Drug Name TRIMETAZIDINE !

astarel MR" #$ mg%tab &ID Drug classes: ANTI'AN(INA

Mechanism Of Action
Selective inhibition of an enzyme of fatty acid oxidation: the long-chain 3-ketoacyl CoA thiolase 3-!A"#$ "his inhibition results in: %eduction in fatty acid oxidation& Stimulation of glucose oxidation$ "he cou'ling of glycolysis (ith glucose oxidation is im'roved and A") 'roduction is further increased* (hile cell acidosis and Ca+, overload are limited$ "he increase in total glucose utilization has been evidenced by studies using -./D0 'ositron emission tomogra'hy )1"#$

Indication
)reventive treatment of e'isodes of angina 'ectoris$

Contraindicatio n
2y'ersensitivity$ Severe renal im'airment CrCl 334 m56min#$ 5actation$

Adverse Effect
Commonly* dizziness* headache* abdominal 'ain* diarrhea* dys'e'sia* nausea* vomiting* rash* 'ruritus* urticaria* asthenia$ %arely* 'al'itations* extrasystoles* tachycardia* arterial hy'otension* orthostatic hy'otension that may be associated (6 malaise* dizziness or fall* in 'articular in 'atients taking antihy'ertensive treatment* flushing$ Commonly* body tem'erature elevation* restlessness* headache* nausea and vomiting* diarrhea* lo( or high blood 'ressure* tachycardia* slee'ing troubles or insomnia* blurred vision* chest 'ains :ccasionally* may stimulate 'arasym'athetic effects* fleeting ? discrete

Nursing Responsibilities
Check for doctor7s order 8onitor blood 'ressure and 'ulse rate before and after giving the meds$ 9otify 'rescribing signs of heart failure such as s(elling of hands and feet or S:;$ Advise 'atient of the side effects of the drug$

CITICO)INE Z*napse" +, ml &ID Drug classes:

NE-ROTONIC./ NOOTRO0IC.

Citicoline increase a brain chemical called 'hos'hatidylcholine$ "his brain chemical is im'ortant for brain function$ <t decreases brain tissue damage (hen the brain is in=ured$ <t is usually kno(n that 'hos'holi'id* es'ecially lecithin* decreases follo(ing decline in brain activity (ith cerebral trauma$ Citicoline* (hich is a co-enzyme* accelerates the biosynthesis of lecithin in the body$ "his medication

Cerebrovascular diseases

Any allergy or hy'ersensitivity to the drug 2y'ertonia of the 'arasym'athetic nervous system >se cautiously for 'regnancy and lactation Conscious use for 'atient (ith renal and he'atic damage

Citicoline may be taken (ith or (ithout food$ "ake it (ith or bet(een meals$ "he su''lement should not be taken in the late afternoon or at night because it can cause difficulty slee'ing$ Contact the 'hysician immediately if allergic reaction such as hives* rash* or itching* s(elling in your face or hands* mouth or throat* chest tightness or trouble breathing are ex'erienced$ Citicoline thera'y should be started (ithin +@ hours of a stroke$ "he 'hysician (ill 'rescribe the correct dosage and the length of time it