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Contraindications: hypersensitivity, active pathological bleeding, lactation, use

1. Generic name: Metformin and Sitagliptin cautiously with bleeding disorders, recent surgery, hepatic impairment, pregnancy
Brand name: Janumet Side effects: Headache, dizziness, weakness, hypertension, edema, nausea, GI distress,
Classification: Anti diabetic constipation, diarrhea. Increased bleeding risk
Dosage: 50mg 1 tab OD Nursing considerations:
Action: Decreases hepatic glucose production. Decreases intestinal glucose absorption. • Assess for hypersensitivity to clopidogrel
Increases sensitivity to insulin. • Assess for bleeding disorders
Indications: Management of type 2 diabetes mellitus; may be used with diet, insulin, or • Provide small frequent meals if GI upset occurs
sulfonylurea hypoglycemia. • Provide comfort measures and arrange for analgesics if headache occurs
Contraindications: hypersensitivity, metabolic acidosis, dehydration, sepsis, renal
• Give client awareness to the side effects of the drug
dysfunction, hepatic
impairment. • Provide a safety environment
Side effects: diarrhea, nausea, unpleasant metallic taste. 4. Generic name: Rosuvastatin calcium
Nursing considerations: Brand name: Crestor
• Assess for patient's history of diabetes Classification: Anti-hyperlipidemic
HMG-CoA reductase inhibitor
• Monitor for patient's blood glucose before and after giving medications Dosage: 20 mg 1 tab OD
• Assess for hypersensitivity to Metformin Action: A fungal metabolite that inhibits the enzyme (HGM-CoA) that catalyzes the first
• Assess for patient's renal function step in the cholesterol synthesis pathway, resulting in a decrease
• Monitor for signs and symptoms of hypoglycemic reactions (e.g. cold and In serum cholesterol, serum LDLs (associated with increased risk of coronary artery
clammy skin) disease) and either an increase or no change in serum HDLs (associated with decreased)
• Discontinue if renal impairment occurs Indications: an adjunct to diet in the treatment of elevated total cholesterol, mixed
dyslipidemia, atherosclerosis,
• Instruct patient to do proper foot care
Contraindications: hypersensitivity, impaired hepatic function, alcoholism, renal
• instruct patient for unpleasant metallic taste of the drug impairment, advanced age, hypothyroidism
Side effects: Nausea, dyspepsia, diarrhea, constipation, vomiting, rhinitis, sinusitis,
2. Generic Name: Losartan cough, dyspnea, pneumonia
Brand Name: Cozaar Nursing considerations:
Classification: antihypertensive • Arrange for proper consultation about need for diet and exercise changes
Dosage: 50/500 mg 1 tab BID • Administer drug at bed time
Action: blocks vasoconstrictor and aldosterone producing effects of angiotensin II at
• Monitor patient closely for signs of muscle injury, especially higher doses
receptor sites, including vascular smooth muscle and the adrenal glands
Indications: Hypertension, DM type 2, CHF, and patients who can not tolerate ACE • Provide comfort measures to deal with headache, muscle cramps, or
inhibitors nausea
Contraindications: hypotension, pregnancy and lactation • Offer support and encouragement to deal with disease, diet, drug therapy,
Side Effects: fatigue, weakness, drug induced hepatitis, bradycardia, hypotension and follow-up care.
Nursing Considerations: 5. Generic Name: Vitamin B complex
• Monitor for blood pressure, ECG, pulse frequently during dose adjustments Classification: Vitamins
• Monitor for intake and output ratios and daily weight. -Includes Vitamin B1, B2, B6 and B12
• Assess for signs and symptoms of CHF Dosage: 1 tab OD PO PC breakfast
• Assess for signs and symptoms of Hypotension
• Instruct patient to have a low fat low sodium diet regimen
• Assess for signs of angioedema
• Monitor BUN and serum creatinine levels
• Monitor for signs of hyperkalemia

