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Patients Medication List Drug/ Dose Classification

Route

Freq.

Times Given

Mechanism of Action

Patient Rational

Side Effects

Nursing Implications

Med Pass Supplement Nutritional Supplement Lactulose, Cephulac/ Chronulac Gastrointestinal Agent, hyperosmotic laxative Namenda Mematine Anti-Alzheimers agent

60 ml

PO

TID

100 1300 2100

Provides calories and protein without reducing appetite for meals

10 gm/ 15 ml

PO

1 Daily

1000

Acidifies colon contents, osmotic effect of organic acids causes laxative action

Used to administer medications and supplement nutrition Constipatio n

Can cause upset stomach and allergic reactions, nausea, rashes, flushing, sweating & headaches Diarrhea

Determine if pt is allergic to ingredients, record amount consumed as percentage

Safe to give ? Yes

Effects are seen in 24-48 hours, ensure patient does not self-medicate with another laxative because of slow onset, notify Dr. if diarrhea persists for more than 24 hours, could be sign of overdoes and need for med adjustment

Yes

10 mg TAB

PO

1 daily

2200

100 mg Quetiapine Apotex (Seroquel) Antipsychotic 25 mg Quetiapine Apotex (Seroquel)

PO

1 Daily

2200

Binds to CNS receptor sites, prevents binding of glutamate, and excitatory neurotransmitter, decreases symptoms of dementia, does not slow progression, cognitive enhancement, does not cure disease. Serves as an antagonist of dopamine and serotonin. Also antagonizes histamine H1 receptors and Alpha1 Adrenergic receptors. Serves as an antagonist of dopamine and serotonin. Also antagonizes histamine H1 receptors and Alpha1 Adrenergic receptors.

Alzheimer s Disease, Dementia

Dizziness, fatique, headache, sedation, hypertension, rash, urinary frequency

Assess cognitive function (memory, attention, reasoning, language, ability to perform simple tasks). Check for improvement in cognitive function after admin. Review contraindications, warnings, and interactions. Focus on severe renal impairment.

Yes

Alzheimer s Disease, Dementia

Neuroleptic Malignant Syndrome, Seizures, dizziness, weight gain

Monitor mental status & mood changes (mood, ideation, delusions, hallucinations, behavior) Assess for suicidal tendencies. Monitor BP and pulse. Observe patient carefully when admin medication to ensure is swallowed and not hoarded. Monitor mental status (mood, ideation, delusions, hallucinations, behavior) Monitor mood changes. Assess for suicidal tendencies. Monitor BP and pulse. Observe patient carefully when admin medication to ensure is swallowed and not hoarded. Monitor for side effects.

Yes

PO

1 Daily

1000

Alzheimer s Disease, Dementia

Neuroleptic Malignant Syndrome, Seizures, dizziness, weight gain

Yes

Patients Medication List Drug/Classification Dose

Route

Freq.

Times Given 1000 2200

Mechanism of Action

Patient Rational Alzheimers Disease, Dementia

Side Effects

Nursing Implications

3 mg Rivastigmine Sun (Exelon) Cholinesterase inhibitor

PO

BID

Centrally acting, selective, long-acting reversible cholinesterase inhibitor, causes elevated acetylcholine levels in the cortex which slows the neuronal degradation that occurs in Alzheimers disease.

25 mg Spironolactone Mut (aldactone) Electrolyte and water balance agent, potassium sparing diuretic

PO

1 Daily (hold for systolic BP <120 record BP per policy)

1000

Diuretic agent that promotes sodium and chloride excretion without concomitant loss of potassium

Hypertension, CHF, hepatic cirrhosis

Insomnia, fatigue, dizziness, confusion, ataxia, insomnia, somnolence, tremor, agitation, depression, anxiety, abnormal thinking, syncope, rash, flushing purpura, nausea, vomiting, diarrhea, anorexia, dyspepsia, abnormal pain, flatulence, constipation Lethargy, mental confusion, fatigue, abdominal cramps, nausea, vomiting, fluid and electrolyte imbalance

Determine if patient has allergy to rivastigmine, pregnancy, lactation, sick sinus syndrome, GI bleeding, seizures, asthma, COPD, Asses for orientation, affect, BP, Pulse, abdominal exam, renal and liver function tests

Safe to give? Yes

PO Trazodone tab barr Desyrel Antidepressant

1 Daily

2200

Alters the effect of serotonin in the CNS

Dementia, Alzheimers Disease

drowsiness, confusion, dizziness, fatigue, hallucinations, headache, insomnia, nightmares, slurred speech, syncope, weakness, blurred vision, tinnitus, hypotension, arrhythmias, chest pain, hypertension, palpitations, tachycardia, dry mouth, altered taste, constipation, diarrhea, excess salivation, flatulence, nausea, vomiting, rash, myalgia, termor

Check blood pressure before initiation of therapy, monitor serum electrolytes and assess for signs of fluid electrolyte imbalance, monitor daily I&O, check for edema, weight pt under standard conditions and daily once therapy commences, observe for and report immediately onset of mental changes Monitor BP and pulse rate before and during initial therapy. Monitor ECGs in patients with pre-existing cardiac disease, check for improvement of sleep, mood and behavior, focus on hypersensitivity, recovery period if pt has had a MI, and concurrent electroconvulsive therapy.

Yes

Yes

Patients Medication List Drug/Classification Dose

Route

Freq.

Times Given 1000 2200

Mechanism of Action

Patient Rational Dementia, Alzheimers type with disturbance of conduct

Side Effects

Nursing Implications

Valproic Acid QU (250 mg/ 5 ml) Antiepileptic agent

125 mg/ 2.5 ml

BID

Mechanism of action not understood, antiepileptic activity may be related to the metabolism of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA)

20 mg Omeprazole cap apot Prilosec Antisecretory agent Proton pump inhibitor

PO

1 Daily

Gastric acid pump inhibitor, suppresses gastric acid secretion by specific inhibition of the hydrogen potassium ATPase enzyme system at the secretory surface of the gastric parietal cells, blocks the final step of acid production

Acid reflux, GERD

Prozac Fluoxetine Teva Antidepressants

20 mg CAP

PO

1 Daily

1000

Selective serotoninreuptake inhibitor (SSRI)

Dementia, Alzheimers Disease

Sedation, tremor, emotional upset, depression, psychosis, aggression, hyperactivity, behavioral deterioration, weakness, transient increases in hair loss, rash, petechiae, nausea, vomiting, diarrhea, indigestion, abd cramps, constipation, anorexia with weight loss, increases appetite Headache, dizziness, asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, dream abnormalities, rash, inflammation, urticarial, pruritus, alopecia, dry skin, diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophy, URI symptoms, cough, epistaxis, back pain, fever Seizures, anxiety, h/a, tremor, drowsiness, insomnia, diarrhea, nervousness, sexual dysfunction, excessive sweating, pruritus

Give drug with food if GI upset occurs, assess for hypersensitivity to valproic acid, hepatic dysfunction, pregnancy, lacation, weight, skin color, lesions, orientation, affect, reflexes, bowel sounds, normal output, CBC and differential, bleeding time tests, hepatic function tests, serum ammonia level, exocrine pancreatic function tests, EEG Assess for hypersensitivity to omeprazole or any of its other components, pregnancy, lacation, skin lesions, Temperature, reflexes, affect, urinary output, abdominal examination, respiratory auscultation. Administer before meals.

Safe to give? Yes

Yes

Use cautiously in severe hepatic or renal impairment, patients with concurrent chronic illness or multiple drug therapy

Yes