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Dancing

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Submitted By Ammban77701
Words 1944
Pages 8
NAME OF DRUG: Citalopram GENERIC NAME: Citalopram
TRADE NAME: Celexa
NORMAL DOSAGE & ROUTE:
PO: (Adults)
20 mg once daily initially, may be ↑ in 1 wk to 40 mg/day
CLASSIFICATION:
T her. Class.­ antidepressants Pharm. Class.­ selective serotonin reuptake inhibitors ssris
ACTION:
Selectively inhibits the reuptake of serotonin in the CNS.
THERAPEUTIC EFFECT:
Antidepressant action.
INDICATIONS:
Depression
CONTRAINDICATIONS:


Hypersensitivity;



Concurrent use of MAO inhibitors or MAO­like drugs (linezolid or methylene blue);



Concurrent use of pimozide;



Congenital long QT syndrome, bradycardia, hypokalemia, hypomagnesemia, recent myocardial infarction, decompensated heart failure (↑ risk of QT interval prolongation);



Concurrent use of QT interval prolonging drugs

SIDE/ADVERSE EFFECTS:
CNS:
NEUROLEPTIC MALIGNANT SYNDROME UICIDAL THOUGHTS pathy onfusion rowsiness
,
S
, a , c , d , insomnia , weakness , agitation, amnesia, anxiety, ↓ libido, dizziness, fatigue, impaired concentration, ↑ depression, migraine headache EENT: abnormal accommodation
Resp: cough CV:
TORSADE DE POINTES
, postural hypotension, QT interval prolongation, tachycardia
GI: abdominal pain norexia iarrhea ry mouth yspepsia latulence saliva ausea
, a , d , d , d , f ,

, n , altered taste, ↑ appetite, vomiting GU: amenorrhea, dysmenorrhea, ejaculatory delay, erectile dysfunction, polyuria
Derm: sweating , photosensitivity, pruritus, rash
Metabolic: weight loss, weight gain
F and E: hyponatremia MS: arthralgia, myalgia
Neuro: tremor , paresthesia
Misc:
SEROTONIN SYNDROME
, fever, yawnin

NURSING IMPLICATIONS:

May cause serious, potentially fatal reactions when used with AO inhibitors
M
; concurrent use contraindicated; allow at least 14 days between citalopram and AO inhibitors
M
Concurrent use with AO­inhibitor like drugs
M
, such as linezolid methylene blue or
, may ↑ risk of serotonin syndrome; concurrent use contraindicated; do not start therapy in patients receiving linezolid methylene blue or
; if linezolid methylene blue or need to be started in a patient receiving citalopram, immediately discontinue citalopram and monitor for signs/symptoms of serotonin syndrome for 2 wk or until 24 hr after last dose of linezolid or methylene blue, whichever comes first (may resume citalopram therapy 24 hr after last dose of linezolid or methylene blue)
Concurrent use with pimozide may result in prolongation of the QTc interval and is contraindicated.
QT interval prolonging drugs may ↑ the risk of QT interval prolongation and torsade de pointes (concurrent use should be avoided).

PATIENT TEACHING:
Advise patient, family, and caregivers to look for suicidality, especially during early therapy or dose changes. Notify health care professional immediately if thoughts about suicide or dying, attempts to commit suicide, new or worse depression or anxiety, agitation or restlessness, panic attacks, insomnia, new or worse irritability, aggressiveness, acting on dangerous impulses, mania, or other changes in mood or behavior or if symptoms of serotonin syndrome occur. NAME OF DRUG: Norvasc
GENERIC NAME: Almodipine Besylate
TRADE NAME: Amlodipine
NORMAL DOSAGE & ROUTE:
PO: (Adults)
5–10 mg once daily; antihypertensive in fragile or small patients or patients already receiving other antihypertensives CLASSIFICATION:
Ther. Class: Antihypertensive
Pharm. Class: Calcium channel blocker
ACTION:
Inhibits the transport of calcium into myocardial and vascular smooth muscle cells, resulting in inhibition of excitation­contraction coupling and subsequent contraction.

