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GENERIC NAME/ BRAND NAME Generic Name: Tramadol Dosage: 50 mg/tab; 1 tab T.I.D.

Dosage in Adult: Patients who require rapid analgesic effect: 50-100 mg P.O. every 4-6 hours; do not exceed 400 mg/day.

CLASSIFICATION

INDICATIONS Relief of moderate to moderately severe pain Relief of moderate to severe chronic pain in adults who need around-theclock treatment for extended periods Unlabeled uses: premature ejaculation; restless leg syndrome

CONTRAINDICATIONS Contraindicated with allergy to tramadol or opioids or acute intoxication with alcohol, opioids, or psychoactive drugs Use cautiously with seizures; concomitant use of CNS depressants, MAOIs, SSRIs, TCAs, renal impairment, hepatic impairment

SIDE EFFECTS CNS: Headache, dizziness, sedation, vertigo, confusion, dreamy, sweating, anxiety, seizures CV: hypotension, tachycardia, bradycardia DERMATOLOGIC: Sweating, pruritus, rash Pallor, urticaria GI: Nausea, Vomiting, dry mouth, constipation, flatulence OTHER: Potential for abuse, anaphylactic reactions

NURSING INTERVENTIONS Control environment, (temperature, lighting) if sweating or CNS effects occur Limit use in patients with past or present history of addiction to or dependence on opioids. Advise patient to report if severe nausea, dizziness, severe constipation occurs.

Classification: Analg esic (centrally-acting) Mechanism of Action: Binds to mu-opioid receptors and inhibits the reuptake of norepinephrine and serotonin; causes many effects similar to opioids dizziness, somnolence, nausea, constipation- but does not have the respiratory depressant effects.

GENERIC NAME/ BRAND NAME Generic Name: Ferrous sulfate Dosage: 325 mg/tab; 1 tab T.I.D. Dosage in Adult: Replacement in deficiency states; 90 mg300 mg/day (6mg/kg/day) P.O. for approximately 6-10 months may be required.

CLASSIFICATION

INDICATIONS Prevention and treatment of iron deficiency anemias Dietary supplement of iron Unlabeled use; Supplemental use during epoethin therapy to ensure proper hematologic response to epoetin

CONTRAINDICATIONS Contraindicated with allergy to any ingredients; sulfite allergy; hematochromatosis, hematosiderosis, hemolytic anemia Use cautiously with normal iron balance; peptic ulcer,regional enteritis, ulcerative colitis

SIDE EFFECTS CNS: CNS toxicity,acisosis, coma and death withoverdose GI: GI upset, anorexia, nausea, vomiting, diarrhea, dark stools, temporary staining of teeth(liquid preparations)

NURSING INTERVENTIONS Advise the patient to take the drug on an empty stomach or Give drug with meals( avoid milk, eggs, coffee, and tea) if GI discomfort is severe; slowly increase to build up tolerance Warn patient that stool maybe darken or green Arrange for periodic monitoring of Hct and Hgb Levels Do not take this drugs with antacids or tetracyclines Advise patient to report if severe GI upset, lethargy, rapid respirations, constipation occurs.

Classification: Iron preparation Mechanism of Action: Elevates the serum iron concentration, which then helps to form Hgb or trapped in the reticuloendothelial cells and eventual conversion to a usable form of iron

GENERIC

CLASSIFICATION

INDICATIONS

CONTRAINDICATIONS

SIDE EFFECTS

NURSING

NAME/ BRAND NAME Generic Name: Simvastatin Dosage: 40 mg/tab; 1 tab O.D. @ HS Dosage in Adult: Initially, 20 mg PO, up to 80 mg PO daily in the evening. Usual range, 5-80 mg/day. Maximum dose, 80 mg/day. Adjust at 4week interval.

