Lukban, Elaine Cherizdee A4A DRUG NAME Atorvastatin (Lipitor) MECHANISM OF ACTION INDICATION ADVERSE REACTION CNS: headache,

asthenia, insomnia CV: peripheral edema EENT: pharyngitis, rhinitis, sinusitis GI: abdominal pain, constipation, anorexia, diarrhea, nausea, dyspepsia, flatulence GU: UTI Musculoskeletal: rhabdomyolysis, arthrisis, arthralgia, myalgia Respiratory: bronchitis Skin: rash Other: allergic reactions, flulike syndrome, infection CONTRAINDICATION NURSING CONSIDERATION - Patient should follow a standard cholesterol lowering diet before & during therapy - Before treatment, assess patient for underlying causes for hypercholesterolemia & obtain a baseline lipid profile. Obtain periodic liver function test results & lipid levels before starting treatment & at 6 & 12 weeks after initiation, or after an increase in dosage & periodically thereafter - Watch for signs of myositis

Inhibits HMGCoA reductase, an early (and rate Antilipemics limiting) step in cholesterol biosynthesis.

- In patients with clinically evident coronary heart disease, to reduce the risk of nonfatal MI, fatal & nonfatal strokes, angina heart failure, & revascularization procedures - Adjunct to diet to reduce LDL, total cholesterol, apolipoprotein B, & triglyceride levels & to increase HDL levels in patients with primary hypercholesterolemia & mixed dyslipidemia - Alone or as adjunct to lipid lowering treatments, such as LDL apheresis, to reduce total & LDL cholesterol in patients with homozygous familial

- Contraindicated in patients hypersensitive to drug & in those with active liver disease or unexplained persistent elevations of transminase levels. - Contraindicated in pregnant & breast-feeding women & in women of childbearing age - Use cautiously in patients with history of liver disease or heavy alcohol use - Withhold or stop drug in patients at risk for renal failure caused by rhabdomyolysis resulting from trauma; in serious, acute conditions that suggest myopathy; & in major surgery, severe acute infection, hypotension, uncontrolled seizures, or severe metabolic, endocrine, or

Lukban, Elaine Cherizdee A4A hypercholesterolemia electrolyte disorders. - Limit use in children to those older than age 9 with homozygous familial hypercholesterolemia

DRUG NAME

MECHANISM OF ACTION Citicoline is an interneuronal communication enhancer. It increases the neurotransmission levels because it favors the synthesis and production speed of dopamine in the striatum, acting then as a dopaminergic agonist thru the inhibition of tyrosine hydroxylase.

INDICATION

ADVERSE REACTION - Fleeting and discrete hypotension effect, increased parasympathetic affects, low blood pressure - Itching or hives, swelling in face or hands, chest tightness, tingling in mouth and throat - Body temperature elevation - Restlessness - Headaches,

CONTRAINDICATION

NURSING CONSIDERATION - Citicoline may be taken with or without food. Take it with or between meals. - The supplement should not be taken in the late afternoon or at night because it can cause difficulty sleeping. - Women who are pregnant or trying to become pregnant should consult with their doctor before taking the supplements. Not enough is known about the use of Citicoline during pregnancy and breastfeeding. Stay on the safe side and avoid use.

Citicoline (Somazine) Neurotonics, Nootropics

- CVD in acute & recovery phase, symptoms & signs of cerebral insufficiency (dizziness, memory loss, poor concentration, disorientation, recent cranial trauma & their sequelae.)

- Any allergy or hypersensitivity to the drug - Hypertonia of the parasympathetic nervous system - Use cautiously for pregnancy and lactation - Conscious use for patient with renal and hepatic damage - Parasympathetic hypertonia

Lukban, Elaine Cherizdee A4A Nausea and vomiting - Diarrhea - Low or high blood pressure, Tachycardia - Sleeping troubles or insomnia - Blurred vision - Chest pains - Special attention should be paid for administration in the neonate, premature and children. - Contact the physician immediately if allergic reaction such as hives, rash, or itching, swelling in your face or hands, mouth or throat, chest tightness or trouble breathing are experienced. - Citicoline therapy should be started within 24 hours of a stroke. The physician will prescribe the correct dosage and the length of time it should be taken for a medical condition. Somazine must not be administered along with medicaments containing meclophenoxate

