DRUG STUDY

Far Eastern University

Institute of Nursing
LEADERSHIP AND MANAGEMENT

Student Nurse In –Charge: Student Head Nurse: LEOCHICO, Maricris M.

Patient: Alfredo Martinez Date: 12/15/2010
Room and Bed No.: 505 Bed D
Name Of Dosage Drug Class Indication Contraindication Adverse Effect Nursing
Drug Responsibilities
Generic : 5 mg/ tab Calcium • Angina • Contraindic • CNS: Assessment
Amlodipine 1 tab OD channel-blocker pectoris ated with Dizziness, • History:
Antianginal due to allergy to light- Allergy to
Trade name: drug coronary amlodipine, headedne amlodipine,
Norvasc Antihypertensiv artery impaired ss, impaired
e spasm hepatic or headache, hepatic or renal
(Prinzmet renal asthenia, function, sick
Therapeutic al's function, fatigue, sinus
actions variant sick sinus lethargy syndrome,
Inhibits the angina) syndrome, heart block,
movement of
• CV:
• Chronic heart block lactation, CHF
Peripheral
calcium ions stable (second or
across the
edema, • Physical: Skin
angina, third
arrhythmi lesions, color,
membranes of alone or degree),
as edema; P, BP,
cardiac and in lactation.
• Dermatol baseline ECG,
arterial combinati • Use
ogic: peripheral
muscle cells; on with cautiously
Flushing, perfusion,
inhibits other with CHF,
rash auscultation; R,
transmembra agents pregnancy. adventitious
ne calcium • Essential • GI:
sounds; liver
flow, which hypertens Nausea,
evaluation, GI
results in the ion, alone abdominal
normal output;
depression of or in discomfort
liver and renal
impulse combinati function tests,
formation in on with Interactions
urinalysis
specialized other Drug-drug
cardiac antihypert Possible
Interventions
pacemaker ensives increased serum
cells, slowing • Monitor patient
• levels and toxicity
carefully (BP,
of the velocity of cyclosporine if cardiac rhythm,
of conduction taken and output)
of the cardiac concurrently while adjusting
impulse, drug to
depression of therapeutic
myocardial dose; use
contractility, special caution
and dilation of if patient has
coronary CHF.
arteries and Teaching points
arterioles and • Take with
peripheral meals if
arterioles; upset
these effects stomach
lead to occurs.
decreased
cardiac work,
decreased
cardiac
oxygen
consumption,
and in
patients with
vasospastic
(Prinzmetal's)
angina,
increased
delivery of
oxygen to
cardiac cells.

