Brand name: Fluimucil

Generic name: Acetylcysteine

Indication:
Treatment of respiratory affections characterized by thick and viscoushypersecretions: acute bronchitis, chronic bronch
itis and its exacerbations; pulmonaryemphysema, mucoviscidosis and bronchiectasis.
Drug Classification:
Therapeutic category: Mucolytic agent
Mechanism of Action:
Exerts mucolytic action through its free sulfhydryl group which
opensup the disulfide bonds in the mucoproteins thus lowering mucous viscosity. The exactmechanism of action in
acetaminophen toxicity is unknown. It is thought to act by providing substrate for conjugation with the toxic
metabolite.
Dosage:
Adults:
1 sachet of Acetylcysteine 200 mg or 2 sachets of Acetylcysteine100 mg, 2-3 times a day1 Acetylcysteine 600
mg effervescent tablet daily ( preferably in the evening)For the prevention of exacerbation, the use of FLUIMUCIL 200
mg sachets is recommended.
Children:
Aged up to 2 years: 1 sachet of 200 mg daily or 2 sachets of 100 mg daily.3-7 years: 1 sachet of 200 mg twice daily or
2 sachets of 100 mg twice a day.
The duration of treatment should be 5-10 days in acute phase, whereas it may be continued in the chronic state for
several months, according to the advice of physician.
Special Precaution:
Use with caution in patients > 60 years of age. Use with caution in patients with High blood pressure, ischemic heart
disease, diabetes,
increased intraocular pressure, GI or GU obstruction, asthma, thyroid disease, or prostatic hypertrophy. Notrecommen
ded for use in children.
Pregnancy risk category B
Adverse Effects:
Hypersensitivity reactions have been reported in patients receiving acetylcysteine, including bronchospasm,
angioedema, rashes and pruritus, may occur. Other adverse effects reported include nausea and vomiting, fever,
syncope, sweating, arthralgia, blurred vision, disturbances of liver function.
Contraindication:
MAO inhibitor therapy within 14 days initiating therapy; severehypertension; severe. Coronary artery disease, hyperse
nsitivity to pseudoedephrine, acrivastine or any component; renal impairment.
Form:
Solution, as Sodium: 10%; 20%
Nursing Responsibilities:
Monitor effectiveness of therapy and advent of adverse/allergic effects. Instruct patient in appropriate use and adverse
effects to report.
Brand Name: Carnicor
Generic Name: L-carnitine
Indications:
Chronic myocardial ischemia, cardiac failure, angina pectoris, arrhythmia, acute myocardial ischemia.
Drug Classification:
Cardiac Drugs
Mechanism of Action:
Facilitates the transport of fatty acids into cellular mitochondria. The fatty acids are then used to produce energy.
Dosage:
Chronic myocardial ischemia, cardiac failure Tab 2-3 tab tid. Inj 1 g bid-tid IV(slowly over 2-3 min) or IM. Angina
pectoris, arrhythmia tab 2 tab tid. Inj 1 g bid IV (slowly over 2-3 min) or IM, acute myocardial ischemia.2 g bid-tid
IV(slowly over 2-3 min) or IM. Soln 50-100mg/kg body wt.
Special Precaution:
Standard assays for mutagenicity indicate that L-carnitine is not mutagenic. Reproductive studies have been
performed in rats and rabbits at doses up to 3.8times the human doses used for the treatment of primary and
secondary L-carnitine deficiency on the basis of surface area and have revealed no evidence of impaired fertility or
harm to the fetus due to L-carnitine. However, there are no adequate and well-controlled studies in pregnant women.
Because animal reproduction studies are not always predictive of human response, supplemental L-carnitine should be
used by pregnant women only if clearly indicated and only under medical supervision. It is not known whether Lcarnitine is excreted in human milk. Supplemental L-carnitine is not advised for nursing mothers.
Pregnancy Risk: B
Adverse Reaction:
Nausea, Vomiting, cramps, diarrhea, body odor.

