DRUG NAME Brand Name: LANOXIN Generic Name: Digoxin Drug Class: Antiarrhythmics, inotropics

MODE OF ACTION Increases the force of myocardial contraction. Prolongs refractory period of the AV node. Decreases conduction through the SA and AV nodes. Increased cardiac output (positive inotropic effect) and slowing of the heart rate (negative chronotropic effect).

INDICATION Cardiac failure accompanied by atrial fibrillation; management of chronic cardiac failure where systolic dysfunction or ventricular dilatation is dominant; management of certain supraventricular arrhythmias, particularly chronic atrial flutter & fibrillation.

ADVERSE DRUG REACTION CNS disturbances, dizziness; visual disturbances (blurred or yellowish vision); arrhythmia, conduction disturbances, bigeminy, trigeminy, PR prolongation, sinus bradycardia; nausea, vomiting, diarrhea; urticarial or scarlatiniform w/ eosinophilia.

NURSING CONSIDERATION  Monitor apical pulse before administering.  Monitor blood pressure periodically in patients receiving IV dogoxin.  Monitor intake and output ratios and daily weights.  Observe patient for signs and symptoms of toxicity.  Oral preparations can be administered without regard to meals.  Before administering initial loading dose, determine whether patient has taken any digitalis preparations in the preceding 23 wk.

CONTRAINDICATIO N

Intermittent complete heart block or 2nd degree AV block esp if there is a history of Stokes-Adams attacks; arrhythmia caused by cardiac glycoside intoxication, supraventricular arrhythmia caused by Wolff-ParkinsonWhite syndrome; ventricular tachycardia or fibrillation; hypertrophic obstructive cardiomyopathy. Hypersensitivity to other digitalis glycosides.

Generic Name: TELMISARTAN Brand Name: Micardis Drug Class: Angiotensin II Antagonists / Diuretics

Telmisartan (Teli marketed by cadila pharma) is an Angiotensin Receptor Blocker (ARB) that shows high affinity for the angiotensin II type 1 (AT1) receptors, has a long duration of action, and has the longest half-life of any ARB. In addition to blocking the Renin-Angiotensin System (RAS), telmisartan acts as a selective modulator of Peroxisome proliferator-activated receptor gamma (PPAR-γ), a central regulator of insulin and glucose metabolism. It is believed that telmisartan’s dual mode of action may provide protective benefits against the vascular and renal damage caused by diabetes and cardiovascular disease (CVD). Telmisartan has binding affinity 3000 times greater for AT1 than AT2 receptors. Telmisartan also has the longest half life (24

Treatment for essential hypertension. Blocks vasoconstricting.

Telmisartan: Headache, upper respiratory tract infection, dizziness. Hydrochlorothiazide: Anorexia, gastric irritation, muscle spasm, sleep disturbances.

 Monitor client for hypotension after starting drug. Place client supine if hypotension occurs, and give IV normal saline, if needed.  For patient whose renal function may depend on the activity of the rennin angiotensin aldosterone system (such as those with severe heart failure) treatment with ACE inhibitors and angiotensin receptors antagonist has caused oliguria or progressive azotemia and acute renal failure or death.

Pregnancy & lactation. Cholestasis & biliary obstructive disorders. Severe hepatic & renal impairment (CrCl <30 mL/min). Refractory hypokalemia, hypercalcemia.

