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Generic name : Acetaminophen

Brand Name :Biogesic,Tylenol

General action:Anti-pyretic&Analgesic

Specific action :

Antipyretic: Reduces fever byacting directly onthe hypothalamicheat-

regulatingcenter to causevasodilation andsweating, whichhelps dissipateheat

Analgesic: Siteand mechanism of action unclear.

Indication :To relieve mild to moderate pain due to things such as headache, muscle and

joint pain, backache and period pains. It is also used to bring down a high temperature.

For this reason, paracetamol can be given to children after vaccinations to prevent post-

immunization pyrexia (high temperature).Paracetamol is often included in cough, cold

and flu remedies.

Route and Dosage : Adults and children 500-1000 mg orally every 4-6 hours

Contraindication :

Contraindicated in patients hypersensitive to drug.

Alexander, Anneth

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Use cautiously in patients with long term alcohol use because therapeutic doses

cause hepatotoxicity in these patients

Adverse effects :

Hematologic: hemolytic anemia,neutropenia, leucopenia, pancytopenia.

Hepatic: Jaundice

Metabolic: Hypoglycemia

Skin: rash, urticaria.

Nursing Responsibilities :

Use liquid form for children andpatients who have difficultyswallowing.

In children, don’t exceed five dosesin 24 hours.

Advise patient that drug is only forshort term use and to consult thephysician if

giving to children forlonger than 5 days or adults forlonger than 10 days.

Advise patient or caregiver thatmany over the counter productscontain

acetaminophen; be awareof this when calculating total dailydose.

Warn patient that high doses orunsupervised long term use cancause liver

damage.

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Generic name :Carbocisteine

Brand Name :Solmux,Loviscol

General action:MUCOKINETICS/EXPECTORANTS

Specific action :Reduces the viscosity of bronchial secretions &facilitate expectoration.

Indication :Acute/chronic disorders of the upper &lower respiratory tract associated with

the secretion &formation of excessive and viscid mucus

Route and Dosage :

Capsule:

Adult: 250mg 2 caps,500mg 1 cap TIDSuspension:Adult – 15ml;

Pedia: 6-12yrs: 5ml, 2-5 yrs: 1.25-2.5 mlSyr:6-12yrs: 10ml2-5 yrs: 2.5ml

Drops:12-24mos: 1.25ml, 9-11mos: 1ml, 6-8mos:0.75ml, 3-5mos: .50ml,<3mos: 0.25mlAll

doses 3-4x/ day

Contraindication :

Contraindicated on active peptic ulcer.

Hypersensitivity to carbocisteine

Adverse effects :Nausea, headache, vomiting, anorexia, gastric discomfort, diarrhea, GI bleeding

Nursing Responsibilities :

assess cough: type, frequency, character

advice medical consultation for persistent cough of more than 7 days

advice pt. to avoid smoking

suggest sugarless lozenges to decrease throat irritation and cough

Alexander, Anneth

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Generic name :Isosorbidemononitrate

Brand Name :Imdur

General action:

Antianginal,

Nitrate,

Vasodilator

Specific action :The principal pharmacological action of ISMN and all organic nitrates in

general is relaxation of vascular smooth muscle, producing dilatation of peripheral

arteries and veins, especially the latter. Dilatation of the veins promotes peripheral

pooling of blood and decreases venous return to the heart, thereby reducing left

ventricular end-diastolic pressure and pulmonary capillary wedge pressure (preload).

Arteriolar relaxation reduces systemic vascular resistance, and systolic arterial pressure

and mean arterial pressure (afterload). Dilatation of the coronary arteries also occurs. The

relative importance of preload reduction, afterload reduction, and coronary dilatation

remains undefined.

Indication :

Dinitrate: Treatment and prevention of angina pectoris

Mononitrate: Prevention of angina pectoris

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Unlabeled use (dinitrate): Used with hydralazine in patients with advanced CHF

Route and Dosage :The recommended starting dose of IMDUR Tablets is 30 mg (given

as a single 30-mg tablet or as ½ of a 60-mg tablet) or 60 mg (given as a single tablet)

once daily. After several days, the dosage may be increased to 120 mg (given as a single

120-mg tablet or as two 60-mg tablets) once daily. Rarely, 240 mg may be required. The

daily dose of IMDUR Tablets should be taken in the morning on arising. IMDUR

Extended Release Tablets should not be chewed or crushed and should be swallowed

together with a half-glassful of fluid.

Contraindication :

Contraindicated with allergy to nitrates, severe anemia, head trauma, cerebral

hemorrhage, hypertrophic cardiomyopathy, narrow-angle glaucoma, postural

hypotension

Use cautiously with pregnancy, lactation, acute MI, CHF.

Adverse effects :

CNS: Headache, apprehension, restlessness, weakness, vertigo, dizziness,

faintness

CV: Tachycardia, retrosternal discomfort, palpitations, hypotension, syncope,

collapse, orthostatic hypotension, angina, rebound hypertension, atrial fibrillation,

postural hypertension

Dermatologic: Rash, exfoliative dermatitis, cutaneous vasodilation with flushing

GI: Nausea, vomiting, incontinence of urine and feces, abdominal pain, diarrhea

GU: Dysuria, impotence, urinary frequency

Other: Muscle twitching, pallor, perspiration, cold sweat, arthralgia, bronchitis

Nursing Responsibilities :

Give sublingual preparations under the tongue or in the buccal pouch; discourage

the patient from swallowing.

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Create a nitrate-free period to minimize tolerance.

Give oral preparations on an empty stomach, 1 hr before or 2 hr after meals; take

with meals if severe, uncontrolled headache occurs.

Place sublingual tablets under your tongue or in your cheek; do not chew or

swallow the tablet. Take the isosorbide before chest pain begins, when activities

or situation may precipitate an attack. Take oral isosorbidedinitrate on an empty

stomach, 1 hour before or 2 hours after meals; do not chew or crush sustained-

release preparations; do not take isosorbidemononitrate to relieve acute anginal

episodes.

You may experience these side effects: Dizziness, lightheadedness (may be

transient; use care to change positions slowly); headache (lie down in a cool

environment, rest; over-the-counter preparations may not help; take drug with

meals); flushing of the neck or face (reversible).

Report blurred vision, persistent or severe headache, rash, more frequent or more

severe angina attacks, fainting.

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Scientific name :PeperoniaPellucida

An annual herb, favoring shady,damp and loose soil.Often grows in groups in nooks inthe

garden and yard.Conspicious in rocky parts of canals .

Common Name :Ulasimang- bato

A weed, with heart-shaped leaves also known as "pansit-pansitan", grows in shady parts

of the garden and yard. It is effective in fighting arthritis and gout. The leaves can be

eaten fresh (about a cupful) as salad or like tea.

Indication :Lowers uric acid. (Rheumatism and gout)

Preparation:

Wash leaves well. One and a half cup leaves are boiled in two glassfuls of water

over lower fire. Do not cover pot. Cool and strain. Divide into three parts and

drink each part three times a day after meals.

May also be eaten as salad. Wash the leaves well. Prepare one and a half cups of

leaves. Divide into 3 parts and take as salad three times a day.

Parts utilized:

leaves

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Nursing Responsibilities

Use only half the dosage prescribed for fresh parts like leaves when using dried

parts.

Do not use stainless steel utensils when boiling decoctions.Only use earthen,

enameled ,glass or alike utensils.

As rule of thumb ,when boiling leaves and other plant parts ,do not cover the

pot ,and boil in low flame.

Decoctions loose potency after some time.Dispose of decoctions after one day .To

keep fresh during the day ,keep lukewarm in a flask or thermos.

Always consult with a doctor if symptoms persist or if any sign of allergic

reaction develops.

PYRALVEX

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Generic Name

Anthraquinone Glycosides/Salicylic Acid

Brand Name

Pyralvex

Drug Class

Anti-Inflammatory

Analgesic

Therapeutic Actions

Pyralvex solution contains two active ingredients, salicyclic acid and rhubarb extract.

Salicylic acid is a type of medicine called a salicylate. Salicylic acid works by blocking

the action of a substance in the body called cyclo-oxygenase. Cyclo-oxygenase is

involved in the production of various chemicals in the body, including some known as

prostaglandins. Prostaglandins have many actions, and are involved in causing

inflammation. The body produces prostaglandins in response to injury and they cause an

increase in the blood supply to the area of damage. This will result to swelling, heat,

redness and pain in that area. By blocking cyclo-oxygenase, salicylic acid prevents the

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formation of prostaglandins and hence reduces inflammation and pain in the area of the

mouth it is applied to. Rhubarb extract contains anthraquinone glycosides, which also

relieve inflammation.

Indications

Relief of pain from mouth ulcers and denture irritation; gingivitis; stomatitis

Contraindications and Cautions

Contraindicated to hypersensitivity to any of the constituents;

Not to be used in children and adolescents under the age of 16. This is because there is a

possible association between salicylates and Reye's Syndrome when given to children;

Use cautiously with pregnancy, lactation

Available Forms

Solution – 10mL

Dosage

Apply liberally to the sore areas of the mouth 3-4 times daily using the brush provided.

Adverse Effects

GI: transient local burning sensation at the site of application, Temporary discoloration of

teeth or oral mucosa, Ulceration at site of application if used excessively

Hypersensitivity: Allergic reactions, including rash and urticaria

Nursing Considerations

Tell patient to not use Pyralvex if allergic (hypersensitive) to rhubarb extract or

salicylic acid or any of the other ingredients of Pyralvex.

Keep all medicines out of the reach and sight of children. Do not give to children

or adolescents under the age of 16 years. This is because there is a possible link

between salicylates and Reye’s syndrome when given to children. 

Store below 25 °C.

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Do not use Pyralvex after the expiry date which is stated on the bottle as

month/year.

Always use Pyralvex exactly as your doctor had told you.

Do not exceed the stated frequency of application as excess Pyralvex may be

harmful.

Do not use for more than 7 days.

Avoid rinsing your mouth or eating for 15 minutes after use.

Each bottle should be used by only one person.

When applied for denture irritation, leave 30 minutes after applying the gel before

putting the dentures back in. Don’t apply the gel directly to the dentures, as this

can further irritate the gums.

Pyralvex is a colored liquid and can stain material. Care should be taken to ensure

that the liquid is not spilt or dropped onto clothing.

