Drugs GRP!!

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Generic name : Acetaminophen Brand Name :Biogesic,Tylenol General action:Anti-pyretic&Analgesic Specific action :
Antipyretic:
Reduces
fever
byacting
directly
onthe
hypothalamicheat-
regulatingcenter to causevasodilation andsweating, whichhelps dissipateheat Analgesic: Siteand mechanism of action unclear.
Indication :To relieve mild to moderate pain due to things such as headache, muscle and joint pain, backache and period pains. It is also used to bring down a high temperature. For this reason, paracetamol can be given to children after vaccinations to prevent postimmunization pyrexia (high temperature).Paracetamol is often included in cough, cold and flu remedies.
Route and Dosage : Adults and children 500-1000 mg orally every 4-6 hours
Contraindication : Contraindicated in patients hypersensitive to drug. Alexander, Anneth
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Use cautiously in patients with long term alcohol use because therapeutic doses cause hepatotoxicity in these patients
Adverse effects : Hematologic: hemolytic anemia,neutropenia, leucopenia, pancytopenia. Hepatic: Jaundice Metabolic: Hypoglycemia Skin: rash, urticaria.
Nursing Responsibilities : Use liquid form for children andpatients who have difficultyswallowing. In children, dont exceed five dosesin 24 hours. Advise patient that drug is only forshort term use and to consult thephysician if giving to children forlonger than 5 days or adults forlonger than 10 days. Advise patient or caregiver thatmany over the counter productscontain acetaminophen; be awareof this when calculating total dailydose. Warn patient that high doses orunsupervised long term use cancause liver damage.
Alexander, Anneth
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Generic name :Carbocisteine Brand Name :Solmux,Loviscol General action:MUCOKINETICS/EXPECTORANTS Specific action :Reduces the viscosity of bronchial secretions &facilitate expectoration. Indication :Acute/chronic disorders of the upper &lower respiratory tract associated with the secretion &formation of excessive and viscid mucus Route and Dosage : Capsule: Adult: 250mg 2 caps,500mg 1 cap TIDSuspension:Adult 15ml; Pedia: 6-12yrs: 5ml, 2-5 yrs: 1.25-2.5 mlSyr:6-12yrs: 10ml2-5 yrs: 2.5ml Drops:12-24mos: 1.25ml, 9-11mos: 1ml, 6-8mos:0.75ml, 3-5mos: .50ml,<3mos: 0.25mlAll doses 3-4x/ day Contraindication : Contraindicated on active peptic ulcer. Hypersensitivity to carbocisteine
Adverse effects :Nausea, headache, vomiting, anorexia, gastric discomfort, diarrhea, GI bleeding Nursing Responsibilities : assess cough: type, frequency, character advice medical consultation for persistent cough of more than 7 days advice pt. to avoid smoking suggest sugarless lozenges to decrease throat irritation and cough
Alexander, Anneth
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Generic name :Isosorbidemononitrate Brand Name :Imdur General action: Antianginal, Nitrate, Vasodilator
Specific action :The principal pharmacological action of ISMN and all organic nitrates in general is relaxation of vascular smooth muscle, producing dilatation of peripheral arteries and veins, especially the latter. Dilatation of the veins promotes peripheral pooling of blood and decreases venous return to the heart, thereby reducing left ventricular end-diastolic pressure and pulmonary capillary wedge pressure (preload). Arteriolar relaxation reduces systemic vascular resistance, and systolic arterial pressure and mean arterial pressure (afterload). Dilatation of the coronary arteries also occurs. The relative importance of preload reduction, afterload reduction, and coronary dilatation remains undefined. Indication :

Dinitrate: Treatment and prevention of angina pectoris Mononitrate: Prevention of angina pectoris
Alexander, Anneth
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Unlabeled use (dinitrate): Used with hydralazine in patients with advanced CHF
Route and Dosage :The recommended starting dose of IMDUR Tablets is 30 mg (given as a single 30-mg tablet or as of a 60-mg tablet) or 60 mg (given as a single tablet) once daily. After several days, the dosage may be increased to 120 mg (given as a single 120-mg tablet or as two 60-mg tablets) once daily. Rarely, 240 mg may be required. The daily dose of IMDUR Tablets should be taken in the morning on arising. IMDUR Extended Release Tablets should not be chewed or crushed and should be swallowed together with a half-glassful of fluid. Contraindication :
Contraindicated with allergy to nitrates, severe anemia, head trauma, cerebral hemorrhage, hypertrophic cardiomyopathy, narrow-angle glaucoma, postural hypotension
Use cautiously with pregnancy, lactation, acute MI, CHF.
Adverse effects :
CNS: Headache, apprehension, restlessness, weakness, vertigo, dizziness, faintness
CV: Tachycardia, retrosternal discomfort, palpitations, hypotension, syncope, collapse, orthostatic hypotension, angina, rebound hypertension, atrial fibrillation, postural hypertension
Dermatologic: Rash, exfoliative dermatitis, cutaneous vasodilation with flushing GI: Nausea, vomiting, incontinence of urine and feces, abdominal pain, diarrhea GU: Dysuria, impotence, urinary frequency Other: Muscle twitching, pallor, perspiration, cold sweat, arthralgia, bronchitis
Nursing Responsibilities : Give sublingual preparations under the tongue or in the buccal pouch; discourage the patient from swallowing. Alexander, Anneth
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Create a nitrate-free period to minimize tolerance. Give oral preparations on an empty stomach, 1 hr before or 2 hr after meals; take with meals if severe, uncontrolled headache occurs. Place sublingual tablets under your tongue or in your cheek; do not chew or swallow the tablet. Take the isosorbide before chest pain begins, when activities or situation may precipitate an attack. Take oral isosorbidedinitrate on an empty stomach, 1 hour before or 2 hours after meals; do not chew or crush sustainedrelease preparations; do not take isosorbidemononitrate to relieve acute anginal episodes.
You may experience these side effects: Dizziness, lightheadedness (may be transient; use care to change positions slowly); headache (lie down in a cool environment, rest; over-the-counter preparations may not help; take drug with meals); flushing of the neck or face (reversible).
Report blurred vision, persistent or severe headache, rash, more frequent or more severe angina attacks, fainting.
Alexander, Anneth
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Scientific name :PeperoniaPellucida
An annual herb, favoring shady,damp and loose soil.Often grows in groups in nooks inthe garden and yard.Conspicious in rocky parts of canals .
Common Name :Ulasimang- bato A weed, with heart-shaped leaves also known as "pansit-pansitan", grows in shady parts of the garden and yard. It is effective in fighting arthritis and gout. The leaves can be eaten fresh (about a cupful) as salad or like tea.
Indication :Lowers uric acid. (Rheumatism and gout) Preparation:
Wash leaves well. One and a half cup leaves are boiled in two glassfuls of water over lower fire. Do not cover pot. Cool and strain. Divide into three parts and drink each part three times a day after meals.
May also be eaten as salad. Wash the leaves well. Prepare one and a half cups of leaves. Divide into 3 parts and take as salad three times a day.
Parts utilized:
leaves Alexander, Anneth
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Nursing Responsibilities Use only half the dosage prescribed for fresh parts like leaves when using dried parts. Do not use stainless steel utensils when boiling decoctions.Only use earthen, enameled ,glass or alike utensils. As rule of thumb ,when boiling leaves and other plant parts ,do not cover the pot ,and boil in low flame. Decoctions loose potency after some time.Dispose of decoctions after one day .To keep fresh during the day ,keep lukewarm in a flask or thermos. Always consult with a doctor if symptoms persist or if any sign of allergic reaction develops.
Alexander, Anneth
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PYRALVEX
Generic Name Anthraquinone Glycosides/Salicylic Acid
Brand Name Pyralvex
Drug Class Anti-Inflammatory Analgesic
Therapeutic Actions Pyralvex solution contains two active ingredients, salicyclic acid and rhubarb extract. Salicylic acid is a type of medicine called a salicylate. Salicylic acid works by blocking the action of a substance in the body called cyclo-oxygenase. Cyclo-oxygenase is involved in the production of various chemicals in the body, including some known as prostaglandins. Prostaglandins have many actions, and are involved in causing inflammation. The body produces prostaglandins in response to injury and they cause an increase in the blood supply to the area of damage. This will result to swelling, heat,
Bamba, Romellene
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redness and pain in that area. By blocking cyclo-oxygenase, salicylic acid prevents the formation of prostaglandins and hence reduces inflammation and pain in the area of the mouth it is applied to. Rhubarb extract contains anthraquinone glycosides, which also relieve inflammation.
Indications Relief of pain from mouth ulcers and denture irritation; gingivitis; stomatitis
Contraindications and Cautions Contraindicated to hypersensitivity to any of the constituents; Not to be used in children and adolescents under the age of 16. This is because there is a possible association between salicylates and Reye's Syndrome when given to children; Use cautiously with pregnancy, lactation
Available Forms Solution 10mL
Dosage Apply liberally to the sore areas of the mouth 3-4 times daily using the brush provided.
Adverse Effects GI: transient local burning sensation at the site of application, Temporary discoloration of teeth or oral mucosa, Ulceration at site of application if used excessively Hypersensitivity: Allergic reactions, including rash and urticaria
Nursing Considerations Tell patient to not use Pyralvex if allergic (hypersensitive) to rhubarb extract or salicylic acid or any of the other ingredients of Pyralvex. Keep all medicines out of the reach and sight of children. Do not give to children or adolescents under the age of 16 years. This is because there is a possible link between salicylates and Reyes syndrome when given to children. Bamba, Romellene
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Store below 25 C. Do not use Pyralvex after the expiry date which is stated on the bottle as month/year. Always use Pyralvex exactly as your doctor had told you. Do not exceed the stated frequency of application as excess Pyralvex may be harmful. Do not use for more than 7 days. Avoid rinsing your mouth or eating for 15 minutes after use. Each bottle should be used by only one person. When applied for denture irritation, leave 30 minutes after applying the gel before putting the dentures back in. Dont apply the gel directly to the dentures, as this can further irritate the gums.
Pyralvex is a colored liquid and can stain material. Care should be taken to ensure that the liquid is not spilt or dropped onto clothing.
Bamba, Romellene
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PLATEXAN
Generic Name Clopidogrel bisulfate
Brand Names Platexan, Plavix
Drug Class Adenosine diphosphate (ADP) receptor antagonist Antiplatelet
Therapeutic Actions Inhibits platelet aggregation by blocking ADP receptors on platelets, preventiong clumping of platelets
Indications Treatment of patients at risk for ischemic events recent MI, recent ischemic CVA, peripheral artery disease Treatment of patients with acute coronary syndrome Unlabeled use: as loading dose with aspirin to prevent adverse cardiac events in coronary stent implantation
Bamba, Romellene
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Contraindications and Cautions Contraindicated to hypersensitivity to clopidogrel, acute pathological bleeding such as peptic ulcer or intracranial hemorrhage, lactation Use cautiously with pregnancy, bleeding disorders, recent surgery, hepatic impairment
Available Forms Tablets 75 mg
Dosages Recent MI, CVA, peripheral artery disease: 75 mg PO daily Acute coronary syndrome: 300 mg PO loading dose, then 75 mg/day PO with aspirin
Adverse Effects CNS: headache, dizziness, weakness, syncope, flushing CV: hypertension, edema Dermatologic: rash, pruritus GI: nausea, GI distress, constipation, diarrhea, GI bleeding Other: increased bleeding risk
Nursing Considerations Tell patient to not use the drug if allergic (hypersensitive) to it. Store at 15 and 30 C (59 and 86 F) Throw away and never use any unused medicine after the expiration date Provide small frequent meals if GI upset occurs. Monitor patient for bleeding; limit invasive procedures. Follow the directions on the prescription label.
Bamba, Romellene
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OMEGA-3
Generic Name Omega-3-acid ethyl esters
Brand Names Lovaza
Drug Class Lipid-lowering drug Omega-3 fatty acid
Therapeutic Actions Inhibits liver enzyme systems leading to a decrease in the synthesis of triglycerides in the liver; lowering serum triglyceride levels
Indications As an adjunct to diet to reduce very high or greater than 500 mg/dL triglyceride levels in adult patients
Contraindications and Cautions Contraindicated with known allergy to any component of capsule Use cautiously with known sensitivity to fish products, pregnancy, lactation
Bamba, Romellene
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Available Forms Capsules 1 g
Dosages 4 g/day PO taken as a single dose (4capsules) or into two dose 2 capsules PO bid
Adverse Effects CV: angina GI: taste perversion, dyspepsia, eructation Other: pain, back pain, rash, flu-like symptoms, infection
Nursing Considerations Assess history of allergy to any component of the drug, fish products, pregnancy, and lactation. Reserve use for patients with very high triglyceride levels. Ensure that patient continues diet and exercise program to control lipids. Suggest the use of contraceptive measures; it is not known if it will affect fetus. Suggest another method of feeding the baby if a woman is nursing; it is not known if it will cross breast milk. Encourage small frequent feedings if GI effects are uncomfortable. If missed a dose, take it as soon as you remember and then return to normal schedule. Do not make-up doses. Do not take more than 4 capsules a day. May need to ask patient to have periodic blood test to evaluate the effects of drug to the body. In storing, protect from light and moisture. Do not store in the bathroom. Do not freeze. Keep all drug products away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this drug when it is expired or no longer needed.
Bamba, Romellene
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SAMBONG
Scientific Name: Blumea balsamifera English Names: Camphor Tagalog Names: Ayohan, Bulaklak Ga buen, Kaliban Visayan Names: Kambihon, Lakdanbulan, Alibhon, Alimon
It is a plant that reaches 1 to 3 meters in height with rough hairy leaves. Young plants around mother plant may be separated when they have three or more leaves.
Common Uses: Anti-edema, diuretic, anti-urolithiasis. Boil chopped leaves in water for 15 minutes until one glassful remains. Cool and strain.
Dried Leaves Adult 7-12 years old 4 tablespoons
Fresh Leaves 6 tablespoons tablespoon of adult dose
Divide decoction into 3 parts. Drink one part 3 times a day. Note: Sambong is not a medicine for kidney infection.
Bamba, Romellene
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Sambong is used as herbal medicine and is a shrub that grows wild in the tropical climate countries such as Philippines, India, Africa and found even in eastern Himalayas. Sambong is widely used in the Philippines as herbal medicine. Sambong leaves are known for its ngai or Blumea camphor that is used as herbal medicine to treat kidney stones, wounds and cuts, rheumatism, anti-diarrhea, anti spasms, colds and coughs and hypertension. The Philippine Council for Health Research and Development (PCHRD) has developed the technology for a sambong herbal medicine tablet.
I.
Other Traditional Uses/Indications of Sambong Fever - Sambong roots and leaves are used as herbal treatment for fevers, sambong leaves and roots are pounded then dissolved in cold water. Applied with a soft cloth over the nape, forehead, uderarms and other body parts to bring down the body temperature.
Rheumatism - Sambong roots and leaves are also used as herbal medicine treatment for rheumatism. Sambong roots and leaves are pounded and applied as poultice on the affected body part. Sambong roots and leaves may also be boiled and are applied as warm compress onto affected area.
Headache - Sambong is also used to treat headache, sambong leaves are pounded and applied as a poultice over the forehead. Coughs and colds - Sambong tea are also used as herbal medicine for colds and coughs. Stomach pains - Sambong tea are also used for herbal treatment of diarrhea and stomach spasms. As a disinfectant - Sambong juice are also used for treatment of cuts and wounds.
Preparations Sambong Tea Preparation:

