DRUG STUDY: RANITIDINE

DRUG ORDER (Generic name, dosage, route, frequency, etc.) RANITIDINE HYDROCHLORIDE TRADE / BRAND NAME PHARMACOLOGIC ACTION OF DRUG Competitively inhibits gastric acid secretion by blocking the effect of histamine on histamine h2 receptors. Both daytime and nocturnal basal gastric acid secretions, as well as food- and pengastrinstimulated gastric acid are inhibited. Weak inhibitor of cytochrome P-450 (drug metabolizing enzymes); thus, drug interactions involving inhibitions involving inhibition of hepatic metabolism are not expected to occur INDICATIONS AND CONTRAINDICATIONS INDICATIONS ADVERSE EFFECTS OF THE DRUG DESIRED ACTION ON YOUR CLIENT NURSING RESPONSIBILITIES/ PRECAUTIONS Assess stomach pain, noting characteristics, frequency of occurrence, triggers, things that alter/relieve Note H. pylori, UGI, or endoscopy findings

ZANTAC

Management of ulcer disease, persistent dyspepsia, & patients at risk of acid CNS: aspiration during general dizziness, insomnia, anesth or childbirth.
CONTRAINDICATION Cirrhosis of the liver, impaired renal or hepatic function

GI: constipation, There will be an diarrhea, abdominal evidence of duodenal peptic ulcer healing GERD, pain headache, Decrease in the malaise, abdominal pain/ vertigo, discomfort confusion, anxiety, hallucinations CV: bradycardia tachycardia HEMATOLOGIC: thrombocytopenia, granulocytopenia, leukopenia, pancytopenia or

DRUG STUDY : ENALAPRIL

DRUG ORDER (Generic name, dosage, route, frequency, etc.) ENALAPRIL MALEATE VASOTEC TRADE / BRAND NAME PHARMACOLOGIC ACTION OF DRUG Enalapril (and its active metabolite enalaprilat) inhibit angiotensin-converting enzyme resulting in decreased plasma angiotensin II, which leads to decreased vasopressor activity and decreased aldosterone secretion. The parenteral product is enalaprilat injection INDICATIONS AND CONTRAINDICATIONS INDICATIONS ADVERSE EFFECTS OF THE DRUG CV: palpitations, hypotensions, chest pain, angina, CVA, MI, cardiac arrest GI: diarrhea, abdominal pain, alterations in taste, anorexia, dry mouth, constipation, dyspepsia RESPIRATORY: bronchitis, cough, dyspnea, bronchospasm, URI, pneumonia, asthma HEMATOLOGIC: hrmolytic anemia, neutropenia, thrombocytopenia, bone marrow depressions DESIRED ACTION ON YOUR CLIENT There will be a decrease in BP and decrease in preload and afterload with CHF NURSING RESPONSIBILITIES/ PRECAUTIONS Record ECG, VS and weight Monitor CBC, electrolytes, renal and LFTs. Reduce dose with impaired renal function

Treatment of essential & renovascular HTN, CHF & prevention of coronary ischemic events in patients w/ left ventricular dysfunction. CONTRAINDICATIONS Angioedema, hereditary or idiopathic. Hyperkalemia, renal artery stenosis, bilateral or in a solitary kidney or renal transplant, renal function impairment.

DRUG STUDY: CITICOLINE

DRUG ORDER (Generic name, dosage, route, frequency, etc.) CITICOLINE

TRADE / BRAND NAME

PHARMACOLOGIC ACTION OF DRUG

INDICATIONS AND CONTRAINDICATIONS

ADVERSE EFFECTS OF THE DRUG Stomach pain, diarrhea; hypotension, tachycardia, bradycardia.

