Eposino 4000 IU SQ

Terbutaline (Bricanyl) 2.5 mg 1 tab OD

Amlopidine 10 mg 1 tab OD (prn)

Ticagrelor 90 mg 1 tab BID

Iberet Folic 1 tab BID

Sevelamer 800 mg 1 tab TID w/ meals

Cinacalcet 30 mg 1 tablet PO OD

Telmisartan 80 mg 1 tab OD (prn)

Metoprolol 50 mg 1 tab BID

Name of Drug: Erythropoietin

• Brand Name: Eposino

• Chemical/Therapeutic Classification: Haematopoietic Agents

• Indication: Treatment of anemia, especially in renal anemia resulting from renal function insufficiency,
including hemodialysis and non-hemodialysis of chronic renal failure.

• Dosage: 4000 IU SQ

• Drug action: Replicates the impact of erythropoietin, serving both as a growth factor and a
differentiating factor, thereby augmenting the production of red blood cells.

• Side Effects and Adverse Reactions: Chest pain, fever, headache, increased blood pressure, swelling of
the face, fingers, ankles, feet, or lower legs, weight gain

• Nursing Responsibilities:

Before starting therapy, evaluate

patient’s iron status. Patient
should receive adequate iron
supplementation beginning no
later than when epoetin alfa
treatment starts and continuing
throughout therapy. Patient may
need vitamin B12and folic acid
Monitor BP before therapy. Blood
pressure may increase, especially
when hematocrit increases in the
early part of therapy.
Monitor blood counts; elevated
hematocrit may cause excessive
clotting Inform patient that pain in
limbs and
long may occur after
injection(usually within 2 hours.)
Patient may need additional
heparin to prevent clotting during
dialysis treatment.
Tell patient to monitor blood
pressure at home and to adhere to
dietary restrictions
Before starting therapy, evaluate
patient’s iron status. Patient
should receive adequate iron
supplementation beginning no
later than when epoetin alfa
treatment starts and continuing
throughout therapy. Patient may
need vitamin B12and folic acid
Monitor BP before therapy. Blood
pressure may increase, especially
when hematocrit increases in the
early part of therapy.
Monitor blood counts; elevated
hematocrit may cause excessive
clotting Inform patient that pain in
limbs and
long may occur after
injection(usually within 2 hours.)
Patient may need additional
heparin to prevent clotting during
dialysis treatment.
Tell patient to monitor blood
pressure at home and to adhere to
dietary restrictions
 Before starting therapy, evaluate patient’s iron status.
 Patient should receive adequate iron supplementation beginning no later than when epoetin alfa
treatment starts and continuing throughout therapy.
 Patient may need vitamin B12and folic acid Monitor BP before therapy.
 Bloodpressure may increase, especially when hematocrit increases in the early part of therapy.
 Monitor blood counts; elevated hematocrit may cause excessive clotting Inform patient that pain
inlimbs andlong may occur after injection(usually within 2 hours.)
 Patient may need additional heparin to prevent clotting during dialysis treatment.Tell patient to
monitor blood pressure at home and to adhere to dietary restrictions

Name of Drug: Terbutaline

• Brand Name: Bricanyl

• Chemical/Therapeutic Classification: Beta agonists

• Indication: To prevent or reverse bronchospasm from asthma, bronchitis, or

emphysema

• Dosage: 2.5 mg 1 tab OD

• Drug action: Terbutaline activates bronchial beta-2 receptors, increasing cAMP and relaxing smooth
muscle in bronchioles.

• Side Effects and Adverse Reactions: Nervousness, tremor, drowsiness, dizziness, headache,
palpitations, arrhythmias, tachycardia

• Nursing Responsibilities:
  Assess patient’s respiratory rate, depth, and quality; oxygen saturation; and activity tolerance at
regular intervals because continuous use of beta2-agonists for 12 months or longer accelerates
the decline in pulmonary function.
 Use terbutaline cautiously in patients with cardiovascular disease because drug can adversely
affect cardiovascular function. Monitor patient’s heart rate and rhythm and blood pressure, and
assess for chest pain.

Name of Drug: Amlopidine

• Brand Name: Norvasc

• Chemical/Therapeutic Classification: Calcium channel blocker

• Indication: Management of hypertension, coronary artery disease (chronic stable angina, vasospastic
[Prinzmetal’s or variant] angina).

• Dosage: 10 mg 1 tab OD (prn)

• Drug action: Dilates coronary arteries, peripheral arteries/arterioles. Decreases total peripheral
vascular resistance and B/P by vasodilation.

• Side Effects and Adverse Reactions: Headache, peripheral edema, dizziness, flushing, rash, gingival
hyperplasia, tachycardia

• Nursing Responsibilities:

 Assess B/P (if systolic B/P is less than 90 mm Hg, withhold medication, contact physician).
 Assess for peripheral edema behind medial malleolus (sacral area in bedridden pts).
 Assess skin for flushing.
 Question for headache, asthenia.

Name of Drug: Ticagrelor

• Brand Name: Brilinta

• Chemical/Therapeutic Classification: Antiplatelet

• Indication: Reduce rate of cardiovascular death, MI, stroke in pts with acute coronary syndrome (ACS)
or history of MI.

• Dosage: 90 mg 1 tab BID

• Drug action: Reversibly inhibits platelet P2Y12 ADP receptor to prevent signal transduction and platelet
activation.

