DRUG NAME MODE OF ACTION INDICATION ADVERSE NURSING CONTRAINDICATIO

DRUG REACTION CONSIDERATION N

Brand Name: LANOXIN Increases the force of Cardiac failure CNS disturbances,  Monitor apical
Generic Name: Digoxin myocardial accompanied by dizziness; visual pulse before Intermittent complete
Drug Class: Antiarrhythmics, contraction. Prolongs atrial fibrillation; disturbances (blurred or administering. heart block or 2nd
inotropics refractory period of the management of yellowish vision);  Monitor blood degree AV block esp if
AV node. Decreases chronic cardiac arrhythmia, conduction pressure there is a history of
conduction through the failure where systolic disturbances, bigeminy, periodically in Stokes-Adams attacks;
SA and AV nodes. dysfunction or trigeminy, PR patients arrhythmia caused by
Increased cardiac ventricular dilatation prolongation, sinus receiving IV cardiac glycoside
output (positive is dominant; bradycardia; nausea, dogoxin. intoxication,
inotropic effect) and management of vomiting, diarrhea;  Monitor intake supraventricular
slowing of the heart certain urticarial or and output arrhythmia caused by
rate (negative supraventricular scarlatiniform w/ ratios and daily Wolff-Parkinson-
chronotropic effect). arrhythmias, eosinophilia. weights. White syndrome;
particularly chronic  Observe patient ventricular tachycardia
atrial flutter & for signs and or fibrillation;
fibrillation. symptoms of hypertrophic
toxicity. obstructive
 Oral cardiomyopathy.
preparations Hypersensitivity to
can be other digitalis
administered glycosides.
without regard
to meals.
 Before
administering
initial loading
dose, determine
whether patient
has taken any
digitalis
preparations in
the preceding 2-
3 wk.
Generic Name: Telmisartan (Teli Treatment for Telmisartan: Headache,  Monitor client Pregnancy & lactation.
TELMISARTAN marketed by cadila essential upper respiratory tract for hypotension Cholestasis & biliary
Brand Name: Micardis pharma) is an hypertension. infection, dizziness. after starting obstructive disorders.
Drug Class: Angiotensin II Angiotensin Receptor Blocks Hydrochlorothiazide: drug. Place Severe hepatic & renal
Antagonists / Diuretics Blocker (ARB) that vasoconstricting. Anorexia, gastric client supine if impairment (CrCl <30
shows high affinity for irritation, muscle spasm, hypotension mL/min). Refractory
the angiotensin II type sleep disturbances. occurs, and hypokalemia,
1 (AT1) receptors, has give IV normal hypercalcemia.
a long duration of saline, if
action, and has the needed.
longest half-life of any  For patient
ARB. whose renal
In addition to blocking function may
the Renin-Angiotensin depend on the
System (RAS), activity of the
telmisartan acts as a rennin
selective modulator of angiotensin
Peroxisome aldosterone
proliferator-activated system (such as
receptor gamma those with
(PPAR-γ), a central severe heart
regulator of insulin and failure)
glucose metabolism. It treatment with
is believed that ACE inhibitors
telmisartan’s dual and angiotensin
mode of action may receptors
provide protective antagonist has
benefits against the caused oliguria
vascular and renal or progressive
damage caused by azotemia and
diabetes and acute renal
cardiovascular disease failure or death.
(CVD).
Telmisartan has
binding affinity 3000
times greater for AT1
than AT2 receptors.
Telmisartan also has
the longest half life (24
hrs) of all angiotensin

Generic Name: Esomeprazole
Brand Name: Nexium
Dug Class:
Antacids, Antireflux Agents &
Antiulcerants
Generic Name: Warfarin
Brand Names: Coumadin,
Jantoven
Drug Class: Anticoagulants,
Antiplatelets & Fibrinolytics
(Thrombolytics)
II type 1 receptor
antagonists.
