Brand Name: Norvasc Classification: cardiovascular agent; calcium channel blocker; antihypertensive agent Indications: Treatment of essential hypertension

and angina Dosage: 10mg 1 tab BID Action: Inhibits calcium ions from entering the slow channels or select voltage sensitive areas of vascular smooth muscle and myocardium during depolarization. Side Effects: Rash, headache, dizziness and nausea

Adverse Effects: CNS: Lightheadedness,

fatigue, lethargy CV: Peripheral edema, arhythmias Dermatologic: Flushing GI: Abdominal discomfort Interactions: Drug-drug: possible increased serum levels and toxicity of cyclosporine if taken concurrently. Contraindications: Allergy to amlodipine; Hepatic or renal impairment; Sick sinus syndrome; Heart block ; Sick sinus syndrome; Lactation

Nursing Responsibilities: Orient self with the 10 rights of giving medication before administering drug to the patient. Assess patient for history of allergy to amlodipine, impaired hepatic or renal function, sick sinus syndrome, heart block, or CHF. Physical assessment such as the skin lesion, color and edema. Assess for adverse drug reactions; report irregular heartbeat, swelling of the hands and feet, shortness of breath, pronounced dizziness, and constipation. Monitor patients blood pressure, pulse rate and cardiac rhythm frequently. Monitor for S&S of dose-related peripheral or facial edema that may not be accompanied by weight gain; rarely, severe edema may cause discontinuation of drug. Instruct patient to take drug with meals if abdominal discomfort occurs; advise on eating small, frequent meals for nausea and vomiting. Instruct patient to take oral form with meals to improve absorption. Instruct patient not to rise quickly off the bed. Instruct patient to avoid sudden changes in position.

Brand Name: Lopressor, Norometoprol Classification: Cardiovascular system drugs, antihypertensive Indications: Hyperthension; Early intervention in acute MI; Agina pectoris Dosage: 100 mg/tab ; BID Action: Unknown. A selective beta blocker that selectively blocks beta receptors; decreases cardiac output, peripheral resistance, and cardiac oxygen consumption, and depresses rennin secretion. Side Effects: Fatigue, dizziness, hypotension.

Adverse Effects:CNS: depression; CV: bradycardia, heart failure, AV block; GI: nausea, diarrhea; Respiratory: dyspnea; Skin: rash Interactions: Drug-drug:Amobarbital, aprobarbital, butabarbital,bulatbital, mephobarbital, pentobarbital, phenobarbital, primidone, secobarbital: May reduce metoprolol effect. May need to increase beta-blocker dose;Chlorpromazine: May decrease hepatic clearance. Watch for greater beta-blocking effect.; Cimetidine: May increase beta-blocker effects. Consider another H2 agonist or decrease dose of beta blocker.; Hydralazine: May increase levels and effects of both drugs. Monitor patient closely. May need to adjust dosage. Contraindications:Contraindicated in patients hypersensitive to drug or other beta blockers; Contraindicated in patients with sinus bradycardia, greater than first-degree heart block, cardiogenic shock, or overt cardiac failure when used to treat hypertension or agina. When used to treat MI, drug is contraindicated in patients with heart rate less than 45 beats/min, greater than first-degree heart block, PR interval of 0.24 second or longer with firstdegree heart block, systolic blood pressure less than 100 mmHg or moderate to severe cardiac failure.; Use cautiously in patients with heart failure, diabetes, or respiratory or hepatic disease

Nursing Responsibilities: Always check patients apical pulse rate before giving drug. If its slower than 60 beats/minute, withhold drug and call prescriber immediately. Monitor glucose level closely in diabetic patients because drug masks common signs and symptoms of hypoglycemia. Monitor blood pressure frequently; metoprolol masks common signs and symptoms of shock. Beta blocker may mask tachycardia caused by hyperthyroidism. Store drug at room temperature and protect from light. Discard solution if its discolored and contains particles. Beta selectivity is lost at higher doses. Watch for peripheral side effects. Dont confuse metoprolol with metaprotenol or metolazone. Instruct patient to take drug exactly as prescribed and to take it with meals. Caution patient to avoid driving and other tasks requiring mental alertness until response to therapy has been established. Tell patient to alert prescriber if shortness of breath occurs. Instruct patient not to stop drug suddenly but to notify prescriber about unpleasant adverse reactions. Inform her that drug must be withdrawn gradually over 1 or 2 weeks.

