DRUG STUDY

KALIUM DURULE 1 tab TID

Drug Class: ElectrolyteActions:

Principal intracellular cation of most body tissues, participates in a number of physiologic processes-maintaining intracellular tonicity; transmission of nerve impulses; contraction of cardiac skeletal and smooth muscle; maintenance of normal renal function; also plays role in carbohydrate metabolism and various enzymatic reactions.

Indications:• Prevention and correction of potassium deficiency; when

associated with alkalosis, use potassium chloride when associated with acidosis, use potassium acetate, bicarbonate, citrate and gluconate

• IV: treatment of cardiac arrhythmias due to cardiac glycosides

Contraindications:• CI with allergy to tartrazine, aspirin; therapy with

potassium-sparing diuretics or aldosterone-inhibiting agents; severe renal impairment with oliguria, anuria, azotemia; untreated Addison’s disease; hyperkalemia; acute dehydration; heat cramps, GI disorders that delay passage in the GI tract

• Use cautiously with cardiac disorders

Adverse Effects:• Dermatologic: Rash• GI: nausea, vomiting, diarrhea, abdominal

discomfort, GI obstruction, GI bleeding, GI ulceration or perforation

• Hematologic: hyperkalemia-increased serum potassium, ECG changes

• Local: tissue sloughing, local necrosis, local phlebitis and venospasm with injection

Nursing Considerations:• Assess for allergy to the drug• Arrange for serial serum potassium levels before

and during therapy• Administer liquid form to any patient with delayed

GI emptying• Administer after meals or with food and a full

glass of water to decrease GI upset• Have patient swallow tablet whole, do not crush

or chew tablets• Do not use salt substitutes• Inform patient about the adverse effects and

instruct him/her to report occurrence

COLCHICINE 50 mg 1 tab TID

Drug class: Antigout drugActions:

Exact mechanism is unknown; decreases deposition of uric acid, inhibits kinin formation and phagocytosis, and decreases inflammatory reactions to urate crystal deposits.

Indications:• Treatment and prophylaxis of acute gout

flares in adults• Treatment of familial Mediterranean fever

in adults and children 4 year and olderContraindicaions:• Contraindicated with hypersensitivity

to colchicine, concurrent use of cyclosporine, ranolazine; presence of heptic or renal impairment

Adverse Effects:• CNS: peripheral neuropathy• Dermatologic: alopecia, rash, purpura,

dermatoses• GI: nausea, diarrhea, vomiting, abdominal

pain, dyspepsia• GU: azoospermia, oligospermia• Hematologic: bone marrow suppression,

elevated AST and ALT, aplastic anemia• Other: myopathy, muscle pain, weakness,

rhabdomyolysis

Nursing Considerations:• Assess hypersensitivity to the drug and renal or

hepatic disorders• Obtain baseline and periodic liver and renal

function tests, serum uric acid levels, CBC• Administer drug as prescribed• Encourage patient to avoid grapefruit juice• Monitor patient for relief of pain and signs and

symptoms of acute gout flair• Monitor GI effects, antidiarrheal medications may

be needed• Inform patient about the adverse effects and

instruct him/her to report if any occurs

OMEPRON 40 mg/IV OD

Drug Class: Antisecretory drug; Proton Pump InhibitorActions:

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

Indications:• Short-term treatment of active duodenal

ulcer and active benign gastric ulcer• Treatment of heartburn or symptoms of

GERD• Long-term treatment therapy for

pathologic hypersecretory conditionsContraindications:• Contraindicated with hypersensitivity to

omeprazole or its components

Adverse Effects:• CNS: headache, dizziness, asthenia, vertigo,

insomnia, apathy, anxiety, paresthesia, dream abnormalities

• Dermatologic: rash, inflammation, urticarial, pruritus, alopecia, dry skin

• GI: diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth, tongue atrophy

• Respiratory: URI symptoms, cough, epistaxis• Other: cancer in preclinical studies, back

pain, fever

Nursing Considerations:• Assess for hypersensitivity to drug or

any of its components• Administer before meals• Instruct the patient to swallow

capsules whole; do not chew or crush• Inform patient about the adverse

effects and instruct him/her to report if any occurs

GLUCOBAY 50 mg/tab BID

Drug Class: Alpha-glucosidase Inhibitor; Antidiabetic

Actions:Alpha-glucosidase inhibitor obtained from

the fermentation process and process of a microorganism; delays the digestion of indigested carbohydrates, leading to smaller increase in blood glucose following meals and a decrease in glycosylated Hgb; does not enhance insulin secretion, so its effect are additive to those of the sulfonylureas in controlling blood glucose