THERAPEUTIC EFFECT:


Systemic vasodilation resulting in decreased BP.



Coronary vasodilation resulting in decreased frequency and severity of attacks of angina.

INDICATIONS:
Alone or with other agents in the management of hypertension, angina pectoris, and vasospastic (Prinzmetal's) angina. CONTRAINDICATIONS:


Hypersensitivity;



Systolic BP <90 mm Hg.

SIDE/ADVERSE EFFECTS:
CNS: dizziness, fatigue
CV: peripheral edema
, angina, bradycardia, hypotension, palpitations
GI: gingival hyperplasia, nausea

Derm: flushing NURSING IMPLICATIONS:


Do not confuse amlodipine with amiloride. Do not confuse Norvasc with Navane.



PO: ay be administered without regard to meal
M

PATIENT TEACHING:
Advise patient to take medication as directed, even if feeling well. Take missed doses as soon as possible within 12 hrs of missed dose. If >12 hrs since missed dose, skip dose and take next dose at scheduled time; do not double doses. May need to be discontinued gradually.
○ Instruct patient on correct technique for monitoring pulse. Instruct patient to contact health care professional if heart rate is <50 bpm.

NAME OF DRUG: Exleon
GENERIC NAME: Rivastigmine
TRADE NAME: Rivastigmine
NORMAL DOSAGE & ROUTE:
PO: (Adults)
1.5 mg twice daily initially; after at least 2 wk, dose may be ↑ to 3 mg twice daily. Further increments may be made at 2­wk intervals up to 6 mg twice daily.

CLASSIFICATION:
Ther. Class: anti­Alzheimers agents
Pharm. Class: Cholinergics (cholinesterase inhibitors)
ACTION:
Enhances cholinergic function by reversible inhibition of cholinesterase.
Does not cure the disease.

THERAPEUTIC EFFECT:


Decreased dementia (temporary) associated with Alzheimer's disease and Parkinson's disease.



Enhanced cognitive ability.

INDICATIONS:


PO: ild to moderate dementia associated with Alzheimer's disease.
M



Transdermal:
Treatment of mild, moderate, or severe dementia associated with Alzheimer's disease and mild to moderate dementia associated with Parkinson's disease.

CONTRAINDICATIONS:


Hypersensitivity to rivastigmine or other carbamates;



History of application site reactions with transdermal product suggestive of allergic contact dermatitis

SIDE/ADVERSE EFFECTS:
CNS: weakness , dizziness, drowsiness, headache, sedation (unusual)
CV: edema, heart failure, hypotension
GI: anorexia , dyspepsia, nausea omiting
, v , abdominal pain, diarrhea , flatulence, weight gain (unusual)
Derm: allergic dermatitis
Neuro: tremor NURSING IMPLICATIONS:


Transdermal:
Apply patch to clean, dry, hairless area that will not be rubbed by tight clothing. Upper or lower back is recommended, may also use upper arm or chest. Do not apply to red, irritated, or cut skin.
Rotate sites to prevent irritation, do not use same site within 14 days. Remove adhesive liner and apply by pressing patch firmly until edges stick well. May be worn during bathing and hot weather. Each 24 hr, remove old patch and discard by folding in half and apply new patch to a new area.

PATIENT TEACHING:
Transdermal:
Instruct patient and caregiver on the correct application, rotation, and discarding of patch. Patch should be folded in half and discarded out of reach of children and pets; medication remains in discarded patch.
Replace missed doses immediately and apply next patch at usual time. Advise patient and caregiver to avoid contact with eyes and to wash hands after applying patch. Avoid exposure to heat sources (excessive sunlight, saunas, heating pads) for long periods.