gather fresh sambong leaves, cut in small pieces wash with fresh water boil 50 grams of sambong leaves to a liter of water let it seep for 10 minutes Bamba, Romellene
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remove from heat drink while warm 4 glasses a day for best results.
Sambong Poultice

gather fresh leaves and roots wash with fresh clean water pound in a mortar grounded leaves may be applied or a juice extract may be used
Sambong Capsules And Tablets Powdered Sambong leaves are available in 250 mg tablets at the DOH's Philippine Institute of Traditional and Alternative Health Care
II.
Other Medical Uses of Sambong According to Scientific Studies Sambong as diuretic for hypertension and fluid retention. Sambong herbal tea is used as a diuretic for fluid retention and hypertension conditions. Sambong herbal tea incites the body to urinate thereby removing excess body fluids and sodium. Clinical studies have shown that a high level of sodium in the blood is a major cause of hypertension.
Sambong delay or averts renal failure. The Philippine National Kidney and Transplant Institute recommends taking sambong herbal medicine for patients with renal problems. Favorable results were noted that sambong may help to delay or avert dialysis or even kidney transplant.
Sambong for the Dissolution of Kidney Stones. The Philippine Department of Health (DOH) has been promoting Sambong herbal tea and tablets as a diuretic and for the dissolution of kidney stones. Sambong has been recently registered in the Bureau of Foods and Drugs as medicine.
Sambong as Anticancer. Sambong contains methanolic extract that has been found to have therapeutic activity against hepatocellular carcinoma cells. A study of sambong (balsamifera) extract inhibits the activity in rat and human hepatocellular carcinoma cells without cytotoxicity. This study suggest a possible therapeutic effect of sambong extracts (balsamifera) in the treatment of hepatoma cancer patients. Bamba, Romellene
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Sambong as Antibacteria and Antifungi. A Phytochemical study indicates that sambong leaves contains the chemicals icthyothereol acetate, cyptomeridiol, lutein and carotene that has been found to have positive activity against microbes such as A niger, T mentagrophytes and C albicans. Results also showed activity against P aeruginosa, S aureus, B subtilis and E col
Bamba, Romellene
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BETADINE* ANTISEPTIC SOLUTION
COMPOSITION: Each 1 mL contains 100 mg povidone-iodine, equivalent to 10 mg available iodine.
PHARMACOLOGICAL Antiseptics, Disinfectants,
CLASSIFICATION: Cleansing Agents
PHARMACOLOGICAL
ACTION:
Povidone-iodine is a multivalent broad spectrum local antiseptic having bactericidal and fungicidal properties. The effect on vegetative cells of various bacteria and fungi is due to the liberation of free iodine from the complex. Many virusses, protozoa, yeasts, cysts and spores are also susceptible.
INDICATIONS: Disinfection of wounds, lacerations, abrasions and burns. Prophylaxis against infection in hospital and surgery procedures.
Preparation of skin and mucous membranes prior to surgery. Post- operative application to protect against infection. Treatment of infected skin conditions.
De Jesus, Renalyn
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CONTRA-INDICATIONS: Hypersensitivity to povidone-iodine.
Povidone-iodine solutions should not be used on patients with a non-toxic nodular colloid goiter. Application to large areas of broken skin should be avoided as excessive absorption of iodine Absorption of povidone-iodine may may interfere with thyroid function occur. tests
DOSAGE
AND
DIRECTIONS
FOR
USE:
Apply full strength, as a paint, or soak or spray as often as needed. Shake the bottle before use and clean the nozzle of the spray pump after use. NOT FOR DOUCHING PURPOSES
SIDE-EFFECTS
AND
SPECIAL
PRECAUTIONS:
Local irritation and sensitivity may occur. If irritation, swelling or redness occur, discontinue treatment and consult your physician.
Hypothyroidism may occur after topical application to neonates. Absorption of povidoneiodine may interfere with thyroid function tests.
Nursing considerations: 1. Not to be used by persons who are allergic to iodine. 2. Not be used in pregnancy or by lactating women.
De Jesus, Renalyn
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Syntex Generic Name: naproxen Drug classes: Nonsteroidal anti-inflammatory drug (NSAID), Analgesic (non-narcotic)
Therapeutic actions Analgesic, anti-inflammatory, and antipyretic activities largely related to inhibition of prostaglandin synthesis; exact mechanisms of action are not known.
Indications Mild to moderate pain Treatment of primary dysmenorrhea, rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, tendinitis, bursitis, acute gout OTC use: temporary relief of minor aches and pains associated with the common cold, headache, toothache, muscular aches, backache, minor pain of arthritis, pain of menstrual cramps, reduction of fever Treatment of juvenile arthritis (naproxen only)
Contraindications Contraindicated with allergy to naproxen, salicylates, other NSAIDs; pregnancy; lactation. De Jesus, Renalyn
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Adverse effects Headache, dizziness, somnolence, insomnia, fatigue, tiredness, dizziness, tinnitus, ophthalmic effects Rash, pruritus, sweating, dry mucous membranes, stomatitis Nausea, dyspepsia, GI pain, diarrhea, vomiting, constipation, flatulence Dysuria, renal impairment, including renal failure, interstitial nephritis, hematuria Bleeding, platelet inhibition with higher doses, neutropenia, eosinophilia, leukopenia, pancytopenia, thrombocytopenia, agranulocytosis, granulocytopenia, aplastic anemia, decreased Hgb or Hct, bone marrow depression, menorrhagia Dyspnea, hemoptysis, pharyngitis, bronchospasm, rhinitis Peripheral edema, anaphylactoid reactions to anaphylactic shock
Nursing considerations Give with food or after meals if GI upset occurs. Arrange for periodic ophthalmologic examination during long-term therapy. Institute emergency procedures if overdose occurs: gastric lavage, induction of emesis, supportive therapy.
De Jesus, Renalyn
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Plasil Brand Name: PLASIL
CLASSIFICATIONS Therapeutic: Antiemetics ACTIONS Physiologic Mechanism Decreased nausea and vomiting. Decreased symptoms of gastric stasis. Pharmacologic Mechanism Blocks dopamine receptors in chemoreceptor trigger zone of the CNS. Stimulates motility of the upper GI tract and accelerates gastric emptying. INDICATION Management of esophageal reflux Treatment and prevention of postoperative nausea and vomiting NURSING CONSIDERATIONS Assess patient for nausea, vomiting, abdominal distention, and bowel sounds before and after administration. May cause drowsiness. Advise patient to avoid concurrent use of alcohol and other CNS depressant while taking this medication. Advise patient to notify health care professional immediately if involuntary movement of eyes, face or limbs occurs. De Jesus, Renalyn
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Bayawas
(Bik.), Biabas (Sul.), Gaiyabat (If.),Gaiyabit (If.)
Geyabas (Bon.), Guayabas (Tag.), Guava (Engl.),Guyabas(Ilk., Tag.), Kalimbahin (Tag.), Psidium cujavus Linn. Bagabas (Ig.), Psidium aromaticum Blanco Bayabas (Ilk., Tag.), Psidium pyriferum Linn. Bayabo (Ibn.), Psidium pomiferum Linn. Bayauas (Bik., Pang.),Tayabas (Tag.) Bayabas or guava is a fruit bearing shrub or small tree that grows in the tropical climate like Mexico, Peru and the Philippines. Bayabas is widely used in the Philippines as herbal medicine and is recognized by the Philippine Department of Health for its antiseptic property. Bayabas or guava fruit is known for being rich in vitamin C and vitamin A. Bayabas leaves and fruits contain eugenol, tannin, saponins, amydalin, phenolic acids, malic acid, ash, aldehydes, catequinic components and flavonoids. Bayabas or guava is used in herbal medicine as antiseptic, anti-inflammatory, antispasmodic, antioxidant hepatoprotective, anti-allergy, antimicrobial, anti-plasmodial, anti-cough, antidiabetic, and antigenotoxic. Bayabas or guava tree grows 3 to10 meters tall with greenish to red-brownish smooth bark. Bayabas produce a round globular bayabas fruit that starts as a flower. The bayabas fruit is green and turns yellowish-green and soft when ripe. Bayabas fruit has many small hard seeds contained in a yellowish pulp. Bayabas fruit is usually eaten while still
De Jesus, Renalyn
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green and hard. How to use Bayabas as an antiseptic and astringent Preparation: Gather fresh bayabas leaves and wash with water. Boil one cup of Bayabas leaves in three cups of water for 8 to 10 minutes. Strain and let cool. To use as mouthwash, gargle To use as wound disinfectant, wash affected areas 2 to 3 times a day. Use as vaginal wash especially after child birth. Fresh Bayabas leaves can also be chewed for the treatment of toothache and gum swelling. To hasten wound healing, fresh Bayabas leaf poultice may be applied to the wound. If symptoms persist or aggravates, stop use and consult your doctor. For diarrhea and control stomach parasites Gather fresh Bayabas leaves, Boil chopped pieces of about 4 to 6 tablespoon for every 18 ounces of water. Strain and let cool. Drink cup of decoction every 3-4 hours until symptoms improve. Bayabas Side Effects Eating too much of Bayabas fruit can cause constipation. If there is no improvement to diarrhea symptoms in two days, consult your doctor.
De Jesus, Renalyn
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Generic name: Budesonide, formoterol fumarate
Brand name: Symbicort
Drug class: Corticosteroid
Therapeutic actions: Anti-inflammatory effect; local administration into nasal passages maximizes beneficial effects on these tissues, while decreasing the likelihood of adverse effects from systemic absorption.
Indications: Regular treatment of asthma where use of a combination (inhaled corticosteroid & long-acting 2-agonist) is appropriate. Symptomatic treatment of patients w/ moderate or severe COPD, w/ significant symptoms & a history of exacerbations.
Contraindications and cautions: Contraindicated with hypersensitivity to drug or for relief of acute asthma or bronchospasm. Use cautiously with TB, systemic infections, lactation.
Dosages: Adults (18 years): 1-2 inhalations once or twice daily. In some cases, up to a maximum of 4 inhalations twice daily may be required as maintenance dose or temporarily during worsening of asthma. Dela Cruz, Stephanie
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Adolescents (12-17 years): 1-2 inhalations once or twice daily. During worsening of asthma, the dose may temporarily be increased to a maximum of 4 inhalations twice daily. Children (4 years): 1-2 inhalations twice daily of 80/4.5 mcg/dose or 1 inhalation twice daily of 160/4.5 mcg/dose. Maximum Daily Dose: 4 inhalations of 80/4.5 mcg/dose or 2 inhalations of 160/4.5 mcg/dose.
Adverse effects: CNS: Headache, dizziness, lethargy, fatigue, paresthesias, nervousness Dermatologic: Rash, edema, pruritus, alopecia Endocrine: HPA suppression, Cushing's syndrome with overdosage and systemic absorption GI: Nausea, dyspepsia, dry mouth Local: Nasal irritation, fungal infection Respiratory: Epistaxis, rebound congestion, pharyngitis, cough Other: Chest pain, asthenia, moon face, acne, bruising, back pain
Nursing considerations Assessment History: Untreated local nasal infections, nasal trauma, septal ulcers, recent nasal surgery, lactation Physical: BP, P, auscultation; R, adventitious sounds; exam of nares
Interventions Inhalation Taper systemic steroids carefully during transfer to inhalational steroids; deaths from adrenal insufficiency have occurred. Arrange for use of decongestant nose drops to facilitate penetration if edema, excessive secretions are present.
Dela Cruz, Stephanie
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Prime unit before use for Pulmicort Turbuhaler; have patient rinse mouth after each use. Use aerosol within 6 mo of opening. Shake well before each use. Store Respules upright and protected from light; gently shake before use; open envelopes should be discarded after 2 wk.
Teaching points Inhalation Do not use more often than prescribed; do not stop without consulting your health care provider. It may take several days to achieve good effects; do not stop if effects are not immediate. Use decongestant nose drops first if nasal passages are blocked. Prime unit before use for Pulmicort Turbuhaler; rinse mouth after each use. Store Respules upright, protect from light; discard open envelopes after 2 wk; gently shake before use. These side effects may occur: Local irritation (use your device correctly), dry mouth (suck sugarless lozenges). Report sore mouth, sore throat, worsening of symptoms, severe sneezing, exposure to chickenpox or measles, eye infections.
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Generic Name: Citicoline
Brand Name: Cholinerv
Classification: Neurotonics, Nootropics
Mechanism of Action: Citicoline seems to increase a brain chemical called phosphatidylcholine. This brain chemical is important for brain function. Citicoline might also decrease brain tissue damage when the brain is injured.It is usually known that phospholipid, especially lecithin, decreases following decline in brain activity with cerebral trauma. Citicoline, which is a co-enzyme, accelerates the biosynthesis of lecithin in the body.
Indication:

Parkinsons disease Head injury Cerebral vascular disease Alzheimers disease Cerebral surgery or acute cerebral disturbance Disturbance of consciousness following brain surgery
Contraindications and cautions
Patients with acute, severe & progressive disturbance of consciousness
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Administration with hemostatics Intracranial pressure relieving drugs or use measures to keep body temp low.
Adverse Effects:

Body temperature elevation Restlessness Headaches Nausea and vomiting Diarrhea Low or high blood pressure Tachycardia Sleeping troubles or insomnia Blurred vision Chest pains
Nursing Management

Citicoline may be taken with or without food. Take it with or between meals. The supplement should not be taken in the late afternoon or at night because it can cause difficulty sleeping.
Women who are pregnant or trying to become pregnant should consult with their doctor before taking the supplements. Not enough is known about the use of Citicoline during pregnancy and breast-feeding. Stay on the safe side and avoid use.
Special attention should be paid for administration in the neonate, premature and children.
Contact the physician immediately if allergic reaction such as hives, rash, or itching, swelling in your face or hands, mouth or throat, chest tightness or trouble breathing are experienced.
Citicoline therapy should be started within 24 hours of a stroke. The physician will prescribe the correct dosage and the length of time it should be taken for a medical condition.
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Banaba SCIENTIFIC NAME: Lagertroemia Speciosa COMMON NAME: Banabalean, Corosolic acid, Crape Myrtle, Crepe Myrtle, Lagerstroemia flos-reginae GENERAL CLASSIFICATION: antioxidant, anti-inflammatory, antidiabetic INDICATION:

Diabetes Weight loss Hypertension Good for the kidneys Aids the digestive system Helps ease urination
PREPARATION AND USAGE:
Fresh leaves, dried leaves, flowers, ripe fruit, root and bark of Banaba can all be used.
Wash the leaves in running water (if fresh). Cut into smaller pieces if desired. Boil Banaba (one cup Banaba to cup of water) for 30 minutes. Drink like tea. Decoction of old leaves and dried fruit (dried from one to two weeks), 50 gms to a pint of boiling water, 4 to 6 cups daily has been used for diabetes. Old leaves and ripe fruit are preferred, believed to have greater glucose lowering effect. Young Dela Cruz, Stephanie
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leaves and flowers have a similar effect, though only 70% that of matures leaves and fruits. The wood has no known glucose lowering effect; the bark, a very small amount.
A decoction of 20 gms of old leaves or dried fruit in 100 cc of water was found to have the equivalent effect to that of 6 to 7.7 units of insulin.
- The bark decoction has been used for the treatment of diarrhea. - The bark, flowers and leaves used to facilitate bowel movements. Decoction of fruits or roots gargled for aphthous stomatitis.
- Decoction of leaves and flowers used for fevers and as diuretic. - Leaf decoction or infusion used for bladder and kidney inflammation, dysuria, and other urinary dysfunctions.
SIDE EFFECT/ ADVERSE REACTION:
To date, no toxicity has been identified.
NURSING INTERVENTIONS:

