!! Brand!name! Generic!Name! Cardiovascular!drugs! 1.!Antihypertensive!(ACE!inhibitor)! !!! Zestril!p.560! Lisinopril! ! Capoten! captopril! Pharmacological! Classification! ! Outcome!/!Indication! Action! ! Side!Effect! Special!Precaution! Antihypertensive!–!(ACE! inhibitor)! Decreased!BP!in!HT,! decreased!preload,! afterload!in!CHF.!Mild!to! moderate!HT,!adjunctive! therapy!of!systolic!CHF! and!acute!MI.! Decreased!BP!in!HT,! decreased!preload,! afterload!in!CHF.! Selectively!suppresses! reninRangiotensionR!aldosterone! systemS!inhibits!ACES!prevents! conversion!of!angiotension!I!to! angiotension!IIS!results!in!dilatation!of! arterial,!venous!vessels.! ! Selectively!suppresses! reninRangiotensionR!aldosterone! systemS!inhibits!ACES!prevents! conversion!of!angiotension!I!to! angiotension!II! Stroke,!proteinuria,!renal! insufficiency,!angioedema,!chest! pain,!hypotension.!Skin!rash! Monitor!BP,!edema!in!feet!and! legs!dailyS!I/O!ratio.!Not!to! discontinue!the!drug!abruptly!or! withdrawal!symptoms!may! occurs.! ! CV:!hypotension,!tachycardia! RESP:!dyspnea,!cough! ! Crushed!and!mixed!with!foodS! ! Monitor!blood!studies:!if! 3 neutrophils!<1000/mm S!monitor! BP,check!for!orthostatic! hypotension,!syncopeS!check!for! edema!in!feet,!legs!dailyS!monitor! weight!daily!in!CHF! Decreased!BP!in! hypertension! Stimulates!central!alpha2Radrenergic! receptors!in!the!CNS,!resulting!in! decreased!sympathetic!outflow!from! the!brain!with!decreased!peripheral! resistance! Monitor!BP,!edema!in!feet!and! legs!dailyS!I/O!ratio.!Not!to! discontinue!the!drug!abruptly!or! withdrawal!symptoms!may! occurs.! ! Mild!to!moderate!HT,!CHF,! BPH! Block!alphaRmediated! vasoconstriction!of!adrenergic! receptors,!inducing!peripheral! vasodilatation.! ! Myocarditis,!CHF,!hepatic! dysfuncation,!pancreatitis,! leucopenia,!thrombocytopenia!and! hemolytic!anemia!and! granulocytopenia! ! [Hypotension,!sedative,!decrease!in! LOC]! Hypotension,!headache,! drowsiness,!weakness,!nausea!and! vomiting.! ! Decrease!BP,!heart!rate,! AV!conduction.!Mild!to! moderate!HT,!acute!MI!to! reduce!cardiovascular! mortality,!angina!pectoris! Decrease!blood!pressure,! heart!rate.!Chronic!stable! angina!pectoris,!HT,!MI,! ! Competitively!blocks!stimulation!of! beta1Radrenergic!receptor!within! vascular!smooth!muscleS!produces! chronotropic,!inotropic!activity! (decrease!rate!of!SA!node!discharge,! increase!recovery!time),!slows! conduction!of!AV!node,!decrease! heart!rate,!which!decrease!O2! consumption!in!myocardiumS!also! decrease!reninR!angiotensionR! aldosterone!system!at!high!dose.! ! Depression,!CHF,!cardiac!arrest,!AV! block,!bradycardia,!pulmonary! edema,!chest!pain.!Agranulocytosis,! eosinophilia,!thrombocytopenic! purpura.!Bronchospasm.! ! Bradycardia,!CHF,!pulmonary! edema,!dysrhythmias,! laryngospasm,!Agranulocytosis,! thrombocytopenia! Monitor!BP,!edema!in!feet!and! legs!dailyS!I/O!ratio.!Not!to! discontinue!the!drug!abruptly!or! withdrawal!symptoms!may! occurs.! ! ! Do!not!give!to!asthma!patient.! CNS:!insomnia,!fatique,!dizziness,! mental!changes! CHF:!cold!extremities,!postural! nd rd hypotension,!2 !or!3 !degree!heart! block! Check!BPS!check!for!edema!in! feet,!legs!dailyS!monitor!I/O,!daily! weight!in!CHF! ! Inhibits!calcium!ion!influx!across!cell! membrane!during!cardiac! depolarization,!produces!relaxation!of! coronary!vascular!smooth!muscle,! dilates!coronary!vascular!arteries,! increase!myocardial!oxygen!delivery! in!patient!with!vasospastic!angina! ! Headache,!dizziness,! lightheadedness,!nausea,!flushing,! StevensRJohnson!syndrome.! ! Monitor!BP,!edema!in!feet!and! legs!dailyS!I/O!ratio.!Not!to! discontinue!the!drug!abruptly!or! withdrawal!symptoms!may! occurs.! ! CHF,!headache,!drowsiness,! Encourage!fluid!intake!and!fibre! Antihypertensive!–!(ACE! inhibitor)! 1.!Antihypertensive!(alphaRadrenergic!blocker)! !!! Aldomet! Methyldopa! Antihypertensive!–! centrally!acting! alphaRadrenergic! inhibitor! !! ! Minipress! Prazosin! Antihypertensive!–!(ACE! inhibitor!/!vasodilator)! 1.!Antihypertensive!(betaRadrenergic!blocker)! !! ! Betaloc!p.617! Metoprolol! Antihypertensive!–! (beta1Radrenergic! blocker),!antianginal! !! ! ! Inderal!p.791! ! Propranolol! ! Atenolol! Antihypertensive!–! (beta1Radrenergic! blocker)!antianginal,! antidysrhythmic!(class! III)! Antihypertensive!–! (beta1Radrenergic! blocker)! 1.!Antihypertensive!(calcium!channel!blocker)! !! ! Adalat! ! Nifedipine! Antihypertensive! (calcium!channel! blocker),!antianginal! ! !! ! Isoptin! ! Verapamil! Decrease!BP,!heart!rate,! prevention!of!angina! pectoris! Decreased!angina!pectoris,! decreased!BP!in!HT! Decreased!angina!pectoris,! First!dose!syncope!( S )!=! postural/standup!hypotension! decreased!BP!in!HT! dysrhythmias! 2.!Antianginal!(betaRadrenergic!blocker)! !! ! Betaloc!p.617! Metoprolol! !! ! Inderal!p.791! Propranolol! ! 2.!Antianginal!(calcium!channel!blocker)! !! ! Adalat! ! Nifedipine! Antihypertensive!–! (beta1Radrenergic! blocker),!antianginal! Antihypertensive!–! (beta1Radrenergic! blocker)!antianginal,! antidysrhythmic!(class! III)! Antihypertensive! (calcium!channel! blocker),!antianginal! ! Competitively!blocks!stimulation!of! beta1Radrenergic!receptor!within! vascular!smooth!muscleS!produces! chronotropic,!inotropic!activity! (decrease!rate!of!SA!node!discharge,! increase!recovery!time),!slows! conduction!of!AV!node,!decrease! heart!rate,!which!decrease!O2! consumption!in!myocardiumS!also! decrease!reninR!angiotensionR! aldosterone!system!at!high!dose.! ! Depression,!CHF,!cardiac!arrest,!AV! block,!bradycardia,!pulmonary! edema,!chest!pain.!Agranulocytosis,! eosinophilia,!thrombocytopenic! purpura.!Bronchospasm.! ! Bradycardia,!CHF,!pulmonary! edema,!dysrhythmias,! laryngospasm,!Agranulocytosis,! thrombocytopenia! Monitor!BP,!edema!in!feet!and! legs!dailyS!I/O!ratio.!Not!to! discontinue!the!drug!abruptly!or! withdrawal!symptoms!may! occurs.! ! ! Do!not!give!to!asthma!patient.! Decreased!angina!pectoris,! decreased!BP!in!HT! Inhibits!calcium!ion!influx!across!cell! membrane!during!cardiac! depolarization,!produces!relaxation!of! coronary!vascular!smooth!muscle,! dilates!coronary!vascular!arteries,! increase!myocardial!oxygen!delivery! in!patient!with!vasospastic!angina! ! Headache,!dizziness,! lightheadedness,!nausea,!flushing,! StevensRJohnson!syndrome.! ! Monitor!BP,!edema!in!feet!and! legs!dailyS!I/O!ratio.!Not!to! discontinue!the!drug!abruptly!or! withdrawal!symptoms!may! occurs.! ! CHF,!headache,!drowsiness,! dizziness,!edema,!nausea,! constipation,!StevensRJohnson! syndrome.! ! CNS:!headache,!fatique,!drowsiness! CV:!edema! GI:!nausea,!constipation! INTEG:!rash! Encourage!fluid!intake!and!fibre! intake! ! Isoptin! ! Verapamil! !! ! Herbesser! Diltiazem!HCl! Antianginal! Ca!antagonist! Isosorbide! dinitrate! Antianginal,!vasodilator! ! Relief!and!prevention!of! angina!pectoris! Nitrate!Vasodilator! (antiRanginal)! Treatment!for!angina! pectoris,!prophylaxis! AntianginalRRantiplatelet! AntiRconvulsant/! antidysrhythmic! (hydantoins)! Glyceryl! Trinitrate! 2.!Antianginal!(antiplatelet)! ! Persantin! Dipyridamole! !! ! Angised!TNG! 3.!Antidysrhythmic! ! !! ! Dilantin!p.752! Phenytoin! intake! Decrease!BP,!heart!rate,! AV!conduction.!Mild!to! moderate!HT,!acute!MI!to! reduce!cardiovascular! mortality,!angina!pectoris! Decrease!blood!pressure,! heart!rate.!Chronic!stable! angina!pectoris,!HT,!MI,! ! !! 2.!Antianginal!(nitrate)! !! ! Isordil!p.526! dizziness,!edema,!nausea,! constipation,!StevensRJohnson! syndrome.! ! Decreased!angina!pectoris,! decreased!BP!in!HT! dysrhythmias! Inhibits!calcium!ion!influx!across!cell! membrane!during!cardiac! depolarization,!produces!relaxation!of! coronary!vascular!smooth!muscle,! dilates!coronary!vascular! arteries,slows!SA/AV!node! conduction!times,!dilates!peripheral! arteries! 