Generic Name Salicylate

Brand Name Aspirin

Classification Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)

Indication For pain on integumentary structures, myalgia, neuralgia, headache, dysmenorrhea, gout. Arthritis, SLE, acute rheumatic fever

Contraindication Hypersensitivity to salicylates, severe anemia, history of blood coagulation defects, vitamin K deficiency, 1 week before and after surgery, pregnancy in the last trimester .

Mechanism Of Action Prevent blood coagulation due to hypertension (narrow blood vessels may cause blood to aggregate) Exhibits antipyretic, antiinflammatory and analgesic effects. The antipyretic effect is due to an action on the hypothalamus, resulting in heat loss by vasodilation of peripheral blood vessels. Anti-inflammatory effects are mediated by a decrease in prostaglandin synthesis. It also decreases platelet aggregation.

Adverse Reaction GI: dyspepsia, heartburn, anorexia, nausea, epigastric discomfort, potentiation of peptic ulcer Allergic:Bronchospasm, asthma-like symptoms, anaphylaxis, skin rashes, urticaria Hematologic: prolongation of bleeding time, thrombocytopenia, leucopenia, Other: Thirst, fever, dimness of vision

Nursin Considerations Assess for pain: type, location and pattern Note for asthma Monitor renal, LFTs and CBC Determine history of peptic ulcers or bleeding tendencies. Precautions: Do not use in children with chicken pox or flu symptoms Lactation Mild diabetes, erosive gastritis, bleeding tendencies, liver or kidney disease.

Name of the Drug Generic Name: furosemide Brand Name: Apo-Furosemide Furoside Lasix Lasix Speacial Novosemide Uritol

Dosage/Route 0.5-1 mg/kg slow IVP over 12 min, may repeat once at 2 mg/kg slow IVP over 1-2 mins.

Action/Classification Action: inhibits sodium and chloride reabsorption at the proximal and distal tubules and the ascending loop of Henlen Classification: Loop Diuretics

Indication/ Contraindications Indications: Edema associated with CHF Cirrhosis with ascites or renal dysfunction For hypertension or in combination with other antihypertensive medications. ICP, nephritic syndrome, hepatic cirrhosis Contraindications: Contraindicated to patients hypersensitive to drug or any of its components and in those with anuria. Use cautiously in patient with hepatic cirrhosis. Patients with allergies to sulfonamides may also be allergic to furosemide. In pregnant woman, use only if benefits outweighs the risk to the fetus. In breast feeding woman, do not use drug.

Adverse Effects/ Side Effects Adverse Effects: vertigo, headache, paresthesia, orthostatic hypotension, thrombophlebitis, abdominal pain, Hypokalemia, anemia, muscle spasm

Nursing Responsibilities Monitor serum glucose, and electrolyte D iet- K+ for all except aldactone I ntake and Output, daily weight U ndesirable effects; Fluid and electrolyte imbalance R eview HR, BP and electrolytes E lderly-Careful T ake with or after meals and in AM I ncrease risk of orthosthatic hypotension; move slowly C ancel alcohol

Generic Name Omeprazole

Brand Name

Classification Antacids, Antireflux Agents & Antiulcerants Antisecretory drug

Indication Short-term treatment of active duodenal cancer Short-term treatment of active benign gastric ulcer Eradication of Helicobacter Pylori First-line therapy for treatment of heartburn or symptoms of GERD

Contraindication Hypersensitivity to omeprazole or its components. Use cautiously with pregnancy, lactation

Mechanism Of Action Gastric-acid pump inhibitor: suppresses gastric acid secretion by specific inhibition of the hydrogen-potassium ATPase enzyme system at the secretory surface of the gastric parietal

Adverse Reaction CNS: headache, dizziness, asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, dream abnormalities Dermatologic: rash, inflammation, urticaria, pruritus, alopecia, dry skin GI: diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophy Respiratory: URI symptoms, cough, epistaxis

Nursing Considerations Assessment: 1. History : hypersensitivity to omeprazole or any of its components; pregnancy, lactation 2. Physical: skin lesions; reflexes; urinary output; abdominal examination; respiratory auscultation Interventions: 1. Administer before meals. 2. Administer antacids with, if needed. 3. Have regular medical follow-up visits. 4. Report severe headache, worsening of symptoms, fever, chills.