Lukban, Elaine Cherizdee A4A Name and Classification Nicardipine (Cardene) Antihypertensives , Antiarrythmias, Antianginals, Vascular Headache, Suppresants Indication Alone or with other agents in the management of hypertension, angina pectoris, and vasospastic (Prinzmetals)an gina. Mechanism of Action Inhibits the transport of calcium into myocardial and vascular smooth muscle cells, resulting in inhibiton of excitationcontraction coupling and subsequent contraction Adverse Effect CNS: dizziness, nervousness, psychiatric disturbances, headache, weakness, shakiness, anxiety, drowsiness, abnormal dreams EENT: Blurred vision, disturbed equilibrium and tinnitus Resp: Shortness of breath, dyspnea, congestion, cough, epistaxis. CV: Peripheral edema, palpitation, hypotension, syncope, arrythmias, chest pain GI: nausea, constipation, diarrhea, abnormal liver function studies, dyspepsia, vomiting, dry mouth, anorexia. Contraindicatio n Contraindicated in: Hypersensitivity, Sick sinus syndrome, Second and third AV block, Blood pressure <90mmHg, CHF, Severe ventricular dysfunction, Recent pulmonary congestion Nursing Management To transfer from IV nicardipine infusion to oral therapy with other hypertensive, start oral therapy simultaneously with discontinuation of nicardipine infusion. If transfering to oral nicardipine therapy, administer first dose of a three times a day regimen 1 hr prior to discontinuation of infusion Dosage adjustments of nicardipine should be made no more frequently than every 3 days.

Lukban, Elaine Cherizdee A4A Name and Classification Omeprazole (Prilosec) Indication Mechanism of Action Binds to an enzyme on gastric parietal cells in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen Adverse Effect CNS: weakness, dizziness, headache, somnolence, fatigue CV: chest pain GI: abdominal pain, acid regurgitation, constipation, diarrhea, flatulence, nausea, vomiting Derm: rash, itching May be administered concurrently with antacids Instruct patient to take medication as directed for the full course of therapy, even if feeling better. May cause occasional drowsiness or dizziness. Advise pt. To avoid alcohol Advise pt. To report onset of black tarry stool, diarrhea, abdominal pain, or persistent headache to the physician promptly Contraindication Contraindicated Hypersensitivity Nursing Management Administer doses before meals, preferably in the morning. Capsules should be swallowed whole; do not crush, open, or chew

Management of gastroesophage al reflux disease that has not Gastrointestinal responded to (antiulcer), Gastric conventional ulcer pump therapy with his inhibitor tamine H2receptor blocking agents Short term management of active duodenal ulcers Treatment of gastric hypersecretory condition associated with Zollinger Ellison syndrome, systemic mastocytosis or multiple endocrine adenomas

Lukban, Elaine Cherizdee A4A DRUG NAME INDICATION MECHANISM OF ACTION Potassium is the predominant action within cells. I ntracellular sodium content is relatively low. In extracellular fluid, sodium predominates and actively transports or pumps sodium out and potassium into cells to maintain these concentration gradients. The intracellular to extracellular potassium gradients are necessary for the conduction of nerve impulses in such specialized tissues as the heart, brain, and skeletal muscle, and for the maintenance of normal renal function and acidbase balance. High intracellular potassium concentrations are necessary for numerous cellular metabolic processes. . ADVERSE EFFECT Diarrhea nausea stomach pain, discomfort, or gas, mild vomiting CONTRAINDICATI ON Renal insufficiency, hyperkalemia, untreated Addison's disease, constriction of the esophagus &/or obstructive changes in the alimentary tract. NURSING MANGEMENT appropriate, discontinuing blood products, foods and medication that contain potassium, as well as ACE inhibitors, beta blocking agents, nonsteroidal antiinflammatory drugs (NSAIDs), heparin, cyclosporine, and potassium-sparing diuretics.

Kalium durule (Potassium Chloride)

Hypokalemia. Prophylaxis during treatment w/ diuretics.

electrolyte replenishe Antihypokalemic

Lukban, Elaine Cherizdee A4A DRUG NAME INDICATION MECHANISM OF ACTION ADVERSE EFFECT CONTRAINDICATION NURSING MANGEMENT

ketorolac tromethamine

Short term management of pain (up to 5days) Ophthalmic relief of ocular itching due to seasonal conductivities and relief of postoperative inflammation after cataract surgery

(Antipyretic, nonopioid analgesic, NSAID)

Anti inflammation and analgesic activity inhibits prostaglandin and leukotrine synthesis.