Brand Name: Kalium Durule Classification: electrolytic and water balance agent Indications:Utilized for treatment of hypokalemia; To prevent and treat potassium deficit secondary to diuretic or corticosteroid therapy. Also indicated when potassium is depleted by severe vomiting, diarrhea; intestinal drainage, fistulas, or malabsorption; prolonged diuresis, diabetic acidosis. Effective in the treatment of hypokalemic alkalosis (chloride, not the gluconate). Dosage:100meq; 1 tab TID Action: Unknown. Principal intracellular cation; essential for maintenance of intracellular isotonicity, transmission of nerve impulses, contraction of cardiac, skeletal, and smooth muscles, maintenance of normal kidney function, and for enzyme activity. Plays a prominent role in both formation and correction of imbalances in acidbase metabolism. Side Effects:Rash, GI bleeding, GI obstruction, GI ulceration, ECG (peaking of T waves, loss of P waves depression of ST segment, prolongation of QTc interval)

Adverse Effects:GI: Nausea, vomiting, diarrhea, abdominal distension;Body Whole: Pain, mental confusion, irritability, listlessness, paresthesias of extremities, muscle weakness and heaviness of limbs, difficulty in swallowing, flaccid paralysis.; Urogenital: Oliguria, anuria.; Hematologic: Hyperkalemia.;Respiratory: Respiratory distress.; CV: Hypotension, Interactions: Drug-drug:Increased risk of hyperkalemia with potassium-sparring diuretics, salt substitutes using potassium. Contraindications: Allergy to amlodipine; Hepatic or renal impairment; Sick sinus syndrome; Heart block; Sick sinus syndrome ; Lactation

Nursing Responsibilities: Orient self with the 10 rights of giving medication before administering drug to the patient Give while patient is sitting up or standing (never in recumbent position) to prevent drug induced esophagitis. Some patients find it difficult to swallow the large sized KCl tablet. Do not crush or allow to chew any potassium salt tablets. Observe to make sure patient does not suck tablet (oral ulcerations have been reported if tablet is allowed to dissolve in mouth). Swallow whole tablet with a large glass of water or fruit juice (if allowed) to wash drug down and to start esophageal peristalsis. Lab test: Frequent serum electrolytes are warranted. Monitor for and report signs of GI ulceration (esophageal or epigastric pain or hematemesis). Montitor I/O. Monitor PR and Cardiac rate. Irregular heartbeat is usually the earliest clinical indication of hyperkalemia. Be alert for potassium intoxication may result from any therapeutic dosage, and the patient may be asymptomatic. The risk of hyperkalemia with potassium supplement increases (1) in older adults because of decremental changes in kidney function associated with aging, (2) when dietary intake of potassium suddenly increases, and (3) when kidney function is significantly compromised.

Brand Name: Avapro Classification: Angiotensin II receptor antagonist (ARB), Antihypertensive Indications: Treatment of hypertension as monotherapy or in combination with other antihypertensives. Slowing of the progression of kidney disease in patients with hypertension and type 2 diabetes

Dosage: 300mg 1 Tab; OD Action: Selectively blocks the binding of angiotensin II to specific tissue receptors found in the vascular smooth muscle and adrenal gland; this action blocks the vasoconstriction effect of the reninangiotensin system as well as the release of aldosterone, leading to decreased blood pressure.
Side Effects:Rash, Headache, dizziness, syncope, muscle weakness

Adverse Effects: Hypotension, orthostatic hypotension; Rash, inflammation, urticaria, pruritus, alopecia, dry skin;Diarrhea, abdominal pain, nausea, constipation, dry mouth, dental pain; URI symptoms, cough, sinus disorders; Cancer in preclinical studies, back pain, fever, gout, fatigue Interactions: Drug-drug: use caution with drugs metabolized by CYP2C9; anticipated effects may altered Contraindications: Contraindicated with hypersensitivity to irbesartan, pregnancy (use during the second or third trimester can cause injury or even death to the fetus), lactation. Use cautiously with hepatic or renal dysfunction, hypovolemia

Nursing Responsibilities: Orient self with the 10 rights of giving medication before administering drug to the patient Assess patient for hypersensitivity to irbesartan, hepatic or renal dysfunction and hypovolemia. Physical assessment, assess the skin color, any lesions and turgor. Administer without regard to meals. Monitor VS specially the BP. Monitor patient I/O. Monitor patients level of consciousness. Assess for any sign of hypotension and dehydration. Advised patient that he may experience side effects such as dizziness, headache, nausea and vomiting Advised to report immediately if fever, chills and dizziness occur.

Brand Name:Osmitrol, Sahar mannitol 20% solution for IV Classification: Osmotic Diuretic; Pregnancy risk category Indications: Test dose for marked oliguria or suspected inadequate renal function;Oliguria; To prevent oligurioa or acute renal failure; To reduce intraocular or intracranial pressure; Diuretics in drug intoxication; Irrigating solution during transurethral resection of prostate gland Dosage: 100cc Action: Increases osmotic pressure of glumerular filtrate, inhibiting tubular reabsorption of water electrolytes; drug elevates plasma osmolality, increasing water flow into extracellular fluid. Side Effects:Diarrhea; dizziness headache

Adverse Effects: CNS: dizziness, headache, blurred vision, seizures CV: hypotension, hypertension, edema, tachycardia, chest pain Dermatologic: urticaria, skin necrosis with infiltration GI: nausea, anorexia, dry mouth, thirst GU: dieresis, urine retention Hematologic: fluid and electrolyte imbalances, hyponatremia Respiratory: pulmonary congestion, rhinitis Interactions: Drug-drug: Litium: may increase urinary excretion of lithium. Monitor litium level closely Contraindications: Contraindicated in patients hypersensitive to drug Contraindicated with anuria due to severe renal disease Use cautiously with pulmonary congestion, active intracranial bleeding, dehydration, renal disease, congestive heart failure, pregnancy, lactation.