 Advise patient that antacids can be used while taking drugs unless otherwise directed by prescriber. pulmonary embolism. Short term maintenace of hemostasis & prevention of rebleeding in patients following therapeutic endoscopy for acute bleeding of gastric or duodenal ulcers. By acting specifically on the proton pump. This effect is dose-related up to a daily dose of 20–40 mg and leads to inhibition of gastric acid secretion. nausea. colitis. constipation. thus reducing gastric acidity. Children. flatulence. Nexium(esomeprazole) is a proton pump inhibitor that suppresses gastric acid secretion by specific inhibition of H+/K+ATPase in the gastric parietal cell. Jantoven Drug Class: Anticoagulants. abdominal pain.Generic Name: Esomeprazole Brand Name: Nexium Dug Class: Antacids. diarrhea. Pharmacology: Coumadin and other coumarin anticoagulants act by inhibiting the synthesis of vitamin Kdependent coagulation factors. atrial fibrillation w/ embolization.  Tell the patient to take drug at least 1 hour before a meal. The signs and symptoms will vary according to the  Use cautiously with divertiticulitis. Nexium blocks the final step in acid production. Antiplatelets & Fibrinolytics (Thrombolytics) Anticoagulant. This is a consequence of the anticoagulant effect. or mild or moderate hepatic or renal Anticoagulation is contraindicated in any localized or general physical condition or personal circumstance in which the hazard of hemorrhage might be greater than its potential clinical . Generic Name: Warfarin Brand Names: Coumadin.  Instruct patient to take drug exactly as prescribed. Headache. Antireflux Agents & Antiulcerants hrs) of all angiotensin II type 1 receptor antagonists. Hypersensitivity to substituted benzimidazoles.and mild or moderate hypertension. Treatment of GERD as an alternative to oral therapy in patients when oral therapy is not appropriate. vomiting. Injection site reaction. adjunct in prophylaxis of systemic embolism Potential adverse reactions to Coumadin may include: Hemorrhage from any tissue or organ. The resultant Prophylaxis & treatment of venous thrombosis.

shortness of breath. Therefore. IX. location and degree or extent of the bleeding. Embryopathy characterized by nasal hypoplasia with or without stippled epiphyses (chondrodysplasia punctata) has been reported in pregnant women exposed to warfarin during the 1st trimester. Approximately 97% is bound to albumin within the plasma.  Tell patient to report adverse reactions promptly. there have been reports of birth malformations in children born to mothers who have been treated with warfarin during pregnancy. headache. including dorsal midline dysplasia characterized by agenesis of the corpus callosum. difficult breathing or swallowing. Bleeding during anticoagulant therapy does not always correlate with prothrombin activity (see Treatment under Overdosage). chest. Pharmacokinetics: After oral administration of Coumadin. DandyWalker malformation. Ventral midline dysplasia. An anticoagulant effect generally occurs within 24 hrs. etc. . and maximal plasma concentrations are reached in 1-9 hrs. Necrosis of skin and other tissues (see Warnings). Central nervous system abnormalities also have been reported.  Tell the patient to eat a daily. Bleeding which occurs when the PT is within the therapeutic range warrants diagnostic investigation since it may unmask a previously unsuspected lesion eg.  I. or in conditions that increase risk of hemorrhage. X and II activities. or unexplained shock. the possibility of hemorrhage should be considered in evaluating the condition of any anticoagulated patient with complaints which do not indicate an obvious diagnosis. peak anticoagulant effect after MI. However. also use cautiously in breastfeeding women. benefits eg: Pregnancy: Women who are or may become pregnant because the drug passes through the placental barrier and may cause fatal hemorrhage to the fetus in utero. tumor. with regional or lumbar bock anesthesia. absorption is essentially complete.M administration isn’t recommended.in vivo effect is a sequential depression of Factors VII. Hemorrhagic complications may present as paralysis. with drainage tubes in any orifice. Anticoagulants have no direct effect on an established thrombus. Other adverse reactions are infrequent and disease. ulcer. abdomen. joint or other pain. consistent amount of leafy green vegetable containing vitamin K. Furthermore. unexplained swelling. the goal of anticoagulant treatment is to prevent further extension of the formed clot and prevent secondary thromboembolic complications which may result in serious and possible fatal sequelae. However. and midline cerebellar atrophy. The degree of depression is dependent upon the dosage administered. nor do they reverse ischemic tissue damage. once a thrombus has occurred.