CNS: Contraindicated with Headache,dizziness, significant renal sommolence,insomia impairment,during labor and Dermatologic: delivery,lactation, rash, pruritus, patient wearing soft sweating contact lenses,aspirin allergy,cocurrent use GI: nausea of NSAID; active dyspepsia, GI pain, peptic ulcer disease or Diarrhea, vomiting, GI bleeding Constipation, hypersensitivity to flatulence, ketoralac. Incomplete hemostasis, high risk Resp: of bleeding, Dyspnea, hemoptysis., pharyngitis, bronchospasm, rhinitis Other: Peripheral edema, Anaphylactoid reaction.

Renal inpairment,impaired hearing allegies,heptic CV, aGI condition,lactation, Pregnancy Physical: Skin color and lesion orientation, reflex, opthalmologis and audiometric evaluation, peripheral sensation, edema,BP, adventious sounds,liver evaluation, clotting times.

Lukban, Elaine Cherizdee A4A INDICATION GENERIC NAME: Mannitol BRAND NAME: Osmitol CLASSIFICATIO N: Osmotic Diuretic Acute oliguric renal failure, toxic renal overdose, edema, ICP, IOP MECHANISH OF ACTION Increases osmolarity of glomenular filtrate which raises osmotic pressure of fluid in renal tubules; decreases in reabsorption of water, electrolytes, increases in urinary output, sodium, chloride excretion. ADVERSE REACTION Dehydration, anuria, intracranial bleeding, headache, blurred vision, nausea & vomiting, volume expansion, chest pain, pulmonary edema, thrist, tachycardia, hypokalemia, chronic renal failure CONTRAINDICATI ON Susceptibility dehydration, anuria due to severe renal disease, Severe pulmonary congestion or frank pulmonary edema, Active intracranial bleeding except during craniotomy. NURSING MANAGEMENT - Monitor V/S, I & O. - Monitor CVP. - Assess for pulmonary artery pressure. - Assess for s/sx of dehydration. - Assess for electrolyte imbalance/ deficit. - Check weight, renal function, fluid balance, and serum and urine sodium and potassium levels daily. - For ICP- assess for neurologic status and intracranial pressure. - For IOP- assess for elevating eye pain and decrease visual acuity.

Lukban, Elaine Cherizdee A4A INDICATION BRAND NAME: Azithromycin URTI, LRTI, skin & soft tissue infections, otitis media, STD & uncomplicated genital infections Community acquired pneumonia caused by susceptible organisms inc. Leogionella pneumophilia, pelvic inflammatory disease caused by susceptible organism MECHANISH OF ACTION Binds to the P site of 50s bacterial ribosomal subunits thereby inhibiting protein synthesis; bactericidal or bacteriostatic depending on concentration with much greater spectrum of activity than erythromycin. ADVERSE REACTION Arthralgia, edema, urticaria, angioedema, Arrhythmias, hypotension, Anor exia, constipation, dyspepsia, flatulence, pancreatitis, oral candidiasis, pyloric stenosis, Interstitial nephritis and acute renal failure, vaginitis. Thrombocytopenia CONTRAINDICATION Hypersensitivity to azithromycin or any of the macrolides Impaired hepatic function, NURSING MANAGEMENT - Assess patient for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and throughout therapy. - First dose may be given before receiving results. - Observe for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). - Discontinue azithromycin at first sign of rash; may be lifethreatening. Stevens-Johnson syndrome or toxic epidermal necrolysis may develop. Treat symptomatically; may recur once treatment is stopped.