Wash the leaves thoroughly. Make sure to boil the leaves well.
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Generic name: Multivitamins with iron Brand name: Iberet Drug class: Vitamins & Minerals (Pre & Post Natal) / Antianemics Therapeutic actions: Provides elemental iron, an essential component in the formation of hemoglobin. Indication: Treatment & prevention of Fe-deficiency & concomitant folic acid deficiency w/ associated deficient intake or increased need for vit B-complex in nonpregnant adults. Contraindication: Thalassemia, sideroblastic anemia, hemochromatosis &
hemosiderosis. Childn. Dosage: 1 tab OD AR: Allergic reactions, GI effects, hyperbilirubinemia, acneform vulgaris deterioration or acneform exanthema eruption, bright yellow urine discoloration, flushing, dizziness or faintness, peripheral sensory neuropathies, stone formation, crystalluria & oxalosis, black discoloration of stool. Nursing Responsibilities:
Tell patient to continue regular dosing schedule if she misses a dose. Patient shouldnt double the dose.
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To avoid staining teeth, give elixir iron preparations with straw. Check for constipation; record color and amount of stool. Teach dietary measures for preventing constipation.
Do not crush, chew, sustain or release preparations. If overdose is suspected, tell the client to contact local poison control center or emergency room immediately.
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Brand name: Aprovel Generic name: Irbesartan General Action: Anti-hypertensive, ARB Specific action: Selectively blocs the binding of angiotensin II to specific tissue receptors found in the vascular smooth muscle and adrenal gland; this action blocks the vasoconstriction effects of the rennin-angiotensin system as well as the release of aldosterone, leading to decreased BP. Indications: Treatment of hypertension as monotherapy or in combination with other antihypertensives. Slowing of the progression of nephropathy in patients with hypertension and type 2 diabetes. Dosage: Tablets- 75,150,300mg Dosage adults: Diabetic nephropathy:300 mg/day PO as a single dose
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Hypertension: 150mg PO daily as one dose, adjust slowly to determine effective dose, maximum
Pediatric Patients 13-16 yr 150 mg/day PO; maximum dose 300mg.
Pediatric Patients 6-12 yr 75 mg/day PO, titrate to a maximum of 150 mg/day
Contraindications: Contraindicated with hypertensitivity to irbesartan, pregnancy (use during the second and third trimester can cause injury or even death to the fetus) Use cautiously with hepatic or renal impairmengt, hypovolemia, volume or sodium depletion, lactation. Adverse Effects: CNS: Headache, dizziness, syncope,muscle weakness, sleep disturbances CV: hypotension, orthostatis hypotension, flushing. Dermatologic: rash, inflammation, urticaria, pruritus, alopecia, dry skin. GI: diarrhea, abdominal pain, nausea, constipation, dry mount, dental pain, dyspepsia Respiratory: URI symptoms, cough, sinus disease Other: cancer in preclinical studies, back pain, fever gout, fatigue, neutropenia, angioedema. Nursing Responsibilities: Monitor patients BP regularly. Monitor patients electrolytes. Assess patients and familys knowledge of drug therapy Give with a diuretic if drug is needed to control blood pressure
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Place in supine position an give an IV infusion of NSS if patient becomes hypotensive Tell patient that drug may be taken once daily with or without food. Instruct client avoid driving and hazardous activities until CNS effects of the drug are known.
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Brand Name: Zovirax Generic Name: Acyclovir General Action: Antiviral, purine nucleoside analogue Specific Action: Antiviral activity inhibits viral DNA replication. Indications: Initial and recurrent mucosal and cutaneous HSV-a and HSV-2 and varicella zoster infections in immunocompromised patients Herpes simplex encephalitis Treatment of neonatal HSV infections Acute treatment of herpes zosters(shingles) and chicken pox(varicella) Ointment: initial herpes genital infections, limited mucocutaneous HSV infections in immonocompromised patients. Cream: recurrent herpes labialis (cold sores) in patients 12yr or older. Unlabeled uses: cytomegalovirus and HSV infection following transplant, ocular and other herpes simplex infections, varicella pneumonia, disseminated primary eczema herpecticum Dosage:
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Parental Herpes simplex: 5-10 mg/kg infused IV over 1 hr every 8 hr for 5-10 days. Oral Initial genital herpes: 200mg every 4hr five times daily (1,000 mg/day) for 10 days. Long term suppressive therapy: 400 mg BID for up to 12mo. Intermittent therapy;200mg every 4hr five times daily for 5 days Acute herpes zosters; 800 mg every 4hr five times daily while awake for 7-10 days Chicken pox 800mg qid for 5 days Pediatric patient(parental) HSV infections in patients younger than 12yr: 10 mg/kg infused IV over 1 hr every 8hr for 7 days Varicella zoster infection in patients younger than 12 yr: 20mg/kg IV over 1 hr every 8 hr for 7 days. Shingles, HSV encephalitis in patients 3 mo to 12 yr: 20mg/kg IV over 1 hr every 8hr for 10 days Neonatal HSV: 10mg/kg infused over 1hr every 8hr for 10 days. IV more than 50ml/min 25-50ml/min 10-25ml/min 0-10ml/min Contraindication Contraindicated with allergy to acyclovir, seizures, heart failure, renal disease, lactation. Use cautiously with pregnancy. Adverse Effects Systemic administration CNS: headache, vertigo, depression, tremors, encephalopathic changes 5mg/kg every 8 hr 5mg/kg every 12 hr 5mg/kg daily 2.5mg/kg daily
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Dermatologic: inflammation or phlebitis at infection sites, rash, hair loss GI: nausea, vomiting, diarrhea, anorexia GU: crstalluria with rapin IV administration, hematuria, increased BUN Topical Administration Dermatologic: transient burning at site of application Nursing Responsibilities Complete the full course of oral therapy, and do not exceed the prescribe dose. Oral acyclovir is not a cure for your disease but should make you feel better. Avoid sexual intercourse while visible lesions are present. Wear rubber gloves or finger cots when applying the drug to present autoinoculation of other sites and transmission to others. This drug may cause burning, stinging, itching, rash; notify your health care provider if these are pronounced.
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FUCICORT Generic Name: Betamethasone valerate, Fusidic acid Brand Name: Fucicort General Action: Antibiotic Specific Action: Derma/ Fixed-Dose Combinations, Topical/ Antibiotic & Antiinflammatory, Topical Indication: Inflammatory dermatoses where bacterial infection is present or likely to occur.
Dosage: Cream 5 g
Contraindication: Viral skin disease, perioral dermatitis, rosacea, fungal skin infections and ulcerative conditions. Adverse Effects: Local atrophic changes in skin; hypersensitivity
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Nursing Responsibilities: Apply the ointment on the dry skin Assess for any allergic reaction Assess for any irritation on the skin Apply the right amount of cream Only apply the ointment on the affected area
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PANDAN LALAKI Scientific Name: Pandanus odoratissimus L. English: Fragrant screwpine Tagalog: Pandan lalaki Erect, branched small tree, growing 3-5 meters, the trunk bearing many prop roots. Leaves are spirally crowded toward the ends of the branches, linear lanceolate, slenderly long-acuminate, up to 1.5 meters long, 3-5 cm wide, the margrins and midrib armed with sharp spiny teeth pointing toward the apex of the leaf. The male inflorescence is fragrant, pendulous, up to 0.5 meter long. Fruit is solitary, pendulous, ellipsoid to globose-ellipsoid, about 20 cm long, composed of 50-75 obovoid, angular, fibrous and fleshy drupes, 4-6 cm long, narrow below and truncate at the apex. Distribution. In thickets along seashores throughout the Philippines
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Common Name Parts utilized Constituents Essential oil,
Sensitive Plant, Humble Plant, Shameful Plant, Sleeping Grass, Touch-me-not
and alkaloids, glycosides
characteristics and tannin.
The prop roots possess diuretic properties. Medicinal uses Diuretic: Take decoction of fresh or dried prop root as tea.
Headache, arthritis, stomach spasms: Decoction of leaves. Poultice of fresh leaves mixed with oil also used for headaches.
Culinary: An aromatic leaf used to perfume rice dishes.
Wound healing: Pulverized dried leaves used to facilitate wound healing. Poultice of mash of cabbage of plant, mixed with salt and juice of Citrus microcarpa, for abscesses. Others: Decoction of roots believed to have aphrodisiac and cardiotonic properties. Also used for the arthritis and to prevent strengthens spontaneous the abortion. gums.
Chewing
roots
Decoction of roots combined with sap of banana plant for urethral injections for variety of urinary complaints. Nursing Responsibilities: Follow the right amount of leaves. Wash thoroughly the leaves and roots. Dont over boil the leaves. Use fresh leaves Estacio, Joanne
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Scientific Name Tagalog Name Parts Used Uses:
Mimosa Pudica L Makahiya Root, Flower, Leaves and Stem Expectorant, Antidepressant, Analgesic, Anti spasmodic, Leaves are used for Diabetes, for mumps Collect leaves from this plants and prepare them to be
for Mumps
mince. Place the minced leaves of Mimosa to the swollen parts of the mumps. Let it for 30 mins. And do it 3 times a day. Collect a cup of leaves of Mimosa that is pulverized or minced and boil it for 10 minutes of 2 glass of water. Doses:
For Diarrhea
Adult : 1 teacup and take 3 times the whole day or till the diarrhea is present. 2-6 yr Old: 1/4 teacup 3 times a day 7-12 yr Old: 1/2 teacup 3 times a day.
For asthma expectorant For Bladder stones For Diabetes
Decoction 5 grasp of plant in 2 glass of water.cool and Drink. Decoction of roots Decoction of leaves
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Generic Name Brand Name General Action
Hydrogen Peroxide Agua Oxinada topical anti-infectives Hydrogen peroxide is an oxidising agent with antibacterial and antiviral activity. It is used as an antiseptic, disinfectant, and deodorant. It also has a mild haemostatic action. It exerts its antiseptic action
Specific Action
partly by its ready release of oxygen when applied to tissues, but this effect is reduced in the presence of organic matter. The mechanical effect of effervescence may be more useful for wound cleansing than the antimicrobial action. Hydrogen peroxide has traditionally been used as a wound cleanser
Indication
Hydrogen peroxide is also commonly used in mouthwashes, mostly as a "debriding agent"
Hydrogen Peroxide is used to help remove earwax,
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usually by softening the wax Contraindication Instillation of hydrogen peroxide into closed body cavities. For earwax: Dilute 6% hydrogen peroxide solution Route and Dosage with 3 parts of water, immediately before use. For Wound cleansing: 6% solution or 1-1.5% cream. Nausea and vomiting Burns in the mouth, throat, esophagus, and stomach Bleeding in the stomach Adverse Effects Inflammation of the intestines Stomach ulcer Rupture of the colon
Nursing Responsibilities
Do not apply directly on wound
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Mebendazole Vermox Anthelmintic Irreversibly block glucose uptake by susceptible
Specific Action
helminthes, depleting glycogen stores needed for survival and reproduction of helminthes, causing death. Treatment of trichuris trichiura, enterobius
