Drug Order

Generic Name: Amlodipine

Mechanism of Action

Indication
Angina pectoris due to coronary artery Spasm, Chronic stable angina, alone or in combination with other agents, Essential hypertension, alone or in combination with other antihypertensive

Contraindic ation
The presence of any allergies to nitrates. These drugs are also contraindicated in the following conditions: Sever e anemia, head trauma or hemorrhage, preg nancy and lactation.

Adverse Effect
CNS: Dizziness, lightheadedness, headache, asthenia, fatigue, lethargy CV: Peripheral edema, arrhythmias Dermatologic: Flushing, rash GI: Nausea, abdominal Discomfort

Nursing Responsibilities
BEFORE: -Obtain patients history to allergy of amlodipine. -Assess vital signs before therapy. DURING: -Monitor patients BP, cardiac rhythm -Monitor intake and output. AFTER: -Monitor vital signs. -Be alert for adverse effect. >Advise patient to take medication as directed, even if feeling well. >Take missed doses as soon as possible unless almost time for next dose; do not double doses. > Caution patient to change positions slowly to minimize orthostatic

Inhibits the movement of calcium ions across the membranes of cardiac Brand Name: and arterial muscle cells; Norvasc inhibits transmembrane calcium flow, which Classification: results in the depression -Calcium of impulse formation in channel-blocker specialized cardiac -Anti-anginal pacemaker cells, slowing Drug of the velocity of Antihypertensive conduction of the cardiac impulse, depression of Route: myocardial contractility, Oral and dilation of coronary arteries and arterioles and Frequency: peripheral arterioles; OD these effects lead to decreased cardiac work, Time: decreased cardiac oxygen 8am consumption, and in patients with vasospastic angina, increased delivery of oxygen to cardiac cells.

hypotension. > Advise patient to notify health care professional if irregular heartbeats, dyspnea, swelling of hands and feet, pronounced dizziness, nausea, constipation, or hypotension occurs or if headache is severe or persistent. > Caution patient to wear protective clothing and use sunscreen to prevent photosensitivity reactions.

Drug Order
Generic Name: Ipratropium /Albutero l (Salbuta mol) Brand Name: DuoNeb Classification: Bronchodilator Frequency: Q6 Route: Inhalants Time: 6am-12nn-6pm12mn

Mechanism of Action
Relaxing the smooth muscles of the bronchioles

Indication
Management of reversible broncho spasm associated with obstructive airway diseases in patients who require more than a single bronchodilator

Contraindication
-Patients who is allergic to the Drugs -Patients with Hypertropic obstructive cardiomyopathy -Patients having tachyarrythmia

Adverse Effect
Fine tremor of Skeletal Muscle; Palpitations; Headache, dizziness, nervousness; Dryness of the mouth, throat irritation; urinary retention.

Nursing Responsibilities
-Use Cautiously to patients with known sensitivity to atropine, soybeans, and peanuts. -Assess Vital Signs Before drug administration -Observe for paradoxical broncho spasm (Wheezing). If Condition occurs, withhold Medication and notify physician or other healthcare professional immediately. -Instruct patient to contact health care professional immediately if shortness of breath is not relieved by medication or is accompanied by diaphoresis, dizziness, palpitations, or chest pain.

-Advise the patient to rinse mouth with water after using the nebulizer to minimize dry mouth

Drug Order
Generic Name: Vitamin B Complex Brand Name: Pharex Classification: Vitamins and Minerals Route: Oral Frequency: OD Time: 8am

Mechanism of Action
A coenzyme that stimulate metabolic function and is needed for cell replication, hematopoiesis, and nucleoprotein and myelin synthesis

Indication
Peripheral neuro paralysis Anemia

Contraindication
Hypersensitive to vitamin B 12 or cobalt

Adverse Effect
CV: Peripheral vascular thrombosis, heart failure. GI: Transient diarrhea. Respi: Pulmonary edema. Skin: Itching, transitory exanthema, urticaria. Other: anaphylaxis, anaphylactoid reactions with parenteral administration, pain or burning at injection site.

Nursing Responsibilities
BEFORE: ~ Determine reticulocyte count, hct, Vit.B12, iron, folate levels before beginning therapy. ~ Obtain a sensitivity test history before administration ~ Avoid I.V. administration because faster systemic elimination will reduce effectiveness of vitamin. DURING: ~ Dont give large doses of vitamin B12 routinely; drug is lost through excretion. ~Dont mix parenteral preparation in same syringe with other drugs.

AFTER: ~ Protect Vit.B12 from light. Dont refrigerate or freeze. ~ Monitor patient for hypokalemia for first 48hours, as anemia correct itself. Give potassium supplements, as needed