September 4, 2009

GENERIC
NAME
citicholine

lactulose

BRAN
D
NAME
Zynaps
e

DOSAGE

INDICATIO
N

MECHANISM
OF ACTION

CONTRAINDICATI
ON

500mg IV
q8
Discontinu
ed on
September
9, 2009

Cerebrovascu
lar Diseases,
accelerates
the recovery
of
consciousness
and
overcoming
motor deficit.

hypertonia of the
parasympathetic

Lilac

80cc HS

Constipation

Citicoline
activates the
biosynthesis of
structural
phospholipids
in the neuronal
membrane,
increases
cerebral
metabolism
and increases
the level of
various
neurotransmitt
ers, including
acetylcholine
and dopamine.
Citicoline has
shown
neuroprotectiv
e effects in
situations of
hypoxia and
ischemia.
. metabolism of
lactulose
by

ADVERSE
EFFECT

NURSING
RESPONSIBILITI
ES
citicoline may
Watch out for
exert a
hypotensive
stimulating
effects
action of the
Somazine
parasympathetic,
must not be
as well as a
administered
fleeting and
along with
discrete
medicaments
hypotensor effect
containing

Low galactose diet & Abdominal

intestinal obstruction discomfort

Do not
administer if

bacteria results
in
reduced
colonic
pH
which
stimulates
peristalsis and
decreases stool
transit time. In
turn, decreased
water
reabsorption
from the feces
further
facilitates the
passage of soft
well-formed
stools.
And
increased
osmotic
pressure
of
fecal material
secondary to
an increase in
colonic organic
acids results in
accumulation
of fluid from
surrounding
tissues, helping
to soften stool
mass.

associated w/
flatulence or
cramps.
Prolonged use or
large doses may
result in diarrhea
w/ excessive loss
of water &
electrolytes

patient has
already pass
out stool
especially if
stool is liquid

Mannitol

100cc IV

Raised
intracranial
pressure

Nimodipine Nimoto 30 mg / tab Prophylaxis

p
2 tabs q 6
and treatment
of ischemic
neurological
deficits due to

It raises the
osmotic
pressure of the
plasma
allowing water
to be drawn out
of body tissues.

Calcium
channel
blocking agent
that is
relatively

Pulmonary
congestion
or
oedema; intracranial
bleeding;
CHF;
metabolic
oedema
with
abnormal
capillary
fragility;
anuria due to severe
renal disease; severe
dehydration.

None

Fluid and
electrolyte
imbalance;
acidosis (with
high doses).
Nausea,
vomiting, thirst;
headache,
dizziness,
convulsions,
chills, fever;
tachycardia,
chest pain;
blurred vision;
urticaria and
hypotension or
hypertension;
acute renal
failure; skin
necrosis;
thrombophloebiti
s.

Severe BP
lowering, GI
disturbances,
deterioration of
renal function,

Take care to
avoid
extravasation.
Observe
injection site
for signs of
inflammation
or edema
check for signs
of fluid and
electrolyte
imbalance
measure I&O
accurately and
record to
achieve proper
fluid balance
monitor vital
signs closely.
Report
significant
changes in BP
and signs of
CHF
Take apical
pulse prior to
administering
drug and hold
it if pulse is

cerebral
vasospasms
after
subarachnoid
hemorrhage

selective for
cerebral
arteries
compared with
arteries
elsewhere in
the body. This
may be
attributed to
the drugs high
lipid solubility
and specific
binding to
cerebral tissue.

disturbances of
heart rhythm,
phlebitis,
increase of liver
enzymes.

below 60.
notify the
physician.
Establish
baseline data
before
treatment is
started.BP,
pulse and
laboratory
evaluations of
liver and
kidney
function.
Monitor
frequently for
adverse drug
effects,
including
hypotension,
peripheral
edema,
tachycardia, or
skin rash.
Monitor
frequently for
dizziness or
lightheadednes
s in older
adult, risk of

hypotension is
increased.
Phenobarbi
tal

60 mg/tab
1 tab HS

Used as a
sedative in
anxiety or
tension states.

It depresses the
sensory cortex,
reduces motor
activity,
changes
cerebellar
function, and
produces
drowsiness,
sedation and
hypnosis. Its
anticonvulsant
property is
exhibited at
high doses.

Severe renal and

hepatic disorders.
Severe respiratory
depression, dyspnoea
or airway
obstruction;
porphyria.
Pregnancy.