Indication
vermicularis, ascaris lumbricoides, ancylostoma duodenale, necator americanus Contraindicated with allergy to mebendazole,
Contraindication
pregnancy Use cautiously with lactation
Route and Dosage Adverse Effects
Oral 100 mg Transient abdominal pain, diarrhea and fever Administer Drug with food
Treat all family member for pinworm infestation Disinfect toilet facilities after patient use Tablet may be chewed or crushed
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Mefenamic Acid Apo-mefenamic, ponstel NSAID Anti-inflammatory, analgesic, and antipyretic activities
Specific Action
related to inhibition of prostaglandin synthesis; exact mechanisms of action are not known. Relief of moderate pain when therapy will not exceed 1
Indication
week Treatment for primary dysmenorrheal
Contraindication Route and Dosage
Contraindicated with hypersensitivity to mefenamic acid, aspirin allergy Oral 250mg CNS: headache, dizziness, somnolence, insomnia, fatigue, tiredness, tinnitus, ophthalmic effects Dermatologic: rash, pruritus, sweating, dry mucous membranes, stomatitis
Adverse Effects
GI: Nausea, dyspepsia, Gi pain, diarrhea, vomiting, constipation, flatulence GU: Dysuria, renal impairment Respiratory: Dyspnea, Hemoptysis, pharyngitis,
bronchspasm, rhinitis
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Other: Peripheral edema, anaphylactoid reactions to anaphylactic shock Take drug with food Nursing Responsibilities Discontinue drug and consult health care provider if rash,, diarrhea, or digestive problem occurs.
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Bryophyllum pinnatum (Lam.) Kurz. Botany Katakataka is an erect, more or less branched, smooth, succulent herb, 0.4 to 1.4 meters in height. Leaves are simple or pinnately compound, with the leaflets elliptic, usually about 10 centimeters long, thick, succulent, and scalloped margins. Plantlets grow along the notches of the leaf margins which can develop while still attached to the plant or when detached, a fascinating characteristic that earns its name. Flowers are cylindric, and pendulous in a large, terminal panicle. Calyx is tubular, cylindric, inflated, brownish or purplish, 3.5 to 4 centimeters long. Corolla is tubular, about 5 centimeters long, inflated at the base, and then constricted, the exserted parts being reddish or purplish and the lobes tapering to a point. Fruit is a follicle with many see. Distribution - In open settled areas, thickets, dry second-growth forests, sometimes planted, and locally Prehistoric Also introduction from tropical from Asia December or to abundant. Malaya. March.
cultivated,
flowering
- Pantropic.
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Constituents Yields arachidic acid, astragalin, behenic acid, beta amyrin, benzenoids, bersaldegenin, beta-sitosterol, bryophollenone, bryophollone, bryophyllin, caffeci acid, ferulic acid, quercetin, steroids, and taraxerol. Phytochemical evalutation of leaf extract yielded bryophyllum A, B and C, a potent cytotoxic bufadienolide orthoacetate. Bufadienolide has been reported to be poisonous with digitalis-toxicity type cardiac effects (slowing of heart rate, heart blocks and potentially Leaves yield malic acid. Properties Leaves considered astringent, antiseptic, and counterirritant. Parts Entire plant. May be collected year round; preferably used utilized fresh. fatal ventricular arryhthmias. Bryophillin A, a bufadienolide compound, has shown anti-tumor promoting activity.
Uses Folkloric - Leaves used as astringent, antiseptic, and counterirritant against poisonous insect bites. - Pounded fresh material is applied as a poultice for a variety of conditions: Sprains, eczema, infections, burns, carbuncle and erysipelas.
- Leaves, made pliable by hold over fire, are applied to wounds, bruises, boils; also, used as poultice or power in bad ulcers.
- Juice is mixed with lard and used for diarrhea, dysentery, cholera, and phthisis. - Pounded leaves are applied as poultices to the soles of the feet to stop hemorrhages. Leaves are used as topicals in dislocation, ecchymoses, callosities.
- Leaves, pounded and mixed with salt, used as plaster and applied to stomach to relieve
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eneurosis. - For boils, the whole leaf is pressed by hand, to and fro, until it becomes moist with the leaf extract. A small opening is made in the middle of the leaf which is then placed on the boil with hole over the pointing of the abscess.
- For asthma, leaves of leaves places in hot water for 15 minutes, then juice squeezed out of Juice of the leaves Rico, rubbed juice Leon, or used cough used leaf tied for medicine leaves, in biliuos juice on the earache is made and diarrhea used mhead and from and as for drunk. lithiasis. diuretic. headaches. ophthalmia. the roots.
In Puerto Leaves Leaf In Sierre are
- In Brazil leaves, heated over fire and mixed with oil, are used as emollient and refrigerant for facial swelling associated with neuralgia or tooth trouble. Also, used for asthma and bronchitis.
- In Jamaica, leaves used for coughs and colds. Sometimes, it is mixed with salt or honey, for headaches, colds, bronchial affections, and hypertension. Heated leaves used for swellings In Africa, In China used used for for and earaches, eye arthritis, problems, bruises, and burns as and abscesses. diuretic. ulcers.
rheumatoid
- In Nigeria, leaf decoction usually taken to lower blood pressure. Toxicity Cattle Poisoning: A report of 2 adult cattle deaths attributed the fatalities to a large of amount of feeding of B pinnatum plants. The main autopsy findings were acute rumenitis, Studies Depressant: Neuropharmacological Effects of Aqueous Leaf Extract of Bryophyllum Pinnatum in Mice: Study revealed CNS depressant activity of the aqueous leaf extract that could be due to the presence of bufadienolide. Antinociceptive / Anti-inflammatory / Antidiabetic: Leaf extract study of BP on animals showed it to possess antinociceptive, anti-inflammatory and hypoglycemic reduction of bronchiolar lumens and emphysema.
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properties probably due to the flavonoid, polyphenol and triterpenoid contents. Antiulcer: (1) Results of methanolic extract study in rats showed that BP possessed potent antiulcer properties. Leaf extract showed significant reduction in incidence of ulceration in indomethacin-induced gastric ulceration in a dose-dependent manner. (2) Study of methanolic fractionn of extract of BP showed significant anti-ulcer activity in nine different experimental animal models. Tocolytic / Pre-term labor: (1) Study characterized the tocolytic activity of BP in vitro vs the betamimetic, fenoterol. Results confirmed its tocolytic activity and justifies further clinical studies. (2) Intravenous tocolysis with Bryophyllum pinnatum is better tolerated than beta-agonist application. (3) In vitro results showed B. pinnatum juice inhibits the oxytocin-induced increase of Ca in human myometrial cells in a dose-dependent manner. The inhibition was attributed to a specific effect on the oxytocin signalling pathway. Analgesic: The study concludes that the aqueous extract of BP has strong analgesic potency comparable in a times- and dose-dependent manner to a nonsteroidal antiinflammatory drug. Antileishmanial: The antileishmanial activity assessment of unusual flavonoids from Kalanchoe pinnata: Quercetin from K pinnata has demonstrated to be a potent antileshmanial flavonoid. Another study yielded unusual flavonoids with antileishmanial effect. Cytotoxic: A study isolated a potent cytotoxic bufadienolide orthoacetate and identified as bersaldegenin 1,3, 5-orthoacetate. Antimicrobial: Extract of leaves showed activity against all test organisms except for Candida albicans. Of all the extracts of Bp, themethanol extract was the most active with marked antibacterial activities against control strain of S aureus, E faecalis, B subtilis and P aeruginosa. Antihypertensive: Study showed a blood pressure lowering effect. However, since the reduction in blood pressure was only slight, and because of potential hepatotoxic nephrotoxic effects, and cardiotoxicity at high doses, it is not suggested as a blood pressure lowering agent.
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GENERIC NAME: Ranitidine BRAND NAME: Zantac
CLASSIFICATION Therapeutic: Anti-ulcer agents Pharmacologic: Histamine H2 antagonists DOSAGE 20 mg IV q8h MECHANISM OF ACTION
Inhibits the action of histamine at the H2 receptor site located primarily in gastric parietal cells, resulting in inhibition of gastric acid secretion. Oballo, Neil Bryan
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In addition, ranitidine bismuth citrate has some antibacterial action against H. pylori. INDICATION Treatment and prevention of heartburn, acid indigestion, and sour stomach.
CONTRA INDICATIONS Contraindicated in: Hypersensitivity, Cross-sensitivity may occur; some oral liquids contain alcohol and should be avoided in patients with known intolerance. Use Cautiously in: Renal impairment Geriatric patients (more susceptible to adverse CNS reactions) Pregnancy or Lactation
SIDE EFFECTS/ ADVERSE EFFECTS CNS: Confusion, dizziness, drowsiness, hallucinations, headache CV: Arrhythmias GI: Altered taste, black tongue, constipation, dark stools, diarrhea, drug-induced hepatitis, nausea GU: Decreased sperm count, impotence ENDO: Gynecomastia
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HEMAT: Agranulocytosis, Aplastic Anemia, neutropenia, thrombocytopenia LOCAL: Pain at IM site MISC: Hypersensitivity reactions, vasculitis NURSING IMPLICATIONS/RESPONSIBILITIES
Assess patient for epigastric or abdominal pain and frank or occult blood in thestool, emesis, or gastric aspirate. Nurse should know that it may cause false-positive results for urine protein; test with sulfosalicylic Inform patient that it may cause drowsiness or acid. dizziness.
Inform patient that increased fluid and fiber intake may minimize constipation. Advise patient to report onset of black, tarry stools; fever, sore throat; diarrhea; dizziness; rash; confusion; or hallucinations to health car professional promptly. Inform patient that medication may temporarily cause stools and tongue to appear gray black.
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Generic Name: Omeprazole magnesium Product Name: Losec Tablets Indication of Losec Tablets: Used in the treatment of a number of conditions associated with too much acid production when over-the-counter antacid medications have failed: Gastroesophageal reflux - GORD (symptomatic)
c ulcer (treatment and relapse prevention
treatment and relapse prevention)
Zollinger-Ellison syndrome Action of Losec Tablets: Losec works by inhibiting certain cells involved in acid production to reduce the amount of acid produced in the stomach. This reduces erosion of the stomach cells and helps with the pain associated with peptic ulcer disease. It also helps in diseases where too much stomach acid is regurgitated back into the oesophagus. Dose advice of Losec Tablets:
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Tablets should be swallowed whole or dissolved in water or juice and drunk, not chewed or crushed.AdultsSymptomatic GORD: -20mg/day
-40mg/day -8 weeks -20mg/dayH. pylori ulcer: sec HP 7)Duodenal ulcer: -40mg/day -8 weeks -20mg/dayGastric ulcer and NSAID ulcer: -40mg/day -8 weeks Zollinger-Ellison syndrome:
-20kg: 10-20mg/day for 2-8 weeks -40mg/day for 2-8 weeks
Schedule of Losec Tablets: S4
Common side effects of Losec Tablets: Losec is generally well tolerated, but the following adverse effects have been reported in less than 10% of patients:- Diarrhoea- Constipation- Abdominal pain- Nausea and Vomiting- Flatulence- Headache
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Penicillin G Popular Brand Name Pen G Dose/route:

IM 400,000-600,000 units q6h. High doses are needed in order to maintain adequate serum levels since serum half-life is short.
IM/oral (oral absorption is erratic; parenteral route is recommended, though chances
of developing allergic reactions are increased). Therefore penicillin G is reserved for severe infections, or when the oral route is compromised (as in malabsorption syndrome and vomiting)
Drug action:
Inhibits enzymes responsible for cell wall synthesis of susceptible organisms.
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This creates an osmotically unstable cell wall that swells and bursts from osmotic pressure.
It is a bactericidal drug in normal doses. This drug is excreted through the renal system.
How supplied: Available for IM injection:

Aqueous crystalline penicillin G procaine penicillin G benzathine penicillin G
Spectrum covered:
A narrow-spectrum antibiotic because at usual doses it mainly affects grampositive aerobic and facultative microorganisms, some anaerobes, and spirochetes.
Effective against anaerobes associated with dental and periodontal diseases of acute or chronic types: Diphtheroids, fusobacteria, peptostreptococci,
spirochetes, Actinomyces, Veillonella, and some Bacteroides, Prevotella and Prophyromonas spp.
Effective for grampositive cocci (S. aureus, S. viridans, S. faecalis, S. bovis, S. pneumoniae), gram negative cocci (N. gonorrhoeae, N. memingitidis), grampositive bacilli (B. anthracis, Clostridium. species), gram-negative bacilli (S. moniliformis), spirochetes (T. pallidum), Actinomyces, Peptococcus,
Peptostreptococcus species.
Penicillin G is slightly more effective against these organisms than is penicillin V that may be important in severe infections.
Indications: Penicillin G is reserved for severe infections, or when the oral route is compromised (as Oballo, Neil Bryan
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in malabsorption syndrome and vomiting), and for some patients requiring prophylactic coverage. Drug interactions: Penicillins can decrease the effectiveness of oral contraceptives. Tetracyclines, erythromycins, lincomycins all decrease the antimicrobial effectiveness of penicillin. Aspirin, probenecid, and butazolidin may potentiate penicillin's effects. Penicillin may potentiate coumadin and tandearil effects. Contraindications: Patients with known allergies to penicillin, which is approximately 3% of the population. In patients with renal impairment, dosages should be decreased since excretion of drug is by the renal system. A different formulation should be used in these patients such as penicillin procaine that allows a slow release into the serum from the intramuscular site. Precaution with pregnancy category B, lactation, and hypersensitivity to cephalosporins. Side effects: The penicillins are among the least toxic drugs known. They rarely elicit adverse reactions in humans unless present in excessive concentrations. They can disrupt the normal gastrointestinal flora and cause nausea, vomiting, diarrhea, abdominal pain, colitis, and anorexia. To minimize diarrhea it is recommended that penicillin be taken with two to three tablespoons of yogurt, or a lactobacillum tablet. Fatal anaphylaxis is estimated to occur in one in 10,000 users. At high doses penicillin can have a toxic effect that can cause seizures, platelet dysfunction, hemolytic anemias of an immunologic type, encephalitis, and nephritis. Pseudomembraneous colitis is an occasional adverse reaction.
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Generic Name: Rifampicin Brand Name: Rifampin Classification: Antibiotic, Antitubercular Indication: Tuberculosis (all forms) - as part of a combination therapy Therapeutic Action: Rifampicin has a broad-spectrum bactericidal action which inhibits bacterial RNA synthesis by binding to the subunit of DNA-dependent RNA polymerase, thus blocking RNA transcription. It is commonly used in the treatment of tuberculosis, leprosy and opportunistic Contraindication: Hypersensitivity, jaundice, severe hepatic disease. IM/SC admin. Porphyria. Not to be used for treatment of meningococcal disease. Side Effects: Red- orange discoloration of urine, GI disturbances, pseudomembranous colitis (rare), abnormalities of liver function, fatalities in those with liver disorders, atypical mycobacterial infections.
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Dosage: Oral Tuberculosis Adult: 10 mg/kg mg/kg daily daily or or 2-3 2-3 times times wkly. wkly. Max: Max: 600 600 mg/day. mg/day.
Child: 10-20
Hepatic impairment: Dosage reduction may be necessary. Nursing Responsibility:

Administer on an empty stomach, 1 hr before or 2 hr after meals. Administer in a single daily dose. Consult pharmacist for rifamoin suspension for patients unable to swallow capsules. Prepare patient for the reddish-orange coloring of body fluids (urine, sweat, sputum, tears, feces, saliva); soft contact lenses may be permanently stained; advise patients not to wear them during therapy.
Warning: arrange for follow-up visits for liver and renal function tests, CBC, and ophthalmic examinations.
Teach client to take drug in a single daily dose. Take on an empty stomach, 1 hr before or 2 hrs after meals.
Inform client to take this drug regularly; avoid missing any doses; do not discontinue this drug without consulting the health care provider.
Tell client to have periodic medical checkups, including eye examinations and blood test, to evaluate the drug effects. Inform client that he may experience the drugs side effects (especially the red colored secretion)
Instruct client to see his physician if he experience fever, chills, muscle and bone pain, excessive tiredness or weakness, loss of appetite, N/V, yellowing of eyes/skin, unusual bleeding or bruising, skin rash or itching.
Instruct client to remove contact lenses as they may discolor
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Generic name: Isoniazid Brand name: Niazid Classification: Antituberculotic Indications

Tuberculosis of all forms Prophylaxis in specific patients who are tuberculin reactors (positive Mantoux test)) or who are considered to be high risk for TB.
Therapeutic Action This medication is used with other medications to treat active tuberculosis (TB) infections or alone to prevent those who have a positive TB test from developing symptoms of TB. Isoniazid belongs to a class of drugs known as antibioticsthat are active against tuberculosis. Interferes with lipid and nucleic acid biosynthesis in actively growing tubercle bacilli.
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Contraindication Isoniazid is contraindicated in patients who develop severe hypersensitivity reactions, including drug -induced hepatitis; previous isoniazid-associated hepatic injury; severe adverse reactions to isoniazid such as drug fever, chills, arthritis; and acute liver disease of any etiology. Side effects

Peripheral neuropathy Nausea and vomitting Thrombocytopenia Local irritation at IM site Epigastric distress Elevated AST
Stock dose Oral Tuberculosis Adult: 5 mg/kg daily. Max: 300 mg daily. For intermittent treatment: 10 mg/kg 3 times a wk or 15 mg/kg twice wkly. Similar doses may also be given via IM admin. For latent tuberculosis: 300 mg daily for 6 mth; alternatively, 5 mg/kg daily or 15 mg/kg twice wkly for 9 mth.
Child: 10-15 mg/kg/day in 1-2 divided doses (max: 300 mg/day). Alternatively, intermittent therapy can be given at 20-40 mg/kg (max: 900 mg) 2-3 times wkly. For latent tuberculosis: 10-20 mg/kg/day or 20-40 mg/kg twice wkly for 9 mth. Max: 300 mg/dose for daily regimen and 900 mg/dose for intermittent regimens. Nursing responsibilities
History: allergy to the drug.
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Can cause peripheral neuropathy which is manifested by tingling sensation on extremities. It can be prevented through use of supplemental vitamin B6 (pyridoxine).
Physical: skin color, lesions, T; orientation, reflexes, peripheral sensirivity, bilaterally grip strength ophthalmologic examination; R, adventitious sounds; liver evaluation; CBC;LFTs renal fxn tests, blood glucose.
Give in an empty stomach 1 hr before or 2 after meals; may be given with food if GI UPSET OCCURS.
Give in a single daily dose. Reverse parenteral dose for pt unable to take oral meds. Dec. foods containing tyramine or histamine in pt diet. Consult doctor and arrange for daily pyridoxine in diabetic, alcoholic or malnourished pt also for pt that develops peripheral neuritis, and those with HIV.
Family health teachings:

Take this drug in single daily dose. Take drug on an empty stomach, 1 hour before or 2 hours after meals. If GI distress occurs, may be taken with food.
Take this drug regularly, avoid missing doses, do not discontinue without first consulting your health care provider.
Do not drink alcohol or drink as little as possible. There is an inc. risk of heap if these two drugs are combined.
Avoid foods containing tyramine, consult a dietitian to obtain a list of foods containing tyramine or histamine.
Have periodic medical check-ups, including an eye examination and blood test, to evaluate the drug effects.
Report for weakness, fatigue, loss of appetite, n/v, yellowing of skin or eyes, darkening of the urine, numbness or tingling in hands or feet,
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Generic Name: Pyrazinamide Classification: Antituberculotic Indication: For the initial treatment of active tuberculosis in adults and children when combined with other antituberculous agents. Therapeutic action: Pyrazinamide has bactericidal action against M. tuberculosis in acid environment present in macrophages and inflammed tissue. Together with rifampicin provides greatest sterilising action with reduction in relapse rate. Reduces tubular secretion of uric acid. Contraindication: Contraindicated in patients hypersensitive to drug and in those with severe hepatic disease or acute gout. Use cautiously in patients with diabetes mellitus, renal failure, or gout. Side Effects: - darkened urine
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- difficult urination - fatigue - fever - loss of appetite - pain and swelling in the joints - skin rash - unusual bleeding or bruising - upset stomach - vomiting - yellowing of the skin or eyes Dosage: Oral Tuberculosis Adult: As part of a mulitdrug regimen, 20-25 mg/kg (max: 2 g) daily or 1.5-3 g 3 times wkly. Child: As part of a mulitdrug regimen, 35 mg/kg daily or 50 mg/kg 3 times wkly or 75 mg/kg twice wkly. Max dose: 3 g daily. Nursing responsibilities In patients with diabetes mellitus, pyrazinamide therapy may hinder stabilization of serum glucose levels. In many cases, drug elevates serum uric acid levels. Although usually asymptomatic, a uricosuric drug, such as probenecid or allopurinol, may be needed. Monitor liver function, especially enzyme and bilirubin levels, and renal function, especially serum uric acid levels, before therapy and thereafter at 2- to 4-week intervals. Patients with concomitant HIV infection may need a longer course of treatment. Pyrazinamide may interfere with urine ketone determinations. Drug temporarily decreases 17-ketosteroid levels and increases protein-bound iodine and urate levels.
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Breast-feeding
patients
Drug appears in breast milk. Safety in breast-feeding women hasnt been established. An alternative Safe use to in breast-feeding children is hasnt recommended been during therapy. patients definitely established. patients
Pediatric
Geriatric
Because elderly patients commonly have diminished renal function, which decreases drug excretion, Explain disease drug process should and rationale be for used long-term cautiously. therapy.
Teach patient signs and symptoms of hypersensitivity and other adverse reactions, and emphasize need to report them; urge patient to report unusual reactions, especially signs of gout. Make sure patient understands how and when to take drugs; urge patient to complete entire prescribed regimen, to comply with instructions for around-the-clock dosage, and to keep follow-up appointments.
Page | 72
Generic Name: Ethambutol Brand Name: Myambutol Classification: Antituberculosis agent Indication: Treatment of pulmonary tuberculosis in combination with 1 or more other antituberculous agents Therapeutic Action: Ethambutol interferes with RNA synthesis, causing suppression of Mycobacteria multiplication. It also has bacteriostatic action against M tuberculosis by acting on rapidly growing pathogens in cavity walls and is also effective in slow-growing pathogens. Has some action against atypical opportunistic Mycobacteria e.g. M kansasii, M avium complex (MAC). Contraindication: Hypersensitivity; optic neuritis. Lactation.
Page | 73
Side Effects Malaise; headache; dizziness; mental confusion; disorientation; possible hallucinations; numbness and tingling of extremities. Decreased visual acuity. Anorexia; nausea; vomiting; GI upset; abdominal pain. Eosinophilia. Transient liver function impairment. Elevated serum uric acid; precipitation of acute gout. Pulmonary infiltrates. Hypersensitivity (including anaphylactoid reactions; dermatitis; pruritus); fever; joint pain. Dosage Oral Primary treatment of pulmonary and extrapulmonary tuberculosis
Adult: As hydrochloride: Initial 8 wk: 15 mg/kg/day or 30 mg/kg thrice wkly given with isoniazid, rifampicin and pyrazinamide. For patients with history of antimycobacterial therapy: Initial doses: 25 mg/kg/day for 60 days, thereafter reduce to 15 mg/kg/day. Child: For treatment of drug-resistant tuberculosis: 15-25 mg/kg daily or 50 mg/kg twice wkly. For congenitally acquired tuberculosis: Neonates: 15 mg/kg once daily and 1 mth: 15 mg/kg once daily or 30 mg/kg 3 times wkly for 2 mth initial treatment phase.