Nexium(esomeprazole) Treatment of GERD Headache, abdominal  Instruct patient
is a proton pump as an alternative to pain, constipation, to take drug Hypersensitivity to
inhibitor that oral therapy in diarrhea, flatulence, exactly as substituted
suppresses gastric acid patients when oral nausea, vomiting. prescribed. benzimidazoles.
secretion by specific therapy is not Injection site reaction.  Tell the patient Children.
inhibition of H+/K+- appropriate. Short - to take drug at
ATPase in the gastric term maintenace of least 1 hour
parietal cell. By acting hemostasis & before a meal.
specifically on the prevention of  Advise patient
proton pump, Nexium rebleeding in patients that antacids
blocks the final step in following therapeutic
can be used
acid production, thus endoscopy for acute
reducing gastric bleeding of gastric or while taking
acidity. This effect is duodenal ulcers. drugs unless
dose-related up to a otherwise
daily dose of 20–40 directed by
mg and leads to prescriber.
inhibition of gastric
acid secretion.
Anticoagulant. Prophylaxis & Potential adverse  Use cautiously Anticoagulation is
Pharmacology: treatment of venous reactions to Coumadin with contraindicated in any
Coumadin and other thrombosis, atrial may include: divertiticulitis, localized or general
coumarin fibrillation w/ Hemorrhage from any colitis,and mild physical condition or
anticoagulants act by embolization, tissue or organ. This is a or moderate personal circumstance
inhibiting the synthesis pulmonary consequence of the hypertension, or in which the hazard of
of vitamin K- embolism, adjunct in anticoagulant effect. The mild or hemorrhage might be
dependent coagulation prophylaxis of signs and symptoms will moderate greater than its
factors. The resultant systemic embolism vary according to the hepatic or renal potential clinical
in vivo effect is a after MI. location and degree or disease; with benefits eg: Pregnancy:
sequential depression extent of the bleeding. drainage tubes Women who are or
of Factors VII, IX, X Hemorrhagic in any orifice; may become pregnant
and II activities. The complications may with regional or because the drug
degree of depression is present as paralysis; lumbar bock passes through the
dependent upon the headache, chest, anesthesia; or in placental barrier and
dosage administered. abdomen, joint or other conditions that may cause fatal
Anticoagulants have pain; shortness of breath, increase risk of hemorrhage to the
no direct effect on an difficult breathing or hemorrhage; fetus in utero.
established thrombus, swallowing; unexplained also use Furthermore, there
nor do they reverse swelling; or unexplained cautiously in have been reports of
ischemic tissue shock. Therefore, the breastfeeding birth malformations in
damage. However, possibility of women. children born to
once a thrombus has hemorrhage should be  I.M mothers who have
occurred, the goal of considered in evaluating administration been treated with
anticoagulant treatment the condition of any isn’t warfarin during
is to prevent further anticoagulated patient recommended. pregnancy.
extension of the with complaints which  Tell patient to Embryopathy
formed clot and do not indicate an report adverse characterized by nasal
prevent secondary obvious diagnosis. reactions hypoplasia with or
thromboembolic Bleeding during promptly. without stippled
complications which anticoagulant therapy  Tell the patient epiphyses
may result in serious does not always correlate to eat a daily, (chondrodysplasia
and possible fatal with prothrombin consistent punctata) has been
sequelae. activity (see Treatment amount of leafy reported in pregnant
Pharmacokinetics: under Overdosage). green vegetable women exposed to
After oral Bleeding which occurs containing warfarin during the 1st
administration of when the PT is within vitamin K. trimester. Central
Coumadin, absorption the therapeutic range nervous system
is essentially complete, warrants diagnostic abnormalities also
and maximal plasma investigation since it have been reported,
concentrations are may unmask a including dorsal
reached in 1-9 hrs. previously unsuspected midline dysplasia
Approximately 97% is lesion eg, tumor, ulcer, characterized by
bound to albumin etc. agenesis of the corpus
within the plasma. An Necrosis of skin and callosum, Dandy-
anticoagulant effect other tissues (see Walker malformation,
generally occurs within Warnings). and midline cerebellar
24 hrs. However, peak Other adverse reactions atrophy. Ventral
anticoagulant effect are infrequent and midline dysplasia,
may be delayed 72-96 consist of alopecia, characterized by optic
hrs and its duration of urticaria, dermatitis, atrophy, and eye
action may persist for fever, nausea, diarrhea, abnormalities have
4-5 days, thus abdominal cramping, been observed. Mental
producing a smooth, systemic cholesterol retardation, blindness,
long-lasting response microembolization, and other central
curve. Coumadin is purple toes syndrome, nervous system
metabolized by hepatic cholestatic hepatic injury abnormalities have
microsomal enzymes and hypersensitivity been reported in
to inactive metabolites reactions. association with 2nd
that are excreted into Priapism has been and 3rd trimester
the bile, reabsorbed associated with exposure. Although
and excreted into the anticoagulant rare, teratogenic
urine. administration; however, reports following in
Coumadin is a potent a causal relationship has utero exposure to
drug with a half-life of not been established. warfarin include
2½ days; therefore its urinary tract anomalies
effects may become eg, single kidney,
more pronounced as asplenia, anencephaly,
daily maintenance spina bifida, cranial
doses overlap. nerve palsy,
hydrocephalus, cardiac
defects and congenital
heart disease,
polydactyly,
deformities of toes,
diaphragmatic hernia,
and corneal leukoma.
