DRUG STUDY

Name of the Drug Classification and Mechanism of Action Classification: Anti-anginals Action: Isoket is a moderate to long acting oral organic nitrate used for the relief and prophylactic management of angina pectoris. It relaxes the vascular smooth muscle and consequent dilatation of peripheral arteries and veins. Dilatation of the veins promotes peripheral pooling of blood and decreases venous return to the heart, thereby reducing left ventricular enddiastolic pressure and pulmonary Indication Contraindication Side Effects Nursing Responsibilities Monitoring Parameters

Generic Name: Isosorbide dinitrate Brand name: Isoket

Available form: Tablet Dose: 1 amp Route: IV incorporated Frequency: Stat

Acute angina attacks

Contraindicated to patients with cardiogenic shock, circulatory collapse, severe hypotension, marked anemia, head trauma, cerebral hemorrhage, severe hypovolemia. .

CNS: headache, dizziness CV: orthostatic hypotension, tachycardia, palpitation, ankle edema

GI: nausea, vomiting Skin: rash

Instructed the patient to take without regard to meals. Absorption is faster on empty stomach. Monitor blood pressure and intensity and duration of drug response. Advise patient that stopping drug abruptly may cause spasm of coronary arteries and increased angina symptoms and potential risk for heart attack. Advise patient

May cause false reduced cholesterol level in using Zlatkis-Zak color reaction.

capillary wedge pressure (preload). Arteriolar relaxation reduces systemic vascular resistance, systolic arterial pressure, and mean arterial pressure.

who complains of tingling sensation with SL drug to try holding the cheeks.

Instruct the patient to rise up slowly in bed to avoid dizziness.

Name of Drug Generic Name: Clonidine hydrochloride Brand Name: Catapres Available Form: Tablet Dose: 75 mg Route: Sublingual Frequency: stat

Classification and Mechanism of Action Classification: Antihypertensive drug Action: Thought to stimulate alpha2 receptors and inhibit central vasomotor centers, decreasing sympathetic outflow to the heart, kidneys and peripheral vasculature and lowering peripheral vascular resistance, blood pressure and heart rate.

Indications Hypertension

Contraindications Contraindicated to patients hypersensitive to drug. Use cautiously to patients with severe coronary insufficiency , conduction disturbance, recent MI, cerebrovascular disease, chronic renal failure or impaired liver function.

Side Effects CNS: drowsiness, dizziness, sedation, weakness, fatigue CV: bradycardia, severe rebound hypertension, orthostatic hypotension GI: constipation, dry mouth, nausea, vomiting GU: urine retention Metabolic: weight gain Skin: pruritus, rash

Nursing Responsibilities Monitor blood pressure and pulse rate frequently. Dosage is usually adjusted to patients blood pressure and tolerance. Elderly patient may be sensitive to the drugs effects. Caution the patient that the drug may cause drowsiness but this usually diminishes within 4-6 weeks. Inform patient that dizziness upon standing can be minimized by rising slowly from sitting or lying position and avoid sudden position changes. Advise patient that stopping drug abruptly may cause severe rebound high blood pressure. Tell him dosage must be reduced gradually over 2 to 4 days as instructed by prescriber.

Monitoring Parameters May decrease urinary excretion of cathechol amines .

Name of Drug Generic Name: Furosemide Brand Name: Lasix Available Form: Injection Dose: 20 mg/ml Route: IV Frequency: stat

Classification and Action Classification: Loop Diuretics Action:

Indications a. Acute pulmonary edema b. Edema

Contraindications Contraindicated to patients hypersensitivity to drug and those with anuria. Use cautiously in patients with hepatic cirrhosis and in those allergic to sulfonamides.

Side Effects CNS: vertigo, headache, dizziness, paresthesia, weakness CV: orthostatic hypotension EENT: transient deafness, blurred vision, tiinitus GI: abdominal discomfort, pain, diarrhea,nausea, Vomiting GU: nocturia, oliguria, frequent urination Hematologic: agranulocytosis, aplastic anemia, leucopenia, thrombocytopenia Hepatic: jaundice Metabolic: dehydration, hypokalemia, hyperglycemia, hyponatremia, hypocalcemia, hypomagnesemia Musculoskeletal: muscle spasm

Nursing Considerations If oliguria or azotemia develops or increases, drug may be need to stop. . Monitor for signs of hypokalemia. Monitor blood glucose in diabetic client. Drug may not be well absorbed orally in patient with severe heart failure. Drug may need to be given I.V even if the patient is taking other drugs. Monitor uric acid levels, especially in patients with a history of gout. Tell patient to check with prescriber or pharmacist before taking OTC drugs.

