DRUG Brand Name: Vessel Due Generic Name: Soludexide Classification: Anticoagulant, antithrombotics & fibrinolytics Dosage: 1 cap

BID

ACTION Inhibits coagulation by attacking several sites of the coagulation system. Its effect is dependent on thepresence of antithrombin III, an alpha 2globulin whose activity is augmented by heparin. The heparinantithrombin complex inactivates factors IXa, Xa, XIa and XIIa, and prevents thrombin formation. Furthermore, the complex reverses the effect of already formed thrombin. In

INDICATION Vascular pathologies w/ thrombotic risk, transient ischemic attacks & cerebrovascular disease, peripheral vascular insufficiency, diabetic retinopathy, MI, retinal vasal thrombosis.

ADVERSE CONTRAINDICATION EFFECT/ SIDE EFFECT Hypersensitivity to Adverse Effect: sulodexide, heparin & nausea, heparin- like products. vomiting, Diathesis & epigastralgia. hemorrhagic Side Effect: diseases.

NURSING CONSIDERATIONS

Assess patients for signs of bleeding and hemorrhage (ble eding gums; nosebleed; unusual bruising; black, tarry stools; hematuria; fall in hematocrit or blood pressure; guaiacpositive stools). Notify physician if these occur. Monitor patient for hypersensitivity reactions (chills, fever, urticaria). Report sign s to physician Subcutaneous: observe injection sites for hematomas, ecchymosis, or inflammation. Monitor platelet count every 2-3 days throughout therapy. May cause mild thrombocytopenia, which appears on the 4th day and resolves

high concentrations, heparin also inhibits thrombocyte aggregation.

despite continued heparin therapy.

DRUG

ACTION

INDICATION

CONTRAINDICATION

ADVERSE EFFECT/ SIDE EFFECT

NURSING CONSIDERATIONS

Brand Name: Generic Name: Sangobion Classification: Dosage:

DRUG Brand Name: Nitroglycerin Generic Name: Deponit Classification: Nitrates Dosage:

ACTION Relaxes vascular smooth muscle with a resultant decrease in venous return and decrease in arterial BP, which reduces left ventricular workload and decreases myocardial oxygen consumption.

INDICATION Sublingual, translingual preparations: Acute angina Oral sustained release, sublingual, topical, transdermal, translingual,t ransmucosal preparations: Prophylaxis of angina Unlabeled uses: Reduction of cardiac workload in acute MI and in CHF(subling ual, topical); adjunctive treatment of Raynaud's disease (topical)

CONTRAINDICATION Contraindicated with allergy to nitrates, severe anemia, early MI, head trauma,cerebral hemorrhage, hypertro phic cardiomyopathy, pregnancy, lactation.

ADVERSE EFFECT/ SIDE EFFECT CNS: Headache, apprehensio n, restlessness, weakness, vertigo, dizziness,fai ntness CV: Tachycardia, retrosternal discomfort, p alpitations, hypotension, syncope, collapse, orthostatic hypotension, angina Dermatologic : Rash, exfoliative de rmatitis, cutaneous vasodilation withflushing, pallor, perspiration,

NURSING CONSIDERATIONS History: Allergy to nitrates, severe anemia, early MI, head trauma, cerebral hemorrhage, hypertr ophic cardiomyopathy, hepatic or renal disease, hypotension or hypovolemia, increa sed intracranial pressure, constrictive pericardi tis, pericardial tamponade, pregnancy, lactation Administer transdermal systems to skin site free of hair and not subject to much movement. Shave areas that have a lot of hair. Do not apply to distal extremities. Change sites slightly to decrease the chance of local irritation and

cold sweat, contact derm atitis transdermal preparations, topical allergic reactions topical nitroglycerin ointment GI: Nausea, vomiting, inc ontinence of urine and feces, abdominal pain Local: Local burning sensation at the point of dissolution (sublingual)

sensitization. Remove transdermal system before attempting defibrillation or cardioversion. To use transdermal systems, you may need to shave an area for application. Apply to a slightly different area each day. Use care if changing brands; each system has a different concentration. These side effects may occur: Dizziness, lightheadedness (may be transient; change positions slowly); headache (lie down in a cool environment and rest; over-thecounter preparations may not help); flushing of the neck or face(transient). Report blurred vision, persistent or

severe headache, rash, more frequent or more severe angina attacks, fainting.

DRUG Brand Name: Erdosteine Generic Name: Zertin Classification: Mucolytic Dosage: 300mg 1 tab BID

ACTION Erdosteine contains two sulfhydryl groups, which are freed after metabolic transformation in the liver. The liberated sulfhydryl groups break the disulphide bonds, which hold the glycoprotei n fibers of mucus together. This makes the bronchial secretions mor e fluid and enhances elimination.

INDICATION Treatment of acute and chronic bronchitis and its exacerbations. Respiratory disorders characterized by abnormal bronchial secretions and impaired mucus transport

CONTRAINDICATION Peptic Ulcer Disease Liver Cirrhosis Ascites Liver damage

ADVERSE EFFECT/ SIDE EFFECT Sweating Vertigo Flushing

NURSING CONSIDERATIONS This drug can be taken with or without food For the reason that of a probable intrusion of erdosteine metabolites with the methionine metabolism, erdosteine is not recommended in subjects experiencing hepatic cirrhosis and insufficiency of the cystathionine synthetase enzyme. Ectrin Suspension is also contraindicated for Phenylketonuria, bec ause of existence of aspartame.

DRUG Brand Name: Novomix Generic Name: Insulin Classification: Anti-diabetic drugs Dosage: 16units 515mins BS

ACTION Decreases blood glucose; by transport of glucose into cells and the conversion of glucose to glycogen indirectly decreases blood pyruvate and lactate, decreases phosphate and potassium.

INDICATION Management of type I and type II DM which cannot be controlled by exercise, diet or weight reduction alone

ADVERSE CONTRAINDICATION EFFECT/ SIDE EFFECT Hypoglycemia Lipodystrophy Insulinoma Insulin resistance Hypersensitivity reactions Allergic reactions Diabetic Coma Hypoglycemia

NURSING CONSIDERATIONS Note the frequency of blood glucose monitoring is determined by the type of insulin regimen and health status of the patient. Monitor for hypoglycemia at time of peak action of insulin. Onset of hypoglycemia (blood sugar: 5040 mg/dL) may be rapid and sudden. Teachings: Note that Hypoglycemia can result from excess insulin, insufficient food intake, vomiting, diarrhea, unaccustomed exercise, infection, illness, nervous or emotional tension, or overindulgence in

alcohol. Carry some form of fast-acting carbohydrate (e.g., lump sugar, Life-Savers or other candy) at all times to treat hypoglycemia.