Generic: Antipyretic • Mild to • Allergy to • Acute Assessment

Aspirin Analgesic moderate salicylates aspirin • History:
(nonopioid) pain or NSAIDs toxicity: Allergy to
Anti- • Fever (more Respirator salicylates or
inflammatory • Inflammat common y alkalosis, NSAIDs; allergy
Antirheumatic ory with nasal hyperpnea to tartrazine;
Antiplatelet conditions polyps, , hemophilia,
Salicylate — asthma, tachypnea bleeding ulcers,
 NSAID rheumatic chronic , hemorrhagic
Trade name: fever, urticaria); hemorrha states, blood
Tromcor rheumatoi allergy to ge, coagulation
d arthritis, tartrazine excitemen defects,
osteoarthr (cross- t, hypoprothromb
Therapeutic itis sensitivity confusion, inemia, vitamin
actions • Reduction to aspirin is asterixis, K deficiency;
Analgesic and of risk of common); pulmonary impaired
recurrent hemophilia, edema, hepatic
antirheumatic bleeding seizures, function;
TIAs or
effects are stroke in ulcers, tetany, impaired renal
attributable to males hemorrhagi metabolic function;
with c states, acidosis, chickenpox,
aspirin's
history of blood fever, influenza;
ability to TIA due to coagulation coma, CV children with
inhibit the fibrin defects, collapse, fever
synthesis of platelet hypoprothr renal and accompanied
emboli ombinemia respiratory by dehydration;
prostaglandin , vitamin K failure surgery
• Reduction
s, important of risk of deficiency (dose scheduled
mediators of death or (increased related within 1 wk;
nonfatal risk of 20–25 g in pregnancy;
inflammation.
MI in bleeding) adults, 4 g lactation
Antipyretic patients • Use in • Physical: Skin
effects are with cautiously children) color, lesions;
not fully history of with • Aspirin temperature;
infarction impaired intoleran eighth cranial
understood, renal
or ce: nerve function,
but aspirin unstable function; Exacerbati orientation,
probably acts angina chickenpox on of reflexes, affect;
pectoris , influenza bronchosp P, BP,
in the
• MI (risk of asm, perfusion; R,
thermoregulat prophylax Reye's rhinitis adventitious
ory center of is syndrome (with nasal sounds; liver
• Unlabeled in children polyps, evaluation,
the
use: and asthma, bowel sounds;
hypothalamus teenagers);
Prophylaxi rhinitis) CBC, clotting
to block children times,
s against • GI:
effects of cataract with fever urinalysis, stool
Nausea,
formation accompani guaiac, renal
endogenous dyspepsia,
with long- ed by and liver
heartburn,
pyrogen by
inhibiting term use dehydratio epigastric function tests
n; surgery discomfort
synthesis of scheduled , anorexia, Interventions
the within 1 hepatotoxi • Give drug
prostaglandin wk; city with food or
pregnancy • Hematolo after meals
intermediary.
(maternal gic: if GI upset
Inhibition of anemia, occurs.
Occult
platelet antepartal blood loss, • Give drug
aggregation is and hemostati with full
postpartal c defects glass of
attributable to hemorrhag
• Hypersen water to
the e, reduce risk
sitivity:
inhibition of prolonged of tablet or
Anaphylac
gestation, capsule
platelet toid
and lodging in
synthesis of reactions
prolonged the
to
thromboxane labor have esophagus.
anaphyla
been • Do not
A2, a potent ctic
reported; crush, and
vasoconstricto shock
readily ensure that
r and inducer crosses the • Salicylis patient
placenta; m:
of does not
possibly Dizziness,
platelet chew
teratogenic tinnitus,
sustained-
aggregation. ; maternal difficulty
release
This effect ingestion of hearing,
preparation
aspirin nausea,
occurs at low s.
during late vomiting,
• Do not use
doses and pregnancy diarrhea,
aspirin that
lasts for the has been mental
has a
associated confusion,
life of the strong
with the lassitude
platelet (8 vinegar-like
following (dose
odor.
days). Higher adverse related)
Interactions • Report
doses inhibit fetal
Drug-drug ringing in
effects: low
the synthesis the ears;
birth • Increased
dizziness,
of weight, risk of
confusion;
prostacyclin, a increased bleeding
abdominal
intracranial with oral
potent pain; rapid
hemorrhag anticoagul
vasodilator e, ants, or difficult
stillbirths, heparin breathing;
and neonatal nausea,
• Increased
inhibitor of death); risk of GI vomiting.
platelet lactation. ulceration
aggregation. with
steroids,
phenylbut
azone,
alcohol,
NSAIDs
• Increased
serum
salicylate
levels due
to
decreased
salicylate
excretion
with urine
acidifiers
(ammoniu
m
chloride,
ascorbic
acid,
methionin
e)
Generic : 40 mg/ tab Antihyperlipide • To reduce the • Contraindicated Nausea & • Monitor patient’s
Atorvastatin 1 tab OD mic risk of MI, in patients vomiting, lipid and liver
Calcium @ HS HMG co-enzyme stroke, angina, hypertensive to diarrhea, function levels at
A (HMG CoA) and the drug and in abdominal pain, baseline and
Trade name: inhibitor revascularizati those with constipation, periodically
Lipitor/ on procedures active liver dyspepsia & thereafter.
Simvastatin in patients with disease or flatulence. • Monitor patient for
no evidence of conditions Headache, skin signs of
CAD with linked with rashes, dizziness, rhabdomyolyis,
Therapeutic multiple risk unexplained blurred vision, especially if taking
actions factors. persistent insomnia, more than one class
Inhibits HMG • Heterozygous increases in dysgeusia. of lipid lowering
familial transaminase Cholestatic drugs.
CoA, the
enzyme that hypercholester levels. jaundice, pruritus, • Asses patient’s and
olemia. • Adolescent girl hypoglycemia, family’s knowledge
catalyzes the hyperglycemia.
• Adjunct to diet must be at least of drug therapy.
first step in to reduce 1 year post- Anorexia,
the elevated LDL, menarche pancreatitis,
total alopecia, weight
cholesterol
cholesterol, gain, Stevens-
synthesis apo B, and Johnson
pathway, triglyceride syndrome. Back
resulting in a levels to & chest pain,
increase HDL muscle cramps,
decrease in level in peripheral
serum patients with edema, malaise &
cholesterol, primary fatigue
hypercholester Drug and food
serum LDLs
olemia and interaction:
(associated mixed Cyclosporine,
with dyslipidemia. fibric acid
derivatives,
increased risk
erythromycin,
of CAD), and niacin, azole
increases antifungals. Oral
serum HDLs antacid
containing Mg &
(associated Al hydroxide,
with colestipol,
decreased risk efavirenz &
rifampin. Digoxin.
of
Protease
CAD); inhibitors,
increases diltiazem HCl &
hepatic LDL grapefruit juice.
Norethindrone &
recapture ethinylestradiol.
sites,
enhances
reuptake and
catabolism of
LDL;
lowers
triglyceride
levels.