INTERVENTIONS Classification: Antihyp erlipedemic, HMG-CoA reductase inhibitor Mechanism of Action: Inhibits HMG-CoA reductase, the enzyme that catalyzes the first step in the cholesterol synthesis pathway, resulting in an decrease in serum cholesterol, serumLDLs and either an increase or no change in serum HDLs. To reduce the risk of coronary disease, mortality, and CV events, including CVA, TIA, MI, and reduction in need for bypass surgery and angioplasty in patients with coronary heart disease and hypercholesterole mia Adjunct to diet in the treatment of elevated total cholesterol and LDL cholesterol with primary hypercholesterole mia (types II-a and II-b) in those unresponsive to dietary restriction of saturated fat and cholesterol and other nonpharmacologi c measures Contraindicated with allergy to simvastatin, fungal byproducts Use cautiously with impaired hepatic and renal function, cataracts. CNS: Headache, asthenia, sleep disturbances GI: Flatulence, diarrhea, abdominal pain, cramps, constipation, nausea, dyspepsia, heartburn, liver failure RESPIRATORY: Sinusitis, pharyngitis OTHER: Rhabdomyolysis, acute renal failure, arthralgia, myalgia Ensure that patient has tried a cholesterollowering diet regimen for 3-6 months before beginning therapy. Give in the evening: highest rates of cholesterol synthesis are between midnight and 5 am. Arrange for regular follow-up during long term therapy. Consider reducing dose if cholesterol falls below target. Have periodic blood tests. Advise patient to report if severe GI upset, changes in vision, unusual bleeding or bruising, dark urine occurs.

GENERIC NAME/ BRAND NAME Generic Name: Citicoline Dosage: 1g/tab; 1 tab B.I.D Dosage in Adult:

CLASSIFICATION

INDICATIONS

CONTRAINDICATIONS Contraindicated with allergy to citicoline Use cautiously with impaired hepatic and renal function, cataracts.

SIDE EFFECTS

NURSING INTERVENTIONS Citicoline may be taken with or without food. Take it with or between meals. The supplement should not be taken in the late afternoon or at night because it can cause difficulty sleeping. Special attention should be paid for administration in the neonate, premature and children. Citicoline therapy should be started within 24 hours of a stroke. Advise patient to report immediately if allergic reaction such as hives, rash, or itching, swelling in your face or hands, mouth or throat, chest tightness or

Classification: Neurot onics, Nootropics Mechanism of Action Citicoline seems to increase a brain chemical called phosphatidylcholine. This brain chemical is important for brain function. Citicoline might also decrease brain tissue damage when the brain is injured.It is usually known that phospholipid, especially lecithin, decreases following decline in brain activity with cerebral trauma. Citicoline, which is a co-enzyme, accelerates the biosynthesis of lecithin in the body. This medication

Parkinsons disease, Head injury, Cerebral vascular disease, Alzheimers disease, Cerebral surgery or acute cerebral disturbance, Disturbance of consciousness following brain surgery

Citicoline seems to be safe when taken short-term (up to 90 days). The safety of longterm use is not known. Most people who take citicoline dont experience problematic side effects. However, these are the common side effects reported by some patients: Body temperature elevation Restlessness Headaches Nausea and vomiting

enhances the action of the brain stem ciliary body especially the ascending ciliary body activating system, which is closely related to consciousness, but does not exert effort on the extrapyramidal system. Citicoline increases cerebral blood flow and oxygen consumption of the brain and improves cerebral circulation and metabolism. Scientific research demonstrates that Citicoline consumption promotes brain metabolism by enhancing the synthesis of acetylcholine, restoring phospholipid content in the brain and affecting neuron membrane excitability and osmosis (by its effect

Diarrhea Low or high blood pressure Tachycardia Sleeping troubles or insomnia Blurred vision Chest pains

trouble breathing are experienced.

on the ATP-dependent sodium and potassium pump). When taken orally, its two main components, Cytidine and Choline are absorbed into the bloodstream. Citicoline is also believed to protect nerve cells when in low oxygen conditions. Citicoline may be used for nutritional support in cerebral vascular disease, head trauma, stroke, and cognitive disorders. It also is used by those who have age related mental decline, such as Alzheimers and Parkinsons.