DRUG NAME Generic name: Metoclopromide

ACTION A dopamine receptor antagonist that stimulates upper GI tract & decreases reflux into the esophagus

INDICATION Induced N/V Post-op N/V Diabetic gastroparesis Symtomatic gastroesophageal reflux To facilitate small bowel intubation

CONTRAINDIATION Concurrent use of medication likely to produce: Extra pyramidal reactions

SIDE EFFECT Frequent (10%) Somnolence, restlessness, fatigue, lethargy

NURSING CONSIDERATION Baseline assessment Antiemetic(assess for DHN) Intervention/Evaluation Monitor for anxiety, restlessness, EPS during IV administration Assess skin for rash Evaluate for therapeutic response from gastroparesis

Brand name: Reglan Classification: Dopamine receptor antagonist

Occasional (3%) GI hemorrhage dizziness, anxiety, H/A, insomnia, GI obstruction or breast perforation tenderness, altered Hx of seizure menstruation, disorder constipation, rash, dry Pheocromocytom mouth, a galactorrhea, gynecomatia Rare (3%) HPN or HTN, tachycardia

Px/Family teaching Avoid tasks that require alertness, motor skills until drug response is established Report Extra pyramidal reaction Avoid alcohol

DRUG NAME Generic name: Ranitidin

ACTION An anti ulcer agent that inhibits histamine action at histamine 2 receptors of gastric parietal cells. Reduces volume and hydrogen ion concentration of gastric juice

INDICATION Duodenal ulcers Gastric ulcers GERD Erosive esophagitis Hypersecretory conditions

CONTRAINDIATION Hx of acute porphyria

SIDE EFFECT (2%) occasional: diarrhea (1%) rare: constipation headache

Brand name: Zantac

Classification: Histamine H2 receptor antagonist

NURSING CONSIDERATION Baseline Assessment obtain baseline/ liver function test Intervention/Evaluation Monitor serum AST, ALT levels. Assess mental status in elderly Pt/Family teaching: smoking decreases effectiveness of medication do not take medicine within 1 hour of magnesium or aluminumcontaining antacids transient burning/ itching may occur with IV administration report headache avoid alcohol, aspirin

DRUG NAME Generic name: Tramadol Brand name: Toradol

ACTION An analgesic that binds to mu-opioid receptors and inhibits reuptake of norepinephrine serotonin. Reduces the intensity of pain stimuli reaching sensory nerve endings

INDICATION Moderate to moderately severe pain

CONTRAINDIATION Acute alcohol intoxication Concurrent use of centrally acting analgesics or hypnotics Opioids, or psychotropic drugs, hypersensitivity to opioids

SIDE EFFECT (25%-15%) Frequent: Dizziness/vertig o, nausea, constipation headache, somnolence (10%-5%) Occasional: Vomiting, Pruritus, CNS stimulation (nervousness, anxiety, agitation, tremor, euphoria, mood swings, hallucinations), Asthenia, diaphoresis, dyspepsia, dry mouth, diarrhea (<5%) Rare: Malaise, vasodilation, anorexia,

NURSING CONSIDERATION Baseline Assessment Assess onset, type, location, duration of pain Assess drug hx, especially carbamazepine, CNS depressant medication, MAIOs Review past medical hx Assess renal function and liver function lab values

Classification: Analgesic

Intervention/ Evaluation Monitor pulse, BP Assist with ambulation if dizziness, vertigo occurs Dry crackers, cola may relieve nausea. Palpate bladder for

flatulence, rash, blurred vision, urine retention or urinary frequency, menopausal symptoms

urinary retention Sips of tepid water may relieve dry mouth Assess for clinical improvement, record onset of relief of pain

Pt/ family teaching: May cause dependence Avoid alcohol, OTC medication (analgesics and sedatives) May cause drowsiness, dizziness, blurred vision Avoid tasks requiring alertness, motor skills until response to drug is established. Inform physician if severe constipation, difficulty breathing, excessive sedation, seizures, muscle

weakness, tremors, chest pain, palpitation occurs.

