Cerebrovascular Diseases - E.G. From Ischemia Due To Stroke, Where Citicoline Accelerates The Recovery of Consciousness and Overcoming Motor Deficit

III.
Drug Study
Drug Drug
Classification
Mechanism of
action
Indication Contraindication Adverse
Reactions
Nursing
consideration
CITICOLINE

Dosage
1 g IV q8
Neuroprotective

Citicoline
activates the
biosynthesis of
structural
phospholipids
in the neuronal
membrane,
increases
cerebral
metabolism
and increases
the level of
various
neurotransmitte
rs, including
acetylcholine
and dopamine.
Cerebrovascular
diseases - e.g.
from ischemia
due to stroke,
where Citicoline
accelerates the
recovery of
consciousness
and overcoming
motor deficit.
>contraindicated
with allergy to
citicoline

>Hypertonia of
the
parasympathetic
nervous system

Citicoline may
exert a stimulating
action of the
parasympathetic,
as well as a
fleeting and
discrete
hypotensor effect
>Obtain patients
medical history
especially allergy to
citicoline
>Assess patients
condition
>Monitor Vital
Signs (BP, PR, RR)
>Assess for allergic
reactions like GI
disturbances.
>Direct IV
administration
should be very
slowly to prevent
episodes of
hypotension.
>Advised patient to
report if any
problem occurs
during medication.

Drug Drug
Classification
Mechanism
of action
Indication Contraindicati
on
Side Effect Nursing consideration
Atorvastatin

Brand Name:
Lipitor

Dosage:
80mg 1 tab
ODHS

Antihyperlipide
mic

HMG-CoA
reductase
inhibitor
Inhibits HMG-
CoA
reductase, the
enzyme that
catalyzes the
first step in the
cholesterol
synthesis
pathway,
resulting in
decrease
cholesterol,
serum LDL,
increase
serum HDLs
and lowers
triglyceride
levels
Treatment to
decrease total
cholesterol,
serum
triglycerides and
LDL level
Contraindicated
with allergy to
atorvastatin,
active hepatic
disease
CNS:
Headache
GI:
Flatulence,
constipation
,Liver failure

>Obtain patients
medical history for
allergy to atorvastatin
>Assess patients
condition
>Monitor Vital Signs
>obtain LFTs as a
baseline and periodically
during therapy ,
discontinue if AST or
ALT levels increase to 3
times normal levels
>withhold atorvastatin in
any serious condition
like hypotension,
seizure.
> administer drug
without regard to
food,but at the same
time each day.do not
drink grapefruit drug
whiletaking this drug

> report muscle pain,
fever,changes in color of
urine or stool.
>Advised patient to
report if any problem
occurs during
medication

Drug Drug
Classification
Mechanism of
action
Indication Contraindication Adverse
Reactions
Nursing
consideration
Clopidogrel

Dosage
75mg 1 tab
OD
Adenosine
diphosphate
receptor
antagonist

Antiplatelet

Inhibits platelet
aggregation by
blocking ADP
receptors on
platelets,
preventing
clumping of
platelets
Treatment of
patient at risk for
ischemic events-
recent ischemic
CVA.
Contraindicated
with allergy to
clopidogrel, active
pathological
bleeding such as
peptic ulcer or
intracranial
hemorrhage,

CNS:
Headache,
dizziness,
weakness,
syncope, flushing
CV: Hypertension
Dermatologic:
Rash, pruritus
GI: Nausea, GI
distress,
constipation,
diarrhea, GI bleed
Other: Increased
bleeding risk

>Assess allergy to
clopidogrel,
bleeding disorders,
peptic ulcer
>Assess patients
condition
>Monitor Vital
Signs
>monitor bleeding
parameters
>Take daily as
prescribed . may be
taken with meals
>Report skin rash,
abnormal bleeding

.

Drug Drug
Classification
Mechanism of
action
Indication Contraindication Side
Effects
Nursing consideration
Lactulose

Dosage
30 cc syrup
OD HS
Hold if >2
bowel
movement
per day
Laxative

Ammonia
reduction drug

The drug passes
unchanged into
the colon where
bacteria break it
down to organic
acids that
increase the
osmotic pressure
in the colon and
slightly acidify
the colonic
contents,
resulting in an
increase in stool
water content,
stool softening,
laxative action.
This also results
in migration of
blood ammonia
into the colon
contents with
subsequent
trapping and
expulsion of
feces.
Prevention and
Treatment of
constipation.

>Contraindicated
with allergy to
lactulose, low-
galactose diet.
>Do not
administer other
laxatives with
lactulose.

>Abdominal
fullness,
flatulence,
belching.
>Obtain patients
medical history.
>Assess patients
condition
>Monitor Vital Signs
(BP, PR, RR)
> Assess allergy to
lactulose, low-galactose
diet. diabetes,
> May be taken with fruit
juice or milk to increase
palatability.
>Do not freeze laxative
form. Ask patient to
report diarrhea, severe
belching, abdominal
fullness.
.

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III.

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