NAME OF DRUG: Zestril
GENERIC NAME: Lisinopril
TRADE NAME: Prinivil
NORMAL DOSAGE & ROUTE:
PO: (Adults)
10 mg once daily, can be ↑ up to 20–40 mg/day (initiate therapy at 5 mg/day in patients receiving diuretics). CLASSIFICATION:
Ther. Class: Antihypertensives
Pharm. Class: Ace Inhibitors
ACTION:
Angiotensin­converting enzyme (ACE) inhibitors block the conversion of angiotensin I to the vasoconstrictor angiotensin II. ACE inhibitors also prevent the degradation of bradykinin and other vasodilatory prostaglandins. ACE inhibitors also ↑ plasma renin levels and ↓ aldosterone levels. Net result is systemic vasodilation.

THERAPEUTIC EFFECT:


Lowering of BP in hypertensive patients.



Increased survival and decreased symptoms in patients with heart failure.



Increased survival after myocardial infarction.

INDICATIONS:


Alone or with other agents in the management of hypertension.



Management of heart failure.



Reduction of risk of death or development of heart failure after myocardial infarction.

CONTRAINDICATIONS:


Hypersensitivity



History of angioedema with previous use of ACE inhibitors



Concurrent use with aliskiren in patients with diabetes or moderate­to­severe renal impairment (CCr <60 mL/min) SIDE/ADVERSE EFFECTS:
CNS: dizziness , fatigue, headache, weakness
Resp: cough CV: hypotension , chest pain

GI: abdominal pain, diarrhea, nausea, vomiting
GU: erectile dysfunction, impaired renal function
Derm: rashes F and E: hyperkalemia Misc:
ANGIOEDEMA

NURSING IMPLICATIONS:


PO:
For patients with difficulty swallowing tablets, pharmacist can compound an oral suspension; stable at room temperature for 4 wk. Shake suspension before each use.

PATIENT TEACHING:
Instruct patient to notify health care professional immediately if rash; mouth sores; sore throat; fever; swelling of hands or feet; irregular heart beat; chest pain; dry cough; hoarseness; swelling of face, eyes, lips, or tongue; or if difficulty swallowing or breathing occurs.
○ Instruct patient and family on correct technique for monitoring BP. Advise them to check BP at least weekly and to report significant changes to health care professional.

NAME OF DRUG: Tylenol
GENERIC NAME: Acetaminophen
TRADE NAME: Tylenol
NORMAL DOSAGE & ROUTE:
PO: (Adults and Children >12 yr):
325–650 mg q 6 hr or 1 g 3–4 times daily or 1300 mg q 8 hr (not to exceed 3 g or
2 g/24 hr in patients with hepatic/renal impairment).

CLASSIFICATION:
Ther. Class: Antipyretic, Nonopiod Analgesics
ACTION:


Inhibits synthesis of prostaglandins that may serve as mediators of pain and fever, primarily in the CNS.



Has no significant anti­inflammatory properties or GI toxicity.

THERAPEUTIC EFFECT:


Analgesia.



Antipyresis.

INDICATIONS:


Mild pain,



Fever.

CONTRAINDICATIONS:


Previous hypersensitivity;



Products containing alcohol, aspartame, saccharin, sugar, or tartrazine (FDC yellow dye #5) should be avoided in patients who have hypersensitivity or intolerance to these compounds;



Severe hepatic impairment/active liver disease.

SIDE/ADVERSE EFFECTS:
Derm:
ACUTE GENERALIZED EXANTHEMATOUS PUSTULOSIS TEVENS­JOHNSON SYNDROME OXIC
,
S
,
T
EPIDERMAL NECROLYSIS
, rash, urticaria, hepatoxcitiy

NURSING IMPLICATIONS:


When combined with opioids do not exceed the maximum recommended daily dose of acetaminophen.



PO:
Administer with a full glass of water.


May be taken with food or on an empty stomach.

PATIENT TEACHING:




Chronic excessive use of >4 g/day (2 g in chronic alcoholics) may lead to hepatotoxicity, renal or cardiac damage. Advise patient to avoid alcohol (3 or more glasses per day increase the risk of liver damage) if taking more than an occasional 1–2 doses
Caution patient to check labels on all OTC products. Advise patients to avoid taking more than one product containing acetaminophen at a time to prevent toxicity.

