V.

DRUG STUDY MULTIVITAMINS + ZINC Name of Drug Generic (Brand) Multivitamins + Zinc (Vigor Ace) Classification Dose/ Frequency/ Route 1 cap OD PO Mechanism of Action Vigor-ACE provides the synergistic actions of protective biologic antioxidants: Vitamins C and E, and selenium. Vitamin E protects the cell membranes against damage by preventing the formation of lipid hydroperoxides. Vitamin C and the seleniumcontaining enzyme, glutathione peroxidase, inactivate these oxidizing agents, thus maintaining the integrity and stability of the cell membrane structures. Vigor-ACE also provides vitamin A and zinc to help stimulate and maintain nucleoprotein synthesis which is important in Indication Contraindication Side Effects Nursing Precaution May be taken with or without food (May be taken w/ meals for better absorption). Use in pregnancy: The safety of routine use of >6000 units of vitamin A daily and selenium supplementation in pregnant women has not been established.

Vitamins and/or Minerals

Nutritional supplement to support active functioning in adults & to help restore vitality in aging & convalescing patients.

cellular maintenance and repair. The incorporation of lecithin, a lipotropic agent, in Vigor-ACE, supports normal functioning of the cells by enhancing the mobilization of fats and their subsequent conversion into energy or specific tissue elements. Combining specific cellprotective and nutrient factors, once-a-day VigorACE helps restore and maintain general wellbeing, strength and vitality.

V. DRUG STUDY CIPROFLOXACIN Name of Drug Generic (Brand) Ciprofloxacin Classification Dose/ Frequency/ Route 200 mg/ q 12o No test IV Mechanism of Action Ciprofloxacin promotes breakage of double-stranded DNA in susceptible organisms and inhibits DNA gyrase, which is essential in reproduction of bacterial DNA. Indication Contraindication Side Effects Nursing Precaution May be taken with or without food. (May be taken w/ meals to minimize GI discomfort. Do not take w/ antacids, Fe or dairy products.) Epilepsy, history of CNS disorders; severe renal or hepatic dysfunction; G6PD deficiency; maintain adequate hydration; myasthenia gravis. Caution when used in patients with QT prolongation or risk factors e.g. bradycardia, preexisting cardiac disease or uncorrected electrolyte disturbances. Discontinue treatment if patients experience tendon pain, inflammation or rupture. Avoid usage in methicillin-

Antibiotic (Quinolones)

Susceptible infections

Hypersensitivity. Not to be used concurrently with tizanidine. Avoid exposure to strong sunlight or sun lamps during treatment.

GI disturbances; headache, tremor, confusion, convulsions; rashes; joint pain; phototoxicity. Transient increases in serum creatinine. Haematological, hepatic and renal disturbances. Vasculitis, pseudomembranous colitis and tachycardia. Phototoxicity. Potentially Fatal: Anaphylactoid reaction; cardiopulmonary arrest.

resistant staphylococcus aureus (MRSA) infections due to high level of resistance. May impair ability to drive or operate machinery. Safety and efficacy have not been established in pregnant and lactating women. Not to be used in children <18 yr; except where benefit clearly exceeds risk.

V. DRUG STUDY TRIMETAZIDINE Name of Drug Generic (Brand) Trimetazidine Classification Dose/ Frequency/ Route 35 mg 1 tab BID PO Mechanism of Action Trimetazidine is a cellular acting anti-ischemic agent. It has 3 main properties by which it acts as a cytoprotective agent. It inhibits the anaerobic glycolysis and fatty acid metabolism, thus allowing only aerobic glycolysis. This action helps to restore the energy balance in the cell. It inhibits acidosis and free radical accumulation in the cell. All these action help the cell to restore the normal ionic and metabolic balance. Indication Contraindication Side Effects Nursing Precaution Should be taken with food.

Anti-Anginal Drugs

Angina pectoris

Hypersensitivity. Pregnancy and lactation.

GI disturbances, vomiting, nausea.

