Drug name Classification Dosage Mechanism of action Indication Contraindication Adverse effect Nursing

Responsibility
Clopidogrel Belongs to the Clopidogrel 75 Clopidogrel selectively Prophylaxis of Active Haematoma, -Ensure that
class of platelet mg Tablet Oral inhibits adenosine thromboembolic pathological epistaxis, patients are
aggregation OD diphosphate (ADP) disorders bleeding diarrhoea, aware of the
inhibitors from binding to its Acute coronary (e.g. peptic ulcer dyspepsia, importance of
platelet P2Y12 receptor syndromeST- or intracranial abdominal pain, informing health
and subsequent elevation MI haemorrhage) bruising, bleeding care
activation of at puncture site. professionals,
glycoprotein GPIIb/IIIa Rarely, Stevens- including doctors
complex thus reducing Johnson and dentists, that
platelet aggregation. syndrome, they are taking
erythema clopidogrel
Pharmacokinetics: multiforme, serum before starting
Absorption: Rapidly but sickness, any other
incompletely absorbed interstitial treatment.
from the GI tract pneumonitis,
(approx 50%). lichen planus,
Time to peak plasma myalgia. - Advise patients
concentration: Approx Potentially that excessive
30-60 min. Fatal: Intracranial intake of alcohol
Distribution: Plasma bleeding, GI and should be
protein binding: 98% retroperitoneal avoided with this
(parent drug); 94% haemorrhage, medication.
(carboxylic acid blood dyscrasias,
derivative). thrombotic
Metabolism: Undergoes thrombocytopenic - Ensure that
extensive hepatic purpura. patients know
metabolism via they should
esterase-mediated report any signs
hydrolysis to inactive of increased
carboxylic acid
derivative and by
CYP450-mediated bleeding and
(primarily CYP2C19 bruising.
isoenzyme) oxidation to
active thiol metabolite.
Excretion: Via urine -discourage use
(approx 50%); of NSAID,
faeces(approx 46%) including PTC
both as metabolites preparation,
and unchanged drug. during the
clopidogrel
therapy because
of potential for
bleeding.
 Drug name Classification Dosage Mechanism of action
Digoxin digitalis Digoxin .25mg Digoxin is a cardiac Heart failure;
glycosides tab OD glycoside which has Supraventricular
positive inotropic arrhythmias
activity characterized
by an increase in the
force of myocardial
contraction. It also
reduces the
conductivity of the
heart through the
atrioventricular (AV)
node. Digoxin also
exerts direct action on
vascular smooth
muscle and indirect
effects mediated
primarily by the
autonomic nervous
system and an
increase in vagal
activity.
Pharmacokinetics:
Absorption: Absorption
from the GI tract is
variable.
Distribution: Widely
distributed in tissues,
including the heart,
brain, erythrocytes,
and skeletal muscle.
Indication Contraindication Adverse effect Nursing
Responsibility
Digitalis toxicity, Extra beats, - Monitor apical
ventricular anorexia, nausea pulse for 1 full min
tachycardia/fibrillat and vomiting. before
ion, obstructive Diarrhoea in
administering.
cardiomyopathy. elderly, confusion,
Arrhythmias due to dizziness, Withhold dose and
accessory drowsiness, notify health care
pathways (e.g. restlessness, professional if pulse
Wolff-Parkinson- nervousness, rate is <60 bpm in
White syndrome). agitation and an adult, <70 bpm
amnesia, visual in a child, or <90
disturbances,
bpm in an infant.
gynaecomastia,
local irritation Also notify health
(IM/SC inj), rapid care professional
IV admin may lead promptly of any
to vasocostriction significant changes
and transient in rate, rhythm, or
hypertension. quality of pulse.
Potentially -Monitor BP
Fatal: Cardiac
periodically in
arrhythmias in
combination with patients receiving
heart block. IV digoxin.
-Monitor ECG
throughout IV
administration and
6 hr after each
dose. Notify health
care professional if
20-30% bound to bradycardia or new
plasma proteins. arrhythmias occur.
-Observe IV site for
redness or
infiltration;
extravasation can
lead to tissue
irritation.
-Monitor intake and
output ratios and
daily weights.
Assess for
peripheral edema,
and auscultate
lungs for
rales/crackles
throughout therapy.
-Observe for signs
and symptoms of
toxicity. In adults
and older
children, the first
signs of toxicity
usually include
abdominal pain,
anorexia, nausea,
vomiting, visual
disturbances,
bradycardia, and
other arrhythmias.
-If signs of toxicity
occur and are not
severe,
discontinuation of
digoxin
-Treatment of life-
threatening
arrhythmias may
include
administration of
digoxin immune
Fab (Digibind),
which binds to the
digitalis glycoside
molecule in the
blood and is
excreted by the
kidneys.