Nursing Responsibilities: Assess hypersensitivity of patient with the drug Assess patient if he/she experienced severe or long-term kidney disease, lung swelling or congestion, severe dehydration, bleeding in your brain not caused by surgery, or if patient is unable to urinate Do not expose solutions to low temperatures; crystallization may occur. If crystals are seen, warm the bottle in a hot water bath, then cool to body temperature before administering. Make sure the infusion set contains a filter if giving concentrated mannitol. Monitor serum electrolytes periodically with prolonged therapy. Store at room temperature between 56 and 86 degrees F (13 to 30 degrees C) away from light. Do not refrigerate or freeze. Do not administer unless solution is clear and container is undamaged. Discard unused portion. Do not administer Mannitol 25% if the Fliptop vial seal is not intact. Do not share this medication with others. Laboratory and/or medical tests (e.g., renal function, fluid/electrolytes balance) may be performed to monitor patient progress. If your dose is interrupted or stopped, consult doctor to establish a new dosing schedule/IV rate. Electrolyte-free mannitol solutions should not be given conjointly with blood. If it is essential that blood be given simultaneously, at least 20 mEq of sodium chloride should be added to each liter of mannitol solution to avoid pseudoagglutination. The cardiovascular status of the patient should be carefully evaluated before rapidly administering mannitol since sudden expansion of the extracellular fluid may lead to fulminating congestive heart failure.

Brand Name:Nicholin, Somazine, 5-Cytidine diphosphate choline Classification: Neurotonics, Nootropics Indications: Head injury Cerebral vascular disease Alzheimers disease Cerebral surgery or acute cerebral disturbance Dosage: 500mg 2 caps TID Action: Citicoline seems to increase a brain chemical called phosphatidylcholine. This brain chemical is important for brain function. Citicoline might also decrease brain tissue damage when the brain is injured.It is usually known that phospholipid, especially lecithin, decreases following decline in brain activity with cerebral trauma. Citicoline, which is a co-enzyme, accelerates the biosynthesis of lecithin in the body.

Side Effects:Body temperature elevation; Restlessness; Headaches;Nausea and vomiting; Diarrhea; Low or high blood pressure; Tachycardia; Sleeping troubles or insomnia; Blurred vision; Chest pains

Adverse Effects: Fleeting and discrete hypotension effect, increased parasympathetic affects, low blood pressure Itching or hives, swelling in face or hands, chest tightness, tingling in mouth and throat Interactions: Drug-drug: decreased the effectiveness of (carbidopa/entacapone/levodopa) Contraindicated: Any allergy or hypersensitivity to the drug Hypertonia of the parasympathetic nervous system Use cautiously for pregnancy and lactation Conscious use for patient with renal and hepatic damage

Nursing Responsibilities: Assess hypersensitivity to citicholine. Monitor patient BP, PR, RR and Temp. Monitor I/O Citicoline may be taken with or without food. Take it with or between meals. The supplement should not be taken in the late afternoon or at night because it can cause difficulty sleeping. 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. Advised patient that he may experienced common side effects such blurred vision, tachycardia hypotension, headache, nausea and vomiting. Citicoline therapy should be started within 24 hours of a stroke. The physician will prescribe the correct dosage and the length of time it should be taken for a medical condition. Monitor patients neurological vital signs Note if there are signs of slurring speech

Brand Name: Senokot 187 mg Tablet/ granules Classification: Laxative Indications: For the relief of functional constipation through peristaltic stimulation. Dosage: 2 tabs OD @ HS Action: Senokot preparations contain glycosides (the natural principles of senna) which, upon ingestion, exert no action in the stomach or small intestine. In the colon, according to current theory, enzymatic action converts the inactive glycosides into active aglycones which act specifically in the large bowel through the auerbachs plexus to stimulate peristalsis. Side Effects: This medication may cause diarrhea, nausea, vomiting, rectal irritation, stomach cramps or bloating. If these effects continue or become bothersome, inform your doctor.