Spontaneous abortion
and stillbirth are
known to occur and a
higher risk of fetal
mortality is associated
with the use of
warfarin.
Women of
childbearing potential
who are candidates for
anticoagulant therapy
should be carefully
evaluated and the
indications critically
reviewed with the
patient. If the patient
becomes pregnant
while taking this drug,
she should be apprised
of the potential risks to
the fetus, and the
possibility of
termination of the
pregnancy should be
discussed in light of
those risks.
Hemorrhagic
tendencies or blood
dyscrasias.
Recent or
contemplated surgery
of the central nervous
system, eye, or
traumatic surgery
resulting in large open
surfaces.
Bleeding tendencies
associated with active
ulceration or overt
bleeding of the
gastrointestinal,
genitourinary or
respiratory tracts;
cerebrovascular
hemorrhage;
aneurysms-cerebral,
dissecting aorta;
pericarditis, pericardial
effusions and bacterial
endocarditis.
Threatened abortion,
eclampsia and
preeclampsia.
 Inadequate laboratory
facilities or
unsupervised senility,
alcoholism, psychosis
or lack of patient
cooperation.
Spinal puncture and
other diagnostic or
therapeutic procedures
with potential for
uncontrollable
bleeding.
Miscellaneous: Major
regional, lumbar block
anesthesia and
malignant
hypertension.
Generic name: Potassium Supplemental  For hypokalemia  renal insufficiency  Some patients >Severe renal
Chloride potassium in the form  As prophylaxis  hyperkalemia find it difficult impairment
Brand Name: Kalium Durule of high potassium food during treatment  nausea to swallow the > severe hemolytic
Drug Class: Electrolytes and or potassium chloride with diuretics  vomiting large sized KCl reactions
minerals may be able to restore  To prevent and  irritability tablet. > acute dehydration
normal potassium treat potassium,  muscle weakness Administer >heat cramps
levels. deficit secondary  difficulty in while patient is >hyperkalemia
to diuretics or swallowing sitting up or
corticosteroid standing (never Cautious use in:
therapy. in recumbent >cardiac or renal
 Also indicated position) to disease; systematic
when potassium, prevent drug- acidosis
is depleted by induced
severe vomiting, esophagus.
prolonged  Follow
diuresis and instructions
diabetic acidosis. regarding
dilution.
 Color in some
commercial oral
solutions fades
with exposure
to light but drug

Generic Name: Spironolactone
Brand Name: Aldazide
Drug Class : Diuretics, Other
Antihypertensives
Generic name: Citicoline
effectiveness is
reportedly not
altered.
Spironolactone Essential Gastro-intestinal  Educate to Acute renal
promotes diuresis in hypertension, disorders: abdominal avoid hazardous insufficiency,
patients with oedema oedema and ascites pain, vomiting, nausea, activity such significant impairment
or ascites. of congestive heart diarrhoea, gastro- driving untl of renal function,
Spironolactone acts in failure, cirrhosis of intestinal disturbance. response to anuria, hyperkalemia
the distal portion of the the liver, the Body as a whole: drug is known. or sensitivity to
renal tube by nephrotic syndrome, asthenia, fever,  Take with spironolactone,
competitive inhibition idiopathic oedema. anaphylactoid reaction, meals; avoid thiazide diuretics or to
of aldosterone, a malaise. excessive other sulfonamide-
sodium-retaining, Skin and appendages: ingestion of derived
potassium-excreting rash, pruritis, dermatitis, food high in drugs.sulfonamide-
hormone. photosensitivity. potassium or derived medicines.
