Question

In: Nursing

Age: 45 year Gender: Male Diagnosis: Angina.P. Rx Trimetazidine tablets 35 mg MR , 1 bid...

Age: 45 year

Gender: Male

Diagnosis: Angina.P.

Rx

Trimetazidine tablets 35 mg MR , 1 bid

Atenolol 100 mg , 1/2 tablet od

Isoket 10 mg Tid

according to this prescription find the mistakes, the interaction, dose for adult and Paediatric , the toxicity level , antidotes , follow up,  the counselling and what the suitable medication for this patient ?

Solutions

Expert Solution

Correct prescription is:

Tab Trimetazidine MR 35mg BID

Tab Atenolol 100mg 1/2tablet OD or Tab Atenlol 50mg OD

Tab Isoket 10mg TID

Interaction:

Trimetazidine: increased risk of adverse effect when taking it with metaclopromide,icreased vasodilatory activities of isosorbid mononitrate

Atenolol: apple or orange juice may decrease the drug absorption, so better to avoid these friuts for 4 hours of taking atenolol

Isoket: increase risk for hypotension , when taking along with phosphodiestarase inhibitors.also contraindicated with riociguat

Dose:

Trimetazidine MR 35 mg BID

Atenolol:initially 50mg/day, after 1 week, can increase to 100mg /day or 200mg/day

Isoket:starting dose is 5-20mg/TID, maintanance dose is 10-40mg/TID

Toxicity:

Use of atenolol in pregnancy can leads to fetal hypoglycemia.

Isoket can leads to reduced cardiac output, hypotension, increased intracranial pressure, syncop.

Antogonist:

No specific antagonist

Follow Up:

Followup for blood pressure is needed for patient who is taking atenolol ,Regular follow up with doctor is need to adjust the dose of each drug as per requirement.

Counseling:

patient should be educated, to take these medicines regularly,not to stop without doctor's order. Take the missed dose as soon as remember,and take the usual dose only, if it is the time for next dose,do not take double or extra dose.Daly headache may occur with isoket, it is a marker of drug activity.

Nightingale answered 1 year ago
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