Adverse Effects:Gastrointestinal Disorders: Common: Abdominal pain. Uncommon: Feces discoloration, nausea, rectal hemorrhage, vomiting. Immune System Disorders: Uncommon: Urticaria. Very Rare: Anaphylactic or anaphylactoid reaction. Renal and Urinary Disorders: Uncommon: Chromaturia. Reproductive System and Breast Disorders: Uncommon: Breast milk discoloration. Skin and Subcutaneous Tissue Disorders: Uncommon: Erythematous rash, maculopapular rash, perianal irritation. Interactions: No known drug interactions. Contraindicated: Do not use when abdominal pain, nausea, vomiting, or other symptoms of appendicitis are present, acute abdominal diseae, intestinal hemorrhage, or obstruction , or persistent diarrhea. Store at temperature not exceeding 30 degrees Celsius

Nursing Responsibilities: Orient self with the 10 rights of giving medication before administering drug to the patient Assess hypersensitivity if senna concentrates. Advised that patient may experience common side effect such as diarrhea, nausea and vomiting. Notify physicianif experience: rectal bleeding, rapid heart rate, weakness, dizziness, fainting, sweating, skin rash, unrelieved constipation. Advised that taking the medication may cause the urine to turn pink, red or brownish in color. Monitor patient I/O. Monitor any sign of dehydration. Advised to dink a lot of fluid especially water. Stop taking senna and seek emergency medical attention if you experience symptoms of a serious allergic reaction including difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives. To maintain normal bowel habits, it is important to drink plenty of fluids (4 to 6 eight ounce glasses a day), increase your intake of fiber and roughage and exercise regularly

Brand Name: Lipitor Classification: Antihyperlipidemic; HMG-CoA reductase inhibitor Indications:Heterozygous familial hypercholesterolemia. To lower cholesterol To stabilize plaque and prevent strokes through antiinflammatory and other mechanisms Dosage: 40mg 1 tab OD @ HS Action: Reduces plasma cholesterol and lipoprotein levels by inhibiting HMG-CoA reductase and cholesterol synthesis in the liver and by increasing the number of LDL receptors on liver cells to enhance LDL uptake and breakdown. Side Effects: Allergic reaction, facial or generalized edema, flulike symptoms, infection, lymphadenopathy, weight gain

Adverse Effects: CNS: Abnormal dreams, amnesia, asthenia, emotional lability, facial paralysis, fever, headache, hyperkinesia, lack of coordination, malaise, paresthesia, peripheral neuropathy, somnolence, syncope, weakness, insomnia CV: Arrhythmias, elevated serum CK level, orthostatic hypotension, palpitations, phlebitis, vasodilation, peripheral edema EENT: Amblyopia, altered refraction, dry eyes, dry mouth, epistaxis, eye hemorrhage, gingival hemorrhage, glaucoma, glossitis, hearing loss, lip swelling, loss of taste, pharyngitis, sinusitis, stomatitis, taste perversion, tinnitus, rhinitis ENDO: Hyperglycemia or hypoglycemia GI: Abdominal or biliary pain, anorexia, colitis, constipation, diarrhea, duodenal or stomach ulcers, dysphagia, eructation, esophagitis, flatulence, gastroenteritis, hepatic failure, hepatitis, increased appetite, indigestion, melena, pancreatitis, rectal hemorrhage, tenesmus, vomiting, dyspepsia, nausea, constipation GU: Abnormal ejaculation; cystitis; decreased libido; dysuria; epididymitis; hematuria; impotence; nephritis; nocturia; renal calculi; urinary frequency, incontinence, or urgency; urine retention; vaginal hemorrhage, UTI Heme: Anemia, thrombocytopenia Musculoskeletal: Arthralgia, back pain, bursitis, gout, leg cramps, myalgia, myasthenia gravis, myositis, neck rigidity, tendon contracture, tenosynovitis, torticollis, arthritis Respiratory: Dyspnea, pneumonia, bronchitis Skin: Acne, alopecia, contact dermatitis, diaphoresis, dry skin, ecchymosis, eczema, jaundice, petechiae, photosensitivity, pruritus, rash, seborrhea, ulceration, urticaria

Interactions: Drug-drug: possible severe myopathy or rhabdomyolysis with erythromycin, cyclosporine, niacin, antifungals other HMG-CoA reductase inhibitors Increased digoxin levels with possible toxicity if taken together, monitor digoxin levels Increased estrogen levels with hormonal contraceptives; monitor patient on his combination. Contraindications:Contraindicated in patients hypersensitive to drugs and in those with active liver disease or unexplained persistent elevations of transaminase levels. Contraindicated in pregnant and breastfeeding women and in women of child-bearing age. Use cautiously in patients with history of liver disease or heavy alcohol use Withhold or stop drug in patients at risk for renal failure caused by rhabdomyolysis resulting from trauma; in serious, acute conditions that suggest myopathy; and in major surgery, severe acute infection, hypotension, uncontrolled seizures, or severe metabolic, endocrine, or electrolyte disorders. Use of Atorvastatin in children has been limited to those older than age 9 with homozygous familial hypercholesterolemia. Active hepatic disease, hypersensitivity to atorvastatin or its components, unexplained persistent rise in serum transaminase level

Nursing Responsibilities: Assess for hypersensitivity of the medication to the patient. Assess patient for hepatic dysfunction Monitor patients VS Monitor I/O. Atorvastatin is used in patients with homozygous familial hypercholesterolemia as an adjunct to other lipid-lowering treatments or alone only if other treatments arent available. Atorvastatin adjunct tonot a substitute forlow-cholesterol diet. Atorvastatin may be used with colestipol or cholestyramine for additive antihyperlipidemic effects. Advised patient to expect atorvastatin to be used in patients without obvious coronary artery disease (CAD) but with multiple risk factors (such as age 55 or over, smoker, history of hypertension or low HDL level, or family history of early CAD). Drug is used to reduce risk of MI, angina, and adverse effects of revascularization procedures..

