Name of Drug Furosemide Electrolyte and water balance agent ;Loop Diuretic

Action Inhibits reabsorption of sodium and chloride from the proximal and distal tubular and ascending limb of the loop of Henle, leading to a sodiumrich diuresis.

Adverse Effect CNS: vertigo, paresthesia, weakness, headache, drowsiness, fatigue, blurred vision EENT: Blurred vision; hearing impairment; tinnitus; xanthopsia (yellow vision). CV: orthostatic hypotension, cardiac arrhythmias, thromboplhebitis DERMA: photosensitivity, rash, pruritus, urticaria, purpura, dermatitis. GI: nausea, anorexia, vomiting, oral and gastric irritation, constipation, diarrhea GU: polyuria, glycosuria, nocturia, urinary bladder

Indication Management of edema associated with congestive heart failure and hepatic or renal disease; used alone or in combination with antihypertensives in treatment of hypertension

Contraindication  Allergy with furosemide, sulfonamides; allergy to tartazine( in oral solution); anuria, severe renal failure; hepatic coma; pregnancy; lactation.  Use cautiously with SLE, gout, DM

Nursing Consideration  Determine allergy to furosemides, tatrtazine; electrolyte depletion anuria, severe renal failure, hepatic coma; gout;SLE; DM; lactation; pregnancy  Assess for skin color, lesions, edema,orientation , reflexes, hearing, pulses  Administer with food or milk to prevent GI upset  Decrease dosage if given with other antihypertensive; readjust dosage gradually as blood pressure responds  Measure and record weight to monitor fluid changes  Advise patient to

spasm HEMA: leukopenia, anemia, thrombocytopenia, fluid and electrolyte imbalance, hyperglycemia OTHER: muscle cramps, muscle spasm

get up slowly when rising from a seated or lying position to minimize dizziness.

Name of Drug Trimetezadine (Vastarel) Anti-ischemic (antianginal) metabolic agent

Action prevents a decrease in intracellular adenosine triphosphate levels, thereby ensuring the proper functioning of ionic pumps and transmembranous sodium-potassium flow whilst maintaining cellular homeostasis

Adverse Effect GI: nausea, vomiting and other gastrointestinal disorders RESPI: respiratory illness HEMA:anemia

Indication Long treatment of coronary insufficiency, angina pectoris

Contraindication  Do not take Vastarel MR if you are allergic to any of the constituents.  This drug is generally not recommended during breast feeding

Nursing Consideration  use cautiously in patients with heart failure or hypertension and in elderly patients

Name of Drug

Action

Adverse Effect

Indication

Contraindication

Nursing Consideration  Monitor apical pulse for 1 minute before administering; hold dose if pulse lower than 60bpm in adult and lower than 90bpm in infant  Monitor I&O ratio during digitalization, particularly in patients with impaired renal function. Also monitor for edema daily and auscultate chest for rales.  Avoid giving with meals; this may delay absorption  Monitor for S/S of drug toxicity: In children, cardiac arrhythmias are usually reliable

Digoxin (Lanoxin) Cardiovascular agent; cardiac glycoside; antiarrhythmic

prevents a decrease in intracellular adenosine triphosphate levels, thereby ensuring the proper functioning of ionic pumps and transmembranous sodium-potassium flow whilst maintaining cellular homeostasis

CNS: headache, dizziness, weakness, drowsiness, mental status change GI:nausea, vomiting, abdominal pain, anorexia CV: heart block, rapid heartbeat, and slow heart rate DERMA: EENT: visual disturbance (blurred or yellow vision, light flashes, halos around bright objects) HEMA:high calcium and low magnesium blood levels OTHERS:Personality

 Preventive treatment for episodes of angina pectoris (Chronic stable angina).  prophylactic management and treatment of CHF, control of ventricular rate in patients with atrial fibrillation.  treatment and prevention of recurrent paroxysmal atrial tachycardia

 contraindicated with allergy to digitalis preparations, ventricular tachycardia, ventricular fibrillation, heart block, sick sinus syndrome, acute MI  This drug is generally not recommended during breast feeding

changes, facial pain

signs of early toxicity. Early indicators in adults (anorexia, nausea, vomiting, diarrhea, visual disturbances) are rarely initial signs in children.  Weigh each day under standard conditions.  Assess for GI disturbances, neurologic abnormalities (signs of toxicity) every 2-4 hours during digitalization (daily during maintenance).

Name of Drug Essentiale (Essentiale forte)

Action normalizes the metabolism of lipids and proteins, improves the detoxification function of the liver, restores the cellular structure of the liver and retards the producing of conjunctive tissue

Adverse Effect CNS: nausea GU:abdominal pain, diarrhea and DERMA: skin rash

Indication

Contraindication

Hepatic protectors

 Hepatitis(acute  hypersensitivity and chronic), toxic or allergy to any hepatitis, ingredients of the medicinal and preparation alcoholic hepatitis,  children, pregnat poisonings woman  Diseases of the cardiovascular system: coronary heart disease, stable stenocardia, post-infarction condition, disturbance of the cerebral and peripheral circulation, Hypertension, thrombembolia prophylaxis, atherosclerosis, diabetic angiopathy, thrombembolia prophylaxis and fat embolism(solution for injection)

Nursing Consideration  Do not use Essentialein hypersensitivity or allergy to any ingredientsof the preparation.  Theapplication of Essentialein newborn children isnot safe.  Duringpregnancy women arerecommended to consulttheir health careprovider prior to takingEssentiale.