1.If!BP<30mmHg!"stop! 3! 2.If!platelets<150000/mm "!stop! 3.!Swallow!the!whole!tab! 4.!Store!in!airtight!container!at!rm! temp! Relaxation!of!vascular!smooth! muscle!which!lead!to!decreased! preload,!after!load,!thus!decreasing! left!ventricular!endRdiastolic!pressure,! systemic!vascular!resistance!and! reducing!cardiac!O2!demand! Vascular!headache,!flushing,! dizziness,!weakness!and!faintness.! Postural!hypotension,!nausea,! vomiting!,!tachycardia.! Hypotension* Apply!through!SL! Create!nitrateRfree!period!to! minimize!tolerance! Prevention!of! thromboembolism!in!client! with!heart!valves,! combination!therapy!with! warfarin!sodium,!coronary! artery!disease! Inhibit!clotting!mechanismS!prevent!or! disrupt!the!aggregation!(an! accumulation!of!substances!in!the! blood!that!form!a!group!or!cluster)!of! platelets!needed!to!form!a!clot! LightRheadedness! Administer!75R100mg!PO!QID! with!warfarin!to!prevent! thromboembolism!in!Pt!with! prosthetic!heart!valves! General!tonicRclonic,! seizures,!epilepticus,! nonepileptic!seizures!after! Reye’s!syndrome! Inhibits!spread!of!seizure!activity!in! motor!cortex!by!altering!ion!transport,! increase!AV!condiction!to!decrease! dysrhythmias! Ventricular!fibrillation,!drowsiness,! dizziness,!insomnia,!depression,! hepatitis,! ! nephritis,!anemia,! thrombocytopenia,!StevenRJohnson! syndrome! Check!serum!phenytoin!level!"! malfunction!of!immunization!and! gum!hyperplasia!may!be!resulted! Cannot!relief!MI! !! ! Lanoxin!p.313! Digoxin! Inotropic! antidysrhyhmic,!cardiac! glycoside! !! ! Cordarone! Amiodarone! Amiodarone! AntiRdysrhythmic! Gastrointestinal!drugs! 1.!Antiulcer!(antacid)! ! Gelusil! Decreased!edema,!pulse,! respiration!and!crackles.! Rapid!digitalization!in!acute! and!chronic!CHF,!atrial! flutter,!atrial!tachycardiaS! cardiogenic!shock,! paroxysmal!atrial! tachycardia! Decrease!amount!and! severity!of!ventricular! dysrhymias,!ventricular! tachycardia,! supraventricular!fibrillation,! atrial!fibrillation!not! st controlled!by!1 !line! Inhibits!sodiumRpotassium!ATPase,! which!makes!more!calcium!available! for!contractile!proteins,!resulting!in! increased!cardiac!output,!increase! force!of!contractionS!decrease!heart! rate!and!decrease!AV!conduction! speed.! ! Dysrhythmias,!AV!block,!headache,! drowsiness,!nausea!and!vomiting,! anorexia,!abdominal!pain.! ! Assess!AR!1!min!before!giving! drugS!withhold!if!AR<60! Prolongs!action!potential!duration! and!effective!refractory!period,!slow! sinus!rate!with!increasing!PR!and!QT! intervals,!decrease!peripheral! vascular!resistance! CNS:!headache,!dizziness! CV:!hypotension! 1.! GI!ulcer,!relieve!heartburn,! sour!stomach!and!acid! indigestion.! Relief!upset!stomach!by! hyperacidity! AlOH!&!MgOH:!Neutralise!gastric! acid,!inhibit!the!proteolytic!activity!of! pepsin!(MgOH),!increase!secretion!of! cholecystokinin!from!duodenum!and! stimulate!fluid!secretion!and!intestinal! mobility!(MgOH)! Simethicone:!Remove!excess!gases! in!digestive!tract! Neutralise!gastric!acid! Constipation!or!diarrhea,! hypocalcaemia! 2.! turn!bluish!on!neck,!face,! arms!when!used!for!long! periods!(reversible)! pulmonary!toxicity"! discontinue!(including! pulmonary!fibrosis,dysnea,! fatique,!cough,!fever,!chest! pain,!ARDs)! Gelusil!Active! Ingredients:! ! aluminum! hydroxide,! magnesium! hydroxide,! simethicone! Antacid,!antiulcerant.! Adsorbent,!antiflatulent! ! Mucaine! ! Aluminum! Hydroxide! Antacid! Relieve!mild!heartburn!and! ingestion.! ! ! Oscal! Caltrate! CaCO3! Antacid,!Ca!supplement! Not!for!chronic!therapy! Neutralizes!gastric!acidity! 1.!Antiulcer!(proton!pump!inhibitor)! !! ! Pariet! Rabeprazole! PPI! duodenal!ulcersS! decreased! gastroesophageal!reflux! ! ! PPI! Suppresses!gastric!secretion!by! inhibiting!H/K!ATPase!enzyme! system!in!the!gastric!parietal!cellS! characterized!as!a!gastric!acid!pump! inhibitor,!since!it!blocks!the!final!step! of!acid!production! CNS:!headache,!dizzsiness,! asthenia! GI:!diarrhea,!abdominal!pain,! vomiting,!nausea,!constipation,! flatulence,!acid!regurgitation! MISC:!back!pain! RESP:!upper!respiratory!tract! infection,!cough! 1.! 2.! 3.! 1.! 2.! 3.! 4.! Healing!of!duodenal!ulcers! or!gastric!ulcersS! prevention!of!duodenal! ulcersS!decrease!symptoms! of!gastroesophageal!reflux! disease!(GERD),! heartburn,!gastritis! Inhibits!histamine!at!H2Rreceptor!site! in!gastric!acid!secretion! ! Headache,!dizziness,!depression,! anxiety,!insomnia,!dysrhythmias,! thrombocytopenia,!aplastic!anemia,! Rash! ! Inhibits!histamine!at!H2!receptor!site! in!the!gastric!parietal!cells!which! inhibits!gastric!acid!secretion! Seizures,!dysrhythmias,!paralytic! ileus!jaundice,!thrombocytopenia,! exoliative!dermatitis,!gyneomastia! (longRterm)! Headache,!sleeplessness,! dizziness,!confusion,!hepatotoxicity,! rash,!constipation,!abdominal!pain,! diarrhea! Assess!patient!with!ulcers,!gastric! pH!(~5).!Monitor!I/O!ratio.!Give! antacid!1!hr!before!and!2!hrs! after,!with!food!and!liq.! ! ! Assess!patient!with!ulcers,!gastric! pH!(~5).!Monitor!I/O!ratio! !! !! ! Triact! Losec! Omeprazole! ! 1.!Antiulcer!(H2Rreceptor!antagonist)! !! ! Pepcidine!p.399! Famotidine! !! ! Tagamet!p.234! Cimetidine! ! Zantac!p.812! Ranitidine! AlOH:!antacid! MgOH:!antacid,!laxative! Simethicone:! antiRflatulent! H2Rhistamine!receptor! antagonist,!antiulcer! agent! Inhibit!the!action!of!histamine!on! parietal!cells!of!stomach!and!basal! and!triggering!gastric!acid!secretion! AlOH:!comstipation! MgOH:!diarrhea! Simethicone:diarrhea! (Latter!two!counteract!the!S/E!of! AlOH)! Constipation!or!diarrhea,!nausea! and!vomiting,!confusion!and! excessive!tiredness.! ! GI:!constipation!(laxatives!or!stool! softeners!can!be!given)! Shake!well!before!use.! ! ! Triact:!chew!before!swallowing! ! Antacid:1hr!pc!and!at!bed!time! Ca!supplement:!1/2!pc!and!at!bed! time! assess!bowel!sound!q8h! Swallow!the!whole!tab! diarrhea"discontinue! assess!bowel!sound!q8h! Swallow!the!whole!tab! diarrhea"discontinue! acS!may!give!with!antacids! Assess!patient!with!ulcers,!gastric! pH!(~5).!Monitor!I/O!ratio! 1.!Antiulcer!(protectant)! ! Carafate/! sulcrate! 2.!Antiemetic ! Sucralfate! antiulcer(protectant)! Duodenal!ulcer,!oral! mucositis,!stomatitis!after! radiation!of!head!or!neck! Form!a!complex!that!adhere!to!ulcer! site,!absorbs!pepsin! GI:!dry!mouth,!constipation! 1.! 2.! Swallow!the!whole!tab! give!on!empty!stomach!1hr! ac!and!at!bedtime! 3.! avoid!antacids!1/2hr!b4!ot! 1hr!after!taking!this!drug! 4.!not!to!use!over!8!wks,!avoid! smoking! Hydroxyzine! AntiRanxiety,!sedative,! hypnotic,!antihistamine,! antiemetic! Anxiety!preoperatively,! postoperatively!to!precent! nausea,!vomiting,!to! potentiate!opioid! analgesicsS!sedationS! pruritusS!prevention!of! alcohol,!drug!withdrawalS! ! Absence!of!allergy! symptoms,!rhinitis!pruritus,! absence!of!nausea/! vomiting,!sedation,! absence!of!anxiety! Vomiting,!secretion! (preROT),!involuntary! movement! Depresses!subcortical!levels!of!CNS,! including!limbic!system,!reticular! formation,!anticholinergic,!antiemetic,! antihistaminic!response,!competes! with!H1Rreceptor!sites.! Dizziness,!drowsiness,!seizures,!dry! mouth.! ! Take!1!hr!pc!or!2!hrs!pc! Inhibits!acetycholine!at!receptor!sites! in!autonomic!nervous!system,!which! controls!secretions,!free!acids!in! stomachS!block!central!mescarinic! receptors,!which!decrease! involuntary!movementS!blocks! response!of!iris!sphincter!muscle,! muscle!of!accommodation,!resulting! in!dilation,!paralysis!of! accommodation! Enhances!response!to!acetylcholine! of!tissue!in!upper!GI!tract,!which! causes!contraction!of!gastric!muscle,! relaxes!pyloric,!duodenal!segments,! increases!peristalsis!without! stimulating!secretions,!block! dopamine!in!chemoreceptor!trigger! zone!of!CNS! Depresses!cerebral!cortex,! hypothalamus,!limbic!system,!which! control!activity!aggression,!blocks! neurotransimission!produced!by! DOPamine!at!synapseS!exhibits!a! strong!alphaRadrenergic,! anticholinergic!blocking!actionS! mechanism!for!antipsychotic!effects! is!unclear.S!act!centrally!by!blocking! chemoreceptor!trigger!zone,!which!in! turns!acts!on!vomiting!centre.! ! Acts!on!blood!vessels,!GI,!respiratory! system!by!competing!with!histamine! Pupil!dilation,!photophobia,!blurred! vision,!headache,!drowsiness,!dry! mouth,!constipation,!urinary! hesitancy!and!retention,!nasal! congestion,!decrease!sweating! Provide!adequate!hydration! Prevent!hyperpyrexia!by! controlling!the!surrounding! temperature! Encourage!Pt!to!void!before!drug! administration!due!to!urine! retention!of!its!S/E! Sedation,!fatigue,!restlessness,! sleeplessness,!suicide!ideation,! seizures,!supraventricular! tachycardia! Monitor!BP!if!through!IV! Monitor!extrapyramindal! reactions!and!those!with!diabetes! "!change!dose!of!insulin! Depression,!entrapyramidal! symptoms!(EPS),!neuroleptic! malignant!syndrome.!Circulatory! failure,!tachycardia.!Respiratory! depression.! Identify!neuroleptic!malignant! syndrome:!hyperpyrexia,!muscle! rigidity,!increase!CPK!etcS!notify! prescriber!immediatelyS!drug! should!be!discontinued.!Monitor! bilirubin,!CBC,!liver!function! studies!monthly,!hepatotoxicity! may!occur.! ! Dizziness,!drowsiness,!neuroleptic! malignant!syndrome,!constipation,! Administer!through!IM,!no!SC!due! to!tissue!necrosis! ! Atarax!p.487! !! ! Holopon!/! Buscopan! Hyoscine! methybromide/! hyosineRNR! butylbromide! Antiemetic,! anticholinergic,!mydriatic! !! ! Maxolon!p.613! Metoclopramide! Antiemetic!and! Cholinergic! Decreased!symptoms!of! delayed!gastric!emptying,! decreased!nausea!and! vomiting.!Prevention!of! nausea!vomiting!induced! by!chemotherapy,!delayed! gastric!emptying!&!GER! !! ! Stemetil!p.781! Prochlorperazine! meleate! Antiemetic/!antipsychotic! Nausea,!vomiting,! psychosis.! ! Decreased!nausea,! vomiting,!decreased!S/S!of! psychosis! !! ! Phenergan!p.785! Promethazine! HCl! Antihistamine,! H1Rreceptor!antagonist,! Motion!sickness,!rhinitis,! allergy!symptoms,! antiemetic,! sedative/hypnotic! sedation,!nausea,! preoperative!and! postoperative!sedationS! Absence!of!allergy! symptoms!and!rhinitis,! absence!of!vomiting,! nausea!and!sedation.! ! for!H1Rreceptor!siteS!decrease!allergic! response!by!blocking!histamineS!also! acts!on!chemoreceptor!trigger!zone! to!decrease!vomiting,!increase!CNS! stimulation,!has!anticholinergic! response! urinary!retentionapnea!in!pediatric! patient.! ! Bisacodyl! Laxative,!stimulant! Constipation(short!term),! bowel/rectal!preparation!of! surgery/examination! Increase!motor!activity!of!intestineS! irritate!colonic!intramural!plexusS! increase!H2O!in!the!colon! GI:!nausea,!vomiting,!anorexia,! cramps! Decreased!constipation,! decreased!blood!ammonia! level.! Chronic!constipation,! portalRsystemic! encephalopathy!in!patients! with!hepatic!disease.! ! Decreased!constipation! and!decreased!diarrhea!in! colitis!for!chronic! constipation,!ulcerative! colitis,!irritable!bowel! syndrome! Decreased!constipation!for! acute!constipation,!bowel! preparation!for!surgery!or! exam! Increase!osmotic!pressureS!draws! fluid!into!colonS!prevents!absorption! of!ammonia!in!colon,!increase!water! in!stool.! ! Nausea,!vomiting,!anorexia,! abdominal!cramp,!diarrhea,! flatulence,!distention,!belching! ! Promotes!peristalsis!by!combining! with!water!in!the!intestine!to!form!a! gelRlike!substance!that!is!easily! evacuated! Nausea!and!vomiting,!anorexia,! diarrhea,!cramps,! intestinal/esophageal!blockage.! ! Decrease!constipation!in!12R24! hours.!Give!with!8oz!of!water!or! juice!followed!by!another!8oz!of! juice.! Check!BO!before!given.! ! Stimulates!peristalsis!by!action!on! Auerbach’s!plexusS!softens!feces!by! increasing!water!and!electrolytes!in! large!intestine! Nausea!and!vomiting,!anorexia,! abdominal!cramps,!tetany!( )! Decrease!constipation!in!8R10! hrsS!check!BO!before!use.! ! Decreased!diarrhea!for! diarrhea!(cause! undetermined,!mild!to! moderate! diarrhea! Decreases!gastric!motility,!water! content!of!stool!and!adsorbent,! demulcent.! ! Constipation!(chronic!use)! Check!BO!before!used! ! ! Decreased!loose!stools!for! diarrhea! Inhibits!gastric!motility!by!acting!on! mucosal!receptors!responsible!for! peristalsisS!related!to!opioid! analgesics!as!adjunct! Abdominal!pain,!nausea,!vomiting,! tiredness,!dizziness,!drowsiness,! dry!mouth! Dizziness,!drowsiness,! lightheadedness,!headache,!fatigue,! nausea!and!vomiting,!dry!mouth,! paralytic!ileus,!anaphylaxis,! angioedema,!respiratory!depression! 3.!Laxative! ! ! Dulcolax! !! ! Lactulose!p.536! Lactulose! Laxative!(hyperosmotic/! ammonia!detoxicant)! !! ! Metamucil!p.797! Psyllium! Laxative,!bulkRforming! !! ! Senokot!p.845! Senna,! sennosides! LaxativeRstimulant! ! Kaopectate! p.121! Kaolin!&!pectin! mixture! Antidiarrheal! ! Imodium! Loperamide!HCl! ! antidiarrheal! ! Lomotil!p.324! Diphenoxylate! with!atropine! Antidiarrheal! 1.! 2.! Swallow!the!whole!tab! give!water!for!better! absorption! 3.! don’t!take!within!1hr!of! antacids,!milk! 4.! for!rectal!route,!retain1/2hr! 5.! don’t!use!in!presence!of! abdominal!pain,!nausea,! vomitting! Increase!fluid!intake!to!2L/D,!can! give!with!fruit!juice,!water,!milk! and!normal!ammonia.! ! 4.!AntiRdiarrheal! !! !! Respiratory!drugs! 1.!Bronchodilator! Check!response!after!48!hrs,!if!no! response,!drug!should!be! discontinued.!Check!BO!before! used.! ! !! ! Atrovent! Ipratropium! Anticholinergic,! bronchodilator! inhalation!for!the!treatment! of!obstructive!lung! diseases!(COPD!induced! Bronchospasm,!rhinorrhea! in!children)! Prevention!of! exerciseRinduced!asthma,! acute!Bronchospasm,! bronchitis,!emphysema,! bronchiectasis,!reverse! airway!obstruction.! ! Inhibits!interaction!of!acetylcholine!at! receptor!sites!on!the!bronchial! smooth!muscle,!resulting!decreased! cyclic!guanosine!monophosphate! (cGMP)!and!bronchodilatation.! ! Causes!bronchodilatation!by!action! on!ß2!(pulmonary)!receptors!by! increasing!levels!of!cyclic!adenosine! monophosphate!(cAMP)!which!relax! smooth!muscleS!produce! pronchodilatationS!CNS,!cardiac! stimulation,!increased!diuresis!and! increased!gastric!acid!secretionS! longer!acting!than!isproterenol.! Relaxes!bronchial!smooth!muscle!by! direct!action!on!ß2Radrenergic! receptors!through!accumulation!of! cAMP!at!ßRadrenergic!receptors! sitesS!results!are!bronchodilation,! diuresis,!and!CNS,!and!cardiac! stimulationS!relaxes!uterine!smooth! muscle! Relaxes!smooth!muscle!of!respiration! system!by!blocking! phosphodiesterase,!which!increase! cAMP!which!increase! bronchodilation,!diuresis,!circulation,! CNS!stimulation! Nausea!and!vomiting,!GI!cramp,! cough,!worsening!of!symptoms,! dizziness,!headache,!anxiety,!dry! mouth.! ! Absence!of!wheezing!after!1!hr! !! ! Ventolin!p.52! Albuterol!sulfate! Bronchodilator! (adrenergic! beta2Ragonist)! Antasthmatic! Sympathomimetic! Tremors,!anxiety,!restlessness,! palpotations,!tachycardia,! hypertension,!heartburn,!nausea! and!vomiting,!bromchospasm! Apply!with!minimal!doses!for! minimal!period!of!time!and!no! prolonged!use!due!to! development!of!drug!tolerance! Maintain!a!betaRadrenergic! blocker!on!standby!in!case!of! cardiac!arrhythmias! ! !! ! Bricanyl!durule! p.893! Terbutaline! sulfate! Selective!beta2RagonistS! Bronchodilator! Antasthmatic! Sympathomimetic! Tocolytic!drug! Bronchospasm,! bronchodilation!with!ease! of!breathing! !! ! Theodur! ! Nuelin!SR!p.898! Theophylline! Spasmolytic,! Bronchodilator! Xanthine! Ability!to!breathe!without! difficulties.!Bronchial! asthma,!Bronchospasm!of! COPD,!chronic!bronchitis! Anxiety,!restlessness,!isomnia,! dizziness,!seizures,!headache,! lightRheadedless,!palpitations,!sinus! tachycardia,!dysrhythmias,!nausea,! vomiting,!anorexia,!diarrhea.! ! No!chewing!or!crushing!of! entericRcoated!drugs! Do!not!use!during!pregnancy! Monitor!vital!signs!carefully!for! adverse!effects,!if!serum! theophylline!levels!are!not! available! Keep!diazepam!ready!for!seizure! Prednisolone! Corticosteroid,!synthetic! Severe!inflammatory,! immunoR!suppression,! neoplasmsS!decrease! inflammation,!decreased! adrenal!insufficiency! Depression,!HT,!circulatory!collapse,! embolism,!diarrhea,!nausea,!abd! pain,!pancreatitis,!hemorrhage.! Administer!QD!before!0900!to! mimic!normal!peak!corticosteroid! blood!level! Place!orally!disintegrating!tablet! in!mouth!"