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Lactulose Produces osmosis effect - Constipation, Pt who require a Abdominal discomfort >Assess condition
in colon; resulting salmonellosis. low lactose diet. associated with before therapy and
Classification: distention promotes Galactosemia flatulence and intestinal reassess regularly
Laxatives peristalsis. Also - Treatment of deficiency. cramps. Nausea, thereafter to monitor
decreases ammonia, hepatic Intestinal vomiting, diarrhea on drug͛s effectiveness
Dosage: probably as a result of encephalopathy obstruction. prolonged use.
10 l. bacterial degradation, >Monitor pt for any
which lowers the ph of adverse GI reactions,
colon contents. nausea,vomiting,diarrhea,

>Assess for adverse

reactions.

>For pt. with hepatic

encelopathy:
regularly assess
mental condition.

>monitor I & O.

>monitor for Inc.

glucose level in
diabetic pts.
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Captopril Blocks ACE from ͻ Treatment of Contraindicated with Tachy cardia, angina ͻ Administer 1 hr before
converting angiotensin I hypertension alone or in allergy to captopril, pectoris, MI, or 2 hr after meals.
Classification: to angiotensin II, a combination with history of angiodema Raynaud's syndrome,
Angiotensin-converting powerful thiazide-type diuretics. CHF, hypotension in salt- ͻ Alert surgeon and
enzyme (ACE) inhibitor vasoconstrictor, leading or volume-depleted mark patient's chart with
Antihypertensive to decreased blood ͻ Treatment of CHF in patients notice that captopril is
pressure, decreased patients unresponsive to being taken; the
Dosage: aldosterone secretion, a conventional therapy; angiotensin II formation
25 mg ¼ tab OD small increase in serum used with diuretics and subsequent to
potassium levels, and digitalis. compensatory renin
sodium and fluid loss; release during surgery
increased prostaglandin ͻ Treatment of diabetic will be blocked;
synthesis also may be nephropathy. hypotension may be
involved in the reversed with volume
antihypertensive ͻ Treatment of left expansion.
action. ventricular dysfunction
after MI. ͻ Monitor patient closely
for fall in BP secondary
to reduction in fluid
volume (excessive
perspiration and
dehydration, vomiting,
diarrhea); excessive
hypotension may occur.

ͻ Reduce dosage in
patients with impaired
renal function.
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Morphine Relieves pain by Relief of moderate to Hypersensitivity to Hypotension; orthostatic  Instruct patient to take
stimulating opiate severe acute and chronic opiates; upper airway hypotension; oral preparations with
Classification: receptors in CNS; also pain; relief of pain in obstruction; acute bradycardia; food or juice if GI
Opioid analgesic causes respiratory patients who require asthma; diarrhea caused tachycardia; upset occurs.
depression, peripheral opioid analgesics for by poisoning or toxins. palpitations.  Tell patient not to
Dosage: vasodilation, inhibition more than a few days crush or chew
0.4 ml SQ. of intestinal peristalsis, (sustained-release only); controlled-release
sphincter of Oddi spasm, management of pain not tablets.
stimulation of responsive to  Explain that full
chemoreceptors that nonnarcotic analgesics; effectiveness of drug
cause vomiting and dyspnea associated with may not occur for 30
increased bladder tone. acute left ventricular to 60 min after
failure administration.
Emphasize that drug is
more effective if taken
regularly to prevent
pain rather than to
treat pain after it
occurs.
 Encourage patient to
turn, cough and
breathe deeply every 2
h to prevent
atelectasis.
 Advise patient to
consult with health
care provider if
excessive sedation
occurs or if pain relief
 is inadequate.
 Inform patient that
drug may cause
constipation. Stool
softener, fiber laxative,
increased fluid intake
and bulk in diet may
help alleviate problem.
 Instruct patient to
avoid intake of
alcoholic beverages
and other CNS
depressants.
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Clexane Prevent the certain Treatment of venous Acute bacterial Thrombocytopenia, liver ͻ Administer 1 hr before
molecules in the blood thromboembolic disease endocarditis, major abnormalities. or 2 hr after meals.
Classification: called clotting factors presenting with deep bleeding disorders,
from working. vein thrombosis, increased risk of ͻ Alert surgeon and
Dosage: pulmonary embolism or hemorrhage, mark patient's chart with
both. thrombocytopenia, notice that captopril is
active peptic ulcer, being taken; the
Treatment of unstable hemorrhagic CVA, angiotensin II formation
angina and non-Q wave prosthetic heart valves. subsequent to
MI in conjunction with compensatory renin
aspirin. release during surgery
will be blocked;
Treatment of acute ST hypotension may be
segment elevation MI reversed with volume
(STEMI) including expansion.
patients to be managed
medically or with ͻ Monitor patient closely
percutaneous coronary for fall in BP secondary
intervention in to reduction in fluid
conjunction with volume (excessive
thrombolytic drugs. perspiration and
dehydration, vomiting,
diarrhea); excessive
hypotension may occur.

ͻ Reduce dosage in
patients with impaired
renal function.
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Losartan Used to treat high blood Contraindicated with  Hoarseness
pressure (hypertension). allergy to captopril,  swelling of face,
Classification: history of angiodema mouth, hands, or
angiotensin receptor Used to treat a condition feet
blockers. called diabetic  trouble in
nephropathy. swallowing or
Dosage: breathing
(sudden)

 
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Nitroglycerin Relaxes smooth muscles. Used to treat Angina Tolerance to Monitor blood pressure
pectoris, congestive nitroglycerin can and heart rate on a
Classification: heart failure. decrease, and efficacy regular basis.
Vasodilator. decrease, with
continuous use. Instruct patient to take
Dosage: medication while sitting
5mg SC prn for chest down and to change
pain positions slowly.

Instruct patient to allow

tablets to dissolve under
tongue, and not to chew
or swallow sublingual
tablets.

Instruct patient to seek

emergency help
promptly
if chest pain is
unresolved
after 15 minutes.

Advise patient to use

caution when engaging
in activities requiring
mental alertness.