Liver function tests to be performed before atorvastatin therapy starts, after 6 and 12 weeks, with each dosage increase, and every 6 months thereafter. Expect to measure lipid levels 2 to 4 weeks after therapy starts, to adjust dosage as directed, and to repeat periodically until lipid levels are within desired range. Take drug at the same time each day to maintain its effects. * Take a missed dose as soon as possible. If its almost time for the next dose, the missed dose should be skipped. DO NOT double the dose. * Consult prescriber before taking OTC niacin because of increased risk of rhabdomyolysis. * Notify prescriber immediately if he develops unexplained muscle pain, tenderness, or weakness, especially if accompanied by fatigue or fever. * Advice patient to use only after diet and other nondrug therapies prove ineffective. Patient should follow a standard low-cholesterol diet before and during therapy. * Warn patient to avoid alcohol.

Brand Name: Cardene, Cardene SR Classification: Calcium channel blockers; antianginal; antihypertensive Indications: Nicardipine is used with or without other medications to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Nicardipine is called a calcium channel blocker. It works by relaxing blood vessels so blood can flow more easily.Nicardipine is also used to prevent certain types of chest pain(angina). It may help to increase your ability to exercise and decrease the frequency of angina attacks. This medication must be taken regularly to be effective. It should not be used to treat attacks of chest pain when they occur. Use other medications (such as sublingual nitroglycerin) to relieve attacks of chest pain as directed by your doctor. Consult your doctor or pharmacist for details. Dosage: 10mg Action: Senokot preparations contain glycosides (the natural principles of senna) which, upon ingestion, exert no action in the stomach or small intestine. In the colon, according to current theory, enzymatic action converts the inactive glycosides into active aglycones which act specifically in the large bowel through the auerbachs plexus to stimulate peristalsis.

Side Effects: This medication may cause diarrhea, nausea, vomiting, rectal irritation, stomach cramps or bloating. If these effects continue or become bothersome, inform your doctor.

Action:These medications block the movement of calcium into the smooth muscle cells surrounding the arteries of the body. Since calcium promotes contraction of muscle, blocking calcium entry into the muscle cells relaxes the arterial muscles and causes the arteries to become larger. This lowers blood pressure, which reduces the work that the heart must do to pump blood to the body. Reducing the work of the heart lessens the heart muscle's demand for oxygen and thereby helps prevent angina (heart pain) in patients with coronary artery disease. Unlike verapamil or diltiazem, nicardipine has little effect on heart muscle or on electrical conduction within the heart. Side Effects:Side effects include swelling of the feet (edema), dizziness,headaches, flushing, palpitations, and nausea. Fainting, over growth of the gums, and rash also may occur. It may increase heart rate due to a drop in blood pressure. Nicardipine sometimes causes an increase in the frequency and duration of angina. The reason for this side effect is not clearly understood. Excessively low blood pressure can occur in rare instances, especially during initiation of treatment or following adjustments of dosage.

Adverse Effects: CV: hypotension, arrhythmias, asytoleInteractions: No known drug interactions. Interactions:Rifampin, phenobarbital, phenytoin (Dilantin, Dilantin125), oxcarbazepine (suspension oral Trileptal; oral Trileptal) andcarbamazepine (Tegretol, Tegretol XR , Equetro, Carbatrol) may reduce blood levels of nicardipine by increasing its metabolism (destruction) in theliver. Therapy should be monitored and drug doses should be adjusted accordingly when nicardipine is used with these drugs. Itraconazole (Sporanox), ketoconzole, or clarithromycin (Biaxin) may increase blood levels of nicardipine by reducing its breakdown in the liver and lead to toxicity from nicardipine. It increases serum levels and toxicity of cyclosporine Contraindicated: contraindicated with allergy to nicardipine, pregnancy, lactation use cautiously with impaired hepatic or renal function, sick sinus syndrome, heart block (second-or third-degree)

Nursing Responsibilities: Assess patient to allergy to nicardipine. Checked for any sign of imapaired hepatic or renal function, sick sinus syndrome, or heartblock. Physical assessment in skin for color, edema and lesions. Monitor patient carefully (BP and cardiac rhythm) while drug is being titrated to therapeutic dose; dosage may be increased more rapidly in hospitalized patients under close supervision. Monitor BP carefully with concurrent doses of nitrates. Monitor cardiac rhythm regularly during the stabilization of dosage and long term therapy. Monitor I/O. Provide small frequent meals if GI upset occurs. Advised patient that he may experience some side effects nausea, vomiting and headache. Advised patient to report irregular heartbeat, SOB, swelling of hands and feet, pronounced dizziness, constipation.

