DRUG STUDY

GENERIC/ TRADE NAME

Acetylcyst e i n e

DOSAGE/ FREQUEN CY 600 mg 1 tab BID

CLASSIFICATI ON Respiratory/ Cou gh & Cold Prep arati ons/ Muc okin etics /Exp ecto rant s

INDICATION Treatment of respirator y affections characte rized by thick and viscous hypersecr etions: acute and chronic bronchitis and its exacerbat ions, pulmonar y emphyse ma, mucovisci dosis and bronchiec tasis. For the treatment of hypertension and prophylaxis of angina.

CONTRAINDICATION Hypersensitivit y. Tab and granules: Phenylketonuri a (contains aspartame).

SIDE EFFECTS Pyrosis, nausea, vomiting. Rarely, urticaria and bronchospasm. Nasopharyngeal and gastrointestinal irritation like rhinitis, stomatitis.

NURSING RESPONSIBILITIES If patients condition doesnt improve within 10 days, tell him to notify prescriber. Drug shouldnt be used for prolonged period without direct medical supervision. Inform patient that drug may have a foul taste or smell.

FLUIMUCIL

Amlodipine Besylate

10 mg/tab 1 tab OD in PM

Cardio/

Anti hype rten sive s/ Calci

Cardiogenic shock, MI, acute unstable angina, severe aortic stenosis, chronic stable angina.

Dizziness, flushing, headache, hypotension, peripheral edema, tachycardia & palpitations. Nausea & other GI

Assess patients blood pressure or angina before therapy and regularly thereafter. Monitor patient carefully for pain. In some patients,

um Anta goni sts

disturbances, increased micturition frequency, lethargy, eye pain, & mental depression. Rashes, fever & abnormalities in liver function including cholestasis. Gingival hyperplasia, myaglia, tremor & impotence.

increased frequency, duration, or severity of angina or even acute MI has developed after starting a calcium channel blocker or increasing dosage. Be alert reactions. for adverse

Atorvastati n Calcium

40 mg now, then OD

Cardio/ LipidReg ulati ng Drug s/ Stati ns

Primary hypercholester olemia, heterozygous familial hypercholester olemia or combined hyperlipidemia in patients who have not responded adequately to diet and other appropriate measures. Long-term therapy of mild to severe hypertension. Hypertensive

Active liver disease or elevation of serum transaminase more than 3 times the upper limit of normal, pregnancy, lactation, women of childbearing potential.

Chest pain, face edema, fever, neck rigidity, malaise, photosensitivity reaction, generalized edema asthenia, muscle cramps, Stevens-Johnson Syndrome, toxic epidermal necrolysis eythema multiforme, weight gain, malaise and fatigue.

Advise patient to continue taking drug even after feeling better. Teach patient about proper diet, weight control, and exercise, and explain their role in controlling elevated lipid levels. Warn patient to avoid alcohol. Tell patient to inform prescriber of adverse reactions, such as muscle pain, tenderness, or weakness, especially if accompanied by fever or malaise. Advise patient not to stop drug abruptly because doing so may cause severe rebound hypertension. Explain that

Clonidine Hydochlori de CATAPRES

45 mg 1 tab BID

Cardio/

Anti hype rten sive

Sick sinus syndrome.

Local skin irritation, allergic contact dermatitis, hypo- & hyperpigmentation of the skin.

s/ Cent rally acti ng Drug s

crisis.

dose must be reduced gradually over 2 to 4 days. Tell patient to take the last daily dose immediately before bedtime. Caution patient that drug can cause drowsiness, but that he will develop tolerance to this adverse effect. Urge patient to rise slowly and avoid sudden position changes to reduce orthostatic hypotension. Instruct patient to keep the Diskus in a dry place, to avoid washing the mouthpiece or other parts of the device, and to avoid taking the Diskus apart. Tell patient to stop taking an oral or inhaled longacting beta2 agonist simultaneously when beginning the Diskus. Instruct patient to rinse mouth after each inhalation to prevent oral

Fluticasone , Salmeterol SERETIDE

500 mcg Diskus 1 PUFF BID

Respiratory/ Drug s for Asth ma/ COP D/ Sym path omi meti cs

Regular treatment of reversible obstructive airways disease (ROAD), including asthma where use of combination therapy (bronchodilator and inhaled corticosteroid) is appropriate. Maintenance treatment of