Contraindications:
None Known
Form: Tablet 330 mg
Nursing Responsibilities:
Monitor patients tolerance during the 1st week of therapy and after increasing dosage.
Caution patient not to share drug with others.
May give enteral liquid alone or dissolved in drinks or liquid food.
Do not refrigerate solution.
Brand Name: Neobloc
Generic Name: Metropolol tartrate
Indications:
Hypertension and chronic angina pectoris
Drug Classification:
Anti-hypertensive drug, Beta-blocker
Mechanism of Action:
A selective beta blocker that selectively blocks beta 1 receptors, decreases cardiac output, peripheral resistance and
cardiac oxygen consumption and depresses rennin secretion.
Dosage:
Adult-initially 100mg daily, may increase at weekly interval to max.400mg/day/ Maintenance 100-400mg/day.
Special Precaution:
Avoid abrupt withdrawal. Diabetes, 1st trimester of pregnancy
Pregnancy Risk: C, D in 2nd and 3rd trimesters
Adverse Reaction:
GI and sleep pattern disturbances headache, dizziness, and weakness.
Contraindications:
Heart block> 1st degree, AV block II and III, cardiogenic shock, overt cardiac failure, sinus, bradycardia, bronchospastic
disease.
Form:
Tablets- 100mg, 200mg. Injection-1mg/ 1 ml in 5-ml ampules,
Nursing Responsibilities:
Check for the patients apical pulse before giving the medication; if pulse is slower do not give the drug.
In diabetic patients, monitor the glucose level closely because the drug masks common sign and symptoms of
hypoglycemia.
Monitor the BP frequently, the drug masks common signs and symptoms of shock.
Beta blockers may mask tachycardia caused by hyperthyroidism.
When therapy is stopped, reduce dose gradually for 1-2 weeks.
Instruct patient to take drug exactly as prescribed.
Caution patient to avoid tasks requiring mental alertness until response to therapy has been established.
Instruct patient not to stop drug suddenly.
Drug is not advised for breastfeeding women.
What is pravastatin?
Pravastatin is in a group of drugs called HMG CoA reductase inhibitors, or "statins." It reduces levels of "bad"
cholesterol (low-density lipoprotein, or LDL) and triglycerides in the blood, while increasing levels of "good" cholesterol
(high-density lipoprotein, or HDL).
Pravastatin is used to lower cholesterol and triglycerides (types of fat) in the blood.
Pravastatin is also used to lower the risk of stroke, heart attack, and other heart complications in people with or
without coronary heart disease or other risk factors.
Pravastatin is used in adults and children who are at least 8 years old.
Pravastatin
Dosage
Adult: PO 10-40 mg/day at bedtime, adjust at 4-wkly intervals if needed. Max: 40 mg/day.
Administration
May be taken with or without food.
Contraindications
Hypersensitivity; active liver disease; childn <8 yr. Pregnancy, lactation.
Special Precautions
Severe intercurrent illness increases risk of myopathy, rhabdomyolysis and renal failure; stop pravastatin during
illness. Severe renal impairment, monitor regularly renal function and creatinine kinase. Women of childbearing
potential, use adequate contraception.
Adverse Drug Reactions

GI symptoms, headache, insomnia, chest pain, rash, fatigue, dizziness, myalgia, hypersensitivity, anaphylaxis,
angioedema, rhabdomyolysis, renal failure, hepatitis, alopoecia, paraesthesia, impotence, gynaecomastia.
Mechanism of Action
Pravastatin inhibits HMG-CoA reductase, the enzyme which catalyses the rate-limiting step in cholesterol biosynthesis.
It reduces conc of total cholesterol and LDL (LDL) cholesterol and triglyceride. It produces an increase in high-density
lipoprotein (HDL) cholesterol and it increases hepatic cholesterol uptake from blood.
Generic Name: Calcium Gluconate
Brand Name: Kalcinate
Classifications: fluid and electrolytic and water balance agent; replacement solution
Pregnancy Category: B
Availability
500 mg, 650 mg, 975 mg, 1 gm tablets; 10% injection
Actions
Calcium is an essential element for regulating the excitation threshold of nerves and muscles, for blood clotting
mechanisms, cardiac function (rhythm, tonicity, and contractility), maintenance of renal function, for body skeleton
and teeth. Also plays a role in regulating storage and release of neurotransmitters and hormones; regulating amino
acid uptake and absorption of vitamin B12, gastrin secretion, and in maintaining structural and functional integrity of
cell membranes and capillaries. Calcium gluconate acts like digitalis on the heart, increasing cardiac muscle tone and
force of systolic contractions (positive inotropic effect).
Therapeutic effects
Rapidly and effectively restores serum calcium levels in acute hypocalcemia of various origins and effective cardiac
stabilizer under conditions of hyperkalemia or resuscitation.
Uses
Negative calcium balance (as in neonatal tetany, hypoparathyroidism, vitamin D deficiency, alkalosis). Also to
overcome cardiac toxicity of hyperkalemia, for cardiopulmonary resuscitation, to prevent hypocalcemia during
transfusion of citrated blood. Also as antidote for magnesium sulfate, for acute symptoms of lead colic, to decrease
capillary permeability in sensitivity reactions, and to relieve muscle cramps from insect bites or stings. Oral calcium
may be used to maintain normal calcium balance during pregnancy, lactation, and childhood growth and to prevent
primary osteoporosis. Also in osteoporosis, osteomalacia, chronic hypoparathyroidism, rickets, and as adjunct in
treatment of myasthenia gravis and Eaton-Lambert syndrome.
Contraindications
Ventricular fibrillation, metastatic bone disease, injection into myocardium; administration by SC or IM routes; renal
calculi, hypercalcemia, predisposition to hypercalcemia (hyperparathyroidism, certain malignancies); pregnancy
(category B).
Cautious use
Digitalized patients, renal or cardiac insufficiency, sarcoidosis, history of lithiasis, immobilized patients; lactation.
Generic name:
Levofloxacin
Brand name:
Levan
Classification:
Antibiotic, Fluoroquinolone
Therapeutic actions:
Bactericidal: Interferes with DNA by inhibiting DNA synase replication insusceptible gram-negative and gram-positive
bacteria, preventing cell reproduction.
Indications:
Treatment of adults with community-acquired pneumonia, acute maxillary sinusitis caused by susceptible bacteria
Treatment of acute exacerbation of chronic bronchitis caused by susceptible bacteria
Treatment of complicated and uncomplicated skin and skin structure infections caused by susceptible bacteria
Treatment of complicated and uncomplicated UTIs and acute pyelonephritis caused by susceptible bacteria
Treatment of chronic bacterial prostatitis due to Escherichia coli, Enterococcus faecalis, Staphylococcus species
Treatment of nosocomial pneumonia due to methicillin-sensitive Staphylococcus aureus, Pseudomonas strains,
Serratia species, Escherichia coli, Klebsiella species, Haemophilus influenzae, Streptococcus pneumoniae
Contraindications and cautions:
Contraindicated with allergy to fluoroquinolones, lactation.
Use cautiously with renal dysfunction, seizures, pregnancy

