Clinical Meds

Demadex

torsemide

Therapeutic - antihypertensive

Pharmacologic - loop diuretic

10 - 200mg/day

Inhibits reabsorbtion of sodium & chloride from loop of Henle & distol Renal tubule

increases renal excretion of water, sodium, chloride, magnesium, hydrogen, calcium

Mobilization of excess fluid of edema

decrease B/P

dehydration

hypokalemia

hypochloremia

hypovolemia

metabolic alkalosis

assess fluid status by weight & I&O

assess edema, lung sounds, skin turgor

monitor BP

assess tinnitis & hearing loss

assess frequently for skin rash

give in AM with food or milk to minimize gastric irritation

decrease edema, BP, abdominal girth, & Weight

increase urinary output

supplement vitamin for increased overall health by providing a number of vitamins

improve nutritional status and prevent vitamin deficiency

N/D

constipation

Life threatening - allergic reaction

assess drug interactions

do no take with antacids, thyroid meds, & some antibiotics

Not a substitute for a proper diet

don't double dose a missed dose

provision of essential vitamins to assist with maintaining health

lisinopril

Prinivil, Zestril

pharmacologic - ACE inhibitor

therapeutic - antihypertensive

10 - 40 mg/day

Block conversion of angiotensin I to angiotensin II (vasoconstrictor)

increase renin levels, decrease aldosterone levels for systemic vasodilation

Lower BP, manage HTN

decrease development of HF, stroke, MI

cough, hypotension, taste disturbances

Life threatening - agranulocytosis, angioedema

monitor bp & P, weight, & resolution of fluid overload

assess for angioedema - dyspnea, facial swelling

decrease BP without excessive side effects

decrease risk of HF

docusate sodium

Dulculax, Colase, Correctol

Pharmacologic - stool softener

therapeutic - laxative

50 - 400 mg in 4 divided doses

promotes incorporation of water into stool, resulting in softer fecal mass. 

May promote electrolyte and water secretion into the colon

softening and passage of stool

prevent constipation

mild cramps

D

rash

dependance possible over prolonged use

give with full glass of water or juice

don't give within 2 hours of another stool softener

does not stimulate peristalsis

soft, formed bowel movement within 24 - 48 hours

citalopram

CeleXA

Pharmacologic - SSRI

Therapeutic - antidepressant

20 - 40 mg/day

selectively inhibits the reuptake of seratonin in the CNS

Antidepressant

drowsiness, insomnia, weakness, N/D, dyspepsia, apathy, confusion, abdominal pain, anorexia, dry mouth, flatulence, increased saliva, sweating, tremors

Life Threatening - Neuroleptic malignant syndrome, suicidal thoughts, Torsade De Pointes, serotonin syndrome

assess for suicidal tendancies, mood changes

assess for serotonin syndrome, autonomic instability, & negative GI symptoms

increased sense of well being

renewed or increased intrests in surroundings

pharmacologic - salicylate

therapeutic - antipyretic, nonopiod analgesic

50 - 325 mg/day

decrease platelet aggregation

produce analgesic and decreased inflamation & fever by inhibiting the production of prostaglandins

Prophylaxis - decreased incidence of transient ischemic attacks & MI

dyspepsia

epigastric distress

N

patients having asthma, allergies, & nasal polyps or allergic to tartrazine have increased risk to develop hypersensitiviy reactions

assess for rashperiodically

assess for pain and note time of med administration & determine peak

assess for fever and note associated signs

monitor hepatic function

increase ease of joint movement

prevention of transient ischemic attacks & MI