DRUG NAME Keto-analogue 600mg/tab I tab TID

CLASSIFICATION Keto-aminoacid Parenteral Nutrition Pharmacological group

MECHANISM OF ACTION The plasma kinetics of amino acids and their integration in metabolic pathways are well established. It should nevertheless be noted that, in uremic patients, the plasma disturbances do not seem to depend on digested amino acid intake, and that the postabsorptive kinetics seems to be disturbed very early in the development of the disease.

INDICATION Keto analogue of amino acid primarily indicated to conditions like Chronic renal insufficiency.

ADVERSE EFFECT Hypercalcaemia may develop

CONTRAINDICATION Contraindicated in conditions like hypercalcaemia

NURSING CONSIDERATION -Taken during meals to allow proper absorption. -The serum calcium level should be monitored regularly. -Ensure the sufficient supply with calories.

DRUG NAME Allopurinol 100mg/tab 1tab OD

CLASSIFICATION Anti- gout drug

MECHANISM OF ACTION Inhibits the enzymes responsible for the conversion of purines to uric acid, thus reducing the production of uric acid with a decrease in serum and sometimes urinary uric acid levels, relieving the signs and symptoms of gout.

INDICATION Primary and secondary gout

ADVERSE FFECT CNS: headache, drowsiness, peripheral neuropathy, neuritis, paresthesias. DERMATOLOGIC: rashes, scaly, or exfoliative GI: nausea and vomiting, diarrhea, abdominal pain HEMATOLOGIC: anemia, leukopenia, thrombocytopenia, bone marrow depression

CONTRAINDICATION With allergy to allopurinol, blood dyscrasias

NURSING CONSIDERATION -Be cautious with renal failure -Take the drugs after meals -Report rash; unusual bleeding or bruising, fever, chills, gout attack.

DRUG NAME Ferrous sulfate

CLASSIFICATION Iron preparation

MECHANISM OF ACTION Elevates the serum iron concentration, which, then helps to form HGB or trapped in the reticuloendothelial cells for storage and eventual conversion to a usable form of iron.

INDICATION

ADVERSE FFECT

CONTRAINDICATION With allergy to ay ingredient; sulphate allergy; hemochromatosis, haemolytic anemias

Prevention and CNS: CNs toxicity, treatment of iron acidosis, coma, and deficiency anemias. death with overdose GI: nausea, vomiting, anorexia, diarrhea

NURSING CONSIDERATION -Take drug with an empty stomach with water -Do not take this preparation with antacids or tetracyclines -Report severe GI upset,lethargy, rapid, respirations, constipation

DRUG NAME Nifedipine 30mg/tab 1tab TID

CLASSIFICATION Anti- angina, Antihypertension

MECHANISM OF ACTION Inhibits the movement of calcium, ions across the membranes of cardiac and arterial muscle cells; inhibition of trans membrane calcium flow results in the depression of impulse formation in specialize cardiac pacemaker cells in slowing of the velocity of conduction of the cardiac impulse, in the depression of myocardial contractility.

INDICATION SR preparation only: treatment of hypertension

ADVERSE FFECT CNS: dizziness, nervousness CV: angina, hypotension, arrhythmias GI: nausea, diarrhea, constipation.

CONTRAINDICATION With allergy to nifedipine

NURSING CONSIDERATION -Do not chew, cut or crush sustained/ released tablets. Swallow whole. -Report irregular heartbeat, shortness of breathing, swelling of hands or feet, pronounced dizziness, constipation.

DRUG NAME Epoetin Alfa (EPO)

CLASSIFICATION Recombinant human erythropoetin

MECHANISM OF ACTION A natural glycoprotein in the kidneys, which stimulated red blood cell production in the bone marrow

INDICATION Treatment of anemia associated with chronic renal failure.

ADVERSE FFECT CNS: seizure, CVA CV: hypertension, edema

CONTRAINDICATION With uncontrolled hypertension

NURSING CONSIDERATION -Maintain all of the usual activity and restriction but applies to renal failure. -Report difficulty of breathing, numbness, and chest pain.

DRUG NAME Sodium bicarbonate (NAHCO3)

CLASSIFICATION Antacid

MECHANISM OF ACTION Increases plasma bicarbonate

INDICATION Treatment of metabolic acidosis, Minimization of uric acid.

ADVERSE FFECT GI: gastric rupture following ingestion. HEMATOLOGIC: systematic alkalosis, hypokalemia secondary to intracellular shifting of potassium.

CONTRAINDICATION Allergy to components of preparations; low serum chloride

NURSING CONSIDERATION -Use cautiously with impaired renal function. -Do not take within 12 hours of any other drugs to decrease of drug interaction. -Report irritability, headache and tremors

DRUG NAME Telmisartan

CLASSIFICATION Angiotensin/ diuretics

MECHANISM OF ACTION An angiotensin receptors blocker(ARB) that shows high affinity for the angiotensin II type 1(AT) receptors, has a long duration of action and has the longest half-life of any ARB.

INDICATION Treatment for essential hypertension, blocks vasoconstricting

ADVERSE FFECT Headache, upper respiratory tract infection, dizziness, hydrochlorothiazide, anorexia, gastric irritation muscle spasm, sleep disturbances.

CONTRAINDICATION Pregnancy and lactation, chotestasis and biliary obstructive disorders. Severe hepatic and renal impairement.

NURSING CONSIDERATION -Monitor patient for hypotension after starting drug. Place the patient supine if hypotension occurs.

DRUG NAME Atenolol 50mg/tab

CLASSIFICATION Anti-anginal, antihypertensive

MECHANISM OF ACTION Blocks beta-adrenergic receptors of the sympathetic nervous system in the heart and juxtaglomerular apparatus(kidney),thus decreasing the excitability of the heart, decreasing cardiac output and oxygen consumption decreasing the release of rennin from the kidney and lowering blood pressure.

INDICATION Treatment of angina pectoris due to coronary atherosclosis, treatment for MI.

ADVERSE FFECT Allergic reactions, pharyngitis, fever, sore throat, loss of appetite, depression, decrease of exercise tolerance.

CONTRAINDICATION Contraindicated with sinus, bradycardia, second and third degree heart block, cardiogenic shock, CHF,pregnancy

NURSING CONSIDERATION -Do not stop taking this drug unless told to do so by a health care provider. -Report difficulty of breathing, night cough, confusion, rash, fever, sore throat, swelling of extremities, slow pulse.