Drug Name a.

Phenytoin Brand Name: Dilantin Injection Date Prescribed: January 18, 2012

Drug Therapeutic Effects Classification Antiepileptic Control of grand mal agent, (tonic-clonic) and Hydantoin psychomotor seizures Control of status epilepticus of the grand mal type (parenteral administration)

Adverse Effects Nausea, vomiting, diarrhea, constipation, drowsiness, insomnia, transient nervousness, motor twitchings, fatigue, irritability, depression, numbness, tremor, headache, photophobia, diplopia, Dizziness, lightheadedness headache, asthenia, fatigue, lethargy, Peripheral edema, arrhythmias,Fl ushing, rash, Nausea, abdominal discomfort

Contraindications Contraindicated with hypersensitivity to hydantoins, sinus bradycardia, sinoatrial block, Stokes-Adams syndrome, pregnancy (data suggest an association between antiepileptic drug use and an elevated incidence of birth defects; however, do not discontinue antiepileptic therapy in pregnant women who are receiving such therapy to prevent major seizures; this is likely to precipitate status epilepticus, with attendant hypoxia and risk to both mother and fetus), lactation. Contraindicated with allergy to amlodipine, impaired hepatic or renal function, sick sinus syndrome, heart block (second or third degree), lactation.

Nursing Considerations Use only clear parenteral solutions; a faint yellow color may develop, but this has no effect on potency. If the solution is refrigerated or frozen, a precipitate might form, but this will dissolve if the solution is allowed to stand at room temperature. Do not use solutions that have haziness or a precipitate. Administer IV slowly to prevent severe hypotension; the margin of safety between full therapeutic and toxic doses is small. Continually monitor patient's cardiac rhythm and check BP frequently and regularly during IV infusion. Suggest use of fosphenytoin sodium if IV route is needed. Monitor injection sites carefully; drug solutions are very alkaline and irritating. Give oral drug with food to enhance absorption and to reduce GI upset. Discontinue drug if rash, depression of blood count, enlarged lymph nodes, hypersensitivity reaction, signs of liver damage, or Peyronie's disease (induration of the corpora cavernosa of the penis) occurs. Institute another antiepileptic drug promptly. Monitor patient carefully (BP, cardiac rhythm, and output) while adjusting drug to therapeutic dose; use special caution if patient has CHF. Monitor BP very carefully if patient is also on nitrates. Monitor cardiac rhythm regularly during stabilization of dosage and periodically during long-term therapy. Administer drug without regard to meals.

b. Amlodipine besylate Brand Name: Norvasc Date Prescribed: January 18, 2012

Calcium channelblocker, Antianginal drug, Antihypertensive

Chronic stable angina, alone or in combination with other agents Essential hypertension, alone or in combination with otherantihypertensives

Drug Name

Drug Classification

Therapeutic Effects

Adverse Effects

Contraindications

Nursing Considerations

c. Furosemide Brand Name: Apo-Furosemide (CAN), Furoside (CAN), Lasix, Myrosemide (CAN) Date Prescribed: January 18, 2012

Loop diuretics

Edema associated with CHF, cirrhosis, renal disease (oral, IV) Acute pulmonary edema (IV) Hypertension (oral)

Dizziness, vertigo, Nausea, anorexia, vomiting, oral and gastric irritation, constipation, diarrhea,

d. Mannitol Brand Name: Osmitrol Date Prescribed: January 18,2012

Osmotic Diuretics

Adjunct in the treatment of: acute oliguric renal failure, edema, increased intracranial of intraocular pressure, toxic overdose.

confusion, headache blurred vision, chest pain, tachycardia nausea, thirst, vomiting dehydration,

e. Lactulose Brand Name: chronulac, acilac, heptalac, evalose, costilac Date Prescribed: January 18, 2012

hyperosmotic laxative

for constipation, painful anal and rectal conditions, preventions and treatment of portalsystemic encephalophaty (PSE)

Side effect:

Nausea, vomiting
Adverse effects: GI:

flatulence, , belching, abdo minal cramps, pain,distention

CLINICAL ALERT! Name confusion has occurred between furosemide and torsemide; use extreme caution. Administer with food or milk to prevent GI upset. Give early in the day so that increased urination will not disturb sleep. Do not mix parenteral solution with highly acidic solutions with pH below 3.5. Do not expose to light, may discolor tablets or solution; do not use discolored drug or solutions. Discard diluted solution after 24 hr. Arrange to monitor serum electrolytes, hydration, liver function. Arrange for potassium-rich diet or supplemental potassium as needed. Hypersensitivity; anuria; o Monitor vital signs, urine output, CVP, and pulmonary dehydration; active cranial artery pressures before and hourly throughout administration. bleeding o Assess patient for signs and symptoms of dehydration or signs of fluid overload. o Assess patient for anorexia, muscle weakness, numbness, tingling, confusion and excessive thirst. o Monitor neurologic status and intracranial pressure readings in patients receiving this medication to decrease cerebral edema. o Monitor for persistent or increased eye pain or decreased visual acuity. o Do not use solution that is cloudy or contains a precipitate. low galactose diet, check stool consistency galactosemia monitor electrolyte levels, especially in elderly patients monitor I&0 monitor patient for any adverse effects, GI reactions, nausea and vomiting, diarrhea may be move palatable. Mixed with fruit juice/milk increase oral fluid intake to prevent dehydration do not use with other laxatives

Contraindicated with allergy to furosemide, sulfonamides; allergy to tartrazine (in oral solution); electrolyte depletion; anuria, severe renal failure; hepatic coma; pregnancy; lactation.

Drug Name f. Simvastatin Brand Name: Zocor Date Prescribed: January 18, 2012

Drug Classifications Antihyperlipidemic HMG CoA inhibitor

g. Paracetamol Brand Name: Tempra Date Prescribed: January 18, 2012

Non-opioid analgesic and Antipyretic

Adverse Effects Adjunct to diet in the Headache, treatment of elevated diarrhea, total cholestrol and abdominal LDL cholesterol with pain, cramps, primary constipation, hypercholesterolemia nausea liver in those unresponsive failure, to dietary restriction Sinusitis, of saturated fat and acute renal cholesterol failure, To reduce the risk of arthralgia, stroke, TIA, MI in myalgia patients with coronary heart disease and hypercholesterolemia to reduce fever Side Effects: nausea, vomiting Adverse Effects: Jaundice, rashes or anaphylaxis, severe oliguria, dark urine, abdominal pain

Therapeutic Effects

Contraindications Contraindicated with allergy to simvastatin, fungal byproducts, pregnancy, lactation. Use cautiously with impaired hepatic and renal function, cataracts.

Nursing Considerations Ensure that patient has tried a cholesterol-lowering diet regimen for 36 mo before beginning therapy. Give in the evening; highest rates of cholesterol synthesis are between midnight and 5 AM. Advise patient that this drug cannot be taken during pregnancy; advise the use of barrier contraceptives. Arrange for regular follow-up during long-term therapy. Consider reducing dose if cholesterol falls below target.

Patients with hypersensitivity to the drug, severe hepatic or renal disease, G6PD deficiency

- Assess temperature directly before and 1 hour after giving medication. - When given IVTT, slowly infuse the drug and assess for phlebitis upon and after administration - Prepare acetylcysteine as an antidote for toxicity of acetaminophen - Can be given without regards to meals. - If respirations are <12/min (<20/min in children), withhold the medication and contact the physician. - Keep patient free from nauseating foods or odors to prevent nausea andvomiting - Assess for signs of hepatic and renal damage such as jaundice of skin and eyes, dark urine, severe oliguria or anuria

Drug name h. telmisartan Brand Name: Micardis

Drug Classification

Adverse Effects Telmisartan is used for Like other the treatment of angiotensin hypertension (high receptor blood pressure). It also blockers, is used for reducing the telmisartan risk of heart generally is attack,stroke, or death well-tolerated. from cardiovascular The most causes in patients 55 common side years of age or older at effects have high risk of developing beenheadache major cardiovascular , dizziness, events who are unable back pain, to take ACE inhibitors fatigue, and diarrhea

Therapeutic effects

Contraindications Do not use this medication if you are pregnant. Telmisartan may cause injury and even death to the unborn baby if you take it during the second and third trimesters of pregnancy. You should not use this medication if you are allergic to telmisartan. In rare cases, telmisartan can cause a condition that results in the breakdown of skeletal muscle tissue, leading to kidney failure. Call your doctor right away if you have muscle pain, tenderness, or weakness especially if you also have fever, nausea or vomiting, and dark colored urine

Nursing considerations -Avoid drinking alcohol. It can lower your blood pressure and may increase some of the side effects of telmisartan. -To be sure this medication is helping your condition, your blood pressure will need to be checked on a regular basis. Do not miss any scheduled appointments.