DRUG NAME CITICOLINE 500mg 1 cap TID

GENERAL ACTION CNS drug Neuroprotective

SPECIFIC ACTION Citicoline activates the biosynthesis of structural phospholipids in the neuronal membrane, increases cerebral metabolism and increases the level of various neurotransmitters, including acetylcholine and dopamine. Citicoline has shown neuroprotective effects in situations of hypoxia and ischemia. Citicoline is an interneuronal communication enhancer. It increases the neurotransmission levels because it favors the synthesis and production speed of dopamine in the striatum, acting then as a dopaminergic agonist thru the inhibition of tyrosine-hydroxylase. Supplemental potassium in the form of high potassium food or potassium chloride may be able to restore normal potassium levels

INDICATIONS CVD in acute &recovery phase, symptoms &signs of cerebral insufficiency (dizziness, memory loss, poor concentration, disorientation, recent cranial trauma & their sequelae.)

CONTRAINDICATIONS ADVERSE EFFECTS Parasympathetic hypertonia >>Stomach pain >>diarrhea >>hypotension >>tachycardia >>bradycardia

NURSING RESPONSIBILITIES 1.Somazine should not be administered along with medications containing meclophenoxate. 2.Watch out for hypotensive effects.

KALIUM 1 tab TID

Electrolyte

>>For hypokalemia >>As prophylaxis during treatment with diuretics >>To prevent and treat potassium, deficit secondary to diuretics or corticosteroid therapy. >>Also indicated when potassium is depleted by severe vomiting, prolonged

>Severe renal impairment >severe hemolytic reactions >acute dehydration >heat cramps >hyperkalemia Cautious use in: >cardiac or renal disease; systematic acidosis

>>renal insufficiency >>hyperkalemia >>nausea >>vomiting >>irritability >>muscle weakness >>difficulty inswallowing

1.Some patients find it difficult to swallow the large sized KCl tablet. 2.Administer while patient is sitting up or standing (never in recumbent position) to prevent drug-induced esophagus. 3.Follow instructions regarding dilution. 4.Color in some commercial

diuresis anddiabetic acidosis

oral solutions fades with exposure to light but drug effectiveness is reportedly not altered. >>Allergy and hypersensitivity to any content of this drug >>Hypercalcemia >>Disturbed amino acid metabolism >>Caution use for patients with phenylketonuria >> Patients whose occupation requires the handling of mercury or mercury compounds. >>Caution with Methycobal should not be used for >1 month in patients if no clinically therapeutic outcome is observed. >>Hypercalcemia may develop

KETOSTERIL 1 tab TID

Ketoanalogs; Essential amino acids

Normalizes metabolic process, promotes recycling product exchange. Reduces ion concentration of potassium, magnesium and phosphate

>>Protein energy malnutrition >>Prevention and treatment of conditions caused by modified or insufficient protein metabolism in chronic renal failure

1. Evaluate for any contraindications. 2. Take drug as prescribed. 3. Warn the patient about possible side effects and how to recognize them. 4. Give with food if GI upset occurs. 5. Frequently assess for hypercalcemia. 1. Assess hypersensitivity. 2. Sugar-coated tablets should be protected from light and moisture after opening package (light decreases the content and tablets may turn reddish with exposure to moisture). 3. Take drug as prescribed. 4. Warn the patient about possible side effects and how to recognize them.

METHYCOBAL 1 tab TID

Nootropics Neurotonics/ Neurotrophics

Mecobalamin is a kind of endogenous co-enzyme B12. Mecobalamin plays an important role in transmethylation as a coenzyme of methionine synthetase in the synthesis of methionine from homocysteine. Mecobalamin is well transported to nerve cell organelles, and promotes nucleic acid and protein synthesis. Mecobalamin is better transported to nerve cell organelles than cyanocobalamin in rats. It has been shown in experiments with cells from the brain origin and spinal nerve cells in rats to be involved in the synthesis of thymidine from deoxyuridine, promotion of deposited

>>Repairs the peripheral nerve damage and relieves the neuropathic symptoms such as pain, numbness or paralysis. >>Improves anemia due to vitamin B12 deficiency.