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PLATEXAN

Generic Name

Clopidogrel bisulfate

Brand Names

Platexan, Plavix

Drug Class

Adenosine diphosphate (ADP) receptor antagonist

Antiplatelet

Therapeutic Actions

Inhibits platelet aggregation by blocking ADP receptors on platelets, preventiong

clumping of platelets

Indications

Treatment of patients at risk for ischemic events – recent MI, recent ischemic CVA,

peripheral artery disease

Treatment of patients with acute coronary syndrome

Unlabeled use: as loading dose with aspirin to prevent adverse cardiac events in coronary

stent implantation

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Contraindications and Cautions

Contraindicated to hypersensitivity to clopidogrel, acute pathological bleeding such as

peptic ulcer or intracranial hemorrhage, lactation

Use cautiously with pregnancy, bleeding disorders, recent surgery, hepatic impairment

Available Forms

Tablets – 75 mg

Dosages

Recent MI, CVA, peripheral artery disease: 75 mg PO daily

Acute coronary syndrome: 300 mg PO loading dose, then 75 mg/day PO with aspirin

Adverse Effects

CNS: headache, dizziness, weakness, syncope, flushing

CV: hypertension, edema

Dermatologic: rash, pruritus

GI: nausea, GI distress, constipation, diarrhea, GI bleeding

Other: increased bleeding risk

Nursing Considerations

Tell patient to not use the drug if allergic (hypersensitive) to it.

Store at 15 and 30 °C (59 and 86 °F)

Throw away and never use any unused medicine after the expiration date

Provide small frequent meals if GI upset occurs.

Monitor patient for bleeding; limit invasive procedures.

Follow the directions on the prescription label.

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OMEGA-3

Generic Name

Omega-3-acid ethyl esters

Brand Names

Lovaza

Drug Class

Lipid-lowering drug

Omega-3 fatty acid

Therapeutic Actions

Inhibits liver enzyme systems leading to a decrease in the synthesis of triglycerides in the

liver; lowering serum triglyceride levels

Indications

As an adjunct to diet to reduce very high or greater than 500 mg/dL triglyceride levels in

adult patients

Contraindications and Cautions

Contraindicated with known allergy to any component of capsule

Use cautiously with known sensitivity to fish products, pregnancy, lactation

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Available Forms

Capsules – 1 g

Dosages

4 g/day PO taken as a single dose (4capsules) or into two dose – 2 capsules PO bid

Adverse Effects

CV: angina

GI: taste perversion, dyspepsia, eructation

Other: pain, back pain, rash, flu-like symptoms, infection

Nursing Considerations

Assess history of allergy to any component of the drug, fish products, pregnancy,

and lactation.

Reserve use for patients with very high triglyceride levels.

Ensure that patient continues diet and exercise program to control lipids.

Suggest the use of contraceptive measures; it is not known if it will affect fetus.

Suggest another method of feeding the baby if a woman is nursing; it is not

known if it will cross breast milk.

Encourage small frequent feedings if GI effects are uncomfortable.

If missed a dose, take it as soon as you remember and then return to normal

schedule. Do not make-up doses. Do not take more than 4 capsules a day.

May need to ask patient to have periodic blood test to evaluate the effects of drug

to the body.

In storing, protect from light and moisture. Do not store in the bathroom. Do not

freeze.

Keep all drug products away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless

instructed to do so.

Properly discard this drug when it is expired or no longer needed.

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SAMBONG

Scientific Name: Blumea balsamifera

English Names: Camphor

Tagalog Names: Ayohan, Bulaklak Ga buen, Kaliban

Visayan Names: Kambihon, Lakdanbulan, Alibhon, Alimon

It is a plant that reaches 1 ½ to 3 meters in height with rough hairy leaves. Young

plants around mother plant may be separated when they have three or more leaves.

Common Uses:

Anti-edema, diuretic, anti-urolithiasis. Boil chopped leaves in water for 15

minutes until one glassful remains. Cool and strain.

Dried Leaves Fresh Leaves

Adult 4 tablespoons 6 tablespoons

7-12 years old ½ tablespoon of adult dose

Divide decoction into 3 parts. Drink one part 3 times a day.

Note: Sambong is not a medicine for kidney infection.

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Sambong is used as herbal medicine and is a shrub that grows wild in the tropical

climate countries such as Philippines, India, Africa and found even in eastern Himalayas.

Sambong is widely used in the Philippines as herbal medicine. Sambong leaves are

known for its ngai or Blumea camphor that is used as herbal medicine to treat kidney

stones, wounds and cuts, rheumatism, anti-diarrhea, anti spasms, colds and coughs and

hypertension. The Philippine Council for Health Research and Development (PCHRD)

has developed the technology for a sambong herbal medicine tablet.

I. Other Traditional Uses/Indications of Sambong

Fever - Sambong roots and leaves are used as herbal treatment for fevers,

sambong leaves and roots are pounded then dissolved in cold water. Applied with

a soft cloth over the nape, forehead, uderarms and other body parts to bring down

the body temperature.

Rheumatism - Sambong roots and leaves are also used as herbal medicine

treatment for rheumatism. Sambong roots and leaves are pounded and applied as

poultice on the affected body part. Sambong roots and leaves may also be boiled

and are applied as warm compress onto affected area.

Headache - Sambong is also used to treat headache, sambong leaves are pounded

and applied as a poultice over the forehead.

Coughs and colds - Sambong tea are also used as herbal medicine for colds and

coughs.

Stomach pains - Sambong tea are also used for herbal treatment of diarrhea and

stomach spasms.

As a disinfectant - Sambong juice are also used for treatment of cuts and wounds.

Preparations

Sambong Tea Preparation:

gather fresh sambong leaves, cut in small pieces

wash with fresh water

boil 50 grams of sambong leaves to a liter of water

let it seep for 10 minutes

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remove from heat

drink while warm 4 glasses a day for best results.

Sambong Poultice

gather fresh leaves and roots

wash with fresh clean water

pound in a mortar

grounded leaves may be applied or a juice extract may be used

Sambong Capsules And Tablets

Powdered Sambong leaves are available in 250 mg tablets at the DOH's Philippine

Institute of Traditional and Alternative Health Care

II. Other Medical Uses of Sambong According to Scientific Studies

Sambong as diuretic for hypertension and fluid retention. Sambong herbal tea

is used as a diuretic for fluid retention and hypertension conditions. Sambong

herbal tea incites the body to urinate thereby removing excess body fluids and

sodium. Clinical studies have shown that a high level of sodium in the blood is a

major cause of hypertension.

Sambong delay or averts renal failure. The Philippine National Kidney and

Transplant Institute recommends taking sambong herbal medicine for patients

with renal problems. Favorable results were noted that sambong may help to

delay or avert dialysis or even kidney transplant.

Sambong for the Dissolution of Kidney Stones. The Philippine Department of

Health (DOH) has been promoting Sambong herbal tea and tablets as a diuretic

and for the dissolution of kidney stones. Sambong has been recently registered in

the Bureau of Foods and Drugs as medicine.

Sambong as Anticancer. Sambong contains methanolic extract that has been

found to have therapeutic activity against hepatocellular carcinoma cells. A study

of sambong (balsamifera) extract inhibits the activity in rat and human

hepatocellular carcinoma cells without cytotoxicity. This study suggest a possible

therapeutic effect of sambong extracts (balsamifera) in the treatment of hepatoma

cancer patients.

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Sambong as Antibacteria and Antifungi. A Phytochemical study indicates that

sambong leaves contains the chemicals icthyothereol acetate, cyptomeridiol, lutein and ß-

carotene that has been found to have positive activity against microbes such as A niger, T

mentagrophytes and C albicans. Results also showed activity against P aeruginosa, S

aureus, B subtilis and E col

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BETADINE* ANTISEPTIC SOLUTION

COMPOSITION:

Each 1 mL contains 100 mg povidone-iodine, equivalent to 10 mg available iodine. 

PHARMACOLOGICAL CLASSIFICATION: 

Antiseptics, Disinfectants, Cleansing Agents

PHARMACOLOGICAL ACTION:

Povidone-iodine is a multivalent broad spectrum local antiseptic having bactericidal and

fungicidal properties. The effect on vegetative cells of various bacteria and fungi is due to

the liberation of free iodine from the complex. Many virusses, protozoa, yeasts, cysts and

spores are also susceptible.

INDICATIONS:

Disinfection of wounds, lacerations, abrasions and burns. Prophylaxis against infection in

hospital and surgery procedures. 

Preparation of skin and mucous membranes prior to surgery. Post- operative application

to protect against infection. Treatment of infected skin conditions.

CONTRA-INDICATIONS:

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Hypersensitivity to povidone-iodine.

Povidone-iodine solutions should not be used on patients with a non-toxic nodular colloid

goiter.

Application to large areas of broken skin should be avoided as excessive absorption of

iodine may occur.

Absorption of povidone-iodine may interfere with thyroid function tests

DOSAGE AND DIRECTIONS FOR USE:

Apply full strength, as a paint, or soak or spray as often as needed.

Shake the bottle before use and clean the nozzle of the spray pump after use.

NOT FOR DOUCHING PURPOSES

SIDE-EFFECTS AND SPECIAL PRECAUTIONS:

Local irritation and sensitivity may occur. If irritation, swelling or redness occur,

discontinue treatment and consult your physician. 

Hypothyroidism may occur after topical application to neonates. Absorption of povidone-

iodine may interfere with thyroid function tests.

Nursing considerations:

1. Not to be used by persons who are allergic to iodine.

2. Not be used in pregnancy or by lactating women.

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Syntex

Generic Name: naproxen

Drug classes: Nonsteroidal anti-inflammatory drug (NSAID), Analgesic (non-narcotic)

Therapeutic actions

Analgesic, anti-inflammatory, and antipyretic activities largely related to inhibition of

prostaglandin synthesis; exact mechanisms of action are not known.

Indications

· Mild to moderate pain

· Treatment of primary dysmenorrhea, rheumatoid arthritis, osteoarthritis, ankylosing

spondylitis, tendinitis, bursitis, acute gout

· OTC use: temporary relief of minor aches and pains associated with the common cold,

headache, toothache, muscular aches, backache, minor pain of arthritis, pain of menstrual

cramps, reduction of fever

· Treatment of juvenile arthritis (naproxen only)

Contraindications

· Contraindicated with allergy to naproxen, salicylates, other NSAIDs; pregnancy;

lactation.

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Adverse effects

Headache, dizziness, somnolence, insomnia, fatigue, tiredness, dizziness, tinnitus,

ophthalmic effects

Rash, pruritus, sweating, dry mucous membranes, stomatitis

Nausea, dyspepsia, GI pain, diarrhea, vomiting, constipation, flatulence

Dysuria, renal impairment, including renal failure, interstitial nephritis, hematuria

Bleeding, platelet inhibition with higher doses, neutropenia, eosinophilia, leukopenia,

pancytopenia, thrombocytopenia, agranulocytosis, granulocytopenia, aplastic anemia,

decreased Hgb or Hct, bone marrow depression, menorrhagia

Dyspnea, hemoptysis, pharyngitis, bronchospasm, rhinitis

Peripheral edema, anaphylactoid reactions to anaphylactic shock

Nursing considerations

· Give with food or after meals if GI upset occurs.

· Arrange for periodic ophthalmologic examination during long-term therapy.

· Institute emergency procedures if overdose occurs: gastric lavage, induction of emesis,

supportive therapy.