Generic: 5 mg/ tab Antihypertensiv • Treatmen • Contraindic • CNS: Assessment

Enalapril 1 tab OD e t of ated with Headache, • History:
Maleate ACE inhibitor hypertens allergy to dizziness, Allergy to
ion alone enalapril. fatigue, enalapril,
or in • Use insomnia, impaired renal
combinati cautiously paresthesi function, salt or
Trade name: on with with as volume
Buergli other impaired depletion,
Therapeutic
• CV:
antihypert renal lactation,
Syncope,
actions ensives, function; pregnancy
chest pain,
especially salt or
Renin, palpitation • Physical: Skin
thiazide- volume
synthesized s, color, lesions,
type depletion
by the hypotensio turgor; T;
diuretics (hypotensi n in salt- orientation,
kidneys, is • Treatmen on may or volume- reflexes, affect,
released into t of acute occur); depleted peripheral
and lactation, patients sensation; P,
the circulation chronic pregnancy.
• GI: Gastric BP, peripheral
where it acts CHF
irritation, perfusion;
on a • Treatmen mucous
nausea,
plasma t of membranes,
vomiting,
asympto bowel sounds,
precursor to diarrhea,
matic left liver
abdominal
produce ventricula evaluation;
pain,
angiotensin I, r urinalysis, renal
dyspepsia,
dysfunctio and liver
which is elevated
n (LVD) function tests,
converted by liver
• Unlabeled CBC, and
enzymes
angiotensin- use: differential
Diabetic • GU:
converting Proteinuria
nephropat Interventions
enzyme to hy , renal
• Monitor
angiotensin II, insufficien
a potent cy, renal patients on
failure, diuretic therapy
vasoconstricto polyuria, for excessive
r that also oliguria, hypotension
causes urinary after the first
frequency, few doses of
release of
impotence enalapril.
aldosterone
• Hematolo • Monitor patient
from the gic: carefully
adrenals; both Decreased because peak
hematocri effect may not
of these be seen for 4
t and
actions hemoglobi hr. Do not
increase BP. n administer
second dose
Enalapril • Other:
until BP has
blocks the Cough,
been checked.
muscle
conversion of cramps,
angiotensin I hyperhidro
to angiotensin sis
II, decreasing
Interactions
BP, Drug-drug
decreasing • Decrea
aldosterone sed
hypote
secretion, nsive
slightly effect
increasing if
taken
serum K+
concur
levels, and rently
causing Na+ with
and fluid loss; indom
ethacin
increased ,
prostaglandin rifampi
synthesis also n
may be
involved in
the
antihypertensi
ve action. In
patients with
heart
failure,
peripheral
resistance,
afterload,
preload, and
heart size are
decreased.

Generic name: 500 mg/ Analgesic • Relief of • Contraindic • CNS: Assessment

tramadol tab 1 tab (centrally moderate ated with Sedation, • History:
hydrochlorid for acting) to allergy to dizziness Hypersensitivit
e headache moderatel tramadol or or vertigo, y to tramadol;
PRN y severe opioids or headache, pregnancy;
Brand name: pain acute confusion, acute
Dolcet intoxication dreaming, intoxication
with sweating, with alcohol,
Therapeutic alcohol, anxiety, opioids,
actions opioids, or seizures psychotropic
psychotropi drugs or other
Binds to mu- • CV:
c drugs. centrally acting
opioid Hypotensi
• Use on, analgesics;
receptors and cautiously lactation;
tachycardi
inhibits the with a, seizures;
reuptake of pregnancy, bradycardi concomitant
lactation, a use of CNS
norepinephrin seizures, depressants or
e and concomitan • Dermatol
MAOIs; renal or
t use of ogic:
serotonin; hepatic
CNS Sweating,
causes many impairment;
depressant pruritus,
past or present
effects similar s or MAOIs, rash,
history of
renal or pallor,
to the opioids opioid addiction
—dizziness, hepatic urticaria • Physical: Skin
impairment • GI: color, texture,
somnolence, . Nausea, lesions;
nausea, vomiting, orientation,
constipation dry mouth, reflexes,
—but does not constipatio bilateral grip
n, strength,
have the
flatulence affect; P,
respiratory auscultation,
• Other:
depressant Potential BP; bowel
effects. for abuse, sounds, normal
anaphyla output; liver
ctoid and kidney
reactions function tests
Interactions
Drug-drug Interventions
• Decreased • Control
effectiven environment
ess with (temperature,
carbamaz lighting) if
epine sweating or
• Increased risk CNS effects
of tramadol occur.
toxicity with
MAOIs