What is Arimidex?

Arimidex (anastrozole) lowers estrogen levels in postmenopausal women, which may slow the growth of certain types
of breast tumors that need estrogen to grow in the body.
Arimidex is used to treat breast cancer in postmenopausal women. It is often given to women whose cancer has
progressed even after taking tamoxifen (Nolvadex, Soltamox).
Arimidex may also be used for purposes not listed in this medication guide.
Indications for ARIMIDEX:
In postmenopausal women: adjuvant treatment of hormone receptor-positive early breast cancer; first-line treatment
of hormone receptor-positive or unknown locally advanced or metastatic breast cancer; advanced breast cancer with
disease progression after tamoxifen therapy.
Mechanism of Action: Anastrozole selectively inhibits aromatase. The principal source of circulating estrogen
(primarily estradiol) is conversion of adrenally-generated androstenedione to estrone by aromatase in peripheral
tissues. Therefore, aromatase inhibition leads to a decrease in serum and tumor concentration of estrogen, leading to
a decreased tumor mass or delayed progression of tumor growth in some women. Anastrozole has no detectable effect
on synthesis of adrenal corticosteroids, aldosterone, and thyroid hormone.
Anastrozole may cause side effects. Tell your doctor if any of these symptoms are severe or do not go
away:
Weakness, headache, hot flashes, sweating, stomach pain, nausea, vomiting, loss of appetite, constipation,
diarrhea, heartburn, weight gain, joint, bone, or muscle pain, breast pain, mood changes, depression, difficulty
falling asleep or staying asleep, nervousness, dizziness, vaginal bleeding, vaginal dryness or irritation, pain,
burning, or tingling in the hands or feet, dry mouth, hair thinning

Drug Name
LEVOFLOXACIN
Brand name
Levaquin
Classification
Pharmacologic class:
Fluoroquinolone
Therapeutic class:
Anti-infectives

Action
Inhibits bacterial
DNA gyrase and
prevents
DNA
replication,
transcription,
repair,
and
recombination in
susceptible
bacteria.

Side Effects
CNS:
encephalopathy,
seizures,
dizziness, insomnia, pain, headache,
paresthesia
CV:
chest
pains,
palpitations,
vasodilation
GI:
pseudomembranous
colitis,
abdominal pain, constipation, pain,
diarrhea, dyspepsia, flatulence, nausea,
vomiting
GU: vaginitis
HEMATOLOGIC:
lymphopenia,
eosinophilia, hemolytic anemia
METABOLIC: hypoglycemia
MUSCULOSKELETAL: back pain,
tendon rupture
RESPIRATORY: allergic pneumonitis
SKIN: erythema multiforme, StevenJohnson syndrome, photosensitivity ,
pruritus, rash
OTHER: anaphylaxis, multisystem
organ failure, hypersensitivity reaction

Nursing Consideration
1. If patient experiences symptoms of
excessive CNS stimulation, stop the
drug and notify physician. Begin
seizure precautions.
2. Patients with acute hypersensitivity
reactions may need treatment with
epinephrine, oxygen, IV fluids,
antihistamines, corticosteroids and
airway management.
3. Drug may cause abnormal ECG.
4. Obtain specimen for culture and
sensitivity.
5. Monitor for glucose level and renal,
hepatic and hematopoietic blood
studies.
6. This can cause pseudomembranous
colitis. If diarrhea occurs stop the
drug and notify the physician.