Generic Name Captopril

Brand Name

Classification Angiotensinconverting enzyme (ACE) inhibitor Antihypertensive

Indication Treatment of hypertension alone or in combination with thiazide-type diuretics Treatment of CHF in patients unresponsive to conventional therapy; used with diuretics and digitalis Treatment of diabetic nephropathy Treatment of left ventricular dysfunction after MI Unlabeled uses: Management of hypertensive crises; treatment of rheumatoid arthritis; diagnosis of anatomic renal artery stenosis, hypertension related to scleroderma renal crisis; diagnosis of primary aldosteronism, idiopathic edema; Bartter's syndrome; Raynaud's syndrome

Contraindication Contraindicated with allergy to captopril, history of angiodema. Use cautiously with impaired renal function; CHF; salt or volume depletion, lactation, pregnancy.

Mechanism Of Action Blocks ACE from converting angiotensin I to angiotensin II, a powerful vasoconstrictor, leading to decreased blood pressure, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increased prostaglandin synthesis also may be involved in the antihypertensive action

Adverse Reaction CV:Tachy cardia, angina pectoris, MI, Raynaud's syndrome, CHF, hypotension in saltor volume-depleted patients Dermatologic: Rash, pruritus,pemphigoid -like reaction, scalded mouth sensation, exfoliative dermatitis, photosensitivity, alopecia GI: Gastric irritation, aphthous ulcers, peptic ulcers, dysgeusia, cholestatic jaundice, hepatocellular injury, anorexia, constipation GU:Proteinuri a, renal insufficiency, renal failure, polyuria, oliguria, urinary frequency Hematologic: Neutropenia, agranulocytosis, thrombocytopenia, hemolytic anemia, pancytopenia Other:Cough, malaise, dry mouth, lymphadenopathy

Nursing Considerations History: Allergy to captopril, history of angioedema, impaired renal function, CHF, salt or volume depletion, pregnancy, lactation Physical: Skin color, lesions, turgor; T; P, BP, peripheral perfusion; mucous membranes, bowel sounds, liver evaluation; urinalysis, renal and liver function tests, CBC and differential Administer 1 hr before or 2 hr after meals. Alert surgeon and mark patient's chart with notice that captopril is being taken; the angiotensin II formation subsequent to compensatory renin release during surgery will be blocked; hypotension may be reversed with volume expansion. Monitor patient closely for fall in BP secondary to reduction in fluid volume (excessive perspiration and dehydration, vomiting, diarrhea); excessive hypotension may occur. Reduce dosage in patients with impaired renal function

Generic Name Atorvastatin

Brand Name Lipitor

Classification Dyslipidaemic Agents

Indication Reduction of elevated total & LDL cholesterol, apolipoprotein B & triglycerides & increase HDL cholesterol in patients w/ primary hypercholesterolemia, mixed hyperlipidemia, heterozygous & homozygous familial hypercholesterolemia. Elevated serum triglyceride levels, dysbetalipoproteinemia who do not respond to adequate diet. Secondary prevention of the combined risk of death, nonfatal MI, cardiac arrest & rehospitalization for angina pectoris in patients w/ CV disease &/or dyslipidemia.

Contraindication Active liver disease or elevated serum transaminases >3 times the upper limit of normal. Pregnancy & lactation.

Mechanism Of Action Selective, competitive inhibitor of HMG-CoA reductase, the ratelimiting enzyme that converts 3hydroxy-3methylglutarylcoenzyme A to mevalonate, a precursor of sterols, including cholesterol. Cholesterol and triglycerides circulate in the bloodstream as part of lipoprotein complexes. With ultracentrifugation, these complexes separate into HDL (high-density lipoprotein), IDL (intermediate-density lipoprotein), LDL (low-density lipoprotein), and VLDL (verylow-density lipoprotein) fractions. Triglycerides (TG) and cholesterol in the liver are incorporated into VLDL and released into the plasma for delivery to peripheral tissues. LDL is formed from VLDL and is catabolized primarily through the high-affinity LDL receptor. Clinical and pathologic studies show that elevated plasma levels of total cholesterol (total-C), LDL-cholesterol (LDL-C), and apolipoprotein B (apo B) promote human atherosclerosis and are risk factors for developing cardiovascular disease, while increased levels of HDL-C are associated with a decreased cardiovascular risk.

