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MR is for use in adults only. Dose may vary from 30120mg, taken once daily Should be taken with food, preferably at breakfast time Tablets are modified release, therefore should not be broken or chewed Always titrate dose according to individual patient requirements, in steps of 30mg Daily dose should not exceed 120mg Diamicron MR can replace other Gliclazide 80mg tablets, one for one
INDICATIONS Diamicron MR is used in the treatment of type II (non-insulin dependent) diabetes that cannot be controlled with diet and exercise.
ACTIONS Gliclazide is a blood glucose-lowering agent. Non-insulin dependent diabetes (NIDDM) is due to a decreased sensitivity of the body cells to insulin, but the pancreas still has the ability to produce insulin. Gliclazide stimulates the islet cells of the pancreas to secrete insulin, and also increases their sensitivity to their normal stimulus, glucose. These effects restore the (first-phase) insulin secretion that has become diminished in NIDDM patients. Gliclazide also has effects outside the pancreas, where it improves insulinstimulated usage of glucose. This combined with its continuing ability to
CONTRAINDICATIONS This medication must not be used in the following cases: -if you are allergic to gliclazide -if you have diabetes requiring treatment with insulin, -in case of diabetes complicated by ketosis and acidosis, diabetic precoma -if you suffer from severe liver or kidney disease. -in case of porphyria: accumulation of pigments (porphyria) in the body -if you are presently taking a treatment with miconazole (see interactions with other medications) -if you are breastfeeding
SIDE EFFECTS Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect. Disturbances of the gut such as diarrhoea, constipation, indigestion, nausea, vomiting or abdominal pain. Temporary visual disturbances at
NURSING CARE Patients who are NPO may need to have their dose held to avoid hypoglycemia
meaning the blood concentrations of Gliclazide increase slowly. Enhances transmembrane passage of glucose hypersensitivity t o insulin .Diamicron MR is a modified release tablet. Regular Insulin. This produces steadier insulin release and more moderated diabetic control. Low blood glucose level (hypoglycaemia. Skin reactions such as rash and itch. Novolin R. clear. injection site reaction pruritus. Velosulin. Velosulin Human -diabetic comadiabetic acidosisclients sufferingfrom labile diabetes. Pork Regular Iletin II. Velosulin BR. Inflammation of the liver (hepatitis). Disturbances in the normal levels of blood cells in the blood. Lab tests: Periodic postprandial blood glucose.stimulate insulin secretion. Test urine for Generic name: Insulin Injection [Regular] (in´su-lin) Brand name: Humulin R. and HbA1C. allow Gliclazide to have long-term blood glucose-lowering ability. Disturbance in liver function. Yellowing of the skin and eyes (jaundice). rash Assessment & Drug Effects Note: Frequency of blood glucose monitoring is determined by the type of insulin regimen and health status of the patient. Short-acting. Regular Purified Pork Insulin. colorless solution of exogenous unmodified insulin extracted from beta cells in pork pancreas or synthesized by recombinant DNA technology (human). Hypoglycemia. start of treatment. hypokalemia.
and h.1 U/h continuous infusion across cell membranes of most body cells and by unknown mechanism may itself enter the cell to activate selected intermediary metabolic processes.4–7. (dose adjustments based on blood glucose determinations) Ketoacidosis adult:IV 2. (dose adjustments based on blood glucose determinations) child:SC 2–4 U 15–30 min a.2 U/h continuous infusion child:IV 0. Check BP. ketones in new. Monitor for hypoglycemia at time of peak action of insulin. exercises vigorously. Acetone without sugar in the urine usually signifies insufficient carbohydrate intake. followed by 0. followed by 2.c. whenever blood glucose is substantially elevated.1 U/kg loading dose. if patient has lost weight. Promotes conversion of glucose to glycogen.4–7. may indicate onset of ketoacidosis. Notify physician promptly for presence of acetone with sugar in the urine.s. and h.c. and type 1 diabetes. or has an illness.Classifications: hormone and synthetic substitute. insulin Pregnancy Category: B Route & dosage Diabetes Mellitus adult:SC 5–10 U 15– 30 min a.s. antidiabetic agent. and blood glucose and ketones every hour during treatment for .2 U loading dose. I&O ratio. unstable. Onset of hypoglycemia (blood sugar: 50–40 mg/dL) may be rapid and sudden.
