endo and gi

8/12/2019 endo and gi

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FINASTERIDE

Used to treat male patterned baldness

As well As

Enlarged prostate gland


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FINASTERIDE

C Hormone, androgen inhibitor, hair stimulant. Used to treat benign prostatic hyperplas(enlargement of prostate gland) also to treat male-pattern baldness

H Results will show increased urinary flow; decreased post-voiding dribbling; hair growt3-6 months

E may be taken with or without food

C -

side effects may include impotence, decreased libido, sexual dysfunction; consult healtprovider if symptoms are severe or dont go away.

Take at the same time everyday There are two brand names Propeciaresults may not occur for 3 months andProscar r

may take 6-12 months

K - Pregnant women or women who may become pregnant should not touch crush tablets

coming contact with the semen of the patient taking this product

Possible secondary malignancy side effect; monitor for symptoms in change of breast slumps, pain, or discharge


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Vasopressinto treat diabetes insipidus


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Vasopressin

C Pituitary hormone. And anti-diuretic hormone; Used to treat diabetes insipidus as abnormal Post operative distention

H Results will show absence of severe thirst, decreased urine output Monitor pulse and blood pressure Measure I/O ratio, daily weight, fluid electrolyte balance, check for edema in extre

E IM/SUBCUT bib-qid as needed continuous IV INF 0.0005 units/ kg/hr

C teach patient to measure and record I&O Avoid alcohol and all over-the-counter medications unless approved by prescriber

K May cause drowsiness, headache, vertigo, if you experience irregular heartbeat, ch

pain, trouble breathing notify healthcare provider Monitor for behavioral changes, disorientation, and lethargic as they may be signs

water intoxication.


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Levothyroxine

C - Thyroid hormone, used to treat hypothyroidism

H absence of depression; increased weight loss, absence of constipation; Periodically monitor blood pressure, pulse, weight and height, routine blood work

check levels.E take at the same time everyday preferably in the morning on an empty stomach, Separate in acids, iron, and calcium products by four hours

C Treatment is like long; full effect may take up to six wks

Hyperthyroid child will show immediate behavior/personality change Avoid OTC preparations with iodine and iodine rich foods Soy I can decrease thyroid hormone that

K - can cause anxiety, insomnia, tachycardia, nausea, diarrhea, weight loss, menstrua

irregularities Contact medical provider if experiencing increased nervousness, excitability, and

irritability which indicate over dosage


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PTU propylthiouracil

Used for Hyperthyroidism

& preparation of thyroidecto


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PTU (propylthiouracil)

C Thyroid hormone antagonist; Used for preparation of thyroidectomy, thyrotoxic chyperthyroidism

H evaluate therapeutic response by weight gain decreased pulse, decreased T4,

decreased BP

E take with meals to decrease GI upset Take medication at the same time each day to maintain product levelC Take pulse daily; keep a graph of weight, pulse and mood Avoid OTC products and foods containing iodine

Do not discontinue product without consulting healthcare professional because thcrisis may occur

Do not skip doses or double dose Carry emergency ID listing condition and medicationK May cause liver disease Consult healthcare provider if experiencing swelling, sore throat, mouth lesions Report any fluid buildup around the eyes, mental depression, cold intolerance


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famotidinePepcid

C:

H2 Histamine receptor antagonist(H2RAs)- used for treatment of GERD,peptic ulcer disease, erosive esophagitis,and also combined to help control upper

GI tract bleeding.H:

decreased abdominal pain


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famotidinePepcid

E:

Take exactly as prescribed with water

15mins-1hr before eating

IV form also available

C:

Inform patient that smoking decreases drugs effectiveness

Advise pt. that H2 receptors antagonist are not to be taken within 1 hour of antacid

K:

Remarkably low incidence of adverse effects

Medication can have a narrowing therapeutic range on certain meds such as theopwarfarin, lidocaine and phenytoin.

Inform doctor or pharmacist of any medical history of kidney, liver or long problem


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lansoprazoleProtonix

C:

Proton Pump Inhibitors (PPIs).- 1stlineof therapy for erosive esophagitis,symptomatic GERD that are poorlyresponsive to other medicaltreatments such as therapy with H2receptors antagonists, short-term

treatment of active duodenal ulcersand active benign gastric ulcers,gastric hypersecretory conditions,NSAID induced ulcers, and for stressulcer prophylaxis.


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lansoprazole

ProtonixH:

Decrease in epigastric pain, fullness, and abdominal swelling associapeptic ulcer, gastritis, esophagitis, gastric hyperacidity, or hiatal hern

Also available as Prevpac for a combined treatment of H. Pyloric infec

E:

PO take 30 mins before meal

NG Route capsule can be opened and poured of granules in NG feewith plunger removed

Oral syringe can be dissolved 15mg/4mL or 30mg/10mL water


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lansoprazole

ProtonixC:

Well tolerated

Granules may be sprinkled from the capsule into a tablespoon oif needed

K: Long-term use of PPIs arise new concern of developing osteop

May increase serum levels of diazepam and phenytoin


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diphenoxylate/atropine

Lomotil

C:

Antidiarrheals used to treatdiarrhea

Synthetic opiate agonist used to

reduce bowel motility combinedwith atropine to dry up body

fluids and slow gut movement.


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diphenoxylate/atropine

LomotilC:

Avoid OTC unless prescribed

Do not use alcohol or CNS depressants

Not to exceed recommended dose

Do not operate heavy machinery due to dizziness or drowsiness

K:

Do not take with MAOIs Do not give to pregnant women, hepatic disease, ulcerative colitis an

hepatic disease.

Product maybe habit forming


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lactulose

EnuloseC:

Laxative; ammonia detoxicant(hyperosmotic). used to chronicconstipation, portalsystemicencephalopathy in patients with hepatic

disease.H:

Decreased constipation, decreasedblood ammonia levels, and clearing ofmental state


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lactulose

Enulose

C:

Do not use laxatives for long term

To dilute with water or fruit juice to counteract sweet taste

Take on empty stomach for rapid action

Report diarrhea because it may indicate over-dose

K:

Breastfeeding, Pregnancy, geriatric patients, debilitated patients, DM


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lactulose

Enulose

E:

Given PO with 8oz with fruit juice, water, milk. May also be takeempty stomach to increase effectiveness.

Kristalose can be dissolved in 4oz water

Rectal route enema has to be diluted with 300ml lactose/700ml Administer by using rectal balloon catheter.


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Metformin

C- Endocrine drug. The purpose: inhibits hepatic glucose producincreases sensitivity of peripheral tissue to insulin.

H- therapeutic response: decrease in polyurea, absence of dizzigait, A1c at normal level, clear sensorium

Giving with meals to reduce GI upset. Can be taking in the mornevening.

Do not use with dofetilide; may cause lactic acidosis.


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Metformin

C- regularly sel-monitor blood glucose

Must be continued on daily basis

Avoid OTC medications, alcohol unless approved by prescriber

Metformin is not a cure, only controls symptoms. Take with meals

Carry emergency ID and glucagon emergency kit.

Side effects are headache, weakness, dizziness, drowsiness, tinnitus, vertigo, agitation


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Metformin

K- assess CBC ( baseline, q3mo) during treatment, check LFTs pAST, LDH, renal stuies: BUN, creatinine during treatment, gluco

acid


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Glipizide

C- use for type 2 diabetes mellitus. Causes functioning B cells inrelease insulin, leading to drop in blood glucose levels.

H- Improved serum glucose, absence of dizziness, stable gait, csensorium, decrease in polyurea. Precautions: in pregnancy, ca

severe renal/hepatic disease


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Glipizide

E- take 30 min before meals. Comes in tablets form. Max 40 mgdivided dose or 15 mg/dose.

C- report bleeding, bruising, weight gain, edema, sore throat. P

be continued on daily basis. use sunscreen or stay out of the sunprotective clothing. Do not drink alcohol


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Glipizide

K- assess blood glucose, for severe hypoglycemia give IV D50Wdextrose solution.


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Sildenafil

Viagra

C: Erectile agent, antihypertensive, peripheral vasodilator. Phosptype-5 inhibitor.

H: Decreasing pulmonary hypertension, improved exercise tolerato perform sexually (male)


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Sildenafil

ViagraE:

Increased fluids, bulk in diet for constipation, urinaryretention

With food, milk for GI symptoms

Crushed if patient unable to swallow

Oral conc: dilute prior to use with 4 oz (1/2 cup) of water,orange juice, ginger ale, or lemon/lime soda; do not mix witother liquids

Avoid use with other CNS depressants


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Sildenafil

Viagra

C:

Product does not protect against sexually transmitted diseasesHIV

Product absorption is reduced with high-fat meal

Notify doctor and stop taking product if vision occurs or erectio


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Sildenafil

Viagra

K:Do not to pregnant women, anatomical penile deformities, sickanemia, leukemia, multiple myeloma, retinitis pigmentosa, ble

disorders, active peptic ulceration, CV/renal/hepatic didease, mantihypertensive regimens, geriatric patients

Isotretinoin


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Isotretinoin

Accutane

C:Antiacne agent, retinoid. Used for severe recalcitrant

nodulocystic acneH: Decreased acne production and facial oil

E:

Recommended dosage range for accutane is 0.5-1.0mg/kg/day givin in two divided doses with food for 15-20

weeks

By mouth: swallow capsule whole, do not crush or chew,take with full glass of water and do not lie down for 10 min


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Isotretinoin

Accutane

K:

Do not give to pregnant women, skeletal, bone mineral densityhyperostosis, premature epiphyseal closure

Do not flush down toilet or pour in drain


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Calcium Acetate

Phoslo

C: Antacid, calcium supplement, calcium product. Used for hyperduring pregnancy, hyperphosphatemia, not suitable for therapyosteoporosis, hypoparathyroidism

H: Decreased acidity, absence of pain, also decreased hyperphoswith renal failure

Calcium Acetate


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PhosloE:

PO Route: Do not give enteric-coated within 1 hr of calciumcarbonate

Ulcer treatment: give 1 and 3 hr after meals and at bed time

Phosphate binder: 1 hr after each meal, snack, and at bed

Supplement: 1-1.5 hr after meals; avoid oxalic acid foods(spinach), phytic acid (cereals) or phosphorous (milk), may

decrease Ca absorption Suspension: shake well, use calibrated measuring device


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Calcium Acetate

Phoslo

C:

Increased fluids to 2L unless contraindictated add; add bulk to diet foconstipation; notify prescriber of constipation

Do not switch unless directed by doctor

Avoid excessive use of alcohol, caffeine, tobacco

Avoid spinach, cereals, diary products in large

amount


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Calcium Acetate

Phoslo

K: Do not give to pregnant women, breast feedind, geriatric patierestriction, decreased GI mobility, GI obstruction, dehydratationdisease


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Alendronate

FosamaxC: Bone-resorption inhibitor, bisphosphonate. Used for

treatment and prevention of osteoporosis in postmenopauwomen

Treatment of osteoporosis in men, Pagets disease

Treatment of corticosteroid-induced osteoporosis inpostmenopausal women not receiving estrogen and in menwho are on continuing corticosteroid treatment with lowbone mass


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Alendronate

Fosamax

H: Increased bone mass, absence of fractures

E:

Tablet: take with 8 oz water 30 min before 1stmeal, beverage, or medday

Do not lie down for 30 min or over after dose, do not take at bedtime rising

Liquid: use oral syringe or calibrated device, give in AM with 2 or mor30 min or more before meal, beverage, or med

Alendronate


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FosamaxC:

Remain upright for 30 min after dose to prevent esophageal

irritation If dose is missed, skip, do not double or take later in day. Take

the AM before meal and other meds with 6-8 oz water (nomineral)

Perform weight-bearing exercise to increase bone density

Let doctor know if pregnant, breastfeeding. Inform dentist ouse of this product

Maintain good oral hygiene


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Alendronate

Fosamax

C: Do not give to pregnant women, breastfeeding, children, CCr

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