DRUG NAME Generic name: Allopurinol Brand name: zyloprim Classification: antigout

ACTION A xanthine oxidase ihibitor that decreases uric acid production by inhibiting xanthine oxidase, an enzyme.

INDICATION Chromic gouty arthritis To prevent uric acid nephropathy during chemotherapy Prevention of uric acid calculi Recurrent calcium oxalate calculi

CONTRAINDIATION Asymptomatic hyperuricemia Impaired renal, hepatic function CHF DM HTN

SIDE EFFECT Occasional (oral): somnolence, unusual hair loss (IV) rash, nausea, vomiting (rare: diarrhea, headache

NURSING CONSIDERATION Baseline Assessment instruct to drink 1012 glasses (8oz) of fluid daily while taking medication Intervention/Evaluation Discontinue medication if (+) rash or other reactions of allergic reaction appears. Monitor I & O (output should be at least 2000ml per day) Assess CBC, uric acid and hepatic function serum levels Assess urine for cloudiness, unusual color, odor. Assess for therapeutic response Reduce joint tenderness, swelling,

redness, limited motion Pt/Family teaching: May take 1 week or longer for full therapeutic effect Encourage drinking 10-12 glasses of fluid daily while taking medication Avoid tasks that requires alertness, motor skills until response to drug is establish.

DRUG NAME Generic name: Felodipine

ACTION An antihypertensive and antianginal agent that inhibits Ca movement across cardiac and vascular smooth muscle cell membranes Potent peripheral vasodilator (does not depress SA or AV nodes)

INDICATION HTN

CONTRAINDIATION None known

SIDE EFFECT Frequent (22%-18%) headache, peripheral edema Occasional (6%-4%) flushing respiratory infxn, dizziness, light headedness, asthenia, (lose of strength, weakness) Rare (3%) paresthesia, abdominal discomfort, nervousness, muscle cramping, cough, diarrhea, constipation

NURSING CONSIDERATION Baseline assessment assess BP,apical pulse immediately before drug administration Intervention/Evaluation assist with ambulation if light headedness, dizziness occur Px/Family teaching do not abruptly discontinue medication compliance with therapy regimen is essential to control HTN to avoid hypotensive effect rise slowly from lying to sitting position. Wait momentarily before

Brand name: Plendil Classification: Ca channel blocker

standing contact physician if palpitations, shortness of breath,dizziness, nausea ccurs. Swallow tablet whole; do not crush or chew Avoid grapefruit juice

DRUG NAME Generic name: Rosuvastatia calcium Brand name: crestor Classification: Anti-hyperlipidemic

ACTION An antihyperlipidemic that interferes with cholesterol biosynthesis by inhibiting the conversion of the enzyme HMG-COA To mevalonate, a precursor to cholesterol

INDICATION Hyprelipidemia, dyslipidemia, Renal impairment Concurrent cyclosporine use Concurrent lipidlowering theraphy

CONTRAINDIATION Active hepatic asl Breastfeeding Pregnancy Unexplained, persistent elevation of serum transaminase levels

SIDE EFFECT Occasional (9%-3%) Pharynsitis, headache, diarrhea, dyspepsia including heartburn and epigastric distress, nausea Rare (>3%) Myalgia, asthenia or unusual fatigue and weakness, backpain, jaundice

NURSING CONSIDERATION Baseline assessment Question for possibility of pregnancy before initiating theraphy Assess baseline lab results: (serum cholesterol, triglycerides liver function test) Intervention/Evaluation Mon. serum cholesterol, triglyceride results for therapeutic response Mon. liver Fxtests Mon. creatinin phosphokinase Assess for h/a, sore throat Be alert for myalgia/weakness Px/Family teaching

Periodic lab tests are essential part of therapy Maintain appropriate diet Report side effects: Cramps, muscle pain, weakness especially with fever