diarrhea. thus producing a smooth. a causal relationship has not been established. long-lasting response curve. characterized by optic atrophy. diaphragmatic hernia. Women of childbearing potential who are candidates for anticoagulant therapy should be carefully . consist of alopecia. systemic cholesterol microembolization. therefore its effects may become more pronounced as daily maintenance doses overlap.may be delayed 72-96 hrs and its duration of action may persist for 4-5 days. fever. single kidney. asplenia. deformities of toes. and other central nervous system abnormalities have been reported in association with 2nd and 3rd trimester exposure. Although rare. urticaria. however. nausea. purple toes syndrome. and eye abnormalities have been observed. reabsorbed and excreted into the urine. hydrocephalus. Priapism has been associated with anticoagulant administration. Spontaneous abortion and stillbirth are known to occur and a higher risk of fetal mortality is associated with the use of warfarin. Coumadin is a potent drug with a half-life of 2½ days. blindness. cranial nerve palsy. cholestatic hepatic injury and hypersensitivity reactions. cardiac defects and congenital heart disease. spina bifida. anencephaly. polydactyly. dermatitis. teratogenic reports following in utero exposure to warfarin include urinary tract anomalies eg. Coumadin is metabolized by hepatic microsomal enzymes to inactive metabolites that are excreted into the bile. and corneal leukoma. abdominal cramping. Mental retardation.

Recent or contemplated surgery of the central nervous system. eye. Hemorrhagic tendencies or blood dyscrasias. cerebrovascular hemorrhage. and the possibility of termination of the pregnancy should be discussed in light of those risks. dissecting aorta. genitourinary or respiratory tracts. Threatened abortion. pericardial effusions and bacterial endocarditis. or traumatic surgery resulting in large open surfaces. she should be apprised of the potential risks to the fetus. If the patient becomes pregnant while taking this drug. pericarditis. aneurysms-cerebral. Bleeding tendencies associated with active ulceration or overt bleeding of the gastrointestinal.evaluated and the indications critically reviewed with the patient. eclampsia and .

 Follow instructions regarding dilution. Inadequate laboratory facilities or unsupervised senility. Miscellaneous: Major regional.  Color in some commercial oral solutions fades with exposure preeclampsia. >Severe renal impairment > severe hemolytic reactions > acute dehydration >heat cramps >hyperkalemia Cautious use in: >cardiac or renal disease.  Also indicated when potassium. lumbar block anesthesia and malignant hypertension.  For hypokalemia  As prophylaxis during treatment with diuretics  To prevent and treat potassium.        renal insufficiency hyperkalemia nausea vomiting irritability muscle weakness difficulty in swallowing  Some patients find it difficult to swallow the large sized KCl tablet. psychosis or lack of patient cooperation.Generic name: Potassium Chloride Brand Name: Kalium Durule Drug Class: Electrolytes and minerals Supplemental potassium in the form of high potassium food or potassium chloride may be able to restore normal potassium levels. systematic acidosis . Administer while patient is sitting up or standing (never in recumbent position) to prevent druginduced esophagus. deficit secondary to diuretics or corticosteroid therapy. Spinal puncture and other diagnostic or therapeutic procedures with potential for uncontrollable bleeding. prolonged diuresis and diabetic acidosis. is depleted by severe vomiting. alcoholism.

