DRUG STUDY

Generic Name: Amlodipine

Brand Name: Norvasc

Therapeutic Class: Antihypertension

Pharmacologic Class: Calcium channel blockers

Indications:
Alone or with other agents of management of hypertension, angina pectoris
and vasospastic (prinzmental) angina.

Action:
Inhibits the transport of Calcium into myocardial and vascular smooth muscle
cells, resulting in inhibition of excitation. Contraction coupling and subsequent
contraction.

Therapeutic effect:
Systemic vasodilatation resulting in decreased blood pressure.

Contraindications/Precautions:
Hypersensitivity; BP <90mmhg

Adverse Drug Effect:

Headache, dizziness, fatigue, peripheral edema, angina, bradycardia,
hypotension, and gingival hyperplasia.

Nursing responsibility:
1. Monitor blood pressure and pulse rate before therapy during dose titration
and periodically during prolonged therapy. Monitor ECG, I&O.
2. Advise patient to take medication as directed even if feeling well. Take
missed doses as soon as possible unless almost time for next dose. Don’t
double doses, may need to discontinue gradually.
3. Advise patient to avoid large amounts (6-8 glasses of grapefruit juice/daily)
during therapy.
4. Caution patient to change position slowly to minimize orthostatic
hypertension.
5. Instruct patient and family in proper technique for monitoring blood pressure.
Advise patient to take blood pressure weekly and to report significant
changes to health care professionals.
Generic Name: Simvastatin
Brand Name: Zocor

Indications:
Adjuctive management of primary hypercholesterolemia and mixed
dyslipidemias. Secondary prevention of cardiovascular events for high risk in CHD
(history of diabetes).

Action:
Inhibits an enzyme, 3hydroxy, 3methy glutaryl Coenzyme A (HMG-COA)
reductase which is responsible for catalyzing an early step in synthesis of
cholesterol.

Therapeutic Effect:
Decrease total and LDL cholesterol and triglycerides.

Contraindications/Precautions:
Hypersensitivity; Active liver disease or unexplained persistent increase in
AST or ALT; OB, lactation, pregnant

Adverse Drug Effect:

Dizziness, headache, insomnia, weakness, chest pain, rhinitis, abdominal
cramps, constipation diarrhea, flatus, heartburn, and rashes.

Nursing responsibility:
1. Obtain a dietary history, especially with regard to fat consumption.
2. If patient develops muscle tenderness during therapy, monitor CK levels. If
CK are >10 x the upper limit of normal myopathy occurs, therapy should be
discontinued.
3. Instruct patient to notify health care professional if unexplained muscle pain,
tenderness or weakness occurs; especially accompanied by fever or malaise.