Drug: Coumadin (warfarin) Indications: Pulmonary Embolism, Deep Vein Thrombosis, MI, Rheumatic Heart disease w/heart valve damage,prosthetic heart valves,atrial fibrillation Mechanism of Action: Inhibits Vitamin-K dependent action of clotting factors II, VII, IX, X, formed in liver Side Effects: CNS: Fever, GI: diarrhea, anorexia, nausea, vomiting, cramps,, mouthulcerations, sore mouth, melena GU: enhanced uric acid excretion, hematuria, excessive menstrual bleeding Hematologic: hemmorhage Hepatic: hepatitis, Jaundice Skin: dermititis, urticaria, necrosis, gangrene, alopecia, rash Contraindications: * Contraindicated in patients hypersensitive to drug and in those with bleeding from the GI, GU, or respiratory tract; aneurism, cerebrovascular hemorrhage, severe or malignant hypertension,; severe renal or hepatic disease; subacute bacterial endocarditis, pericarditis, or pericardial effusion; or blood dyscrasias or hemorrhagic tendencies. * Contraindicated during pregnancy, threatened abortion, eclampsia or preeclampsia and after surgery involving large open area, eye, brain or spinal cord; recent prostatectomy; major regional lumbar block anesthesia, spinal puncture, or diagnostic, or therapeutic invasive procedures. * Avoid using in patients with a history of warfarin induced necrosis; in unsupervised patients with senility, alcoholism or psychosis; or in situations in which there are adequete laboratories for coagulation testing. * Use cautiously in patients with diverticulitis, colitis, mild or moderate hypertension, or mild or moderate hepatic or renal disease; with drainage tubes in any orifice; with regional or lumbar block anesthesia; with heparin induced thrombocytopenia, and deep venous thrombosis; or in conditions that increase the risk of hemorrhage. * use cautiously in breast feeding women

Drug: Imdur (isosorbide mononitrate) Indications: Acute anginal attacks (S.L. isosorbide dinitrate only); to prevent conditions that may cause anginal attacks Mechanism of Action: Thought to reduce cardiac oxygen demand by decreasing preload and afterload. Drug may increase blood flow through the collateral coronary vessels. Side Effects: CNS: headache, dizziness, weakness CV: Orthostatic hypotension, tachycardia, palpations, ankle edema, flushing, fainting EENT: S.L. Burning. GI: Nausea, vomiting. Skin: Cutaneous vasodilation, rash Contraindications: * Contraindicated in patients with hypersensitivity or idiosyncracy to nitrates and in those with severe hypotension, angle closure glaucoma, increased intercranial pressure, shock, or acute MI with low left ventricular filling pressure. * use cautiously in patients with blood volume depletion (such as from diuretic therapy) or mild hypotension

Drug: Morphine Indications: Severe pain * Moderate to severe pain requiring continuous around the clock opiod. Single dose epidural extended pain relief after major surgery Mechanism of Action: Unknown. Binds with opiod receptors in the CNS, altering perception of and emotional response to pain Side Effects: CNS: Dizziness, Euphoria, light-headedness, nightmares, sedation, somnolence, siezures, depression, hallucinations, nervousness, physical dependence, syncope. CV bradycardia, cardiac arrest, shock, hypertension, hypotension, tachycardia. GI: constipation, nausea, vomiting, anorexia, biliary tract spasms, dry mouth, ileus. GU: urine retention Hemotologic: thrombocytopenia Respiratory: apnea, respiratory arrest, respiratory depression. Skin: diaphoresis, edema, pruitis and skin flushing. Other: decreased libido Contraindications: Contraindicated in patients hypersensitive to drug and those with conditions

that would preclude I.V administration of opiods (acute bronchial asthma or upper airway obstruction). * Contraindicated in patients with GI obstruction * Use with caution in elderly or

debilitated patients and in those with head injury, increased intercranial pressure, seizures, chronic pulmonary disease, prostatic hyperplasia, severe hepatic or renal disease, acute

abdominal conditions, hypothyroidism, Addison's disease, and urethral stricture. * Use with caution in patients with circulatory shock, biliary tract disease, CNS depression, toxic psychosis,

acute alcoholism, delirium trmens, and seizure disorders.

