411 Perfecto Cortez Drug Felodipine Dosage 10mg 1 tab OD Indication -essential hypertension, alone or in combination with other

antihypertensive s Mode of Action Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells; inhibits transmembra ne calcium flow, which results in depression of impulse formation in specialized cardiac pacemaker cells, slowing of the velocity of conduction of the cardiac impulse, depression of myocardial Side Effect & Adverse Effects CNS: dizziness, lightheadedness, headache, fatigue CV: palpitations Dermatologic: rash, pruritus GI: nausea, abdominal discomfort Contraindication Nursing s Responsibilities Contraindicated Monitor blood in patients pressure frequently hypersensitive during initiation of to drug. therapy. Because drug-induced vasodilation has a gradual onset, acute hypotension is rare -Administer drug without regard to meals Notify prescriber if signs of heart failure occur, such as swelling of hands and feet or shortness of breath. Health Teaching Caution patient to continue taking drug, even when he feels better.

contractility, and dilation of coronary arteries and arterioles and peripheral arterioles; these effects lead to decreased cardiac work, decreased cardiac oxygen consumption, and in patients with vasospastic angina, increased delivery of oxygen to cardiac cells Drug Simvastatin Dosage 20 mg 1 tab Indication To reduce the risk of coronary disease, Mode of Side Effect & Action Adverse Effects Inhibits HMG- CNS: dizziness, lightCoareductase, headedness, the enzyme headache, fatigue

-Take with meals if upset stomach occurs

Contraindication Nursing s Responsibilities Contraindicated Give medications in in patients evening, highest hypersensitive rate of cholesterol

mortality and CV events, including CVA, TIA, MI and reduction in need for bypass surgery

that catalyzes the first step in cholesterol synthesis pathway, resulting in a decrease in serum cholesterol, serum LDLs, and either an in crease or no change in serum HDL

CV: palpitations Dermatologic: rash, pruritus GI: nausea, abdominal discomfort

to drug.

synthesis are between midnight and 5 am Health teaching Do not drink grapefruit in the evening

Drug Vitamin B complex

Dosage 1 tab

Indication The patient had stroke at 2003, for his maintenance

Mode of Action A coenzyme that stimulate metabolic function and is needed for cell replication, hematopoeisi s, nucleoprotein and myelin

Contraindication s Contraindicated CV: peripheral in patients vascular thrombosis, hypersensitive heart failure to drug. Dermatologic:itchin g, urticaria GI: transient diarrhea

Side Effect & Adverse Effects

Nursing Responsibilities Determine reticulocyte, hematocrit, vitamin b12, iron, before beginning therapy Obtain sensitivity test before giving medication Don t give large

sheet

doses of vitamin b12 routinely; drug is lost through excretion Protect vitamin b12 from light

Drug Tranexamic acid

Dosage 1 vial

Indication To control hemorrhage, patient has chief complain of hematochesia

Mode of Action Tranexamic acid is a synthetic derivative of the amino acid lysine. It exerts its antifibrinolyti c effect through the reversible blockade of lysine-binding sites on plasminogen molecules. Antifibrinolytic

Side Effect & Adverse Effects Diarrhoea, nausea, vomiting, disturbances in colour vision, giddiness, hypotension (after rapid IV inj), thromboembolic events

Contraindication s Severe renal failure, active intravascular clotting, thromboembolic disease, colour vision disorders, subarachnoid bleeding.

Nursing Responsibilities Unusual change in bleeding pattern should be immediately reported to the physician. For women who are taking Tranexamic acid to control heavy bleeding, the medication should only be taken during the menstrual period. Tranexamic Acid should be used with extreme caution in CHILDREN younger

drug inhibits endometrial plasminogen activator and thus prevents fibrinolysis and the breakdown of blood clots. The plasminogenplasmin enzyme system is known to cause coagulation defects through lytic activity on fibrinogen, fibrin and other clotting factors. By inhibiting the action of plasmin (finronolysin) the anti-

than 18 years old; safety and effectiveness in these children have not been confirmed. The medication can be taken with or without meals. Swallow Tranexamic Acid whole with plenty of liquids. Do not break, crush, or chew before swallowing. If you miss a dose of Tranexamic Acid, take it when you remember, then take your next dose at least 6 hours later. Do not take 2 doses at once.

fibrinolytic agents reduce excessive breakdown of fibrin and effect physiological hemostasis.

412 Esteban Beltran Drug Augmentin Dosage 625 mg 1 tab Indication Indicated for upper respiratory tract infections, patient is diagnosed with COPD and received to have cough Mode of Action Amoxicillin is a semisynthetic antibiotic with a broad spectrum of antibacterial activity agonist may gram-positive and gramnegative microorganis ms. Amoxicillin is, however, Side Effect & Adverse Effects GIT- diarrhea, nausea, vomiting CNS: Lethargy, hallucinations, seizures GU: nephritis Hematologic: anemia, thrombocytopenia Contraindication Nursing s Responsibilities History of Encouraged patient hypersensitivity to take it full course to beta lactams of therapy, do not stop because you feel better This antibiotic is specific for this problem and should not be used to selftreat other problems

susceptible to degradation by lactamases and therefore, spectrum of activity of amoxicillin alone does not include organisms which produce these enzymes.Clav ulanic acid is a beta lactam, structurally related to the penicillin s, which posses the abilty to inactivate a wide range of b-lactamase enzymes commonly found in microorganis ms.