if engaged in active sports. or IV glucose 10%–50%. Notify physician of local reactions at injection site. Give patients with severe hypoglycemia glucagon. epinephrine.ketoacidosis with IV insulin. Inject insulin into the abdomen rather than a near muscle that will be heavily taxed. may develop 1–3 wk after therapy starts and last several hours to days.. usually disappear with .g. Gatorade. give oral carbohydrate (e. Patient & Family Education Learn correct injection technique. or Pedialyte) to prevent secondary hypoglycemia. dilute corn syrup or orange juice with sugar. As soon as patient is fully conscious.
unaccustomed exercise. nervous or emotional tension. infection. diarrhea. Note: Hypoglycemia can result from excess insulin. usually 3–6 wk. Failure to show signs of .continued use.5–3 oz [45–90 mL] for child) followed by a meal of longer-acting carbohydrate or protein food. Take 4 oz (120 mL) of any fruit juice or regular carbonated beverage (1. Do not change prescription lenses during early period of dosage regulation. vision stabilizes. Severe hypoglycemia is an emergency situation. or overindulgence in alcohol. insufficient food intake. Respond promptly to beginning symptoms of hypoglycemia. vomiting. illness.
Check blood glucose regularly during menstrual period. go to bed.recovery within 30 min indicates need for emergency treatment. loss of diabetes control (hyperglycemia or hypoglycemia) is common. Carry some form of fast-acting carbohydrate (e. Notify physician of S&S of diabetic ketoacidosis.g. as prescribed by physician. and drink noncaloric liquids liberally (every hour if possible).. Continue taking insulin during an illness. LifeSavers or other candy) at all times to treat hypoglycemia. Consult physician for insulin regulation if unable . lump sugar. adjust insulin dosage accordingly.
to eat prescribed diet. Pyrexia of unknown origin and for symptomatic relief of fever and pain as sociated with common childhood disorders. basic life support measures may be necessary. tonsillitis. As an antipyretic. Children up to 10 years: 1-2 mL. Avoid OTC medications unless approved by physician. • Treatment of overdose: Monitor serum levels regularly. pregnancy. Do not breast feed while taking this drug without consulting physician. . • Avoid using multiple preparations containing acetaminophen. if needed for longer than 10 days. N-acetylcysteine should be available as a specific antidote. Temporary relief of pain and discomfort. • Give drug with food if GI upset is noted. • Consult physician if needed for children < 3 yr. chronic alcoholism. Headache and high grade fever Do not exceed the recommended dosage. post-immunization reactions. Infants: ½-1 mL. • Discontinue drug if hypersensitivity reactions occur. which helps dissipate heat As an analgesic. it should be used with caution with impaired hepatic function. the site and mechanism of action unclear. Not for patients with hypersensitivity to acetaminophen. if continued fever. In severe cases. upper respiratory tract infections. Generic Name: Paracetamol Brand Name: Aeknil Classification: Analgesics (Nonopioid) Anti-pyretics DOSAGE Adults and Children ≥10 years: 2-3 mL. after tonsillectomy and other conditions where patient is unable to take oral medications but where paracetamol can be administered with advantage. lactation. severe or recurrent pain occurs (possible serious illness). Carefully check all OTC products. dose may be administered IV very slowly. dose may be repeated 4-hourly till temperature returns to normal. Depending on severity of case. For prevention of febrile convulsion. acetaminophen reduces fever by acting directly on the hypothalamic heat-regulating center to cause vasodilation and sweating.
Make sure to drink plenty of water or other fluids everyday while taking Ciprofloxacin. Ciprofloxacin is used to treat infections of the skin. and Shigellabacteria. Do not take the medication . musc le pain. They could make the medication less effective. arthritis and t oothache. or with calciumfortified juice. Bactericidal. Ciprofloxacin is also frequently used to treat urinary infections caused by bacteria such as E. interferes with DNA replication in susceptible bacteria preventing cell reproduction Allergy to ciprofloxacin. but do not use them alone when taking ciprofloxacin. cold. Campylobacter jej uni . Instruct client to report any adverse reaction to the physician or nurse. Tell patient that antacids and mineral supplements may decrease the absorption of Ciprofloxacin which makes it less effective. norfloxacin or other fluoroquinolones nausea vomiting stomach pain heartburn diarrhea feeling an urgent need to urinate headache vaginal itching and/or discharge Twice a day dosage. Ciprofloxacin is effective in treating infectious diarrheas caused by E. He may eat or drink dairy products or calcium-fortified juice with a regular meal. lungs. airways. sinusitis.Ciprofloxacin Dosage: 500mg Frequency: BID Route: Per Orem Classification: Antibacterial fluoroquinolone Headache. coli. Instruct patient not to take ciprofloxacin with dairy products such as milk or yogurt. coli. bones. and joints caused by susceptible bacteria .