Drug: Isordil (isosorbide dinitrate) Indications: Acute anginal attacks (S.L. isosorbide dinitrate only); to prevent conditions that may cause anginal attacks Mechanism of Action: Thought to reduce cardiac oxygen demand by decreasing preload and afterload. Drug may increase blood flow through the collateral coronary vessels. Side Effects: CNS: headache, dizziness, weakness CV: Orthostatic hypotension, tachycardia, palpations, ankle edema, flushing, fainting EENT: S.L. Burning. GI: Nausea, vomiting. Skin: Cutaneous vasodilation, rash Contraindications: * Contraindicated in patients with hypersensitivity or idiosyncracy to nitrates and in those with severe hypotension, angle closure glaucoma, increased intercranial pressure, shock, or acute MI with low left ventricular filling pressure. * use cautiously in patients with blood volume depletion (such as from diuretic therapy) or mild hypotension

Aspirin: Antipyretic, Analgesic, anti-inflammatory, Antirheumatic, Antiplatelet Salicylate, NSAID USE: Mild to moderate pain, fever, inflammatory conditions (rheumatic fever, rheumatois arthritis, osteoarthritis), reduction of risk of TIAs or CVA, reduction of risk of MI, prophylaxis against cataract formation

Mechanism: - inhibits the synthesis of prostaglandins - acts in the thermoregulatory center of the hypothalamusto block effects of endogenous pyrogen by inhibiting synthesis of the prostaglandin intermediary

- inhibition of platelet synthesis of thromboxane A2 and therefore aggregation

Side: Effects: -acute aspirin toxicity (resp alkalosis, hyperpnea, tachypnea, hemorrhage, excitement, confusion, asterixis, pulmonary edema, seizures, tetany, metabolic acidosis, fever, coma, CV collapse, renal & resp failure) -aspirin intolerance GI (nausea, dyspepsia, heartburn, epigastric discomfort, anorexia, hepatoxicity)

-hematologic (occult blood loss, hemostatic defects)

Contraindications: -contraindicated w/ allergy to salicylates or NSAIDs, tartrazine, hemophilia, bleeding ulcers, hemorrhagic states, blood coagulation defects, hypoprothrombinemia, vitamin K deficiency

Plavix (clopidogrel) ADP receptor antagonist Antiplatelet USE: - Patients at risk for ischemic events – recent MI, CVA, PAD - patients with acute coronary syndrome Decrease arthrothrombotic events in CABG and other heart Patients

Mechanism: - inhibits platelet aggregation by blocking ADP receptors on

platelet, preventing clumping of platelets. ANTI-PLATELET

Side: Effects: -CNS (headache, dizziness, weakness, syncope, flushing -CV (hyoertension, edema) -Derm (rash, pruritis) -GI (nausea, GI distress, constipation, diarrhea, GI bleed) -increased bleeding risk

Contraindications: -contraindicated w/ allergy to clopidogrel, active pathological bleeding, lactation - use cautiously with bleeding disorders, recent surgery, hepatic impairment, pregnancy -increased risk of bleeding w/ NSAIDs & warfarin CAUTIONS: Bleeding Hepatic Renal

Heparin (Anti-Coagulant) USE: -prevention & treatment of venous thrombosis & pulmonary embolism -treatment of atrial fibrillation w/ embolization -diagnosis & treatment of DIC -prevention of clotting in blood samples & heparin lock sets -acute MI, left ventricular thrombi

Mechanism: -inactivates factor XA, inhibiting thrombus formation by blocking the conversion of prothrombin to thrombin & fibrinogen to fibrin -inactivates factor XIII, thrombin-induced activation of factors V and VIII