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Plasil

Brand Name: PLASIL

CLASSIFICATIONS

Therapeutic: 

Antiemetics

ACTIONS

Physiologic Mechanism

• Decreased nausea and vomiting.

• Decreased symptoms of gastric stasis.

Pharmacologic Mechanism

• Blocks dopamine receptors in chemoreceptor trigger zone of the CNS.

• Stimulates motility of the upper GI tract and accelerates gastric emptying.

INDICATION

• Management of esophageal reflux

• Treatment and prevention of postoperative nausea and vomiting

NURSING CONSIDERATIONS

• Assess patient for nausea, vomiting, abdominal distention, and bowel sounds before and

after administration.

• May cause drowsiness.

• Advise patient to avoid concurrent use of alcohol and other CNS depressant while

taking this medication.

• Advise patient to notify health care professional immediately if involuntary movement

of eyes, face or limbs occurs.

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Bayawas  (Bik.), Biabas (Sul.), Gaiyabat (If.),Gaiyabit (If.)

Geyabas (Bon.), Guayabas (Tag.), Guava (Engl.),Guyabas(Ilk.,

Tag.), Kalimbahin (Tag.), Psidium cujavus Linn. Bagabas (Ig.), Psidium aromaticum

Blanco Bayabas (Ilk., Tag.), Psidium pyriferum Linn. Bayabo (Ibn.), Psidium pomiferum

Linn. Bayauas (Bik., Pang.),Tayabas (Tag.) 

Bayabas or guava is a fruit bearing shrub or small tree that grows in the tropical climate

like Mexico, Peru and the Philippines. Bayabas is widely used in the Philippines as herbal

medicine and is recognized by the Philippine Department of Health for its antiseptic

property. Bayabas or guava fruit is known for being rich in vitamin C and vitamin A.

Bayabas leaves and fruits contain eugenol, tannin, saponins, amydalin, phenolic acids,

malic acid, ash, aldehydes, catequinic components and flavonoids.

Bayabas or guava is used in herbal medicine as antiseptic, anti-inflammatory, anti-

spasmodic, antioxidant hepatoprotective, anti-allergy, antimicrobial, anti-plasmodial,

anti-cough, antidiabetic, and antigenotoxic.

Bayabas or guava tree grows 3 to10 meters tall with greenish

to red-brownish smooth bark. Bayabas produce a round

globular bayabas fruit that starts as a flower. The bayabas

fruit is green and turns yellowish-green and soft when ripe.

Bayabas fruit has many small hard seeds contained in a

yellowish pulp. Bayabas fruit is usually eaten while still

green and hard.

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Page | 26

How to use Bayabas as an antiseptic and astringent

Preparation:

Gather fresh bayabas leaves and wash with water.

Boil one cup of Bayabas leaves in three cups of water for 8 to 10 minutes.

Strain and let cool.

To use as mouthwash, gargle

To use as wound disinfectant, wash affected areas 2 to 3 times a day.

Use as vaginal wash especially after child birth.

Fresh Bayabas leaves can also be chewed for the treatment of toothache and gum

swelling.

To hasten wound healing, fresh Bayabas leaf poultice may be applied to the wound.

If symptoms persist or aggravates, stop use and consult your doctor.

For diarrhea and control stomach parasites

Gather fresh Bayabas leaves,

Boil chopped pieces of about 4 to 6 tablespoon for every 18 ounces of water.

Strain and let cool.

Drink ¼ cup of decoction every 3-4 hours until symptoms improve.

Bayabas Side Effects

Eating too much of Bayabas fruit can cause constipation.

If there is no improvement to diarrhea symptoms in two days, consult your doctor.

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Generic name: Budesonide, formoterol fumarate

Brand name: Symbicort

Drug class: Corticosteroid

Therapeutic actions: Anti-inflammatory effect; local administration into nasal passages

maximizes beneficial effects on these tissues, while decreasing the likelihood of adverse

effects from systemic absorption.

Indications: Regular treatment of asthma where use of a combination (inhaled

corticosteroid & long-acting β2-agonist) is appropriate. Symptomatic treatment of patients

w/ moderate or severe COPD, w/ significant symptoms & a history of exacerbations.

Contraindications and cautions:

Contraindicated with hypersensitivity to drug or for relief of acute asthma or

bronchospasm.

Use cautiously with TB, systemic infections, lactation.

Dosages:

Adults (≥18 years): 1-2 inhalations once or twice daily. In some cases, up to a maximum

of 4 inhalations twice daily may be required as maintenance dose or temporarily during

worsening of asthma.

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Adolescents (12-17 years): 1-2 inhalations once or twice daily. During worsening of

asthma, the dose may temporarily be increased to a maximum of 4 inhalations twice

daily.

Children (≥4 years): 1-2 inhalations twice daily of 80/4.5 mcg/dose or 1 inhalation twice

daily of 160/4.5 mcg/dose. Maximum Daily Dose: 4 inhalations of 80/4.5 mcg/dose or 2

inhalations of 160/4.5 mcg/dose.

Adverse effects:

CNS: Headache, dizziness, lethargy, fatigue, paresthesias, nervousness

Dermatologic: Rash, edema, pruritus, alopecia

Endocrine: HPA suppression, Cushing's syndrome with overdosage and systemic

absorption

GI: Nausea, dyspepsia, dry mouth

Local: Nasal irritation, fungal infection

Respiratory: Epistaxis, rebound congestion, pharyngitis, cough

Other: Chest pain, asthenia, moon face, acne, bruising, back pain

Nursing considerations

Assessment

History: Untreated local nasal infections, nasal trauma, septal ulcers, recent nasal

surgery, lactation

Physical: BP, P, auscultation; R, adventitious sounds; exam of nares

Interventions

Inhalation

Taper systemic steroids carefully during transfer to inhalational steroids; deaths

from adrenal insufficiency have occurred.

Arrange for use of decongestant nose drops to facilitate penetration if edema,

excessive secretions are present.

Prime unit before use for Pulmicort Turbuhaler; have patient rinse mouth after

each use.

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Page | 29

Use aerosol within 6 mo of opening. Shake well before each use.

Store Respules upright and protected from light; gently shake before use; open

envelopes should be discarded after 2 wk.

Teaching points

Inhalation

Do not use more often than prescribed; do not stop without consulting your health

care provider.

It may take several days to achieve good effects; do not stop if effects are not

immediate.

Use decongestant nose drops first if nasal passages are blocked.

Prime unit before use for Pulmicort Turbuhaler; rinse mouth after each use.

Store Respules upright, protect from light; discard open envelopes after 2 wk;

gently shake before use.

These side effects may occur: Local irritation (use your device correctly), dry

mouth (suck sugarless lozenges).

Report sore mouth, sore throat, worsening of symptoms, severe sneezing,

exposure to chickenpox or measles, eye infections.

Dela Cruz, Stephanie

Page | 30

Generic Name: Citicoline

Brand Name: Cholinerv

Classification: Neurotonics, Nootropics

Mechanism of Action: Citicoline seems to increase a brain chemical called

phosphatidylcholine. This brain chemical is important for brain function. Citicoline might

also decrease brain tissue damage when the brain is injured.It is usually known that

phospholipid, especially lecithin, decreases following decline in brain activity with

cerebral trauma. Citicoline, which is a co-enzyme, accelerates the biosynthesis of lecithin

in the body.

Indication:

Parkinson’s disease

Head injury

Cerebral vascular disease

Alzheimer’s disease

Cerebral surgery or acute cerebral disturbance

Disturbance of consciousness following brain surgery

Contraindications and cautions

Patients with acute, severe & progressive disturbance of consciousness

Administration with hemostatics

Dela Cruz, Stephanie

Page | 31

Intracranial pressure relieving drugs or use measures to keep body temp low.

Adverse Effects:

Body temperature elevation

Restlessness

Headaches

Nausea and vomiting

Diarrhea

Low or high blood pressure

Tachycardia

Sleeping troubles or insomnia

Blurred vision

Chest pains

Nursing Management

Citicoline may be taken with or without food. Take it with or between meals.

The supplement should not be taken in the late afternoon or at night because it can

cause difficulty sleeping.

Women who are pregnant or trying to become pregnant should consult with their

doctor before taking the supplements. Not enough is known about the use of

Citicoline during pregnancy and breast-feeding. Stay on the safe side and avoid

use.

Special attention should be paid for administration in the neonate, premature and

children.

Contact the physician immediately if allergic reaction such as hives, rash, or

itching, swelling in your face or hands, mouth or throat, chest tightness or trouble

breathing are experienced.

Citicoline therapy should be started within 24 hours of a stroke. The physician

will prescribe the correct dosage and the length of time it should be taken for a

medical condition.

Dela Cruz, Stephanie

Page | 32

Banaba

SCIENTIFIC NAME: Lagertroemia Speciosa

COMMON NAME: Banabalean, Corosolic acid, Crape Myrtle, Crepe Myrtle,

Lagerstroemia flos-reginae

GENERAL CLASSIFICATION: antioxidant, anti-inflammatory, antidiabetic

INDICATION:

Diabetes

Weight loss

Hypertension

Good for the kidneys

Aids the digestive system

Helps ease urination

PREPARATION AND USAGE:

Fresh leaves, dried leaves, flowers, ripe fruit, root and bark of Banaba can all be

used.

Wash the leaves in running water (if fresh). Cut into smaller pieces if desired.

Boil Banaba (one cup Banaba to cup of water) for 30 minutes. Drink like tea.

Decoction of old leaves and dried fruit (dried from one to two weeks), 50 gms to a

pint of boiling water, 4 to 6 cups daily has been used for diabetes. Old leaves and

ripe fruit are preferred, believed to have greater glucose lowering effect. Young

Dela Cruz, Stephanie

Page | 33

leaves and flowers have a similar effect, though only 70% that of matures leaves

and fruits. The wood has no known glucose lowering effect; the bark, a very small

amount.

A decoction of 20 gms of old leaves or dried fruit in 100 cc of water was found to

have the equivalent effect to that of 6 to 7.7 units of insulin.

- The bark decoction has been used for the treatment of diarrhea.

- The bark, flowers and leaves used to facilitate bowel movements.

- Decoction of fruits or roots gargled for aphthous stomatitis.

- Decoction of leaves and flowers used for fevers and as diuretic.

- Leaf decoction or infusion used for bladder and kidney inflammation, dysuria,

and other urinary dysfunctions.

SIDE EFFECT/ ADVERSE REACTION:

To date, no toxicity has been identified.

NURSING INTERVENTIONS:

Wash the leaves thoroughly.

Make sure to boil the leaves well.

Dela Cruz, Stephanie

Page | 34

Generic name: Multivitamins with iron

Brand name: Iberet

Drug class: Vitamins & Minerals (Pre & Post Natal) / Antianemics

Therapeutic actions: Provides elemental iron, an essential component in the formation

of hemoglobin.

Indication: Treatment & prevention of Fe-deficiency & concomitant folic acid

deficiency w/ associated deficient intake or increased need for vit B-complex in

nonpregnant adults.