Indications:• Adjunct to diet to lower blood glucose in those

patients with type 2 diabetes mellitus whose hyperglycemia cannot be managed by diet alone

• Combination therapy with sulfonylurea, metformin or insulin to enhance glycemic control in patients who do not receive adequate control with diet and either drug alone

Contraindications:• Contraindicated with hypersensitivity to drug;

DKA; cirrhosis; inflammatory bowel disease; conditions that deteriorate with increase gas in the bowel; type 1 diabetes, colonic ulceration

Adverse Effects:• Endocrine: hypoglycaemia• GI: abdominal pain, flatulence,

diarrhea, anorexia, nausea, vomiting• Hematologic: leukopenia,

thrombocytopenia, anemia

Nursing Considerations:• Assess hypersensitivity to drug• Monitor serum glucose levels frequently to

determine drug effectiveness and dosage• Inform patient the likelihood of abdominal

pain and flatulence• Instruct the patient not to discontinue the

drug without consulting the health care provider

• Inform patient about the adverse effects and instruct him/her to report if any occurs

SIMVASTATIN 10 mg/tab HS

Drug Class: Antihyperlipidemic; HMG-CoA reductase inhibitor

Actions:Inhibits HMG-CoA reductase, the

enzyme that catalyzes the first step in the cholesterol synthesis pathway, resulting in a decrease in serum cholesterol, serum LDLs and either an increase or no change in serum HDLs

Indications:• Adjunct to diet in the treatment of elevated total

cholesterol and LDL cholesterol with primary hypercholseterolemia

• To reduce the risk of coronary disease, mortality and CV events, including CVA, TIA, MI and reduction in the need for bypass surgery and angioplasty in patients with coronary heart disease and hypercholesterolemia

• Treatment of patients with isolated hypertriglyceridemiaContraindications:• Contraindicated with allergy to simvastatin, fungal

byproducts, active liver disease or unexplained, persistent elevations of serum transaminase, pregnancy, lactation

• Use cautiously with impaired hepatic and renal functions, cataracts

Adverse Effects:• CNS: headache, asthenia, sleep

disturbances• GI: flatulence, diarrhea, abdominal

pain, cramps, constipation, nausea, dyspepsia, heartburn, liver failure

• Respiratory: sinusitis, pharyngitis• Other: rhabdomyolysis, acute renal

failure, arthralgia, myalgia

Nursing Considerations:• Assess hypersensitivity to drug• Administer in the evening• Instruct the patient not to drink

grapefruit juice while using this drug• Obtain periodic blood tests• Inform patient about the adverse

effects and instruct him/her to report if any occurs

ZEGEN (Cefuroxime)1.5 grams/ IV every 8 hours

Drug Class: Second generation CephalosporinActions:

It exerts its bactericidal activity by interfering with the synthesis of the bacterial cell wall. It binds to specific penicillin-binding proteins responsible for the synthesis of peptidoglycan, a heteropolymeric structure that gives the cell wall its mechanical stability.

Indications:• infections caused by susceptible strains of microorganisms

including upper & lower respiratory tract• uncomplicated skin & skin structure infections• treatment of bone & joint infections• surgical infections • UTIContraindications:• breastfeeding women as cefuroxime axetil is distributed into

milk.• hypersensitivity to cefuroxime or other cephalosporins or any

component of Zegen• Patients taking aminoglycosides and cephalosporins• Patients taking furosemide and ethacrynic acid.

Cepahalosporin taken with furosemide increase the risk of renal toxicity

Adverse Effects:• Gastrointestinal: Nausea, vomiting, diarrhea or loose

stools, gagging, abdominal/epigastric pain, abdominal cramps, dyspepsia, flatulence, heartburn, indigestion, GI bleeding and infection

• Hematologic: Decreased hematocrit and hemoglobin concentrations, transient eosinophilia and neutropenia, pancytopenia, thrombocytopenia, leukopenia, lymphocytopenia, agranulocytosis, leukocytosis, lymphocytosis, monocytosis, thrombocytosis, basophilia, anemia, aplastic and hemolytic anemia, epistaxis or haemorrhage

• Nervous System: Headache, dizziness, vertigo, malaise, fatigue, drowsiness, somnolence or sleepiness, weakness, insomnia

• Musculoskeletal: Muscle spasm of the neck, muscle cramps or stiffness, arthralgia/joint pain or swelling

Nursing Responsibilities:• Before giving the drug, inquire about any

sensitivity to the drug or other cephalosporins.

