DRUG Generic: Furosemide Brand: Lasix Classification: Loop Diuretics Dosage: 40 mg Route: Intravenous Frequency: Every 12 hours

ACTION Inhibits sodium and chloride reabsorption at the proximal tubules, distal tubules and ascending loop of Henle leading to excretion of water together with sodium, chloride and potassium.

INDICATION Treatment of edema associated with congestive heart failure (CHF)

CONTRAINDICATION Hypersensitivity to sulfonylureas Anuria

ADVERSE EFFECT Orthostatic hypertension, thrombophlebitis, chronic aortitis, vertigo, headache, dizziness, paresthesia, restlessness, fever, photo sensitivity, urticaria, pruritus

NURSING CONSIDERATION 1. Assess patients underlying condition before starting therapy. 2. Monitor for renal, cardiac, neurologic, GI, pulmonary manifestations of hypokalemia 3. Monitor neurologic, respiratory manifestations of hyperchloremia: weakness, lethargy, coma, deep rapid breathing. 4. Assess fluid volume status: urine: color, quality and specific gravity, I & O ratio, weight, skin turgor. 5. Assess patients and familys knowledge of drug therapy.

DRUG Generic: AcetylSalicylic Acid Brand: Aspirin Classification: Non Steroidal Antiinflammatory Drugs(NSAIDs) Dosage: 80mg Route: Oral Frequency: Once a day

ACTION Exhibits antipyretic, antiinflammatory and analgesic effects. The antipyretic effect is due to an action on the hypothalamus, resulting in heat loss by vasodilation of peripheral blood vessels. Antiinflammatory effects are mediated by a decrease in prostaglandin synthesis. It also decreases platelet aggregation.

INDICATION For pain on integumentary structures, myalgia, neuralgia, headache, dysmenorrhea, gout. Arthritis, SLE, acute rheumatic fever

CONTRAINDICATION Hypersensitivity to salicylates, severe anemia, history of blood coagulation defects, vitamin K deficiency,

ADVERSE EFFECT GI: dyspepsia, heartburn, anorexia, nausea, epigastric discomfort, potentiation of peptic ulcer Allergic: Bronchospas m, asthmalike symptoms, anaphylaxis, skin rashes, urticaria Hematologic: prolongation of bleeding time, thrombocytop enia, leucopenia, Other: Thirst, fever, dimness of vision

NURSING CONSIDERATION Assess for pain: type, location and pattern Note for asthma Monitor renal, LFTs and CBC Determine history of peptic ulcers or bleeding tendencies.

DRUG Generic: Trimetazidine Brand: Vastarel MR Classification: Anti-Anginal Drugs Dosage: 35 mg Route: Oral Frequency: Twice a day

ACTION acts by directly counteracting all the major metabolic disorders occurring within the ischemic cell. The actions of trimetazidine include limitation of intracellular acidosis, correction of disturbances of trans membrane ion exchanges, and prevention of excessive production of free radicals, decrease myocardial oxygen requirement by decreasing the heart rate, ventricular volume, blood pressure and contractility.

INDICATION - acute anginal attacks - prevent situation that may cause anginal attacks

CONTRAINDICATION Hypersensitivity to any drug component

ADVERSE EFFECT Nausea and Vomiting, headache, edema

NURSING CONSIDERATION 1. Check for doctors order 2. Monitor blood pressure and pulse rate before and after giving the meds. 3. Notify prescribing signs of heart failure such as swelling of hands and feet or SOB. 4. Advise patient of the side effects of the drug.