!dissolve!"!swallow! ! Decrease!inflammation!by! suppressing!migration!of! polymorphonuclear!leukocytes,! fibroblastsS!reversal!to!increase! capillary!permeability!and!lysosomal! stabilization,!minimal! mineralocorticoid! ! hydrocortisone! ! ! ! HT,!tachycardia,!cardiac!arrest,! nausea!and!vomiting,!tremors,! anxiety,!insomnia,!headache! 2.!Corticosteroid! !! ! ! Prednisolone! p.772! ! 3.!Mucolytic!agent! !! ! Bisolvon! Bromhexine!HCl! Mucolytic!agent!(muscus! expectorant)! ! ! Nausea,!GI!disturbance,!loss!of! appetite,!abd.!pain! ! !! ! flumucil! acetylcysteine! mucolytic!agent! Decrease! viscosity! of! secretions! in! respiratory! tract! by! breaking! disulfide! links!of!munoproteins! Decrease! hepatotoxicity! from! aceraminophen! overdose,! decrease! the! toxicity! of! mucous! in! respiratory! disorder! Dizziness! drowsiness,! rhinorrhea,! nausea! Only! if! suction! machine! is! available,!encourage!fluid!intake!if! no!contraRindication! 4.!Expectorant! ! ! MES! Ammonia! carbonate!&! ipecacuanha! tincture!mixture! ! Expectorant!sputum! expel! Productive!cough!and!cold! remedy! Increase!bronchio!secretion,!reduce! viscosity!of!sputum,!easier!to!expel.! ! ! Dextromethorph an!HCl! Pseudoephedrin e!HCl! Triprolidine!HCl! Dextromethorphan:! nonopioid!antitussive! Pseudoephedrine:! Nasal!decongestant,! sympathomimetic!amine! Triprolidine:* Dextromethorphan:! nonproductive!cough! Pseudoephedrine:! nasal!congestion!by!cold,! fever!and!allergies,! eustachian!tube!congestion! Triprolidine:* Dextromethorphan:* lacks!analgesic!and!addictive! properties,!control!cough!spasms!by! depressing!the!cough!center!in! medulla,!analogue!of!codeine! nonproductive!cough! Pseudoephedrine:* cause!vasoconstriction!in!mucous! membranes!of!nasal!passages!"! shrinkage!"!promotes!drainage!and! improve!ventilation! Triprolidine:* Dextromethorphan:* respiratory!depression!(overdose)! Pseudoephedrine:* Fear,!anxiety,!tenseness,! restlessness,!headache,! lightRheadedness,!dizziness,! drowsiness,!tremors,!seizuresS!HT,! arrhythmiasS!pallorS!n/v! ! [Dizziness,!anxiety,!palpitation,! nervousness]! Monitor!vital!signs! Drug!may!mask!the!S/S!of! serious!diseases! Cough! may! be! S/S! of! serious! underlying!disorders! No!prolonged!use! Monitor!CV!effects!carefully! Act!by!inhibiting!the!spread!of!seizure! activity!in!the!motor!cortex!by! increasing!levels!of! gammaRaminobutyric!acid!(GABA)!in! brain.! ! Inhibits!spread!of!seizure!activity!in! motor!cortex!by!altering!ion!transport,! increase!AV!condiction!to!decrease! dysrhythmias! Bone!marrow!depression.!GI! symptoms,!slurred!speech,! confusion! ! Check!serum!valproic!level!"! thrombopenia!if!too!high!in!level! Ventricular!fibrillation,!drowsiness,! dizziness,!insomnia,!depression,! hepatitis,! ! nephritis,!anemia,! thrombocytopenia,!StevenRJohnson! syndrome! Paralysis,!worsening!of!seizures,! HT,!CHF,!AV!block,!hepatitis,!renal! failure,!thrombocytopenia,! leukocytosis,!ansmia,!eosinophilia,! StevenRJohnson!syndrome.! ! Dizziness,!drowsiness,!confustion,! headache,!orthostatic!hypotension,! ECG!changes,!tachycardia,!blurred! vision,!neutropenia,!respiratory! depression.! Check!serum!phenytoin!level!"! malfunction!of!immunization!and! gum!hyperplasia!may!be!resulted! Dryness!of!mouth,!constipation! Decrease!perspiration,!increase! susceptibility!to!stroke.! ! 5.!Nonopioid!antitussive! !! ! Actified! compound! Neurologic!and!neuromuscular!drugs! 1.!AntiRconvulsant! !! ! Epilim!p.995! Valproate! AntiRconvulsant! (hydantoins)! Seizures,!convulsion! !! ! Dilantin!p.752! Phenytoin! AntiRconvulsant/! antidysrhythmic! (hydantoins)! General!tonicRclonic,! seizures,!epilepticus,! nonepileptic!seizures!after! Reye’s!syndrome! !! ! Tegretol! Carbamazepine! Anticonvulsant! TonicR!chonic,! complexRpartial,!mixed! seizures,!trigeminal! neuralgia,!bipolar!disorder! Exact!mechanism!unknown,!appears! to!decrease!polysynaptic!responses! and!block!postetanic!potentiation! !! ! Valium!p.305! Diazepam! Antianxiety,! anticonvulsant,!skeletal! muscle!relaxant,!central! acting! ! Anxiety,!acute!alcohol! withdrawal,!adjunct!in! seizure!disorders,! preoperative!skeletal! muscle!relaxation,!rectally! for!acute!repetitive! seizuresS! Decreased,!anxiety,! restlessness,!insomnia! Potentiates!the!actions! ! GABA,!esp,! in!limbic!system,!reticular!formation,! enhance!presympathetic!inhibition,! inhibits!sponal!polysynaptic,!afferent! paths.! ! Trihexyphenidyl! HCl! Antiparkinson!/! cholinergic!blocker! Parkinsonian!symptoms,! drugRinduced! entrapyramidal!symptoms,! decrease!involuntary! movement! Blocks!central!muscarinic!receptors,! which!decrease!involuntary! movements,!sweating,!salivation.! ! Access!BP,!RR,!orthostatic!BP,! size!of!lymph!nodes.! ! Urine,!sweat!may!be!darken! DDA! 2.!Antiparkinsonium! ! !! ! Artane! 1mg!/!TDS! !! ! Sinemet! 25/100! ! Carbidopa!(25)!–! p.179! Levodopa!(100)! *note:&two&drug& together&form& sinemet! Antiparkinson!agent! Parkinsonism,!restless!legs! syndrome,!chronic! manganese!intoxication,! cerebral!arteriosclerosisS! ! Absence!of!involuntary! outcome! Decarbocylation!of!levodopa!to! periphery!is!inhibited!by!carbidopaS! more!levodopa!is!made!available!for! transport!to!brain!and!conversion!to! dopamine!to!the!brain! Involuntary!choreiform!movement,! hand!tremors( ),!fatigue,! headache,!anxiety,!twitching,! numbness( ),!weakness,! confusion,!agitation,!insomnia,! nightmare,!orthostatic!hypotension,! nausea,!vomiting,!anorexia,!abd! pain,!dry!mouth,!flatulence!( ),!dysphagia,!bitter!taste,!diarrhea,! constipation! Urine,!sweat!may!be!darken! Type!2!diabetes,!NIDDM! Inhibiting!ATPRsensitive!potassium! channels!in!pancreatic!beta!cells! which!stimulate!insulin!secretion! Stimulates!insulin!secretion!by!the! pancreas,!normalizes!fasting!and! postprandial!blood!sugar! ! Hypoglycemia,!fatigue,!drowsiness,! weakness!and!diarrhea! Check!glucose!level!before!given! take!30!minutes!before!meals.! ! Hypoglycemia,!gastrointestinal! disturbance,!skin!reactions!(rare),! hematological!disorders!(rare)! ! Check!L/R/T!function! Taken!with!food! Inhibits!hepatic!glucose!production! and!increase!sensitivity!of!peripheral! tissue!to!insulin! Delays!the!digestion!of!ingested! carbohydrates!"!smaller!increase!in! blood!glucose!"!decrease!in! glycosylated!Hgb! Does!not!enhance!insulin!secretion! Lactic!acidosis,!gastrointestinal! (diarrhea,!cramps,!nausea,!nausea! and!vomiting),!hormonal! ! Endocrine:!hypoglycemia! GI:!abdominal!pain,!flatulence,! diarrhea! Hematologic:!leucopenia,! thrombocytopenia! Regularly!check!blood!glucose! level!before!and!after!meals! Decrease!edema!in!lung!tissue! EENT:!loss!of!hearing! ELECT:!hypokalemia,! hypochloremic!alkalosis,! hypomagnesemia,!hyperuricemia,! hypocalcemia,!hyponatremia! Endo:!hypoglycaemia! GI:!nausea! ! GU:!polyuria! Integ:!rash,!pruitus,!purpura! 1.! Endocrine!drugs! 