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Generic name: Calcium Carbonate Brand name: Tums Classification: Antacid, Calcium supplement Suggested Dose: Tablets250,500, 650,

975 mg, 1g, 1.25g, 1.5g; Powder2,400 mg: Injection10%, 1.1g/5mL; Syrup1.8 g/5mL Ordered dose: 1 tab 3x/day (6am-12nn-6pm) Mechanism of action: Calcium supplement - It is essential for bone formation and blood coagulation. It is also used a replacement of calcium in deficiency states. Antacid - neutralizes or reduces gastric acidity, increasing the pH, or reversibly reduce or block the secretion of acid by gastric cells to reduce acidity in the stomach.

Indication: Dietary supplement when calcium intake is inadequate Treatment of calcium deficiency Prevention of hypocalcemia

Contraindication: Contraindicated with allergy to calcium, renal caculi, hypercalcemia, ventricular fibrillation during cardiac resuscitation Use cautiously with renal impairement

Side effects: CNS: syncope, tingling CV: cardiac arrest, arrythmias, bradycardia GI: constipation, nausea, vomiting, abdominal pain, dry mouth, thirst GU: calculi, hypercalciuruia Local: phlebitis (IV only)

Adverse effects: CV: slowed heart rate, peripheral vasodilation, local burning

Local: local irritation, severe necrosis Metabolic: hypercalcemia, rebound hyperacidity

Nursing responsibility: 1) Give calcium carbonate antacid 1 and 3 hr after meals and at bed time 2) Monitor VS especially BP and PR. 3) Asses for heartburn, indigestion, abdominal pain. 4) Monitor serum calcium before treatment. 5) Assess for nausea and vomiting, anorexia, thirst, severe constipation.

Generic name: Aminoral Brand name: Classification:

Used in the treatment of urological problems. Other Drugs Acting on the Genito-Urinary System

Suggested dose: Adult 70 kg Chronic renal insufficiency, compensated or decompensated retention 4-8 tab tid.

Ordered dose: 600g 1 tab 3x/day (6am-12nn-6pm)

Mechanism of action: Pharmacokinetics: The plasma kinetics of amino acids and their integration in metabolic pathways are well established. It should nevertheless be noted that, in uremic patients, the plasma disturbances do not seem to depend on digested amino acid intake, and that the post-absorptive kinetics seems to be distributed very early in the development of the disease. In normal individuals, there is an increase in the plasma level of ketoanalogues, 10 min after oral ingestion. These levels reach values that are approximately 5 times higher than the initial level. Peak levels are reached within 20-60 min and normal levels are reached again after 90 min. Gastrointestinal absorption is thus very rapid. In the plasma a simultaneous increase in levels of the ketoanalogue and the corresponding amino acid show that transamination of the ketoanalogues are very rapid. Due to natural pathways of disposal of -ketonic acids in the organism, it is probable that exogenous intakes are very rapidly

integrated into metabolic cycles. Ketoacids follow the same catabolic pathways as the classical amino acids. No specific study on ketoacid excretion has been performed to date. Indication: Prevention and therapy of damages due to faulty or deficient protein metabolism in chronic renal insufficiency in connection with limited protein food of 40 g/day (for adults)

Contraindications: Hypersensitivity to drugs Hypercalcemia, amino acid metabolism disorder.

Side effects: hypercalcemia

Adverse effects: Nursing responsibility: 1) Monitor I&O 2) Take with food

Generic name: Dextrose 5% in water Classification: Isotonic then hypotonic Parenteral fluid Electrolyte supplement

Ordered dose:

Mechanism of action Dextrose provides a source of calories. Dextrose is readily metabolized, may decrease losses of body protein and nitrogen, promotes glycogen deposition and decreases or prevents ketosis if sufficient doses are provided Isotonic solutions are designed to match the makeup of your intracellular fluid and are equal in osmotic pressure inside and outside your cells. This prevents any fluid shifting in and out of your cells.


Lactated Ringers and 5% Dextrose Injection, is indicated as a source of water, electrolytes and calories or as an alkalinizing agent.


solutions containing dextrose may be contraindicated in patients with known allergy to corn or corn products

Side effects:

severe burning, pain, or swelling around the IV needle; warmth, redness, oozing, or bleeding where the IV was placed; fever, ongoing cough; high blood sugar (increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, weight loss); headache, trouble concentrating, memory problems, weakness, feeling unsteady, hallucinations, fainting, seizure, shallow breathing or breathing that stops; low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling); or anxiety, sweating, pale skin, severe shortness of breath, wheezing, pain, fast or uneven heart rate.

Less serious side effects may include:

mild irritation around the IV needle; upset stomach; or swelling in your hands or feet.

Nursing responsibility: 1) Monitor I&O

2) Assess the site for any swelling, redness and pain 3) Monitor VS especially RR and CR 4) Increase oral fluid intake as thirst sensation often decreases with aging

Reference: Fluids & Electrolytes-An Incredibly East Pocket Guide, (2009), Lippincott, Williams, and Wilkins, Ambler PA, pp 179-181 Kozier, Barabra; Glenora, Erb; Berman, Audrey; Snyder, Shirlee J, Kozier and Erb's Fundamentals of Nursing, Chapter 52 'Fluid, electrolyte, and acid-balance' (2010) Prentice Hall New Jersey, p1455