These notes were stolen from TAMAYO, TEANU

CITICOLINE CNS Indications

BID8 1g 1tab Stimulant, Citicoline is indicated in CVD in acute recovery phase in severe s/sx of cerebrovascular
Peripheral insufficiency and in-cranial traumatism and their sequellae.
Vasodilators, MOA
Cerebral Citicoline consumption promotes brain metabolism by restoring phospholipid content in the brain
Activators, and regulation of neuronal membrane excitability. It also influences the mitochondria or energy
Nootropics factories of the brain cells and found to improve memory function. ^O2 and Blood flow to brain
involved in the biosynthesis action.
Contraindications
Any allergy or hypersensitivity to the drug
Hypertonia of the parasympathetic nervous system meclophenoxate
Use cautiously for pregnancy and lactation
Conscious use for patient with renal and hepatic damage
Adverse Effects
Fleeting and discrete hypotension effect, increased parasympathetic effects, low blood pressure
Itching or hives, swelling in face or hands, chest tightness, tingling in mouth and throat
Nursing Responsibilities
Take Citicoline as prescribed
Take Citicoline on time
Monitor patients neurologic status
Note if there are signs of slurring of speech
Note for adverse reactions
Titer medication when discontinuing
Teach patient on how to take the drug
Arrange for regular follow-ups
Carvedilol Beta-blocker Indications
2.5 mg Hypertension, alone or with other oral drugs, especially diuretics
1tab Treatment of mild to severe CHF of ischemic or cardiomyopathic origin with digitalis, diuretics, ACE
tab inhibitors
PM Left ventricular dysfunction (LVD) after MI
Unlabeled uses: Angina (2550 mg bid)
MOA
Significantly reduces plasma renin activity. Carvedilol causes vasodilation by blocking the activity
of -blockers, mainly at alpha-1 receptors. It exerts antihypertensive effect partly by reducing total
peripheral resistance and vasodilation. It is used in patients with renal impairment, NIDDM or
IDDM.
Adverse effects
Bradycardia, AV block, angina pectoris, hypervolemia, leucopenia, hypotension, peripheral edema,
allergy, malaise, fluid overload, melena, periodontitis, hyperuricemia, hyponatremia
Contraindications
Hypersensitivity; severe chronic heart failure, bronchial asthma or related bronchospastic
conditions; severe hepatic impairment. Patients with NYHA class IV cardiac failure, 2nd or 3rd AV
block, sick sinus syndrome (unless a permanent pacemaker is in place), cardiogenic shock or
severe bradycardia. Lactation.
Physical: Baseline weight, skin condition, neurologic status, P, BP, ECG, respiratory status, LFTs,
renal and thyroid function tests, blood and urine glucose
Interventions
Nursing consid.
WARNING: Do not discontinue drug abruptly after chronic therapy (hypersensitivity to
catecholamines may have developed, causing exacerbation of angina, MI, and ventricular
arrhythmias); taper drug gradually over 2 wk with monitoring.
Consult with physician about withdrawing drug if patient is to undergo surgery (withdrawal is
controversial).
Give with food to decrease orthostatic hypotension and adverse effects.
Monitor for orthostatic hypotension and provide safety precautions.

Ca+VitD 1 Tab Supplement Vitamin D helps your body absorb calcium and phosphorus. This combination medication is used
OD to prevent or treat low blood calcium levels in people who do not get enough calcium from their
diets. It may be used to treat conditions caused by low calcium levels such as bone loss
Side Effects
Constipation or stomach upset may occur.
Telmisartan Angiotensin MOA
+HLTZ receptor belongs to a class of medications known as angiotensin II receptor antagonists. These medications
40/12mg/tab blocker reduce blood pressure by blocking the actions of a chemical (angiotensin II) that causes blood
BID8 vessels to constrict or tighten. It is used to treat mild to moderate high blood pressure.
Side Effects
Dizziness or lightheadedness may occur as your body adjusts to the medication
Contraindications
Contra
Hypersensitivity to telmisartan or other angiotensin receptor antagonists (e.g., losartan, eprosartan,
etc.); pregnancy [(category C) first trimester, (category D) second and third trimester], lactation.
Nursing
Monitor BP carefully after initial dose; and periodically thereafter. Monitor more frequently with
preexisting biliary obstructive disorders or hepatic insufficiency.
Monitor dialysis patients closely for orthostatic hypotension.
NeuroAid Indication: It is suitable for those who have had a stroke within the past six months and suffer from
paralysis or reduced neurological functions as a result. The drug is able to help improve functions
such as the ability to speak, think, and move around.
MOA:
These notes were stolen from TAMAYO, TEANU