DESIRED ACTION ON YOUR CLIENT To minimize the attack of sroke

NURSING RESPONSIBILITIES/ PRECAUTIONS

CHOLINERV

INDICATIONS Citicoline is a complex Cerebrovascular disorders organic molecule that including ischemic stroke, functions as an parkinsonism & head injury. intermediate in the CONTRAINDICATIONS biosynthesis of cell Parasympathetic membrane phospholipids. It hypertonia. is also known as CDPcholine or cytidine diphosphate choline (cytidine 5'diphosphocholine). CDPcholine belongs to the group of biomolecules in living systems known as nucleotides that play important roles in cellular metabolism.

Somazine must not be administered along with medicaments containing meclophenoxate

DRUG ORDER (Generic name, dosage, route, frequency, etc.) CEFUROXIME

TRADE / BRAND NAME

PHARMACOLOGIC ACTION OF DRUG Cefuroxime axetil is absorbed from the GIT and is rapidly hydrolyzed in the intestinal mucosa and blood to cefuroxime. Absorption is enhanced in the presence of food. Peak plasma concentrations are reported about 2-3 hrs after an oral dose. It is widely distributed in the body including pleural fluid, sputum, synovial fluid and aqueous humor, but only achieves therapeutic concentrations in the CSF when the meninges are inflamed. It crosses the placenta and has been detected in breast milk. It is excreted unchanged by glomerular filtration and renal tubular secretion and high concentrations are achieved in the urine.

INDICATIONS AND CONTRAINDICATIONS INDICATIONS

ADVERSE EFFECTS OF THE DRUG GI disturbances, pseudomembranous colitis, headache, eosinophilic & transient increase in hepatic enzymes, false +ve Coomb's test.

DESIRED ACTION ON YOUR CLIENT

NURSING RESPONSIBILITIES/ PRECAUTIONS

AXET

Infections of the bone & joint, upper & lower resp tract, skin & soft tissue; surgical infections, UTI, gonorrhea.
CONTRAINDICATIONS

There will be a Note for reasons for resolution on the S&S therapy, characteristics of of infection S&S, culture results, baseline assessment

Hypersensitivity to cephalosporins.

DRUG STUDY: CETRIAXONE

DRUG ORDER (Generic name, dosage, route, frequency, etc.) CEFTRIAXONE

TRADE / BRAND NAME

PHARMACOLOGIC ACTION OF DRUG

INDICATIONS AND CONTRAINDICATIONS INDICATIONS

ADVERSE EFFECTS OF THE DRUG

DESIRED ACTION ON YOUR CLIENT Resolution of S&S of infection There will be a negative report on culture sensitivity test

NURSING RESPONSIBILITIES/ PRECAUTIONS Note for reasons for therapy, characteristics of S&S, culture results, baseline assessment Assess for GI disease. Report any bleeding/ bruising, diarrhea.

ROCEPHIN

Ceftriaxone exerts in vitro activity against a wide range of gram-negative and grampositive microorganisms. It is highly stable to most lactamases, both penicillinases and cephalosporinases, of grampositive and gram-negative bacteria Long-acting, broadspectrum cephalosporin antibiotic

Sepsis, meningitis; abdominal, biliary tract, GIT, bone, joints, soft tissue, renal, resp tract, ENT, genital & skin & wound infections. UTI, gonorrhea. Periop prophylaxis of infections.
CONTRAINDICATIONS

Systemic Adverse Effects: GI Complaints (about 2% of cases): Loose stools or diarrhea, nausea, vomiting, stomatitis and glossitis. Hematological Changes (about 2%): Eosinophilia, leukopenia, granulocytopenia, hemolytic anemia and thrombocytopenia. Skin Reactions (about 1%): Exanthema, allergic dermatitis, pruritus, urticaria, edema and erythema multiforme.

hypersensitivity to cephalosporins.

DRUG ORDER (Generic name, dosage, route, frequency, etc.) SIMVASTATIN

TRADE / BRAND NAME

PHARMACOLOGIC ACTION OF DRUG

INDICATIONS AND CONTRAINDICATIONS INDICATIONS

ADVERSE EFFECTS OF THE DRUG Constipation, diarrhea, flatulence, heartburn, stomach pain, dizziness, headache, nausea, skin rash. Rarely, myalgia, myositis or rhabdomyolysis.