GENERIC NAME: Zithromax

CLASSIFICATIO N: Anti-infectives

Lukban, Elaine Cherizdee A4A Drug Name/Classific ation Lactulose G.I tract drugs Laxatives Indication Mechanism of action Produces an osmotic effect in colon; resulting distention promotes peristalsis. Also decreases ammonia, probably as a result of bacterial degradation, which lowers the pH of colon contents. Adverse Effect Contraindication Nursing Considerations Monitor sodium level for hypernatremia, especially when giving higher doses to treat hepatic encephalopathy Monitor mental status and potassium levels when giving to patients with hepatic encephalopathy Replace fluid loss

Constipation To prevent and treat hepatic encephalopathy, including hepatic precoma and coma in patients with severe hepatic disease

G.I: abdominal cramps, belching, diarrhea, flatulence, gaseous distention, nausea & vomiting.

Contraindicated in patients on a low galactose diet. Use cautiously in patients with diabetes mellitus

Lukban, Elaine Cherizdee A4A

Drug Name/Classificati on
Losartan (Cozaar)

Indication

Mechanism of Adverse Effect action

Inhibits vasoconstrictive and aldosterone secreting action of angiotensin II by blocking angiotensin II receptor on the surface of vascular smooth muscle and other tissue cells CNS: Dizziness, asthenia, fatigue, headache, insomnia CV: chest pain, edema EENT: nasal congestion, sinusitis, pharyngitis G.I: Abdominal pain, nausea, diarrhea Musculoskeletal: muscle cramps, myalgia, back or leg pain Respiratory: Cough, upper respiratory infection Other: Angioedema

Contraindicatio n
Contraindicated in patients hypertensive to drug. Breastfeeding isn t recommended during losartan therapy Use cautiously in patients with impaired renal or hepatic function

Nursing Consideration s
Drug can be used alone or with other hypertensives Monitor patient s blood pressure closely to evaluate effectiveness of therapy. Monitor patients who are also taking diuretics for symptomatic hypotension Regularly asses patient s renal function

Hypertension Nephropathy in type 2 diabetec patients To reduce risk of stroke in patients with hypertension and left ventricular hypertrophy

CV system drugs Antihypertensives

Lukban, Elaine Cherizdee A4A

DRUG NAME CLASSIFICATION Generic name: clindamycin clindamycin hydrochloride clindamycin palmitate hydrochloride Brand name: Cleocin, Dalacin C (CAN) , Cleocin Pediatric, Cleocin Phosphat e, Cleocin T, Cleocin Vaginal Ovules, ClindaDerm (CAN), Clindagel, ClindaMax, Clindets Drug class Lincosamide antibiotic

INDICATION

MECHANISM OF ACTION

ADVERSE EFFECT

CONTRAINDICAT ION Systemic administration: Contraindicated with allergy to clindamycin, history of asthma or other allergies, tartrazine (in 75- and 150mg capsules); hepatic or renal dysfunction; lactation.

NURSING MANAGEMENT Systemic administration: Culture infection before therapy. Administer oral drug with a full glass of water or with food to prevent esophageal irritation. Do not give IM injections of more than 600 mg; inject deep into large muscle to avoid serious problems. Do not use for minor bacterial or viral infections. Monitor LFTs and renal function tests, and blood counts with prolonged therapy. Topical

Systemic administration: Serious infections caused by susceptible strains of anaerobes, streptococci, staphylococci, pne umococci; reserve use for penicillinallergic patients or when penicillin is inappropriate; less toxic antibiotics (erythromycin) should be considered Parenteral: Treatment of septicemia caused by staphylococci, streptococci; acute hematogeno us osteomyelitis; adjunct to surgical treatment of chronic bone and joint infections due to susceptible

Inhibits protein Systemic synthesis in administration: susceptible bacteria, CV: Hypotension, cardiac causing cell death. arrest (with rapid IV infusion)

GI: Severe colitis, including pseudo membranous coli tis, nausea, vomiting, diarrhea, abdominal pain, esophagitis, anorexia, jaundice, Use cautiously in liver function newborns and changes infants due to benzyl alcohol Hematologic: Neu content; tropenia, leukopeni associated with a, agranulocytosis, gasping syndrome. eosinophilia Topical Hypersensitivity: dermatologic Rashes, urticaria t solution, vaginal o anaphylactoid re preparation: actions Contraindicated with allergy Local: Pain to clindamycin or li following ncomycin.