Neuroaid can assist individuals to make improved recoveries. It has the ability to increase the
production of neurons in the brain and also helps the neurons to connect with each other. This
essentially helps the brain to rewire itself so that communication between the brain and body can
be restored. Afterward, stroke patients may be able to regain their independence much quicker.
Brand name: Therapeutic Indication:
FluimucilGen category: Treatment of respiratory affections characterized by thick and viscoushypersecretions: acute
eric name: Mucolytic bronchitis, chronic bronchitis and its exacerbations; pulmonaryemphysema, mucoviscidosis and
Acetylcystein agent bronchiectasis.
e Mechanism of Action:
Exerts mucolytic action through its free sulfhydryl group which opensup the disulfide bonds in the
mucoproteins thus lowering mucous viscosity. The exactmechanism of action in acetaminophen
toxicity is unknown. It is thought to act by providingsubstrate for conjugation with the toxic
metabolite.
Adverse Effects:
Hypersensitivity reactions have been reported in patients receivingacetylcysteine, including
bronchospasm, angioedema, rashes and pruritus, may occur
Contraindication:
MAO inhibitor therapy within 14 days initiating therapy; severehypertension; severe. Coronary
artery disease, hypersensitivity to pseudoedephrine,acrivastine or any component; renal
impairment.
Nursing Responsibilities:
Monitor effectiveness of therapy and advent of adverse/allergic effects. Instruct patient in
appropriate use and adverse effects to report
ay zi thro Pregnancy MOA:
my'sin) Category B Azithromycin blocks transpeptidation by binding to 50s ribosomal subunit of susceptibl eorganisms
Zithromax,Zm Drug class anddisrupting RNA-dependent proteinsynthesis at thechainelongation step.
ax Contraindicated
Macrolid With hypersensitivityto azithromycin,erythromycin,or anymacrolideantibiotic.
Use cautiouslywith gonorrhea or syphilis,pseudomembranous colitis,hepatic or
renalimpairment,lactation.
Nursing
Culture site of infection beforetherapy.
Administer on anempty stomach 1 hr before or 23 hr after meals. Food affectsthe absorption of
thisdrug.
Take the full courseprescribed. Do nottake with antacids.Tablets and oralsuspension can betaken
with or withoutfood
Metformin Brand MOA
Name:Gluco Biguanide oral hypoglycemic agent. Unlike sulfonylureas, biguanides do not stimulate the release
500g 1tab phage, of insulin from the beta cells of the pancreas. Mechanism of action is thought to be due to both
(AM) Glucophage increasing the binding of insulin to its receptor and potentiating insulin action. Improves tissue
XR sensitivity to insulin, increases glucose transport into skeletal muscles and fat, and suppresses
1gm 1tab (PM) Classificatio gluconeogenesis and hepatic production of glucose, thus lowering blood glucose levels. TX: DM2
ns: hormone Contraindications
and Hypersensitivity to metformin; renal, hepatic, or cardiopulmonary insufficiency; alcoholism;
synthetic concurrent infection.
substitute; Nursing
antidiabetic; Monitor blood glucose and HbA1C, and lipid profile periodically.
biguanide Monitor known or suspected alcoholics carefully for decreased liver function.
Pregnancy Monitor cardiopulmonary status throughout course of therapy; cardiopulmonary insufficiency may
Category: B predispose to lactic acidosis.
Monitor for hypoglycemia
Generic Classificatio MOA
Name:Omepra ns:gastrointe An antisecretory compound that is a gastric acid pump inhibitor. Suppresses gastric acid secretion
zole stinal agent; by inhibiting the H+, K+-ATPase enzyme system [the acid (proton H+) pump] in the parietal cells.
40 mg 1tab proton pump Suppresses gastric acid secretion relieving gastrointestinal distress and promoting ulcer healing.
OD inhibitor Duodenal and gastric ulcer. Gastroesophageal reflux disease including severe erosive esophagitis
Pregnancy Contraindications
Category:C Long-term use for gastroesophageal reflux disease, duodenal ulcers; lactation. ab tests: Monitor
Availability: urinalysis for hematuria and proteinuria. Periodic liver function tests with prolonged use.
10 mg, 20 Nursing
mg, 40 mg Report any changes in urinary elimination such as pain or discomfort associated with urination, or
capsules blood in urine.Report severe diarrhea; drug may need to be discontinued.
Generic Classificatio MOA
Name:Lactulo ns:gastrointe Reduces blood ammonia; appears to involve metabolism of lactose to organic acids by resident
se stinal agent; intestinal bacteria. Acidifies colon contents, which retards diffusion of nonionic ammonia (NH3)
hyperosmoti from colon to blood while promoting its migration from blood to colon. In the acidic colon, NH3 is
20 cc c laxative converted to nonabsorbable ammonium ions (NH4) and is then expelled in feces by laxative action.
Pregnancy Cautious use
Category:C Diabetes mellitus; concomitant use with electrocautery procedures (proctoscopy, colonoscopy);
older adult and debilitated patients; pediatric use.
Nursing
Laxative action is not instituted until drug reaches the colon; therefore, about 2448 h is needed.
Do not self-medicate with another laxative due to slow onset of drug action.
Notify physician if diarrhea (i.e., more than 2 or 3 soft stools/d) persists more than 2448 h.
Diarrhea is a sign of overdosage.
Amlodipine Calcium MOA
besylate channel- Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells;
10mg tab blocker inhibits transmembrane calcium flow, which results in the depression of impulse formation in
AM Antianginal specialized cardiac pacemaker cells, slowing of the velocity of conduction of the cardiac impulse,
drug depression of myocardial contractility, and dilation of coronary arteries and arterioles and
These notes were stolen from TAMAYO, TEANU

