Drug Study "cardiovascular"

FUNCTION: it is an Iron Supplement. It elevates the serum iron concentration, which then helps to form Hgb or trapped in the reticuloendothelial cells for storage and eventual conversion to a usable form of iron. DRUG NAME: FEOSOL GENERIC NAME: ferrous sulfate BRAND NAME/S: Feosol, Fer-Gen-Sol, Fer-in-Sol, Fer-In-Sol, Feratab, FeroSul, Ferra T.D. Caps, Ferro-Bob, Lydia E. Pinkham, MyKidz Iron 10, Slow Fe, Slow Release Iron DOSAGE/ROUTE/STANDARD DIRECTIONS: Adults: Daily requirements: Men, 10 mg/day PO; women, 18 mg/day PO: pregnant and lactating women, 30-60mg/day PO Replacement in iron-deficiency anemia: 90-300mg/day (6 mg/kg/day) PO for approximately 6-10 mo maybe required. Pediatric: 10-15mg/day PO daily requirements.

USE: Ferrous sulfate is used to treat iron deficiency anemia (a lack of red blood cells caused by having too little iron in the body). ABSORPTION: absorb rapidly in the intestine EXCRETION: Unknown

SIDE EFFECT/ADVERSE REACTION: constipation, upset stomach, black or dark-colored stools, temporary staining of the teeth. Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. NURSING CONSIDERATIONS: confirm the doctors order. Give the drug with meals (avoiding coffee, egg, milk, tea). Warn patient that the stool maybe dark or green. Arrange for periodic monitoring of Hct and Hgb levels. Assess for the reaction of the drug for 5 hrs. Document the procedure.

FUNCTION: Oral anticoagulant, Coumarin derivative. DRUG NAME: Warfarin

GENERIC NAME: Warfarin

BRAND NAME/S: Coumadin DOSAGE/ROUTE/STANDARD DIRECTIONS: Adults: 2-5mg/day PO. Adjust dosage according to PT response. For maintenance 210 mg/day PO based on PT ratio or INR. Geriatric patients: lower doses are usually needed; begin with saller doses than those recommended for dults, and closely monitor PT or INR. USE: Venous thrombosis and its extension, treatment, prophylaxis. Treatment of thromboembolic complications of atrial fibrilliation with embolization and cardiac valve replacement. Pulmonary embolism, treatment prophylaxis. ABSORPTION: absorb in the intestines and crosses the placenta EXCRETION: feces, urine SIDE EFFECT/ADVERSE REACTION: alopecia, urticaria, dermatitis, nausea, vomiting, anorexia, abdominal cramping, diarrhea, retroperitoneal hematoma, priapism, nephropathy, red-orange urine. NURSING CONSIDERATIONS: verify the doctor’s order. assess allergy to warfarin. Do not use drug if the patient is pregnant (use contraceptives). Monitor closely PT ratio and INR. Administer the drug in IV form if the client can not take it orally. Document the procedure.

FUNCTION: it is a granulocyte colony-stimulating factor. Increases the production of neutrophils within bone marrow with little effects on the production of other hemopoietic drug. DRUG NAME: Neupogen GENERIC NAME: Filgrastim

BRAND NAME/S: Neopogen DOSAGE/ROUTE/STANDARD DIRECTIONS: Adults: 100-120mg PO TID or QID. Reduce dose when symptoms improve. Use up to 1,200 mg/day in severe urinary urgency following pelvic radiotherapy. USE: To decrease the incidence of infection in patients with nonmyeloid mlignancie receiving myelosuppressive anticancer drugs . to reduce the time of neutrophil recovery and duration of fever, following induction or consoliadation chemotherapy treatment for acute myeloid leukemia. Treatment of severe chronic neutropenia. ABSORPTION: absorb in the intestine and crosses the placenta EXCRETION: Unknown SIDE EFFECT/ADVERSE REACTION: headache, fever generalized weakness, fatigue, alopecia, rash, nausea, vomiting, stomatitis, anorexia, bone pain, generalized pain. NURSING CONSIDERATIONS: Verify the doctor’s order. hypersensitivity to E. coli products, pregnancy, lactation. Obtain CBC and platelet count before and twice weekly before therapy. Doses maybe increase after chemotherapycycles. Do not give the drug within 24hr after the chemotherapy. Document the procedure.

FUNCTION: it is an anticoagulant. It inactivate factor XA, therefore inhibiting thrombus and clot formation by blocking the conversion of prothrombin to thromboplastin and fibrinogen to fibrin, the final steps in clotting process. DRUG NAME: Heparin GENERIC NAME: Heparin

BRAND NAME/S: Hepalean, Heparin Leo DOSAGE/ROUTE/STANDARD DIRECTIONS: Adults:

Subcutaneous (deep subcutaneous injection) – IV loading dose 5,000 units the 10,000-20,000 units ubcutaneously followed by 8,000-10,000 units q 8hr or 15,00020,000 q 12hr. Intravenous – initial dose of 10,000 units and then 5,000-10,000 units q 4-6hr thereafter for 7 days or until patient is fully ambulatory. USE: For the prevention and treatment of venous thrombosis and pulmonary embolism. For the treatment of atrial fibrillation with embolization. Diagnosis and treatment of DIC. Prevention of clotting in blood samples and heparin lock sets during dialysis procedure. ABSORPTION: broken down in the liver EXCRETION: Urine SIDE EFFECT/ADVERSE REACTION: loss of hair, bruising, thrombocytopenia, elevated AST, ALT levels, hyperkalemia, chills, fever, urticaria, asthma NURSING CONSIDERATIONS: Verify the doctor’s order. Assess for recent surgery or injury; sensitivity to heparin; hyperlipidemia; pregnancy. Adjust dose according to coagulation test results performed just before injection (30 min before each intermittent dose or q 4-6 hr if continous IV dose). Therapeutic range aPTT: 1.5-2.5 times control. Always check compatibilities with other IV solutions. Use heparin locked needles to avoid repeated injections. Give deep subcutaneous injection; do not give heparin by IM injection. Document the procedure.

FUNCTION: it is a thrombolytic agent. DRUG NAME: Urokinase GENERIC NAME: Urokinase

BRAND NAME/S: Abbokinase DOSAGE/ROUTE/STANDARD DIRECTIONS: Adults – give through constant infusion pump: Priming dose of 4,400 IU/kg as an admixture with 5% dextrose injection or 0.9% sodium chloride at rate of 90 ml/hr over 10 min. Then give 4, 400 UI/kg/hr at a rate of 15ml/hr for 12 hr. At the end of infusion, flush the tubing wit 0.9% of sodium chloride or 5% dextrose injection equal to the volume of the tubing. At the end of infusion, treat with continous heparin IV

infusion. USE: For lysis of pulmonary emboli or pulmonary emboli with unstable hemodynamics in adults. ABSORPTION: absorb in the intestine and crosses the placenta and in the breast milk EXCRETION: Unknown SIDE EFFECT/ADVERSE REACTION: headache, angionorotic edema, arrhythmias, skin rash, uticaria, itching, flushing, bleding. Difficulty of breathing, bronchospasm. NURSING CONSIDERATIONS: Verify the doctor’s order. assess history of hypersensitivity to urokinase. Regulary monitor coagulation studies. Apply pressure or pressure dressing to control superficial bleeding. Avoid any arterial invasive procedures. Arrange for blood typing and cross matching of blood if serious blood loss occurs. Document the procedure.

FUNCTION: it is a synthetic vitamin, it allows the absorption of vitamin B12, which is essential to cell growth and reproduction, hematopoeisis and nucleoprotein. DRUG NAME: Vitamin B12 (intranasal) GENERIC NAME: Cyanocobalamin

BRAND NAME/S: Vitamin B12 DOSAGE/ROUTE/STANDARD DIRECTIONS: One spray (500mcg) in one nostril, once per week.

USE:Maintenance of patient in hematologic remission after IM vit B12 therapy for pernicious anemia. Maintenance in therapeutic levels of vitamin B12 in patients with HIV, AIDS, MS, and Chrons disease.

ABSORPTION: absorb in the intestine and amy cross in the placenta and breast milk. EXCRETION: Unknown SIDE EFFECT/ADVERSE REACTION: headache, bone marrow suppression, rhinitis, nasal congestion, fever, pain, local irritation. NURSING CONSIDERATIONS: Verify the doctor’s order . confirm diagnosis before administering the drug. Monitor serum of vitamin B12. Document the procedure.

FUNCTION: it is a Immunostimulant . Treatment of Anemia of Chronic Renal Failure DRUG NAME: Epogen Factor VIII GENERIC NAME: Epoetin Alfa

BRAND NAME/S: Epogen DOSAGE/ROUTE/STANDARD DIRECTIONS: Starting Dose: Adults Pediatric Patients 50 to 100 Units/kg TIW; IV or SC 50 Units/kg TIW; IV or SC Increase Dose by 25% If: 1. Hemoglobin is < 10 g/dL and has not increased by 1 g/dL after 4 weeks of therapy or 2. Hemoglobin decreases below 10 g/dL Reduce Dose by 25% When: 1. Hemoglobin approaches 12 g/dL or,

2. Hemoglobin increases > 1 g/dL in any 2-week period USE: is indicated for the treatment of anemia in patients with chronic renal failure (CRF) on dialysis. EPOGEN® is indicated to elevate or maintain the red blood cell (RBC) level and to decrease the need for transfusions in these patients. ABSORPTION: unknown EXCRETION: t 1/2 • SIDE EFFECT/ADVERSE REACTION: chest pain or heavy feeling, pain • • • •

spreading to the arm or shoulder, nausea, sweating, general ill feeling; feeling short of breath, even with mild exertion; sudden numbness or weakness, especially on one side of the body; sudden headache, confusion, problems with vision, speech, or balance; or pain or swelling in one or both legs.

eeling short of breath, even with mild exertion; swelling of your ankles or feet; increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness); feeling light-headed, fainting; or seizure (black-out or convulsions). NURSING CONSIDERATIONS: check the doctor’s order. Assess for history of allergy to epogen. Observe for the action of the drug or its reaction in 5hrs. Document the procedure.