V. DRUG STUDY ASA (ACETYLSALICYLIC ACID) Name of Drug Generic (Brand) Acetylsalicylic acid (Aspilet) Classification Dose/ Frequency/ Route 80 mg 1 tab OD PO Mechanism of Action Platelet aggregation inhibitors excluding heparin. Indication Contraindication Side Effects Nursing Precaution Should be taken with food (Take immediately after meals w/ a full glass of water unless patient is fluid-restricted. Swallow whole, do not chew/ crush/ bite the tab. ). Heavy alcohol consumption. Hemophilia, vit K deficiency or liver disease. Do not use 1 wk prior to & during labor, delivery & any surgery. Severe renal & hepatic insufficiency. 3rd trimester of pregnancy & lactation. Avoid use in childn or teenagers for viral infections w/ or w/o fever for risk of Reye's syndrome.

Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)

Reduction of atherosclerotic events (MI, stroke or vascular death) in patients w/ atherosclerosis documented by recent stroke, MI or established peripheral arterial disease.

Asthma, rhinitis & nasal polyps. History of active peptic ulcer disease. Hypersensitivity.

Fever, hypothermia, thirst. Dysrhythmias, hypotension, tachycardia. Agitation, cerebral edema, coma, confusion, dizziness, headache, subdural or intracranial hemorrhage, lethargy, seizures. Dehydration, hyperkalemia, metabolic acidosis, resp alkalosis, dyspepsia, GI bleeding, ulceration & perforation, nausea, vomiting, transient hepatic enzyme elevations, hepatitis, Reye's syndrome, pancreatitis. Prolongation of prothrombin time, disseminated intravascular coagulation, coagulopathy, thrombocytopenia. Acute anaphylaxis, angioedema, asthma, bronchospasm, laryngeal edema, urticaria. Hearing loss, tinnitus.

Prolonged pregnancy & labor, stillbirths, low birth wt infants, antepartum & postpartum bleeding. Hyperpnea, pulmonary edema, tachypnea. Interstitial nephritis, papillary necrosis, proteinuria, renal insufficiency & failure. Rhabdomyolysis. Hypo/hyperglycemia.

V. DRUG STUDY CETIRIZINE Name of Drug Generic (Brand) Cetirizine Classification Dose/ Frequency/ Route 10 mg tab OD at bedtime PO Mechanism of Action Cetirizine is a potent and highly selective antagonist of the peripheral histamine H1receptor on effector cells in the GI tract, blood vessels and respiratory tract. Indication Contraindication Side Effects Nursing Precaution Hepatic or renal impairment; elderly; tasks requiring mental alertness eg, driving or operating heavy machinery; pregnancy.

Antihistamines & Antiallergics

Allergic conditions

Hypersensitivity; lactation.

Somnolence, insomnia, malaise, headache, dizziness; GI discomfort, dry mouth, abdominal pain, diarrhoea, nausea, vomiting; occasional hypersensitivity; epistaxis, pharyngitis, bronchospasm.

V. DRUG STUDY FERROUS + FOLATE Name of Drug Generic (Brand) Ferrous + folate (Fortifer FA) Classification Dose/ Frequency/ Route 1 cap OD PO Mechanism of Action Indication Contraindication Side Effects Nursing Precaution Should be taken on an empty stomach (Best taken between meals. May be taken w/ meals to reduce GI discomfort.).

Vitamins & Minerals / Antianemics

Prevention & treatment of Fedeficiency anemia & folate deficiency

GI irritation.

V. DRUG STUDY CIPROFLOXACIN Name of Drug Generic (Brand) Ciprofloxacin Classification Dose/ Frequency/ Route 500 mg 1 tab/cap BID PO Mechanism of Action Ciprofloxacin promotes breakage of double-stranded DNA in susceptible organisms and inhibits DNA gyrase, which is essential in reproduction of bacterial DNA. Indication Contraindication Side Effects Nursing Precaution May be taken with or without food. (May be taken w/ meals to minimize GI discomfort. Do not take w/ antacids, Fe or dairy products.) Epilepsy, history of CNS disorders; severe renal or hepatic dysfunction; G6PD deficiency; maintain adequate hydration; myasthenia gravis. Caution when used in patients with QT prolongation or risk factors e.g. bradycardia, preexisting cardiac disease or uncorrected electrolyte disturbances. Discontinue treatment if patients experience tendon pain, inflammation or rupture. Avoid usage in methicillin-

Antibiotic (Quinolones)

Susceptible infections

Hypersensitivity. Not to be used concurrently with tizanidine. Avoid exposure to strong sunlight or sun lamps during treatment.