Side: Effects: -derm (loss of hair) -hematologic (hemorrhage, bruising, thrombocytopenia, elevated AST, ALT

levels,hyperkalemia -hypersensitivity (chills, fever, urticaria, asthma) -osteoporosis, suppression of renal function, white clot syndrome

Contraindications: -contraindicated w/ hypersensitivity to heparin; severe thrombocytopenia; uncontrolled bleeding; any patient who cannot be monitored regularly w/ blood coagulation tests; labor & immediate postpartum period -increased bleeding w/ anticoagulants, salicylates, penicillins, cephalosporins

Lovenox (enoxaparin) Low-molecular weight heparin Antithrombotic USE: -prevention of DVT, which may occur after hip replacement, knee replacement, abdominal surgery -prevention of ischemic complications of unstable angina & non-Q wave MI -treatment of DVT who have severly restricted mobility

Mechanism: -low-molecular weight heparin -inhibits thrombus and clot formation by blocking factor Xa, factor IIa, preventing the formation of clots

Side: Effects: -hematologic (hemorrhage, bruising, thrombocytopenia, elevated AST, ALT levels, hyperkalemia -hypersensitivity (chills, fever, urticaria, asthma) -fever, pain, local irritation, hematoma, erythema at site, epidural or spinal hematoma w/ spinal tap

Contraindications: -contraindicated w/ hypersensitivity to enoxaparin,

heparin, pork products; severe thrombocytopenia; uncontrolled bleeding -use cautiously with pregnancy or lactation, h/o GI bleed, spinal tap, spinal/epidural anesthesia -increased bleeding w/ anticoagulants (same as heparin)

Integrillin (eptifibatide) Antiplatelet drug Glycoprotein IIb/IIIa receptor antagonist USE: -treatment of acute coronary syndrome -prevention of cardiac ischemic complications in patients undergoing elective, emergency, or urgent percutaneous coronary intervention

Mechanism: inhibits platelet aggregation by binding to the glycoprotein IIb/IIIa receptor on the platelet, which prevents the binding of fibrinogen & other adhesive ligands to the platelet

Side: Effects: -CNS (headache, dizziness, weakness, syncope, flushing) -derm (rash, pruritis) -GI (nausea, GI distress, constipation, diarrhea) -Hematologic (thrombocytopenia) -bleeding, hypotension Contraindications: -contraindicated w/ allergy to eptifibatide, bleeding diathesis, hemorrhagic CVA, active abnormal bleeding or CVA within 30 days, uncontrolled or severe hypertension, major surgery w/in 6 wks, dialysis, severe renal impairment, low platelet count -use cautiously in the elderly, w/ pregnancy, lactation, renal insufficiency -use cautiously when combining w/ other drugs that affect blood clotting

MetaProlol Lopressor (metoprolol) Beta-selective adrenergic blocker, Antihypertensive

USE: -hypertension, -prevention of reinfarction in MI patients, -long term treatment of angina pectoris Mechanism: Decrease HR-competitively blocks beta-adrenergic receptors in the heart, decreasing the

influence of the SNS on these tissues and the excitability of the heart, decreasing CO and the release of rennin and lowering BP -acts in the CNS to reduce sympathetic outflow and vasoconstrictor tone

Side: Effects: -allergic (pharyngitis, erythematous rash, fever, sore throat, laryngospasm) -CNS (dizziness, vertigo, tinnitus, fatigue, emotional depression, paresthesias, sleep disturbances, hallucinations, disorientation, memory loss, slurred speech) -CV (CHF, cadiac arrythmias, PVI, claudication, CVA, pulmonary edema, hypotension)

-derm (rash, pruritis, sweating, dry skin) -EENT (eye irrigation, dry eyes, conjunctivitis, blurred vision) -GI (gastric pain, flatulence, constipation, diarrhea, N/V) -joint pain, muscle cramp -respiratory (bronchospasm, dyspnea, cough, bronchial obstruction, rhinitis)

