Medical Management DM Table 4.

1 Generic name: Brand name: Therapeutic class: Indication: Dosage: Drug action: Acarbose Glucobay Antidiabetic/ Alpha-glucosidase inhibitor Management of type 2 diabetes mellitus 50mg 1tab OD Lowers blood glucose by inhibiting the enzyme alpha-glucosidase in the GI tract, delay and reduce glucose absorption Abdominal pain, diarrhea and flatulence

Side/adverse effects: Nursing responsibilities:

Monitor for hypoglycemia and serum glucose level prior to administration Administer after breakfast Inform the patient not to take medication if she/he missed the dose. Do not double dose Inform patient about the action of the drug and its effects

Table 4.2 Generic name: Brand name: Therapeutic class: Indication: Dosage: Drug action: Insulin Glargine Lantus antidiabetics Control hyperglycemia in patients with type 2 DM 10 units sq OD Blood glucose level by stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic glucose production Hypoglycemia, sweeling, pruritus and allergic reaction Assess for signs of hypoglycemia. Monitor blood glucose level. Educate the family or the patient how to administer the medication, route and dosage. Inform the patient this medication can

Side/adverse effects: Nursing responsibilities:

manage hyperglycemia not treatment for diabetes. Emphasize the compliance of this medication. Educate the family of the patient about the drug, its side effects and why is it given to the patient

HTN Table 4.3 Generic name: Brand name: Therapeutic class: Indication: Dosage: Drug action: Amlodipine Vasalat anti-hypertensive/ Calcium channel blocker Management for hypertension 5g 1tab OD Inhibit the transport of calcium into myocardial and vascular smooth muscles cells resulting in inhibition of contraction, systemic vasodilation thus decreasing the blood pressure Headache, dizziness, edema, hypotension, bradycardia, nausea Advice patient to take it as directed even if feeling well. Take missed dose as soon as possible. Do not double dose. Taper the dose Teach the family of techniques on how to monitor blood pressure and pulse rate Inform patient to avoid food contains salts and potassium Caution the patient to avoid sudden change in movements and activities that requires alertness Provide safety Inform patient that this medication does not cure but just manage the hypertension

Side/adverse effects: Nursing responsibilities:

Table 4.4 Generic name: Brand name: Therapeutic class: Indication: Dosage: Furosemide Lasix loop diuretics Renal disease and hypertention 40mg IVTT stat

Drug action:

Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal Renal Tubule. Increase renal excretion of water, sodium, chloride, magnesium, potassium and calcium. Effectiveness persists in impaired renal function. It is given stat because the patient is experiencing fluid volume excess and sodium and potassium retention as manifested by increase in blood pressure, edema on both feet and being supported by laboratory exams such as increase sodium and potassium in the blood.

Side/adverse effects:

Dehydration, hypokalemia, hypochloremia, hypovolemia, hypocalcemia, hypomagnesemia, hyponatremia, blurred vision, dizziness, headache, anorexia, dry mouth, nausea and vomiting, paresthesia Assess fluid status Nursing Monitor blood pressure responsibilities: Assess side/adverse effects. Report immediately to health care provider if there is any Caution the patient about sudden change and position and should avoid activities that required alertness Advice the patient to continue additional management of hypertension Emphasize the need for check ups Table 4.5 Generic name: Brand name: Therapeutic class: Indication: Telmisartan Pritor Anti-Hypertensive/ antagonist Angiotensin II receptor

Manage hypertension and treat diabetic nephropathy of patient with diabetes mellitus type 2 40mg 1tab OD Block the vasoconstrictor and aldosteroneproducing effects of angiotensin II at the receptor sites including vascular smooth muscles and adrenal glands thus decreasing the blood pressure and slows the progression of diabetic nephropathy dizziness, hypotension, tachycardia, edema, chest pain, abdominal pain, diarrhea, nausea and vomiting Teach the family of techniques on how to monitor blood pressure and pulse rate Administer with meals

Dosage: Drug action:

Side/adverse effects: Nursing responsibilities:

Advice patient to take medication as directed even feeling well Take missed dose as soon as remembered. Do not double dose. Do not discontinue until physician say so Inform patient to avoid food contains salts and potassium Caution the patient to avoid sudden change in movements and activities that requires alertness Provide safety Inform patient that this medication does not cure but just manage the hypertension

Table 4.6 Generic name: Brand name: Therapeutic class: Indication: Dosage: Drug action: Calvit-C Dehlvi Anti-fatigue Generalized fatigue 500mg 1tab TID Contains natural calcium and Vitamin C Calcium is essential for the growth and development of healthy bones and strong teeth It also helps control blood cholesterol levels, assists nerve, muscle and digestive function, regulates heart muscle function and sleep Vitamin C also helps prevent atherosclerosis by strenghtening the artery walls through its participation in the synthesis of collagen, and by preventing the undesirable adhesion of white blood cells to damaged arteries

