b.

Drug Study Name of Date classification Dose/freq/route Mechanism Drug ordered of Action Ciprofloxacin 08/06/10 fluoroquinolone 500 mg 1 tab Inhibits antibiotic PO bacterial DNA synthesis, mainly by blocking DNA gyrase; Bactericidal Specific Indication Mild to moderate UTI Contraindication Nursing precaution Contraindicated Headache, Advise in patient restlessness , patient to sensitive to tremor, drink fluoroquinolones dizziness, plenty of fatigue, fluids to Use cautiously drowsiness, reduce in patient with insomnia, risk of CNS disorder depression, urine such as severe lightheadedness, crystals cerebral seizure atherosclerorsis CV: Instruct of seizure thombophlebitis, patient to disorder edema, chest avoid pain caffeine GU: while Crystalluria taking this Hematology: drug Leukopenia, because neutropenia it’s potential for increase caffeine effects Side effects

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Name of Drug Amlodipin e

Date ordered 08/06/1 0

classificatio n calcium channel blocker

Dose/freq/rout e 1 gram OD

Mechanis m of Action Inhibits calcium ion influx across cardiac and smooth muscle clls. Thus decreasing myocardial contractilit y and oxygen demand; also dilates coronary arteies and arterioles

Specific Indication Hypertensio n

Contraindicatio n

Side effects

Nursing precaution Monitor blood pressure frequently during initiation of therapy. Because drg induced vasodilatio n has a gradual onset of acute hypotnsion is rare Caution patient to continue taking drug, even when feeling better

Contraindicated CNS: headache, in patients to somnolence, drug fatigue, dizziness, Use cautiously lightheadedness in patient , paresthesia receiving other CV:Edema, peripheral flushing, vasodilations palpitation especially with GI: nausea, svere aortic abdominal pain stenosis and in GU: sexual those wit heart difficulties failure

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Name of Drug Lactulose

Date ordered 08/04/10

Classification Dose/freq/ route laxative 30 ml OD

Mechanism of Action Produces an osmotic effect in colon; resulting distention promotes peristalsis. Also decreases ammonia, probably as result of bacterial degradation which lowers the pH of colon contents

Specific Indication Constipation

Contraindication Side effects Contraindicated GI: in patient in a abdominal low galactose cramps, diet belching, diarrhea, Use cautiously gaseous in patient with distention, diabetes flatulence, mellitus nausea and vomiting

Nursing precaution To minimize sweet taste, dilute with water or fruit juices Monitor sodium level of hypernatremia, especially when giving in high doses to treat hepatic encephalopathy

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Name of drug Losartan

Date ordered 08/01/10

classification Dose/ freq/ route angiotensin 1 tab OD II receptor antagonist

Mechanism of Action

Specific Indication

Contraindication Side effects

Nursing precaution Monitor patients blood pressure closely to evaluate effectiveness to therapy Tell patient to avoid salt substitutes these produce ,ay contain potassium which can cause increase potassium level in patient taking Losartan

Inhibits Hypertension Contraindicated vasoconstriction in patient and aldosterone hypertensive to secreting action drugof angiotensin II breastfeeding is by blocking not angiotensin II recommended receptor on the during Losartan surface of therapy vascular smooth muscle Use cautiously to other tissue in patient with cells impaired renal or hepatic function

CNS: dizziness, asthenia, fatigue, headache, insomnia CV : edema, chest pain EENT : nasal congestion, sinusitis, pharyngitis, sinus disorder GI : Abdominal pain, nausea, diarhhea, dyspepsia

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Name of Drug Senna concentrate

Date ordered 08/01/10

Classification Dose/ freq/ route laxative 2 tabs @ H.S

Mechanism of Action Unknown. Stimulant laxative that increases peristalsis, probably by direct effect on smooth muscle of the intestine. It’s thought to either irritate the musculature or stimulate the colonic intramural plexus.

Specific Indication Acute constipation preparation for bowel examination

Contraindication Side effects Contraindicated in patient with ulcerative bowel lesion, fecal impaction, intestinal obstruction, intestinal perforation GI: nausea, vomiting, diarrhea, loss of normal bowel function with excessive use, abdominal cramps GU: redpink discoloration in alkaline urine, yellow brown discoloration acidic uine Metabolic: electrolyte imbalance such as hypokalemia

Nursing precaution Before giving drug for constipation, determine whether patient has adequate fluid intake, exercise and diet Teach patient about dietary sources of bulk, including bran and other cereals, fresh fruit and vegetable

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Name of Drug Captopril

Date ordered 08/01/10

Classification Dose/ freq/ route Ace Inhibitor 25mg I tab every 6 hours

Mechanism of action

Specific indication

Contraindication Side effects

Nursing precaution Instruct patient to take drug 1 hour before meals; food in the GI tract may reduce absorption Inform patient that lightheadedness is possible, especially during first few days of therapy Monitor patient’s blood pressure and pulse rate frequently

Thought to Hypertension Contraindicated inhibit ACE, in patient preventing hypersensitive conversion of to drug or other angiotnsin I to ACE inhibitors angiotensin II, a potent Use cautiously vasoconstrictor. in patient with Reduced impaired renal formation of function or Angiotensin II serious decreases autoimmune peripheral disease arterial resitance, decreasing aldosterone secretion, which reduces sodium and water retention and lowers blood pressure

CNS: dizziness, fainting, headache, malaise, fatigue, fever CV: Tachycardia, hypotension, angina pectoris GI: Abdominal pain. Anorexia, constipation, diarrhea, dry mouth, nausea and vomiting

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Name of Drug Fluimucil

Date ordered 08/03/10

Classificatio n Nacetylcystein e

Dose/ freq/ route 600mg tab + ½ glass water OD

Mechanism of action It does so by hydrolyzing glycosaminoglyca ns, tending to break down/lower the viscosity of mucin-containing body secretions/compo nents.

Specific indication Treatment of abnormal, sticky, or thick mucus secretions in various lung problems (eg, chronic emphysema, bronchitis, asthmatic bronchitis, pneumonia, during anesthesia, following surgery or various lung tests).

Contraindicatio n

Side effects changes in taste drowsine ss mouth sores nausea, vomiting runny nose

Nursing precaution Acetylcyste ine oral solution is taken directly by mouth. The solution should be diluted with a soft drink or fruit juice prior to taking it. Regular cola will often mask the odor of the solution best (the acetylcyste ine solution will often smell like sulfur or rotten eggs).

Contraindicate d in patient hypersensitive to this drug

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