>>Anorexia, >>nausea and >>diarrhea >>rashes >> Anaphylactoid reactions eg, decrease in blood pressure or dyspnea may occur

folic acid utilization and metabolism of nucleic acid. Also, mecobalamin promotes nucleic acid and protein synthesis in rats more than cobamamide does. Mecobalamin promotes axonal transport and axonal regeneration. Mecobalamin normalizes axonal skeletal protein transport in sciatic nerve cells from rat models with streptozotocininduced diabetes mellitus. MYONAL 1 tab TID Muscle Relaxant Skeletal Muscle Relaxation: Inhibition of Experimentally-Induced Muscle Rigidity: Eperisone HCl suppresses intercollicular sectioninduced decerebrate rigidity (-rigidity) and ischemic decerebrate rigidity (-rigidity) in rats dose-dependently. Suppression of Spinal Reflexes: In spinal cats, eperisone HCl suppresses mono- and polysynaptic reflex potentials induced through spinal nerve efferent root stimulation to a similar degree. Improvement of myotonic conditions caused by the following diseases : Neck-shoulder-arm syndrome, scapulohumeral periarthritis and low back pain Spastic paralysis caused by the following diseases : Cerebrovascular disorders, spastic spinal paralysis, cervical spondylosis, sequelae of surgical trauma (including cerebrospinal tumor), sequelae of trauma (spinal injury and head injury), amyotrophic lateral Patients with a history of hypersensitivity to any ingredients of MYONAL. Precautions: (1) Patients with a history of drug hypersensitivity (2) Patients with hepatic function disorder [MYONAL may aggravate hepatic function.] >>Shock and >>anaphylactoid reactions >>redness, >> itching, >>urticaria, >>edema of the face or other parts and >>dyspnea 1. Assess hypersensitivity. 2. Observe 10 rights of drug administration. 3. May be taken with or without food. 4. Patients should be cautioned against engaging in potentially hazardous activities requiring alertness. 5. Patient should therefore be closely monitored. 6. If abnormal findings are observed, the drug should be discontinued and appropriate measures taken.

LIPOLIN Opthalmic Gel tube Lubricant OD every 4 hours

Artificial tears are an eye solution, used to moisten the eyes as an eye rinse and to prevent dry eyes. Ocular lubricants are used as a protective coating to protect eye/s from injury.

sclerosis, infantile cerebral palsy, spinocerebellar degeneration, spinal vascular disorder, subacute myelo-optico neuropathy (SMON) and other encephalomyelopathies >>keep the eye moist, >>help to protect the eye from injury and infection, and >>decrease symptoms of dry eyes such as burning, itching, and feeling as if something is in the eye

Precaution: >>Remove contact lens prior to administration. May cause transient blurring of vision in large doses. >>May affect driving or operating machinery. >>Pregnancy & lactation

>>rash >>itching/swelling (especially of the face/tongue/throat), >>severe dizziness, >>trouble breathing.

1. Assess hypersensitivity to the drug and its components. 2. Observe 10 rights of drug administration. 3. Do not use a solution that has changed color or is cloudy. 4. Wash hands first. To avoid contamination, be careful not to touch the dropper or top of the ointment tube or let it touch your eye. Always replace the cap tightly after each use. Tilt your head back, look up, and pull down the lower eyelid to make a pouch. For drops/gels, place the dropper directly over the eye and squeeze out 1 or 2 drops as needed. Look down and gently close your eye for 1 or 2 minutes. Place one finger at the corner of the eye near the nose and apply gentle pressure. This will prevent the medication from draining away from the eye.