Lukban, Elaine Cherizdee A4A organisms; do not use to treat meningitis; does not cross the bloodbrain barrier. Topical dermatologic solution: Treatment of acne vulgaris Vaginal preparation: Treatment of bacterial vaginosis injection, induratio n and sterile abscess after IM injection, thrombop hlebitis after IV use Topical dermatologic solution: CNS: Fatigue, headache Dermatologic: Co ntact dermatitis, dryness, gramnegative folliculitis GI: Pseudomemb ranous colitis, dia rrhea, bloody diarrhea; abdominal pain, sore throat GU: Urinary frequency Vaginal preparation GU: Cervicitis, vag initis, vulvar irritatio n Use caution with history of regional enteritis or ulcerative colitis; history of antibioticassociated colitis. dermatologic administration: Keep solution away from eyes, mouth and abraded skin or mucous membranes; alcohol base will cause stinging. Shake well before use. Keep cool tap water available to bathe eye, mucous membranes, abraded skin inadvertently contacted by drug solution. Vaginal preparation: Give intravaginally, preferably at hs.

Lukban, Elaine Cherizdee A4A

DRUG NAME CLASSIFICATION INDICATION MECHANISM OF ACTION ADVERSE EFFECT CONTRAINDICATIO N NURSING MANAGEMENT

Generic name: digoxin Brand name: Digitek, Lanoxicaps, Lanoxin, NovoDigoxin (CAN) Drug class Cardiac glycoside Cardiotonic

CHF Atrial fibrillation

Increases intracellular calcium and allows more calcium to enter the myocardial cell during depolarization via a sodiumpotassium pump mechanism; this increases force of contraction (positive inotropic e ffect), increases renal perfusion (seen as diuretic effect in patients with CHF), decreases heart rate (negative chronotro pic effect), and decreases AV node conduction velocity.

CNS: Headache, weakness, drowsiness, visual disturbances, mental status change CV: Arrhythmias GI: GI upset, anorexia

Contraindicated with allergy to digitalis preparations, ventricular tachycardia, ventricular fibrillation, heart block, sick sinus syndrome, IHSS, acute MI, renal insufficiency and electrolyte abnormalities + (decreased K , decreased Mg2+, increased Ca 2+ ). Use cautiously with pregnancy and lactation.

WARNING: Monitor apical pulse for 1 min before administering; hold dose if pulse < 60 in adult or < 90 in infant; retake pulse in 1 hr. If adult pulse remains < 60 or infant < 90, hold drug and notifyprescriber. Note any change from baseline rhythm or rate. Take care to differentiate Lanoxicaps from Lanoxi n; dosage is very different Check dosage and preparation carefully. Avoid IM injections, which may be very painful. Follow diluting instructions carefully, and use diluted solution promptly. Avoid giving with meals; this will delay absorption. Have emergency equipment ready; have K+ salts, lidocaine, phenytoin, atropine, cardiac monitor readily available in case toxicity develops. WARNING: Monitor for therapeutic drug levels: 0.52 ng/mL.

Lukban, Elaine Cherizdee A4A Drug Name/ Classification CEFUROXIME (ceftin) Indication Mechanism of Action Bactericidal: inhibits synthesis of bacterial cell wall, causing cell death. Adverse Effect Thrombophlebitis (IV site); pain, burning, cellulitis (IM site); superinfections, positive Coombs test. GI: diarrhea, nausea, antibioticassociated colitis. Skin: Rash, pruritus, urticaria Contraindication Hypersensitivity to cephalosporins and related antibiotics; pregnancy (category B), lactation Nursing Management Determine history of hypersensitivityreactions tocephalosporins,penicillins, and historyof allergies, particularly to drugs, before therapy is initiated. Inspect IM and IV injection sites frequently for signs of phlebitis. Report onset of loose stools or diarrhea. Although Pseudomembranous colitis. Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes.

Infections caused by susceptible organisms in the lower respiratory Antibiotic tract, urinary Cephalosporin tract, skin and (second skin structures; generation) also used for treatment of meningitis, gonorrhea and otitis media and for perioperative prophylaxis (e.g. open-heart surgery), early Lyme disease.