Name of Drug Aspirin Non-narcotic Analgesic, antiinflammatory, antipyretic

Action Inhibits prostaglandin synthesis, acts on the hypothalamus heat-regulating center to reduce fever, blocks prostaglandin synthetase action which prevents formation of the platelet-aggregating substance thromboxane A2

Adverse Effect CNS: fatigue GI: gastrointestinal ulceration, nausea, dyspepsia, anorexia RESPI: dyspnea DERMA: rash, urticaria NEURO&MUSCU: weakness HEMA:hemolytic anemia, occult blood loss OTHERS: anaphylactic shock High dosages: gastroinestinal bleeding or gastric mucosal lesions Low grade toxicity : ringing in the ears, generalized pruritus, headache, dizziness, flushing, tachycardia, hyperventilation, sweating, and thirst. Febrile dehydrated children can reach

Indication  treatment of mild to moderate pain, inflammation, and fever  may be used as prophylaxis for myocardial infarction and transient ischemic episodes  management for rheumatoid arthritis, rheumatic fever, osteoarthritis, and gout (high dose)

Nursing Consideration  hypersensitivity to  monitor for signs salisylates or other or symptoms of NSAIDs; bleeding adverse effects with special disorders; allergy attention to 8th to tartazine dye; cranial nerve asthma diagnosis function  use cautiously with  Assess type, impaired renal function; location, duration chickenpox, of pain, and influenza inflammation.  Inspect appearance of affected joints for immobility, deformities, and skin condition.  Monitor urinary pH (pH from 6.5 to 5.5), may result in toxicity.  Assess skin for evidence of bruising.  When given as an antipyretic, assess body temperature before and 1 hour after giving

Contraindication

toxic levels quickly

medication.  Evaluate for therapeutic response: relief of pain, stiffness, swelling; increase in joint mobility, reduced joint tenderness, and improved grip strength.

Name of Drug Paracetamol Anti-pyretic

Action Inhibits prostaglandin synthesis in the CNS and blocks the pain impulse through a peripheral action. It acts on the hypothalamic heatregulating center, producing peripheral vasodilation. It results in antipyresis and produces analgesic effect.

Adverse Effect  Hematologic: hemolytic anemia, neutropenia, leucopenia, pancytopenia.  Hepatic: Jaundice  Metabolic: Hypoglycemia  Skin: rash, urticaria  Early signs of toxicity: Anorexia, nausea, diaphoresis (excessive sweating), generalized weakness within the first 12-24 hours.  Late signs of toxicity: Vomiting, right upper quadrant tenderness, elevated liver function tests within 48-72 hours

Indication Symptomatic relief of pain and fever.

Contraindication  Contraindicated in patients hypersensitive to drug.  Use cautiously in patients with long term alcohol use because therapeutic doses cause hepatotoxicity in these patient

Nursing Consideration  Assess temperature directly before and 1 hour after giving medication.  Use liquid form for children and patients who have difficulty swallowing.  In children, don t exceed five doses in 24 hours.  Advise patient that drug is only for short term use and to consult the physician if giving to children for longer than 5 days or adults for longer than 10 days.  Advise patient or caregiver that many over the counter products contain acetaminophen;

after ingestion. Antidote: Acetylcysteine.

be aware of this when calculating total daily dose.  Warn patient that high doses or unsupervised long term use can cause liver damage  Give drug with food if GI upset occurs  Evaluate for therapeutic response: relief of pain, stiffness, swelling; increasing in joint mobility; reduced joint tenderness; improve grip strength.

Name of Drug Calcium Pantothenic (Moriamin Forte) Multivitamins and minerals

Action

Adverse Effect

Indication malnutrition, protein and vitamin deficiencies, anemia, convalescence, restoration and maintenance of body resistance, pregnancy and lactation, adjuvant in the therapy of peptic ulcer and TB

Contraindication  contraindicated for patient s with malabsorption syndrome

 Stimulates hypervitaminosis normalerythropoiesi (large doses) s andStimulates normalerythropoiesi s andneucloproteinsy nthesis.  NutritionalSuppleme nt

Nursing Consideration  Assess patient for signs of vitamin deficiency before and periodically throughout therapy.  Assess nutritional status through 24 h diet recall. Determine frequency of consumption of vit rich food  Assess patient sfolic aciddeficiency beforestarting therapystarting therapy  Evaluate CBC and assess patient s physical statusthroughout therapy.

Name of Drug Doxofylline (Ansimar) Antiasthmatic & COPD Preparations

Action Adrenergic bronchodilators and phosphodiesterase inhibitors both work by increasing intracellular level of cyclic-3 ,5 adenosine monophosphate (cAMP)

Adverse Effect Nausea, vomiting, epigastric pain, cephalalgia, irritability, insomnia, tachycardia, extrasystole, tachypnea, hyperglycemia, albuminuria

Indication  Bronchial asthma & pulmonary disease w/ spastic bronchial component.

Contraindication  Acute MI, hypotension, lactation

Nursing Consideration  Assess lung sounds, pulse and blood pressure before administration and during peak of medication. Not amount, color, and character of sputum produced.  Monitor pulmonary function tests before initiating therapy and periodically during therapy to determine effectiveness of medication.  Observe for paradoxical bronchospasm (wheezing). If conditions occur, withhold medication and

notify physician of other health care professional immediately