NAME OF DRUG GENERIC NAME: Furosemide BRAND NAME Lasix DOSAGE Adult: Initially 1/2-1-2 tab/day Maintenance: 1/21

tab/day 20-40 mg IV/IM Children: 2 mg/kg body/wt Classification: Anti-Ulcer

INDICATION

ACTION

CONTRAINDICATION Anuria hepatic coma & precoma severe hypokalemia &/or hyponatremia hypovolemia w/ or w/o hypotension Hypersensitivity to furosemide or sulfonamides

SIDE EFFECTS

NURSING CONSIDERATION To prevent nocturia, give preparation in the morning and early in the afternoon Watch for signs of hpokalemia do not confuse with Torsemide or Lasix with Lonox advise patient to take drug with food to prevent GI upset inform patient of possible need for potassium or magnesium supplements

acute pulmonary edema edema hypertension

inhibits sodium and chloride reabsorption at the proximal and distal tubules and the ascending loop of Henle

vertigo, dizziness, headache, paresthesia, orthostatic hypotension, thrombophlebitis, abdominal pain, hypokalemia, anemia muscle spasm

NAME OF DRUG GENERIC NAME: Clonidine hydrochloride BRAND NAME Catapres DOSAGE 01-02 mg P.O B. Classification: Antianginals

INDICATION Essential renal and malignant hypertension

ACTION

CONTRAINDICATION

SIDE EFFCTS drowsiness dizziness fatigue sedation nervousness headache orthostatic hypotension bradycardia urine retetion impotence transient glucose intolerance (after large dose) constipation pruritis dermatitis

NURSING CONSIDERATION Monitor blood pressure and pulse rate. May be given rapidly lower blood pressure in some hypertensive emergencies. Rising slowly and avoid sudden position change to prevent orthostatic hypotension. Remove patch before defribrillation to prevent arcing

Inhibits central Patient hypersensitive to vasomotor clonidine centers, thereby decreasing sympatheric outflow.

NAME OF DRUG GENERIC NAME: Ferrous sulfate Brand Name: Classification: Iron Preparation Dose, Route, PO freq: BID

INDICATION Prevention and treatment of iron deficiency anemia. Dietary supplement for iron.

ACTION

CONTRAINDICATION

SIDE EFFECTS Dizziness N&V Nasal Congestion Dyspnea Hypotension CHF MI Muscle cramps Flushing

NURSING CONSIDERATION Advice patient to take medicine as prescribed. Caution patient to make position changes slowly to minimize orthostatic hypotension. Instruct patient to avoid concurrent use of alcohol or OTC medicine without consulting the physician. Advise patient to consult physician if irregular heartbeat, dyspnea, swelling of hands and feet and hypotension occurs. Inform patient that angina attacks may occur 30 min. after administration due reflex tachycardia. Encourage patient to comply with additional intervention for hypertension like proper diet, regular exercise, and lifestyle changes and stress management.

Elevates the Hypersensitivity serum iron Severe hypotension. concentration which then helps to form High or trapped in the reticuloendothelial cells for storage and eventual conversion to a usable form of iron.

NAME OF DRUG GENERIC NAME: phenytoin

INDICATION Although it has been used in many conditions, phenytoin's only approved use is as an antiseizure medication (anticonvulsant), especially to prevent tonicclonic (grand mal) seizures and complex partial seizures (psychomotor seizures). It may be used alone or with phenobarbital or other anticonvulsants..

ACTION For the control of generalized tonicclonic (grand mal) and complex partial (psychomotor, temporal lobe) seizures and prevention and treatment of seizures occurring during or following neurosurgery.

CONTRAINDICATION Phenytoin is contraindicated in those patients who are hypersensitive to phenytoin or other hydantoins.

SIDE EFFECTS - bloody nose; - blurred or double vision; - constipation; - dark urine; - difficulty coordinating movements; - difficulty swallowing; - drowsiness; - easy bruising; - fever; - headache; - increased hair growth; - insomnia; - loss of taste and appetite; - mental confusion; - muscle twitching; - nervousness; - redness, irritation, bleeding, and swelling of the gums; - skin rash; - slurred speech; - sore throat; - stomach pain; - swollen glands; - tiny purple-colored skin spots; - unusual bleeding; - upset stomach; - vomiting; - weight loss

NURSING CONSIDERATION

BRAND NAME: Dilantin ROUTE: ORAL Frequency: TID Form: Tablet

Dosage: 50mg

full effectiveness of PO administered hydantoins is delayed and may take 6-9 days to be fully established when hydantoins are substituted for or added to another antivconvulsant medication, their dosage is gradually increased, while dosage of the other drug isdecreased avoid IM, SC or pervascular injections list reasons for theray, onset, characteristics of signs and symptoms note history and nature of seizures, addressing location, frequency and duration

NAME OF DRUG GENERIC NAME: Amlodipine BRAND NAME: Norvas DOSAGE: 5 mg/ tab 1 tab OD