Na) and renal function. vomiting. idiopathic oedema. the nephrotic syndrome. paraesthesia. Acute renal insufficiency. hyperkalemia or sensitivity to spironolactone. Body as a whole: asthenia. Isobutylhydrochlorothi azide promotes sodium and water excretion by inhibiting sodium and chloride reabsorption in the kidney tubule. avoid excessive ingestion of food high in potassium or use of salts substitutes. gastrointestinal disturbance.sulfonamidederived medicines. diarrhoea. serum electrolyte s (K. monitor I and O ratios and daily weight. significant impairment of renal function. malaise.  Diuretic effect may be delayed 2-3 days and maximum hypertensive may be delayed 2-3weeks. Psychiatric disorders: impotence. BP. photosensitivity. pruritis. headache. a sodium-retaining. . oedema and ascites of congestive heart failure. fever. Skin and appendages: rash. anuria. The combination of spironolactone and isobutylhydrochlorothi azide provides an effective treatment for many patients who would not respond to either drug alone. dermatitis.Generic Name: Spironolactone Brand Name: Aldazide Drug Class : Diuretics. Metabolic and nutritional disorders: electrolyte disturbances. Nervous system disorders: dizziness.  Take with meals. Gastro-intestinal disorders: abdominal pain. menstrual disorders. thiazide diuretics or to other sulfonamidederived drugs. nausea. Other Antihypertensives Spironolactone promotes diuresis in patients with oedema or ascites. Spironolactone acts in the distal portion of the renal tube by competitive inhibition of aldosterone. anaphylactoid reaction.  Educate to avoid hazardous activity such driving untl response to drug is known. including malignancy. potassium-excreting hormone. Reproductive disorders: breast disorders. Haematological disorders: thrombocytopenia to light but drug effectiveness is reportedly not altered. Essential hypertension. Neoplasm: breast neoplasm. cirrhosis of the liver. The combination results in an additive diuretic effect since both drugs will increase sodium and water excretion by acting in different parts of the renal tubule.

Low blood pressure (faintness. Ped treatment for dyslexia in Hyperkinesia. especially in deficit conditions. vomiting. cortical myoclonus.  Administer the drug in IV form if the client can not take it orally. impaired balance. chest tightness. Ask the patients name Always observe aseptic technique  During: Explain the procedure to the patient/SO. Patients with parasympathetic hypertonia. trouble breathing.upper abdominal pain. After: Cerebral hemorrhage. Symptomatic treatment of the psycho-organic syndrome whose features are memory loss. sedative or neurovegetative activities. recent cranial trauma and their sequelae. somnolence.  Assess allergy to warfarin. alone or in combination. swelling in your face or hands. disorientation. Treatment of cerebrovascular accident in acute and recovery phase. end stage renal disease. It increases the energy output of the brain cell and activates its neurophysiological potentialities. Allergic reaction: Itching or hives. Nausea. Explain what is the general action of the drug to the body. It increases the energy output of the brain cell and activates its neurophysiological potentialities. Slow or fast heart beat. w/ the exception of dizziness of vasomotor or psychic origin.  Prior to:   Wash hands thoroughly. skin & subcutaneous tissue disorders. Pharmacology: Piracetam acts selectively upon the telencephalon by improving its associative function. symptoms and signs of cerebral insufficiency eg. Nootropil is virtually nontoxic and has no stimulating. nervousness.diarrhea. vertigo & associated disorders of balance. aggravated epilepsy. headache.  Do not use rug if the ptient is pregnant (use contraceptives). ataxia.  Document the procedure. memory loss. vomiting. anaphylactoid reaction. vertigo.nausea. wt gain.   . attention disorders & lack of drive. Nootropil is virtually nontoxic and has no stimulating. dizziness.  Monitor closely PT ratio and INR. Pregnancy & lactation. or diarrhea (loose BMs)  Verify the doctor’s order. CNS Drugs & Agents for ADHD Neurovascular enhancer. Pharmacology: Piracetam acts selectively upon the telencephalon by improving its associative function. Generic Name: Piracetam Brand Names: Nootropil Drug Class Nootropics & Neurotonics Treatment of post stroke sequelae ie aphasia. Huntington's chorea. poor concentration. sedative or neurovegetative activities. Gastrointestinal disorders. dizziness). Headache. depression. asthenia. or rash. swelling or tingling in your mouth or throat. especially in deficit conditions. insomnia.Generic name: Citicoline Brand name: Zynapse Drug Class: Neuroprotective.

