DRUG NAME

DOSAGE, FREQUENCY AND ROUTE 25mg/tab p.o every 6hrs as needed for SBP less than or equal 160mmhg

MECHANISM OF ACTION Prevents conversion of angiotensin I to angiotensin II, which leads to decreased vasoconstriction and, ultimately, to lower blood pressure. Also decreases blood pressure by increasing plasma renin secretion from kidney and reducing aldosterone secretion from adrenal cortex. Decreased aldosterone secretion prevents sodium and water retention.

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GENERIC NAME: Captopril BRAND NAME:

Heart failure Hypertension

Hypersensitivity to drug or other ACE inhibitors.

CLASSIFICATION: Antihypertensive HOW SUPPLIED: a. Patients Supply: tablet b. Other forms:

CNS: headache, dizziness, drowsiness, fatigue, weakness, insomnia CV: angina pectoris, tachycardia, hypotension EENT: sinusitis GI: nausea, diarrhea, anorexia GU: proteinuria, erectile dysfunction, decreased libido, gynecomastia, renal failure Hematologic: anemia, agranulocytosis, leukopenia, pancytopenia, thrombocytopenia Metabolic: hyperkalemia Respiratory: cough, asthma, bronchitis, dyspnea, eosinophilic pneumonitis Skin: rash, angioedema Other: altered taste, fever

Before >Check doctors order >Do handwashing >Monitor vital signs During >Remember 5 rights >Let the patient state his name >Explain the purpose why the medication is given After >Document the medication given in patients chart >Monitor for any unusualities >Do handwashing Nursing Considerations: Monitor for sudden blood pressure drop within 3 hours of initial dose if patient is receiving concurrent diuretics and on a low-sodium diet. Tell patient to take drug 1 hour before meals on empty stomach. Advise patient to report fever, rash, sore throat, mouth sores, fast or irregular heartbeat, chest pain, or cough.

Inform patient that dizziness, fainting, and light-headedness usually disappear once his body adjusts to drug. Tell patient his ability to taste may decrease during first 2 to 3 months of therapy. Caution patient to avoid over-thecounter medications unless approved by prescriber.

DRUG NAME

DOSAGE, FREQUENCY AND ROUTE 10mg OD

MECHANISM OF ACTION Blocks dopamine receptors by disrupting CNS chemoreceptor trigger zone, increasing peristalsis and promoting gastric emptying

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GENERIC NAME: Metoclopramide BRAND NAME: Clomitene CLASSIFICATION: Antiemitic HOW SUPPLIED: a.Patients Supply: tablet b. Other forms: -suspension -capsule -injection

Prevention of postoperative nausea and vomiting

Hypersensitivity to drug

CNS: drowsiness, restlessness, anxiety, depression, irritability, fatigue, lassitude, insomnia, tardive dyskinesia, parkinsonian-like reactions, extrapyramidal reactions, akathisia, dystonia CV: hypertension, hypotension, arrhythmias GI: nausea, constipation, diarrhea, dry mouth GU: gynecomastia

Before >Check doctors order >Do handwashing >Monitor vital signs During >Remember 5 rights >Let the patient state his name >Explain the purpose why the medication is given After >Document the medication given in patients chart >Monitor for any unusualities >Do handwashing

Nursing Considerations: Monitor blood pressure during I.V. administration. Stay alert for depression and other adverse CNS effects. Watch for extrapyramidal reactions, which usually occur within first 24 to 48 hours of therapy. To reverse these symptoms, give diphenhydramine 50 mg I.M. or benztropine 1 to 2 mg I.M.,

as prescribed. Check for development of parkinsonian-like symptoms, which may occur within first 6 months of therapy and usually subside within 2 to 3 months after withdrawal. With long-term use, assess patient for tardive dyskinesia. In diabetic patient, stay alert for gastric stasis. Insulin dosage may need to be adjusted. Tell patient to take 30 minutes before meals. Instruct patient to report involuntary movements of face, eyes, or limbs. Caution patient to avoid driving and other hazardous activities until drug's effects are known.

DRUG NAME

DOSAGE, FREQUENCY AND ROUTE 187mg 1tab po OD @ bedtime

MECHANISM OF ACTION Causes local irritation in colon, which promotes peristalsis and bowel evacuation. Softens feces by increasing water and electrolytes in large intestine.

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GENERIC NAME: Senna concentrate BRAND NAME: Senokot CLASSIFICATION: Anti-inflammatory HOW SUPPLIED: A. Patients supply >Tablet B. Other forms >caplets > drops > elixir >liquid

Acute constipation; preparation for bowel examination

Hypersensitivity to drug or its components GI bleeding or obstruction Suspected appendicitis or undiagnosed abdominal pain Acute surgical abdomen Fecal impaction Inflammatory bowel disease (such as Crohn's disease)

GI: nausea, vomiting, diarrhea, abdominal cramps, nutrient malabsorption, yellow or yellowish-green feces, loss of normal bowel function (with excessive use), dark pigmentation of rectal mucosa (with longterm use), proteinlosing enteropathy GU: reddish-pink discoloration of alkaline urine, yellowish-brown discoloration of acidic urine Metabolic: electrolyte imbalances (such as hypokalemia) Other: laxative dependence (with long-term or excessive use)

Before >Check doctors order >Do handwashing >Monitor vital signs During >Remember 5 rights >Let the patient state his name >Explain the purpose why the medication is given After >Document the medication given in patients chart >Monitor for any unusualities >Do handwashing Nursing Considerations: Assess bowel movements to determine laxative efficacy. In long-term use, monitor fluid balance, nutritional status, and electrolyte levels and watch for laxative dependence. Tell patient using drug for constipation to take at bedtime with a glass of water. In long-term use, advise patient to watch for and report signs and symptoms of nutritional

deficiencies and fluid and electrolyte imbalance. If patient will undergo bowel examination, advise him to take drug 12 to 14 hours before procedure, followed by a clear liquid diet.

DRUG NAME

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GENERIC NAME: Coamoxiclav BRAND NAME: CLASSIFICATION: Pharmacologic class: Bactericidal

1tab p.o 2x a day

HOW SUPPLIED: A. Patients supply tablet B. Other forms

Inhibits enzymes involved information of peptidoglycan layer of bacterial cell wall No effect on human cell wallsBactericidal ; only works ondividing bacteriaWell absorbed enterallyClavula nic acid inhibits bacteriallactamase.

Lower resp tract Hypersensitivity to infections, otitis penicillins media, sinusitis, skin & soft tissue infections, UTI, pre& postsurgical procedures, bone & joint, dentalinfections.

Allergic reactionsitching, rashes, fever angioneuroticoedemaanaphylaxis (1 in 50,000to 100,000) Cross-allergy with other penicillins Partial cross-allergy with cephalosporins (10%)Hepatitis, cholestatic jaundice Erythema multiforme(including Stevens-Johnson) Toxic epidermal necrolysis; exfoliative dermatitis Diarrhea, vomiting Rashes Neutropenia Anaemia.

Before >Check doctors order >Do handwashing >Monitor vital signs During >Remember 5 rights >Let the patient state his name >Explain the purpose why the medication is given After >Document the medication given in patients chart >Monitor for any unusualities >Do handwashing Nursing Considerations: History of hypersensitivity, Renal impairment, Hepatic impairment maycause cholestatic jaundiceup to 6 weeks after cessation May cause maculopapular rashes almost always in presence of glandular fever.