DRUG STUDY

Generic Name OMEPRAZOLE Brand Name: Losec,Prilosec Classification: gastrointestinal agent; proton pump inhibitor. Dsage,Frequency and Route 40 mg/ cap 1 cap OD Mechanism of Action Suppresses gastri c acid secretion relieving gastrointestinal distress and promoting ulcer healing. Indication Duodenal and gastric ulcer. GERD including severe erosive esophagitis (4 to 8 wk treatment). Long-term treatment of pathologic hypersecretory conditions such as ZollingerEllison syndrome,multip le endocrine adenomas, and systemic mastocytosis. In combination with clarithromycin to treat duodenal ulcers associated with Helicobacter pylori. Edema associated with CHF, cirrhosis, renal Contraindication Long-term use for gastroesophageal reflux disease, duodenal ulcers; lactation. Adverse Effects CNS:Headache, dizziness, fatigue. GI:Diarrhea, abdominal pain, nausea, mild transient increases in liver function tests. Urogenital:Hem aturia, proteinuria. Skin:Rash. Nursing Responsibilities Patient & Family Education Report any changes in urinary eliminatio n such as pain or discomfort associated with urination, orblood in urine. Report severe diarrhea; drug may need to be discontinu ed.

FUROSEMIDE Brand Name: Lasix

20 mg/tab 1 tab OD

Inhibits reabsorption of Na and chloride mainly in the

Severe sodium and water depletion, hypersensitivity

Fluid and electrolyte imbalance. Rashes,

Observe patients receiving parenteral

CLAssification: Loop Diuretic

medullary portion of the ascending Loop of Henle. Excretion of potassium and ammonia is also increased while uric acid excretion is reduced. It increases plasma-renin levels and secondary hyperaldosteroni sm may result. Furosemide reduces BP in hypertensives as well as in normotensives. It also reduces pulmonary oedema before diuresis has set in.

disease,Acute pulmonary edema,Hyperten sion

to sulphonamides and furosemide, hypokalaemia, hyponatraemia, precomatose states associated with liver cirrhosis, anuria or renal failure. Addisons disease.

photosensitivity, nausea, diarrhoea, blurred vision, dizziness, headache, hypotension. Bone marrow depression (rare), hepatic dysfunction. Hyperglycaemia, glycosuria, ototoxicity.

drug carefully; closely monitor BP and vital signs. Monitor BP during periods of diuresis and through period of dosage adjustment. Monitor I&O ratio and pattern. Report decrease or unusual increase in output. Excessive diuresis can result in dehydratio n and hypovolemi a, circulatory collapse, and hypotensio

n. Weigh patient daily under standard conditions. Instruct patient to eat potassiumrich foods daily (e.g., bananas, oranges, peaches, dried dates) to reduce or prevent potassium depletion. Instruct to avoid replacing fluid losses with large amounts of water. Instruct to avoid prolonged exposure to direct sun.

CARVEDILOL Brand name: Coreg Classification: Alpha- and betaadrenergic blocker, Antihypertensive

6.25 mg/ tab tab OD

Carvedilol causes vasodilation by blocking the activity of blockers, mainly at alpha-1 receptors. It exerts antihypertensive effect partly by reducing total peripheral resistance and vasodilation. It is used in patients with renal impairment, NIDDM or IDDM.

Hypertensio n, alone or with other oral drugs, especially diuretics Treatment of mild to severe CHF of ischemic or cardiomyop athic origin with digitalis, diuretics, ACE inhibitors Left ventricular dysfunction (LVD) after MI

Hypersensitivity; severe chronic heart failure, bronchial asthma or related bronchospastic conditions; severe hepatic impairment. Patients with NYHA class IV cardiac failure, 2nd or 3rd AV block, sick sinus syndrome (unless a permanent pacemaker is in place), cardiogenic shock or severe bradycardia. Lactation.

Bradycardia, AV block, angina pectoris, hypervolemia, leucopenia, hypotension, peripheral edema, allergy, malaise, fluid overload, melena, periodontitis, hyperuricemia, hyponatremia, increased alkaline phosphatase, glycosuria, prothrombin time, SGPT and SGOT levels

AMIODARONE Brand

200 mg/tab 1 tab OD

Type III antiarrhythmic: Acts directly on

life-threatening recurrent ventricular

Contraindicated with hypersensitivity

CNS: Malaise, fatigue, dizziness,

Instruct to take drug with meals. Instruct to do not stop taking drug unless instructed to do so by a health care provider. Advised to report difficulty breathing, swelling of extremitie s, changes in color of stool or urine, very slow heart rate, continued dizziness. Check the BP of the patient. Monitor cardiac rhythm

name:Cordarone.Pa cerone Classification: Antiarrhythmic {Class III}

cardiac cell membrane; prolongs repolarization and refractory period; increases ventricular fibrillation threshold; acts on peripheral smooth muscle to decrease peripheral resistance

arrhythmias, reatment of refractory sustained or paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia; treatment of symptomatic atrial flutter

to amiodarone, sinus node dysfunction, heart block, severe bradycardia, hypokalemia, lactation.