Bradycardia,
hypotension,
syncope;
drowsiness,
lethargy, CNS
excitation or
depression,
impaired
judgment,
confusion,
nervousness,
headache,
insomnia,
nightmares,
hallucinations,
anxiety,
dizziness; rash,
thrombocytopeni
a, megaloblastic
anaemia;
respiratory
depression,
apnoea
(especially with
rapid IV admin),

Observe
patients
receiving large
doses closely
for at least 30
mins to endure
that sedation is
not excessive.
Keep patient
under constant
observation
when drug is
administered
every hour or
more often if
indicated
Monitor serum
drug levels.
Serum
concentrations
>50 mcg/ml
may cause
coma.
Therapeutic
serum
concentrations
of 15-40

mcg/ml
produce
anticonvulsant
activity in
most patients.
Expect
barbiturates to
produce
restlessness
when given to
patients in pain
because these
drugs do not
have analgesic
action
Be prepared
for paradoxical
responses
Monitor for
drug
interactions.
Barbiturates
increase the
metabolism of
many drugs,
leading to
decreased
pharmacologic
al effects of
those drugs.

Ranitidine

Zantac

50 mg IV q
8 shifted to
September
7, 2009

Prophylaxis
of stress
ulceration
and recurrent
hemorrhage
from peptic
ulcer

Potent antiulcer drug that

competitively
and reversibly
inhibits
histamine
action at H2receptor sites
on parietal
cells, thus
blocking
gastric acid
secretion.

Safe use during

pregnancy or
lactation is not
established

Headache,
malaise,
dizziness, mental
confusion,
agitation,
depression,
hallucinations in
older adult.
Constipation,
nausea,
abdominal pain

Avoid
administering
with betablockers,
calcium
channel
blockers,
warfarin, oral
contraceptives
Potential
toxicity results
from decreased
clearance
(elimination)
and therefore
prolonged
action; greatest
in the older
adult patients
or those with
hepatic or
renal
dysfunction.
Be alert for
early signs of
hepatotoxicity;
jaundice (dark
urine, pruritus,
yellow slera

Tramadol

Tramal

50 mg /
cap 1 cap q
8
RTC
shifted to
September
10, 2009

Moderate to
severe acute
or chronic
pain and in
painful
diagnostic or
therapeutic
measures

Centrally
acting opiate
receptor
agonist that
inhibits the
uptake of
norepinephrine
and serotonin,
suggesting
both opiod and
nonopioid
mechanisms of
pain relief.
May produce
opioid-like
effects, but
causes less
respiratory
depression than
morphine

Hypersensitivity to
tamadol or other
opioid analgesics;
patients on MAOI,
patients acutely
intoxicated with
alcohol, hypnotics,
centrally acting
analgesics, opioids,
or psychotropic
drugs; patients on
obstetric
preoperative
medication, lactation.

Drowsiness,
dizziness,
vertigo, fatigue,
headache,
restlessness,
euphoria,
confusion,
anxiety,
palpitations,
vasodilation,
nausea,
constipation,
urinary
retention/frequen
cy.

and skin)
Long term
therapy may
lead to vitamin
B12
deficiency.
Assess for
level of pain
relief and
administer
dose as needed
but not to
exceed the
recommended
total daily
dose.
Monitor vital
signs and
assess for
orthostatic
hypotension or
signs of CNS
depression.
Discontinue
drug and
notify the
physician if
s/sx of
hypersensitivit
y occur.

Assess bowel
and bladder
function,
report urinary
frequency or
retention.\
Take
appropriate
safety
precautions.

September 6, 2009
GENERI
C NAME

DOSAG
E

INDICATIO
N

Potassium
chloride

BRAN
D
NAME
Kalium
durule

1 tab TID
* 6 doses

hypokalemia

Ranitidine

Zantac

150 mg /

Prophylaxis

MECHANIS
M OF
ACTION
Provides a
direct
replacement of
potassium in
the body

CONTRAINDICATIO
N

ADVERSE
EFFECT

Renal insufficiency,
hyperkalemia, untreated
Addisons disease,
constriction of the
esophagus and or
obstructive changes in
the alimentary tract.

Diarrhea,
nausea,
stomach
pain,
discomfort or
gas vomiting.

Potent anti-

Safe use during

Headache,

NURSING
RESPONSIBILITIE
S
Watch out for
levels of
potassium
electrolyte level
to prevent
hyperkalemia.
Observe 10 rights
of giving
medication.
Watch out for
possible adverse
reaction of the
patient.
Potential toxicity

tab q 12

of stress
ulceration and
recurrent
hemorrhage
from peptic
ulcer

ulcer drug that

competitively
and reversibly
inhibits
histamine
action at H2receptor sites
on parietal
cells, thus
blocking
gastric acid
secretion.

pregnancy or lactation is malaise,

not established
dizziness,
mental
confusion,
agitation,
depression,
hallucination
s in older
adult.
Constipation,
nausea,
abdominal
pain

results from
decreased
clearance
(elimination) and
therefore
prolonged action;
greatest in the
older adult
patients or those
with hepatic or
renal
dysfunction.
Be alert for early
signs of
hepatotoxicity;
jaundice (dark
urine, pruritus,
yellow slera and
skin)
Long term
therapy may lead
to vitamin B12
deficiency.