fall in hematocrit or blood pressure. fever.   . Parenteral: Pain.  Hypersensitivity to sulodexide. Sulodexide differs from heparin by having a longer halflife and a decreased effect on systemic clotting and bleeding. Monitor patient for hypersensitivity reactions (chills. Notify physician if these occur. unusual bruising. heparin.  Observe the patients for possible untoward reaction. hematuria. tarry stools. vomiting. Instruct to take the medication exactly as directed. Pregnancy. As admin of heparin and low molecular wt heparin results in a Antithromb otic. and heparin-like products.combination w/ appropriate measures eg speech therapy. Diathesis. Oral: Nausea. It is hypolipidaemic and antithrombotic and has been administered by mouth and parenterally for peripheral vascular disease and cerebrovascular disease. guaiac-positive stools). urticaria). epigastric pain. burning and haematoma at injection site. Assess patients for signs of bleeding and hemorrhage (bleeding gums. haemorrhagic conditions. nosebleed. Report signs to physician. Antiplatelets & Fibrinolytics (Thrombolytics) See available brands of sulodexide Sulodexide is a heparinoid consisting of 80% fast moving heparin and 20% dermatan sulfate. black. Record the drug after its administration (charting). Monitor platelet  Generic Name: Sulodexide Brand Name: Vessel Due F Drug Class : Anticoagulants. It is also included in topical preparations for local vascular inflammation and soft tissue disorders.

vomiting. CHF. Generic Name: Mannitol Brand name: Osmitrol. Absorption: Small amounts are absorbed from the GI tract. Reduction of high intraocular pressure when the pressure cannot be lowered by other means. Nausea. acute renal failure. metabolic oedema with abnormal capillary fragility. Promotion of diuresis in the prevention or treatment of the oliguric phase of acute renal failure before irreversible renal failure becomes established. 1 mg of sulodexide is equivalent to 10 LSU. blurred vision. tachycardia. dizziness. thrombophloebitis. convulsions. acidosis (with high doses). Distribution: Concentrated in extracellular compartments. Onset: Diuresis: 1-3 hr. Promotion of urinary excretion of toxic materials. It does not penetrate the blood-brain barrier nor the eye.  The cardiovascular status of the patient should be carefully evaluated before rapidly administering mannitol since sudden expansion of the extracellular fluid may lead to fulminating congestive heart failure. chills.release of lipoprotein lipase.  Shift of sodium-free intracellular fluid into the extracellular compartment following mannitol infusion may lower serum sodium concentration and aggravate Pulmonary congestion or oedema. which appears on the 4th day and resolves despite continued heparin therapy. chest pain. anuria due to severe renal disease. urticaria and hypotension or hypertension. Miscellaneous Mannitol increases urinary output by inhibiting tubular reabsorption of water and electrolytes. Duration: Reduction in intracerebral pressure: 1. headache. Reduction of intracranial pressure and brain mass. skin necrosis. It raises the osmotic pressure of the plasma allowing water to be drawn out of body tissues. May cause mild thrombocytope nia. the activity of sulodexide is expressed as Lipoprotein lipase Releasing Units (LSU).5-6 hr. Metabolism: Minimal hepatic metabolism. severe dehydration. fever. count every 2-3 days throughout therapy. Resctisol Drug Class : Diuretics. intracranial bleeding. Edema Fluid and electrolyte imbalance. Reduction in intracerebral pressure: around 15 min. thirst. .

converted to glycogen.  When exposed to low temperatures.  Electrolyte-free mannitol solutions should not be given conjointly with blood. If it is essential that blood be given simultaneously. mannitol administration may obscure and intensify inadequate hydration or hypovolemia. Excretion: Urine via the kidneys (unchanged drug). at least 20 mEq of sodium chloride should be added to each liter of mannitol solution to avoid pseudoagglutin ation.  By sustaining diuresis. the container should be . pre-existing hyponatremia. If crystals are observed. solutions of mannitol may crystalize.