Brand Name: MLC 601; MOleac Classification: M03BX - Other centrally acting agents ; Used as muscle relaxants. Indications: It helps support neurological, motor and cognitive functions resulting in a better quality of life. Dosage: 4 capsule TID Action: NeuroAiD has been proved to stimulates the secretion of BDNF. The in vitro and in vivo results show that NeuroAiD makes cell more resistant against glutamate aggression, increases neurite outgrowth and connectivity as well as reduces the infarct volume, therefore results in better neurological functions. Side Effects: May cause increase thirsty and dry mouth

Adverse Effects: vomiting, nausea, and mild headaches Interactions: Research on drug interactions with aspirin as an antiplatelet agent were conducted and revealed no severe side effect. Yet today, no other interaction researches have been recorded so far. Contraindicated: Not allowed for use in pregnancy, lactating mothers and children below 18.

Nursing Responsibilities:

Orient self with the 10 rights of giving medication before administering drug to the patient Note for the age and condition of the patient. Advised that patient may experience common side effects such as thirsty and dry mouth. Advised to report immediately if experienced headches, nausea and vomiting. Advised to increased oral fluid to lessen the dryness experienced. Monitor Patients VS. Checked the GCS. Checked the motor response and reflex.

Brand Name: Ebewe; Bulgaria Classification: C04A - PERIPHERAL VASODILATORS ; Used as peripheral vasodilators Indications: Complex therapy of endogenous depression (in combination with psychotherapy and antidepressants) Post-apopletic complications Chronic cerebrovascular disorders Brain and spinal cord injuries (craniocerebral trauma, post operative trauma, concussion, cerebral contusion,) Alzheimer disease Ischemic stokes (treatment the complications) Mental retardation Senile dementia Dosage: 2152mg/ml/am

Action: is a nootropic drug which contains low molecular biologically active neruropeptides, which penetrate through blood-brain barrier and act directly on the nerve cells. The drug possesses a multimodal organo-specific effect on the brain, provides metabolic regulation, neuroprotection, functional neuro-modulation, and neurotrophic activity as well. Cerebrolysin improves the efficiency of aerobic energy metabolism in the brain, improves the intracellular protein synthesis in the developing and aging brain. Side effects: heat, sweating, dizziness, tachycardia or fibrillation. agitation, hypertension, hypotension, lethargy, tremors, depression, apathy, dizziness, headache, shortness of breath, diarrhea, nausea) were identified during clinical trials and occurred equally in patients, receiving Cerebrolysin , and patients taking placebo.

Adverse Effects: Digestive system: loss of appetite, indigestion, diarrhea, constipation, nausea and vomiting. Central nervous system and peripheral nervous system: rarely - excitement, vaggressive behavior, confusion, insomnia, seizures, convulsions. Allergic reactions: hypersensitivity reactions, headache, pain in the neck, legs, lower back, shortness of breath, chills and collaptoid state. Local reactions: hyperemia of the skin, itching and burning at the injection site. According to the results of clinical studies there were reported the following Cerebrolysin side effects: Cardiovascular system: hypertension, hypotension. Central nervous system and peripheral nervous system: fatigue, tremor, depression, apathy, dizziness. Interactions: Cerebrolysin may enhance the effects of antidepressants and MAO inhibitors in concomitant use. The drug is not compatible with lipid containing solution and solutions which change pH. The medication should not be mixed with aminoacids solution. Contraindicated: Acute kidney insufficiency; Epileptic status; Known hypersensitivity to any of the drug ingredients

Nursing Responsibilities:

Assess for hypersensitivity of the drug to the patient. Assess any signs of kidney dysfunction, Checked the other medications intake, it may cause drug interactions. Advised patient that he may experience the common side effects listed. Advised to report immediately if any drug reactions occur. Monitor I/O. Checked patients VS Checked patients NVS Checked patients level of consciousness. Instructed to increased oral fluid intake.

Brand Name: abenol, acephen,aceta,actamin, aminofen, tempra, valorin, panadol, feverall, Biogesic Classification: Cardiovascular system drugs; Nonopioid analgesics and antipyretics, Pregnancy risk category B Indications: Mild pain or fever Dosage: 500mg IVTT q6 hours Action: Unknown. Thought to produce analgesia by blocking pain impulse by inhibiting synthesis of prostaglandin in the CNS or of other substances that sensitize pain receptors to stimulation. The drug may relieve fever through central action in the hypothalamic heat-regulating center. Side Effects: jaundice, rash

Adverse Effects: Hematologic: hemolytic anemia, neutropenia, leucopenia, pancytopenia Hepatic: jaundice Metabolic: hypoglycemia Skin: rash, urticaria Interactions: Hematologic: hemolytic anemia, neutropenia, leucopenia, pancytopenia Hepatic: jaundice Metabolic: hypoglycemia Skin: rash, urticaria Contraindicated: Many OTC and prescription products contain acetaminophen, be aware of this when calculating total daily dose. Use liquids form for children and patients who have difficulty swallowing In children, do not exceed five doses in 24 hours