3. Generic name: CLopidogrel


Brand name: Norplat
Classification: Anti platelet
Action: Inhibits platelet aggregation by blocking ADP receptors on platelets, preventing
clumping of platelets.
Indications: treatment of patients at risk for ischemic events and peripheral artery
disease, acute coronary syndrome, as a loading dose with aspirin to prevent adverse
cardiac events in coronary stent implantation
Action: B1: Thiamin: Required for the metabolism of carbohydrates and for normal nerve function
B2: Riboflavin:
Required for the metabolism of carbohydrates and amino acids and for healthy mucous membranes, such as those lining the mouth
B6: Pyridoxine: Required for the metabolism of amino acids and fatty acids, for nerve function, for formation of red blood cells and for healthy skin
B12: Cobalamin: Required for maturation of red blood cells, for nerve function, and DNA synthesis
Indication: Indicated to the following diseases, manifesting with a vitamin B deficiency: neuritis; alcohol, toxic, and post infectious polyneuritis; diabetic polio neuropathy; neuralgia;
sciatica central spastic conditions; myasthenia; paresthesia; atherosclerosis; Wernicke’s encephalopathy; vegetative neurosis; dermatitis; neurodermatitis; psoriasis; lupus
erythematodes; furunculosis; stomatitis;
Contraindication: Vitamin B complex should not be used in hypersensitivity to any of the vitamins, containing in the preparation, as well as in patients with 2nd and 3rd degree arterial
hypertension
Side effects: Although the preparation is very well tolerated, in rare cases in predisposed patients itching, urticaria, and Quincke’s edema may appear.
Nursing considerations:
• Make sure patient gets the right dose
• The vitamin should be taken once a day

6. Generic name: Cilostazol


Brand name: Pletal
Classification: Antiplatelet
Dosage: 50mg/tab 1 tab BID PC
Action: Reversibly inhibits platelet aggregation induced by a variety of stimuli including ADP, thrombin, collagen, shear stress, epinephrine, arachidonic acid by inhibiting cAMP
phosphodiesterase III; produces vascular dilation in vascular beds with a specificity for femoral beds; seems to have no effect on renal arteries.
Indication: Reduction of symptoms of intermittent claudication allowing increased walking distance.
Contraindication: Contraindicated with allergy to cilostazol, heart failure of any severity (decreased survival rates have occurred), active bleeding, hemostatic disorders.
Side effects: dizziness, headache, heart failure, tachycardia, palpitations, diarrhea, cough, dyspepsia, peripheral edema, infection, back pain
Nursing considerations:
• Assess for heart failure
• Administer drug on an empty stomach, at least 30 min before or 2 hr after breakfast and dinner
• Encourage patient to avoid use of grape fruit juice
• Establish walking distance to monitor drug effectiveness
• Establish safety precautions to avoid injury and bleeding
• Encourage patient to continue therapy, results may not be seen for 2-4 wks
• Give patient awareness to the side effects of the drug