Side/adverse effects: Nursing responsibilities:

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Encourage patient to consume more of sardines, dairy products and soya milk which are rich in calcium and citrus fruits, green vegetables, tomatoes and strawberries which are rich in vit.C Avoid carbonated drinks, alcohol, caffeine and increase intake of salts

Table 4.7 Generic name: Sulodexide

Brand name: Therapeutic class: Indication: Dosage: Drug action:

Vessel Due F Anti-thrombotic Diabetes mellitus 250 SLU 1cap OD Vessel Due-F contains sulodexide, a glycosaminoglycan featuring a marked antithrombotic action either on arterial or venous systems and also capable of normalizing altered viscosimetry parameters generally present in patients with vascular pathologies with thrombotic risk

Side/adverse effects: Nursing responsibilities:

Hemorrhage, nausea, vomiting and abdominal pain hemocoagulative parameters monitored Taken with meals Do not discontinue unless physician Watch for any signs of hemorrhage should be

directed bleeding

by or

Table 4.8 Generic name: Brand name: Therapeutic class: Indication: Dosage: Drug action: Ferrous Sulfate Sorbifer Antianemics Treat iron deficiency in patient having kidney disease who undergoing hemodialysis 300mg 1tab OD Iron is an essential mineral found in hemoglobin, myoglobin and many enymes, enters to blood streams and tranported to organs of the reticuloendothelial system (liver, bone marrow, spleen) where it is separate out and becomes part of iron stores Hypotension, nausea, constipation, dark stools, diarrhea, epigastric pain, vomiting, dyspnea and cough

Side/adverse effects:

Nursing responsibilities:

Assess nutritional status and dietary history Assess any signs of allergic reaction take it as directed Report immedietly to physician if stomach pain, fever, nausea and vomiting and diarrhea occured

Table 4.9 Generic name: Brand name: Therapeutic class: Indication: Dosage: Drug action: Metoclopramide Plasil Antiemetics Prevent or treat nausea and vomiting 40mg 1tab OD Blocks dopamine receptors in chemoreceptor trigger zone of the CNS. Stimulates motility of the upper GI tract and accelerates gastric emptying

Side/adverse effects:

Restlessness, drowsiness, fatigue & lassitude. Less frequent insomnia, headache, dizziness, nausea, galactorrhea, gynecomastia or bowel disturbances assess patient for nausea, vomiting, Nursing abdominal distention, and bowel sounds responsibilities: before and after administration May cause drowsiness Advise patient to avoid concurrent use of alcohol and other CNS depressant while taking this medication Advise patient to notify health care professional immediately if involuntary movement of eyes, face or limbs occurs Table 4.10 Generic name: Brand name: Therapeutic class: Indication: Dosage: Drug action: Omeprazole Losec Anti-ulcer agent/Proton-pump inhibitor Reduction of risk of GI bleeding 20mg 1cap OD Binds to an enzyme or gastric parietal cells in the presence of acidic gastric pH, preventing the

final transport of hydrogen ions into gastric lumen thus diminished accumulation of acid Side/adverse effects: Dizziness, abdominal pain, fatigue, headache, checst pain, nausea and vomiting Assess for epigastric pain Nursing Administer before meals responsibilities: Do not chew or crust Instruct the patient to cautiously take the medication as ordered. Do not discontinue. Do not double dose Inform patient ot avoid activity that requires alertness Advice the patient to report any signs of bleeding

Table 4.11 Name: Therapeutic class: Indication: Pro Vitality Dietary Supplements Nutrient supplement for patient having chronic disases such as heart disease, cancer, and diabetes 3 capsule OD TRE-EN-EN GRAIN CONCENTRATES Feed your cells--energize your life. Good nutrition begins at the cellular level. Tre-enen is the world's first and only whole grain lipids and sterols supplement proven to enhance energy and vitality by optimizing cell membrane function. It energizes your entire body by helping your cells function more efficiently. CAROTENOID COMPLEX Carotenoid Complex is the world's first and only whole food supplement clinically proven by USDA researchers to protect your heart, defend your cells, and boost your ommune power. OMEGA-III SALMON OIL PLUS The world's first complete fish oil supplement with guaranteed potency of all eight members of the omega-3 family. Recent human clinical trails proved its bioavailability to support heart and cardiovascular health, as presented

Dosage: Drug action:

at Experimental Biology 2008

Side/adverse effects: Nursing responsibilities:

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Encourage patient to still eat nutrional foods Educate the patient regarding the supplement, its benefits and it is being given to her Inform her that she shold not be reliant of the supplement and she should encourage to enhance her lifestyle