the administration set should include a filter. Do not infuse mannitol solution if crystals are present. pulmonary Essential hypertension. Discard unused portion. See NOTE under how supplied. Do not administer Mannitol 25% if the Fliptop vial seal is not intact.warmed to redissolve.  Take apical Diseases that constrict the respiratory tract (bronchial asthma. CHF. Generic Name: Carvedilol Brand Name: Dilatrend Drug Class: Antihypertensive Decreased heart rate and pulse pressure. When infusing 20% or 25% mannitol concentrations.     Fatigue Dizziness Bradycardia CHF  Monitor BP and pulse prior and throughout therapy.  Do not administer unless solution is clear and container is undamaged. chronic bronchitis. . then cooled to body temperature before administering.

rheumatic. nausea. Assessment & Drug Effects  Assess patients who develop severe diarrhea and vomiting for dehydration and electrolyte imbalance. diarrhoea. dental. Pregnancy. if less than 50 bpm. . Patient & Family Education  Discontinue emphysema). vomiting or abdominal pain  Headache  Dizziness  Drowsiness  Skin rashes  Visual disturbances  Retention of water in the body tissues (fluid retention).  Lab tests: With long-term therapy (not recommended) obtain periodic complete blood counts.  Disturbances of the gut such as indigestion. withhold medication and notify physician. uterine tube contraction and ovarian cyclic AMP and progesterone formation in animal models.  Diabetics should closely monitor blood sugar. metabolic acidosis. or simultaneous MAOI therapy. The pharmacological activity of Ponstan may be due in part to its ability to inhibit the synthesis of prostaglandins.    Pulmonary edema Hypotension Constipation Impotence pulse. swelling of the laryngeal mucosa. too slow heart rate. MI w/ complications. regular exercise. sinus node syndrome. traumatic. Pharmacokinetics and Metabolism: Mefenamic acid is well absorbed from the Relief of pain including muscular. allergic rhinitis. Generic name: Mefenamic acid Brand Name: Ponstan Drug Class: Anti-pyretic or antipyretic and anti-inflammatory analgesics Ponstan has analgesic. and lifestyle modification. severe liver dysfunction. 2nd & 3rd degree AV block. Children <14 yr. and kidney function tests. SA block. shock. anti-inflammatory and anti-pyretic properties. post-op & postpartum pain. constipation.  Advise patient for proper diet. Ponstan also inhibits the action of exogenous prostaglandins on uterine muscle. Also for the relief of primary dysmenorrhea. Hct and Hgb. resulting in swelling (oedema)  Awareness of your heartbeat (palpitations)  Ulceration of the stomach or Ulceration in the upper or lower intestinal tract. headache & in childn w/ fever & juvenile RA.

hematemesis.  Administer Severe sodium and water depletion. ecchymoses. Over 50% of the dose may be recovered in the urine as unchanged drug or conjugated metabolites. sore throat. Monitor blood glucose for loss of glycemic control if diabetic. tongue and throat (angioedema) or narrowing of the airways (bronchospasm)  Kidney. Rashes. intestines  Bleeding from the stomach or intestines  Inflammation of the pancreas (pancreatitis)  Allergic reactions such as severe skin rashes. Mefenamic acid is extensively bound to plasma proteins. dark stools. Contact physician. or malaise occur. or rash occur and do not use again. Generic Name: Furosemide Furosemide inhibits reabsorption of Na and  Oral.gastro-intestinal tract. IV: Fluid and electrolyte imbalance. . Peak plasma concentrations occur in about 2 to 4 hours. with no drug accumulation. Notify physician if persistent GI discomfort. Plasma levels are proportional to dose. following multiple doses. Do not breast feed while taking this drug without consulting physician. epistaxis. Do not drive or engage in potentially hazardous activities until response to drug is known. liver or blood disorders     drug promptly if diarrhea. swelling of the lips. fever. It may cause dizziness and drowsiness. with a half-life of 2 to 4 hours.

