DRUG STUDY

GENERIC/ BRAND NAME Citicoline sodium

Brand Names: Zynapse, Somazina, Cholinerv Classification: CNS Stimulant, Peripheral Vasodilators, Cerebral Activators, Nootropics DOSAGES: Citicoline I gm IV every 8hours

ACTIONS
Citicoline increases blood flow and O2 consumption in the brain. It is also involved in the biosynthesis action.

INDICATIONS
Citicoline is indicated in CVD in acute recovery phase in severe s/sx of cerebrovascular insufficiency and in-cranial traumatism and their sequellae. Citicoline in CVA, stimulates brain function.

CONTRAINDICATION
Any allergy or hypersensitivity to the drug Hypertonia of the parasympathetic nervous system Use cautiously for pregnancy and lactation Conscious use for patient with renal and hepatic damage

ADVERSE EFFECTS
Fleeting and discrete hypotension effect, increased parasympathetic effects, low blood pressure Itching or hives, swelling in face or hands, chest tightness, tingling in mouth and throat

DRUG INTERACTIONS The efficacy of levodopa may increase when administration of citicoline is given in combination with levodopa.

NURSING RESPONSIBILITIES

Take Citicoline as prescribed Take Citicoline on time Monitor patients neurologic status Note if there are signs of slurring of speech Note for adverse reactions Titer medication when discontinuing Teach patient on how to take the drug Arrange for regular follow-ups

GENERIC/ BRAND NAME

Cerebrolysin

ACTIONS
The peptide fraction stimulates cell differentiation, bolsters nerve cell function and induces mechanisms of protection and repair. In animal experiments, Cerebrolysin directly influences neuronal and synaptic plasticity, thus improving learning. In models of cerebral ischemia, Cerebrolysin reduced infarct volume, inhibited edema formation, stabilized microcirculation, doubled the survival rate, and normalized lesion-related neurological failure and learning deficits.

INDICATIONS
Neurotrophic agent

CONTRAINDICATION
Hypersensitivity to one

ADVERSE EFFECTS
In rare cases, the

DRUG INTERACTIONS
On the basis of Cerebrolysin's pharmacological profile, special attention should be given to possible additive effects when used in conjunction with antidepressants or MAO inhibitors. In such cases, it is recommended that the dose of the antidepressant is lowered. Incompatibilities: Cerebrolysin should not be mixed with balanced amino acid solutions in an infusion. Cerebrolysin is incompatible with solutions which change the pH (58) and with lipidcontaining solutions. The compatibility

NURSING RESPONSIBILITIES
Instructions for Use & Handling: For single use only. Use only clear, amber solutions. Remove the solution from the vials/ampules immediately before use. When Cerebrolysin is administered via a long-term IV catheter, the catheter has to be rinsed before and after the application with physiological sodium chloride solution. Cerebrolysin must be stored at room temperature not exceeding 25C and protected from light. Do not freeze. Shelf-Life: 5 years.

Classification: Nootropics & Neurotonics/Neur otrophics DOSAGES: Citicoline 10ml/ampoules, 3 ampoules to be infused for 90mins. IV , once a day with aseptic technique

for the treatment of acute ischemic stroke, dementia & traumatic brain injury.
Organic, metabolic

of the components of Cerebrolysin. Epilepsy.

Severe renal

and neurodegenerative disorders of the brain especially senile dementia of Alzheimer's type; postapoplectic complications; craniocerebral trauma; postoperative trauma, cerebral contusion or concussion.

impairment. Although there are no data indicating that Cerebrolysin causes renal stress,
Cerebrolysin should not

be administered in the presence of existing severe renal failure.

desired activating effects have also been associated with agitation (aggression, confusion, insomnia). In 1 study, rare cases of hyperventilation, hypertension, hypotension, tiredness, tremor, depression, apathy, dizziness and symptoms of influenza (eg, cold, cough, respiratory tract infections) were reported.
Single cases of grand

mal attacks and convulsions have been reported after administration of Cerebrolysin. In rare cases, gastrointestinal disturbances eg, loss of appetite, dyspepsia, diarrhea, constipation, vomiting

and nausea, have been observed. If injected too quickly, feelings of heat or sweating, dizziness, and in isolated instances, palpitations or arrhythmias may result.

Injection site reactions eg, erythema, pruritus and burning have been reported. In very rare cases, hypersensitivity or allergic reactions eg, skin and local inflammatory reactions, headache, neck and limb pain, fever, low back pain, dyspnea, chills and shock-like state have been observed.

over 24 hrs at room temperature in the presence of light has been tested with the following standard infusion solutions: 0.9% sodium chloride solution (NaCl 9 mg/mL), Ringer's solution (Na+ 153.98 mmol/L, Ca+2 2.74 mmol/L, K+ 4.02 mmol/L, Cl- 163.48 mmol/L), glucose 5%. Vitamins and cardiovascular drugs may be given concomitantly with Cerebrolysin but the drugs should not be mixed with Cerebrolysin in the syringe