Monitoring Parameters May increase glucose levels, cholesterol, triglycerides, calcium and uric acid levels. May decrease potassium, sodium, chloride and hemoglobin levels. May decrease platelet, granulocyte and WBC counts.

A potent drug that inhibits sodium and chloride reabsorption at the proximal and distal tubules and ascending loop of Henle.

c. Hypertension

Name of Drug Generic Name: Captopril Brand Name: Capoten Dose: 25mg/tab Route: P.O. Available form: Tablet Frequency: BID

Classification and Action Classification: Angiotensin Converting Enzyme inhibitor Action: Inhibits Angiotensin Converting Enzyme inhibitor, preventing conversion of angiotensin I to angiotensin II, potent vasoconstrictor. Less angiotensin II decrease peripheral arterial resistance, decrease aldosterone secretion, which reduces sodium and water retention that lowers blood pressure. .

Indication Hypertension and heart failure

Contraindications Contraindicated to patients with history of angioedema. Use cautiously to patients with impaired renal function or serious autoimmune disorders especially systemic lupus erythematosus, and exposed to drugs that affect WBC counts or immune response.

Side Effects CNS: Headache, dizziness CV: postural hypotension, tachycardia GI: abdominal pain, dysgeusia, anorexia, dry mouth, nausea, vomiting Respiratory: Nagging, nonproductive cough Skin: Rash, angioedema Metabolic: Hyperkalemia

Nursing Responsibility

Monitoring Parameters May increase alkaline phosphatase, bilirubin, potassium level. May decrease hemoglobin and hematocrit, granulocyte, platelet RBC, WBC count.

Regularly monitor the patients blood pressure. Instruct the patient to rise up in bed slowly to prevent dizziness. Assess the patient for history or presence of renal impairment before administration. Give the drug before meals for faster reabsorsption.

Name of Drug Generic Name: Salbutamol Brand Name: Combivent Available Forms: nebules Dosage: 1 nebule Route: Nebulization Frequency:TID

Classification and Action Bronchodilator Salbutamol is a selective 2-adrenomimetic agent stimulating mainly the 2adrenergic receptors and to a lesser extent 1adrenergic receptors in the myocardium. Due to these changes bronchial smooth muscle relaxation and inhibition of mast cell degranulation develop. The antiasthmatic action of Salbutamol is related to the decrease of edema and mucus secretion.

Indication Bronchospasm

Contraindications The drug should be used with caution in patients with heart diseases and probable rhythm disorders (advanced high grade valvular diseases, ischemic heart disease, cardiomyopathy, etc.), as well as in patients with diabetes mellitus

Side Effects CNS: tremors, nervousness, headache, hyperactivity, insomnia, dizziness, weakness CV: tachycardia, palpitation, hypertension GI: nausea, vomiting, heartburn, anorexia, altered taste .

Nursing Responsibility Decrease the clients sensitivity to spirometry Warn patient about risk of paradoxical bronchospasm and stop drug immediately if it occurs. Teach patient to perform oral inhalation correctly.

Monitoring Parameters This drug may decrease the serum potassium

Name of Drug Generic Name: Levodropropizine Brand Name: Levopront Available Forms: tablet Dose: 30 mg Route: p.o Frequency:q6

Classification and Action Antitussive It acts as either centrally or locally to inhibit the cough response receptors in the medulla or at the site of irritation to decrease frequency and intensity.

Indication Suppress persistent dry or ineffective cough

Side Effects Drowsiness, constipation and GI upset

Contraindications Contraindicated to patients wit excessive production of mucus, severe liver dysfunction.

Nursing Responsibility Monitor the clients respiratory status Observe for signs of drowsiness. Advise the patient not to do activities that needs concentration like driving. If constipation happens, use laxatives to relieve it.

Monitoring Parameters Monitor hepatic studies throughout the therapy.