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DRUG STUDY Name of Drug / Classification Dosage / Route of Administration Adults Initially, 5mg PO daily; dosage may gradually

increased over 1014 days to a maximum dose of 10mg PO daily. Patients with Hepatic impairment; Initially 2.5mg PO daily; dosage may be adjusted over 7-14 days based on clinical assessment Oral Mechanism of Action Amlodipine is in a group of drugs called calcium channel blockers. Amlodipine relaxes (widens) blood vessels and improves blood flow. Amlodipine is used to treat high blood pressure (hypertension) or chest pain (angina) and other conditions caused by coronary artery disease. Inhibits reabsorption of sodium and chloride in distal renal tubule, increasing excretion of sodium chloride and water by the kidney may decrease peripheral resistance. Indication Nursing Responsibilities

Amlodipine Antiangianal Antihypertensive Calcium Channel blocker (Norvasc)

Angina Pectoris due to coronary artery spasm. Chronic stable angina alone or in combination with other drugs.

Monitor cardiac rhythm regulary during stabilization of dosage and periodically during long-term therapy. Administer drug without regard to meals. Monitor BP, use with caution on patient with history of heart failure.

Indapramide Thiazide-like diuretic

Adults Edema; 2.5mg/day PO as single dose in the morning. May be increased to 5mg/day if no changes in 1 week. Hypertension; 1.25mg/day PO. May be increased up to 2.5mg/day if response is not satisfactory after 4 wk Oral

Edema associated with heart failure. Hypertension, as sole therapy or in combination with other hypertensive

Give with food or milk if GI upset occurs. Give early in the day so increased urination will not disturb sleep. Monitor weight

Simvastatin Adults Antihyperlipidemic Tablets 5, 10, 20, 40, 80 mg; Zocor orally disintegrating tablets 10, 20, 40, 80 mg Initially 20mg PO up to 80mg daily in the evening. Usual range, 5-80 mg/day. Maximum dose, 80mg/day. Adjust at 4-week intervals. Oral

Inhibits HMGCoA reductase 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

Simvastatin is used together with lifestyle changes (diet, weight-loss, exercise) to reduce the amount of fatty substances such as low-density lipoprotein (LDL) cholesterol ('bad cholesterol') and triglycerides in the blood and to increase the amount of highdensity lipoprotein (HDL) cholesterol ('good cholesterol') in the blood

Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor instructs you otherwise. Grapefruit can increase the amount of this medication in your bloodstream. If you also take certain other drugs to lower your cholesterol (bile acidbinding resins such as cholestyramine or colestipol), take simvastatin at least 1 hour before or at least 4 hours after taking these medications. These products can react with simvastatin, preventing its full absorption. Administer with food and milk to prevent GI upset. Monitor serum electrolytes, hydration, liver and renal function. Monitor changes. weight

Adults Tablets 20, 40, 80 mg oral solution 10mg 40mg/5mL; injection 10mg/mL Furosemide is used to reduce extra fluid in the body (edema) caused by conditions such as heart failure, liver disease, and kidney disease. This can lessen symptoms such as shortness of breath and swelling in your arms, legs,abdomen. Lasix (furosemide) is indicated in adults and pediatric patients for the treatment of edema associated with congestive heart failure, cirrhosis of the liver, and renal disease, including the nephrotic syndrome.

Furosemide Loop Diuretic

Lantus Insulin Antidiabetic Hormone

Insulin is a hormone Injection 100 secreted by units/mL, 500 beta cells of the units/mL pancreas that, SQ by receptor mediated effects, promotes the storage of the bodys fuels, facilitating the transport of metabolites and ions through cell membranes and stimulating the synthesis of glycogen from glucose, of fats from lipids and proteins from amino acids Adults Adults Tablets 2.5mg Oral Inhibits 1.25mg, reabsorption of sodium and chloride in distal renal tubules, increasing excretion of sodium chloride and water by the kidney, may decrease peripheral resistance.

Treatment of type 1 diabetes mellitus Treatment of type 2 diabetes mellitus that cannot be controlled by diet or oral drugs

Give maintenance doses subcutaneously, rotating injection sites regularly to decrease incidence of lipodystrophy. Use caution when mixing two types of insulin; always draw the regular insulin into the syringe first, if mixing with lipsro draw the lispro first; use mixtures of regular and NPH Monitor BG level.

Indapamide Thiazide-like diuretic (indoline)

Edema associated with heart failure Hypertension, as sole therapy or in combination with other hypertensives

Monitor for Orthostatic BP, perfusion Give with food or milk if GI upset occurs Monitor and record weight regularly Give early in the day so urination will not disturb sleep

Metoprolol Antihypertensive Beta-Selective adrenergic blocker

Blocks betaAdults Tablets- 25, 50, adrenergic 100mg receptors in Oral heart and juxtaglomerular apparatus, decreasing the influence of the sympathetic nervous system on these tissues and the excitability of the heart, decreasing cardiac output and release renin and lowering BP; acts in the CNS to reduce sympathetic outflow and vasoconstrictor tone. Adults Tablet-0.1, 0.2, 0.3 mg transdermal epidural injection 100mcg/mL Stimulates CNS alpha2adrenergic receptors, inhibits sympathetic Cardio accelerator and vasoconstrictor Centers decreases Sympathetic outflow from the CNS.

Hypertension, alone or with other diuretics. Immediate release tablets and injection prevention of reinfarction in MI patients who are hemodynamically stable or within 310 days of acute MI Long-term treatment of acute MI

Monitor for sinus bradycardia (HR <45bpm), cardiogenic shock, Systolic BP <100mmHg Do not discontinue abruptly after longterm therapy. Continual cardiac monitoring.

Catapres Antihypertensive Central Analgesic Sympatholytic

Used in in patient with hypertension alone or as a part of combination therapy.

Do not discontinue abruptly, discontinue therapy by reducing dosage gradually over 2-4 days to avoid rebound hypertension, tachycardia, flushing, nausea, vomiting, cardiac arrhythmias Do not discontinue prior to surgery. Monitor BP carefully.

Ferrous Sulfate Iron preparation

Adults Tablet Lactating: 9-27mg / kg / day Deficiency state: 6mg / kg / day Oral

Elevates serum iron concentration reticulo endothelial cells for storage and eventual conversion to a usable form of iron.

Prevention and treatment of iron deficiency anemia. Dietary supplement of iron

Check for hypersensitivity to drugs. Give drug with meals (avoid milk eggs, coffee and tea) Prevent staining of teeth; have the patient drink solution with straw. Warn stool may be dark or green

Lovastatin HMG-CoA reductase

Inhibis HMGAdults Tablet CoA reductase, 10mg, 20mg, an early (and 40mg (extended rate limiting) release) step in cholesterol biosynthesis.

To prevent and treat coronary heart disease; hyperlipidemia

Check for function test,

liver