• Store the reconstituted suspension in the refrigerator

• Monitor patient's renal function when cefuroxime is given concurrently with aminoglycosides and/or diuretics because adverse renal effects may occur

• Monitor the patient for superinfection• Report to the physician if skin rashes occur

ZENITH 500 gm/ tab 1 tab OD

Drug Class: MacrolideActions:• Azithromycin monohydrate is active

against certain bacteria. Azithromycin passes into the bloodstream from the GIT and is carried to the diseased tissue, where it starts acting against the bacteria.

Indications:• Treatment of the following conditions

caused by organisms sensitive to azithromycin: Infections of the upper and lower respiratory tract eg, infections of the ear, nose and throat, bronchitis and pneumonia; infections of the skin and soft tissue; infections of the genitals due to Chlamydia trachomatis.

Contraindication:• Hypersensitivity to azithromycin

monohydrate or other macrolides• Pregnancy and lactation

Adverse Effects:• Hypersensitivity Reactions: Rare: Hypersensitivity

reactions eg, skin and mucous skin reactions; redness with or without itching, photosensitivity (especially sunlight and UV rays), pain in the joints

• GI Tract Disorders: Problems may occasionally occur in the form of loss of appetite, impaired digestion, loose stools, upper abdominal complains (pain, cramps), nausea, vomiting, diarrhea

• Liver and Bile Duct Disorders: Cases of impaired liver function including hepatitis, jaundice, hepatic necrosis and hepatic failure have been reported.

• Kidneys: Inflammation of the kidneys and acute renal failure

Nursing responsibilities:• Inquire about hypersensitivity to azithromycin and

other macrolides• Instruct the patient that the drug can be taken with

or without food, to swallow whole, do not chew/crush.

• Monitor patients with impaired liver function, kidney disease or serious GI problems with vomiting and diarrhea; with serious allergies or asthma.

• If side effects occur like severe and persistent diarrhea, inform the physician immediately

• Remind the patient to take the medication as prescribed by the physician

• Do not give to pregnant or lactating women

CELEBREX 400 mg 1 cap OD

Drug Class: Non- Steroidal Anti-inflammatory Drug

Action:It inhibits prostaglandin synthesis,

primarily via the inhibition of cyclooxygenase-2 (COX-2)

Indications:• Treatment of signs and symptoms

of osteoarthritis and rheumatoid arthritis. Management and treatment of postsurgical and dental pain and acute flare pain of osteoarthritis

Contraindications:• Patients with known hypersensitivity to

celecoxib and those who have demonstrated allergic-type reactions to sulfonamides.

• Celebrex should not be given to patients who have experienced asthma, urticaria or allergic-type reactions after taking aspirin or other NSAIDs

Adverse effects:• General: Aggravated allergy, allergic reaction,

asthenia, chest pain, cyst NOS, generalized edema, face edema, fatigue, fever, hot flushes, influenza-like symptoms, pain, peripheral pain

• Gastrointestinal: Constipation, diverticulitis, dysphagia, eructation, esophagitis, gastritis, gastroenteritis, gastroesophageal reflux, hemorrhoids, hiatal hernia, melena, dry mouth, stomatitis, tenesmus, tooth disorder, vomiting.

• Cardiovascular: Aggravated hypertension, angina pectoris, coronary artery disorder, myocardial infarction

Nursing Responsibilities:• Tell the patient that the drug may be taken

with or without food.• Do not give to patients with hypersensitivity

to celecoxib, and patients with asthma.• Monitor patient for GI ulceration or

bleeding.• Inform the patient about signs and

symptoms of serious GI toxicity and to tell immediately to the physician if it occurs.

• Instruct the patient to take the medication as prescribed to avoid drug overdose.

GABAPENTIN (Neurotin)100 mg/ cap OD at HS

Drug class: Anti- convulsantActions:

Gabapentin was formed by the addition of a cyclohexyl group to gamma-aminobutyric acid (GABA), which allowed this form of GABA to cross the blood-brain barrier. Despite its structural similarity to GABA, gabapentin does not bind to GABA receptors in the CNS. Its mechanism of action is unknown, but may involve enhanced neuronal GABA synthesis.

