DRUG NAME

MECHA NISM OF ACTION

INDICATION

ADVERSE REACTION

CONTRAINDIC ATION

NURSING CONSIDERATION

Atorvastatin (Lipitor)

Antilipemics

Inhibits HMGCoA reductas e, an early (and rate limiting) step in cholester ol biosynthe sis.

- In patients with clinically evident coronary heart disease, to reduce the risk of nonfatal MI, fatal & nonfatal strokes, angina heart failure, & revascularization procedures

CNS: headache, asthenia, insomnia

CV: peripheral edema

EENT: pharyngitis, rhinitis, sinusitis

- Adjunct to diet to reduce LDL, total cholesterol, apolipoprotein B, & triglyceride levels & to increase HDL levels in patients with primary hypercholesterolemi a & mixed dyslipidemia

GI: abdominal pain, constipation, anorexia, diarrhea, nausea, dyspepsia, flatulence

Contraindicated in patients hypersensitive to drug & in those with active liver disease or unexplained persistent elevations of transminase levels.

- Patient should follow a standard cholesterol lowering diet before & during therapy

GU: UTI

Contraindicated in pregnant & breast-feeding women & in women of childbearing age

- Before treatment, assess patient for underlying causes for hypercholesterolemia & obtain a baseline lipid profile. Obtain periodic liver function test results & lipid levels before starting treatment & at 6 & 12 weeks after initiation, or after an increase in dosage & periodically thereafter

Musculoskeletal: rhabdomyolysis, arthrisis, arthralgia, myalgia

- Use cautiously

- Watch for signs of

- Alone or as adjunct to lipid lowering treatments, such as LDL apheresis, to reduce total & LDL cholesterol in patients with homozygous familial hypercholesterolemi a

Respiratory: bronchitis

in patients with myositis history of liver disease or heavy alcohol use

Skin: rash - Withhold or stop drug in patients at risk for renal failure caused by rhabdomyolysis resulting from trauma; in serious, acute conditions that suggest myopathy; & in major surgery, severe acute infection, hypotension, uncontrolled seizures, or severe metabolic, endocrine, or electrolyte

Other: allergic reactions, flulike syndrome, infection

disorders.

- Limit use in children to those older than age 9 with homozygous familial hypercholesterol emia

DRUG NAME

MECHANI SM OF ACTION

INDICATION

ADVERSE REACTION

CONTRAINDICA TION

NURSING CONSIDERATION

Citicoline (Somazine)

Neurotonics, Nootropics

Citicoline is an interneuron al communica tion enhancer. It increases the neurotrans mission levels because it favors the synthesis and production speed of dopamine in the striatum, acting

- CVD in acute & recovery phase, symptoms & signs of cerebral insufficiency (dizziness, memory loss, poor concentration, disorientation, recent cranial trauma & their sequelae.)

- Fleeting and discrete hypotension effect, increased parasympathetic affects, low blood pressure

- Any allergy or hypersensitivity to the drug

- Citicoline may be taken with or without food. Take it with or between meals.

- Itching or hives, swelling in face or hands, chest tightness, tingling in mouth and throat

- Hypertonia of the parasympathetic nervous system

- The supplement should not be taken in the late afternoon or at night because it can cause difficulty sleeping.

- Body temperature elevation

- Use cautiously for pregnancy an d lactation

- Restlessness

- Conscious use for patient with renal and hepatic damage

- 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

- Headaches, Nausea and vomiting

then as a dopaminerg ic agonist thru the inhibition of tyrosine hydroxylase .

- Diarrhea

Parasympathetic hypertonia

Citicoline during pregnancy and breast-feeding. Stay on the safe side and avoid use.

- Low or high blood pressure, Tachycardia - Sleeping troubles or insomnia - Special attention should be paid for administration in the neonate, premature and children.

- Blurred vision

- Chest pains

- 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. Somazine must not be administered along with medicaments containing meclophenoxate