Drug study1.Citicholine 1gm IVTT q 6 hoursC:Neurotonic,nootropic,CNS stimulant A: Activates the biosynthesis of structural phospholipids in the neural membrane,increases cerebral metabolism and increases the level of various transmitters, including acetycholine and dopamine.Citicholie has shown neuroprotective effects in situations of hypoxia and ischemia.I:cerebral vasculature diseaseC:tachycardia,nausea and vomitting,insomnia,blurred visionA: Exert a stimulating action of the parasympathetic, as well as fleeting and discrete hypotensor effectN:Watch out for hypotensive effects

2Atorvastatin 8mg/tab OD pc supperC:HMG-CoA reductaseA:Prevent the production of cholesterol in the liver by inhibiting HMG CoA reductase, an enzyme that makes cholesterol. Reduces toatl cholesterol I:reduction of risk for stroke and heart attack in DM type 2C:hypersensitivity,active liver disease, pregnancy and lactationA:headache,flatulence,diarrhea,nausea and vomitting,myalgiaN:tell patient to take medication te same time each day to maintain its effectInstruct client to notify physician if unexplained muscle pain,tenderness ,weakness occurs,especially if accompanied by feverAdvise patient that this medications should be used in conjucton with diet restrictions(fat cholesterol,alcoholcarbohydrates)

3.Amino acid (Ketosteril)60mg/tab TID pcC:Ketoanalogs;essential amino acidsA: Normalizes metabolic process, promotes recycling product exchange. Reduces ion concentration of potassium, magnesium and phosphate.I: Protein energy malnutritionPrevention and treatment of conditions caused by modified or insufficient protein metabolism in chronic renal failureC: Allergy and hypersensitivity to any content of this drugHypercalcemiaDisturbed amino acid metabolismCaution use for patietn with phenylketonuriA:HypercalcemiaN:Evaluate for any contraindicationsTake drug as prescribedWarn the patient about possible side effects and how to recognize themGive with food if GI upset occursFrequently assess for hypercalcemia4.Clopidogrel 75mg/tab 1tab OD pc lunchC:Platelet aggregation inhibitor;Anti-platelet rug

A:Inhibits platelet aggregation by irreversibly inhibiting the binding of ATP to platelet receptorsI:reduction of atherosclerotic event(MI ,stroke,Vasculature disease)C:Hypersensitivity, Pathologic bleeding (peptic ulcer,intracranial hemorrhage),lactationA:GI bleeding, thrombotic thrombocytopenic purpura,fatigue,epistaxis,edema,arthralgiaN:Asssess patient for symptoms of strokeAssess for any signs of bleedingMonitor patient for signs of thrombotic thrombocytopenia purpura

5.Lactulose 30cc OD q HS C:osmotics;laxativesA:Metabolism of lactulose by bacteria results In reduced colonic pH which stimulates peristalsis and decreases water reabsorption from the feces further facilitates the passage of soft well formed stools.And increased osmotic pressure of fecal material secondary to an increase in colonic organic acids results in accumulation of fluid from surrounding tissues,helping to soften stool mass.I:ConstipationC:low galactose diet and intestinal obstructionA: Abdominal discomfort associated with flatulence or cramps. Prolong use or large doses may result in diarrhea with excessive loss of water and electrolytesN:Do not administer if patient has already pass out stool especially if stool is liquidAdvise client not to constantly use laxatives because this may lead to dependenceAssess color, consistencyand amount of stool produced 6.Sitagliptin 50mg/tab 1 tab OD po pc lunchCdipeptidyl peptidase-4 (DPP-4) inhibitorsA:reduces blood glucose levels by inhibiting DPP-4 and increasing the levels of GLP-1 and GIP.I:Sitagliptin is combined with diet and exercise to improve blood glucose levels in patients with type 2 diabetes. It also may be combined with other types of oral drugs for diabetes or insulin.C;Used cautiously with renal disorders,hypersensitivityA:upper respiratory tract infection and headache,abdominal pain,nausea and diarrhea.N: Advise to combined with exercise and diet to improve blood glucose levels in individuals with type 2 diabetes. Side effects, drug interactions, warnings and precautions, and pregnancy information should be reviewed prior to taking this medication.

7.Amlopdipine 5mg/tab;1 tab OD pc supperClassification: Calcium Channel Blocker

Action: Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells; inhibits transmembrane calcium flow, which results in the depression of impulse formation in specialized cardiac pacemaker

cells, slowing the velocity of conduction of the cardiac impulse, depression of myocardial contractility and dilation of coronary arteries and arterioles and peripheral arterioles. These effects lead to decreased cardiac work, decreased cardiac oxygen consumption and in patients with vasospastic (Prinzmetal’s) angina, increased delivery of oxygen to cardiac cells

Indication: Angina Pectoris, essential hypertension Contraindication: Hypersensitivity to amlodipine, impaired hepatic or renal

function, sick sinus syndrome, heart block, lactation. Adverse effects:

CNS: Dizziness, light-headedness, headache, asthenia, fatigue, lethargy CV: Peripheral edema, arrhythmias Derma: Flushing, Rash GI: Nausea, abdominal discomfort

Nursing considerations: a. Assess skin lesions, color, edema and acquire baseline ECG. b. Assess routinely for signs and symptoms of CHF such as dyspnea, rales/crackles, weight gain, peripheral edema, jugular venous distention c. Monitor patient carefully while adjusting drug to therapeutic dose, use special caution if patient has heart failure. d. Monitor Input and Output and daily weights. Auscultate daily for pulmonary rales. e. Administer drug without regards to meals. Report irregular heartbeat, shortness of breath, swelling of the hands or feet and pronounced dizziness, constipation. f. Take with meals if stomach upset occurs.

g. Tell patient that side effects like nausea and vomiting and headache may be experienced8.Clonidine 75mg/tab; 1tab sublingualC:Adrenergics: Anti-hypertensivesA: thought to stimulate the alpha2-adrenergic receptors centrally and inhibit the central vasomotor centers,thereby decreasing sympathetic outflow to the heart,kidneys, and peripheral vasculature,resulting in decreased peripheral vascular resistance,systolic and diastolic blood pressure and heart rateI:Essential hypertensionC: Hypersensitivity to drugA: drowsiness,dizziness,sedation,severe rebound hypertension,weight gain, pruritis, urine retention,dry mouthN:Monitor blood pressure before and after administration of medication Instruct patient about the side effect of the medications Raise side-rails and dangle legs before ambulating for orthostatic hypotension Instruct client that abrupt discontinuation of drug may cause severe rebound hypertension 9.Humulin-R insulinC:Short acting insulin;

A:Human recombinant is a hormone that is produced in the body to treat diabetes. It is a synthetic insulin,it lowers blood glucoseI:DM type 2C:Hypersensitivity,HypoglycemiaA:sweating,dizziness,palpitation, blurred vision,hypoglycemiaN:Watch for signs of hypoglycemia such as cold-clammy hands,dizziness,and etc Instruct px to avoid simple sugar food Rotate injection site to prevent lipodystrophy Administer insulin at room temperature

10. Cilostazol 50mg/tab BID pc BF and supperC:Anti-platelet and vasodilatorA:Reduces pain of intermittent claudication by dilating the arteries,therby improving the flow of blood and oxygen to the legs.Also reduces the ability of blood to clotI:Intermittent ClaudicationC:hypersensitivityblood disorders,heart disease,kidney diseaseA;Headache,diarrhea ,runny nose and dizzinessN: Assess for pain in the leg Monitor for bleedings Instruct client if headache ,diarrhea ,runny nose persist consult your physician immediately