Indications:• Treatment of partial seizures with or

without secondary generalization; neuropathic pain.

Contraindications:• Allergies, depression• Myasthenia Gravis• Abnormal liver function test• Moderate to severe kidney impairment• Having thoughts of suicide• Taking antacid• lactating mothers

Adverse effects:• Somnolence• Dizziness• Ataxia• Fatigue• Nystagmus• Tremor• Diplopia• Amblyopia• Pharyngitis• Dysarthria

• Weight gain• Dyspepsia• Amnesia• Weakness• Paresthesia• Arthralgia• Purpura• Leucopenia• Anxiety • UTI

Nursing responsibilities:• Tell the patient that the drug may be taken

with or without food.• Gabapentin should be used with caution in

patients with a history of psychotic illness, renal impairment, dosage reduction in patients with reduced renal function or those undergoing hemodialysis.

• Do not give the drug with antacid because antacids slows the absorption of gabapentin

APPEBON1 cap OD

Drug Class: Appetite enhancerAction: unknownIndications:• Poor appetite, underweight, anorexia nervosa• For nutritional support in post-op cases,

metabolic disorders & convalescence.Contraindications• Angle closure glaucoma, prostatic hypertrophy

& primary hemochromatosis

Adverse Effects:• Drowsiness & dulling of mental alertness,

dry mouth, headache, nausea, jitteriness, tiredness.

Nursing considerations:• Instruct the patient to take the drug with

food• Educate the patient that the drug may

impair ability to drive or operate machinery.

• Use cautiously in pregnant women

INDERAL (Propanolol)10 mg/tab 1 tab BID

Drug class: Beta- blockerActions:• Propranolol inhibits the sympathetic nervous system by blocking

the beta receptors on the nerves of the sympathetic system. Since stimulation of the sympathetic nervous system is responsible for increasing the rate with which the heart beats, by blocking the action of these nerves propranolol reduces the heart rate and is useful in treating abnormally rapid heart rhythms.

• It also reduces the force of contraction of heart muscle and thereby lowers blood pressure. By reducing the heart rate and the force of muscle contraction, propranolol reduces the need for oxygen by heart muscle. Since heart pain (angina pectoris) occurs when oxygen demand of the heart muscle exceeds the supply of oxygen, propranolol, by reducing the demand for oxygen, is helpful in treating heart pain.

Indications:• angina• anxiety• migraine• essential tremor• high blood pressure• arrhythmias• thyrotoxicosisContraindications:• History of bronchial asthma or bronchospasm, bradycardia,

cardiogenic shock, hypotension, metabolic acidosis, after prolonged fasting, severe peripheral arterial circulatory disturbances, 2nd- or 3rd-degree heart block, sick sinus syndrome, untreated (w/ an α-adrenoceptor antagonist) pheochromocytoma, uncontrolled heart failure, Prinzmetal's angina. Patients prone to hypoglycemia.

Adverse Effects:• Cold extremities, GI & sleep disturbances, fatigue,

lassitude.• Deterioration in heart failure, mood changes.• Hypoglycemia, paresthesia. Bradycardia, confusion,

nightmares, dizziness, postural hypotension which may be associated w/ syncope, heart block, alopecia, thrombocytopenia, purpura, psoriasiform skin reactions, exacerbation of psoriasis, visual disturbances, CNS symptoms including hallucinations & psychoses.

• Rashes & dry eyes (discontinue drug).• Exacerbation of intermittent claudication,

Raynaud's phenomenon, bronchospasm,

Nursing Considerations:• Do not give this drug to pregnant women.

Infants exposed to this medication during pregnancy may have low birth weight, low blood sugar, or slow breathing/heartbeat.

• Do not give this medication to breastfeeding mothers. This drug passes into breast milk.

• Instruct the patient to take the drug on an empty stomach.

• Inquire about any sensitivity to the drug or any of its contents.

Nursing Considerations:• Instruct the patient not to smoke. • Educate patients with diabetes that this product

may prevent the fast/pounding heartbeat they would usually feel when their blood sugar level falls too low (hypoglycemia).

• To reduce the risk of dizziness and light headedness, instruct patient to get up slowly when rising from a sitting or lying position.

• Educate the patient not to stop taking the drug without consulting the physician.