-decreased exercise intolerance, development of ANA Contraindications: -contraindicated w/ sinus bradycardia, second or third degree heart block, cardiogenic shock, CHF, second and third trimesters of pregnancy

-use cautiously with diabetes or thyrotoxicosis; asthma or COPD; pregnancy -increased effects w/ verapamil, cimetidine, methimazole, propylthiouracil, hydralazine -increased risk of orthostatic hypotension if taken w/ prazosin -decreased effects if taken with NSAIDs, clonidine, rifampin

-decreased effects w/ barbiturates -hypertension followed by severe bradycardia when taken with epinephrine

Atenolol Beta-selective adrenergic blocker, Antianginal, Antihypertensive USE: -treatment of angina pectoris due to coronary atherosclerosis -hypertension -treatment of MI -prevention of migraines, alcohol withdrawal syndrome, treatment of ventricular and supraventricular arrythmias

Mechanism: -blocks beta-adrenergic receptors of the SNS in the heart and kidney, decreasing CO and oxygen consumption, decreasing the release of rennin from the kidney, and lowering BP

Side: Effects: -allergic (pharyngitis, erythematous rash, fever, sore throat, laryngospasm, respiratory distress

-CNS (dizziness, vertigo, tinnitus, fatigue, depression, paresthesias, sleep disturbances, hallucinations, disorientation, memory loss, slurred speech -CV (bradycardia, CHF, cardiac arrythmias, sinoatrial or AV node block, tachycardia, PVI, claudication, CVA, pulmonary edema, hypotension

-derm (rash, pruritis, sweating, dry skin) EENT (eye irritation, dry eyes, conjunctivitis, blurred vision -GI (gastric pain, flatulence, constipation, diarrhea, N/V) -GU (impotence, decreased libido)

-joint pain, muscle cramps -Respiratory (bronchospasm, dyspnea, cough, bronchial obstruction) -decreased exercise tolerance, development of antinuclear antibodies

Contraindications -contraindicated with sinus bradycardia, second or third degree heart block,

cardiogenic shock, CHF, pregnancy -use cautiously w/ renal failure, diabetes or thyrotoxicosis, lactation, respiratory disease -increased effects w/ verapamil, anticholinergics, quinidine

Captopril ACE inhibitor, Antihypertensive USE: -treatment of hypertension, CHF, diabetic nephropathy, left ventricular

dysfunction after MI -management of hypertensive crises; treatment of rheumatoid arthritis; diagnosis of primary aldosteronism; idiopathic edema; Bartter’s syndrome; Raynaud’s syndrome

Mechanism: -blocks ACE from converting angiotensin I to angiotensin II, a powerful vasoconstrictor, leading to decreased BP, decreased alsosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increased prostaglandin synthesis also may be involved in the antihypertensive action

Side: Effects: -CNS (dizziness, drowsiness, unsteadiness, fatigue, headache, exc) -CV (CHF, aggravation of HTN, hypotension, syncope, edema, arrythmias, exc) -derm (pruritis, urticaria, Stevens-Johnson syndrome, photosensitivity reactions) -GI (nausea, vomiting, hepatitis, massive hepatic cellular necrosis w/ loss of intact liver tissue) -GU (urinary freq, acute urinary retention, renal failure, elevated BUN, exc) -hematologic (bone marrow suppression)

-respiratory (pulmonary hypersensitivity Contraindications-contraindicated w/ allergy to captopril, h/o angioedema, second or third trimester of pregnancy -use cautiously w/ impaired renal function, CHF, salt or volume depletion, lactation -increased risk of hypersensitivity reactions with allopurinol -decreased effects w/ indomethacin -increased effects w/ probenecid

Altace (ramipril) Antihypertensive, ACE inhibitor

USE: -treatment of HTN -treatment of CHF in stable patients the first few days after an MI -to decrease the risk of MI, CVA, death from CV disease in patients at risk for developing CAD