1 tab PM Antihyperten peripheral arterioles; these effects lead to decreased cardiac work, decreased cardiac oxygen
sive consumption, and in patients with vasospastic (Prinzmetals) angina, increased delivery of oxygen
Pregnancy to cardiac cells.
Category C Contraindications and cautions
Contraindicated with allergy to amlodipine, impaired hepatic or renal function, sick sinus syndrome,
heart block (second or third degree), lactation.
Use cautiously with CHF, pregnancy.
WARNING: Monitor patient carefully (BP, cardiac rhythm, and output) while adjusting drug to
therapeutic dose; use special caution if patient has CHF.
Monitor BP very carefully if patient is also on nitrates.
Monitor cardiac rhythm regularly during stabilization of dosage and periodically during long-term
therapy.
Administer drug without regard to meals.
Vildagliptin ral anti- This medication is an oral antidiabetic agent, prescribed for type 2 diabetes mellitus along with
hyperglycem other medications
ic agent MOA
(anti-diabetic vildagliptin inhibits the inactivation of GLP-1[2][3] and GIP[3] by DPP-4, allowing GLP-1 and GIP to
drug) of the potentiate the secretion of insulin in the beta cells and suppress glucagon release by the alpha
new cells of the islets of Langerhans in the pancreas.
dipeptidyl Contra
peptidase-4 Contraindicated in patients with type 1 diabetes, diabetic ketoacidosis, severe liver impairment,
(DPP-4) during pregnancy and breastfeeding.
inhibitor Nursing
Caution should be exercised in patients with history of severe kidney disease.
It may cause dizziness or fatigue, do not drive a car or operate machinery while taking this
medication.
Patient may develop with increased risk of foot ulcers and blistering of the skin; if it is so consult
with your doctor.
Monitor liver function and blood sugar level regularly while taking this medication.
Side Effects :
Most Common : Low blood sugar level, tremor, headache, weight gain and fluid retention.
Central Nervous System : Dizziness, fatigue, and feeling weak.
OMX supplement Immune booster.
supplement
For maintenance & restoration of intestinal microbial balance during and after
treatment w/ antibiotics, chemotherapy, diarrhea, & other digestive disorder.
Preferably be taken 1 hr before meal
septaz Anti- Fourthgenerationcephalos porin thatinhibits bacterialcell wallsynthesis, promotesosmoticinstability,
infectives,ce anddestroys bacteria
phalosporin contraindicated in patient hypersensitiveto drug,cephalosporin, beta-lactam antibiotics, or penicillin
monitor for superinfection
Metoclopramid gastrointesti Potent central dopamine receptor antagonist. Structurally related to procainamide but has little
e nal agent; antiarrhythmic or anesthetic activity. Exact mechanism of action not clear but appears to sensitize
10mg iv 8 prn prokinetic GI smooth muscle to effects of acetylcholine by direct action. increases resting tone of esophageal
agent (gi sphincter, and tone and amplitude of upper GI contractions. As a result, gastric emptying and
stimulant); intestinal transit are accelerated with little effect, if any, on gastric, biliary, or pancreatic secretions.
autonomic Antiemetic action results from drug-induced elevation of CTZ threshold and enhanced gastric
nervous emptying. In diabetic gastroparesis, indicated by relief of anorexia, nausea, vomiting, persistent
system fullness after meals.
agent; direct- Contraindicatons
acting Sensitivity or intolerance to metoclopramide; allergy to sulfiting agents; history of seizure disorders;
cholinergic concurrent use of drugs that can cause extrapyramidal symptoms; pheochromocytoma;
(parasympat mechanical GI obstruction or perforation; history of breast cancer
homimetic); nursing
antiemetic Report immediately the onset of restlessness, involuntary movements, facial grimacing, rigidity, or
tremors. Extrapyramidal symptoms are most likely to occur in children, young adults, and the older
adult and with high-dose treatment of vomiting associated with cancer chemotherapy. Symptoms
can take months to regress.
Be aware that during early treatment period, serum aldosterone may be elevated; after prolonged
administration periods, it returns to pretreatment level.
Lab tests: Periodic serum electrolyte.
Monitor for possible hypernatremia and hypokalemia, especially if patient has CHF or cirrhosis.
Adverse reactions associated with increased serum prolactin concentration (galactorrhea,
menstrual disorders, gynecomastia) usually disappear within a few weeks or months after drug
treatment is stopped.
Tramadol Binds to mu-opoid receptors.Inhibits reuptakeof serotonin andnorepinephrinein the
50mg IV q8 CNS.Therapeuticeffect:decreased pain
prnpain NSAID contra
Resp depression,especially in presenceof cyanosis andexcessive bronchialsecretion, and after
opon biliary tract. Acutealcoholism, headinjuries, conditions inwhich intracranialpressure is raised.
Attack of bronchospasm. Heartfailure secondary tochronic lung disease
nursing
assess type, locationand intensity of painbefore 2-3 hr after administration.2. assess BP and
RR.Respi depression hasnot occurred withrecommended doses.3. advise patient to
changeposition slowly tominimize orthostatichypotension.4. do not confuse tramadolfrom toradol.
Paracetamol NSAID Decreases fever by a hypothalamic effect leading to sweating and vasodilation
Inhibits pyrogen effect on the hypothalamic-heat-regulating centers
Inhibits CNS prostaglandin synthesis with minimal effects on peripheral prostaglandin synthesis
Does not cause ulceration of the GI tract and causes no anticoagulant action.
Contra: renal insufficiency; anemia
These notes were stolen from TAMAYO, TEANU