Lukban, Elaine Cherizdee A4A

Drug Name/ Classification CEFTRIAXONE SODIUM (Rocephin) Indication -lower respiratory infections caused by S. Pneumoniae, S. Aureus. -acute bacterial otitis media. -UTI -gonorrhea -intra-abdominal infections -sin and skin structure infections -septicemia -bone and joint infection -meningitis Mechanism of Action Bactericidal: inhibits synthesis of bacterial cell wall, causing cell death. Adverse Effect CNS: headache, dizziness, lethargy, paresthesias GI: nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence, pseudomembranous colitis, hepatotoxicity, GU: nephrotoxicity Hematologic: bone marrow depression- decreased WBC count, decreased platelet, decreased hematocrit. Hypersensitivity: ranging from rash to fever to anaphylaxis Local: Pain, abscess at injection site. Contraindicatio n -Contraindicated with allergy to cephalosporins or penicillins -Use cautiously with renal failure, lactation and pregnancy. Nursing Management Assess: -History: Hepatic and renal impairment, lactation, pregnancy -Physical: skin status, renal function test. Intervention: -culture infection and arrange for sensitivity test during therapy. -check manufacturer s details. Stability of reconstituted and diluted solution depends on diluents, concentration, and types of container. -protect drug from light. -do not mix with ceftriaxone with other antimicrobial drugs -have Vit. K available in case of hypoprothrobemia occurs. -discontinue if hypersensitivity reaction occurs. Health teaching -avoid alcohol while taking this drug and for 3 days after because severe reactions may occur.

Antibiotic Cephalosporin (third generation)

Lukban, Elaine Cherizdee A4A

DRUG NAME/ CLASSIFICATION

SODIUM BICARBONATE

INDICATION
-Barium Enema Colonoscopy preparation of bowel for procedure -Fecal Impaction -Operative procedure on large intestine, Colorectalpreparation of bowel for procedure

MEACHANISM OF ACTION
Polyethylene glycol acts an osmotic agent to produce a laxative effect. Along with the electrolyte solution, practically no net absorption or excretion of ions or water occurs.

ADVERSE EFFECTS
Common Gastrointestinal: Anal irritation, Bloating symptom, Epigastric fullness, Nausea, stomach cramps, Vomiting Serious -Dermatologic: Urticaria -Immunologic: Anaphylaxis(rare)

CONTRAINDIC ATION
-bowel perforation -gastric retention gastrointestinal obstruction -ileus -toxic colitis -toxic megacolon

NURSING MANAGEMENT
-Advise patient to report urticaria, rhinorrhea, or dermatitis. -Patient should not eat solid food for at least 2 hour (preferably 3 to 4h) before taking this preparation. - Encourage patient to drink each portion rapidly, as this method is preferred over drinking small amounts continuously. The solution may be more palatable if chilled first.

Class: -Laxative -Hyperosmotic

Lukban, Elaine Cherizdee A4A

DRUG NAME/ CLASSIFICATION

AMLODIPINE (Norvasc)

INDICATION
Disorder of cardiovascular system; -Hypertension -Stable Angina -Variant Angina

MEACHANISM OF ACTION
Amlodipine is a dihydropyridine calcium antagonist (calcium ion antagonist or slowchannel blocker) that inhibits the transmembrane influx of calcium ions into vascular smooth muscle and cardiac muscle. Experimental data suggest that amlodipine binds to both dihydropyridine and nondihydropyridine binding sites. The contractile processes of cardiac muscle and vascular smooth muscle are dependent upon the movement of extracellular calcium ions into these cells through specific ion channels.

ADVERSE EFFECTS
- Very often: peripheral edema ,fatigue - Often: dizziness; palpitations; muscle-, stomach- or headache; dyspepsia; nausea - Sometimes: blood disorders, development of breasts in men (gynecomastia), impotence, depression, insomnia, tachycardia, gingival enlargement - Rarely: erratic behavior, hepatitis, jaundice - Very rarely: hyperglycemia, tremor, Stevens-Johnson syndrome

CONTRAINDICATIO N
Known sensitivity to amlodipine

NURSING MANAGEMENT
-Instruct patient to report signs/symptoms of exacerbation of angina or myocardial infarction with initiation and increase in dose. Patients with severe cardiovascular disease have an increased risk. -Advise patient there are multiple significant drug-drug interactions for this drug. Consult healthcare professional prior to new drug use (including otc and herbal drugs). -Instruct patient to take a missed dose as soon as possible, but if it has been more than 12 hours since the dose was missed, skip the dose.

Class: -Calcium Channel Blocker -Cardiovascular Agent -Dihydropyridine