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Vioxx Teaching 79

Instructed in new medication Vioxx to manage osteoarthritis. In addition, warned of possible S/E such as headache, asthenia, fatigue, dizziness, aseptic meningitis, hypertension, lower-extremity edema, sinusitis, diarrhea, dyspepsia, epigastric discomfort, heartburn, nausea, abdominal pain, GI bleeding, urinary tract infection, hyponatremia, back pain, bronchitis, upper respiratory tract infection, pulmonary edema and flu-like syndrome. Patient may experience signs and symptoms of GI bleeding, including bloody vomitus, blood in urine and stool and black, tarry stools. Advised to call MD if he experiences these signs or symptoms. Report rash, unexplained weight gain or edema. Avoid aspirin and products containing aspirin unless prescriber has instructed otherwise. Avoid OTC anti-inflammatories such as ibuprofen (Advil) unless prescriber has instructed it. All NSAIDs including Rofecoxib may adversely affect the liver. Signs and symptoms of liver toxicity include nausea, fatigue, lethargy, itching, jaundice, right upper quadrant tenderness and flu-like syndrome. Instructed to stop therapy and call MD immediately if patient experiences these signs or symptoms. Women must inform MD if they become pregnant, or they are planning on becoming pregnant while taking drugs. This drug may be taken without regard to food although taking it with food may decrease GI distress. The most common adverse effects of this drug are dyspepsia, epigastric discomfort, heartburn and nausea. Taking drug with food may help minimize these effects.

Amitriptyline Teaching 82

Instructed in new medication Amitriptyline to manage depression. In additon, warned of possible S/E such as coma, seizures, hallucinations, delusions, disorientation, ataxia, tremor, peripheral neuropathy, anxiety, insomnia, restlessness, drowsiness, dizziness, weakness, fatigue, headache, extrapyramidal reactions, MI, stroke, arrhythmias, heart block, orthostatic hypotension, tachycardia, ECG changes, hypertension, edema, blurred vision, tinnitus, mydriasis, increased intraocular pressure, dry mouth, nausea, vomiting, anorexia, epigastric distress, diarrhea, constipation, paralytic ileum, urine retention, agranulocytosis, thrombocytopenia, leukopenia, eosinophilia, hypoglycemia, hyperglycemia, rash, urticaria, photosensitivity, diaphoresis and hypersensitivity reaction. Instructed to take full dose at bedtime but warned patient of possible morning orthostatic hypotension. Avoid alcohol during drug therapy. Consult MD before taking other medications. Avoid activities that require alertness and good psychomotor coordination until CNS effects of drug are known. Drowsiness and dizziness usually subside after a few weeks. Dry mouth may be relieved with sugarless hard candy or gum. Saliva substitutes may be needed. Instructed to use a sun block, wear protective clothing and avoid prolonged exposure to strong sunlight. To prevent photosensitivity reactions. Do not stop drug therapy abruptly.

Atenolol Teaching 89

Instructed in new medication Atenolol to manage hypertension. In addition, warned of possible S/E such as fatigue, lethargy, vertigo, drowsiness, dizziness, fever, bradycardia, hypotension, heart failure, intermittent claudication, nausea, diarrhea, thrombocytopenia, hyperkalemia, hypoglycemia, increased risk of developing type-two diabetes, dyspnea, bronchospasm, rash and leg pain. Instructed to take drug exactly as prescribed at the same time every day. Do not stop drug suddenly but do call prescriber if unpleasant adverse reactions occur. If pulse rate is below 60 beats/minute, stop taking drug and call prescriber. Women: notify prescriber if pregnancy occurs. Drug usage might be discontinued.

Albuterol Teaching 109

Instructed in new medication Albuterol to prevent or treat bronchospasm in patients with reversible obstructive airway disease. In addition, warned of possible S/E such as tremor, nervousness, dizziness, insomnia, headache, hyperactivity, weakness, CNS stimulation, malaise, tachycardia, palpitations, hypertension, dry and irritated nose and throat (with inhaled form), nasal congestion, epistaxis, hoarseness, heartburn, nausea, vomiting, anorexia, bad taste in mouth, increased appetite, hypokalemia, muscle cramps, bronchospasm, cough, wheezing, dyspnea, bronchitis, increased sputum or hypersensitivity reactions. Warned patient about possibility of paradoxical bronchospasm. If this occurs, discontinue drug immediately. If more than one inhalation is ordered, instructed to wait at least 2 minutes before repeating procedure. Use of an aero chamber may improve drug delivery to the lungs. If steroid inhaler used, advised to use the bronchodilator first and then advised to wait about 5 minutes before using the steroid. This allows the bronchodilator to open the air passages for maximum effectiveness. Advised to remove canister and wash inhaler with warm, soapy water at least once a week.

Aricept Teaching 114

Instructed in new medication Aricept to manage moderate dementia of the Alzheimer type. In addition, warned of possible S/E such as headache, insomnia, dizziness, fatigue, depression, abnormal dreams, somnolence, seizures, tremor, irritability, paresthesia, aggression, vertigo, ataxia, restlessness, abnormal crying, nervousness, aphasia, syncope, pain, chest pain, hypertension, vasodilation, atrial fibrillation, hot flashes, hypotension, cataract, blurred vision, eye irritation, sore throat, nausea, diarrhea, vomiting, anorexia, fecal incontinence, GI bleeding, bloating, epigastric pain, frequent urination, ecchymosis, weight loss, dehydration, muscle cramps, arthritis, toothache, bone fracture, dyspnea, bronchitis, pruritus, urticaria, diaphoresis, influenza, and increased libido. The drug does not alter the underlying degenerative disease but can temporarily stabilize or relieve symptoms. Effective therapy depends on taking drug at regular intervals. Instructed to take drug in the evening, just before bedtime. Immediately report significant adverse effects or changes in overall health status. Inform health care team that patient is taking drug before he receives anesthesia. Avoid OTC cold or sleep remedies because of the potential for increased anticholinergic effects.

Hypertension Teaching 129

Instructed in S/S of high blood pressure such as fatige, palpitation, dizziness, headaches, nosebleeds, blurring of vision.

Cardiac Teaching 137

Instructed in complication requiring medical intervention associated with hypertension such as SOB, blurred vision, headache and extreme weakness.

Cardiac Teaching 140

Instructed in S/S of hypertension such as blurred vision, nouse bloods, dizziness, headache, palpitations, etc.

Cardiac Teaching 176

Instructed in risk factors associated with heart disease, including smoking, family history, hypertension, stress and diet.

Atenolol Teaching 221

Instructed patient about how Atenolol blocks stimulation of receptors within vascular smooth muscle. It also decreases heart rate, decreases comsumption of oxygen by myocardium and it is used to treat hypertension, prophylaxis of angina pectoris, suspected or known myocardial infarction.