1.!Antidiabetic! !! ! Daonil! Glibenclamide! ! !! ! Diamicron! Gliclazide! ! Tolbutamine! ! Antidiabetic!drug,! hypoglycemic! (sulfonylurea)! Antidiabetic!drug,! hypoglycemic! (sulfonylurea)! ! !! ! Glucophage! Metformin! Antidiabetic!drug! !! ! Glucobay! Acarbose! AlphaRglucosidase! inhibitor! Antidiabetic! Furosemide! ! Loop!diurectic! ! Monitor!serum!glucose!levels! frequently! Genitourinary!drugs! !! ! Lasix! ! Acts!on!ascending!loop!of! Henle!and!inhibit! reabsorption!of!electrolytes! and!waterS!increase! excretion!of!K!in!distal! tubules! Slight!antihypertensive! effect!and!peripheral! vasodilation! 2.! 3.! 4.! 5.! 6.! ! Natrilix! ! Indapamide! ! Diuretic,! antihypertensive(mild!to! moderate)! ! Decrease!BP!and!edema!in! lung!tissues,!peripherally! Acts!on!the!distal!tubule!and!thick! ascending!loop!o!f!Henle!in!the! kidney,!increasing!the!secretion!of! Na,!H2O,!Cl,!Mg,!K,!HCO3! CNS:!headache,!dizziness,!fatique,! weakness,!nervousness,!agitation! ELECT:!hypokalemia,! hypercalcemia,!hyponatremia,! hypochloremic,!alkalosis,! hypomagnesemia! GI:!nausea! GU:!polyuria,!nocturia,!frequency! ! 1.! 2.! 3.! 4.! ! periodic!testing!of!hearing!if! high!dose!is!given!by!IV! route! monitor!I/O!ratio! caution!to!orthostatic! hypotension! Take!in!day!to!prevent! ncturia! ! report!if!weight!loss!of!>5lb! within!1!week! Avoid!OTC!medication!and! alcoho! take!the!medication!early!in! the!day!to!prevent!nocturia! report!if!weight!loss!of!>5lb! within!1!week! meal!rich!in!K!due!to!K!loss! caution!to!orthostatic! hypotension! INTEG:!pruritus! ! Aldactone! ! Spironlactone! ! KRsparing!diuretic! ! Diuretic!and! antihypertensive!effect! while!retainging!KS!lowered! aldosterone!levelsS!for! edema!of!CHF,! hypertension,! diureticRinduced! hypokalemia,!primary! hyperaldosteronism,! edema!of!nephritic! syndrome,!cirrhosis!of!the! liver!with!ascites! Compete!with!aldosterone!at!receptor! sites!in!the!distal!tubule!in!the!renal! system,!resulting!in!excretion!of!Na,! Cl,!H2O,!HCO3!and!CaS!retain!K,! PO3!and!H! CNS:!confusion,!drowsiness! ELECT:!hyperkalemia! INTEG:!rash,!pruritus! 1.! May!block!pain!impulse!peripherally! that!occur!in!response!to!inhibition!of! prostaglandin!synthesisS!does!not! possess!inflammatory!propertiesS! antipyretic!action!results!from! inhibition!of!prostaglandins!in!the! CNS!(hypothalamic!heatRregulating! centre)! ! Acts!as!agonist!at!specific!opioid! receptors!in!CNS!to!produce! analgesic!effect.! ! Both!panadol!and!doloxene!action.! ! Hepatotoxic,!hepatic!seizure,! decrease!platelets! ! Toxicity:!Cyanosis,!anemia,! jaundice,!rash,!convulsion,!coma,! death! Pregnancy!B,!anemia,!hepatic! disease,!renal!disease,!chronic! alcoholism,!elderly!and!lactation.! ! GI!disturbance,!drowsiness,! dizziness,!fatigue! ! DDA! drowsiness,!dizziness,! fatigue!,constipation!or!diarrhea,! nausea!and!vomiting! CHF,!laryngeal!edema,!cholestatic! hepatitis,!hepatotoxicity,!,!dysuria,! hematuria,!oliguria,!UTI,! bronchospasm! Check!L/R!function! 2.! 3.! ! ! take!the!medication!early!in! the!day!to!prevent!nocturia! report!if!weight!loss!of!>5lb! within!1!week! avoid!meal!with!high!K! Pain!medication! ! !! ! Panadol!p.38! Paracetamol! acetaminophen! Analgesic,!antipyretic! Mild!to!moderate!pain!and! fever! !! ! Doloxene! Dextropropoxyph ene! Analgesic!(opioid)! ! Mild!to!moderate!pain!and! as!an!antiRtussive! ! !! ! Dologesic! ! Analgesic! Mild!to!moderate!pain! !! ! Voltaren!p.308! Paracetamol!&! Dextropropoxyph ene! Diclofenac! sodium! NSAID,!nonopioid! analgesic! Decrease!pain!and! inflammation! !! ! Indocid!p.507! Indomethacin! NASID!Antirheumatic! Decrease!pain!and! inflammation,!or!closure!of! patent!ductus!arteriosus! !! ! Aspirin!p.111! Acetylsallcylic! acid! ! Analgesic,!antiRpyretic,! antiR!inflammatory,!antiR! platelets! Decrease!pain,! inflammation,!fever,! absence!of!MI,!transient! ischemic!attacks,! thrombosis! Inhibits!prostaglandin!synthesis!by! decreasing!enzyme!needed!for! biosynthesisS!analgesic,! antiRinflammatory,!antipyretic! properties! ! Inhibits!prostaglandin!synthesis!by! decreasing!enzyme!needed!for! biosynthesisS!analgesic,! antiRinflammatory!and!antipyretic! ! ! Blocks!pain!impulses!in!CNS,! reduces!inflammation!by!inhibition!of! prostaglandins!synthesisS!antipyretic! action!results!from!vasodilatation!of! peripheral!vessels,!decrease!platelet! aggregation.! ! Cholestatic!hepatitis,!ulceration,! perforation,!GI!bleeding! nephrotoxicity!(dysuria,!hematuria,! oliguria)! Seizures,!coma,!GI!bleeding,! hepatitis,!leucopenia,!neutropenia,! hemolytic!anemia,!Reye’s! syndrome,!anaphyaxis!and! laryngeal!edema! ! [Reye’s!syndrome:!affect!organs,! e.g.!brain!and!liver!"!fatal]! R!must!be!continued!for! prescribed!time,!avoid!aspirin,! NSAID.! ! R!take!a!full!glass!of!water!to! enhance!full!absorption.! ! RGive!food/milk!to!decrease! gastric!symptoms!and!prevent! ulceration.! ! RDo!not!break,!crush!and!chew.! ! .! RMonitor!renal!(I/O),!liver,!blood! studies.! R!assess!hepatotoxicity!(dark! urine,!clay!coloured!stool),! allergic!reaction.! R!take!w/!8oz!of!water!&!sit!up!for! 30!mins!to!facilitate!drug!passing! to!stomach.! ! ! !! DF!118! ! Ultram! Dihydrocodeine! Analgesic!(synthetic! opioid)! Postoperative!(moderately! to!severe)!pain,!severe! dyspnea,!antiRtussive! Tramadol! Central!anagesic! Bind!to!opioid!receptors! and!inhibits!reuptake!of! norepinephrine,serotoninS! does!not!cause!histamine! release!or!affect!heart!rate! ! ! morphine! Opioid!analgesic! Severe!painS!given!after!or! during!an!MI! ! ! methadone! Opioid!analgesic! Severe!pain! ! Naprosyn! Naproxen! Nonsteroidal! antiinflammatory,! nonopioid!analgesic! Decrease!pain!and! inflammation,S!mild!to! moderater!pain,,!acute!gout! ! Ponstan! Mefenamic!acid! ! NSAID! Moderate!pain,!rheumatoid! arthritis! Erythromycin! ! AntiRinfective! Mild!to!moderate! respiratory!tract,!skin,!soft! tissue!infections! Depress!pain!impulse!transmission!at! the!spinal!cord!level!by!interaction! with!opioid!receptors,!produce!CNS! depression,!decrease!cough!reflex,! increase!the!pain!tolerance,! respiratory!suppress.! ! Relief!of!pain! GI!disturbance,!respiratory! suppress,!constipation,!dryness! mouth,!dependence,!intolerance.! ! DDA! Orthostatic!hypotension! Decreae!pain!impulse!transmission!at! the!spinal!cord!level!by!interacting! with!opioid!receptors,!produces!CNS! depression! CNS:!confusion,!sedation! Precautions!to!pregnancy!C,! seizure!disorder,!lactation,! children,!elderly! ! Avoid!OTC!medication!and! alcohol! 1.!PO:!swallow!thw!whole!tab! ! Inhibit!prostaglandin!synthesis!by! decreasing!enzyme!needed!for! biosynthesisS!analgesic,! antiinflammatory! ! AntiRinflammatory,!analgesic!and! antipyretic!activities!related!to! Inhibition!of!prostaglandin!synthesis! CNS:!drowsiness,!confusion,! sedation,!dizziness,!headache! GI:!nausea,!vomiting,!anorexia,! constipation,!cramps! INTEG:!rash! ! 1.! Diarrhoea,!skin!rashes,! bronchospasm! Aspirin!in!nature!"!carefully! administer!x!peptic!ulcer,!GIB,!HT,! HF!Pt.! GI:!nausea,!vomiting,!diarrhea! GU:!vaginitis,!moniliasis! 1.! 2.! monitor!BP!and!bowel! change! caution!to!orthostatic! hypotension! Check!for!edema!in!feet,!ankle,! legs! ! AntiRinfective! 1.!AntiRinfective! ! ! Binds!to!50S!ribosomal!subunits!of! susceptible!bacteria!and!suppresses! protein!synthesis! 2.! 3.! 4.! 5.! 6.! ! Klacid! Clarithromycin! Antiinfective! ! Bactericidal!actionS!mild!to! moderate!infections!of! upper!respiratory!tract,! lower!respiratory!tractS! uncomplicated!skin!and! skin!structure!infection! ! 1.! 2.! 3.! 4.! severe!diarrhea"! discontinue! decreased!urine!output"! maybe!nephrotoxicity! Take!all!the!medications! prescribed!for!the!length!of! time!ordered! Caution!to!superinfection:! vaginal!itching,!loose! foulRsmelling!stools! at!least!1hr!ac!or!2hr!pc,! take!with!full!glass!of!water! crushed,!not!swallow!the! whole!tab,!except!the! entericRcoat!tab! assess!bowel!pattern.!If! severe! diarrhea"discontinue! Take!all!the!medications! prescribed!for!the!length!of! time!ordered! Caution!to!superinfection:! ! Swallow!the!whole!tab! ! 