September 8, 2009
GENERI
C NAME
Mannitol

BRAN
D
NAME

DOSAGE

INDICATIO
N

50 cc q 8

Raised

MECHANIS CONTRAINDICATIO ADVERSE

M OF
N
EFFECT
ACTION
It raises the Pulmonary congestion Fluid and

NURSING
RESPONSIBILITI
ES
Take care to

discontinue
d on
September
10, 2009

intracranial
pressure

osmotic
pressure
of
the
plasma
allowing
water to be
drawn out of
body tissues.

or oedema; intracranial
bleeding;
CHF;
metabolic
oedema
with
abnormal
capillary
fragility;
anuria due to severe
renal disease; severe
dehydration.

electrolyte
imbalance;
acidosis (with
high doses).
Nausea,
vomiting, thirst;
headache,
dizziness,
convulsions,
chills, fever;
tachycardia,
chest pain;
blurred vision;
urticaria and
hypotension or
hypertension;
acute renal
failure; skin
necrosis;
thrombophloebiti
s.

avoid
extravasation.
Observe
injection site for
signs of
inflammation or
edema
check for signs
of fluid and
electrolyte
imbalance
measure I&O
accurately and
record to
achieve proper
fluid balance
monitor vital
signs closely.
Report
significant
changes in BP
and signs of
CHF

September 10, 2009

GENERIC
NAME
Tramadol

BRAN
D
NAME
Dolcet

DOSAG
E

INDICATIO
N

1 tab TID

Moderate to

MECHANIS
M OF
ACTION
Analgesic

CONTRAINDICATIO
N

ADVERSE
EFFECT

Acute intoxication with

CNS and GI

NURSING
RESPONSIBILITIE
S
Assess for level

HCl 37.5
mg,
paracetamo
l 325 mg

severe pain

alcohol, hypnotics,
narcotics, centrallyacting analgesics,
opioids or psychotropic
drugs. Hypersensitivity.

disturbances
. Nausea,
dizziness.
Fatigue,
constipation,
dry mouth.

Potassium
chloride

Kalium
durule

1 tab TID

hypokalemia

Provides a
direct
replacement of
potassium in
the body

Renal insufficiency,
hyperkalemia, untreated
Addisons disease,
constriction of the
esophagus and or
obstructive changes in
the alimentary tract.

Diarrhea,
nausea,
stomach
pain,
discomfort
or gas
vomiting.

of pain relief and

administer dose
as needed but not
to exceed the
recommended
total daily dose
Discontinue drug
and notify the
physician if s/sx
of
hypersensitivity
occur
Take appropriate
safety
precautions.
To be taken with
food to avoid GI
upset.
Watch out for
levels of
potassium
electrolyte level
to prevent
hyperkalemia.
Observe 10 rights
of giving
medication.
Watch out for
possible adverse
reaction of the

patient.
September 11, 2009
GENERI
C NAME
metoprol
ol

BRAN
D
NAME

DOSAG
E

INDICATIO
N

50
mg/tab
BID

Hypertensio
n

MECHANIS
M OF
ACTION
Metoprolol
selectively
inhibits adrenergic
receptors but
has little or
no effect on
2-receptors
except in
high doses.

CONTRAINDICATI
ON

ADVERSE EFFECT

NURSING
RESPONSIBILITI
ES
2nd or 3rd degree AV Bradycardia,
Take apical
block; decompensated hypotension, arterial
pulse and BP
heart failure;
insufficiency, chest
before
clinically relevant
pain, CHF, ,
administering
sinus bradycardia.
palpitation, syncope,
drug. Report to
Severe peripheral
dizziness, fatigue,
physician
arterial circulatory
depression,
significant
disorders. Cardiogenic confusion, headache,
changes in rate,
shock. Asthma.
insomnia, short-term
rhythm, or
Phaeochromocytoma
memory loss, rash,
quality of pulse
(without -blockade), sexual
or variations in
systolic BP <100
dysfunction/impotenc
BP prior to
mmHg. Metabolic
e,; diarrhea,
administration.
acidosis. Pregnancy
constipation,
Monitor BP,
(2nd and 3rd
flatulence, GI pain,
HR, and ECG
trimesters).
heartburn, nausea,
carefully during
Heart failure, heart
administration
block, bronchospasm. Expect maximal
effect on BP
after 1 week of
therapy
Observe
hypertensive

patients with
CHF closely for
impending heart
failure.
Dyspnea on
exertion,
orthopnea,
night cough,
edema,
distended neck
veins.
Monitor I&O,
daily weight,
auscultate daily
for pulmonary
rales.