Generic/Brand Name & Classification Generic: simvastatin

Dose, Strength& Formula Ordered: 40mg 1 tab OD

Indication/Mechanis m of action Indications: To treat hyperlipidemia, homozygous familial hypercholesterolemia , adolescent familial heterozygous hypercholesterolemia Mechanism Of Action: Interferes with the hepatic enzyme hydroxymethylbutar yl-conenzyme A reductase. This action reduces the formation of mevalonic acid, a cholesterol precursor, thus interupting the pathway necessary for cholesterol synthesis (Jones and Bartlett 2011, 940941).

Adverse effects/Drug Interactions Drug Interaction: Increased risk for myopathy, bleeding. Decreased simvastatin bioavailability. Increased risk for acute renal failure. Adverse Effects: CNS: Dizziness, fatigue, headache CV: Chest pain GI: Abdominal pain, diarrhea, flatulence, nausea, vomiting, constipation, pancreatitis. MS: Myalgia, myopathy RESP: Upper respiratory tract infection

Nursing Responsibilities Before: 1. Use simvastatin cautiously in elderly patients and with renal or hepatic impairment. During: 1. Monitor serum lipoprotein level, as ordered.

Rationale

Client Teaching

Brand: Zacor

Timing: 8pm Duration: Unknown

1. To avoid further complication of the disease (jones and Bartlett 2011, p.941). 1. To evaluate response to therapy (Jones and Bartlett 2011, p.941). 2. To decrease risk of drug toxicity (Jones and Bartlett 2011, p.941).

-Urge patient to take drugs in the evening. -Urge patient to follow low fat, cholesterol lowering diet. -Urge patient to notify prescriber immediately about muscle pain, tenderness or weakness.

Classifications: Chemical Class: Synthetically derived fermentation product of Aspergillusteneus Therapeutic Class: Antihyperlipidemi c Pregnancy Category: X

Other forms: I.V.F, I.M, I.V, Tablets, Oral Solution

2. Patient must avoid grape juice.

SKIN: Eczema, pruritus, After: rash 1. Expect to monitor liver function test results every 3 to 6 months

1. For abnormal elevation if present (Jones and Bartlett 2011, p.941).

Generic/Brand Name & Classification Generic: omeprazole

Dose, Strength& Formula Ordered: 40g IVTT OD Timing: 10am Duration: Unknown

Indication/Mechanis m of action Indications: To provide shortterm treatment of active benign ulcer, to treat duodenal or gastric ulcer associated with Helicobacter pyloru and to provide longterm treatment of gastric hypersecretory conditions Mechanism Of Action: Omeprazole interferes with gastric acid secretion by inhibiting the hydrogen-potassiumadenosine triphosphate enzyme system or proton pump in gastric parietal cells. Normally proton pump uses energy from hydrolysis of

Adverse effects/Drug Interactions Drug Interaction: Decreased clearance and increased blood vessels, plasma atazanavir or nelfinavir level. Increased blood levels of omeprazole and clarithromycin. Adverse Effects: CNS: Agitation, dizziness, fatigue, headache, drowsiness CV: Chest pain, hypertension, peripheral edema ENDO: Hypoglycemia EENT: Neuritis, stomatitis GI: Abdominal pain, constipation, diarrhea, flatulence, nausea, vomiting, indigestion, pancreatitis GU: Interstitial nephritis MS: Back pain RESP: Cough SKIN: Pruritus, StevenJohnson Syndrome,

Nursing Responsibilities BEFORE: 1. Be aware of long-term use of omeprazole.

Rationale

Client Teaching

Brand: Losec

1. May increase the risk of gastric carcinoma (Jones and Bartlett 2012, p.764). 1. Drug can interfere with absorption of vitamin B12 (Jones and Bartlett 2011, p.764). 2. May increase gastric secretion during therapy (Jones and Bartlett 2011, p.765).

-Advise patient to notify prescriber immediately about abdominal pain or diarrhea.

Classifications: Chemical class: Substituted benzimidazole Therapeutic class: Antiulcer Pregnancy category: C

Other forms: Delayed release capsule Tablets, pral suspension

DURING: 1.Monitor patient for macrocytic anemia.

2. Encourage patient to avoid alcohol, aspirin products, ibuprofen.

1. Documentation is a legal paper that the medication was truly administered to the right patient. (Deglin and vallerand,2005)

AFTER: 1. Document the medication in the patients chart (time,dateand dose)

adenosine triphosphate to drive hydrogen and chloride out of parietal cells and into the stomach lumen in exchange for potassium that leaves the stomach lumen and enters parietal cells (Jones and Bartlett 2011, p.704).

urticarial OTHERS: Anaphylaxis, angioedema, hyponatremia

IVF STUDY
TYPE OF SOLUTION PNSS Plain Normal Saline Solution CLASSIFICATION Isotonic Table Salt (sodium chloride) CONTENT 0.9% sodium chloride MECHANISM INDICATIONS OF ACTION Plasma volume *Used to give expander IVF/Intravenous fluid to the patient suffering from salt and water deprivation CONTRAINDICATIONS None HOW SUPPLIED 1000ml/ 1L DOSE NURSING RESPONSIBILITIES 30 *Monitor patient ggts/miin frequently for: a. Signs of infiltration or sluggish flow. b. Signs of phlebitis/infection. c. Dwell time of catheter and need to be replaced d. Condition of catheter dressing. * Check the level of the IVF. *Correct medication solution an volume is given. *Check and regulate the drop rate. *Change the IVF solution if needed.