Baclofen Central Baclofen is an antispastic. It inhibits both monosynaptic and polysynaptic reflexes at spinal level.
Iv tab bid acting Adverse effects
prn for hiccup muscle Sedation, drowsiness, ataxia, dizziness, headache, confusion, hallucinations, skin reactions, GI
relaxant symptoms, enuresis.
Contra
Hypersensitivity. Active peptic ulcer disease
nursing
Patients given implantable device for intrathecal delivery need to learn about the programmable
delivery system, frequent checks; how to adjust dose and programming.
Give with caution to patients whose spasticity contributes to upright posture or balance in
locomotion or whenever spasticity is used to increase function.
BLACK BOX WARNING: Taper dosage gradually to prevent hallucinations, possible psychosis
Lantus (insulin he primary activity of insulin, including insulin glargine, is regulation of glucose metabolism. Insulin
pen) and its analogs lower blood glucose levels by stimulating peripheral glucose uptake, especially by
14 u 5q OPITS skeletal muscle and fat, and by inhibiting hepatic glucose production. Insulin inhibits lipolysis in the
adipocyte, inhibits proteolysis, and enhances protein synthesis.
LANTUS is contraindicated in patients hypersensitive to insulin glargine or the excipients.
Nursing
Assess patient periodically for symptoms of hypoglycemia (anxiety; restlessness;
tingling in hands, feet, lips, or tongue; chills; cold sweats; confusion; cool, pale skin; difficulty in
concentration; drowsiness; nightmaresor trouble sleeping; excessive hunger; headache; irritability;
nausea; nervousness; tachycardia; tremor; weakness; unsteady gait)and
hyperglycemia (confusion, drowsiness; flushed, dry skin; fruit-like breath odor;
rapid, deep breathing, polyuria; loss of appetite; unusual thirst) during therapy.
Monitor body weight periodically. Changes in weight may necessitate changes in
insulin dose.
Brand Name: Bronchodilat It relieves nasal congestion and reversible bronchospasm by relaxing the smooth muscles of the
DUAVENTGe er bronchioles. The relief from nasal congestion and bronchospasm is made possible by the following
neric mechanism that takes place when Salbutamol is administered.
Name:IPRAT
ROPIUMSAL First, it binds to the beta2-adrenergic receptors in the airway of the smooth muscle which then
BUTAMOL leads to the activation of the adenyl cyclase and increased levels of cyclic- 35-adenosine
monophosphate (cAMP).
Neb q8 When cAMP increases, kinases are activated.
Kinases inhibit the phosphorylation of myosin and decrease intracellular calcium.
Decreased in intracellular calcium will result to the relaxation of the smooth muscle airways.
Contraindications

Hypersensitivity to adrenergic amines

Hypersensitivity to fluorocarbons

ssess lung sounds, PR and BP before drug administration and during peak of medication.
Observe fore paradoxical spasm and withhold medication and notify physician if condition occurs.
do back tapping afteryou nebulizer thepatient
Flumicil neb Monitor effectiveness of therapy and advent of adverse/allergic effects. Instruct patient in
q12 appropriate use and adverse effects to report