Mechanism: -blocks ACE from converting angiotensin I to angiotensin II, a powerful vasoconstrictor, leading to decreased BP, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increased prostaglandin

synthesis also may be involved in the antihypertensive action

Side: Effects: -CV (tachycardia, angina pectoris, CHF, MI, Raynaud’s syndrome, hypotension, syncope) -Derm (rash, pruritis, photosensitivity, Stevens-Johnson syndrome) -GI (gasrtric irritation, aphtlous ulcers, dysgeusia, anorexia, constipation, cholestatic jaundice) -GU (proteinuria, renal insufficiency, renal failure, polyuria, oliguria)

-hematologic (neutropenia, pancytopenia) -cough, malaise, dry mouth, angioedema Contraindications: -contraindicated w/ allergy to ramipril, pregnancy -use cautiously w/ impaired renal function, CHF, salt or volume depletion, lactation -increased serum levels and increased toxicity w/ lithium

Lipitor (atorvastatin) Antihyperlipidemic, HMG-CoA reductase inhibitor USE: -treatment of elevated total cholesterol, serum triglycerides, and LDL cholesterol in pt’s w/ hypercholesterolemia -to increase HDL-C in pt’s w/ primary hypercholesterolemia -to treat boys and post-menarchal girls ages 10-17 w/ heterozygous familial cholesteremia -prevention of CV disease

Mechanism: -inhibits HMG-CoA reductase, the enzyme that catalyzes the first step in cholesterol synthesis pathway, resulting in a decrease in serum cholesterol, serum LDLs, and increases serum HDLs -increases hepatic LDL recapture sites, enhances reuptake and catabolism of LDL; lowers triglyceride levels

Side: Effects: -CNS (headache, asthenia) -GI (flatulence, abdominal pain, cramps, constipation, nausea, dyspepsia, heartburn,

liver failure) -respiratory (sinusitis, pharyngitis) -rhabdomyolysis with acute renal failure, arthralgia, myalgia

Contraindications: -contraindicated with allergy to atorvastatin, fungal byproducts, active hepatic disease, or unexplained and persistant elevations of transamine levels, pregnancy, lactation -use cautiously w/ impaired endocrine function

-possible severe myopathy or rhabdomyolysis w/ erythromycin, cyclosporine, niacin, fibric acid derivatives, antifungals

Zocor (simvastatin) Antihyperlipidemic

HMG-CoA Reductase inhibitor USE: -treatment of elevated total cholesterol, serum triglycerides, and LDL cholesterol in pt’s w/ hypercholesterolemia

- secondary prevention of CV events in hypercholesterol with CHD or @ risk for CHD -to reduce the risk of coronary disease, mortality, and CV events -treatment of type III hyperlipoproteinemia -to treat boys and post-menarchal girls ages 10-17 w/ heterozygous familial cholesteremia

Mechanism: -inhibits HMG-CoA reductase, the enzyme that catalyzes the first step in cholesterol synthesis pathway, resulting in a decrease in serum cholesterol, serum LDLs, & either an increase or no change in serum HDLs

Side: Effects: -CNS (headache, asthenia, sleep disturbances) -GI (flatulence, diarrhea, abdominal pain, cramps, constipation, nausea, dyspepsia, heartburn, liver failure -respiratory (sinusitis, pharyngitis)

--rhabdomyolysis with acute renal failure, arthralgia, myalgia Contraindications: -contraindicated w/ allergy to simvastatin, fungal byproducts, pregnancy, lactation

-use cautiously w/ impaired hepatic and renal function, cataracts -increased risk for myopathy or rhabdomyolysis w/ erythromycin, rithromcin, HIV protease inhibitors, itraconazole, ketoconazole, clarithromycin, nefazodone

