GENERIC NAME: DILTIAZEM TRADE NAME: Cardizem CD, CartiaXT, Dilacor XR, Dilt-XR, Diltia XT, Diltiazem HCl

extended-Release, Taztia XT, Tiazac, Cardizem LA (Extended-Release) CLASSIFICATION: Calcium channel blocker ACTION: Inhibits influx of Ca through cell membrane, resulting in depression of automaticity and conduction velocity in cardiac muscle; Decreases SA and AV conduction and prolongs AV node effective and functional refractory periods; Also decreases myocardial contractility and peripheral vascular resistance; decrease in HR INDICATIONS: Angina pectoris due to coronary artery spasm; Chronic stable angina; Hypertension (extended- or sustained-release only); Temporary control of rapid ventricular rate in A-Fib or flutter; Rapid conversion of paroxysmal SVT to sinus rhythm. ROUTES OF ADMINISTRATION: Tablets (Immediate- and Extended-Release), ExtendedRelease Capsules, IV Bolus, Continuous Infusion IV USUAL DOSAGE: Angina: initial 30 mg 4X daily, then increase gradually to total dose of 180360 mg (3-4 doses), 180 mg Ext. Release initially, then increase to 360 mg; HTN: 180-240 mg Ext. Release once daily, may titrate up to 540 mg/day: A-Fib IV bolus: 0.25 mg/kg given over 2 min, then if inadequate, second dose (0.35 mg/kg) in 15 min; Continuous Inf IV: Initial infusion rate is 10 mg/hr, may be increased in 5 mg increments to 15 mg/hr ADVERSE REACTIONS: AV block, bradycardia, edema, dizziness/lightheadedness, headache, dyspnea, rhinitis, infection, pain INTERACTIONS: Amiodarone possible cardiotoxicity with bradycardia and cardiac output; anesthetics - risk of depression of cardiac contractility, conductivity, and automaticity as well as vascular dilation; Digoxin possible serum digoxin levels; Lithium - risk of neurotoxicity; Theophyllines risk of pharmacologic and toxicologic theophylline effects CONTRAINDICATIONS: Hypotension or cardiogenic shock; second- or third-degree AV block and sick sinus syndrome except in presence of a functioning ventricular pacemaker; acute MI, pulmonary congestion; IV diltiazem with IV beta-blockers: A-Fib or atrial flutter associated with an accessory bypass tract; ventricular tachycardia; use of Cardizem LyoJect Syringe in newborns, lactation NURSING CONSIDERATIONS: Do not confuse Cardizem with Cardene; sublingual nitroglycerin may be taken concomitantly for acute angina; diltiazem may also be taken together with long-acting nitrates; note edema or CHF; review ECG for AV block; monitor vital signs, renal and liver function tests; take extended-release capsules on an empty stomach; do not open, chew, or crush; swallow whole; may cause drowsiness/dizziness; record blood pressure for review; rise slowly from lying to sitting to standing position

GENERIC NAME: DOCUSATE SODIUM TRADE NAME: Colace, Dioctyn Softgels, Docu, D.O.S., D-S-S, Dulcolax Stool Softener, Ex-Lax Stool Softener, Gena Soft, Non-Habit Forming Stool Softener, Phillips Liqui-Gels, Regulex SS, Silace Stool Softener CLASSIFICATION: Laxative, Emollient ACTION: Acts by lowering the surface tension of feces and promoting penetration by water and fat (increases softness of fecal mass; not absorbed systematically, does not seem to interfere with absorption of nutrients INDICATIONS: Lessens strain of defecation in persons with hernia or CV diseases or other diseases in which stool straining should be avoided; megacolon or bedridden patients; Constipation associated with dry, hard stools ROUTES OF ADMINISTRATION: Capsules, Soft-Gel Capsules, Oral Liquid, Syrup, Tablets USUAL DOSAGE: Adults and persons above 12 y/o: 50-500 mg; Under 3 y/o: 10-40mg; 3-6 y/o: 20-60 mg; 6-12 y/o: 40-120 mg
ADVERSE REACTIONS: Diarrhea, nausea & vomiting, perianal irritation, flatulence, cramps, dehydration, electrolyte balance disturbance due to dehydration INTERACTIONS: May absorption of mineral oil from GI tract; CONTRAINDICATIONS: Nausea, vomiting, abdominal pain, intestinal obstruction; severe abdominal pain due to appendicitis, enteritis, ulcerative colitis, diverticulitis, intestinal obstruction, fecal impaction, undiagnosed abdominal pain NURSING CONSIDERATIONS: Drink glass of water with each dose; may take oral solutions with milk or juice to help mask taste; may take 1-3 days to soften fecal matter due to minimally absorbing docusate salts; assess activity levels, diet, water intake, exercise routines; have client identify habits and BM activities; note length of time it takes for laxative to take effect; with abdominal pain and discomfort, note location, triggers, type of discomfort, rule out other intestinal disorders/obstruction where laxatives should not be used