* Monitor bowel and bladder function. Be prepared to discontinue drug and provide supportive care. hypersensitive to drug or other opioids. * For better analgesic . A centrally acting synthetic analgesic compound not chemically related to opioids. Thought to bind to opioid receptors and inhibit reuptake of norepinephrine and serotonin. nausea. headache.in larger amounts. incoordination. or diarrhea. vertigo. labile blood pressure. Ultracet) Classifications: Analgesic To treat moderate to moderately severe pain Unknown. vasodilation. * Monitor CV and respiratory status. * Reassess level of pain at least 30 minutes after administration. constipation. Anticipate need for laxative. tachycardia. such as agitation. vomiting. vomiting. chest pain. hyperthermia. hyperreflexia. hallucinations. nausea. coma. or take it for longer than recommended by the doctor Generic Name: Tramadol Hydrochloride Brand Name: (Ultram. Withhold dose and notify prescriber if respirations decrease or rate is below 12 breaths/minute. * Monitor patient closely for evidence of serotonin syndrome. Notify prescriber at once because serotonin syndrome may be lifethreatening. Use cautiously in patients at risk for seizures dizziness.
Avoid driving and other potentially hazardous activities that require mental alertness until drug’s CNS effects are known. * In the case of an overdose. Drug can produce dependence similar to that of codeine or dextropropoxyphene and thus has potential for abuse.effect. * Take drug as prescribed and not to increase dose or dosage interval unless ordered by prescriber. * Monitor patient for drug dependence. * Withdrawal symptoms may occur if drug is stopped abruptly. naloxone may also increase risk of seizures. * Check with prescriber before taking any OTC drugs as drug interactions . give drugs before onset of intense pain. Drug may reduce seizure threshold. * Monitor patients at risk for seizures. * For ambulatory patients: Be careful in rising and walking. Reduce dosage gradually.
Does not diffuse adequately to the CSF 1.8 grams/IV Topical: Apply a thin film on the affected area. Prevents peptide formation 3. Agranulocyt osis 15. Give parenteral dosage for hospitalized clients only 4. Anaphylaxis 14. Itching 9. Pseudomemb ranous colitis 3. Use in clients with a history of regional enteritis. ulcerative colitis. Use parenteral form for anaerobic infections 2. meningitis. Assess extent of infections and if improvement occurs 7. Treatment of serious respiratory tract infections caused by anaerobes 2. septicemia and abdominal infections 3. Serious infections caused by Streptococci/ Staphylocicci/ Pneumococci 4. Oily skin 12. lincosamide Dosage: Per Orem: 150300mg q6h. With IV. Skin rashes 6. Hypersensitivity 2. Administer IV over 2060 minutes 5. Cardiopulm onary arrest 13.Generic Name: Clindamycin hydrochloride Brand Name: DalacinC. 1. antibioticassociated colitis 4. 1. Use in treating minor bacterial infections 3. Nausea and vomiting 5. Life-threatening infections: 4. Dry skin 7. Monitor liver and renal function 8. Burning 8. especially when therapy starts or dosage changes. For severe infections: 300-450mg q6h. Suppresses protein synthesis by microorganisms by binding to ribosomes 2. Diarrhea 2. Peeling 11. Assess for diarrhea and possible colitis 6. Adjunct to surgery for chronic 1. following infusion to prevent hypotension . Skin erythema 10. Reduce dosage in severe renal impairment 3. Lactation 1. * Avoid giving tramadol to patients with acute abdominal conditions because it may mask evidence and disrupt assessment of the abdomen. Treatment of serious skin and soft tissue infections. Cleocin Classification: Antibio tic. keep in bed for 30 min. Use for treating viral infections 5. * Monitor patient closely for evidence of suicidal thinking or behavior. Aplastic may occur. Tinnitis 4.