Adverse Reaction Nausea, diarrhea, dyspepsia & flatulence, myalgia. Hypoglycemia, hyperglycemia, anorexia. Thrombocytopenia, tendon rupture, wt gain, hypoesthesia, amnesia, dizziness, dysguesia, Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme, bullous rashes, urticaria, rhabdomyolysis, back & chest pain, peripheral edema, malaise & fatigue. Cholestasis, pain in extremity, musculoskeletal pain, muscle spasm, joint swelling, nightmares, blurred vision, hepatitis, muscle fatigue, neck pain, pyrexia, nasopharyngitis, pharyngolarengeal pain, epistaxis.

Nursing Considerations Monitor for creatine phosphokinase & transaminase elevations. Avoid alcohol consumption. Temporarily discontinue therapy in patient w/ an acute, serious condition suggestive of a myopathy of renal failure secondary to rhabdomyolysis.

Generic Name Trimetazidine

Brand Name Vastarel

Classification Anti-angina

Indication - acute anginal attacks - prevent situation that may cause anginal attacks

Contraindication Lactation.

Mechanism Of Action Selective inhibition of an enzyme of fatty acid -oxidation: the longchain 3-ketoacyl CoA thiolase (3KAT). This inhibition results in: Reduction in fatty acid oxidation; Stimulation of glucose oxidation. The coupling of glycolysis with glucose oxidation is improved and ATP production is further increased, while cell acidosis and Ca2+ overload are limited. The increase in total glucose utilization has been evidenced by studies using 18FDG positron emission tomography (PET).

Adverse Reaction - Nausea and Vomiting, headache, edema

Nursing Considerations 1. Check for doctors order 2. Monitor blood pressure and pulse rate before and after giving the meds. 3. Notify prescribing signs of heart failure such as swelling of hands and feet or SOB. 4. Advise patient of the side effects of the drug.

Generic Name clopidogrel

Brand Name Plavix

Classification Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)

Indication Treatment of patients at risk for ischemic events history of MI, ischemic stroke, peripheral artery disease Treatment of patients with acute coronary syndrome

Contraindication Allergy to clopidogrel, active pathological bleeding such as peptic ulcer or intracranial hemorrhage, lactation.

Mechanism Of Action Inhibits platelet aggregation by blocking ADP receptors on platelets, preventing clumping of platelets

Adverse Reaction CNS:Headache, dizziness,weakness, syncope, flushing CV: Hypertension, edema Dermatologic:Ras h, pruritus GI: Nausea, GI distress, constipation, diarrhea, GI bleed Other:Increased bleeding risk

Nursing Considerations Assess for symptoms of stroke, MI during treatment Monitor liver function studies: AST, ALT, bilirubin, creatinine if patient is on long-term therapy Monitor blood studies: CBC,Hgb, Hct, protime, cholesterol if the patient is on long-term therapy; thrombocytopenia and neutropenia may occur. Precautions: bleeding disorders, recent surgery, hepatic impairment, pregnancy

Generic Name Per 1.2 g vial Co-amoxiclav: Amoxicillin 1 g & clavulanic acid 200 mg

Brand Name Amoclav

Classification Bactericidal

Indication Lower resp tract infections, otitis media, sinusitis, skin & soft tissue infections, UTI, pre & post-surgical procedures, bone & joint, O & G infections, dental infections.

Contraindication History of penicillin hypersensitivity. Superinfections involving Pseudomonas or candida. Pregnancy & lactation

Mechanism Of Action Inhibits enzymes involved in formation of peptidoglycan layer of bacterial cell wall No effect on human cell walls Bactericidal; only works on dividing bacteria Well absorbed enterally Clavulanic acid inhibits bacterial -lactamase

Adverse Reaction Allergic reactions - itching, rashes, fever - angioneurotic oedema - anaphylaxis (1 in 50,000 to 100,000) Cross-allergy with other penicillins Partial cross-allergy with cephalosporins (10%) Hepatitis, cholestatic jaundice Erythema multiforme (including StevensJohnson) Toxic epidermal necrolysis; exfoliative dermatitis Diarrhea, vomiting Rashes Neutropenia Anaemia

Nursing Considerations Pregnancy History of hypersensitivity Renal impairment Hepatic impairment - may cause cholestatic jaundice up to 6 weeks after cessation May cause maculopapular rashes - almost always in presence of glandular fever

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