Digoxin Cardiac glycoside Cardiotonic

USE: -CHF -Atrial fibrillation

Mechanism: -increases intracellular calcium & allows more calcium to enter the myocardial cell during depolarization via a Na-K pump mechanism; this increases force of contraction, increases renal perfusion, decreases heart rate, and decreases AV node

conduction velocity

Side: Effects: -CNS (headache, weakness, drowsiness, visual disturbances, mental status change -CV (arrythmias) -GI (GI upset, anorexia) Contraindications: -contraindicated w/ allergy to digitalis preparations, ventricular

tachycardia, ventricular fibrillation, heart block, sick sinus syndrome, IHSS, acute MI, renal insufficiency and electrolyte abnormalities -use cautiously w/ pregnancy & lactation -increased incidence of cardiac arrythmias w/ K-losing diuretics -hold drug if pulse is <60 in adult, <90 in infant

Aldactone (spironolactone)

Potassium-sparing diuretic, Aldosterone antagonist USE: Congestive heart failure and edema, hypokalemia, high levels of aldosterone,

Mechanism: Diuretic that retains Potassium

Side: Effects: Numbness, muscle pain, weakness, irregular heartbeat, drowsiness, loss of urination, shallow breathing, nausea Contraindications: Kidney disease, problems urinating, hyperkalemia, alcoholism

Amiodarone (Cardarone) USE: Life threatening Arrhythmia, Ventricular tachycardia or fibriliation

Mechanism: Amiodarone shows beta blocker-like and potassium channel blocker-like actions on the SA and AV nodes, increases the refractory period via sodium- and potassium-channel effects, and slows intra-cardiac conduction of the cardiac action potential, via sodium-channel effects.

Side: Effects: Can be fatal, side effects may last several months, worsening of arrhythmia, can harm unborn fetus, wheezing, blurred vision, numbness, nausea. Contraindications: cardiogenic shock; severe sinus-node dysfunction, causing marked sinus bradycardia; second- or third-degree atrioventricular block; and when episodes of bradycardia have caused syncope (except when used in conjunction with a pacemaker). Hypersensitivity to iodine.

Labetolol USE: Hypertension

Mechanism: Beta-adrenergic blocking agent (Beta blocker)

Side: Effects: Impaired thinking and reactions, slow or uneven heartbeats, syncope, shortness of breath, swelling of ankles, depression, insomnia, impotence. Contraindications: Bronchial asthma, overt cardiac failure, greater-than-first-degree heart block, cardiogenic shock, severe bradycardia, other conditions associated with severe and prolonged hypotension.

Colace (Docusate) USE: Constipation, Stool Softener, to avoid straining

Mechanism: The active ingredient, docusate sodium – is a stool softener that allows water and fats to enter the stool, which helps soften fecal material, making natural defecation easier.

Side: Effects: Rectal bleeding, severe abdominal pain, nausea, vomiting, constipation, diarrhea, bitter taste or throat irritation. Possible electrolyte imbalance, dependence Contraindications: Intestinal problems, stomach pain, nausea, vomiting, do not take mineral oil or aspirin while taking Colace.

Lasix (furosemide) USE: For adults and pediatric patients for the treatment of edema associated with congestive heart failure, cirrhosis of the liver, and renal disease, including the nephrotic syndrome. Oral Lasix may be used in adults for the treatment of hypertension

Mechanism: Lasix is a diuretic which is an anthranilic acid derivative. (Lasix (furosemide) is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion)

Side: Effects: pancreatitus, jaundice, anorexia, oral and gastric irritation, cramping diarrhea, constipation, nausea, vomiting, systemic vasculitis, interstitial nephritis, necrotizing angitis, aplastic anemia, thrombocytopenia, agranulocytosis, hemolytic anemia, leukopenia, anemia Contraindications: Lasix is contraindicated in patients with anuria and in patients with a history of hypersensitivity to furosemide.

Cardizem (diltiazem hydrochloride) USE: for the treatment of hypertension. It may be used alone or in combination with other antihypertensive medications. It is also indicated for the management of chronic

stable angina.

Mechanism: Diltiazem hydrochloride is a calcium ion cellular influx inhibitor (slow channel blocker or calcium antagonist).