glycosuria. hepatic dysfunction. anuria or renal failure.  Give early in the day so that increased urination will not disturb sleep. nausea. It increases plasma-renin levels and secondary hyperaldosteronism may result. hypokalaemia. Hyperglycaemia.  Have plenty of water when taking this drug. tonsillitis. hypotension. Furosemide reduces BP in hypertensives as well as in normotensives. Fever & pain associated w/ common childhood disorders. It also reduces pulmonary oedema before diuresis has set in. ototoxicity. sudden death and cardiac arrest. dizziness. blurred vision. may be prolonged in neonates and renal and hepatic impairment. Absorption: Fairly rapidly absorbed from the GI tract (oral). Excretion: Via urine (as unchanged). Toxicity may result from  Instruct the patient to take with meals. Hypokalaemia and magnesium depletion can cause cardiac arrhythmias. with food or milk to prevent GI upset. hypersensitivity to sulphonamides and furosemide. diarrhoea. Addison's disease. upper resp tract infections post- Paracetamol has rarely been found to produce any adverse effects in therapeutic doses and is usually well tolerated by aspirin-sensitive patients. Pyrexia of unknown origin. cirrhosis. Bone marrow depression (rare). Potentially Fatal: Rarely.Drug Class : Diuretics See available brands of furosemide Generic Name: Paracetamol Brand Name: Aeknil Drug Class : Analgesics (NonOpioid) & Antipyretics chloride mainly in the medullary portion of the ascending Loop of Henle. Distribution: Crosses the placenta and enters breast milk. headache. .  Avoid IV use if oral use is at all possible. Proteinbinding: 99%. Nephropathy. hyponatraemia. Antipyretic.  Reduce dosage if given with other antihyperte nsives. 2 hr (elimination half-life). Excretion of potassium and ammonia is also increased while uric acid excretion is reduced. readjust dosage gradually as BP responds. analgesic. precomatose states associated with liver cirrhosis. Pharmacology: Paracetamol produces analgesia by raising the threshold of the pain center in the brain and by obstructing Edema associated with CHF. renal disease  IV: Acute pulmonary edema  Oral: Hypertensio n photosensitivity.

impulses at the painmediating chemoreceptors. Following oral administration. methemoglobinaemia which can result in cyanosis. thrombocytopenia and leucopenia. hematological toxicity eg. cold. The drug produces antipyresis by an action on the hypothalamus. muscle pain. Pharmacokinetics: Paracetamol is rapidly and almost completely absorbed from the gastrointestinal tract. immunization reactions. Approximately 85% of a dose of paracetamol is excreted in the urine within 24 hrs after administration. a single toxic dose of the drug or from chronic ingestion. and on longterm use. peak plasma levels are attained in 10 min to 1 hr and the half-life is 75 min to 3 hrs. renal damage can result. sinusitis. arthritis & toothache. Prevention of febrile convulsion. heat dissipation is increased as a result of vasodilation and increased peripheral blood flow. mercapturate and unchanged drug. The following adverse reactions have been reported: Skin eruption. Distribution of paracetamol to most body tissues and fluids is both rapid and uniform. . Paracetamol is excreted in the urine primarily as the glucuronide and smaller amounts as the sulfate. after tonsillectomy & other conditions. Headache.

Generic Name: NALBUPHINE HYDROCHLORIDE Brand Name: Nubain Class : Anaesthetics . Nalbuphine HCl has the effect of lowering the cardiac work load and can be used immediately in myocardial infarction (use with caution where emesis is involved).  Monitor V/S & I&O.  Document indications for therapy. Infrequently sweating. type/ onset of symptoms & anticipated. Sedation. GI upsets.Local & General. Pre-op analgesia. 10 mg of which is comparable in analgesic potency to 810 mg of morphine sulfate. whether administered IV. Post-op somatic & visceral pain. The t½ of nalbuphine is 5 hrs. as a supplement to balanced anesth. allergic reactions. .  Note general client condition. Hemodynamic studies in patients with severe arteriosclerotic heart Relief of moderate to severe pain. SC or IM. dry mouth. dizziness. headache. The onset of action occurs within 2-3 min after IV administration of nalbuphine HCl and in <10 min following SC or IM injection. Clinical experience suggests that in some patients. surgical anesth. analgesia may be longer lasting than from comparable doses of morphine. Patients who are hypersensitive to nalbuphine HCl. effects having been observed in acute and chronic pain for 3-8 hrs. for obstet analgesia during labor & relief of pain following MI. Analgesics (Opioid) Pharmacology: Nalbuphine HCl is a potent analgesic. vertigo.

