Medications:

1.) Furosemide IVTT

Classification: Loop diuretic
Action: inhibits reabsorption of Na and chloride mainly in the medullary portion of
the ascending Loop of Henle. Excretion of potassium and ammonia is also increased
while uric acid excretion is reduced. It increases plasma-renin levels and secondary
hyperaldosteronism may result. Reduces BP in hypertensives as well as in
normotensives. It also reduces pulmonary oedema before diuresis has set in.
I: Hypertension, Edema associated with CHF, cirrhosis, renal disease
C: Severe sodium and water depletion, hypersensitivity to sulphonamides
and furosemide, hypokalaemia, hyponatraemia, precomatose states associated with
liver cirrhosis, anuria or renal failure
A: Fluid and electrolyte imbalance, nausea, diarrhoea, blurred vision, dizziness,
headache, hypotension. Bone marrow depression (rare), hepatic dysfunction
N:
-Do not expose to light, may discolor tablets or solution; do not use discolored drug
or -solutions.
-Administer with food or milk to prevent GI upset.
-Measure and record weight to monitor fluid changes.
-Arrange for potassium-rich diet or supplemental potassium as needed.
-Arrange to monitor serum electrolytes, hydration, liver and renal function.

2.) Lactulose(Duphalac)
Classification:
Laxative; Ammonia reduction drug
Action:
Drug passes unchanged into the colon where bacteria break it down to organic acids that
increase the osmotic pressure in the colon and slightly acidify the colonic contents, resulting
in an increase in stool water content, stool softening, laxative action
Indication:
Treatment of constipation and prevention of portal-systemic encephalopathy

Contraindication:
Any allergy or hypersensitivity to the drug
Diabetes, pregnancy and lactation
Adverse effects:
Transient flatulence, distention, intestinal cramps, belching, diarrhea, nausea.

Nursing Considerations:
Monitor serum ammonia levels
Carefully monitor blood glucose levels in diabetic patients
Monitor with long term therapy for potential electrolyte and acid base imbalance
Note for adverse reactions

Titer medication when discontinuing

Atorvastatin