Isobutylhydrochlorothi Nervous system use of salts
azide promotes sodium disorders: dizziness, substitutes.
and water excretion by headache, paraesthesia.  Diuretic effect
inhibiting sodium and Psychiatric disorders: may be delayed
chloride reabsorption impotence. 2-3 days and
in the kidney tubule. Neoplasm: breast maximum
The combination of neoplasm, including hypertensive
spironolactone and malignancy. may be delayed
isobutylhydrochlorothi Metabolic and 2-3weeks;
azide provides an nutritional disorders: monitor I and O
effective treatment for electrolyte disturbances. ratios and daily
many patients who Reproductive disorders: weight, BP,
would not respond to breast disorders, serum
either drug alone. The menstrual disorders. electrolyte s (K,
combination results in Haematological Na) and renal
an additive diuretic disorders: function.
effect since both drugs thrombocytopenia
will increase sodium
and water excretion by
acting in different parts
of the renal tubule.
Neurovascular Treatment of Gastrointestinal  Verify the Patients with
Brand name: Zynapse enhancer. cerebrovascular disorders. Allergic doctor’s order. parasympathetic
Drug Class: Pharmacology: accident in acute and reaction: Itching or  Assess allergy hypertonia.
Neuroprotective, CNS Drugs & Piracetam acts recovery phase, hives, swelling in your to warfarin.
Agents for ADHD selectively upon the symptoms and signs face or hands, swelling  Do not use rug
telencephalon by of cerebral or tingling in your mouth if the ptient is
improving its insufficiency eg, or throat, chest tightness, pregnant (use
associative function. It dizziness, memory trouble breathing, or contraceptives).
increases the energy loss, poor rash, Low blood pressure  Monitor closely
output of the brain cell concentration, (faintness, dizziness), PT ratio and
and activates its disorientation, recent Slow or fast heart beat, INR.
neurophysiological cranial trauma and Headache, Nausea,  Administer the
potentialities, their sequelae. vomiting, or diarrhea drug in IV form
especially in deficit (loose BMs) if the client can
conditions. Nootropil not take it
is virtually nontoxic orally.
and has no stimulating,  Document the
sedative or procedure.
neurovegetative
activities.

Generic Name: Piracetam Pharmacology: Treatment of post Hyperkinesia, wt gain,  Prior to: Cerebral
Brand Names: Nootropil Piracetam acts stroke sequelae ie asthenia, nervousness, Wash hands hemorrhage, end
Drug Class selectively upon the aphasia, cortical somnolence, depression, thoroughly.
stage renal disease,
Nootropics & Neurotonics telencephalon by myoclonus, alone or vertigo,upper abdominal  Ask the patients
improving its in combination, pain,diarrhea,nausea, name Huntington's chorea.
associative function. It vertigo & associated vomiting, anaphylactoid  Always observe Pregnancy &
increases the energy disorders of balance, reaction, ataxia, impaired aseptic lactation.
output of the brain cell w/ the exception of balance, aggravated technique
and activates its dizziness of epilepsy, headache,  During:
neurophysiological vasomotor or psychic insomnia, skin & Explain the
potentialities, origin. Symptomatic subcutaneous tissue procedure to the
especially in deficit treatment of the disorders. patient/SO.
conditions. Nootropil psycho-organic  Explain what is
is virtually nontoxic syndrome whose the general
and has no stimulating, features are memory action of the
sedative or loss, attention drug to the
neurovegetative disorders & lack of body.
activities. drive. Ped treatment  After:
for dyslexia in Record the drug
combination w/ after its
 appropriate measures administration
eg speech therapy. (charting).

 Observe the
patients for
possible
untoward
reaction.
 Instruct to take
the medication
exactly as
directed.
