SIMs MEDS (JGrey) - Generic/Trade name Classification...

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Generic/Trade name Metformin XR pg. 662-664 Classification Oral Antidiabetic Mechanism of Action Inhibits glucose production in the liver; increases tissue sensitivity to insulin Dosage and Route 500 mg XR daily Is this a Safe Dose? Yes, max 2000 mg/day Drug/food Interactions Calcium channel blocker, corticosteriods, diuretics, sympathomimetics: increased hypoglycemia, Beta-blockers Garlic, green tea: increased hypoglycemia Glucosamine: increased hyperglycemia Side Effects / Adverse Reactions Headache, weakness, dizziness, heart failure, lactic acidosis, thrombocytopenia Lab / VS needed prior to administration Blood glucose Nursing Considerations Assessment: assess for hypoglycemia, hyperglycemia reactions soon after meals, monitor CBC, liver function test, renal test, glucose, folic acid, vitamin B12, monitor for lactic acidosis Implementation: give XR tablets in the morning to prevent hypoglycemia reactions in the PM, give with meals to prevent GI upset SURGERY: if patient is having surgery or NPO should be temporarily discontinued Why is this patient taking this? Patient is diagnosed with Diabetes Mellitus Is it effective? How do you know? Provide the evidence. Patient has a blood glucose WNL Generic/Trade name Colace/ Docusate Sodium (Skidmore-Roth, 2015 p. 327) Classification Laxative, emollient Mechanism of Action Increase water and fat penetration in intestine; allowing for ease with stool passage Dosage and Route 100mg PO, PRN; daily Is this a Safe Dose? PO 50-300 mg/day (docusate sodium) is the standard dose Drug/food Interactions Mineral oil- toxicity Flax, Senna- increase laxative effect. Side Effects / Adverse Reactions EENT: Bitter taste, throat irritation. GI: Nausea, anorexia, cramps, diarrhea. INTEG: Rash Lab / VS needed prior to administration Ask patient about there BMs or any pain they have been having Nursing Considerations Assessment: Assess for cramping, rectal bleeding, nausea,
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and Patient Teaching and vomiting. Identify cause of constipation- identify fluids, bulk, or exercise is missing from lifestyle. Implementation: PO: Dilute in juice or other fluid to mask taste. Give tablets or capsules with 8 oz. of liquid on an empty stomach. Teaching: Take with full glass of water, increase fluid intake, exercise to help with bowel function. Softened stools may not happen immediately and take up to 3 days for medication to work. Do not use product if experiencing nausea, vomiting. Notify prescriber of unrelieved constipation. Symptoms of electrolyte imbalance occur: muscle cramps, pain, weakness, dizziness, and excessive thirst. Patients with heart disease avoid using Valsalva maneuver. Pharmacodynamics: Unknown Why is this patient taking this? To prevent constipation and to soften stools Is it effective? How do you know? Provide the evidence. Regular bowel movements Generic/Trade name Toprol XL/ Metoprolol p.684 Classification Beta-blocker/ Antihypertensive Mechanism of Action Lowers blood pressure by blocking beta receptors negative chronotropic effect Dosage and Route 50mg XR, PO; daily Is this a Safe Dose? Yes, max is 400mg/day Drug/food Interactions
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