Route
Freq.
Times Given
Mechanism of Action
Patient Rational
Side Effects
Nursing Implications
Med Pass Supplement Nutritional Supplement Lactulose, Cephulac/ Chronulac Gastrointestinal Agent, hyperosmotic laxative Namenda Mematine Anti-Alzheimers agent
60 ml
PO
TID
10 gm/ 15 ml
PO
1 Daily
1000
Acidifies colon contents, osmotic effect of organic acids causes laxative action
Can cause upset stomach and allergic reactions, nausea, rashes, flushing, sweating & headaches Diarrhea
Effects are seen in 24-48 hours, ensure patient does not self-medicate with another laxative because of slow onset, notify Dr. if diarrhea persists for more than 24 hours, could be sign of overdoes and need for med adjustment
Yes
10 mg TAB
PO
1 daily
2200
PO
1 Daily
2200
Binds to CNS receptor sites, prevents binding of glutamate, and excitatory neurotransmitter, decreases symptoms of dementia, does not slow progression, cognitive enhancement, does not cure disease. Serves as an antagonist of dopamine and serotonin. Also antagonizes histamine H1 receptors and Alpha1 Adrenergic receptors. Serves as an antagonist of dopamine and serotonin. Also antagonizes histamine H1 receptors and Alpha1 Adrenergic receptors.
Assess cognitive function (memory, attention, reasoning, language, ability to perform simple tasks). Check for improvement in cognitive function after admin. Review contraindications, warnings, and interactions. Focus on severe renal impairment.
Yes
Monitor mental status & mood changes (mood, ideation, delusions, hallucinations, behavior) Assess for suicidal tendencies. Monitor BP and pulse. Observe patient carefully when admin medication to ensure is swallowed and not hoarded. Monitor mental status (mood, ideation, delusions, hallucinations, behavior) Monitor mood changes. Assess for suicidal tendencies. Monitor BP and pulse. Observe patient carefully when admin medication to ensure is swallowed and not hoarded. Monitor for side effects.
Yes
PO
1 Daily
1000
Yes
Route
Freq.
Mechanism of Action
Side Effects
Nursing Implications
PO
BID
Centrally acting, selective, long-acting reversible cholinesterase inhibitor, causes elevated acetylcholine levels in the cortex which slows the neuronal degradation that occurs in Alzheimers disease.
25 mg Spironolactone Mut (aldactone) Electrolyte and water balance agent, potassium sparing diuretic
PO
1000
Diuretic agent that promotes sodium and chloride excretion without concomitant loss of potassium
Insomnia, fatigue, dizziness, confusion, ataxia, insomnia, somnolence, tremor, agitation, depression, anxiety, abnormal thinking, syncope, rash, flushing purpura, nausea, vomiting, diarrhea, anorexia, dyspepsia, abnormal pain, flatulence, constipation Lethargy, mental confusion, fatigue, abdominal cramps, nausea, vomiting, fluid and electrolyte imbalance
Determine if patient has allergy to rivastigmine, pregnancy, lactation, sick sinus syndrome, GI bleeding, seizures, asthma, COPD, Asses for orientation, affect, BP, Pulse, abdominal exam, renal and liver function tests
1 Daily
2200
drowsiness, confusion, dizziness, fatigue, hallucinations, headache, insomnia, nightmares, slurred speech, syncope, weakness, blurred vision, tinnitus, hypotension, arrhythmias, chest pain, hypertension, palpitations, tachycardia, dry mouth, altered taste, constipation, diarrhea, excess salivation, flatulence, nausea, vomiting, rash, myalgia, termor
Check blood pressure before initiation of therapy, monitor serum electrolytes and assess for signs of fluid electrolyte imbalance, monitor daily I&O, check for edema, weight pt under standard conditions and daily once therapy commences, observe for and report immediately onset of mental changes Monitor BP and pulse rate before and during initial therapy. Monitor ECGs in patients with pre-existing cardiac disease, check for improvement of sleep, mood and behavior, focus on hypersensitivity, recovery period if pt has had a MI, and concurrent electroconvulsive therapy.
Yes
Yes
Route
Freq.
Mechanism of Action
Side Effects
Nursing Implications
BID
Mechanism of action not understood, antiepileptic activity may be related to the metabolism of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA)
PO
1 Daily
Gastric acid pump inhibitor, suppresses gastric acid secretion by specific inhibition of the hydrogen potassium ATPase enzyme system at the secretory surface of the gastric parietal cells, blocks the final step of acid production
20 mg CAP
PO
1 Daily
1000
Sedation, tremor, emotional upset, depression, psychosis, aggression, hyperactivity, behavioral deterioration, weakness, transient increases in hair loss, rash, petechiae, nausea, vomiting, diarrhea, indigestion, abd cramps, constipation, anorexia with weight loss, increases appetite Headache, dizziness, asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, dream abnormalities, rash, inflammation, urticarial, pruritus, alopecia, dry skin, diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophy, URI symptoms, cough, epistaxis, back pain, fever Seizures, anxiety, h/a, tremor, drowsiness, insomnia, diarrhea, nervousness, sexual dysfunction, excessive sweating, pruritus
Give drug with food if GI upset occurs, assess for hypersensitivity to valproic acid, hepatic dysfunction, pregnancy, lacation, weight, skin color, lesions, orientation, affect, reflexes, bowel sounds, normal output, CBC and differential, bleeding time tests, hepatic function tests, serum ammonia level, exocrine pancreatic function tests, EEG Assess for hypersensitivity to omeprazole or any of its other components, pregnancy, lacation, skin lesions, Temperature, reflexes, affect, urinary output, abdominal examination, respiratory auscultation. Administer before meals.
Yes
Use cautiously in severe hepatic or renal impairment, patients with concurrent chronic illness or multiple drug therapy
Yes