Contraindicated in patients hypersensitive to drug or any of its components. Also contraindicated as primary therapy for status asthmaticus or other potentially life threatening acute asthmatic

Salmeterol: Tremor, subjective palpitations and headache, cardiac arrhythmias, arthralgia, hypersensitivity reactions, muscle cramps (rarely). Fluticasone: Hoarseness, candidiasis of mouth and throat, paradoxical bronchospasm.

chronic obstructive pulmonary disorder including chronic bronchitis and emphysema. Furosemid e FUSEM 40 mg IV q12 Cardio/ Anti hype rten sive s/ Diur etics / Loop Diur etics Edema, associated w/ CHF, hepatic cirrhosis & renal disease.

episodes. Drug isnt indicated for exerciseinduced bronchospasm. 1st trimester of pregnancy. Anuria in patients receiving lithium therapy Most common: fluid & electrolyte imbalanced after either single large doses or prolonged admin. Relatively uncommon: allergy, nausea, diarrhea, blurred vision, dizziness, headache, pancreatitis, photosensitivity, skin rashes, muscle spasm, & hypotension.

candidiasis. Inform patient that improvement may be seen within 30 minutes after a Seretide dose; however full benefit may not occur for 1 week or more. Advise Patient to stand slowly to prevent dizziness, not to drink alcohol, and to minimize strenuous activities in hot weather. Instruct patient to report ringing in the ears, severe abdominal pain, or sore throat and fever because they may indicate toxicity. Tell patient to check with prescriber before taking OTC drug or herbal remedies. Advise patient to take drug with food to minimize GI upset. Warn patient not to change position suddenly and to rise slowly to avoid orthostatic hypotension.

Hydrochlor othiazide, Losartan potassium COMBIZAR

Losartan 100 mg + HCTZ 25 mg = Combizar 1 tab OD in AM

Cardio/

Anti hype rten sive s/ Angi oten sin II

For the management of hypertension.

Hypersensitivit y. Pregnancy. Patients w/ anuria.

Abdominal pain, edema/swelling, asthenia/fatigue, headache. Palpitation, diarrhea, nausea, back pain, dizziness. Dry cough, sinusitis, bronchitis, pharyngitis, upper

Hydrocorti sone

100 mg TIV q12

Anta goni sts, Card io/ Anti hype rten sive s/ Diur etics / Thia zide s& Thia zideLike Diur etics Derma/ Antiinfla mma tory Drug s/ Topi cal Corti cost eroi ds

resp infection, rash.

Instruct patient not to drink alcohol during drug therapy. Advise patient to use sunblock to prevent photosensitivity reactions. Tell patient to check with prescriber before taking OTC drugs or herbal remedies.

Inflammation & pruritic manifestation of corticosteroidresponsive dermatoses.

Containdicated in patients hypersensitive to drug or any of its components, and in those with systemic fungal infections. Hydrocotisone sodium succinate is contraindicated to premature

Burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform, eruptions, hypopigmentation, perioral dermatitis, allergic contact dermatitis, skin maceration, secondary infection, skin atrophy, striae & miliaria.

Tell patients signs of early adrenal insufficiency (fatigue, muscle weakness, joint pain, fever, anorexia, nausea, dyspnea, dizziness, and fainting). Tell patient not to abruptly stop taking the drug without prescribers consent. Abruptly stopping therapy may lead to rebound inflammation, fatigue,

infants.

weakness, arthalgia, fever, dizziness, lethargy, depression, fainting, orthostatic hypotension, dyspnea, anorexia, and hypoglycemia. After prolonged use, sudden withdrawal may be fatal. Warn patient receiving long-term therapy about cushigoid symptoms, and tell him to report sudden weight gain or swelling to prescriber. Warn patient about easy bruising. Warn patient that drug isnt effective for treating acute episodes of bronchospasm where rapid response is needed. Tell patient to avoid accidentally spraying into eyes. Temporary blurring of vision may result. Tell patient to wait at least 2 minutes before repeating when using more than one inhalation. Tell patient to rinse mouth after using oral

Ipratropiu m bromide, Salbutamol COMBIVEN T

Neb q6 x 3 doses

Respiratory/ Drug s for Asth ma/ COP D/ Anti choli nerg ics

Management of reversible bronchospasm associated with obstructive airway diseases in patients who require more than a single bronchodilator.