5.! ! Zinnal! ! Cefuroxime! axetil! ! AntiRinfective! Cephalosorin!(second! generation)! Streptococcus,! Haemophilus,!Moraxella,! E.!coli,!Klebsiella! Inhibit!bacterial!cell!wall!synthesis,! render!cell!wall!osmotically!unstable,! leadint!to!cell!death!by!binding!to!cell! wall!membrane! ! ! Penicillin! ! Broad!spectrum! antiRinfective! Respiratory!tract!infections,! pneumonia,!skin!and!soft! tissue!infections,! prevention!of!rheumatic! fever,!glomerulonephritis! Interferes!with!cell!wall!replication!of! susceptible!organisms,!osmotically! unstable!cell!wall!swells,!and!bursts! from!osmotic!pressure,!resulting!in! cell!death! !! !! Ampicillin! BroadRspectrum! AntiRinfective! Infections!of!respiratory! tract,!skin,!skin!structure,! genitourinary!tractS!otitis! media,!meningitis,! septicemia,!sinusitis,!and! endocarditis!prophylaxis! GI:!diarrhea,!NV,!anorexia,! abdominal!pain,!flatulence,! pseudomembranous*colitis* Hematologic:!bone*marrow* depression! Hypersensitivity:!rash!to!fever!to! anaphylaxis! GI:!nausea,!vomiting,!diarrhea! GU:!vaginitis,!moniliasis! Coma,!seizures,!nausea,!vomiting,! diarrhea,!vafiniris,!moniiasis,! anemia,!rash.! ! 2L!fluid!intake!during! diarrhea!episode! 6.! give!q12h!to!maintain!serum! level! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Cautiously!on!renal!failure!Pt.! Prepare!Vit.!K!in!case!of! hypoprothrombinemia! 1.! 2.! 3.! 4.! 5.! 1.! 2.! 3.! 4.! 5.! 6.! 7.! !! ! Amoxil! Amoxicillin! Antiinfective! Antiulcer! GI:!nausea,!vomiting,!diarrhea! INTEG:!urticaria,!rash! 1.! 2.! 3.! 4.! 5.! 6.! 7.! !! !! cloxacillin! Broad!spectrum! AntiRinfective! BetaRlactamase!resistant! penicillin! PenicillinaseRproducing! staphylococci,!streptococci,! respiratory!tract,!skin,!skin! structure!infectionsS! sinusitis! Interferes!with!cell!wall!replication!of! susceptible!organisms,!the!cell!wall,! rendered!osmotically!unstable,! swells,!and!bursts!from!osmotic! pressureS!resists!penicillinase!action! that!inactivates!penicillins! GI:!nausea,!vomiting,!diarrhea! GU:!vaginitis,!moniliasis! 1.! 2.! 3.! 4.! 5.! 6.! 7.! 8.! evere!diarrhea"!discontinue! decreased!urine!output"! maybe!nephrotoxicity! Caution!to!superinfection! Take!10R14!days! shake!susp! severe!diarrhea"! discontinue! decreased!urine!output"! maybe!nephrotoxicity! Take!all!the!medications! prescribed!for!the!length!of! time!ordered! Caution!to!superinfection! ! may!be!crushed! Take!for!10R14!days!to! ensure!organism!deathand! prevent!superinfection! shake!well!b4!each!dose,! store!in!refrigerator!for!2wk! or!1wk!at!rm!temp! severe!diarrhea"! discontinue! decreased!urine!output"! maybe!nephrotoxicity! Caution!to!superinfection! Take!for!10R14!days!to! ensure!organism!death!and! prevent!superinfection! store!in!tight!container! shake!well!b4!use.! ac!"!due!to!food!absorption! disturbance! severe!diarrhea"! discontinue! decreased!urine!output"! maybe!nephrotoxicity! Take!10R14!days! ! Caution!to!superinfection! swallow!the!whole!tab! store!in!tight!container! shake!well!b4!use.! ac!"!due!to!food!absorption! disturbance! !! ! Flagyl!p.619! Metronidazole! Trichomonacide! Amebicide! Antiinfective! Intestinal!amediasis,! amebic!abscess,! (refractory)!trichomoniasis,! bacterial!anaerobic! infections,!giardiasis,! septicemia,!endocarditis,! bone,!joint!and!lower! respiratory!tract!infections.! ! DrectRacting!amebicide/! trichomonacideS!binds,!degrades! DNA!in!organism.! ! GI:!nausea,!vomiting,!diarrhea,! anorexia! 1.! 2.! 3.! 4.! 5.! 6.! 7.! ! ! ! Cipro! ! ! ! Ciprofloxacin! ! Ofloxacin! ! Streptomycin! Urinary!antiRinfectives,! broad!spectrum! AntiRinfective! AntiRinfective,! antiRtuberculosis! Adult!UTIS!chronic!bacterial! prostatitisS!acute!sinusitisS! lower!respiratory,!skin,! joint,!bone!infectionsS! infectious!diarrhea,! exposure!to!inhalation! anthraxS!conjunctivitis,! corneal!ulcers! Interferes!with!conversion!of! intermediate!DNA!fragments!into!high! molecular!weight!DNA!in!bacteriaS! DNA!gyrase!inhibitor! CNS:!headache! GI:!diarrhea! INTEG:!rash! Treatment!of!lower! respiratory!tract! infections(pneumonia,! bronchitis),!genitourinary! infections!(prostatitis,! UTIs),!skin!and!skin! structure!infections,! conjunctivitis! Interferes!with!conversion!of! intermediate!DNA!fragments!into!high! molecular!weight!DNA!in!bacteria! Active!TB! Interferes!with!protein!synthesis!in! bacterial!cell!by!binding!to!ribosomal! subunit,!causing!inaccurate!peptide! sequence!to!form!in!protein!chain,! resulting!in!bacterial!death! EENT:!Ototoxicity! GI:!nausea,!vomiting,!anorexia! INTEG:!rash! Inhibits!RNA!synthesis,!decrease! tubercle!bacilli!replication! Peripheral!neuropathy,!dizziness,! nausea,!vomiting,!jaundice,!fatal! hepatitis,!seizures! Nausea,!vomiting,!anorexia,! diarrhea,!heartburn,!hematuria,! acute!renal!failure.! ! Headache,!confusion,! disorientation,!abd!distress,! anorexia,!nausea,!vomiting,! elevated!uric!acid,!acute!gout! 1.! 2.! 3.! 4.! 5.! ! 1.! 2.! 3.! 4.! 5.! ! 1.! 2.! ! severe!diarrhea"! discontinue! decreased!urine!output"! maybe!nephrotoxicity! Caution!to!superinfection! give!with!or!after!meal! store!in!light!resistant! container,!but!not! refrigerator! The!drug!has!a!metallic! taste,!and!urine!may!turn! dark! ac!"!due!to!food!absorption! disturbance! severe!diarrhea"! discontinue! decreased!urine!output"! maybe!nephrotoxicity! Take!all!the!medications! prescribed!for!the!length!of! time!ordered! Caution!to!superinfection! ! rinse!mouth!frequently,!use! sugarless!candy!or!gum!for! dry!mouth! severe!diarrhea"! discontinue! Take!all!the!medications! prescribed!for!the!length!of! time!ordered! increase!fluid!to!2L/day!to! avoid!crystalluria! give!with!8oz!of!water! don’t!give!with!Fe,!Al,!Zn! products!or!antacids!which! decrease!the!absorption!and! form!insoluble!chelate! decreased!urine!output"! maybe!nephrotoxicity! caution!to!superinfection! 2.!AntiRtubercular! ! !! ! Rimifon!p.524! Isoniazid! Antitubercular! !! ! Rifadin,! Rimactane!p.821! Rifampicin! (Rifampin)! Antitubercular! !! ! Myambutol!p.390! Ethambutol! Antitubercular! Pulmonary!TB!as!an! adjunctS!other!infections! caused!by!mycobacteria! Pulmonary!TB,! meningococcal!carriers! (prevention)! Pulmonary!TB,!as!an! adjunct!other! mycobacterial!infections! Inhibits!DNARdependent!polymerase,! decreases!replication! Inhibits!RNA!synthesis,!decreases! tubercule!bacilli!replication! Better!to!take!with!empty! stomach.!1hr!ac!or!2hrs!pc! Better!to!take!with!empty! stomach.!1hr!ac!or!2hrs!pc! Give!with!meal,!give!2!hrs!before! antacid.! ! !! ! Tebrazid!p.798! Pyrazinamide! Antitubercular!agent! Tuberculosis,!as!an!adjunct! when!other!drugs!are!not! feasible! Bactericidal!interference!with!liquidS! nucleic!acid!biosynthesis!is!possible! Headache,!increased!uric!acid,! hepatotoxicity! Check!L!function!(AST,!ALT)!prior! to!and!every!2R4!wks!during! therapy! Liver!damage!/!hyperuricemia! with!acute!gouty!arthritis!"!stop! acyclovir! AntiRviral! Decreased!amount!and! time!of!healing!of!lesions! Interferes!with!DNA!synthesis!by! conversion!to!acyclovir!triphosphate,! causing!decreased!viral!replication,! time!of!lesional!healing! CNS:!dizziness,!headache! 1.! 2.! 3.! 3.!AntiRviral! ! ! ! 4.! 5.! Swallow!the!whole!tab! may!give!with!8oz!of!water! ! store!at!rm!temp!with!dry! place! may!take!b4!infection!occur! or!when!itching!and!pain! occur! shake!susp!b4!use! 4.!AntiRfungal! ! Mycostatin! ! Nystatin! ! AntiRfungal! ! Fungicidal!against!Candida! organisms! Interferes!with!fungal!DNA!replicationS! bind!sterols!in!fungal!cell!membrane,! which!increase!permeability,!resulting! in!leaking!of!cell!nutrients! ! 1.! 