Mode of Action Generic Antiinfective Name: : Meropenem interferes with cell wall Brand replication Name: of susceptible Meronem

organisms; osmotically Dosage: 1 unstable cell gm IV every wall swells and 8 hours bursts from osmotic pressure

Medication

Indication For serious infections caused by grampositive or gramnegative organisms

Contraindicatio n Hypersensitivity to meropenem orimipenem

Adverse Reaction CNS:fever, somnolence, seizures, dizziness, weakness, headache, myoclonia CV:hypotension , palpitations GI:diarrhea, nausea, vomiting, pseudomembran eous colitis, hepatitis, glossitis Blood:eosinop hilia, neutropenia, decreased Hgb, Hct Integumentary :rash, urticaria, pruritus, pain at inj site, phlebitis, erythema at inj site RESP:chest discomfort, dyspnea, hyperventilation bronchospasm , angioedema, rashes and pruritus, may occur. Other advers e effects reported include nausea and vomiting,

Nursing Intervention Assess patient for previous sensitivity reaction to carbapenems Assess patient for signs and symptoms of infection, including characteristics of wounds, sputum, urine, stool Complete C/S tests before beginning drug therapy Assess for allergic reactions, anaphylaxis. Identify urine output Monitor blood studies Monitor electrolytes Assess bowel pattern daily Monitor for bleeding

Generic Name: Acetylcystei ne Brand Name: Fluimucil

Mucolytic agent: Exerts mucolytic action through its free sulfhydryl group which opensu p the disulfide

Treatm ent of respira tory affecti ons charact erized by thick and

MAO inhibitor therapy within 14 days initiating therapy; severe hypertensi on; severe Coronary

Monitor for effectiveness of therapy and occurrence of adverse reactions. Instruct patients SO in appropriate use and adverse effects to report. Monitor for bronchospasm.

Dosage: 600 b o n d s i n mg tab the BID mucoprot eins thus lowering mucous viscosity . The e x a c t mech anism of action in acetaminoph en toxicity is unknown. It is thought to act by providingsub strate for conjugation with the toxic metabolite. Generic AntiName: anginal: Ivabradine Ivabradine is HCL a pure heart rateBrand lowering Name: agent, acting Coralan by selective and specific Dosage: 7.5 inhibition mg 1 tab of the OD cardiac pacemaker current that controls the spontaneous diastolic depolarisatio n in the sinus node and regulates heart rate. The cardiac

viscou s hyperse cretions : acute bronchit is, chronic bronchit is and its exacerb ations; pulmon ary emphysem a, mucovisci dosis and bronchiect asis Symptoma tic treatment of chronic stable angina pectoris in coronary artery disease in patients w/normal sinus rhythm.

artery disease, hypersensi tivity to pseudoede p h r i n e , acriva stine or any component

fever, syncope, sweating, arthralgia, b lurred vision, disturbances of liver function.

Monitor vital signs.

hypersensitivity, blood pressure is<90mmHg;sick sinus syndrome

cardiovascular :bradycardia,p alpitations,sup raventriculare xtrasystoles GI: nausea, constipation

Monitor BP and pulse before therapy, during dosage titration, and periodically throughout therapy. Assess for signs of CHF ( peripheral edema, crackles, dyspnea, weight gain, jugular venous distention) Angina: Assess location, duration, intensity and precipitating factors of patient's anginal pain. Hypertension: Check frequency of refills to monitor adherence.

effects are specific to the sinus node with no effect on intra-atrial, atrioventricu lar or intraventricu lar conduction times, nor on myocardial contractility or ventricular repolarisatio n Generic Name: Atorvastatin calcium Brand Name: Lipitor Dosage: 40 mg 1 tab q8 pm Antihyperlip idemic: Reduces plasma cholesterol and lipoprotein levels by inhibiting HMG-CoA reductase and cholesterol synthesis in the liver and by increasing the number of LDL receptors on liver cells to enhance LDL uptake and breakdown. -patients with primary hyperchole sterolemia and mied lipidemia - To increase HDL-C in patients with primary hyperchole sterolemia and mixed dyslipidem ia hypersensitive to drugs and in those with active liver disease or unexplained persistent elevations of transaminase levels CNS: Abnormal dreams, amnesia, asthenia, emotional lability, facial paralysis, fever, headache, hyperkinesia, lack of coordination, malaise, paresthesia, peripheral neuropathy, somnolence, syncope, weakness, insomnia CV: Arrhythmias, elevated serum CK level, orthostatic

Monitor serum potassium p eriodically. Hypokalemia increases the risk of arrhythmias and should be corrected.