Hypertrophic obstructive cardiomyopath y or tachyarrythmia. Hypersensitivit y to atropine or its derivatives.

Headache, dizziness, nervousness, tachycardia, fine tremor of skeletal muscles and palpitations. Potentially serious hypokalemia may result from beta2agonist therapy. Cough, local irritation and less common inhalation induced broncho spasm.

Lactulose LILAC

30 cc OD @ HS hold for BM >2x/day

Gastro/

Methylpred nisolone MEDROL

16 mg/tab 1 tab BID x 7 days

Chol ago gues , Chol elith olyti cs & Hep atic Prot ecto rs, Gast ro/ Laxa tives /Ene mas Hormones and Rela ted Drug s/ Adre noco rtico ster oid Hor mon es

Constipation. Treatment of hepatic encephalopathy .

Patients who require a low lactose diet. Galactosaemia or disaccharide deficiency. Intestinal obstruction.

Abdominal discomfort associated w/ flatulence and intestinal cramps. Nausea, vomiting, diarrhea on prolonged use.

inhaler. Advise patient to dilute drug with juice or water, or to take with food to improve taste. Inform patient of adverse reactions and tell him to notify prescriber if reactions become bothersome or if having more than two or three soft stools daily.

Endocrine, rheumatic & hematologic disorders. Collagen, dermatologic, ophthalmic, GI, respiratory, & neo plastic diseases. Allergic & edematous states. Acute exacerbations of multiple

Systemic fungal infections. Hypersensitivit y. Lactation.

Fluid & electrolyte, musculoskeletal, GIT, dermatologic, neurological, endocrine, ophth & metabolic disturbances.

Tell patient not to abruptly stop taking the drug without prescribers consent. Teach patient signs of early adrenal insufficiency. Warn patient receiving long-term therapy about cushingoid symptoms, and tell him to report sudden weight gain or swelling. Suggest

Metoclopra mide hydrochlori de

20 mg TIV

Gastro/ Prok ineti c Drug s/An tiflat ulen ts, CNS/ Anti eme tic/A ntiv ertig o

Nicardipine hydrochlori de CARDEPINE

Capsules 20mg, 30mg

Cardio/ Anti hype rten sive s/ Calci um Anta goni

sclerosis & misc like TB meningitis w/ subarachnoid block & trichinosis. Disturbances of GI motility. Nausea & vomiting of central & peripheral origin associated w/ surgery, metabolic diseases, infectious & drug-induced diseases. Facilitate small bowel intubation & radiological procedures of GIT. Hypertensive emergencies or urgencies, periop & post-op HTN, hypertensive states of NPO patients.

exercise or physical therapy, and advise him to ask prescriber about Vitamin D or calcium supplements. GI hemorrhage, mechanical obstruction or perforation, pheochromocyt oma, epileptics. Extrapyramidal reactions, drowsiness, fatigue & lassitude, anxiety. Less frequently, insomnia, headache, dizziness, nausea, galactorrhea, gynecomastia, bowel disturbances. Instruct patient not to drink alcohol during therapy. Advice patient to avoid activities requiring alertness for 2 hours after taking each dose.

Patients who do not have complete hemostasis following intracranial hemorrhage. Increased intra cranial pressure during acute

Peripheral edema, headache, tachycardia, palpitations, localized thrombophlebitis & dose-related hypotension. Abdominal pain, nausea, vomiting,

Tell patient not to stop drug even after he is feeling better. Instruct patients to use alcohol cautiously. Alcohol may further lower blood pressure and increase drowsiness or dizziness while taking

sts

phase of a stroke.

dyspepsia, constipation, diarrhea, dry mouth, anorexia, heartburn, hypokalemia, hypophosphatemia, hyperglycemia, abnormal hepatic function test results, increased plasma renin concentration, headache, dizziness, hypesthesia, intracranial hemorrhage, paresthesia, confusion, hypertonia, somnolence, insomnia, hot flashes, vertigo, hyperkinesia, impotence, mental depression, anxiety, cerebrovascular accident, cerebral ischemia, lassitude, nervousness, lightheadedness, thrombocytopenia, sweating, injection site reaction and pain, rash, polyuria, hematuria, increased urinary frequency, nocturia, urinary

nicardipine. Advise patient not to eat grapefruit or drink grapefruit juice while using Nicardipine unless the doctor directs it otherwise Maximum lowering of blood pressure occurs approximately 1 to 2 hours after taking the medicine. Blood pressure should be taken 1 to 2 hours after the medicine has been taken. Nicardipine may cause dizziness or fainting. These effects may be worse if patient takes it with alcohol or certain medicines. Use Nicardipine with caution. Do not drive or perform other possibly unsafe tasks until patient knows how you react to it.