Review dosing schedule and prescribed length of therapy with patient. Emphasize to patient that treatment will be lengthy and that the entire course of treatment must be completed to avoid relapse or development of resistance.
Advise patient to take each dose without regard to meals, but to take with food if GI upset occurs.
Instruct patient to immediately report the following to health care provider: change in vision, visual abnormalities.
Page | 74
Generic Name: Streptomycin sulfate Classification: Antibiotic, anti-tubercular,anti-infective Indication Infections caused by susceptible strain of mycobacteriumtuberculosis. Serious infections caused by susceptible strains of Yersinia Pestis Therapeutic Action Inhibits CHON synthesis strains of gram negative bacteria, mechanisms of lethal action and fully understood, but functionalintegrity of cell membrane appears to be disrupted. Contraindication Allergy to aminoglycosides, pregnancy, lactation, Herpes vacinia fungal infection.
Page | 75
Side Effects Giddiness, vertigo, tinnitus, ataxia, hypersensitivity reactions, ototoxicity and nephrotoxicity. Dosage: Intramuscular Tuberculosis Adult: 15 mg/kg daily; max: 1 g daily. Reduce max daily dose to 500-750 mg in patients >40 yr. As part of an intermittent therapy: 25-30 mg/kg/day 2-3 times/wk; max: 1.5 g/dose. Not >120 g over the course of treatment should be given unless there are no other treatment Elderly: 60 kg: Dosage reduction is required. Nursing Responsibilities