AMLODIPINE 10 mg 1 tab OD

Calcium-Channel blocker Antianginal Antihypertensive

Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells; inhibits transmembrane calcium flow, which results in the depression of impulse formation in specialized cardiac pacemaker cells, slowing of the velocity of conduction of the cardiac impulse, depression of the myocardial contractility, and dilation of coronary arteries and arterioles and peripheral arterioles; those effects lead to decreased cardiac work, decreased cardiac oxygen consumption, and in patients with vasospastic angina, increased delivery of oxygen to cardiac cells.

>>Angina pectoris due to coronary artery spasm(Prinzmetal's variant angina) >>Chronic stable angina, alone or in combination with other agents >>Essential hypertension, alone or in combination with other antihypertensives

>>allergy to amlodipine, impaired hepatic or renal function, sick sinus syndrome, heart block(second or third degree),lactation. >>Use cautiously with CHF, pregnancy

CNS:Dizziness, lightheadedness, headache, asthenia, fatigue, lethargy CV: Peripheral edema, arrhythmias Dermatologic: Flushing, rash GI:Nausea, Abdominal discomfort

1. Assess hypersensitivity to the drug and its components. 2. Observe 10 rights of drug administration. 3. Obtain vital signs especially BP. 4. Take with meals if GI upset occurs. 5. Report significant swelling of face or extremities. 6.Take care to have support when standing & walking due to possible dose-related light-headedness/dizziness. 7.Report shortness of breath, palpitations, irregular heartbeat, nausea, or constipation to physician.

ATORVASTATIN Antihyperlipidemic Inhibits HMG-CoA 40 mg 1 tab HMG-CoA reductase, the enzyme OD@hs OD reductase inhibitor that catalyzes the first step in the cholesterol synthesis pathway, resulting in a decrease in serum cholesterol, serum LDLs (associated with increased risk of CAD), and increases serum HDLs (associated with decreased risk of CAD); increases hepatic LDL recapture sites, enhances reuptake and catabolism of LDL; lowers triglyceride levels.

>>Adjunct to diet in treatment of elevated total cholesterol, serum triglycerides, and LDL cholesterol in patients with primary hypercholesterolemia (types IIa and IIb)and mixed dyslipidemia, primary dysbetalipoproteinemia, and homozygous familial hypercholesterolemia whose response to dietary restriction

>>allergy to atorvastatin, fungal byproducts, active liver disease or unexplained and persistent elevations of transaminase levels, pregnancy, lactation. >>Use cautiously with impaired endocrine function

CNS: Headache, asthenia GI: Flatulence, abdominal pain, cramps, constipation, nausea, dyspepsia, heartburn, liver failure Respiratory: Sinusitis, pharyngitis Other: Rhabdomyolysis with acute renal failure, arthralgia, myalgia

1. Assess hypersensitivity to the drug and its components. 2. Observe 10 rights of drug administration. 3. WARNING: Withhold atorvastatin in any acute, serious condition (severe infection, hypotension, major surgery, trauma, severe metabolic or endocrine disorder, seizures) that may suggest myopathy or serve as risk factor for development of renal failure. 4. Administer drug without regard to food, but at same time each day.

of saturated fat and cholesterol and other non pharmacologic measures has not been adequate >>To increase HDL-C in patients with primary hypercholesterolemia and mixed dyslipidemia >>Adjunct to diet to treat elevated serum triglyceride levels >>Prevention of CV disease in adults without clinically evident coronary disease but with multiple risk factors for CAD such as age> 55 yr, smoking, hypertension, low HDL-C, family history of early CAD; to reduce the risk of MI and risk for revascularization procedures and angina

5. Atorvastatin may be combined with a bile acid binding agent. Do not combine with other HMGCoA reductase inhibitors or fibrates. 6. You may experience these side effects: Nausea (eat frequent small meals);headache, muscle and joint aches and pains (may lessen over time). 7. Report muscle pain, weakness, tenderness; malaise; fever; changes in color of urine or stool; swelling