DRUG NAME

CONTRAINDICATION
-Allergy to amlodipine -Hepatic or renal impairment -Sick sinus syndrome -Heart block -Sick sinus syndrome -Lactation

ADVERSE REACTION
CNS: Dizziness Lightheadedness Fatigue Lethargy CV: Peripheral edema Arhythmias Dermatologic: Flushing, rash GI: Nausea Abdominal discomfort

INDICATION
-Treatment of essential hypertension and angina.

MECHANISM OF ACTION
Inhibits calcium ions from entering the slow channels or select voltagesensitive areas of vascular smooth muscle and myocardium during depolarization.

NURSING RESPONSIBILITY
--Assess patient for history of allergy to amlodipine, impaired hepatic or renal function, sick sinus syndrome, heart block, or CHF. --Assess for adverse drug reactions; report irregular heartbeat, swelling of the hands and feet, shortness of breath, pronounced dizziness, and constipation. --Monitor BP and cardiac rhythm. Instruct patient to take drug with meals if abdominal discomfort occurs; advise on eating small, frequent meals for nausea and vomiting.

AMLODIPINE
--Generic Name: Amlodipine --Brand Name: Norvasc --Classification: Calcium channel Blocker --Dosage and Frequency: Tablet = 5mg PO bid

CAPTOPRIL
--Generic Name: Captopril --Brand Name:

-Hypersensitivity to captopril, other ACE inhibitors, or any component

CV: Tachycardia Angina ,MI, CHF Raynaud's

-Management of hypertension -Treatment of CHF and diabetic nephropathy

Blocks ACE from converting angiotensin I to angiotensin II

--Assess for history of allergy to captopril and history of angioedema.

Capoten --Classification: Angiotensinconverting enzyme (ACE) inhibitor --Dosage and Frequency: 25mg PO bid

-History of angioedema

syndrome Hypotension in salt- or volumedepleted patients Dermatologic: Rash, pruritus Scalded mouth sensation Dermatitis Photosensitivity Alopecia GI: Gastric irritation Aphthous ulcers Peptic ulcers Cholestatic Jaundice Hepatocellular injury, Anorexia Constipation GU: Proteinuria Renal insufficiency Renal failure Polyuria,oliguria Urinary frequency Hematologic: Neutropenia Agranulocytosis

leading to decreased blood pressure, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increased prostaglandin synthesis also may be involved in the antihypertensive action.

--Use cautiously in patients with CHF, impaired renal function, salt or fluid volume depletion, or in pregnant or lactating women. --Administer 1 hr before or Or 2 hrs. before meals. --Watch out for excessive perspiration, or diarrhea; may cause hypotension --Reduce dosage in patients with impaired renal function. --Instruct patient to report mouth sores, fever, chills, swelling of the hands and feet, irregular heartbeat, difficulty of breathing, chest pain, swelling of the face, eyes, lips, and tongue. --Instruct patient to limit activities to those that do not require alertness and precision.

Thrombocytopenia Hemolytic anemia Pancytopenia Other: Cough, malaise dry mouth lymphadenopathy

METRONIDAZOLE
--Generic Name: Metronidazole --Brand Name: Flagyl --Classification: Antibiotic Amebicide Antiprotozoal --Dosage and Frequency:

Hypersensitivity to metronidazole, Nitroimidazole derivatives, or any component of the formulation; pregnancy.

CNS: Ataxia, dizziness, encephalopathy, fever, headache, light-headedness, peripheral neuropathy, seizures (highdoses) EENT: Dry mouth, lacrimation (topical form), metallic taste, pharyngitis GI: Abdominal cramps or pain, anorexia, diarrhea, nausea,

To treat systemic anaerobic infections caused by Bacteroides fragilis, Clostidium difficile, Clostridium perfingens, Eubacterium, Fusobacterium, Peptococcus, Peptostreptococcus, and Veillonella sp.

Undergoes intracellularchemical reductionduring anaerobicmetabolism. Aftermetronidazole isreduced, it damagesDNA s helical structureand breaks its strands,which inhibits bacterialnucleic acid synthesisand causes cell death,

--If pt has adverse CNSreactions, such asseizures or peripheralneuropathy, tellprescriber and stop drugimmediately. --Monitor pt with severeliver disease becauseslowed metronidazolemetabolism may causedrug to accumulate in thebody and increase therisk of adverse effects. --If skin irritation occurs,apply topical gel lessfrequently or discontinueit, as ordered. --Monitor CBC and cultureand sensitivity test if therapy lasts longer than10 days or if

pancreatitis, vomiting GU: Darkened urine, vaginal candidiasis (oral,parenteral, and topicalforms); burning or irritation of sexual partners penis, candidal cervicitis orvaginitis, dysuria, urinaryfrequency, vulvitis (vaginalform) HEME: Leukopenia MS: Back pain SKIN: burning sensation, stinging sensation, dry skin (topical form); erythema, pruritus, rash, urticaria (oral and parenteral forms)

secondcourse of treatment isneeded a--Give IV drug by slowinfusion over 1 hr; do not give by direct IN injection

OTHER: injection site edema, pain, or, tenderness.