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moa: decrease blood glucose by transport of glucose into the cells and the conve
rsion of glucose toglycoden indirectly increase blood pyruvate and lactate, decr
ease phosphate and pottassium.
I: type 2 DM non insulin dependent which cannot be controlled by diet.
CI:hypoglycemia,insulinomia, hypersensitivity reactions
SE: lypodystrophy, insulin resistance,redness, itching, hives, swelling, tempora
ry visual impairment.
N:assess for hypoglycemic reactions
monitor glycosylated HgB to identify treatment effectiveness
monitor urine ketones during illness
assess for any adverse reactions.
moa: selectively inhibits HMG-COA reductase, which converts HMG-CoA to mevalonat
e,a precursor of sterols. lowers cholecterol and lipoprotien levels.
i:to treat hypercholesterolemia
CI:active liver disease, breastfeeding mothers,
SE:GI disturbances,headache, myalgia,asthenia, myopathy,cholestatic jaundice, pe
ripheral neuropathy
N: monitor cholesterol level before therapy and reassess regularly.
assess nutrition an ddietary habits
monitor bowel pattern daily diarrhea may be a problem.
moa: blocks ADP receptors which prevent fibrinogen binding at that site and ther
e by reduce the possibility of platelet adhesion and aggregation
i:reduction of atherosclerotic events in patients with atherosclerosis documente
d by recent stroke.
CI:hypersensitivity, severe liver impairment, active pathological bleeding, pept
ic ulcer
SE: gi bleeding, purpura, bruising, hematoma, epistaxis, hematuria
n:assess for symptoms of stroke during treatment.
monitor signs of bleeding
monitor liver function studies:AST, ALT, bilirubin
4.clexane, enoxaparin
moa:accelerates formation of antithrombin and deactivates thrombin, preventing c
onvertion of fibrinogen to fibrin.
i: treatment and prophylaxis of venous thromboembolism and to prevent clotting
during extracorporeal circulation.
CI: condition of high risk of uncontrollable hemorrhage including major bleeding
SSE:hemorrhage, thrombocytopenia, local reaction such as pain, hematoma mild irr
itation following subcutaneous injection.
n: obtain istory of coagulation parameters before starting therapy.
monitor drug effectiveness by evaluating signs and symptoms of pulmonary embolis
assess for any signs of bleeding
5.adalat, nifedipine
moa: inhibits calcium ion reflux across cell membrane during cardiac depolarizat
ion, produces relaxation of coronary vascular smooth muscle and peripheralvascul
ar smooth muscle, dilates coronary vaascular arteries, indrease myocardial oxyge
n delivery in patients with vasopastic angina.
i:treatment of vasopastic angina, hypertension.
ci:cardiovascular shock, combination with rifampicin, severe aortic stenosis, se
vere hypotension
se:dizziness, flushing, headache, hypotension, peripheral edema, tachycardia, an
d palpitations.
n: use caution in severe hepatic impairement and severe aortic stenosis.
monitor pulse and blood pressure before starting therapy.
assess therapeutic reactions and adverse effects.
6.calci-aid, calcium carbonate
moa: decreases total acid load of gi tract, increases esophageal sphinchter tone
, strengthens gastric mucosal barrier and reduce pepsin activity by elevating ga
stric pH
i:antacid, calcium suppliment, hyper phosphatemia, hypertention in pregnancy, tr
eatment of hypocalcemia
CI: hypercalcemia, hypercalciuria, bone tumors, sevre renal failure
SE: constipation, flatulence, diarrhea, hypercalcemia, alkalosis, renal dysfunct
ion, acid rebound
n:assess adverse reaction:constipation, constipation, flatulence, diarrhea
assess for hypercalcemia: headache, nausea, vomiting, confusion
7.esomeprazole, nexium
moa: inhibit proton pump in gastric parietal cells effectively blocking the fina
l steps in acid production ,there by reducing gastric acidity.
i:erosive reflux esophagitis, prevents relapse of healed esophagitis, syptomatic
treatment of GERD.
CI:hypersensitvity to esomeprazole.
se: headache, abdominal pain, diarrhea,flatulence, nausea and vomiting, constipa
n:assess hepatic function because drug is extensively metabolize in the liver.
monitor for adverse reactions.
adminster one hour before meals.