metabolism and is regulated and excreted by the kidneys which remains fairly constant
in the body. The normal levels of the creatinine is 0.6-1.2 mg/dL or 50-110 mmol/L.

9/10/10 Normally the sodium

Sodium--- 133.0
Crea---238.68
9/9/10 ABG
PCO2—19 mmol/L
pH—7.385
PCO2 – 24.4 mmHg
PO2 – 39
HCO3 – 17.9 mmol/ L
SO2 – 73 %
9/9/10
Calcium 8.2
CREA 309.4

9/9/10
CBC:
Hct 0.35
Hgb 106
Segmenters 0.79

9/8/10
pH – 7.273
PCO2 – 11 mmol/L
PCO2 – 23.0 mmhg
PO2 – 40 mmHg
HCO3 – 10.6 mmol/L
9/8/10
Potassium—3.3
BUN – 36.02
CREA – 380.12
9/7/10
A/G Ratio 3:0:2:3
Total protein 5.3
Albumin 3.0
9/6/10
Potassium – 5.4
BUN – 13.9
CREA – 738.68
9/4/10
FBS –4.09
HDL-- 33.4
LDL--19.24
Blood Uric Acid--0.33
Total cholesterol--66.0
Triglycerides—88.5
9/3/10
RBC: too many to count
Mucus Threads: Moderate
Protein: (+) (+)(+)(+) positive

9/3/10
HgB 106
HcT 0.35
Segmenters 0.90
Lymphoctes 0.10
8/13/10
X-ray Chest PA
A fibro-nodular density is seen in the
right parahilar area. The heart, breast
vessels and diaphragm are
unremarkablel.
Impression: Pulmo fibrosisright
parahilar area
9/6/10
Ultrasound:
1. Bilateral Renal Parenchymal
disease
2. Moderate Ascites
3. Incidental note of minimal
bilateral pleural effusion
 4. Sonographically normal liver,
gallbladder, pancreas, urinary
bladder and spleen
9/3/10
Cranial CT scan
Impression: Suspicious hypodense
focus in the left occipital lobe.
9/9/10
WBC – 9.9
HcT – 0.35
HgB – 106
Leukocyte:
Segmenters 0.79
Lymphocytes 0.21
Platelet 235

IVF

9/5/ 10 4) D5W 90 cc + 10 cc Nicardipine

9/ 6/10 PNSS 1L x 12°

9/ 6/10 2)D5W 90 cc + 10 cc Nicardipine

9/ 6/10 PNSS 1L x 16°