Teach the patient to avoid alcohol = will increase the risk of hypoglycemia. Glucophage XR) Classification: Metformin . to evaluate effectiveness.bone/joint infections 5. Do not break or crush them. If diarrhea occurs. Withhold drug if patient develops hypoxemia or sepsis this will increase the risk for lactic acidosis. increases glucose transport into Hypoglycemia headache or muscle pain. Mechanism of action is thought to be due to both increasing the binding of insulin to its receptor and potentiating insulin action. Antidiabetic Agents Diabetes Mellitus type 2 Biguanide oral hypoglycemic agent. diarrhea. do not use antiperistaltic agents 11. Improves tissue sensitivity to insulin. gas. Do not use peeling agents on affected acne areas Give with food. stomach pain. Take orally with a full glass of water to prevent stomach distress 10. Treatment of bacterial vaginosis anemia 9. vomiting. Unlike sulfonylureas. Metformin (Glucophage. If using vaginal cream. it weakens latex-containing condoms due to the mineral oil content 12. Swallow them whole. weakness. Treatment of acne vulgaris 6. . biguanides do not stimulate the release of insulin from the beta cells of the pancreas. Take exactly as prescribed. biguanides. or mild nausea. Monitor Blood Glucose levels.
Anxiety. dizziness. and monitoring blood glucose is the regimen of treatment. nausea. Name confusion between clonidine and Klonopin Do not discontinue abruptly. have other BP-controlling drugs on standby. discard any unused portions. controlling weight. monitor BP carefully during surgery. sweating. and decreases sympathetic outflow from the CNS. analgesic skeletal muscles and fat. Store epidural injection at room temperature. tachycardia. discontinue therapy by reducing the dosage gradually over 2–4 days to avoid rebound hypertension. ringing in the ears.Hypertension Clonidine (Catapres) Classification: cardiovascular agent. exercise. inhibits sympathetic cardio accelerator and vasoconstrictor centers. nausea. tiredness. Stress the importance of diet. Do not discontinue prior to surgery. flushing. Contraindicated with hypersensitivity to clonidine or any adhesive layer components of the transdermal system. vomiting. constipation. general weakness. confusion. vomiting. Reevaluate therapy if clonidine tolerance . cardiac arrhythmias (hypertensive encephalopathy and death have occurred after abrupt cessation of clonidine). drowsiness. thus lowering blood glucose levels. central-acting antihypertensive. Stimulates CNS alpha2-adrenergic receptors. dry mouth. and suppresses gluconeogenesis and hepatic production of glucose.
Use the face mask or mouthpiece to breathe in the . hypertension usually returns within 48 hr. or feet trembling or shaking of the hands or feet Use one container of solution or mix the exact amount of solution using the dropper provided for each dose. it binds to bronchospasm the beta24. Monitor BP carefully when discontinuing clonidine . occurs. irregular. Assess compliance with drug regimen in a supportive manner with pill counts. pounding. The chronic relief from nasal obstructive congestion and pulmonary bronchospasm is disorder (COPD) made possible by 2. For the takes place when prevention of Salbutamol is exerciseadministered. Hypersensitivity to fluorocarbons Fast. hands. First. adrenergics (pharmacologic) 1. arms. or other methods. To control and It relieves nasal prevent congestion and reversible reversible airway bronchospasm by obstruction relaxing the smooth caused by muscles of the asthma or bronchioles. or racing heartbeat or pulse shakiness in the legs. Hypersensitivity to adrenergic amines 2. Connect the nebulizer to the face mask or mouthpiece. giving concomitant diuretic increases the antihypertensive efficacy ofclonidine. Quick relief for the following bronchospasm mechanism that 3. Albuterol/ Salbutamol (Ventolin Nebules) Classification: Bronchodilator (therapeutic). induced 1. Place the inhalation solution in the medicine reservoir or nebulizer cup on the machine. Long-term adrenergic 1.
3’5’adenosine monophosphate (cAMP). Clean all the parts of the nebulizer after each use. 4. Kinases inhibit the phosphorylation of myosin and decrease intracellular calcium. 3. 2. Use the nebulizer for about 5 to 15 minutes. Decreased in intracellular calcium will result to the relaxation of the smooth muscle airways. When cAMP increases. . kinases are activated. medicine. or until the medicine in the nebulizer cup is gone.control agent for patients with chronic or persistent bronchospasm receptors in the airway of the smooth muscle which then leads to the activation of the adenyl cyclase and increased levels of cyclic.
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