Drug name Classification Dosage Mechanism of Indication Contraindication Adverse effect Nursing
action Responsibility
Atorvastatin antihyperlipide Atorvasta Atorvastatin Mixed dyslipidaemia, Active liver Headache, - Assess for the
mic tin 40mg competitively inhibits Heterozygous familial disease or flatulence, mentioned
tablet OD HMG-CoA reductase, hypercholesterolaemia, unexplained constipation, contraindications
the enzyme that Nonfamilialhypercholesterola persistent dyspepsia, to this drug (e.g.
catalyses the emia elevations of nausea, hypersensitivity,
conversion of HMG- serum diarrhoea, acute liver disease,
CoA to mevalonate. transaminases. vomiting, pregnancy etc.) to
This results in the Concomitant use anorexia. Pain in prevent potential
induction of the LDL w/ ciclosporin, extremity, adverse effects.
receptors and gemfibrozil, musculoskeletal -Conduct thorough
stimulation of LDL telaprevir, and physical
catabolism, leading to tipranavir. pharyngolaryngea assessment before
lowered LDL- Pregnancy and l; myopathy, beginning drug
cholesterol levels. lactation. muscle spasms, therapy to establish
myalgia, baseline status,
arthralgia, determine effectivity
nasopharyngitis, of therapy, and
insomnia, UTI. evaluate potential
Increased serum adverse effects.
aminotransferase, -Obtain baseline
glycosylated status for
haemoglobin and weight while noting
fasting serum recent
glucose levels. manifestations that
Potentially increases or
Fatal: Severe decreases to
rhabdomyolysis determine patient’s
w/ acute renal fluid status.
failure. Hepatitis, -Assess closely
pancreatitis. patient’s heart rate
Rarely, Stevens- and blood
 Johnson pressure to identify
syndrome, cardiovascular
anaphylaxis, toxic changes that may
epidermal warrant change in
necrolysis. drug dose.
-Assess bowel
patterns to
determine possibility
of developing
constipation and
resultant fecal
impaction.
-Notify prescriber
immediately and
expect to withhold
atorvastatin therapy
if patient develops
an acute condition
suggestive of a
myopathy
(Unexplained muscle
pain, tenderness or
weakness, especially
if accompanied by
elevated CPK level,
fever or malaise).

]
Drug name Classification Dosage Mechanism of action
Citicoline Nootropics Citicolin The extensive damage Parkinson's disease; Pregnant or
&Neurotonics/ e 1gm caused by stroke Cerebrovascular
Neurotrophics IV Q12 requires repair and disorders; Head
regeneration of axons injury
and synapses of
neurons, so new
membrane production
is essential. The
primary mechanism by
which citicoline is
believed to have a
therapeutic effect in
stroke is its ability to
increase the synthesis
of phosphatidylcholine,
the primary neuronal
membrane component.
It also enhances
acetylcholine synthesis
and might thus
ameliorate symptoms
caused by the stroke-
induced loss of
cholinergic neurons.
Stimulating the
synthesis of SAMe,
which aids in
membrane stabilization
and reduces levels
of arachidonic acid.
This is especially
Indication Contraindication Adverse effect Nursing Responsibility
Citicoline has a very -Citicoline may be taken
breast-feeding. low toxicity profile. with or without food. Take it
Clinically, doses of with or between meals.
2000 mg per day -The supplement should
have been observed not be taken in the late
and approved. Minor afternoon or at night
transient adverse because it can cause
effects are rare and difficulty sleeping.
most commonly -Women who are pregnant
include stomach or trying to become
pain and diarrhea. pregnant should consult
with their doctor before
taking the supplements.
Not enough is known about
the use of Citicoline during
pregnancy and breast-
feeding. Stay on the safe
side and avoid use.
-Special attention should
be paid for administration in
the neonate, premature
and children.
-Contact the physician
immediately
if allergic reaction such as
hives, rash, or itching,
swelling in your face or
hands, mouth or throat,
chest tightness or trouble
breathing are experienced.
-Citicoline therapy should
be started within 24 hours
important after of a stroke. The physician
an ischemia, will prescribe the correct
when arachidonic dosage and the length of
acid levels are time it should be taken for a
elevated. medical condition.
 Drug name Classification Dosage Mechanism of Indication Contraindication Adverse effect Nursing
action Responsibility
Penicillin Anti-inffective Penicillin Interferes with Severe Concentrations CNS:Lethargy, Before
Antibiotic 500mg tab bacterial cell wall infections - Allergies to hallucinations, - Assess for
OD synthesis during caused by penicillins, seizures hypersensitivity
active sensitive cephalosporins, or GI:Glossitis, to drug.
multiplication, organisms other stomatitis, gastritis, - Assess for any
causing cell wall (streptococci) allergens sore mouth, furry
contraindications
death and - URTI caused Precaution tongue, black
resultant by - Renal disorders to
³hairy´ tongue,
bactericidal sensitive - Pregnancy the drug.
nausea, vomiting,
activity streptococci - Lactation - Educate about
diarrhea, abdominal
against - Treatment of Drug interaction side effects of
pain, bloody
susceptible syphilis, bejel, Drug to drug drug.
diarrhea,
bacteria. congenital - Decreased After
enterocolitis,
syphilis, effectiveness
pseudomembranous - Monitor client
pinta, yaws with tetracyclines for at least 30
colitis, nonspecific
- Prophylaxis - Inactivation of minutes.
hepatitis
of parenteral - Arrange for
GU:Nephritis
rheumatic fever aminoglycosides regular follow-
Hematologic:
(amikacin, up,
Anemia,
gentamicin,kanamycin, including blood
thrombocytopenia, tests, to
neomycin,tobramycin)
leukopenia, evaluate
Drug to food
- none reported neutropenia, effects.
prolonged bleeding - Instruct to
itme report difficulty
Hypersensitivity:
breathing,
Rash, fever,
rashes, severe
wheezing,
anaphylaxis pain at
Local:Pain, injection site,
mouth sores,
unusual
phlebitis, bleeding or
thrombosis bruising.
- Instruct to take
medication as
advised.