Contraindication: Thalassemia, sideroblastic anemia, hemochromatosis &

hemosiderosis. Childn.

Dosage: 1 tab OD

AR: Allergic reactions, GI effects, hyperbilirubinemia, acneform vulgaris deterioration or

acneform exanthema eruption, bright yellow urine discoloration, flushing, dizziness or

faintness, peripheral sensory neuropathies, stone formation, crystalluria & oxalosis, black

discoloration of stool.

Nursing Responsibilities:

Tell patient to continue regular dosing schedule if she misses a dose. Patient

shouldn’t double the dose.

Dela Cruz, Stephanie

Page | 35

To avoid staining teeth, give elixir iron preparations with straw.

Check for constipation; record color and amount of stool. Teach dietary measures

for preventing constipation.

Do not crush, chew, sustain or release preparations.

If overdose is suspected, tell the client to contact local poison control center or

emergency room immediately.

Dela Cruz, Stephanie

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Brand name: Aprovel

Generic name: Irbesartan

General Action: Anti-hypertensive, ARB

Specific action: Selectively blocs the binding of angiotensin II to specific tissue receptors

found in the vascular smooth muscle and adrenal gland; this action blocks the

vasoconstriction effects of the rennin-angiotensin system as well as the release of

aldosterone, leading to decreased BP.

Indications:

Treatment of hypertension as monotherapy or in combination with other

antihypertensives.

Slowing of the progression of nephropathy in patients with hypertension and type

2 diabetes.

Dosage:

Tablets- 75,150,300mg

Dosage adults:

Diabetic nephropathy:300 mg/day PO as a single dose

Estacio, Joanne

Page | 37

Hypertension: 150mg PO daily as one dose, adjust slowly to determine effective

dose, maximum

Pediatric Patients 13-16 yr

150 mg/day PO; maximum dose 300mg.

Pediatric Patients 6-12 yr

75 mg/day PO, titrate to a maximum of 150 mg/day

Contraindications:

Contraindicated with hypertensitivity to irbesartan, pregnancy (use during the

second and third trimester can cause injury or even death to the fetus)

Use cautiously with hepatic or renal impairmengt, hypovolemia, volume or

sodium depletion, lactation.

Adverse Effects:

CNS: Headache, dizziness, syncope,muscle weakness, sleep disturbances

CV: hypotension, orthostatis hypotension, flushing.

Dermatologic: rash, inflammation, urticaria, pruritus, alopecia, dry skin.

GI: diarrhea, abdominal pain, nausea, constipation, dry mount, dental pain,

dyspepsia

Respiratory: URI symptoms, cough, sinus disease

Other: cancer in preclinical studies, back pain, fever gout, fatigue, neutropenia,

angioedema.

Nursing Responsibilities:

Monitor patient’s BP regularly.

Monitor patient’s electrolytes.

Assess patients and familys knowledge of drug therapy

Give with a diuretic if drug is needed to control blood pressure

Estacio, Joanne

Page | 38

Place in supine position an give an IV infusion of NSS if patient becomes

hypotensive

Tell patient that drug may be taken once daily with or without food.

Instruct client avoid driving and hazardous activities until CNS effects of the drug

are known.

Estacio, Joanne

Page | 39

Brand Name: Zovirax

Generic Name: Acyclovir

General Action: Antiviral, purine nucleoside analogue

Specific Action: Antiviral activity inhibits viral DNA replication.

Indications:

Initial and recurrent mucosal and cutaneous HSV-a and HSV-2 and varicella

zoster infections in immunocompromised patients

Herpes simplex encephalitis

Treatment of neonatal HSV infections

Acute treatment of herpes zosters(shingles) and chicken pox(varicella)

Ointment: initial herpes genital infections, limited mucocutaneous HSV infections

in immonocompromised patients.

Cream: recurrent herpes labialis (cold sores) in patients 12yr or older.

Unlabeled uses: cytomegalovirus and HSV infection following transplant, ocular

and other herpes simplex infections, varicella pneumonia, disseminated primary

eczema herpecticum

Page | 40

Dosage:

Parental

Herpes simplex: 5-10 mg/kg infused IV over 1 hr every 8 hr for 5-10 days.

Oral

Initial genital herpes: 200mg every 4hr five times daily (1,000 mg/day) for 10

days.

Long term suppressive therapy: 400 mg BID for up to 12mo.

Intermittent therapy;200mg every 4hr five times daily for 5 days

Acute herpes zoster’s; 800 mg every 4hr five times daily while awake for 7-10

days

Chicken pox 800mg qid for 5 days

Pediatric patient(parental)

HSV infections in patients younger than 12yr: 10 mg/kg infused IV over 1 hr

every 8hr for 7 days

Varicella zoster infection in patients younger than 12 yr: 20mg/kg IV over 1 hr

every 8 hr for 7 days.

Shingles, HSV encephalitis in patients 3 mo to 12 yr: 20mg/kg IV over 1 hr every

8hr for 10 days

Neonatal HSV: 10mg/kg infused over 1hr every 8hr for 10 days.

IV

more than 50ml/min 5mg/kg every 8 hr

25-50ml/min 5mg/kg every 12 hr

10-25ml/min 5mg/kg daily

0-10ml/min 2.5mg/kg daily

Contraindication

Contraindicated with allergy to acyclovir, seizures, heart failure, renal disease,

lactation.

Use cautiously with pregnancy.

Adverse Effects

Systemic administration

Estacio, Joanne

Page | 41

CNS: headache, vertigo, depression, tremors, encephalopathic changes

Dermatologic: inflammation or phlebitis at infection sites, rash, hair loss

GI: nausea, vomiting, diarrhea, anorexia

GU: crstalluria with rapin IV administration, hematuria, increased BUN

Topical Administration

Dermatologic: transient burning at site of application

Nursing Responsibilities

Complete the full course of oral therapy, and do not exceed the prescribe dose.

Oral acyclovir is not a cure for your disease but should make you feel better.

Avoid sexual intercourse while visible lesions are present.

Wear rubber gloves or finger cots when applying the drug to present

autoinoculation of other sites and transmission to others.

This drug may cause burning, stinging, itching, rash; notify your health care

provider if these are pronounced.

Estacio, Joanne

Page | 42

FUCICORT

Generic Name: Betamethasone valerate, Fusidic acid

Brand Name: Fucicort

General Action: Antibiotic

Specific Action: Derma/ Fixed-Dose Combinations, Topical/ Antibiotic & Anti-

inflammatory, Topical

Indication:

Inflammatory dermatoses where bacterial infection is present or likely to occur.

Dosage:

Cream 5 g

Contraindication:

Viral skin disease, perioral dermatitis, rosacea, fungal skin infections and

ulcerative conditions.

Adverse Effects:

Estacio, Joanne

Page | 43

Local atrophic changes in skin; hypersensitivity

Nursing Responsibilities:

Apply the ointment on the dry skin

Assess for any allergic reaction

Assess for any irritation on the skin

Apply the right amount of cream

Only apply the ointment on the affected area

Estacio, Joanne

Page | 44

PANDAN LALAKI

Scientific Name: Pandanus odoratissimus L.

English: Fragrant screwpine

Tagalog: Pandan lalaki

Erect, branched small tree, growing 3-5 meters, the trunk bearing many prop

roots. Leaves are spirally crowded toward the ends of the branches, linear

lanceolate, slenderly long-acuminate, up to 1.5 meters long, 3-5 cm wide, the

margrins and midrib armed with sharp spiny teeth pointing toward the apex of the

leaf. The male inflorescence is fragrant, pendulous, up to 0.5 meter long. Fruit is

solitary, pendulous, ellipsoid to globose-ellipsoid, about 20 cm long, composed of

50-75 obovoid, angular, fibrous and fleshy drupes, 4-6 cm long, narrow below

and truncate at the apex.

Distribution.

Estacio, Joanne

Page | 45

In thickets along seashores throughout the Philippines

Parts utilized

Constituents and characteristics

Essential oil, alkaloids, glycosides and tannin.

The prop roots possess diuretic properties.

Medicinal uses

Diuretic: Take decoction of fresh or dried prop root as tea.

Headache, arthritis, stomach spasms: Decoction of leaves. Poultice of fresh leaves

mixed with oil also used for headaches.

Culinary:

An aromatic leaf used to perfume rice dishes.

Wound healing: Pulverized dried leaves used to facilitate wound healing.

Poultice of mash of cabbage of plant, mixed with salt and juice of Citrus

microcarpa, for abscesses.

Others:

Decoction of roots believed to have aphrodisiac and cardiotonic properties.

Also used for arthritis and to prevent spontaneous abortion.

Chewing the roots strengthens the gums.

Decoction of roots combined with sap of banana plant for urethral injections for

variety of urinary complaints.

Nursing Responsibilities:

Follow the right amount of leaves.

Wash thoroughly the leaves and roots.

Don’t over boil the leaves.

Estacio, Joanne

Page | 46

Use fresh leaves

Common NameSensitive Plant, Humble Plant, Shameful Plant, Sleeping

Grass, Touch-me-not

Scientific Name Mimosa Pudica L

Tagalog Name Makahiya

Parts Used Root, Flower, Leaves and Stem

Uses:Expectorant, Antidepressant, Analgesic, Anti spasmodic,

Leaves are used for Diabetes, for mumps

for Mumps

Collect leaves from this plants and prepare them to be

mince.

Place the minced leaves of Mimosa to the swollen parts of

the mumps. Let it for 30 mins. And do it 3 times a day.

For Diarrhea

Collect a cup of leaves of Mimosa that is pulverized or

minced and boil it for 10 minutes of 2 glass of water.

Doses:

Adult : 1 teacup and take 3 times the whole day or till

the diarrhea is present.

2-6 yr Old: 1/4 teacup 3 times a day

7-12 yr Old: 1/2 teacup 3 times a day.

For asthma

expectorant

Decoction 5 grasp of plant in 2 glass of water.cool and

Drink.

For Bladder stones Decoction of roots 

For Diabetes Decoction of leaves

Estacio, Joanne

Page | 47

Henson, John Reynold

Page | 48

Generic Name Hydrogen Peroxide

Brand Name Agua Oxinada

General Action topical anti-infectives

Specific Action

Hydrogen peroxide is an oxidising agent with

antibacterial and antiviral activity. It is used as an

antiseptic, disinfectant, and deodorant. It also has a

mild haemostatic action. It exerts its antiseptic action

partly by its ready release of oxygen when applied to

tissues, but this effect is reduced in the presence of

organic matter. The mechanical effect of effervescence

may be more useful for wound cleansing than the

antimicrobial action.

Indication Hydrogen peroxide has traditionally been used as a

wound cleanser

Hydrogen peroxide is also commonly used in

mouthwashes, mostly as a "debriding agent"

Hydrogen Peroxide is used to help remove earwax,

usually by softening the wax

ContraindicationInstillation of hydrogen peroxide into closed body

cavities.

Route and Dosage

For earwax: Dilute 6% hydrogen peroxide solution

with 3 parts of water, immediately before use.

For Wound cleansing: 6% solution or 1-1.5% cream.

Adverse Effects

Nausea and vomiting

Burns in the mouth, throat, esophagus, and stomach

Bleeding in the stomach

Inflammation of the intestines

Henson, John Reynold

Page | 49

Stomach ulcer

Rupture of the colon

Nursing Responsibilities Do not apply directly on wound

Henson, John Reynold

Page | 50

Generic Name Mebendazole

Brand Name Vermox

General Action Anthelmintic

Specific Action

Irreversibly block glucose uptake by susceptible

helminthes, depleting glycogen stores needed for

survival and reproduction of helminthes, causing death.

Indication

Treatment of trichuris trichiura, enterobius

vermicularis, ascaris lumbricoides, ancylostoma

duodenale, necator americanus

Contraindication

Contraindicated with allergy to mebendazole,

pregnancy

Use cautiously with lactation

Route and Dosage Oral 100 mg

Adverse Effects Transient abdominal pain, diarrhea and fever

Nursing Responsibilities

Administer Drug with food

Treat all family member for pinworm infestation

Disinfect toilet facilities after patient use

Tablet may be chewed or crushed

Henson, John Reynold

Page | 51

Generic Name Mefenamic Acid

Brand Name Apo-mefenamic, ponstel

General Action NSAID

Specific Action

Anti-inflammatory, analgesic, and antipyretic activities

related to inhibition of prostaglandin synthesis; exact

mechanisms of action are not known.

Indication

Relief of moderate pain when therapy will not exceed 1

week

Treatment for primary dysmenorrheal

ContraindicationContraindicated with hypersensitivity to mefenamic

acid, aspirin allergy

Route and Dosage Oral 250mg

Adverse Effects CNS: headache, dizziness, somnolence, insomnia,

fatigue, tiredness, tinnitus, ophthalmic effects

Dermatologic: rash, pruritus, sweating, dry mucous

membranes, stomatitis

GI: Nausea, dyspepsia, Gi pain, diarrhea, vomiting,

constipation, flatulence

GU: Dysuria, renal impairment

Respiratory: Dyspnea, Hemoptysis, pharyngitis,

bronchspasm, rhinitis

Other: Peripheral edema, anaphylactoid reactions to

anaphylactic shock

Nursing Responsibilities

Take drug with food

Discontinue drug and consult health care provider if

rash,, diarrhea, or digestive problem occurs.

Henson, John Reynold

Page | 52

Henson, John Reynold

Page | 53

Bryophyllum pinnatum   (Lam.) Kurz.

Botany

Katakataka is an erect, more or less branched, smooth, succulent herb, 0.4 to 1.4 meters

in height. Leaves are simple or pinnately compound, with the leaflets elliptic, usually

about 10 centimeters long, thick, succulent, and scalloped margins. Plantlets grow along

the notches of the leaf margins which can develop while still attached to the plant or

when detached, a fascinating characteristic that earns its name. Flowers are cylindric, and

pendulous in a large, terminal panicle. Calyx is tubular, cylindric, inflated, brownish or

purplish, 3.5 to 4 centimeters long. Corolla is tubular, about 5 centimeters long, inflated

at the base, and then constricted, the exserted parts being reddish or purplish and the

lobes tapering to a point. Fruit is a follicle with many see.

Distribution

- In open settled areas, thickets, dry second-growth forests, sometimes planted, and

locally abundant.

- Prehistoric introduction from tropical Asia or Malaya.

- Also cultivated, flowering from December to March. 

- Pantropic.

Constituents 

• Yields arachidic acid, astragalin, behenic acid, beta

amyrin, benzenoids, bersaldegenin, beta-sitosterol,

bryophollenone, bryophollone, bryophyllin, caffeci

acid, ferulic acid, quercetin, steroids, and taraxerol.

• Phytochemical evalutation of leaf extract yielded

bryophyllum A, B and C, a potent cytotoxic

bufadienolide orthoacetate.

• Bufadienolide has been reported to be poisonous

with digitalis-toxicity type cardiac effects (slowing of heart rate, heart blocks and

potentially fatal ventricular arryhthmias.

Oballo, Neil

Bryan

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• Bryophillin A, a bufadienolide compound, has shown anti-tumor promoting activity.

• Leaves yield malic acid.

Properties

• Leaves considered astringent, antiseptic, and counterirritant.

Parts utilized

Entire plant. May be collected year round; preferably used fresh.

Uses

Folkloric

- Leaves used as astringent, antiseptic, and counterirritant against poisonous insect bites.

- Pounded fresh material is applied as a poultice for a variety of conditions: Sprains,

eczema, infections, burns, carbuncle and erysipelas. 

- Leaves, made pliable by hold over fire, are applied to wounds, bruises, boils; also, used

as poultice or power in bad ulcers.

- Juice is mixed with lard and used for diarrhea, dysentery, cholera, and phthisis.

- Pounded leaves are applied as poultices to the soles of the feet to stop hemorrhages.

- Leaves are used as topicals in dislocation, ecchymoses, callosities.

- Leaves, pounded and mixed with salt, used as plaster and applied to stomach to relieve

eneurosis.

- For boils, the whole leaf is pressed by hand, to and fro, until it becomes moist with the

leaf extract. A small opening is made in the middle of the leaf which is then placed on the

boil with hole over the pointing of the abscess.

- For asthma, leaves of leaves places in hot water for 15 minutes, then juice squeezed out

of the leaves, and drunk. 

- Juice of leaves used in biliuos diarrhea and lithiasis. 

- In Puerto Rico, leaf juice used as diuretic.

- Leaves are rubbed or tied on the mhead for headaches.

- Leaf juice used for earache and ophthalmia.

- In Sierre Leon, cough medicine is made from the roots. 

- In Brazil leaves, heated over fire and mixed with oil, are used as emollient and

Oballo, Neil

Bryan

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refrigerant for facial swelling associated with neuralgia or tooth trouble. Also, used for

asthma and bronchitis.

- In Jamaica, leaves used for coughs and colds. Sometimes, it is mixed with salt or honey,

for headaches, colds, bronchial affections, and hypertension. Heated leaves used for

swellings and abscesses.

- In Africa, used for earaches, eye problems, and as diuretic.

- In China used for rheumatoid arthritis, bruises, burns and ulcers.

- In Nigeria, leaf decoction usually taken to lower blood pressure.

Toxicity

• Cattle Poisoning: A report of 2 adult cattle deaths attributed the fatalities to a large of

amount of feeding of B pinnatum plants. The main autopsy findings were acute

rumenitis, reduction of bronchiolar lumens and emphysema.

Studies

• Depressant: Neuropharmacological Effects of Aqueous Leaf Extract of Bryophyllum

Pinnatum in Mice: Study revealed CNS depressant activity of the aqueous leaf extract

that could be due to the presence of bufadienolide.

• Antinociceptive / Anti-inflammatory / Antidiabetic: Leaf extract study of BP on

animals showed it to possess antinociceptive, anti-inflammatory and hypoglycemic

properties probably due to the flavonoid, polyphenol and triterpenoid contents.

• Antiulcer: (1) Results of methanolic extract study in rats showed that BP possessed

potent antiulcer properties. Leaf extract showed significant reduction in incidence of

ulceration in indomethacin-induced gastric ulceration in a dose-dependent manner. (2)

Study of methanolic fractionn of extract of BP showed significant anti-ulcer activity in

nine different experimental animal models.

• Tocolytic / Pre-term labor: (1) Study characterized the tocolytic activity of BP in vitro

vs the betamimetic, fenoterol. Results confirmed its tocolytic activity and justifies further

clinical studies. (2) Intravenous tocolysis with Bryophyllum pinnatum is better tolerated

than beta-agonist application. (3) In vitro results showed B. pinnatum juice inhibits the

oxytocin-induced increase of Ca in human myometrial cells in a dose-dependent manner.

The inhibition was attributed to a specific effect on the oxytocin signalling pathway.

Oballo, Neil

Bryan

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• Analgesic: The study concludes that the aqueous extract of BP has strong analgesic

potency comparable in a times- and dose-dependent manner to a nonsteroidal anti-

inflammatory drug.

• Antileishmanial: The antileishmanial activity assessment of unusual flavonoids from

Kalanchoe pinnata: Quercetin from K pinnata has demonstrated to be a potent

antileshmanial flavonoid. Another study yielded unusual flavonoids with antileishmanial

effect.

• Cytotoxic: A study isolated a potent cytotoxic bufadienolide orthoacetate and identified

as bersaldegenin 1,3, 5-orthoacetate.

• Antimicrobial: Extract of leaves showed activity against all test organisms except for

Candida albicans. Of all the extracts of Bp, themethanol extract was the most active with

marked antibacterial activities against control strain of S aureus, E faecalis, B subtilis and

P aeruginosa.

• Antihypertensive: Study showed a blood pressure lowering effect. However, since the

reduction in blood pressure was only slight, and because of potential hepatotoxic

nephrotoxic effects, and cardiotoxicity at high doses, it is not suggested as a blood

pressure lowering agent.

Oballo, Neil

Bryan

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GENERIC NAME: Ranitidine

BRAND NAME: Zantac

CLASSIFICATION

Therapeutic: 

Anti-ulcer agents

Pharmacologic:

Histamine H2 antagonists

DOSAGE

20 mg IV q8h

MECHANISM OF ACTION

• Inhibits the action of histamine at the H2 receptor site located primarily in gastric

parietal cells, resulting in inhibition of gastric acid secretion.

• In addition, ranitidine bismuth citrate has some antibacterial action against H. pylori.

Oballo, Neil

Bryan

Page | 58

INDICATION

•Treatment and prevention of heartburn, acid indigestion, and sour stomach.

CONTRA INDICATIONS

Contraindicated in:

•Hypersensitivity, Cross-sensitivity may occur; some oral liquids contain alcohol and

should be avoided in patients with known intolerance.

Use Cautiously in:

• Renal impair- ment

• Geriatric patients (more

susceptible to adverse CNS reactions)

• Pregnancy or Lactation

SIDE EFFECTS/ ADVERSE EFFECTS

• CNS:

Confusion, dizziness, drowsiness, hallucinations, headache

• CV:

Arrhythmias

• GI:

Altered taste, black tongue, constipation, dark stools, diarrhea, drug-induced hepatitis,

nausea

• GU:

Decreased sperm count, impotence

• ENDO:

Gynecomastia

• HEMAT:

Agranulocytosis, Aplastic Anemia, neutropenia, thrombocytopenia

Oballo, Neil

Bryan

Page | 59

• LOCAL:

Pain at IM site

• MISC:

Hypersensitivity reactions, vasculitis

NURSING IMPLICATIONS/RESPONSIBILITIES

• Assess patient for epigastric or abdominal pain and frank or occult blood in thestool,

emesis, or gastric aspirate.

• Nurse should know that it may cause false-positive results for urine protein; test with

sulfosalicylic acid.

• Inform patient that it may cause drowsiness or dizziness.

• Inform patient that increased fluid and fiber intake may minimize constipation.

• Advise patient to report onset of black, tarry stools; fever, sore throat; diarrhea;

dizziness; rash; confusion; or hallucinations to health car professional promptly.

• Inform patient that medication may temporarily cause stools and tongue to appear gray

black.

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Bryan

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Generic Name: Omeprazole magnesium

Product Name: Losec Tablets

Indication of Losec Tablets:

Used in the treatment of a number of conditions associated with too much acid

production when over-the-counter antacid medications have failed:

Gastroesophageal reflux - GORD (symptomatic)

Erosive oesophagitis (treatment and relapse prevention)

Duodenal and gastric ulcer (treatment and relapse prevention

Ulcers associated with H. pylori infection (as part of combination therapy for

treatment and relapse prevention)

Ulcers associated with NSAIDS (treatment and relapse prevention)

Zollinger-Ellison syndrome

Action of Losec Tablets:

Losec works by inhibiting certain cells involved in acid production to reduce the amount

of acid produced in the stomach. This reduces erosion of the stomach cells and helps with

the pain associated with peptic ulcer disease. It also helps in diseases where too much

stomach acid is regurgitated back into the oesophagus.

Dose advice of Losec Tablets:

Tablets should be swallowed whole or dissolved in water or juice and drunk, not chewed

or crushed.AdultsSymptomatic GORD:

Oballo, Neil

Bryan

Page | 61

10-20mg/day

Maximum 4 weeksErosive oesophagitis:

20-40mg/day

4-8 weeks

Maintenance: 10-20mg/dayH. pylori ulcer:

40mg/day with appropriate antibiotics (see Losec HP 7)Duodenal ulcer:

20-40mg/day

4-8 weeks

Maintenance: 10-20mg/dayGastric ulcer and NSAID ulcer:

20-40mg/day

4-8 weeks

Maintenance: 20mg/dayZollinger-Ellison syndrome:

60mg/day

Treatment should continue as long as clinically indicated.Children > 1 year

10-20kg: 10-20mg/day for 2-8 weeks

>20kg: 20-40mg/day for 2-8 weeks

Schedule of Losec Tablets:

S4

Common side effects of Losec Tablets:

Losec is generally well tolerated, but the following adverse effects have been reported in

less than 10% of patients:- Diarrhoea- Constipation- Abdominal pain- Nausea and

Vomiting- Flatulence- Headache

Oballo, Neil

Bryan

Page | 62

Penicillin G

Popular Brand Name

Pen G

Dose/route:

IM 400,000-600,000 units q6h.

High doses are needed in order to maintain adequate serum levels since serum

half-life is short.

IM/oral (oral absorption is erratic; parenteral route is recommended, though

chances

of developing allergic reactions are increased).

Therefore penicillin G is reserved for severe infections, or when the oral route is

compromised (as in malabsorption syndrome and vomiting)

Drug action:

Inhibits enzymes responsible for cell wall synthesis of susceptible organisms.

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This creates an osmotically unstable cell wall that swells and bursts from osmotic

pressure.

It is a bactericidal drug in normal doses.

This drug is excreted through the renal system.

How supplied:

Available for IM injection:

Aqueous crystalline penicillin G

procaine penicillin G

benzathine penicillin G

Spectrum covered:

A narrow-spectrum antibiotic because at usual doses it mainly affects gram-

positive aerobic and facultative microorganisms, some anaerobes, and

spirochetes.

Effective against anaerobes associated with dental and periodontal diseases of

acute or chronic types: Diphtheroids, fusobacteria, peptostreptococci,

spirochetes, Actinomyces, Veillonella, and some Bacteroides, Prevotella and

Prophyromonas spp.

Effective for gram- positive cocci (S. aureus, S. viridans, S. faecalis, S. bovis, S.

pneumoniae), gram negative cocci (N. gonorrhoeae, N. memingitidis), gram-

positive bacilli (B. anthracis, Clostridium. species), gram-negative bacilli (S.

moniliformis), spirochetes (T. pallidum), Actinomyces, Peptococcus,

Peptostreptococcus species.

Penicillin G is slightly more effective against these organisms than is penicillin V

that may be important in severe infections.

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Indications:

Penicillin G is reserved for severe infections, or when the oral route is compromised (as

in malabsorption syndrome and vomiting), and for some patients requiring prophylactic

coverage.

Drug interactions:

Penicillins can decrease the effectiveness of oral contraceptives. Tetracyclines,

erythromycins, lincomycins all decrease the antimicrobial effectiveness of penicillin.

Aspirin, probenecid, and butazolidin may potentiate penicillin's effects. Penicillin may

potentiate coumadin and tandearil effects.

Contraindications:

Patients with known allergies to penicillin, which is approximately 3% of the population.

In patients with renal impairment, dosages should be decreased since excretion of drug is

by the renal system. A different formulation should be used in these patients such as

penicillin procaine that allows a slow release into the serum from the intramuscular site.

Precaution with pregnancy category B, lactation, and hypersensitivity to cephalosporins.

Side effects:

The penicillins are among the least toxic drugs known. They rarely elicit adverse

reactions in humans unless present in excessive concentrations. They can disrupt the

normal gastrointestinal flora and cause nausea, vomiting, diarrhea, abdominal pain,

colitis, and anorexia. To minimize diarrhea it is recommended that penicillin be taken

with two to three tablespoons of yogurt, or a lactobacillum tablet. Fatal anaphylaxis is

estimated to occur in one in 10,000 users. At high doses penicillin can have a toxic effect

that can cause seizures, platelet dysfunction, hemolytic anemias of an immunologic type,

encephalitis, and nephritis. Pseudomembraneous colitis is an occasional adverse reaction.

Page | 65

Generic Name: Rifampicin

Brand Name: Rifampin

Classification: Antibiotic, Antitubercular

Indication: Tuberculosis (all forms) - as part of a combination therapy

Therapeutic Action:

Rifampicin has a broad-spectrum bactericidal action which inhibits bacterial RNA

synthesis by binding to the β subunit of DNA-dependent RNA polymerase, thus blocking

RNA transcription. It is commonly used in the treatment of tuberculosis, leprosy and

opportunistic atypical mycobacterial infections.

Contraindication:

Hypersensitivity, jaundice, severe hepatic disease. IM/SC admin. Porphyria. Not to be

used for treatment of meningococcal disease.

Side Effects:

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Red- orange discoloration of urine, GI disturbances, pseudomembranous colitis (rare),

abnormalities of liver function, fatalities in those with liver disorders, 

Dosage:

Oral

Tuberculosis

Adult: 10 mg/kg daily or 2-3 times wkly. Max: 600 mg/day. 

Child: 10-20 mg/kg daily or 2-3 times wkly. Max: 600 mg/day. 

Hepatic impairment: Dosage reduction may be necessary. 

Nursing Responsibility:

Administer on an empty stomach, 1 hr before or 2 hr after meals.

Administer in a single daily dose.

Consult pharmacist for rifamoin suspension for patients unable to swallow capsules.

Prepare patient for the reddish-orange coloring of body fluids (urine, sweat, sputum,

tears, feces, saliva); soft contact lenses may be permanently stained; advise patients

not to wear them during therapy.

Warning: arrange for follow-up visits for liver and renal function tests, CBC, and

ophthalmic  examinations.

Teach client to take drug in a single daily dose. Take on an empty stomach, 1 hr

before or 2 hrs after meals.

Inform client to take this drug regularly; avoid missing any doses; do not discontinue

this drug without consulting the health care provider.

Tell client to have periodic medical checkups, including eye examinations and blood

test, to evaluate the drug effects.

Inform client that he may experience the drug’s side effects (especially the red colored

secretion)

Instruct client to see his physician if he experience fever, chills, muscle and bone pain,

excessive tiredness or weakness, loss of appetite, N/V, yellowing of eyes/skin,

unusual bleeding or bruising, skin rash or itching.

Instruct client to remove contact lenses as they may discolor

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Generic name: Isoniazid

Brand name: Niazid

Classification: Antituberculotic

Indications

Tuberculosis of all forms

Prophylaxis in specific patients who are tuberculin reactors (positive Mantoux test))

or who are considered to be high risk for TB.

Therapeutic Action

This medication is used with other medications to treat active tuberculosis (TB)

infections or alone to prevent those who have a positive TB test from developing

symptoms of TB. Isoniazid belongs to a class of drugs known as antibioticsthat are active

against tuberculosis. Interferes with lipid and nucleic acid biosynthesis in actively

growing tubercle bacilli.

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Contraindication

Isoniazid is contraindicated in patients who develop severe hypersensitivity reactions,

including drug -induced hepatitis; previous isoniazid-associated hepatic injury; severe

adverse reactions to isoniazid such as drug fever, chills, arthritis; and acute liver disease

of any etiology.

Side effects

Peripheral neuropathy

Nausea and vomitting

Thrombocytopenia

Local irritation at IM site

Epigastric distress

Elevated AST

Stock dose

Oral

Tuberculosis

Adult: 5 mg/kg daily. Max: 300 mg daily. For intermittent treatment: 10 mg/kg 3 times a

wk or 15 mg/kg twice wkly. Similar doses may also be given via IM admin. For latent

tuberculosis: 300 mg daily for 6 mth; alternatively, 5 mg/kg daily or 15 mg/kg twice wkly

for 9 mth. 

Child: 10-15 mg/kg/day in 1-2 divided doses (max: 300 mg/day). Alternatively,

intermittent therapy can be given at 20-40 mg/kg (max: 900 mg) 2-3 times wkly. For

latent tuberculosis: 10-20 mg/kg/day or 20-40 mg/kg twice wkly for 9 mth. Max: 300

mg/dose for daily regimen and 900 mg/dose for intermittent regimens. 

Nursing responsibilities

History: allergy to the drug.

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Can cause peripheral neuropathy which is manifested by tingling sensation on

extremities. It can be prevented through use of supplemental vitamin B6

(pyridoxine).

Physical: skin color, lesions, T; orientation, reflexes, peripheral sensirivity,

bilaterally grip strength ophthalmologic examination; R, adventitious sounds; liver

evaluation; CBC;LFTs renal fxn tests, blood glucose.

Give in an empty stomach 1 hr before or 2 after meals; may be given with food if GI

UPSET OCCURS.

Give in a single daily dose. Reverse parenteral dose for pt unable to take oral meds.

Dec. foods containing tyramine or histamine in pt diet.

Consult doctor and arrange for daily pyridoxine in diabetic, alcoholic or

malnourished pt also for pt that develops peripheral neuritis, and those with HIV.

Family health teachings:

Take this drug in single daily dose.

Take drug on an empty stomach, 1 hour before or 2 hours after meals. If GI

distress occurs, may be taken with food.

Take this drug regularly, avoid missing doses, do not discontinue without first

consulting your health care provider.

Do not drink alcohol or drink as little as possible. There is an inc. risk of heap if

these two drugs are combined.

Avoid foods containing tyramine, consult a dietitian to obtain a list of foods

containing tyramine or histamine.

Have periodic medical check-ups, including an eye examination and blood test, to

evaluate the drug effects.

Report for weakness, fatigue, loss of appetite, n/v, yellowing of skin or eyes,

darkening of the urine, numbness or tingling in hands or feet,

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Generic Name: Pyrazinamide

Classification: Antituberculotic 

Indication: For the initial treatment of active tuberculosis in adults and children when

combined with other antituberculous agents.

Therapeutic action:

Pyrazinamide has bactericidal action against M. tuberculosis in acid environment present

in macrophages and inflammed tissue. Together with rifampicin provides greatest

sterilising action with reduction in relapse rate. Reduces tubular secretion of uric acid.

Contraindication:

Contraindicated in patients hypersensitive to drug and in those with severe hepatic

disease or acute gout. Use cautiously in patients with diabetes mellitus, renal failure, or

gout. 

Side Effects:

- darkened urine

- difficult urination

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- fatigue

- fever

- loss of appetite

- pain and swelling in the joints 

- skin rash 

- unusual bleeding or bruising

- upset stomach

- vomiting

- yellowing of the skin or eyes

Dosage:

Oral

Tuberculosis

Adult: As part of a mulitdrug regimen, 20-25 mg/kg (max: 2 g) daily or 1.5-3 g 3 times

wkly. 

Child: As part of a mulitdrug regimen, 35 mg/kg daily or 50 mg/kg 3 times wkly or 75

mg/kg twice wkly. Max dose: 3 g daily.

Nursing responsibilities

• In patients with diabetes mellitus, pyrazinamide therapy may hinder stabilization of

serum glucose levels. 

• In many cases, drug elevates serum uric acid levels. Although usually asymptomatic, a

uricosuric drug, such as probenecid or allopurinol, may be needed. 

• Monitor liver function, especially enzyme and bilirubin levels, and renal function,

especially serum uric acid levels, before therapy and thereafter at 2- to 4-week intervals. 

• Patients with concomitant HIV infection may need a longer course of treatment. 

• Pyrazinamide may interfere with urine ketone determinations. 

• Drug temporarily decreases 17-ketosteroid levels and increases protein-bound iodine

and urate levels. 

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Breast-feeding patients 

• Drug appears in breast milk. Safety in breast-feeding women hasn’t been established.

An alternative to breast-feeding is recommended during therapy. 

Pediatric patients 

• Safe use in children hasn’t been definitely established. 

Geriatric patients 

• Because elderly patients commonly have diminished renal function, which decreases

drug excretion, drug should be used cautiously. 

• Explain disease process and rationale for long-term therapy. 

• Teach patient signs and symptoms of hypersensitivity and other adverse reactions, and

emphasize need to report them; urge patient to report unusual reactions, especially signs

of gout. 

• Make sure patient understands how and when to take drugs; urge patient to complete

entire prescribed regimen, to comply with instructions for around-the-clock dosage, and

to keep follow-up appointments. 

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Generic Name: Ethambutol

Brand Name: Myambutol

Classification: Antituberculosis agent

Indication: Treatment of pulmonary tuberculosis in combination with 1 or more other

antituberculous agents

Therapeutic Action:

Ethambutol interferes with RNA synthesis, causing suppression of Mycobacteria

multiplication. It also has bacteriostatic action against M tuberculosis by acting on

rapidly growing pathogens in cavity walls and is also effective in slow-growing

pathogens. Has some action against atypical opportunistic Mycobacteria e.g. M

kansasii, M avium complex (MAC).

Contraindication:

Hypersensitivity; optic neuritis. Lactation.

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Side Effects

Malaise; headache; dizziness; mental confusion; disorientation; possible hallucinations;

numbness and tingling of extremities. Decreased visual acuity. Anorexia; nausea;

vomiting; GI upset; abdominal pain. Eosinophilia. Transient liver function impairment.

Elevated serum uric acid; precipitation of acute gout. Pulmonary infiltrates.

Hypersensitivity (including anaphylactoid reactions; dermatitis; pruritus); fever; joint

pain.

Dosage

Oral

Primary treatment of pulmonary and extrapulmonary tuberculosis

Adult: As hydrochloride: Initial 8 wk: 15 mg/kg/day or 30 mg/kg thrice wkly given with

isoniazid, rifampicin and pyrazinamide. For patients with history of antimycobacterial

therapy: Initial doses: 25 mg/kg/day for 60 days, thereafter reduce to 15 mg/kg/day. 

Child: For treatment of drug-resistant tuberculosis: 15-25 mg/kg daily or 50 mg/kg twice

wkly. For congenitally acquired tuberculosis: Neonates: 15 mg/kg once daily and ≥1 mth:

15 mg/kg once daily or 30 mg/kg 3 times wkly for 2 mth initial treatment phase. 

Nursing Responsibilities

Review dosing schedule and prescribed length of therapy with patient.

Emphasize to patient that treatment will be lengthy and that the entire course of

treatment must be completed to avoid relapse or development of resistance.

Advise patient to take each dose without regard to meals, but to take with food if

GI upset occurs.

Instruct patient to immediately report the following to health care provider:

change in vision, visual abnormalities.

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Generic Name: Streptomycin sulfate

Classification: Antibiotic, anti-tubercular,anti-infective

Indication

Infections caused by susceptible strain of mycobacteriumtuberculosis.

Serious infections caused by susceptible strains of Yersinia Pestis

Therapeutic Action

Inhibits CHON synthesis strains of gram negative bacteria, mechanisms of lethal action

and fully understood, but functionalintegrity of cell membrane appears to be disrupted.

Contraindication

Allergy to aminoglycosides, pregnancy, lactation, Herpes vacinia fungal infection.

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Side Effects

Giddiness, vertigo, tinnitus, ataxia, hypersensitivity reactions, ototoxicity and

nephrotoxicity.

Dosage:

Intramuscular

Tuberculosis

Adult: 15 mg/kg daily; max: 1 g daily. Reduce max daily dose to 500-750 mg in patients

>40 yr. As part of an intermittent therapy: 25-30 mg/kg/day 2-3 times/wk; max: 1.5

g/dose. Not >120 g over the course of treatment should be given unless there are no other

treatment options. 

Child: 20-40 mg/kg (max: 1 g) daily or 25-30 mg/kg (max: 1.5 g) 2-3 times wkly. 

Elderly: ≥60 kg: Dosage reduction is required. 

Nursing Responsibilities

Use in route only: give by deep IM injection.

Ensure adequate hydration of patient before and during the therapy.

Monitor for hearing changes.

This drug can only be given by injection.

Report hearing changes,dizziness, pain at injection site, rash.

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Ampalaya

Scientific Name: Momordica Charantia

Botany

Ampalaya is a climbing vine, nearly or quite smooth, annual vine. Tendrils are simple, up

to 20 centimeters long. Leaves are 2.5 to 10 centimeters in diameter, cut nearly to the

base into 5 to 7 lobes, oblong-ovate, variously toothed, and heart-shaped at the base.

Male flower is about 12 millimeters long, and is peduncled, with a rounded, green, and

about 1 centimeter long bract approximately at the middle. Female flower is yellow

flower, about 15 millimeters long, long-stalked with pair of small leaflike bracts at

middle or toward base of stalk. Fruit, in cultivated form, is green, fleshy, oblong,

cylindric, 15 to 25 centimeters long, pointed at both ends, ribbed and wrinkled, bursting

when mature to release seeds; in wild forms, ovoid, about 2 to 4 centimeters long. Seeds

are oblong, compressed 10 to 13 millimeters long, and corrugated on the margins.

Distribution

- Year-round vegetable, extensively cultivated in the Philippines for its bitter edible fruit.

- Wild forms found in open fields, thickets, and waste places at low and medium

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altitudes. 

-  Probably of Asiatic origin.

- Pantropic. 

Constituents

- Phytochemical study yielded alkaloids, glycosides, aglycone, tannin, sterol, phenol and

protein.

- 1898 study reported a bitter alkaloid and a glucoside.

- Leaves and fruit yielded a bitter principle, momordicin.

- A petroleum ether extractive yielded a highly aromatic ethereal oil, a fixed oil, traces of

free fatty acids and carotene.

- Ethyl ether fraction yielded chlorophyll, a glucoside-like substance and resin.

- Water soluble extractive yielded a saponin-like substance and mucilaginous bodies.

Properties

- Considered astringent, antidiabetic, abortifacient, antirheumatic, contraceptive,

galactagogue, parasiticide, anthelmintic, purgative, emetic, antipyretic, febrifuge,

emmenagogue, cooling , tonic, vulnerary.

- Fruit considered tonic and stomachic.

Parts utilized

Leaves, roots and fruits.

Uses

Edibiity / Nutritional

- Both wild and cultivated forms are edible.

- Fruit of wild form usually roasted over fire and eaten with salt or "heko."

- The leaves and fruit - used as vegetables - are excellent sources of Vit B, iron, calcium,

and phosphorus. It has twice the amount of beta carotene in broccoli and twice the

calcium content of spinach.Characteristically bitter-tasting, slight soaking in salty water

before cooking removes some of the bitter taste of the fruit.

- In India, fruit eaten in curries. 

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Ampalaya for Diabetes. Clinical Studies for Ampalaya Bitter Melon demonstrated

hypoglycemic properties (blood sugar lowering) or other actions of potential benefit

against diabetes mellitus.

The hypoglycemic chemicals found in Ampalaya Bitter Melon include a mixture of

steroidal saponins known as charantins, insulin-like peptides, and alkaloids. The

hypoglycemic effect is more pronounced in the fruit of bitter melon where these

chemicals are in greater abundance. The fruit has also shown the ability to enhance cells’

uptake of glucose, to promote insulin release, and potentiate the effect of insulin. In other

in vivo studies, bitter melon fruit and/or seed has been shown to reduce total cholesterol

and triglycerides in both the presence and absence of dietary cholesterol. In one study,

elevated cholesterol and triglyceride levels in diabetic rats were returned to normal after

10 weeks of treatment

Ampalaya for Hemorrhoids. Powdered leaves and root decoction of Ampalaya are

applied to hemorrhoids as astringent.

Ampalaya for Stomach Problems. Ampalaya leaf juice is used to expel intestinal

parasites, treat dysentery, diarrhea, and chronic colitis. Grounded seeds may also be used.

Taken in a spoonfull 3x a day until ailment subsides.

Ampalaya for Cough. Ampalaya leaf juice is used for mild coughs for children.

Administered in a teaspoon 3x a day.

Ampalaya for Burns, Scalds and Wounds. Pounded Ampalaya seeds or leaf are used to

treat burns, scalds and wounds.

Ampalaya as Anti-Cancer, Two compounds extracted from ampalaya bitter melon, α-

eleostearic acid (from ampalaya seeds) and dihydroxy-α-eleostearic acid (from the

ampalayafruit) have been found to induce apoptosis of leukemia cells in vitro. Diets

containing 0.01% ampalaya bitter melon oil (0.006% as α-eleostearic acid) were found to

prevent azoxymethane-induced colon carcinogenesis in rats.

Other acclaimed uses are for the treatment of HIV, treatment of fever and headaches,

treatment of rheumatism and gout, disease of the spleen and liver.

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Amplaya Side Effects

In large dozes, pure Ampalaya juice can be a purgative and may cause pregnancy

abortion.

Philippine News: Diabetes Mellitus

A Philippine herb that has recently gained international recognition for its possible

benefits in the treatment of diabetes mellitus. Despite its bitter taste, it has also become a

popular nutritional drink for a boost of vim and vigor. In fact, the more bitter, the better,

as it is believed that the bitterness is proportionate to its potency. 

      Studies have suggested that ampalaya contains a hypoglycemic polypeptide, a plant

insulin responsible for its blood sugar lowering effect. Other benefits suggested were

body detoxification (including removal of nicotine), strengthening of the immune system

and fertility regulation.

     It is increasingly recommended as an adjunct or supplement to traditional therapeutic

regimens for diabetes mellitus.

Toxicity

None known.

Nursing Responsibilities:

Follow the right amount of leaves.

Wash thoroughly the leaves and roots.

Don’t over boil the leaves.

Use fresh leaves

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GENERIC NAME: losartan

BRAND NAME: Cozaar

DRUG CLASS AND MECHANISM: Losartan is an oral medication that

belongs to a class of drugs called angiotensin receptor blockers (ARBs). Other

ARBs include irbesartan (Avapro), valsartan (Diovan), and candesartan

(Atacand). Angiotensin, formed in the blood by the action of angiotensin

converting enzyme (ACE), is a powerful chemical that attaches to angiotensin

receptors found in many tissues but primarily on smooth muscle cells of blood

vessels. Angiotensin's attachment to the receptors causes the blood vessels to

narrow (vasoconstrict) which leads to an increase in blood pressure

(hypertension). Losartan (more specifically, the chemical formed when the liver

converts the inactive losartan into an active chemical) blocks the angiotensin

receptor. By blocking the action of angiotensin, losartan dilates blood vessels and

thereby reduces blood pressure.

STORAGE: Tablets should be stored at room temperature in a tightly closed,

light resistant container.

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INDICATION: Losartan is used for treating hypertension, left ventricular

hypertrophy (increase in muscle) and diabetic nephropathy (kidney disease). It

may be used alone or in combination with other drugs.

DOSING: The usual starting dose of losartan for adults is 50 mg daily. The

maximum dose is 100 mg daily. The total daily dose may be divided and

administered twice daily. Losartan may be given with or without food.

The starting dose of losartan for pediatric patients 6 years of age or older is 0.7

mg/kg up to 50 mg once daily. Doses more than 1.4 mg/kg or 100 mg daily have

not been evaluated in pediatric patients.

DRUG INTERACTIONS: Inhibitors of cytochrome P450 enzymes such as

fluconazole (Diflucan) reduced the formation of the active drug metabolite in

laboratory studies. Therefore, caution should be used when adding losartan in a

patient taking Nizoral, as reduced activity of losartan may occur.

Losartan may increase levels of blood potassium which can lead to serious heart

problems (arrhythmias). Therefore, concomitant use of other substances that

increase blood-such as potassium-sparing diuretics (for example, spironolactone

(Aldactone), triamterene, and amiloride), potassium supplements, or salt

substitutes containing potassium--may lead to dangerous increases in serum

potassium.

The antihypertensive effect of losartan may be reduced by nonsteroidal

antiinflammatory drugs (for example, indomethacin, ibuprofen, aspirin , and

naproxen).

SIDE EFFECTS: In clinical studies the overall incidence of side effects was

similar to placebo. Side effects reported included diarrhea, muscle cramps,

dizziness, insomnia, and nasal congestion. Losartan also may cause a persistent

cough, increase serum potassium, and angioedema. Losartan may reduce kidney

function in some patients and should not be used by patients who Santos, Krizza

Page | 83

have bilateral renal artery stenosis (narrowing of both arteries going to the

kidneys). Rare cases of rhabdomyolysis (muscle breakdown) have been reported.

NURSING CONSIDERATIONS:

-Administer without regard to meals.

-Ensure that patient is not pregnant before beginning therapy, suggest using

barrier

-birth control while using losartan; fetal injury and deaths have been reported.

-Find an alternative method of feeding the baby if given to a nursing mother.

-Depression of the renin-angiotensin system in infants is potentially very

dangerous.

-Alert surgeon and mark patient's chart with notice that losartan is being taken.

The

blockage of the renin-angiotensin system following surgery can produce

problems. Hypotension may be reversed with volume expansion.

-Monitor patient closely in any situation that may lead to a decrease in blood

pressure secondary to reduction in fluid volume—excessive perspiration,

dehydration, vomiting, diarrhea—excessive hypotension can occur.

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GENERIC NAME: Potassium Chloride

BRAND NAME: Kalium Durule

DRUG CLASSIFICATION AND ACTION: E l e c t r o l y t e ; R e p l a c e

p o t a s s i u m and maintain potassium level. To

preventhypokalemia, prophylaxis duringtreatment w/ diuretics

INDICATION: Supplement

CONTRAINDICATION: Contraindicated in patient with oliguria,anuria,;

patient withuntreated Addison’sdisease or with acutedehydration ,heatcramps,Use

cautiously with patient with cardiacdisease and

renalimpairmentArrhythmias,Heart block,HypotensionCardiac

arrestHyperkalemiaRespiratory paralysis.

SIDE EFFECTS:  Nausea andvomiting ,abdominal pain

NURSING RESPONSIBILITIES: Make sure the powder arecompletely

dissolve before giving. Monitor renal function.after surgery, don’t givedrug until

urine flow is established, tell patient to take drug with or after meals with full

glass of water of fruit juice to lessen GI distress

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GENERIC NAME: Metformin

BRAND NAME: Glucophage

CLASSIFICATION: Biguanide.

ACTION: Inhibits hepatic glucose production and increases sensitivity of

peripheral tissue to insulin.

INDICATIONS

- Diabetes mellitus.

- Polycystic ovary syndrome.

CONTRAINDICATIONS

- Renal impairment.

- Ketoacidosis.

- Should be stopped if tissue hypoxia is likely (for example, in respiratory failure,

sepsis, a recent myocardial infarction or hepatic impairment).

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- If iodine-containing X-ray contrast media have been used, metformin should be

stopped until renal function is normal.

- General anaesthesia (metformin should be stopped two days before and restarted

when renal function is normal).

- Pregnancy.

- Breastfeeding.

CAUTIONS

- Serum creatinine should be measured before treatment and twice a year

thereafter during treatment.

COMMON SIDE EFFECTS:

Anorexia, Nausea, Gastrointestinal problems including vomiting, diarrhoea and

heartburn, Abdominal pain, Thrombocytopenia, Metallic taste in the mouth,

Headache, Weakness, Dizziness, Drowsiness, Tinnitus, Fatigue, Vertigo,

Agitation, Rash.

RARE SIDE-EFFECTS:

Lactic acidosis, Decreased vitamin B12 absorption, Erythema, Hypoglycaemia

INTERACTIONS

- Risk of lactic acidosis is increased with alcohol.

- Hypoglycaemic effect of metformin is enhanced by monoamine oxidase

inhibitors.

NURSING CONSIDERATIONS

- Metformin is the drug of choice for overweight patients for whom dieting has

not controlled diabetes. Can also be used in patients who are not overweight and

when diabetes cannot be controlled with sulphonylurea treatment.

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- Advantages include lower incidence of weight gain.

- Gastrointestinal complaints are more common with higher doses.

- To avoid lactic acidosis do not use in patients with even mild renal problems.

- Store in a tight container in a cool place.

- Side-effects are common and advice about taking the drug with food or using

slow-release tablets can help.

PATIENT TEACHING

- Take with meals to avoid gastrointestinal problems.

- Notify health care staff of lactic acidosis symptoms, including hyperventilation,

fatigue and myalgia.

- Must be taken daily and not discontinued abruptly.

- The patient must inform the prescriber if they have any long-term liver or kidney

problems, heart failure, or if they are a heavy drinker or taking any other

medication.

Nurses should refer to manufacturer's summary of product characteristics and to

appropriate local guidelines.

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Garlic

SCIENTIFIC NAME: Allium Sativum

High cholesterol levels, for blood clots, and to lower blood pressure. It has also

been promoted for colds, bronchitis, and other uses. Check with your pharmacist

for more details regarding the particular brand you use.

Garlic is an herbal product. It is unknown exactly how it works.

Do NOT use Garlic if:

-you are allergic to any ingredient in Garlic

-you are pregnant

-Contact your doctor or health care provider right away if any of these apply to

you.

Before using Garlic:

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Some medical conditions may interact with Garlic. Tell your doctor or pharmacist

if you have any medical conditions, especially if any of the following apply to

you:

-if you are planning to become pregnant or are breast-feeding

-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, stomach or bowel problems, or a blood disease

Some medicines may interact with Garlic. Tell your health care provider if you

are taking any other medicines, especially any of the following:

-HIV protease inhibitors (eg, saquinavir) because effectiveness may be decreased

by Garlic

This may not be a complete list of all interactions that may occur. Ask your health

care provider if Garlic may interact with other medicines that you take. Check

with your health care provider before you start, stop, or change the dose of any

medicine.

How to use Garlic:

Use Garlic as directed by your doctor. Check the label on the medicine for exact

dosing instructions.

-Dosing depends on the use and the source of the product.

-Use as directed on the package, unless instructed otherwise by your doctor.

-The smell of garlic may be noticeable on the breath and skin. If this is

bothersome, use an enteric-coated garlic product.

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-It may take several weeks for garlic to lower cholesterol and up to 6 months to

lower blood pressure.

-If you miss taking a dose of Garlic for 1 or more days, there is no cause for

concern. If your doctor recommended that you take it, try to remember your dose

every day.

Possible side effects of Garlic:

All medicines may cause side effects, but many people have no, or minor, side

effects. Check with your doctor if any of these most COMMON side effects

persist or become bothersome:

Burning of the mouth, stomach, and throat; changes in the menstrual cycle;

lightheadedness; nausea; sweating.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the

chest; swelling of the mouth, face, lips, or tongue).

NURSING CONSIDERATIONS:

-Advise patient not to take garlic if taking warfarin.

-if the patient is diabetic, advise him to consult his physician first before adjusting

his medications.

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