Summary of Medications: (Full descriptive drug cards attached)
Atorvastatin (Lipitor) PO
10mg tab (takes two tabs)
Class: Antihyperlipidemia (HMG-COA Reductase Inhibitors)
Action; HMG-CoA reductase is a rate-controlling enzyme of cholesterol syntheses.
(Mosby, pg 821) If this enzyme is blocked, serum cholesterol and LDL levels decrease,
because more LDL’s are absorbed by the cells for processing into cholesterol.(Karch, pg
638) In return HDL levels increase slightly with this alteration in fat metabolism. These
HMG-COA Reductase Inhibitors block HMG-CoA reductase from completing the
synthesis of cholesterol. (Karch, pg 638)
Reason Patient is Taking: To decrease his cholesterol levels, his cholesterol is
directly affected by his(prior) diagnosis of Coronary Artery Disease. A nutritional
consult was documented on 4/6/04. Advisement by nutrition was to be put on a low
cholesterol diet. Patient verbalized understanding and was receptive to the consult.
He was given information with sample menus.
Isosorbide Mononitrate PO
30 mg 1 tab qd
Class: Antianginal
Action: Produces vasodilation, decreases left ventricular end-diastolic pressure and left
ventricular end-diastolic volume(preload) Increases coronary blood flow by dilating
coronary arteries and improving collateral flow to ischemic regions. (Davis pg. 257)
Nitrates are drugs that act directly on smooth muscle to cause relaxation by dilating
veins, arteries and capillaries, allowing increased blood flow through these
vessels.(Karch pg 623) CAD causes a stiffening and lack of responsiveness in the
coronary arteries, these drugs increase blood flow through healthy coronary arteries. The
main effect is a drop in blood pressure, decreases preload, and decreases afterload.(Karch
pg 623)
Reason Patient is taking: My patient has a prior diagnosis of Coronary Artery
Disease, this medication is helping treat conditions related to this disease process.
He also has a history of hypertension, however on my shift his blood pressure
measured 0800 140/50, on the day prior a 1800 reading was documented at 130/40
and upon admission his blood pressure was 140/60. His apical pulse at 0800 on the
day of my shift 4/7/04 was 72 and regular. Patient teaching may include education
regarding monitoring his blood pressure at home.
Protonix PO
40 mg
1 tab qd
Class: Anti-Ulcer Proton Pump Inhibitor
Action: Suppresses gastric acid secretion by specifically inhibiting the H+, K+, -ATPase
enzyme system on the secretory surface of the gastric parietal cells. This action blocks
the final step of acid production, lowering the acid levels in the stomach.(Karch pg 780)
Reason my patient is taking; It was not documented in the chart of a prior ulcer,
however, S.N. expressed that he frequently suffers from stomach upset from all of
the medications he is on. During my shift on 4/7/04 S.N. did not have any stomach
upset and when asked to rate his stomach pain he stated it was a zero. Patient
teaching would include limiting food intake to foods that are not irritating to the GI
tract. Also discussing prior coping mechanisms with regard to pain would assist
S.N. in dealing with episodes he might have in the future.
Phytonadione Mephyton PO
5 mg 1 Tab qd
Class: Fat Soluble Vitamins
Action: This medication is a form of Vitamin K and is used to reverse the effects of
warfarin. Vitamin K is responsible for promoting the liver synthesis of several clotting
factors. If an increased level of Vitamin K is provided clotting time can be brought back
within a normal range.
Reason my patient is taking: S.N. platelet count was 246 on 4/5/04, however he does
have Cellulitis on his left lower extremity that is not healing with prior treatment.
In the chart there was no documentation of clotting problems, this was a home
medication that he has been taking.
Prednisone PO (Only on even days)
5mg 1 tab qod
Class: Gluco/Corticosteroid
Action: These enter target cells and bind to cytoplasmic receptors, initiating many
complex reactions that are responsible for anti-inflammatory and immunosuppressive
effects. These drugs (Prednisone) also affect K+, Na and H20 levels in the body. These
are used for the short-term treatment of many inflammatory disorders, to relieve
discomfort and to give the body a chance to heal from the effects of inflammation. (Karch
pg 468)
Reason Patient is taking: My patients admitting diagnosis is cellulitis, and with this
condition there is a lot of swelling. This drug is to help alleviate the inflammation
due to his diagnosed condition of cellulitis. At the time I cared for S.N. he rated his
pain level at a zero. S.N.’s WBC level was a 7.4 on 4/5/04. His Neutrophil level was
at a 60.3 and his Monocyte level was 11.8. Although these indices are within normal
limits they are on the higher end of normal limits indicating that the inflammation
process is occurring. Patient teaching would include advising S.N. that a side effect
of this drug is suppressed natural immunity and educating him of the importance of
staying healthy by avoiding people who are sick and building up his already
suppressed immunity with a good diet. (Nutritional consult on 4/6/04)