 Assess location. Generic Name: Cilostazol Brand Name: Pletal Drug Class : Anticoagulants. selective inhibitor of phosphodiesterase-III (PDE-III). characteristics.changes reveal that nalbuphine HCl has circulatory effects similar to those of morphine ie. ecchymosis and skin rash. diarrhoea. . store at 15-30 C. Increase in cAMP in platelets and blood vessels leads to inhibition of platelet aggregation and vasodilation. Cilostazol also inhibits adenosine uptake into cells. which augments the cAMP-elevating effect of PDE-III inhibition. infection. Absorption: Absorbed from the GI tract after oral admin. rhinitis. Antiplatelets & Fibrinolytics (Thrombolytics) Cilostazol is a reversible.  List drugs prescribed to ensure none interact unfavorably. left ventricular end diastolic pressure and cardiac work. abnormal stools. cardiac index. thereby suppressing cyclic adenosine monophosphate (cAMP) degradation. a minimal decrease in oxygen consumption. known predisposition to bleeding. During:  Administer PO medication with meals & with a Heart failure. other cardiac arrhythmias. history of ventricular arrhythmias. nausea. extent of abdominal pain. Nalbuphine HCl antagonist activity is ¼ as potent as nalorphine and approximately 1/40 that of naloxone. severe renal impairment. Peripheral vascular disease Headache. Before:  Do not expose premixed single-dose product to excessive heat. note blood in emesis. stool/ gastric aspirate. pharyngitis. dizziness. vomiting. moderate to severe hepatic impairment. chest pain. palpitations. pain. peripheral oedema. QT interval prolongation.

Klorvess. IV: Pain or phloebitis.  Monitor V/S & I&O. Metabolism: Extensively metabolised hepatically by CYP450 isoenzymes. Kaon CL. remainder excreted in the faece Generic Name: Potassium Chloride Brand Name: K-Dur. .  Monitor plasma potassium levels  Monitoring of acid-base balance. K-Tab. diarrhoea and abdominal cramps. Ten-K. Absorption: Well absorbed from the Prevention of hypokalaemia GI ulceration (sometimes with haemorrhage and perforation or with late formation of strictures) following the use of enteric-coated K chloride preparation. type/ onset of symptoms & anticipated. severe renal or adrenal insufficiency. potassium levels. Excretion: Mainly excreted in the urine. Slow-K. and ECG is recommended. a dose of 300 mg PO/ IV g 12 hr. may be necessary. vomiting.  In renal dysfunction. brain and skeletal muscle. It plays an active role in the conduction of nerve impulses in the heart. Oral: Nausea. acid-base balance.  For IM use. give undiluted. hyperkalaemia. Klotrix. mainly CYP3A4. snack at bedtime. After:  Note general client condition. cardiac toxicity. carbohydrate metabolism and gastric secretion. K-Lor. Hyperchloraemia. KLyte CL Drug Class : Electrolytes Potassium chloride is a major cation of the intracellular fluid.Distribution: 95-98% bound to plasma proteins. maintenance of normal renal function.  Document indications for therapy. contraction of cardiac skeletal and smooth muscles.

Excretion: Mainly via the urine with small amounts via the sweat and feces. Distribution: Active transport mechanism allows K chloride to enter cells from the extracellular fluid. .upper GI tract.

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