INDICATION Angina pectoris due to coronary artery spasm (Prinzmetal's variant angina) Chronic stable angina, alone or in combination with other agents. Essential hypertension, alone or in combination with other antihypertensive

ACTION Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells; inhibits transmembrane calcium flow, which results in the depression of impulse formation in specialized cardiac pacemaker cells, slowing of the velocity of conduction of the cardiac impulse, depression of myocardial contractility, and dilation of coronary arteries and arterioles and peripheral arterioles; these effects lead to decreased cardiac work, decreased cardiac oxygen consumption, and

CONTRAINDICATION Contraindicated with allergy to amlodipine, impaired hepatic or renal function, sick sinus syndrome, heart block (second or third degree), and lactation. Use cautiously with CHF, pregnancy.

SIDE EFFECTS CNS: Dizziness, light-headedness, headache, asthenia, fatigue, lethargy CV: Peripheral edema, arrhythmias Dermatologic: Flushing, rash GI: Nausea, abdominal discomfort

NURSING CONSIDERATION Assessment History: Allergy to amlodipine, impaired hepatic or renal function, sick sinus syndrome, heart block, lactation, CHF Physical: Skin lesions, color, edema; P, BP, baseline ECG, peripheral perfusion, auscultation; R, adventitious sounds; liver evaluation, GI normal output; liver and renal function tests, urinalysis Interventions Monitor patient carefully (BP, cardiac rhythm, and output) while adjusting drug to therapeutic dose; use special caution if patient has CHF. Teaching points Take with meals if upset stomach occurs.

DRUG CLASSIFICATION: Calcium channelblocker Antianginal drug Antihypertensive

Interactions Drug-drug Possible increased serum levels and toxicity of cyclosporine if taken concurrently

in patients with vasospastic (Prinzmetal's) angina, increased delivery of oxygen to cardiac cells.

NAME OF DRUG GENERIC NAME: Clopidogrel BRAND NAME: Plavix DOSAGE: 75mg/tab 1 tab OD DRUG CLASSIFICATION: Antiplatelet agents

INDICATION >Treatment of patients at risk for ischemic events history of MI, ischemic stroke, peripheral artery disease >Treatment of patients with acute coronary syndrome

ACTION >Inhibits platelet aggregation by blocking ADP receptors on platelets, preventing clumping of platelets

CONTRAINDICATION >Contraindicated with allergy to clopidogrel, active pathological bleeding such as peptic ulcer or intracranial hemorrhage, lactation.

SIDE EFFECTS CNS: Headache, dizziness, weakness, syncope, flushing CV: Hypertension, edema Dermatologic: Rash, pruritus GI: Nausea, GI distress, constipation, diarrhea, GI bleed Other: Increased bleeding risk

NURSING CONSIDERATION Assess for symptoms of stroke, MI during treatment Monitor liver function studies: AST, ALT, bilirubin, creatinine if patient is on long-term therapy Monitor blood studies: CBC,Hgb, Hct, protime, cholesterol if the patient is on longterm therapy; thrombocytopenia and neutropenia may occur.

Precautions: bleeding disorders, recent surgery, hepatic impairment, pregnancy

NAME OF DRUG GENERIC NAME: Famotidine BRAND NAME: Pepcid DOSAGE: Tablets: 10, 20, and 40 mg. Suspension: 40 mg per 5 ml teaspoon. Injection: 10 mg/ml and 20 mg/50 ml. DRUG CLASSIFICATION: H2 receptor antagonist

INDICATION > Short-term treatment for duodenal ulcer > short-term treatment for benign gastric ulcer > pathologic hypersecretory conditions (such as ZollingerEllison syndrome) > Hospitalized patients who cant take oral drug or who have intractable ulcers or hypersecretory conditions >Gastro esophageal reflux disease (GERD) >to prevent or treat heartburn

ACTION > Competitively inhibits action of histamine on the H2 at receptor sites of parietal cells, decreasing gastric acid secretions.

CONTRAINDICATION >Hypersensitivity to any component of these products. Cross sensitivity in this class of compounds has been observed. Therefore, Famotidine should not be administered to patients with a history of hypersensitivity to other H2-receptor antagonists.

SIDE EFFECTS > CNS: headache, dizziness, fever, malaise, paresthesia, vertigo. > CV: flushing, palpitations. > EENT: orbital edema, tinnitus. > G.I.: anorexia, constipation, diarrhea, dry mouth, taste perversion. > Musculoskeletal: bone & muscle pain. > Skin: acne, dry skin. > Other: transient irritation at I.V. site.

NURSING CONSIDERATION > assess patient for abdominal pain. Look for blood in emesis, stool or gastric aspirate. > Oral suspension must be reconstituted and shaken before use. > Store reconstituted oral suspension below 86oF (30oC). Discard after 30 days.