tremors, ataxia, paresthesias, lack of coordination CV: Cardiac arrhythmias, CHF, cardiac arrest, hypotension EENT: Corneal microdeposits (photophobia, dry eyes, halos, blurred vision); ophthalmic abnormalities including permanent blindness Endocrine: Hypothyroidism or hyperthyroidism GI: Nausea, vomiting, anorexia, constipation, abnormal LFTs, hepatotoxicity Respiratory: Pulmonary toxicity pneumonitis, infiltrates

continuously. Give drug with meals to decrease GI problems. Advise patient to have regular medical follow-up, monitoring of cardiac rhythm, chest X-ray, eye examination, blood tests Instruct patient to Report unusual bleeding or bruising; fever, chills; intolerance to heat or cold; shortness of breath, difficulty breathing, cough; swelling of ankles or fingers; palpitations;

(shortness of breath, cough, rales, wheezes) Other: Photosensitivity, angioedema CAPROPRIL Brand name: Capoten Classification:ACE inhibitor, Antihypertensive tab (25 mg/dl) BID Captopril competitively inhibits the conversion of angiotensin I (ATI) to angiotensin II (ATII), thus resulting in reduced ATII levels and aldosterone secretion. It also increases plasma renin activity and bradykinin levels. Reduction of ATII leads to decreased sodium and water retention. By these mechanisms, captopril produces a hypotensive effect and a Treatment of hypertension alone or in combination with thiazidetype diuretics Treatment of CHF in patients unresponsive to conventional therapy; used with diuretics and digitalis Treatment of diabetic nephropathy Treatment of left ventricular dysfunction after MI Known hypersensitivity to the drug. Bilateral renal artery stenosis, hereditary angioedema; renal impairment; pregnancy. Hypotension, tachycardia, chest pain, palpitations, pruritus, hyperkalemia. Proteinuria; angioedema, skin rashes; taste disturbance, nonproductive cough, headache.

difficulty with vision

Monitor blood pressure Assess for allergy to captopril, history of angioedem a, impaired renal function, CHF, salt or volume depletion. Administer 1 hr before meals. Instruct to Avoid overthe-counter medication s, especially cough, cold, allergy medication s that may contain

beneficial effect in congestive heart failure.

ingredients that will interact with ACE inhibitors. Instruct to eport mouth sores; sore throat, fever, chills; swelling of the hands or feet; irregular heartbeat, chest pains; swelling of the face, eyes, lips or tongue; difficulty breathing. Instruct to report mouth sores; sore throat, fever, chills; swelling of the hands or feet; irregular heartbeat,

chest pains; swelling of the face, eyes, lips or tongue; difficulty breathing. SPIRONOLACTONE Brand name:Aldactone,No vospiroton Classification: electrolytic and water balance agent ; potassium-sparing diuretic 25 mg/tab 1 tab OD Spironolactone acts on the distal renal tubules as a competitive antagonist of aldosterone. It increases the excretion of sodium chloride and water while conserving potassium and hydrogen ions Adjunctive therapy in edema associated with CHF, nephrotic syndrome, hepatic cirrhosis when other therapies are inadequate or inappropriate Treatment of hypokalemia or prevention of hypokalemia in patients who would be at high risk if hypokalemia occurred: Digitalized patients, patients with cardiac arrhythmias Anuria, hyperkalemia, acute or progressive renal insufficiency. Addisons disease. Fluid or electrolyte imbalance, gynecomastia, GI upset, drowsiness, headache, hyponatremia; tachycardia, hypotension, oliguria, hyperkalemia; confusion, weakness, paresthesia, hirsutism, mental disturbances, menstrual irregularities, loss of libido and impotence. Give daily doses early so that increased urination does not interfere with sleep. Measure and record regular weight to monitor mobilizatio n of edema fluid Avoid giving food rich in potassium. Instruct patient to Report weight change of more than 3 pounds in

1 day, swelling in your ankles or fingers, dizziness, trembling, numbness, fatigue, , deepening of voice, impotence, muscle weakness, or cramps.

IVABRADINE Brand name:Coralan Classofication: Anti-anginal

5 mg/ tab BID

Ivabradine is a heart rate lowering agent that works through selective and specific inhibition of the cardiac pacemaker If curr ent. If current controls the spontaneous diastolic depolarisation in the sinus node and regulate heart rate.

Angina Pectoris

Cardiovascular:br adycardia,palpitat ions,supraventric ularextrasystoles GI: nausea, constipation

blurred vision, bradycardia, 1st degree AVblock, ventricular extrasystole, supraventricular extrasystoles, palpitations, headache, dizziness, nausea, constipation, diarrhoea, vertigo, dyspnoea, muscle cramps, hyperuricaemia,

Check the heart rate and Blood pressure of the patient. Instruct the patient to take this medication with food. Assess for signs of CHF ( peripheral edema, crackles,dys pnea, weight gain, jugula

eosinophilia, elevated bloodcreatinine.

r venous distention. Assess location, duration,int ensity and precipit ating factors of patient's anginal pain . Check frequ ency of refills to monitor adherence.