NAME OF DRUG: Ativan Tablet NORMAL DOSAGE & ROUTE: 0.5mg PO TID
GENERIC NAME: lorazepam
TRADE NAME: Ativan
CLASSIFICATION: Benzodiazepine, Anxiolytic, Sedative­hypnotic
ACTION: Affects chemicals in the brain that may be unbalanced in people with anxiety
INDICATIONS: Used to treat anxiety disorders
CONTRAINDICATIONS: narrow­angle glaucoma;myasthenia gravis; or a history of allergic reaction to any benzodiazepine, such as diazepam (Valium), chlordiazepoxide, clonazepam, flurazepam, and others; pregnancy SIDE/ADVERSE EFFECTS: dizziness, drowsiness; weakness; slurred speech, lack of balance or coordination; memory problems; or feeling unsteady
NURSING IMPLICATIONS:
History: Hypersensitivity to benzodiazepines, propylene glycol, polyethylene glycol or benzyl alcohol; psychoses; acute narrow­angle glaucoma; shock; coma; acute alcoholic intoxication with depression of vital signs; pregnancy; lactation; impaired liver or renal function, debilitation Physical: Skin color, lesions; T; orientation, reflexes, affect, ophthalmologic examination; P, BP; R, adventitious sounds; liver evaluation, abdominal examination, bowel sounds, normal output; CBC, LFTs, renal function tests PATIENT TEACHING:
Take drug exactly as prescribed; do not stop taking drug (in long­term therapy) without consulting health care provider. You may experience these side effects: Drowsiness, dizziness (may be transient; avoid driving or engaging in dangerous activities); GI upset (take drug with food); nocturnal sleep disturbances for several nights after discontinuing the drug if used as a sedative and hypnotic; depression, dreams, emotional upset, crying. Report severe dizziness, weakness, drowsiness that persists, rash or skin lesions, palpitations, edema of the extremities; visual changes; difficulty voiding.

NAME OF DRUG: Cranberry Capsule NORMAL DOSAGE & ROUTE: 405mg PO Daily GENERIC NAME: Cranberry
TRADE NAME: Cranberry

CLASSIFICATION:
Herbal product
ACTION:
It contains a substance that blocks bacteria from attaching to the bladder wall.
INDICATIONS:
Urinary tract infections, to decrease odor from loss of bladder control (incontinence), and for kidney stones.
It may also have other uses. Check with your pharmacist for more details regarding the particular brand you use. Cranberry is an herbal product. CONTRAINDICATIONS:
SIDE/ADVERSE EFFECTS: No COMMON side effects have been reported with the proper use of cranberry.
NURSING IMPLICATIONS:
PATIENT TEACHING: Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you: if you are pregnant, planning to become pregnant, or are breast­feeding; if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement; if you have allergies to medicines, foods, or other substances; if you have diabetes or a history of kidney stones

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...1 Katherine Anne Porter’s “The Rope” and Margaret Atwood’s “The Resplendent Quetzal” have a lot of similarities. These two short stories are based on couples, and the basis of the problem in the two stories seems to be that they do not have children. In “The Resplendent Quetzal” we know that they lost their child at birth. While in “The Rope” we are lost as to the “how” or “why” they do not have children. The two stories show how these couples cope with their issues instead of trying to address it. In “The Rope”, the author does not use “he said” or “she said”, the narrative just goes straight into the conversation or thoughts of the character. The third person narrative technique does not give us insight into the psyche of the characters. It makes it seem like we are watching the incident happen. Each paragraph recounts the dialogue of both static individuals indirectly, without punctuation, in past tense, as if the tale were being told later by an overhearing neighbor. Each paragraph moves, not to a new speaker, but to a new grievance that both parties address; neither ever truly hears the other, although we do. We perceive a map not only of the argument but also of the frustrations that make up the marriage. We get the emotional standpoint of both characters. The story starts using the wife’s point of view who seems to have hysteria. There is no description of her, we do not know her name or where they are. There is also no name or description of the husband. The husband...

Words: 1128 - Pages: 5

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Words: 1529 - Pages: 7