Drug Glimeperide

Dosage 2 mg tab

Indication Diabetes type 2

Mode of Action The primary mechanism of action of glimepiride appears to be dependent on stimulating the release of insulin from functioning pancreas beta cells. In addition, extrapancreatic effects (e.g. reduction of basal hepatic glucose production and increased peripheral tissue sensitivity to insulin and glucose

Side Effect & Adverse Effects Hypoglycaemia: Hyp oglycaemia is the greatest potential risk with all sulfonylureas. Visual reactions: There may be temporary visual impairment (e.g. changes in accommodation and/or blurred vision) due to the change in blood glucose levels, especially at the start of treatment.

Contraindication Nursing s Responsibilities Glimperide is Nursing contraindicated Responsibilities: in patients with y Tell patient known to take drug hypersensitivity with first to the drug. meal of the day. Diabetic y Make sure ketoacidosis, patient with or without understands coma. This that therapy condition should relieves be treated with symptoms insulin. but doesn t cure the disease. He should also understand Gastrointestinal potential reaction: Occasionall risks and y gastrointestinal advantages symptoms such as of taking nausea, vomiting, drug and of sensations of other pressure or fullness treatment in the epigastrium, methods.

uptake) may also play a role in the activity of glimepiride. However, as with other sulfonylureas, the mechanism by which glimepiride lowers blood glucose during longterm administratio n has not been clearly established.

abdominal pain, and diarrhea may occur. Haematologic reactions: Rarely, thrombocytopenia, and in isolated cases, leucopenia may develop. In isolated instances, thrombocytopenic purpura, agranulocytosis, pancytopenia due to myelosuppression, eosinophilia, haemolyti anemia aplastic anemia, erythrocytopenia and granulocytopenia may occur. Dermatologic reactions: Occasiona lly, allertic or pseudo-allergic skin reactions (e.g. pruritus, erythema, urticaria, erythematous and

Stress importance of adhering to diet, weight reduction, exercise, and personal hygiene programs. Explain to patient and family how and when to monitor glucose level and teach recognition of and intervention s for signs and symptoms of high and low glucose levels. Tell patient

maculopapular and bullous skin eruptions or psoriasiforom drug eruption) may occur in patients treated with sulfonylureas

to carry candy or other simple sugars to treat mild episodes of low glucose level. Patient experiencin g severe episode may need hospital treatment. Advise patient to avoid alcohol, which lowers glucose level. Tell patient to take a missed dose as soon as possible unless it is

almost time for next dose; never take two doses at the same time. Tell patient about adverse reactions and drug interactions. Monitor fasting glucose level periodically to determine therapeutic response. Monitor for hypoglycemi a especially with concurrent drugs which enhance hypoglycemi

c effects. Drug Metformin Dosage 500 mg 1 tab Indicati Mode of Action on Diabete Metformin is an s type 2 antihyperglycemic agent which improves glucose tolerance in patients with type 2 diabetes, lowering both basal and postprandial plasma glucose. Its pharmacologic mechanisms of action are different from other classes of oral antihyperglycemic agents. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing Side Effect & Adverse Effects Side Effects of Metformin HCl Occasional: Gastrointestinal disturbances are transient and resolve spontaneously during therapy (diarrhea, nausea, vomiting, abdominal bloating, flatulence, anorexia). Rare: Unpleasant or metallic taste (resolves spontaneously during therapy). Adverse Reactions or Toxic Effect of Metformin HCl Lactic acidosis occurs rarely (0.03 cases/ 1,000 patients) but s a serious, often fatal (50%) complication. Nursing Responsibilities GLUCOPHAGE and Inform the patient GLUCOPHAGE XR of potential are risks/advantages of contraindicated in therapy and of patients with: alternative modes of therapy. 1. Renal Assess Hemoglobin, disease or hematocrit, red renal blood cellsm and dysfunctio serum creatinine n (e.g., as prior to initiation of suggested therapy. by serum Monitor fasting creatinine blood glucose, levels hemoglobin a, and 1.5 mg/dL renal function. [males], Monitor renal 1.4 mg/dL function test for [females] evidence of early or lactic acidosis. abnormal If patient is on oral creatinine sulfonylureas, clearance) assess for which may hypoglycemia. also result Be alert to Contraindications

peripheral glucose uptake and utilization.

Characterized by increase in blood lactate levels (more than 5 mmol/L), decrease in blood pH, electrolyte disturbances. Symptoms include unexplained hyperventilation, myalgia, malaise, and somnolence. May advance to cardiovascular collapse (shock), acute CHF, acute MI, and prerenal azotemia.

from conditions such as cardiovasc ular collapse (shock), acute myocardial infarction, and septicemia 2. Known hypersensi tivity to metformin hydrochlor ide. 3. Acute or chronic metabolic acidosis, including diabetic ketoacidosi s, with or without coma. Diabetic

conditions that alter glucose requirements: fever, increased activity or stress, surgical procedure. Patient Teaching for Clients Taking Metformin HCl Discontinue metformin and contact the physician immediately if evidence of lactic acidosis appears (unexplained hyperventilation, muscle aches, extreme tiredness, unusual sleepiness). Prescribed diet is principal part of treatment; do not skip or delay meals. Diabetes Mellitus requires lifelong control.

ketoacidosi s should be treated with insulin.

Avoid alcohol. Inform physician if headache, nausea, vomiting, diarrhea, skin rash, unusual bruising or bleeding, and change in color of urine or stool occurs.

Drug

Dosage

Indication

Mode of Action

Side Effect & Adverse Effects

Contraindication s

Nursing Responsibilities