DESIRED ACTION ON YOUR CLIENT

NURSING RESPONSIBILITIES/ PRECAUTIONS Note reasons for therapy, characteristics of S&S, culture results. Assess for GI disorders Report for any bleeding/bruising

REDUSCOLE

Treatment of hypercholesterolemia (heterozygous familial & nonfamilial) & mixed dyslipidemia (type IIa & IIb hyperlipoproteinemia).

Treatment of hypercholesterolemia (heterozygous familial & nonfamilial) & mixed dyslipidemia (type IIa & IIb hyperlipoproteinemia).
CONTRAINDICATIONS

Active hepatic disease.

DRUG STUDY : OMEPRAZOLE DRUG ORDER (Generic name, dosage, route, frequency, etc.) NURSING RESPONSIBILITIES/ PRECAUTIONS List reasons for therapy, frequency and characteristics of S&S Record abdominal assessments, radiographic/endoscopic findings Monitor CBC

TRADE / BRAND NAME

PHARMACOLOGIC ACTION OF DRUG

INDICATIONS AND CONTRAINDICATIONS INDICATIONS

ADVERSE EFFECTS OF THE DRUG Headache, abdominal pain, diarrhea N&V, URTI, rash CNS: anxiety disorders, vertigo, insomnia, nervousness HEPATIC: overt liver disease cholestatic CV: angina, tachycardia, bradycardia, palpitation, peripheral edema, elevated BP

DESIRED ACTION ON YOUR CLIENT Promotion of ulcer healing Relief of pain Lower gastric acid production

PEPTISOLV OMEPRAZOLE

Omeprazole suppresses gastric acid secretion by specific inhibition of the enzyme system hydrogen/potassium adenosine triphosphatase (H+/K+ ATPase) present on the secretory surface of the gastric parietal cell.

Treatment of heartburn & other symptoms associated w/ GERD. Erosive esophagitis, gastric hypersecretory condition, Zollinger-Ellison syndrome, systemic mastocytosis, multiple endocrine adenoma & peptic ulcer.
CONTRAINDICATIONS

Chronic hepatic disease.

DRUG STUDY : ASPIRIN

DRUG ORDER (Generic name, dosage, route, frequency, etc.) ASPIRIN TRADE / BRAND NAME ASPILET PHARMACOLOGIC ACTION OF DRUG Aspirin is an analgesic, antiinflammatory and antipyretic. It inhibits cyclooxygenase, which is responsible for the synthesis of prostaglandin and thromboxane. It also inhibits platelet aggregation. INDICATIONS AND CONTRAINDICATIONS INDICATIONS Aspilet Suspected acute MI; Aspilet/EC Prophylactic treatment of thromboembolic disorders, MI, transient ischemic attacks & stroke. For the secondary prevention of CV disease in DM patients esp those w/ history of MI, vascular bypass procedure, stroke or transient ischemic attack & angina & those w/ additional risk factors: HTN, smoking, dyslipidemia & family history of CV disease. Revascularization procedures. Pregnancy-induced HTN. CONTRAINDICATIONS Asthma, rhinitis & nasal polyps. History of active peptic ulcer disease. Hypersensitivity. ADVERSE EFFECTS OF THE DRUG Fever, hypothermia, thirst. Dysrythmias, hypotension, tachycardia. Agitation, cerebral edema, coma, confusion, dizziness, headache, subdural or intracranial hemorrhage, lethargy, seizures. Dehydration, hyperkalemia, metabolic acidosis, resp alkalosis, dyspepsia, GI bleeding, ulceration & perforation, nausea, vomiting, transient hepatic enzyme elevations, hepatitis. DESIRED ACTION ON YOUR CLIENT There will be a relief of pain/discomfort to the patient There will be a decrease fever and vascular mortality NURSING RESPONSIBILITIES/ PRECAUTIONS For pain, rate and determine the type, location, and pattern of pain, if unusual, or if recurring Determine history of peptic ulcers or bleeding tedency