NAME OF DRUG GENERIC NAME: Isosorbide mononitrate (ISMN) BRAND NAME: Imdur, Ismo, Monoket DOSAGE: 20 mg bd or 40 mg once daily. Dose may be increased to 40 mg bd. >Should be taken on an empty stomach DRUG CLASSIFICATION: cardiovascular agent; nitrate vasodilator

INDICATION >Long-term treatment of ischemic heart disease, prevention & treatment of angina attacks, pulmonary HTN, chronic heart failure.

ACTION > Isosorbide mononitrate is a long-acting metabolite of the coronary vasodilator isosorbide dinitrate. It decreases preload as measured by pulmonary capillary wedge pressure (PCWP), and left ventricular end volume and diastolic pressure (LVEDV), with a consequent reduction in myocardial oxygen consumption.

CONTRAINDICATION SIDE EFFECTS >Acute MI w/ low filling pressures, left heart failure w/ low filling pressures, shock, very low BP, hypertrophic obstructive cardiomyopathy, constrictive pericarditis, pericardial tamponade, aortic stenosis, mitral stenosis, marked anaemia, head trauma, cerebral haemorrhage, closedangle glaucoma, hyperthyroidism, acute attacks of angina. Avoid sildenafil, tadalafil, vardenafil. >Headache: drop in BP, dizziness,weakness, increased pulse rate, nausea, vomiting, transient skin disorders, allergic skin reactions. View ADR Monitoring Form

NURSING CONSIDERATION > Assessment & Drug Effects

Monitor cardiac status, frequency and severity of angina, and BP. Assess for and report possible S&S of toxicity, including orthostatic hypotension, syncope, dizziness, palpitations, light-headedness, severe headache, blurred vision, and difficulty breathing. Lab tests: Monitor serum electrolytes periodically.

Patient & Family Education

Do not crush or chew sustained release tablets. May break tablets in two and take with adequate fluid (4 8 oz). Do not withdraw drug abruptly; doing so may precipitate acute angina. Maintain correct dosing interval with twice daily dosing.

Note: Geriatric patients are more susceptible to the possibility of developing postural hypotension. Avoid alcohol ingestion and aspirin unless specifically permitted by physician. Do not breast feed while taking this drug without consulting physician.

NAME OF DRUG GENERIC NAME: Sodium Bicarbonate BRAND NAME: Arm and Hammer Pure Baking Soda, Citrocarbonate, Soda Mint DOSAGE: 1 mEq/kg IVP, may repeat 0.5 mEq/kg 10 min. DRUG CLASSIFICATION: Alkalizing Agent, Buffer, Antacid, electrolyte

INDICATION > Hyperacidity

>Peptic ulcer >Hyperkalemia >Tricyclic antidepressant OD >Shock associated with severe diarrhea, dehydration, uncontrolled DM >Reflux esophagitis

ACTION > Neutralizes gastric acid >Decrease pepsin activity

CONTRAINDICATION SIDE EFFECTS > Contraindicated in

patients with metabolic or respiratory alkalosis; patients who are losing chlorides from vomiting or continuous GI suction; patients taking diuretics known to produce hypochloremia alkalosis; and patients with hypocalcemia in which alkalosis may produce tetany, hypertension, seizures, or heart failure. Oral sodium bicarbonate is contraindicated in patients with acute ingestion of strong mineral acids.

NURSING CONSIDERATION
>Monitor urinary pH, calcium, electrolytes and phosphate levels. >Record amount and consistency of stools. >Clients on low-sodium diets should evaluate sodium contents of antacids.

> GI: Gastric distention,

belching, flatulence. Metabolic: metabolic alkalosis, hypernatremia, hypokalemia, hyperosmolarity (with overdose). Other: Pain and irritation at injection site.

NAME OF DRUG GENERIC NAME: LOSARTAN POTASSIUM BRAND NAME: Cozaar DOSSAGE: Adult: PO 2550 mg in 12 divided doses (max: 100 mg/d); start with 25 mg/d if volume depleted (i.e., on diuretics) DRUG CLASSIFICATION: cardiovascular agent; angiotensin ii receptor antagonist; antihypertensive

INDICATION >Hypertension

ACTION > Angiotensin II receptor (type AT1) antagonist acts as a potent vasoconstrictor and primary vasoactive hormone of the reninangiotensin aldosterone system

CONTRAINDICATION SIDE EFFECTS >Hypersensitivity to losartan, pregnancy [category C (first trimester), category D (second and third trimesters)], lactation > CNS: Dizziness, insomnia, headache. GI: Diarrhea, dyspepsia. Musculoskeletal: Muscle cramps, myalgia, back or leg pain. Respiratory: Nasal congestion, cough, upper respiratory infection, sinusitis.

NURSING CONSIDERATION > Monitor BP at drug trough (prior to a scheduled dose). >Monitor drug effectiveness, especially in AfricanAmericans when losartan is used as monotherapy. >Inadequate response may be improved by splitting the daily dose into twice-daily dose. >Lab tests: Monitor CBC, electrolytes, liver & kidney function with long-term therapy.