Generic Name: Sulodexide is a Oral: Nausea, vomiting,  Assess patients Hypersensitivity to
Sulodexide heparinoid consisting Antithromb epigastric pain. for signs of sulodexide, heparin,
Brand Name: Vessel of 80% fast moving otic. Parenteral: Pain, burning bleeding and and heparin-like
Due F heparin and 20% and haematoma at hemorrhage products. Diathesis,
dermatan sulfate. It is injection site. (bleeding gums; haemorrhagic
Drug Class : Anticoagulants, hypolipidaemic and nosebleed; conditions. Pregnancy.
Antiplatelets & Fibrinolytics antithrombotic and has unusual
(Thrombolytics) been administered by bruising; black,
See available brands of mouth and parenterally tarry stools;
sulodexide for peripheral vascular hematuria; fall
disease and in hematocrit or
cerebrovascular blood pressure;
disease. It is also guaiac-positive
included in topical stools). Notify
preparations for local physician if
vascular inflammation these occur.
and soft tissue  Monitor patient
disorders. Sulodexide for
differs from heparin by hypersensitivity
having a longer half- reactions
life and a decreased (chills, fever,
effect on systemic urticaria).
clotting and bleeding. Report signs to
As admin of heparin physician.
and low molecular wt  Monitor platelet
heparin results in a count every 2-3
release of lipoprotein days throughout
lipase, the activity of therapy. May
 sulodexide is cause mild
expressed as thrombocytope
Lipoprotein lipase nia, which
Releasing Units (LSU). appears on the
1 mg of sulodexide is 4th day and
equivalent to 10 LSU. resolves despite
continued
heparin therapy.
Generic Name: Mannitol increases Promotion of diuresis Fluid and electrolyte  The Pulmonary congestion
Mannitol urinary output by in the prevention or imbalance; acidosis cardiovascular or oedema; intracranial
Brand name: Osmitrol, inhibiting tubular treatment of the (with high doses). status of the bleeding; CHF;
Resctisol reabsorption of water oliguric phase of Nausea, vomiting, thirst; patient should metabolic oedema with
and electrolytes. It acute renal failure headache, dizziness, be carefully abnormal capillary
Drug Class : Diuretics, raises the osmotic before irreversible convulsions, chills, evaluated fragility; anuria due to
Miscellaneous pressure of the plasma renal failure becomes fever; tachycardia, chest before rapidly severe renal disease;
allowing water to be established. pain; blurred vision; administering severe dehydration.
drawn out of body Reduction of urticaria and hypotension mannitol since
tissues. intracranial pressure or hypertension; acute sudden
Onset: Diuresis: 1-3 and brain mass. renal failure; skin expansion of
hr. Reduction in Reduction of high necrosis; the extracellular
intracerebral pressure: intraocular pressure thrombophloebitis. fluid may lead
around 15 min. when the pressure to fulminating
Duration: Reduction cannot be lowered by congestive heart
in intracerebral other means. failure.
pressure: 1.5-6 hr.  Promotion of  Shift of
Absorption: Small urinary sodium-free
amounts are absorbed excretion of intracellular
from the GI tract. toxic fluid into the
Distribution: materials. extracellular
Concentrated in  Edema compartment
extracellular following
compartments. It does mannitol
not penetrate the infusion may
blood-brain barrier nor lower serum
the eye. sodium
Metabolism: Minimal concentration
hepatic metabolism, and aggravate
converted to glycogen. pre-existing
Excretion: Urine via hyponatremia.
the kidneys  By sustaining
(unchanged drug). diuresis,
mannitol
administration
may obscure
and intensify
inadequate
hydration or
hypovolemia.
 Electrolyte-free
mannitol
solutions should
not be given
conjointly with
blood. If it is
essential that
blood be given
simultaneously,
at least 20 mEq
of sodium
chloride should
be added to
each liter of
mannitol
solution to
avoid
pseudoagglutin
ation.
 When exposed
to low
temperatures,
solutions of
mannitol may
crystalize. If
crystals are
observed, the
container
should be
warmed to
redissolve, then
cooled to body
 temperature
before
administering.
See NOTE
under how
supplied. When
infusing 20% or
25% mannitol
concentrations,
the
administration
set should
include a filter.