options.
Child: 20-40 mg/kg (max: 1 g) daily or 25-30 mg/kg (max: 1.5 g) 2-3 times wkly.
Use in route only: give by deep IM injection. Ensure adequate hydration of patient before and during the therapy. Monitor for hearing changes. This drug can only be given by injection. Report hearing changes,dizziness, pain at injection site, rash.
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Ampalaya Scientific Name: Momordica Charantia Botany Ampalaya is a climbing vine, nearly or quite smooth, annual vine. Tendrils are simple, up to 20 centimeters long. Leaves are 2.5 to 10 centimeters in diameter, cut nearly to the base into 5 to 7 lobes, oblong-ovate, variously toothed, and heart-shaped at the base. Male flower is about 12 millimeters long, and is peduncled, with a rounded, green, and about 1 centimeter long bract approximately at the middle. Female flower is yellow flower, about 15 millimeters long, long-stalked with pair of small leaflike bracts at middle or toward base of stalk. Fruit, in cultivated form, is green, fleshy, oblong, cylindric, 15 to 25 centimeters long, pointed at both ends, ribbed and wrinkled, bursting when mature to release seeds; in wild forms, ovoid, about 2 to 4 centimeters long. Seeds are oblong, compressed 10 to 13 millimeters long, and corrugated on the margins. Distribution - Year-round vegetable, extensively cultivated in the Philippines for its bitter edible fruit. - Wild forms found in open fields, thickets, and waste places at low and medium
Page | 77
altitudes. - Probably of Asiatic origin. - Pantropic.
Constituents - Phytochemical study yielded alkaloids, glycosides, aglycone, tannin, sterol, phenol and protein. - 1898 study reported a bitter alkaloid and a glucoside. - Leaves and fruit yielded a bitter principle, momordicin. - A petroleum ether extractive yielded a highly aromatic ethereal oil, a fixed oil, traces of free fatty acids and carotene. - Ethyl ether fraction yielded chlorophyll, a glucoside-like substance and resin. - Water soluble extractive yielded a saponin-like substance and mucilaginous bodies. Properties - Considered astringent, antidiabetic, abortifacient, antirheumatic, contraceptive, galactagogue, parasiticide, anthelmintic, purgative, emetic, antipyretic, febrifuge, emmenagogue, cooling , tonic, vulnerary.
- Fruit considered tonic and stomachic. Parts utilized Leaves, roots and fruits.
Uses Edibiity / Nutritional - Both wild and cultivated forms are edible. - Fruit of wild form usually roasted over fire and eaten with salt or "heko." - The leaves and fruit - used as vegetables - are excellent sources of Vit B, iron, calcium, and phosphorus. It has twice the amount of beta carotene in broccoli and twice the calcium content of spinach.Characteristically bitter-tasting, slight soaking in salty water before cooking removes some of the bitter taste of the fruit. - In India, fruit eaten in curries. Sandoval, Joanne Irene
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Ampalaya for Diabetes. Clinical Studies for Ampalaya Bitter Melon demonstrated hypoglycemic properties (blood sugar lowering) or other actions of potential benefit against diabetes mellitus. The hypoglycemic chemicals found in Ampalaya Bitter Melon include a mixture of steroidal saponins known as charantins, insulin-like peptides, and alkaloids. The hypoglycemic effect is more pronounced in the fruit of bitter melon where these chemicals are in greater abundance. The fruit has also shown the ability to enhance cells uptake of glucose, to promote insulin release, and potentiate the effect of insulin. In other in vivo studies, bitter melon fruit and/or seed has been shown to reduce total cholesterol and triglycerides in both the presence and absence of dietary cholesterol. In one study, elevated cholesterol and triglyceride levels in diabetic rats were returned to normal after 10 weeks of treatment Ampalaya for Hemorrhoids. Powdered leaves and root decoction of Ampalaya are applied to hemorrhoids as astringent. Ampalaya for Stomach Problems. Ampalaya leaf juice is used to expel intestinal parasites, treat dysentery, diarrhea, and chronic colitis. Grounded seeds may also be used. Taken in a spoonfull 3x a day until ailment subsides. Ampalaya for Cough. Ampalaya leaf juice is used for mild coughs for children. Administered in a teaspoon 3x a day. Ampalaya for Burns, Scalds and Wounds. Pounded Ampalaya seeds or leaf are used to treat burns, scalds and wounds. Ampalaya as Anti-Cancer, Two compounds extracted from ampalaya bitter melon, eleostearic acid (from ampalaya seeds) and dihydroxy--eleostearic acid (from the ampalayafruit) have been found to induce apoptosis of leukemia cells in vitro. Diets containing 0.01% ampalaya bitter melon oil (0.006% as -eleostearic acid) were found to prevent azoxymethane-induced colon carcinogenesis in rats. Other acclaimed uses are for the treatment of HIV, treatment of fever and headaches, treatment of rheumatism and gout, disease of the spleen and liver.
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Amplaya Side Effects In large dozes, pure Ampalaya juice can be a purgative and may cause pregnancy abortion.
Philippine News: Diabetes Mellitus
A Philippine herb that has recently gained international recognition for its possible benefits in the treatment of diabetes mellitus. Despite its bitter taste, it has also become a popular nutritional drink for a boost of vim and vigor. In fact, the more bitter, the better, as it is believed that the bitterness is proportionate to its potency.
Studies have suggested that ampalaya contains a hypoglycemic polypeptide, a plant insulin responsible for its blood sugar lowering effect. Other benefits suggested were body detoxification (including removal of nicotine), strengthening of the immune system and fertility regulation.
It is increasingly recommended as an adjunct or supplement to traditional therapeutic regimens for diabetes mellitus.
Toxicity None known. Nursing Responsibilities: Follow the right amount of leaves. Wash thoroughly the leaves and roots. Dont over boil the leaves. Use fresh leaves
Page | 80
GENERIC NAME: losartan BRAND NAME: Cozaar DRUG CLASS AND MECHANISM: Losartan is an oral medication that belongs to a class of drugs called angiotensin receptor blockers (ARBs). Other ARBs include irbesartan (Avapro), valsartan (Diovan), and candesartan (Atacand). Angiotensin, formed in the blood by the action of angiotensin converting enzyme (ACE), is a powerful chemical that attaches to angiotensin receptors found in many tissues but primarily on smooth muscle cells of blood vessels. Angiotensin's attachment to the receptors causes the blood vessels to narrow (vasoconstrict) which leads to an increase in blood pressure (hypertension). Losartan (more specifically, the chemical formed when the liver converts the inactive losartan into an active chemical) blocks the angiotensin receptor. By blocking the action of angiotensin, losartan dilates blood vessels and thereby reduces blood pressure. STORAGE: Tablets should be stored at room temperature in a tightly closed, light resistant container.
Santos, Krizza
Page | 81
INDICATION: Losartan is used for treating hypertension, left ventricular hypertrophy (increase in muscle) and diabetic nephropathy (kidney disease). It may be used alone or in combination with other drugs. DOSING: The usual starting dose of losartan for adults is 50 mg daily. The maximum dose is 100 mg daily. The total daily dose may be divided and administered twice daily. Losartan may be given with or without food. The starting dose of losartan for pediatric patients 6 years of age or older is 0.7 mg/kg up to 50 mg once daily. Doses more than 1.4 mg/kg or 100 mg daily have not been evaluated in pediatric patients. DRUG INTERACTIONS: Inhibitors of cytochrome P450 enzymes such as fluconazole (Diflucan) reduced the formation of the active drug metabolite in laboratory studies. Therefore, caution should be used when adding losartan in a patient taking Nizoral, as reduced activity of losartan may occur. Losartan may increase levels of blood potassium which can lead to serious heart problems (arrhythmias). Therefore, concomitant use of other substances that increase blood-such as potassium-sparing diuretics (for example, spironolactone (Aldactone), triamterene, and amiloride), potassium supplements, or salt substitutes containing potassium--may lead to dangerous increases in serum potassium. The antihypertensive effect of losartan may be reduced by nonsteroidal antiinflammatory drugs (for example, indomethacin, ibuprofen, aspirin , and naproxen). SIDE EFFECTS: In clinical studies the overall incidence of side effects was similar to placebo. Side effects reported included diarrhea, muscle cramps, dizziness, insomnia, and nasal congestion. Losartan also may cause a persistent cough, increase serum potassium, and angioedema. Losartan may reduce kidney function in some patients and should not be used by patients who Santos, Krizza
Page | 82
have bilateral renal artery stenosis (narrowing of both arteries going to the kidneys). Rare cases of rhabdomyolysis (muscle breakdown) have been reported.