Nursing Responsibilities:

Assess vital signs Identify indications for therapy and expected outcomes. Document presence of fever. Rate pain, noting type, onset, location, duration and intensity. Do not take for more than 5 days for pain in children or for more than 3 days for fever without consulting the doctor. In children, dont exceed five doses in 24 hours. Report pallor, weakness and palpitations. Advise client to take only as directed and with food or milk to minimize GI upset Many OTC and prescription products contain paracetamol; be aware of this when calculating total daily dose. Review with parents the difference between the concentrated dropper dose formulation and teaspoon dose formulation. Any unexplained pain or fever that persists longer than 3-5 days requires medical evaluation

Brand Name: Prilosec Classification: gastrointestinal agent; proton pump inhibitor Indications: Duodenal and gastric ulcer. Gastroesophageal reflux disease including severe erosive esophagitis (4 to 8 wk treatment). Long-term treatment of pathologic hypersecretory conditions such as Zollinger-Ellison syndrome, multiple endocrine adenomas, and systemic mastocytosis. In combination with clarithromycin to treat duodenal ulcers associated with Helicobacter pylori. Dosage: 40 mg capsules Action: An antisecretory compound that is a gastric acid pump inhibitor. Suppresses gastric acid secretion by inhibiting the H+, K+-ATPase enzyme system [the acid (proton H+) pump] in the parietal cells. Side Effects: Asthenia, vertigo, insomnia, anxiety, paresthesias, dream abnormalities, inflammation, dry skin, pruritus

Adverse Effects: CNS:Headache, dizziness, fatigue. GI:Diarrhea, abdominal pain, nausea, mild transient increases in liver function tests. Urogenital:Hematuria, proteinuria. Skin:Rash. Interactions: Drug-drug: increased serum levels and potential increase in toxicity of benzodiazephines, phenytoin, warfarin. Decreased absorption with sucralfate, give these drugs at least 30 min apart. Contraindicated: Long-term use for gastroesophageal reflux disease, duodenal ulcers; lactation.

Nursing Responsibilities:

Assess for hypersensitivity to omeprazole. Physical assessment: skin (lesions and color) Monitor I/O, it affect the urinary output. Checked VS. abnormal results in RR. Take medications with food Do not crush or chew the capsule Caution patient to avoid alcohol, salicylates, ibuprofen; may cause GI irritation Patient may experience anorexia; small frequent meals may help to maintain adequate nutrition. Report severe headache, unresolved severe diarrhea, or changes in respiratory status.

Brand Name: Alphapress, Apresoline, Novo-Hyzalin, Supres Classification: Cardiovascular System Drug, Antihypertensive, Pregnancy risk category C Indications: Essential hypertension (orally, alone or with other antihypertensives), severe essential hypertension (parenterally to lower blood pressure quickly) Dosage: 5mEq IVTT PRN for diastolic blood pressure over 110mmHg Action: Unknown. A direct-acting vasodilator that relaxes arterial smooth muscle.

Side Effects: Headache, tachycardia, angina pectoris, palpitations, nausea, vomiting, diarrhea, anorexia, neurotopenia, leucopenia,, agranulocytopenia, agranulocytosis, thromobocytopenia with or without purpura

Adverse Effects: CNS: peripheral neuritis, headache, dizziness; CV: orthostatic hypotension, tachycardia, edema, angina pectoris, palpitations; EENT: nasal congestion GI: nausea, vomiting, diarrhea, constipation, anorexia Hemotologic: neurotopenia, leucopenia, agranulocytopenia, agranulocytosis, thromobocytopenia with or without purpura Skin: rash Interactions: Drug-drug: Diazoxide, MAO inhibitors: May cause severe hypotension. Use together cautiously. Diuretics, other hypotensive drugs: May cause excessive hypotension. Dosage adjustment may be needed. Indomethacin: May decrease effects of hydralazine. Monitor blood pressure. Metoprolol, propanolol: May increase levels and effects of beta blockers. Monitor patient closely and there is a need to adjust the dosage. Contraindicated: Contraindicated in patients sensitive to the drug, Those with coronary artery disease or mitral valvular rheumatic heart disease. Use cautiously in patients with suspected cardiac disease, CVA, severe renal impairment and in those taking antihypertensives

Nursing Responsibilities:

Orient self with the 10 rights of giving medication before administering drug to the patient. Monitor patients blood pressure, pulse rate and weight gain frequently. Hydralazine may decrease sodium retention and tachycardia and to prevent angina attacks. Monitor CBC, lupus eryhtematosus cell preparation, and antinuclear antibody titer determination before therapy and periodically during long-term therapy. Monitor patient closely for signs and symptoms of lupuslike syndrome, and notify physician immediately if they develop. Improve patient compliance by giving the drug and asking the patient not to meddle with the IV regulation. Instruct patient to take oral form with meals to improve absorption. Instruct patient not to rise quickly off the bed. Instruct patient to avoid sudden changes in position. Inform the patient that low blood pressure dizziness can be minimized by rising slowly and avoidance of sudden position changes. Tell patient to notify the physician of unexplained prolonged general tiredness or fever, muscle or joint aching, or angina.