GI disturbances; headache, tremor, confusion, convulsions; rashes; joint pain; phototoxicity. Transient increases in serum creatinine. Haematological, hepatic and renal disturbances. Vasculitis, pseudomembranous colitis and tachycardia. Phototoxicity. Potentially Fatal: Anaphylactoid reaction; cardiopulmonary arrest.

resistant staphylococcus aureus (MRSA) infections due to high level of resistance. May impair ability to drive or operate machinery. Safety and efficacy have not been established in pregnant and lactating women. Not to be used in children <18 yr; except where benefit clearly exceeds risk.

V. DRUG STUDY OMEPRAZOLE Name of Drug Generic (Brand) Omeprazole (Omepron) Classification Dose/ Frequency/ Route 20 mg 1 cap OD PO Mechanism of Action Suppresses gastric secretion by inhibiting hydrogen/potassium ATPase enzyme system in the gastric parietal cell: characterized as gastric acid pump inhibitor, since it blocks the final step of acid production. Indication Contraindication Side Effects Nursing Precaution Symptomatic response to therapy does not rule out presence of gastric malignancy. Pregnancy & lactation. If patient will experience anorexia, small frequent meals may help maintain adequate nutrition. Caution patient to avoid alcohol, salycilates, ibuprofen: may cause GI irritation.

Antacids, Antireflux Agents & Antiulcerants

Active duodenal ulcer & GERD w/ erosive esophagitis

Hypersensitivity to omeprazole or to any components of Omepron. Lactation and children. Combination therapy with clarithromycin should not be used in patients with hepatic impairment.

Constipation, diarrhea, flatulence, nausea, vomiting & acid regurgitation. Abdominal pain, asthenia, headache, dizziness, rash.

V. DRUG STUDY RADIX GENTIANAE Name of Drug Generic (Brand) Radix Gentianae (Sinupret) Classification Dose/ Frequency/ Route 1 tab TID PO Mechanism of Action Indication Contraindication Side Effects Nursing Precaution May be taken with or without food

Other Drugs Acting on the Respiratory System

Acute & chronic inflammations of the sinuses & the resp tract; supplementary measure in antibacterial therapy.

None known to date.

Hardly ever, stomach intolerance.

V. DRUG STUDY ISOSORBIDE MONONITRATE Name of Drug Generic (Brand) Isosorbide Mononitrate Classification Dose/ Frequency/ Route Mechanism of Action Isosorbide mononitrate relaxes vascular smooth muscles by stimulating cyclicGMP. It decreases left ventricular pressure (preload) and arterial resistance (afterload). Indication Contraindication Side Effects Nursing Precaution Should be taken on an empty stomach (i.e. At least one hour before food or two hours after food). Severe renal or severe hepatic impairment, hypothyroidism, malnutrition, or hypothermia. Caution in patients who are already hypotensive. May aggravate angina caused by hypertrophic cardiomyopathy. Tolerance may develop after longterm treatment. Lactation.

Anti-Anginal Drugs

Long-term management of angina pectoris and heart failure.

Severe hypotension or anaemia, hypovolaemia, heart failure due to obstruction, or raised intracranial pressure due to head trauma or cerebral haemorrhage.

Hypotension, tachycardia, flushing, headache, dizziness, palpitation, syncope, confusion. Nausea, vomiting, abdominal pain. Restlessness, weakness and vertigo. Dry mouth, chest pain, back pain, oedema, fatigue, abdominal pain, constipation, diarrhoea, dyspepsia and flatulence. Potentially Fatal: Severe hypotension and cardiac failure.