Do not infuse
mannitol
solution if
crystals are
present.
 Do not
administer
unless solution
is clear and
container is
undamaged.
Discard unused
portion. Do not
administer
Mannitol 25%
if the Fliptop
vial seal is not
intact.

Generic Name: Carvedilol Decreased heart rate  Fatigue  Monitor BP and Diseases that constrict
Brand Name: Dilatrend and pulse pressure. Essential  Dizziness pulse prior and the respiratory tract
Drug Class: Antihypertensive hypertension; CHF.  Bradycardia throughout (bronchial asthma,
 CHF therapy. chronic bronchitis,
 Pulmonary edema  Take apical pulmonary
 Hypotension pulse, if less emphysema), allergic
 Constipation than 50 bpm, rhinitis, swelling of the
 Impotence withhold laryngeal mucosa,
 medication and sinus node syndrome,
notify SA block, 2nd & 3rd
physician. degree AV block, too
 Advise patient slow heart rate, shock,
for proper diet, MI w/ complications,
regular severe liver
exercise, and dysfunction, metabolic
lifestyle acidosis, or
modification. simultaneous MAOI
 Diabetics therapy.
should closely
monitor blood
sugar.

Generic name: Mefenamic acid Ponstan has analgesic, Relief of pain  Disturbances of the Assessment & Drug Ulceration in the upper
Brand Name: Ponstan anti-inflammatory and including muscular, gut such as Effects or lower intestinal
Drug Class: Anti-pyretic or anti- anti-pyretic properties. rheumatic, traumatic, indigestion,  Assess patients tract. Children <14 yr.
pyretic and anti-inflammatory The pharmacological dental, post-op & diarrhoea, who develop Pregnancy.
analgesics activity of Ponstan postpartum pain, constipation, nausea, severe diarrhea
may be due in part to headache & in childn vomiting or and vomiting
its ability to inhibit the w/ fever & juvenile abdominal pain for dehydration
synthesis of RA. Also for the  Headache and electrolyte
prostaglandins. relief of primary  Dizziness imbalance.
Ponstan also inhibits dysmenorrhea.  Drowsiness  Lab tests: With
the action of  Skin rashes long-term
exogenous  Visual disturbances therapy (not
prostaglandins on  Retention of water recommended)
uterine muscle, uterine in the body tissues obtain periodic
tube contraction and (fluid retention), complete blood
ovarian cyclic AMP resulting in swelling counts, Hct and
and progesterone (oedema) Hgb, and
formation in animal  Awareness of your kidney function
models. heartbeat tests.
Pharmacokinetics and (palpitations) Patient & Family
Metabolism:  Ulceration of the Education
Mefenamic acid is well stomach or  Discontinue
absorbed from the intestines drug promptly
gastro-intestinal tract.  Bleeding from the if diarrhea, dark
Peak plasma stomach or stools,
concentrations occur in intestines hematemesis,
 about 2 to 4 hours,  Inflammation of the ecchymoses,
with a half-life of 2 to pancreas epistaxis, or
4 hours. Plasma levels (pancreatitis) rash occur and
are proportional to  Allergic reactions do not use
dose, following such as severe skin again. Contact
multiple doses, with no rashes, swelling of physician.
drug accumulation. the lips, tongue and  Notify
Mefenamic acid is throat (angioedema) physician if
extensively bound to or narrowing of the persistent GI
plasma proteins. Over airways discomfort, sore
50% of the dose may (bronchospasm) throat, fever, or
be recovered in the  Kidney, liver or malaise occur.
urine as unchanged blood disorders  Do not drive or
drug or conjugated engage in
metabolites. potentially
hazardous
activities until
response to
drug is known.
It may cause
dizziness and
drowsiness.
 Monitor blood
glucose for loss
of glycemic
control if
diabetic.
 Do not breast
feed while
taking this drug
without
consulting
physician.