DRUG Generic: Ranitidine Brand: Zantac Classification: H2 Receptor Antagonist Dosage: 50mg Route: Intravenous Frequency: Every 8 hours

ACTION

INDICATION

CONTRAINDICATION Hypersensitivity, Cross-sensitivity may occur; some oral liquids contain alcohol and should be avoided in patients with known intolerance

ADVERSE EFFECT Constipation Diarrhea Fatigue Headache Insomnia Muscle pain Nausea Vomiting Agitation Anemia Confusion Depression Easy bruising or bleeding

Inhibits the action Treatment and of histamine at the prevention of H2 receptor site heartburn, acid located primarily in indigestion, and gastric parietal sour stomach. cells, resulting in Prophylaxis of GI inhibition of gastric hemorrhage from acid secretion stress ulceration

NURSING CONSIDERATION Instruct patient not to take new medication w/o consulting physician Instruct patient to take as directed and do not increase dose Allow 1 hour between any other antacid and ranitidine Avoid excessive alcohol Assess patient for epigastric or abdominal pain and frank or occult blood in the stool, emesis, or gastric aspirate Nurse should know that it may cause false-positive results for urine protein; test with sulfosalicylic acid Inform patient that it may cause drowsiness or dizziness

 Inform patient that increased fluid and fiber intake may minimize constipation Advise patient to report onset of black, tarry stools; fever, sore throat; diarrhea; dizziness; rash; confusion; or hallucinations to health car professional promptly Inform patient that medication may temporarily cause stools and tongue to appear gray black Instruct patients to monitor for and report occurrence of drug-induced adverse reaction

DRUG Generic: Sulodexide Brand: Vessel due F Classification: Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics) Dosage: 1tab Route: Oral Frequency: Twice a day

ACTION Inhibits coagulation by attacking several sites of the coagulation system. Its effect is dependent on the presence of antithrombin III, an alpha 2- globulin whose activity is augmented by heparin. The heparinantithrombin complex inactivates factors IXa, Xa, XIa and XIIa, and prevents thrombin formation. Furthermore, the complex reverses the effect of already formed thrombin. In high concentrations, heparin also inhibits thrombocyte aggregation.

INDICATION Vascular pathologies w/ thrombotic risk, transient ischemic attacks & cerebrovascular disease, peripheral vascular insufficiency, diabetic retinopathy, MI, retinal vasal thrombosis.

CONTRAINDICATION Hypersensitivity to sulodexide, heparin & heparin- like products. Diathesis &hemorrhagic diseases.

ADVERSE EFFECT nausea vomiting epigastralgia Pain burn hematoma at the site of injection. chills fever urticaria

NURSING CONSIDERATION Assess patients for signs of bleeding and hemorrhage (bleeding gums; nosebleed; unusual bruising; black, tarry stools; hematuria; fall in hematocrit or blood pressure; guaiacpositive stools). Notify physician if these occur. Monitor patient for hypersensitivity reactions (chills, fever, urticaria). Report signs to physician Monitor platelet count every 2-3 days throughout therapy. May cause mild thrombocytopenia, which appears on the 4th day and resolves despite continued heparin therapy.

DRUG
Generic: Cefuroxime Brand: Zinacef Classification: Second Generation Cephalosporin Dosage: 750mg Route: Intravenous Frequency: Every 8 hours

ACTION
Inhibits bacterial wall synthesis, rendering cell wall osmotically unstable, leading to cell death by binding to cell wall membrane

INDICATION
Urinary tract infections, Otitis media, Severe infections

CONTRAINDICATION ADVERSE EFFECT

Sensitivity to cephalosporins CNS: Dizziness, headache, fatigue, paresthesia, fever, chills, confusion GI: Diarrhea, nausea, vomiting, anorexia, glossitis, bleeding, increased AST, ALT, bilirubin, LDH, alkaline phosphatase, abdominal pain, loose stools, flatulence, heartburn, stomach cramps, colitis, jaundice GU: vaginitis, pruritus, candidiasis, increased BUN, nephrotoxicity, renal failure, pyuria, dysuria, reversible interstitial nephritis

NURSING CONSIDERATION

Determine history of hypersensitivity reactions to cephalosporins, penicillins, and history of allergies, particularly to drugs, before therapy is initiated. Inspect IM and IV injection sites frequently for signs of phlebitis. Report onset of loose stools or diarrhea. Although pseudomembrano us colitis. Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes.