Patient Name: V.R.

February 1, 2012 Diagnosis: DM II Diabetic foot bilateral DRUG NAME Generic Name: Losartan Potassium Brand Name: Cozaar Drug Classification: Cardiovascula r agent Angiotensin II receptor Antagonist Antihypertens ive Route: Oral Available form: 2 Tablet 50mg TID ACTION 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 INDICATION

Gerard Paul F. Oriza ADVERSE REACTION diarrhea, muscle cramps, dizziness, insomnia, and nasal congestion. Losartan also may cause a persistent cough, increase serum potassium, and angio edema. Losartan may reduce kidney function in some patients and should not be used by patients who have bilateral renal artery stenosis (narrowing of both arteries going to the kidneys). Rare cases of rhabdomyolysis (muscle breakdown) have been reported CONTRAINDICATIONS Hypersensitivity to losartan Pregnancy[category C (first trimester), category D (second and third trimesters)]Lactation NURSING RESPONSIBILITIES Monitor BP at drug trough (prior to a scheduled dose). Monitor drug effectiveness when losartan is used as monotherapy. Inadequate response may be improved by splitting the daily dose into twicedaily dose. Lab tests: Monitor CBC, electrolytes, liver & kidney function with long-term therapy

Losartan is used for treating hypertension, left ventricular hypertrophy (increase in muscle) and diabetic nephropathy (kidney disease)

Patient Name: V.R. February 1, 2012 Diagnosis: DM II Diabetic foot bilateral

Gerard Paul F. Oriza

Generic Name:
Sodium Bicarbonate

Neutralizes gastric acid o

Hyperacidit y Peptic ulcer Hyperkalem ia Tricyclic antidepressant OD Shock associated with severe diarrhea, dehydration, uncontrolled DM Reflux esophagitis

Fluid and GI:

Gastric distention, belching, flatulence. Metabolic: metabolic alkalosis, hypernatremia, hypokalemia, hyperosmolarity (with overdose). Other: Pain and irritation at injection site.

Brand Name: Rhea Sodium Drug Classification: Antacids, Antireflux Agents & Antiulcerants Route: Oral Available Form: 325 mg/tab qid

Decrease pepsin activity

o o

Contraindicated in patients with metabolic or respiratory alkalosis; patients who are losing chlorides from vomiting or continuous GI suction; patients taking diuretics known to produce hypochloremia alkalosis; and patients with hypocalcemia in which alkalosis may produce tetany, hypertension, seizures, or heart failure. Oral sodium bicarbonate is contraindicated in patients with acute ingestion of strong mineral acids.

Monitor urinary pH, calcium, electrolytes and phosphate levels.

Record amount and consistency of stools.

Clients on lowsodium diets should evaluate sodium contents of antacids.

Generic Name: Vessel due F Brand Name:

Inhibits coagulation by attacking several sites of the coagulation system.

Vascular pathologies w/ thrombotic risk, transient ischemic

Cap GI disorders: nausea, vomiting,

Hypersensitivity to sulodexide, heparin & heparinlike products. Diathesis &

Assess patients for signs of bleeding and

Patient Name: V.R. February 1, 2012 Diagnosis: DM II Diabetic foot bilateral Sulodexide Drug Classification: Anticoagulant, antithrombotics & fibrinolytics Route: Oral Available Form: 1-2 cap bid Its effect is dependent on the presence of antithrombin III, an alpha 2-globulin whose activity is augmented by heparin. The heparinantithrombincomplex inactivates factors IXa, Xa, XIa and XIIa, and prevents thrombinformation. Furthermore, the complex reverses the effect of already formedthrombin. In high concentrations, heparin also inhibits thrombocyte aggregation. attacks & cerebrovascular disease, peripheral vascular insufficiency, diabetic retinopathy ,MI, retinal vasal thrombosis.

Gerard Paul F. Oriza epigastralgia. Amp Pain, burn,hemato ma at the site of injection. hemorrhagic diseases. hemorrhage (bleeding gums; nosebleed; unusual bruising; black, tarry stools; hematuria; fall in hematocrit or blood pressure; guaiac- positive stools). Notify physician if these occur. Monitor patient for hypersensitivity reactions (chills, fever, urticaria). Report signs to physician Subcutaneous: observe injection sites for hematomas, ecchymosis, or inflammation. Monitor platelet count every 2-3 days throughout therapy. May

Patient Name: V.R. February 1, 2012 Diagnosis: DM II Diabetic foot bilateral

Gerard Paul F. Oriza cause mild thrombocytopen ia, which appears on the 4th day and resolves despite continued heparin therapy

Generic Name: Human Insulin Brand Name: Humulin 70/30 Drug Classification: Antibiotic, AntiInfective Route: Subcutaneous Available Form: 15 units

Control of blood glucose in diabetic patients

Management of diabetes mellitus

Hypoglycemia, lipodystrophy, pruritus, rash, allergic reactions.

Hypoglycemia

Give 30 minutes before breakfast& supper if using Humulin or Novolin types. Give just before or just after eating if using the Novolog type. Commonly used due to ease in preparation if the proportions are appropriate for the patient. If using Humulin

Patient Name: V.R. February 1, 2012 Diagnosis: DM II Diabetic foot bilateral

Gerard Paul F. Oriza 70/30 with an additional Humalog sliding scale, give Humalog in a separate syringe immediately before the meal