Assess allergy to atorvastatin, fungal byproducts; active hepatic disease; acute serious illness. Assess physical condition noting orientation, affect, muscle strength; liver evaluation, abdominal examination; lipid studies, LFTs, renal function tests. Obtain LFTs as a baseline and periodically during therapy; discontinue drug if AST or ALT levels increase to 3 times normal levels. Withhold atorvastatin in any

hypotension, palpitations, phlebitis, vasodilation, peripheral edema EENT: Amblyopia, altered refraction, dry eyes, dry mouth, epistaxis, eye hemorrhage, gingival hemorrhage, glaucoma ENDO: Hyperglycemi a or hypoglycemia GI: Abdominal or biliary pain, anorexia, colitis, constipation, diarrhea, duodenal or stomach ulcers, dysphagia, esophagitis, flatulence, gastroenteritis , hepatic failure, hepatitis, increased appetite, indigestion, rectal hemorrhage, tenesmus, vomiting, dyspepsia,

acute, serious condition (severe infection, hypotension, major surgery, trauma, severe metabolic or endocrine disorder, seizures) that may suggest myopathy or serve as risk factor for development of renal failure. Ensure that patient has tried cholesterollowering diet regimen for 36 mo before beginning therapy. Administer drug without regard to food, but at same time each day. Atorvastatin may be combined with a bile acidbinding agent. Do not combine with other HMG-CoA reductase inhibitors or fibrates. Consult dietitian about lowcholesterol diets.

nausea, constipation GU: Abnormal ejaculation; cystitis; decreased libido; dysuria; hematuria; impotence; nephritis; nocturia; renal calculi; urinary frequency, incontinence, or urgency; urine retention; UTI Heme: Anemia, thrombocytop eni Musculoskelet al: Arthralgia, back pain, bursitis, gout, leg cramps, myasthenia gravis, neck rigidity, tendon contracture, arthritis Respiratory: Dyspnea, pneumonia, bronchitis Skin: Acne, alopecia, contact dermatitis, diaphoresis, dry skin, ecchymosis, ,

Generic Name: Levetiraceta m

Antiepileptic : unknown, but it inhibits the spread of seizure activity in Brand the brain Name: may be Keppra, Keppra XR related to its ability to inhibit Dosage: 250 polysynaptic responses mg/5 ml 5 and block ml at 8 am posttetanic and 8 pm potentiation

-adjunct in Hypersensitivity partial to levetiracetam seizures Monothera py for partial seizures w/ or w/o secondary generalisat ion

jaundice, petechiae, photosensitivi ty, pruritus, rash, seborrhea, ulceration, urticaria Other: Allergic reaction, facial or generalized edema, flulike symptoms, infection, lymphadenop athy, weight gain Somnolence, asthenia, dizziness, vertigo, depression, emotional instability, hostility, nervousness, ataxia, tremor, amnesia, headache, nausea, dyspepsia, diarrhoea, anorexia, rash, diplopia.

Generic Name: Furosemide Brand

Loop diuretic: Acts on the ascending loop of Henle

Edema in CHF, nephritic syndrome, ascites

Hypersensitivity to sulfonamides Anuria, hypovolemia, electrolyte

CNS: headache, fatigue, weakness, vertigo, paresthesias

Revert to IV use for short-term when oral administration is noit feasible; revert to oral use as soon as patient is able. Give drug with food to prevent GI upset. If CNS, vision and coordination changes occur, establish safety precautions. Do not stop drug abruptly. Risk of seizure precipitation: withdraw gradually. Assess patient for tinnitus, hearing loss, ear pain. Monitor for renal, cardiac, neurologic, GI,

Name: ApoFurosemide (CAN), Lasix

in the kidney; inhibiting reabsorption of electrolytes sodium and Dosage: 400 chloride, mg IV PRN causing excretion of sodium, calcium, magnesium, chloride, water and some potassium

depletion CV:orthstatic hypotension, chest pain, ECG changes, circulatory collapse EENT: loss of hearing, ear pain, tinnitus, blurred vision ELECTROLYT ES:hypokalemia, hypochloremi c alkalosis, hypoagnesemia, hyperuricemia ENDO: hyperglycemia GI: nausea, diarrhea, dry mouth, vomiting, anorexia, cramps, pancreatitis GU: polyuria, renal failure, glycosuria HEMA: thrombocytopeni a, agranulocytos is,l eucopenia, anemia INTEG:rash, pruritus, purpura, sweating, photosensitivi ty, urticaria

pulmonary manifestation of hypokalemia :acidic urine, decreased urine osmolality, nocturia, polyuria and polydipsia Monitor for CNS, GI, cardiovascular, integumentary, neurologic manifestations of hypocalcemia: personality changes, anxiety, disturbances Monitor for manifestations of hyponatremia Monitor electrolytes