Brand Name: Humulin R, Novolin R, Regular Insulin, Pork Regular Iletin II, Regular Purified Pork Insulin, Velosulin, Velosulin BR, Velosulin Human Classification: hormone and synthetic substitute; antidiabetic agent; insulin Indications: Emergency treatment of diabetic ketoacidosis or coma, to initiate therapy in patient with insulin-dependent diabetes mellitus, and in combination with intermediateacting or long-acting insulin to provide better control of blood glucose concentrations in the diabetic patient. Used IV to stimulate growth hormone secretion (glucose counter regulatory hormone) to evaluate pituitary growth hormone reserve in patient with known or suspected growth hormone deficiency. Other uses include promotion of intracellular shift of potassium in treatment of hyperkalemia (IV) and induction of hypoglycemic shock as therapy in psychiatry. Dosage:100 units/mL Action: Short-acting, clear, colorless solution of exogenous unmodified insulin extracted from beta cells in pork pancreas or synthesized by recombinant DNA technology (human). Enhances transmembrane passage of glucose across cell membranes of most body cells and by unknown mechanism may itself enter the cell to activate selected intermediary metabolic processes. Promotes conversion of glucose to glycogen. Side Effects: Headache, tachycardia, angina pectoris, palpitations, nausea, vomiting, diarrhea, anorexia, neurotopenia, leucopenia,, agranulocytopenia, agranulocytosis, thromobocytopenia with or without purpura

Action: Short-acting, clear, colorless solution of exogenous unmodified insulin extracted from beta cells in pork pancreas or synthesized by recombinant DNA technology (human). Enhances transmembrane passage of glucose across cell membranes of most body cells and by unknown mechanism may itself enter the cell to activate selected intermediary metabolic processes. Promotes conversion of glucose to glycogen. Side Effects: Rash Hives Itching Swelling of the mouth or throat Wheezing or other difficulty breathing

Adverse Effects: BodyWhole:Most adverse effects are related to hypoglycemia; ana-phylaxis (rare), hyperinsulinemia [Profuse sweating, hunger, headache, nausea, tremulousness, tremors, palpitation, tachycardia, weakness, fatigue, nystagmus, circumoral pallor; numb mouth, tongue, and other paresthesias; visual disturbances (diplopia, blurred vision, mydriasis), staring expression, confusion, personality changes, ataxia, incoherent speech, apprehension, irritability, inability to concentrate, personality changes, uncontrolled yawning, loss of consciousness, delirium, hypothermia, convulsions, Babinski reflex, coma. (Urine glucose tests will be negatives). CNS:With overdose, psychic disturbances (i.e., aphasia, personality changes, maniacal behavior). Metabolic:Posthypoglycemia or rebound hyperglycemia (Somogyi effect), lipoatrophy and lipohypertrophy of injection sites; insulin resistance. Skin:Localized allergic reactions at injection site; generalized urticaria or bullae, lymphadenopathy. Interactions:Drug-drug: Angiotensin-converting enzyme inhibitors (ACE inhibitors); Octreotide (Sandostatin); Monoamine oxidase inhibitors (MAOIs); Beta Blockers. Drug- Diagnostic: Interference Large doses of insulin may increase urinary excretion of VMA. Insulin can cause alterations in thyroid function tests and liver function test and may decrease serum potassium and serum calcium.. Contraindicated: Hypersensitivity to insulin animal protein.

Nursing Responsibilities: Orient self with the 10 rights of giving medication before administering drug to the patient. Note: Frequency of blood glucose monitoring is determined by the type of insulin regimen and health status of the patient. Lab tests: Periodic postprandial blood glucose, and HbA1C. Test urine for ketones in new, unstable, and type 1 diabetes; if patient has lost weight, exercises vigorously, or has an illness; whenever blood glucose is substantially elevated. Notify physician promptly for presence of acetone with sugar in the urine; may indicate onset of ketoacidosis. Acetone without sugar in the urine usually signifies insufficient carbohydrate intake. Monitor for hypoglycemia at time of peak action of insulin. Onset of hypoglycemia (blood sugar: 5040 mg/dL) may be rapid and sudden. Check BP and blood glucose and ketones every hour during treatment for ketoacidosis with IV insulin. Monitor I/O. Give patients with severe hypoglycemia glucagon, epinephrine, or IV glucose 10%50%. As soon as patient is fully conscious, give oral carbohydrate (e.g., dilute corn syrup or orange juice with sugar, Gatorade, or Pedialyte) to prevent secondary hypoglycemia.