Side: Effects: Cardiovascular: Angina, arrhythmia, AV block (second- or third-degree), bundle branch block, congestive heart failure, ECG abnormalities, hypotension, palpitations, syncope, tachycardia, ventricular extrasystoles.Nervous System: Abnormal

dreams, amnesia, depression, gait abnormality, hallucinations, insomnia, nervousness, paresthesia, personality change, somnolence, tinnitus, tremor.Gastrointestinal: Anorexia, constipation, diarrhea, dry mouth, dysgeusia, mild elevations of SGOT, SGPT, LDH, and alkaline phosphatase (see hepatic warnings), nausea, thirst, vomiting, weight increase. Contraindications: Diltiazem is contraindicated in (1) patients with sick sinus syndrome except in the presence of a functioning ventricular pacemaker, (2) patients

with second- or third-degree AV block except in the presence of a functioning ventricular pacemaker, (3) patients with hypotension (less than 90 mm Hg systolic), (4) patients who have demonstrated hypersensitivity to the drug, and (5) patients with acute myocardial infarction and pulmonary congestion documented by x-ray on admission.

Cozaar - Losartan - Cozaar (losartan potassium tablets) An angiotensin II receptor antagonist. USE: - Treatment of Hypertension - May be used with other antihypertensive agents

- Treatment of diuretic nephropathy - For hypertensive patients with Left ventricular hypertrophy. Mechanism: - Angiotensin II [formed from angiotensin I in a reaction catalyzed by angiotensin converting enzyme (ACE, kininase II)], is a potent vasoconstrictor, the primary vasoactive hormone of the renin-angiotensin system and an important component in the pathophysiology of hypertension. - It also stimulates aldosterone secretion by the adrenal cortex. Losartan and its

principal active metabolite block the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor found in many tissues

Side: Effects: Musculoskeletal: muscle cramps, back pain, leg pain. Nervous System / Psychiatric: Dizziness

Respiratory: Nasal Congestion, Upper respiratory infection, Sinusitis Contraindications: Contraindicated for anyone who is hypersensitive to any of Losartan’s components.

(pregnant women, patients with liver dysfunction, patients treated with diuretics, patients with impaired renal function) COZAAR is available as tablets for oral administration containing either 25 mg, 50 mg or 100 mg of losartan potassium and the following inactive ingredients: microcrystalline cellulose, lactose

hydrous, pregelatinized starch, magnesium stearate, hydroxypropyl cellulose, hypromellose, titanium dioxide, D&C yellow No. 10 aluminum lake and FD&C blue No. 2 aluminum lake.

Genfibrozil [Gemfibrozil?] Lopid A lipid regulating agent. USE: An adjunctive therapy to diet for: - Treatment of adult patients with very high elevations of serum triglyceride levels (Types IV and V hyperlipidemia) who present a risk of pancreatitis and who do not respond adequately to a determined dietary effort to control them. - Reducing the risk of developing coronary heart disease only in Type IIb patients without history of or symptoms of existing coronary heart disease who have had an inadequate response to weight loss, dietary therapy, exercise, and other pharmacologic agents and

who have the following triad of lipid abnormalities: low HDL-cholesterol levels in addition to elevated LDL-cholesterol and elevated triglycerides

Mechanism: LOPID (gemfibrozil tablets, USP) is a lipid regulating agent which decreases serum triglycerides and very low density lipoprotein (VLDL) cholesterol, and increases high density lipoprotein (HDL) cholesterol.

Side: Effects: - Gastrointestinal reaction - Dyspepsia - Abdominal Pain - Acute appendicitis - Atrial Fibrillation

- Diarrhea - Fatigue - Nausea/Vomitting Contraindications: Combination therapy of LOPID with cerivastatin due to the increased risk of myopathy and rhabdomyolysis. - Hepatic or severe renal dysfunction, including primary biliary cirrhosis. - Preexisting gallbladder disease. - Hypersensitivity to gemfibrozil.