2.! shake!the!susp!b4!use! ! store!oral!susp!in! refrigerator,!tab!in!airRtight,! light!resistant!container!at! rm!temp! Allergy!symptoms,!rhinitis,! allergic!dermatoses,!nasal! allergies,!hypersensitive! reactions!inc.!blood! transfusion,!reactions,! anaphylaxis! Motion!sickness,!rhinitis,! allergy!symptoms,! sedation,!nausea,! preoperative!and! postoperative!sedationS! Absence!of!allergy! symptoms!and!rhinitis,! absence!of!vomiting,! nausea!and!sedation.! ! Anxiety!preoperatively,! postoperatively!to!precent! nausea,!vomiting,!to! potentiate!opioid! analgesicsS!sedationS! pruritusS!prevention!of! alcohol,!drug!withdrawalS! ! Absence!of!allergy! symptoms,!rhinitis!pruritus,! absence!of!nausea/! vomiting,!sedation,! absence!of!anxiety! Acts!on!blood!vessels,!GI,!respiratory! system!by!competing!with!histamine! for!H1Rreceptor!siteS!decrease!allergic! response!by!blocking!histamine.! ! Dizziness,!drowsiness,!urinary! retention,!thrombocytopenia,! hemolytic!anemia,!dry!nose,!throat,! mouth! Do!not!cut,!chew!or!crush!SR! tablets! Check!blood!periodically!during! prolonged!therapy! Acts!on!blood!vessels,!GI,!respiratory! system!by!competing!with!histamine! for!H1Rreceptor!siteS!decrease!allergic! response!by!blocking!histamineS!also! acts!on!chemoreceptor!trigger!zone! to!decrease!vomiting,!increase!CNS! stimulation,!has!anticholinergic! response! Dizziness,!drowsiness,!neuroleptic! malignant!syndrome,!constipation,! urinary!retentionapnea!in!pediatric! patient.! ! Administer!through!IM,!no!SC!due! to!tissue!necrosis! Depresses!subcortical!levels!of!CNS,! including!limbic!system,!reticular! formation,!anticholinergic,!antiemetic,! antihistaminic!response,!competes! with!H1Rreceptor!sites.! Dizziness,!drowsiness,!seizures,!dry! mouth.! ! Take!1!hr!pc!or!2!hrs!pc! No!parenteral!solution!should!be! administered!through!IV,!SC,! intraRarterially! Determine!and!treat!underlying! cause!of!vomiting! Drug!masks!S/S!of!serious! conditions! AntiRinflammatory! 1.!AntiRhistamine! st !! ! Piriton!p.223! Chlorpheniramin e!maleate! Antihistamine!(1 ! generation,! nonRselective)! !! ! Phenergan!p.785! Promethazine! HCl! Antihistamine,! H1Rreceptor!antagonist,! antiemetic,! sedative/hypnotic! Hydroxyzine! Antianxiety,!sedative,! hypnotic,!antihistamine,! antiemetic! ! Atarax!p.487! 2.!Corticosteroid! ! !! ! ! Prednisolone! p.772! ! Prednisolone! Corticosteroid,!synthetic! Severe!inflammatory,! immunoR!suppression,! neoplasmsS!decrease! inflammation,!decreased! adrenal!insufficiency! Decrease!inflammation!by! suppressing!migration!of! polymorphonuclear!leukocytes,! fibroblastsS!reversal!to!increase! capillary!permeability!and!lysosomal! stabilization,!minimal! mineralocorticoid! ! Depression,!HT,!circulatory!collapse,! embolism,!diarrhea,!nausea,!abd! pain,!pancreatitis,!hemorrhage.! Administer!QD!before!0900!to! mimic!normal!peak!corticosteroid! blood!level! Place!orally!disintegrating!tablet! in!mouth!"!dissolve!"!swallow! Hydrocortisone! ! ! ! ! Lorazepam! ! Sedative,!antiRanxiety! agent! Decrease!anxiety,! relaxationS!anxiety,! irritability!in!psychiatric!or! organic!disorders,! preoperatively,!insomnia! Potentiates!the!actions!of!GABA,!an! inhibitory!neurotransmitter,!esp!in! limbic!system!and!reticular!formation,! which!depresses!the!CNS! CNS:!dizziness,!drowsiness! CV:!orthostatic!hypotension! EENT:!blurred!vision! 1.! 2.! Decrease!sign!and! symptoms!of!psychosis! Depress!cerebral!cortex,! hypothalamus,!limbic!system,!which! control!activity!and!aggressionS! blocks!neurotransmission!produced! by!dopamine!at!synapseS!exhibits! strong!alperRadrenergic,! anticholinergic!blocking!action.! CNS:!EPS,!pseudoparkinsnism,! akathisia,!dystonia,!tardive! dyskinesia,!drowsiness,! ! headache,!confusion! CV:!Orthostatic!hypotension,! ! GI:!Dry!mouth,!nausea,!vomiting,! anorexia,!constipation,! ! INTEG:! ! Rash,! ! Inhibit!the!synthesis!of!DNA!primarilyS! derived!from!Stretomyces!peuceticus! replication!is!decreased!by!binding!to! DNA,!which!causes!strand!splittingS! active!throughout!entire!cell!cycleS!a! vesicant! INTEG:!rash,!necrosis!at!inj!site! AntiRpsychotic!drugs! 1.!AntiRanxiety! ! ! !! Ativan! ! ! Haldol! haloperidol! Antipsychotic,! Neuroleptic! 3.! 1.! 2.! 3.! Can!be!crushed! provide!sugarless!gum,!hard! candy,!frequent!sips!of!water! for!dry!mouth! not!for!everyday! stress(longer!than!4! mo)"habit!forming! Contraindication:! Parkinson’s!disease* Take!antacids!2!hrs!be4!and! after!the!drugs* store!in!tight,!light!resistant! container* ! 2.!AntiRneoplastic!drug! ! ! Doxil! Blenoxane! ! Doxorubicin! Bleomycin! (SC/IM/IV)! ! AntiRneoplastic,! antiRbiotic! ! ! AntiRneoplastic,! antiRbiotic! ! ! Prevention!of!rapid!growing! malignant!cellsS!Wilm’s! tumorS!bladder,!breast,! cervical,!head,!neck,!liver,! lung,!overian,!prostatic,! stomach,!testicular,!thyroid! cancerS!Hodgkin’s!disease,! acute!lymphoblastic! leukaemiaS!myeloblastic! leukaemiaS! neuroblastomasS! lymphomasS!sarcomas! ! Prevention!of!rapid!growing! malignant!cellsS!cancer!of! head,!neck,!penis,!cervis,! vulva!of!squamous!cell! origin,!Hodgkin’s!disease,! lymphosarcoma,!reticulum! cell!sarcoma,!testicular! carcinoma,!malignant! pleural!effusion! 1.! 2.! 3.! 4.! 5.! 6.! Inhibit!the!synthesis!of!DNA,!RNA,! proteinS!derived!from!Stretomyces! verticillusS!replication!is!decreased!by! binding!to!DNA,!which!causes!strand! splittingS!phase!specific!in!the!G2!and! M!phaseS!a!nonvesicant! GI:!nausea,!vomiting,!weight!loss,! anorexia,!stomatitis! INTEG:!rash,!hyperkeratosis,!nail! changes,!alopecia! 1.! 2.! 3.! avoid!contact!with!skin! give!fluid!b4!chemotherapy! to!hydrate!pt! can!provide!antiRemetic! 30R60mins!b4!giving!drug!to! prevent!vomiting!and!prn! give!antiRbiotics!for! prophylaxis!of!infection! urine!and!other!body!fluid! may!turn!redRorange!for!48hr! may!lose!hair! use!protective!clothing!duing! handling,!preparationS!avoid! contact!with!skin! avoid!brestfeeding! monitor!blood!glucose!level! for!diabetic! ! ! Carboplatin!(IV)! AntiRneoplastic!alkylating! agent! ! Ifex! Ifosfamide! AntiRneoplastic!alkylating! agent! ! ! ! ! ! ! ! ! cisplatin! Methotrexate! ! AntiRneoplastic,! antiRmetabolite! ! fluorouracil! Tamoxifem! AntiRneoplastic! ! Prevention!of!rapid!growing! malignant!cellsS!initial! treatment!of!ovarian!cancer! in!combination!with!other! agentsS!palliative!treatment! of!recurrent!ovarian! carcinoma!after!treatment! with!other!antiRneoplastic! agents,!including!cisplatin! Prevention!of!rapid!growing! malignant!cellsS! Testicular!cancer,! softRtissue!sarcoma,! Ewing’s!sarcoma,! nonRHodgkin’s!lymphoma,! lung,!pancreatic!cancer,! sarcoma! Prevention!of!rapid!growing! malignant!cellsS!advanced! bladder!cancerS!adjunctive! in!metastatic!teaticular! cancer!and!metastatic! ovarian!cancer,!head,!neck,! oesophageal,!prostatic,! lung,!and!cervical!cancerS! lymphoma! Prevention!of!rapid!growing! malignant!cellsS! Acute!lymphocytic! leukaemia,!in!combination! for!breast,!lung,!head,!neck! carcinoma,! lymphosarcoma,! gestational! choriocarcinoma,! hydatidiform!mole,! psoriasis,!rheumatoid! arthritis,!mycosis!fungoides! Prevention!of!rapid!growing! malignant!cellsS! Systemic:!cancer!of!breast,! colon,!rectum,!stomach,! pancreasS!multiple!active! keratoses! Topical:basal!cell! carcinoma! Prevention!of!rapid!growing! malignant!cellsS! Advanced!breast! carcinoma!that!has! Produce!interstrand!DNA!crosslink! and!to!a!lesser!extent!DNA!protein! crosslinksS!activity!is!not!cell!cycle! phase!specific! EENT:!vestibular!toxicity! 1.!can!provide!antiRemetic! 30R60mins!b4!giving!drug!to! prevent!vomiting!and!prn! Alkylates!DNA,!RNAS!inhibits! enzymes!that!allow!synthesis!of! amino!acids!in!proteinsS!activity!is!not! cell!cycle!phase!specific! CNS:!somnolence,!confusion,! hallucinations! Dermatologic:!alopecia! GI:!anorexia,!n/v! GU:!hemorrhagic!cystitis,!hematuria,! potentially*fatal*hemorrhagic* cystitis* Hematologic:!leukopenia! 