Generic Name: Furosemide inhibits  Oral, IV: Edema Fluid and electrolyte  Administer with Severe sodium and
Furosemide reabsorption of Na and associated with imbalance. Rashes, food or milk to water depletion,
Brand Name: Lasix chloride mainly in the CHF, cirrhosis, photosensitivity, nausea, prevent GI hypersensitivity to
Drug Class : Diuretics medullary portion of renal disease diarrhoea, blurred vision, upset. sulphonamides and
See available brands of the ascending Loop of  IV: Acute dizziness, headache,  Reduce dosage furosemide,
furosemide Henle. Excretion of pulmonary hypotension. Bone if given with hypokalaemia,

Generic Name: Paracetamol
Brand Name: Aeknil
Drug Class : Analgesics (Non-
Opioid) & Antipyretics
 
potassium and edema marrow depression other hyponatraemia,
ammonia is also  Oral: (rare), hepatic antihypertensiv precomatose states
increased while uric Hypertension dysfunction. es; readjust associated with liver
acid excretion is Hyperglycaemia, dosage cirrhosis, anuria or
reduced. It increases glycosuria, ototoxicity. gradually as BP renal failure. Addison's
plasma-renin levels Potentially Fatal: responds. disease.
and secondary Rarely, sudden death and  Give early in
hyperaldosteronism cardiac arrest. the day so that
may result. Furosemide Hypokalaemia and increased
reduces BP in magnesium depletion urination will
hypertensives as well can cause cardiac not disturb
as in normotensives. It arrhythmias. sleep.
also reduces  Avoid IV use if
pulmonary oedema oral use is at all
before diuresis has set possible.
in.
Absorption: Fairly
rapidly absorbed from
the GI tract (oral).
Distribution: Crosses
the placenta and enters
breast milk. Protein-
binding: 99%.
Excretion: Via urine
(as unchanged); 2 hr
(elimination half-life),
may be prolonged in
neonates and renal and
hepatic impairment.
Antipyretic, analgesic. Pyrexia of unknown Paracetamol has rarely  Instruct the Nephropathy.
Pharmacology: origin. Fever & pain been found to produce patient to take
Paracetamol produces associated w/ any adverse effects in with meals.
analgesia by raising the common childhood therapeutic doses and is  Have plenty of
threshold of the pain disorders, tonsillitis, usually well tolerated by water when
center in the brain and upper resp tract aspirin-sensitive patients. taking this drug.
by obstructing infections post- Toxicity may result from
impulses at the pain- immunization a single toxic dose of the
mediating reactions, after drug or from chronic
chemoreceptors. The tonsillectomy & ingestion.
drug produces other conditions. The following adverse
 antipyresis by an Prevention of febrile reactions have been
action on the convulsion. reported: Skin eruption,
hypothalamus; heat Headache, cold, hematological toxicity
dissipation is increased sinusitis, muscle eg, thrombocytopenia
as a result of pain, arthritis & and leucopenia,
vasodilation and toothache. methemoglobinaemia
increased peripheral which can result in
blood flow. cyanosis, and on long-
Pharmacokinetics: term use, renal damage
Paracetamol is rapidly can result.
and almost completely
absorbed from the
gastrointestinal tract.
Following oral
administration, peak
plasma levels are
attained in 10 min to 1
hr and the half-life is
75 min to 3 hrs.
Distribution of
paracetamol to most
body tissues and fluids
is both rapid and
uniform.
Paracetamol is
excreted in the urine
primarily as the
glucuronide and
smaller amounts as the
sulfate, mercapturate
and unchanged drug.
Approximately 85% of
a dose of paracetamol
is excreted in the urine
within 24 hrs after
administration.

Generic Name: NALBUPHINE Pharmacology: Sedation. Infrequently  Note general Patients who are
HYDROCHLORIDE Nalbuphine HCl is a Relief of moderate to sweating, GI upsets, client condition. hypersensitive to
potent analgesic, 10 severe pain. Pre-op vertigo, dizziness; dry  Document
Brand Name: Nubain
Class : Anaesthetics - Local &
General, Analgesics (Opioid)
mg of which is analgesia, as a mouth; headache, indications for nalbuphine HCl.
comparable in supplement to allergic reactions. therapy, type/
analgesic potency to 8- balanced anesth, onset of
10 mg of morphine surgical anesth, for symptoms &
sulfate, whether obstet analgesia anticipated.
administered IV, SC or during labor & relief  Monitor V/S &
IM. of pain following MI. I&O.