NURSING CONSIDERATIONS: -Administer without regard to meals. -Ensure that patient is not pregnant before beginning therapy, suggest using barrier -birth control while using losartan; fetal injury and deaths have been reported. -Find an alternative method of feeding the baby if given to a nursing mother. -Depression of the renin-angiotensin system in infants is potentially very dangerous. -Alert surgeon and mark patient's chart with notice that losartan is being taken. The blockage of the renin-angiotensin system following surgery can produce problems. Hypotension may be reversed with volume expansion. -Monitor patient closely in any situation that may lead to a decrease in blood pressure secondary to reduction in fluid volumeexcessive perspiration, dehydration, vomiting, diarrheaexcessive hypotension can occur.
Santos, Krizza
Page | 83
GENERIC NAME: Potassium Chloride BRAND NAME: Kalium Durule
DRUG CLASSIFICATION AND p o t a s s i u m and
ACTION:
Electrolyte;Replace level. To
maintain potassium
preventhypokalemia, prophylaxis duringtreatment w/ diuretics
INDICATION: Supplement
CONTRAINDICATION: Contraindicated
in patient with oliguria,anuria,;
patient withuntreated Addisonsdisease or with acutedehydration ,heatcramps,Use cautiously with patient with cardiacdisease and
renalimpairmentArrhythmias,Heart arrestHyperkalemiaRespiratory paralysis.
block,HypotensionCardiac
SIDE EFFECTS: Nausea andvomiting ,abdominal pain
NURSING RESPONSIBILITIES: Make sure the powder arecompletely dissolve before giving. Monitor renal function.after surgery, dont givedrug until urine flow is established, tell patient to take drug with or after meals with full glass of water of fruit juice to lessen GI distress
Santos, Krizza
Page | 84
GENERIC NAME: Metformin BRAND NAME: Glucophage CLASSIFICATION: Biguanide. ACTION: Inhibits hepatic glucose production and increases sensitivity of peripheral tissue to insulin. INDICATIONS - Diabetes mellitus. - Polycystic ovary syndrome. CONTRAINDICATIONS - Renal impairment. - Ketoacidosis. - Should be stopped if tissue hypoxia is likely (for example, in respiratory failure, sepsis, a recent myocardial infarction or hepatic impairment).
Santos, Krizza
Page | 85
- If iodine-containing X-ray contrast media have been used, metformin should be stopped until renal function is normal. - General anaesthesia (metformin should be stopped two days before and restarted when renal function is normal). - Pregnancy. - Breastfeeding. CAUTIONS - Serum creatinine should be measured before treatment and twice a year thereafter during treatment. COMMON SIDE EFFECTS:
Anorexia, Nausea, Gastrointestinal problems including vomiting, diarrhoea and heartburn, Abdominal pain, Thrombocytopenia, Metallic taste in the mouth, Headache, Weakness, Dizziness, Drowsiness, Tinnitus, Fatigue, Vertigo,
Agitation, Rash. RARE SIDE-EFFECTS:
Lactic acidosis, Decreased vitamin B12 absorption, Erythema, Hypoglycaemia INTERACTIONS - Risk of lactic acidosis is increased with alcohol. - Hypoglycaemic effect of metformin is enhanced by monoamine oxidase inhibitors. NURSING CONSIDERATIONS
- Metformin is the drug of choice for overweight patients for whom dieting has not controlled diabetes. Can also be used in patients who are not overweight and when diabetes cannot be controlled with sulphonylurea treatment.
Santos, Krizza
Page | 86
- Advantages include lower incidence of weight gain. - Gastrointestinal complaints are more common with higher doses. - To avoid lactic acidosis do not use in patients with even mild renal problems. - Store in a tight container in a cool place. - Side-effects are common and advice about taking the drug with food or using slow-release tablets can help. PATIENT - Take with meals to avoid gastrointestinal problems. - Notify health care staff of lactic acidosis symptoms, including hyperventilation, fatigue and myalgia. - Must be taken daily and not discontinued abruptly. - The patient must inform the prescriber if they have any long-term liver or kidney problems, heart failure, or if they are a heavy drinker or taking any other medication. Nurses should refer to manufacturer's summary of product characteristics and to appropriate local guidelines. TEACHING
Santos, Krizza
Page | 87
Garlic SCIENTIFIC NAME: Allium Sativum High cholesterol levels, for blood clots, and to lower blood pressure. It has also been promoted for colds, bronchitis, and other uses. Check with your pharmacist for more details regarding the particular brand you use. Garlic is an herbal product. It is unknown exactly how it works. Do NOT use Garlic if: -you are allergic to any ingredient in Garlic -you are pregnant -Contact your doctor or health care provider right away if any of these apply to you. Before using Garlic:
Santos, Krizza
Page | 88
Some medical conditions may interact with Garlic. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you: -if you are planning to become pregnant or are breast-feeding -if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement -if you have allergies to medicines, foods, or other substances -if you have diabetes, stomach or bowel problems, or a blood disease Some medicines may interact with Garlic. Tell your health care provider if you are taking any other medicines, especially any of the following: -HIV protease inhibitors (eg, saquinavir) because effectiveness may be decreased by Garlic This may not be a complete list of all interactions that may occur. Ask your health care provider if Garlic may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine. How to use Garlic: Use Garlic as directed by your doctor. Check the label on the medicine for exact dosing instructions. -Dosing depends on the use and the source of the product. -Use as directed on the package, unless instructed otherwise by your doctor. -The smell of garlic may be noticeable on the breath and skin. If this is bothersome, use an enteric-coated garlic product.
Santos, Krizza
Page | 89
-It may take several weeks for garlic to lower cholesterol and up to 6 months to lower blood pressure. -If you miss taking a dose of Garlic for 1 or more days, there is no cause for concern. If your doctor recommended that you take it, try to remember your dose every day. Possible side effects of Garlic: All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome: Burning of the mouth, stomach, and throat; changes in the menstrual cycle; lightheadedness; nausea; sweating. Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue). NURSING CONSIDERATIONS: -Advise patient not to take garlic if taking warfarin. -if the patient is diabetic, advise him to consult his physician first before adjusting his medications.
Santos, Krizza

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Page | 1

Contraindication : Contraindicated in patients hypersensitive to drug. Alexander, Anneth

Use cautiously with pregnancy, lactation, acute MI, CHF.

CNS: Headache, apprehension, restlessness, weakness, vertigo, dizziness, faintness

Scientific name :PeperoniaPellucida

Indication :Lowers uric acid. (Rheumatism and gout) Preparation:

leaves Alexander, Anneth

Generic Name Anthraquinone Glycosides/Salicylic Acid

Brand Name Pyralvex

Drug Class Anti-Inflammatory Analgesic

Available Forms Solution 10mL

Generic Name Clopidogrel bisulfate

Brand Names Platexan, Plavix

Drug Class Adenosine diphosphate (ADP) receptor antagonist Antiplatelet

Available Forms Tablets 75 mg

Generic Name Omega-3-acid ethyl esters

Brand Names Lovaza

Drug Class Lipid-lowering drug Omega-3 fatty acid

Available Forms Capsules 1 g

Dried Leaves Adult 7-12 years old 4 tablespoons

Fresh Leaves 6 tablespoons tablespoon of adult dose

Preparations Sambong Tea Preparation:

BETADINE* ANTISEPTIC SOLUTION

COMPOSITION: Each 1 mL contains 100 mg povidone-iodine, equivalent to 10 mg available iodine.

PHARMACOLOGICAL Antiseptics, Disinfectants,

CLASSIFICATION: Cleansing Agents

CONTRA-INDICATIONS: Hypersensitivity to povidone-iodine.

Plasil Brand Name: PLASIL

(Bik.), Biabas (Sul.), Gaiyabat (If.),Gaiyabit (If.)

Generic name: Budesonide, formoterol fumarate

Brand name: Symbicort

Drug class: Corticosteroid

Dela Cruz, Stephanie

Dela Cruz, Stephanie

Generic Name: Citicoline

Brand Name: Cholinerv

Classification: Neurotonics, Nootropics

Contraindications and cautions

Patients with acute, severe & progressive disturbance of consciousness

Dela Cruz, Stephanie

Dela Cruz, Stephanie

PREPARATION AND USAGE:

SIDE EFFECT/ ADVERSE REACTION:

To date, no toxicity has been identified.

Dela Cruz, Stephanie

Dela Cruz, Stephanie

Dela Cruz, Stephanie

Pediatric Patients 13-16 yr 150 mg/day PO; maximum dose 300mg.

Pediatric Patients 6-12 yr 75 mg/day PO, titrate to a maximum of 150 mg/day

Common Name Parts utilized Constituents Essential oil,

Sensitive Plant, Humble Plant, Shameful Plant, Sleeping Grass, Touch-me-not

and alkaloids, glycosides

characteristics and tannin.

Culinary: An aromatic leaf used to perfume rice dishes.

Scientific Name Tagalog Name Parts Used Uses:

For asthma expectorant For Bladder stones For Diabetes

Henson, John Reynold

Generic Name Brand Name General Action

Hydrogen peroxide is also commonly used in mouthwashes, mostly as a "debriding agent"

Hydrogen Peroxide is used to help remove earwax,

Henson, John Reynold

Do not apply directly on wound