7. Generic name: Sulodexide


Brand name: Vessel due F
Classification: Anticoagulant, antithrombotics and fibrinolytics
Dosage: 1 tab BID PC
Action: Inhibits coagulation by attacking several sites of the coagulation system. Its effect is dependent on the presence of antithrombin III, an alpha 2- globulin whose
activity is augmented by heparin. The heparin- antithrombin complex inactive factors IXa, Xa, XIa, and XIIa, and prevents thrombin formation. Furthermore, the complex reverses the
effect of already formed thrombin. In high concentrations, heparin also inhibits thrombocyte aggregation.
Indication: Vascular pathologies with thrombotic risk, transient ischemic attacks and Dosage:
cerebrovascular disease, peripheral vascular insufficiency, diabetic retinopathy, MI, Action: Analgesic and antirheumatic effects attributable to aspirin’s ability to inhibit the
retinal vasal thrombosis. synthesis of prostaglandins, important mediators of inflammation. Antipyretic effects are
Contraindication: Hypersensitivity to sulodexide, heparin and heparin like products. not fully understood, but aspirin probably acts in the thermoregulatory center of the
Diathesis and hemorrhagic diseases. hypothalamus to block effects of endogenous pyrogen by inhibiting synthesis of
Side effects: nausea, vomiting, epigastralgia. Pain, burn, hematoma at the site of prostaglandin intermediary. Inhibition of platelet aggregation is attributable to the
injection inhibition of platelet synthesis of thromboxane A2, a potent vasoconstrictor and inducer
Nursing considerations: of platelet aggregation. This effect occurs at low doses and lasts for the life of the
• Assess patients for signs of bleeding and hemorrhage (bleeding platelet (8 days). Higher doses inhibit the synthesis of prostacyclin, a potent vasodilator
gums;nosebleed; unusual bruising; black, tarry stools; hematuria; fall in and inhibitor of platelet aggregation.
hematocrit or blood pressure; guaiac- positive stools). Notify physician if Indication: mild to moderate pain, fever, inflammatory conditions- rheumatic fever,
these occur. rheumatoid arthritis, osteoarthritis, prophylaxis against cataract formation with long-
• Monitor patient for hypersensitivity reactions (chills, fever, urticaria). term use
Report signs to physician Contraindication: Contraindicated with allergy to salicylates os NSAIDs; allergy to
• Subcutaneous: observe injection sites for hematomas, ecchymosis, or tartrazine; hemophilia, bleeding ulcers, hemorrhagic states, blood coagulation defects,
inflammation hypoprothrombinemia, vitamin K deficiency. Use cautiously with impaired renal function;
chickenpox, influenza; children with fever accompanied by dehydration; surgery
• Monitor platelet count every 2-3 days throughout therapy. May cause mild scheduled within 1 wk; pregnancy; lactation.
thrombocytopenia, which appears on the 4th day and resolves despite Side effects: Acute aspirin toxicity, aspirin intolerance, nausea, dyspepsia, heartburn,
continued heparin therapy. epigastric discomfort, anorexia, occult blood loss, hemostatic defects, dizziness,
vomiting, diarrhea, mental confusion
8. Generic name: Insulin lispro and Insulin lispro protamine Nursing considerations:
Brand name: Humalog mix • Assess for hypersensitivity to salicylates or NSAIDs and to tartrazine;
Classification: Antidiabetic hormone hemophilia, bleeding ulcers, hemorrhagic states, blood coagulation
Dosage: 25 12 ‘u’ SQ ac breakfast defects, hypoprothrombinemia, vitamin K deficiency; impaired hepatic
Action: Insulin is a hormone secreted by beta cells of the pancreas that, by receptor- function; impaired renal function; chickenpox, influenza; children with
mediated effects, promotes the storage of the body’s fuels, facilitating the transport of fever accompanied by dehydration; surgery scheduled within 1 wk
metabolites ions (potassium) through cell membranes and stimulating the synthesis of • Give drug with food after meals if GI upset occurs
glycogen from glucose of fats from lipids, and proteins from amino acids. • Give drug with a full glass of water to reduce risk of tablet or capsule
Indication: Diabetes mellitus type1 and Diabetes mellitus type 2 that cannot be lodging in the esophagus
controlled by diet or oral drugs, sever ketoacidosis, hyperkaletomia
• Do not crush, and ensure that patient does not chew SR preparations
Contraindication: Contraindicated with allergy to pork products, history of smoking or
lung disease • Do not use aspirin that has a strong vinegar like odor
Side effects: Hypersensitivity, hypoglycemia, decline in pulmonary • Give patient awareness of the side effects of the drug
Nursing considerations: • Tell client to report possible occurrence of the following:
• Assess if allergic to pork products -ringing of the ears
• Do not give insulin injection concentrated IV; severe anaphylactic -dizziness
reactions can occur -confusion
• Store insulin in a cool place away from direct sunlight. Refrigeration is -abdominal pain
-rapid or difficult breathing
preferred. Do not freeze insulin.
-nausea and vomiting
• Monitor urine or serum glucose levels frequently to determine
-bloody stools
effectiveness of drug and dosage. Patients can learn to adjust insulin
dosage on sliding scale based on test results.
• Monitor insulin needs during times of trauma or severe stress; dosage
adjustment may be needed
• Tell client to avoid alcohol; serious reactions can occur
• Tell client to report if fever, sore throat, vomiting, hypoglycemic reactions
and rash occur.

9. Generic name: Aspirin


Brand name:
Classification: Analgesic, Anti-inflammatory, Antiplatelet, Antipyretic, Antirheumatic,
NSAID, Salicylate