The onset of action Post-op somatic &
occurs within 2-3 min visceral pain.
after IV administration
of nalbuphine HCl and
in <10 min following
SC or IM injection.
Clinical experience
suggests that in some
patients, analgesia may
be longer lasting than
from comparable doses
of morphine, effects
having been observed
in acute and chronic
pain for 3-8 hrs. The
t½ of nalbuphine is 5
hrs.
Nalbuphine HCl has
the effect of lowering
the cardiac work load
and can be used
immediately in
myocardial infarction
(use with caution
where emesis is
involved).
Hemodynamic studies
in patients with severe
arteriosclerotic heart
changes reveal that
nalbuphine HCl has
circulatory effects
similar to those of
 morphine ie, a minimal
decrease in oxygen
consumption, cardiac
index, left ventricular
end diastolic pressure
and cardiac work.
Nalbuphine HCl
antagonist activity is ¼
as potent as nalorphine
and approximately
1/40 that of naloxone.

Generic Name: Cilostazol Cilostazol is a Peripheral vascular Headache, dizziness, Before: Heart failure; known
Brand Name: Pletal reversible, selective disease palpitations, diarrhoea,  Do not expose predisposition to
inhibitor of abnormal stools; pain, premixed
bleeding; history of
Drug Class : Anticoagulants, phosphodiesterase-III infection; peripheral single-dose
(PDE-III), thereby oedema, nausea, product to ventricular
Antiplatelets & Fibrinolytics
(Thrombolytics) suppressing cyclic vomiting, other cardiac excessive heat; arrhythmias; QT
adenosine arrhythmias, chest pain, store at 15-30 interval
monophosphate rhinitis, pharyngitis, C. prolongation; severe
(cAMP) degradation. ecchymosis and skin  List drugs renal impairment;
Increase in cAMP in rash. prescribed to moderate to severe
platelets and blood ensure none
vessels leads to interact hepatic impairment.
inhibition of platelet unfavorably.
aggregation and  Assess location,
vasodilation. characteristics,
Cilostazol also inhibits extent of
adenosine uptake into abdominal pain;
cells, which augments note blood in
the cAMP-elevating emesis, stool/
effect of PDE-III gastric aspirate.
inhibition. During:
Absorption: Absorbed  Administer PO
from the GI tract after medication with
oral admin. meals & with a
Distribution: 95-98% snack at
bound to plasma bedtime.
proteins.  In renal
Metabolism: dysfunction, a
 Extensively dose of 300 mg
metabolised PO/ IV g 12 hr.
hepatically by CYP450 may be
isoenzymes, mainly necessary.
CYP3A4.  For IM use,
Excretion: Mainly give undiluted.
excreted in the urine, After:
remainder excreted in  Note general
the faece client condition.
 Document
indications for
therapy, type/
onset of
symptoms &
anticipated.
 Monitor V/S &
I&O.
Generic Name: Potassium Potassium chloride is a Prevention of GI ulceration (sometimes  Monitor plasma Hyperchloraemia,
Chloride major cation of the hypokalaemia with haemorrhage and potassium severe renal or adrenal
Brand Name: K-Dur, K-Lor, intracellular fluid. It perforation or with late levels insufficiency.
K-Tab, Kaon CL, Klorvess, plays an active role in formation of strictures)
Slow-K, Ten-K, Klotrix, K- the conduction of following the use of  Monitoring of
Lyte CL nerve impulses in the enteric-coated K chloride acid-base
heart, brain and preparation; balance,
Drug Class : Electrolytes skeletal muscle; hyperkalaemia. Oral: potassium
contraction of cardiac Nausea, vomiting, levels, and ECG
skeletal and smooth diarrhoea and abdominal is
muscles; maintenance cramps. IV: Pain or recommended.
of normal renal phloebitis; cardiac
function, acid-base toxicity.
balance, carbohydrate
metabolism and gastric
secretion.
Absorption: Well
absorbed from the
upper GI tract.
Distribution: Active
transport mechanism
allows K chloride to
enter cells from the
extracellular fluid.
Excretion: Mainly via
the urine with small
amounts via the sweat
and feces.