1.! EENT:!Tinnitus,!hearing!loss,! vestibular!toxicity! GI:!severe!nausea,!vomiting,! diarrhea,!weight!loss! INTEG:!alopecia! Inhibit!the!enzyme!that!reduces!folic! acid,!which!is!needed!for!nucleric! acid!synthesis!in!all!cellsS!cell!cycle! specific!(S!phase)S! immunosuppression! GI:!nausea,!vomiting,!diarrhea,! anorexia,!ulcerative!stomatitis! INTEG:!rash,!alopecia! 2.! 3.! 4.! 5.! 6.! 1.! 2.! 1.! 2.! 3.! 4.! 5.! 6.! 7.! Inhibit!DNA,!RNA!synthesisS! interferes!with!cell!replication!by! competitively!inhibiting!thynidylate! synthesis,!cell!cycle!specific(S! phase),!a!vesicant! GI:!anorexia,!stomatitis! INTEG:!rash! 1.! 2.! 3.! 4.! 5.! Inhibit!cell!division!by!binding!to! cytoplasmic!estrogen!receptorsS! resembles!to!normal!cell!complex!but! inhibit!DNA!synthesis!and!estrogen! CNS:!hot!flushes,!headache,! lightRheadedness! GI:!nausea,!vomiting! INTEG:!rash! 6.! 7.! 1.! 2.! 3.! give!fluids!b4!chemotherapy! to!hydrate!pt! can!provide!antiRemetic! 30R60mins!b4!giving!drug!to! prevent!vomiting!and!prn! avoid!using!aspirin,!NSAIDs! avoid!crowds!or!person!with! known!infection! avoid!vaccination! hair!loss! hydrated!pt!with!NS!over! 8R12hr!b4!treatment! avoid!IM!if! 3 platelets<10000/mm ! ! avoid!contact!with!skin! can!provide!antiRemetic! 30R60mins!b4!giving!drug!to! prevent!vomiting!and!prn! give!antiRbiotics!for! prophylaxis!of!infection! give!in!am! avoid!use!of!aspirin,!NSAIDs! hair!loss! avoid!vaccination! Avoid!contact!with!skin! can!provide!antiRemetic! 30R60mins!b4!giving!drug!to! prevent!vomiting!and!prn! give!antiRbiotics!for! prophylaxis!of!infection! avoid!using!aspirin,!NSAIDs! avoid!crowds!or!person!with! known!infection! avoid!vaccination! hair!loss! swallow!the!whole!tab! store!in!lightRresistant! container!at!rm!temp! hair!loss! ! ! Vinblastine! ! AntiRneoplastic! ! ! Vincristine! ! AntiRneoplastic—miscell aneous! ! responded!to!other!therapy! in!estrogen!recptor!positive! pt,!prevention!of!breast! cancer,!after!breast! surgery/radiation!in!ductal! carcinoma!in!situ! Prevention!of!rapid!growing! malignant!cellsS! ImmunosuppressiveS! breast,!testicular!cancerS! lymphomasS! neuroblastomaS!Hodgkin’s,! nonRHodgkin’s!lymphomasS! mycosis!fungoidesS! histiocytosisS!Kaposi’s! sarcoma! Prevention!of!rapid!growing! malignant!cellsS! ImmunosuppressiveS! breast,!lung!cancerS! lymphomasS! neuroblastomaS!Hodgkin’s! diseaseS!acute! lymphoblastic!and! leukemiasS! rhabdomyosarcoma,! Wilm’s!tumorS!oesteogenic! and!other!sarcoma! ! response!to!target!tissue! Decreasing!serum!uric! acid,!reducing!uric!acid! synthesis.!(Chronic!gout! )! Decrease!pain!and!joint! inflammation.!Gout!and! gouty!arthritis! ! Inhibits!the!enzyme!xanthine!oxidase,! reducing!uric!acid!synthesis! ! Interferes!blood!clotting! Inhibit!mitotic!activity,!arrest!cell!cycle! at!metaphaseS!inhibit!RNA!synthesis,! blocks!cellular!use!of!glutamic!acid! needed!for!purine!synthesis,!a! vesicant! 4.! rash!or!lesion!become!large! at!the!beginning!of!the! therapy!but!temporary! GI:!anorexia,!nausea,!vomiting,! stomatitis! INTEG:!rash! ! 1.! 2.! 3.! 4.! avoid!contact!with!skin! avoid!use!of!aspirin,!NSAIDs! hair!loss! avoid!vaccination! CNS:!decreased!reflexes,! numbness,!weakness,!motor! difficulties! GI:!nausea,!vomiting,!anorexia,! stomatitis,!constipation! INTEG:!alopecia! 1.! avoid!the!use!of!aspirin,! NSAIDs! hair!loss! avoid!vaccination! 2.! 3.! AntiRgout! ! !! !! ! Zyloric!p.60! ! Colgout!p.263! Allopurinol! Antigout,!xanthine! enzyme!inhibitor.! Colchicine! ! Antigout!agent! Warfarin!sodium! Anticoagulants! ! CNS:!Headache! GI:!nausea,!vomiting,!anorexia,! malaise! ! 1.! Inhibits!microtubule!formation!of!lactic! acid!in!leukocytes!which!decreases! phagocytosis!and!inflammation!in! joints.! ! GI:!nausea,!vomiting,!anorexia,! malaise! ! Monitor!serum!cholesterol,!LDLs,! triglycerides!and!glucose!before! drug!administration! Hyperlipidemia!"!administer!with! meal! NIDDM!"!QD!/!BID! Bowel!program!"!reduce! constipation! Monitor!nutritional!status! Prevent!blood!clotting! Fever,diarrhea,!rash! 1.! 2.! 2.! increase!fluid!to!2L!a!day!to! prevent!stone!formation! can!be!crashed! Hematologic!drugs! AntiRcoagulants! ! !! ! Warfarin!Norton! 3.! 4.! Teach!pt.!to!avoid!injury,! Do!not!give!Intramuscular! injections!to!patients! dosage!change!q1R2wk! limited!intake!of!vit!K!food!to! maintain!consistent! prothrombin!levels! ! ! Heparin! ! Anticoagulants,! antithrombotic! ! Prevention!of!thrombi! Prevents!the!conversion!of!fibrinogen! to!fibrin!and!prothrombin!by! enhancing!inhibitory!effects!of! antithrombin!III! CNS:!fever! INTEG:!rash! 1.! 2.! Teach!pt.!to!avoid!injury,! Do!not!give!Intramuscular! injections!to!patients! Needed!for!fat,!protein!and! carbohydrates!metabolismS!enhances! glycogen!release!from!liver!and! muscle!tissues,!needed!as!coenzyme! for!metabolic!transformations!of!a! variety!of!amino!acid! Neutralizes!gastric!acidity! Paresthesia,!flushing,!pain!at! injection!site! ! GI:!constipation!(laxatives!or!stool! softeners!can!be!given)! Antacid:1hr!pc!and!at!bed!time! Ca!supplement:!1/2!pc!and!at!bed! time! 1.!chew!the!tab! ! Vitamine! ! ! !! ! Pyridoxine! Vitamin!B6! Vitamin!B6!and!water! soluble! Vitamin!B6!deficiency!a/s! with!inborn!error,!seizure,! therapy!(isoniazid),!oral! contraceptives,!alcoholism,! polyneuritis! !! ! Oscal! Caltrate! CaCO3! Antacid,!Ca!supplement! Not!for!chronic!therapy! !! !! MultiRvitamin! Vitamin! Prevention!and!treatment! of!vitamine!deficiencies! Needed!for!adequate!metabolism! ! ! Simvastatin! Antilipidemic! Decreasing!cholesterol! levels!and!LDLs,!increased! HDLsS!As!an!adjunct!in! primary!hypercholesR! terolemia,!(types!IIa,!IIb),! mixed!hyperlipidemia,! CAD,!isolated!hypertriR! glyceridemia,!and!type!III! hyperR!lipoproteinemia! Inhibits!HMGRCoA!reductase! enzymes,!which!reduces!cholesterol! synthesis,!this!enzyme!is!needed!for! cholesterol!production.! CNS:!headache! GI:!flatulence,!diarrhea,!abdominal! pain,!cramps,!constipation,!nausea,! liver*failure! Other:!rhabdomyolysis,!acute* renal*failure! Give!30!min!before!AM!and!PM! meal! Antilipidemic! !! ! Zocor!p.848! Throat!preparation! ! Dequadin! Dequalinium!Cl! Throat!preparation! Common!infection!of!mouth! and!throat! Reduce!infection!and!relief!pain! ! Max:!8!lozenges! ! strepsils! ! ! ! ! ! ! Diphenhydramin e! ! Antihistamine! ! Uses:!allergy!symptoms,! rhinitis,!motion!sickness,! antiparkinsonism,!nighttime! sedation,!infant!colic,! nonRproductive!cough,! anaohylaxis,!nasal! allergies,!allergic! dermatoses,!dystonic! reaction! Acts!on!blood!vessels,!GI,!respiratory! system!by!competing!with!histamine! for!H1Rreceptor!siteS!decrease!allergic! response!by!blocking!histamineS! cause!increased!heart!rate,! vasodilation,!secretion! CNS:!dizziness,!drowsiness! GU:!retention! ! Tranexamic!acid,! Cyklokapron! haemostatic! To!impair!the!blood!clot! dissolution! "!prevent!a!further! bleeding!by!forming!blood! Peptic!ulcer! Anorexia* Nausea* vomiting! Caution!to:!thrombosis! (Transamin!may!stabilize!the! thrombosis),!pregnancy.! (Transamin!can!diffuse!to!baby! URTI!remedy! ! Benadryl! ! Haemostatic!drug! ! !! ! Transamin! clot!on!the!wound! from!placenta)! Patient!education:!chew!tablets! well!before!swallowing!and!then! drink!a!full!glass!of!water! Contraindication:!hypersensitivity! to!aluminum!salt!or!magnesium! salt! Antidote,!detoxifying!agent! !! ! Resonium!A! Na!polystyrene! sulphonate! Antidote,!detoxifying! agent! Hyperkalemia! Removes!potassium!by!exchanging! sodium!for!potassium!in!body,!occurs! primarily!in!large!intestine! Constipation,!fecal!impaction! Potassium!level!3.5R5!mg/dl!
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