505k - celis, edna g ti,pi,cm

7/30/2019 505k - Celis, Edna g Ti,Pi,Cm

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FEU – DR. NICANOR REYES MEDICAL FOUNDATION

MEDICAL CENTER

Regalado Avenue, corner Dahlia Street West Fairview, Quezon City 1118

Tel. No.: 427-0213

DEPARTMENT OF INTERNAL MEDICINE

Problem List

Problem Date Identified Date Resolved Management

Elevated Blood pressure 2013

Amlodipine 5mg/tab, 1

tab now then OD,Clonidine 75mcg/tab, 1

tab SL PRN for BP>160/90

Head ache and Nape pain

2013Celecoxib 200mg/tab, 1tab BID PRN for headache



FEU – DR. NICANOR REYES MEDICAL FOUNDATION

MEDICAL CENTER

Regalado Avenue, corner Dahlia Street West Fairview, Quezon City 1118

Tel. No.: 427-0213

DEPARTMENT OF INTERNAL MEDICINE

Therapeutic Index

As of August 30, 2013

Drugs Mode of Action Indications Contraindications Adverse Effects

Amlodipine decreases arterial smooth

muscle contractility and

subsequentvasoconstriction by

inhibiting the influx of

calcium ions through L-

type calcium channels.

Calcium ions entering the

cell through these

channels bind to

calmodulin. Calcium-

bound calmodulin then

binds to and activates

myosin light chain kinase

(MLCK). Activated MLCK

catalyzes the

phosphorylation of the

regulatory light chain

subunit of myosin,

Inhibition of the initial

influx of calcium decreases

the contractile activity of

arterial smooth muscle

cells and results in

vasodilation. The

vasodilatory effects of

amlodipine result in an

overall decrease in bloodpressure.

For the

treatment of

hypertensionand chronic

stable angina.

Use with caution in

patients with severe

bradycardia, heart failure(particularly in

combination with a beta-

blocker), cardiogenic

shock because of the risk

of a slight negative

inotropic effect and

potent hypotensive

effects. Pregnancy Risk

Category C.

the most common

side effects are as

follows:Autonomic

Nervous System:

Flushing. General:

Fatigue.

Cardiovascular:

Edema,

palpitation.

Central and

Peripheral Nervous

System: Vertigo,

headache,

drowsiness.

Gastrointestinal:

Abdominal pain,

nausea.

Clonidine 75

mcg/tab PRN

for BP > or

equal 160/90

mmHg

Central sympatholytic via

stimulation of central

alpha receptors, results in

reduced sympathetic

outflowing, causing

decreased PVR, HR, BP,

and renal vascular

Hypertension,

Cancer pain,

ethanol

withdrawal,

smoking

cessation,

restless legs

Hypersensitivity,

bleeding diasthesis,

hemodynamically

unstable patients, severe

coronary insufficiency,

recent MI, conduction

disturbances,

Skin reactions, dry

mouth,

somnolence,

headache, fatigue,

drowsiness,

dizziness,

hypotension,



resistance, produces

presynaptic and

postjunctional alpha 2

adrenoreceptor analgesia

by preventing pain signal

transmission to brain.

syndrome,

tourette’s

syndrome,

cyclosporine

nephrotoxicity,

menopausal

flushing

cerebrovascular disease,

raynaud’s disease

postural

hypotension,

anxiety,

constipation

Celecoxib highly selective COX-2

inhibitor and primarily

inhibits this isoform of

cyclooxygenase (and thus

causes inhibition of

prostaglandin production)

osteoarthritis,

rheumatoid

arthritis, acute

pain, painful

menstruation

and menstrual

symptoms,

ankylosing

spondylitis, and

to reduce thenumber of

colon and

rectal polyps in

patients with

familial

adenomatous

polyposis

Asthma, uticaria, allergic

type reaction to aspirin

or other NSAIDS, renal

impairment, severe

hepatic impairment,

history of MI or stroke,

undergoing cardiac or

major vascular surgery.

Abdominal pain,

diarrhea,

dyspepsia,

flatulence, nausea,

dizziness,

headache, rhinitis,

pharyngitis,

sinusitis, URTI,

back pain,

insomnia and rash

505k - celis, edna g ti,pi,cm

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