Omeprazol e SYNDEPRA ZOLE

40 mg/tab 1 tab OD prebreakfast

Potassium chloride KALIUM DURULES

1 tab TID x 6 doses

Gastro/ Drugs used in acidpept ic dise ase/ Gast ric Anti secr etor y Drug s/ Prot on Pum p Inhi bitor s Fluids/ Misc ellan eous Flui ds/ Oral Elect

Conditions where inhibition of gastric acid secretion may be beneficial, including aspiration syndromes, dyspepsia, GERD, peptic ulcer disease and ZollingerEllison syndrome.

Contraindicated in patients hypersensitive to drug or any of its components.

retention, conjunctivitis, abnormal or blurred vision, ear disorder, tinnitus. Headache, diarrhea, skin rash. May require disconti nuation upon severity. Rarely, arthralgia, myalgia, paresthesia, aggression, blurred vision, taste disturbance, peripheral edema, hyponatremia, blood disorders including agranulocytosis, leucopenia, thrombocytopenia, interstitial nephritis, hepatotoxicity.

Warn patient not to crush or chew tablets or capsules. Advise patient that OTC drug isnt intended for immediate relief of heartburn or to treat occasional heartburn (one episode of heartburn a week or less). Inform patient that OTC drug may require 1 to 4 days for full effect, although some patients may get complete relief of symptoms within 24 hours.

Hypokalemia. As prophylaxis during treatment w/ diuretics.

Renal insufficiency, hyperkalemia, untreated Addison's disease, hypersensitivity .

Flaccid paralysis, listlessness, mental confusion, paresthesia of limbs, weakness or heaviness of limbs, ECG changes, abdominal pain,

Assess patients condition before starting therapy and regularly thereafter to monitor drugs effectiveness. Be alert for adverse reactions and drug

Rosuvastat in RUSTOR

20 mg/tab 1 TAB OD @ HS

rolyt es/H ydra ting Solu tion s Cardio/ LipidReg ulati ng Drug s/ Stati ns

diarrhea, nausea, vomiting, oliguria, cold skin, gray pallor, phlebitis.

interactions. Tell patient that controlled-release tablets may appear in stool but that the drug has already been absorbed. Teach patient about restricting total fat and cholesterol intake, and recommend weight control, exercise, and smoking cessation programs. Tell patient to report any signs of unexplained muscle pain, tenderness, or weakness, especially if accompanied by malaise or fever. Instruct patient that antacids containing aluminum or magnesium should be taken at least 2 hours after this drug. Instruct patient to take drug 1 hour before each meal and bedtime. Tell patient to continue on prescribed regimen to ensure complete healing. Pain and ulcerative symptoms may subside

Sucralfate ISELPIN

1 gm/tab TID

Gastro/ Drugs used in acidpept ic dise ase/ Cyto

Adjunct to diet to reduce total cholesterol, LDL, apolipoprotein (ApoB), nonHDL, and triglyceride levels, as well as to increase HDL level in primary hypercholester olemia, mixed dyslipidemia; adjunct to diet to treat elevated triglyceride level Duodenal & gastric ulcers, chronic gastritis.

Hypersensitivit y. Active liver disease. Women of child-bearing potential not using appropriate contraceptive measures. Pregnancy & lactation.

Headache, myalgia, asthenia, constipation, dizziness, nausea, abdominal pain. Pruritus, rash and urticaria. Rarely: Myopathy, hypersensitivity reactions including angioedema, rhabdomyolysis, pancreatitis.

Hypersensitivit y. Patients on dialysis.

Constipation, diarrhea, nausea, gastric discomfort, indigestion, dry mouth, rash, pruritus, back pain, dizziness, drowsiness, vertigo.

prot ectiv es

within first sew weeks of therapy. Urge patient to avoid cigarette smoking because it may increase gastric acid secretion and worsen disease. Also tell patient. To avoid alcohol, chocolate, and spicy foods.