• Side Effects and Adverse Reactions: Bleeding, dyspnea, dizziness, nausea, diarrhea, back pain, fatigue.

• Nursing Responsibilities:
  Routinely screen for bleeding.
 Assess skin for bruising, hematoma.
 Monitor renal function, uric acid, digoxin levels if applicable.
 Report hematuria, epistaxis, coffee-ground emesis, black/tarry stools.

Name of Drug: Iberet Folic

• Brand Name:

• Chemical/Therapeutic Classification: Vitamins & Minerals (Pre & Post Natal) / Antianemics

• Indication: Anemia due to iron deficiency, megaloblastic anemia where there is an associated
deficiency of vitamins C and B-complex

• Dosage: 1 tab BID

• Drug action: Iberet-Folic 500 is a hematinic containing iron in a sustained-release system, vitamin C for
enhancement of iron absorption, and the vitamin B complex including folic acid.

• Side Effects and Adverse Reactions: Nausea, vomiting, constipation or diarrhea, gastric pain at high
doses.

• Nursing Responsibilities:

 Prior to administration, assess the patient's nutritional status, especially regarding iron and folic
acid levels.
 Evaluate the patient's medical history, allergies, and any pre-existing conditions.
 Administer the medication with or after meals to minimize gastrointestinal irritation.
 Regularly assess and document the patient's vital signs, iron levels, and hematologic parameters.

Name of Drug: Sevelamer

• Brand Name: Renvela

• Chemical/Therapeutic Classification: Polymeric phosphate binder.

• Indication: Reduction of serum phosphorus in pts with chronic renal disease on hemodialysis.

• Dosage: 800 mg 1 tab TID w/ meals

• Drug action: Binds with dietary phosphorus in GI tract, allowing phosphorus to be eliminated through
normal digestive process, decreasing serum phosphorus level.

• Side Effects and Adverse Reactions: Infection, pain, hypotension, diarrhea, dyspepsia, nausea,
vomiting.

• Nursing Responsibilities:

 Monitor serum phosphate, bicarbonate, chloride, calcium.

  Assess for signs and symptoms of hyperphosphatemia, such as weakness, bone pain, or
abnormal laboratory values.
 Administer sevelamer with meals or as directed by the healthcare provider.

Name of Drug: Cinacalcet

• Brand Name: Sensipar

• Chemical/Therapeutic Classification:

• Indication: Treatment of secondary hyperparathyroidism in pts with chronic renal disease on dialysis.

• Dosage: 30 mg 1 tablet PO OD

• Drug action: Increases sensitivity of calcium-sensing receptor on parathyroid gland to activation by

extracellular calcium, thus lowering parathyroid hormone (PTH) levels.

• Side Effects and Adverse Reactions: Nausea, vomiting, diarrhea, asthenia, hypertension, anorexia,
noncardiac chest pain.

• Nursing Responsibilities:

 Monitor serum calcium, phosphate, ionized calcium for hyperparathyroidism.

 Monitor daily pattern of bowel activity, stool consistency.
 Obtain order for antidiarrhea, antiemetic medication to prevent serum electrolyte imbalance.
 Assess for evidence of dizziness; institute fall risk precautions.

Name of Drug: Telmisartan

• Brand Name: Micardis

• Chemical/Therapeutic Classification: Angiotensin II receptor antagonist.

• Indication: Reduces cardiovascular risk in pts 55 yrs of age and older unable to take ACE inhibitors and
at high risk of major cardiovascular event

• Dosage: 80 mg 1 tab OD (prn)

• Drug action: Blocks vasoconstrictor and aldosterone-secreting effects of angiotensin II, inhibiting
binding of angiotensin II to AT1 receptors.

• Side Effects and Adverse Reactions: Hypotension, rash, hyperkalemia, mild-moderate loss of taste,
hepatotoxicity, pancreatitis, blood dyscrasias, renal damage

• Nursing Responsibilities:

 Obtain B/P, apical pulse immediately before each dose, in addition to regular monitoring (be
alert to fluctuations).
 Monitor B/P, pulse, serum electrolytes, renal function.
  Monitor for hypotension when initiating therapy.

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Name of Drug:

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Name of Drug: Metoprolol

• Brand Name: Lopresor

• Chemical/Therapeutic Classification: Beta1-adrenergic blocker.

• Indication: Treatment of hemodynamically stable acute myocardial infarction

(AMI) to reduce CV mortality, angina pectoris, hypertension.

• Dosage: 50 mg 1 tab BID

• Drug action: Selectively blocks beta1-adrenergic receptors. Therapeutic Effect: Slows heart rate,
decreases cardiac output, reduces B/P. Decreases myocardial ischemia severity.
• Side Effects and Adverse Reactions: Diminished sexual function, drowsiness, insomnia, unusual
fatigue/weakness, Altered taste, dry eyes, nightmares, paresthesia, allergic reaction (rash, pruritus).

• Nursing Responsibilities:

 Measure B/P near end of dosing interval (determines whether B/P is controlled throughout day).
 Monitor B/P for hypotension, respiration for shortness of breath.
 Assess pulse for quality, rate, rhythm. Assess for evidence of HF: dyspnea (esp. on exertion, lying
down), night cough, peripheral edema, distended neck veins.
 Monitor I&O (increased weight, decreased urinary output may indicate HF).