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University of the Philippines The Health Sciences Center
COLLEGE OF NURSING
Sotejo Hall, Pedro Gil Street, Manila
Drug StudyDRUG ORDER(Genericname,Dosage,Route,Frequency,etc.)PHARMACOLOGIC ACTION OFDRUGINDICATIONS ANDCONTRAINDICATIONSADVERSE EFFECTS OFTHE DRUGDESIREDACTION ONTHE CLIENTNURSINGRESPONSIBILITIES/PRECAUTIONS
Aspirin80mg/tab 1tab p lunch POODExhibitsantipyretic, anti-inflammatory andanalgesic effects. The antipyreticeffect is due to anaction on thehypothalamus,resulting in heatloss byvasodilation of peripheral bloodvessels. Anti-inflammatoryeffects aremediated by adecrease inprostaglandinsynthesis. It alsodecreases plateletaggregation.
Indications:
•
For pain onintegumentarystructures,myalgia,neuralgia,headache,dysmenorrhea,gout.
•
Arthritis, SLE,acute rheumaticfever
Contraindications:
•
Hypersensitivity tosalicylates, severeanemia, history of blood coagulationdefects, vitamin K deficiency, 1 weekbefore and aftersurgery,pregnancy in thelast trimester
GI:
dyspepsia, heartburn,anorexia, nausea,epigastric discomfort,potentiation of pepticulcer
Allergic:
Bronchospasm,asthma-like symptoms,anaphylaxis, skin rashes,urticaria
Hematologic:
prolongation of bleedingtime, thrombocytopenia,leucopenia,
Other:
Thirst, fever,dimness of visionPreventbloodcoagulationdue tohypertension (narrowbloodvessels maycause bloodtoaggregate)
•
Assess for pain:type, locationand pattern
•
Note for asthma
•
Monitor renal,LFTs and CBC
•
Determinehistory of pepticulcers orbleedingtendencies.
Precautions:
•
Do not use inchildren withchicken pox orflu symptoms
•
Lactation
•
Mild diabetes,erosive gastritis,bleedingtendencies, liveror kidneydisease.
 
Clopidogrel75mg/tab 1tab ODInhibits plateletaggregation byblocking ADPreceptors onplatelets,preventingclumping of platelets
Indications
•
 Treatment of patients at risk forischemic events—history of MI,ischemic stroke,peripheral arterydisease
•
 Treatment of patients withacute coronarysyndrome
Contraindications
•
Contraindicatedwith allergy toclopidogrel, activepathologicalbleeding such aspeptic ulcer orintracranialhemorrhage,lactation.
•
CNS:
Headache,dizziness,
weakness,syncope, flushing
CV:
Hypertension, edema
Dermatologic:
Rash,
pruritus
GI:
Nausea, GI distress,constipation, diarrhea, GIbleed
Other:
Increasedbleeding riskPreventplateletaggregation
•
Assess forsymptoms of stroke, MI duringtreatment
•
Monitor liverfunction studies:AST, ALT,bilirubin,creatinine if patient is onlong-termtherapy
•
Monitor bloodstudies:CBC,Hgb, Hct,protime,cholesterol if thepatient is onlong-termtherapy;thrombocytopenia andneutropenia mayoccur.
Precautions:
•
bleedingdisorders, recentsurgery, hepaticimpairment,pregnancyHydrochlorothiazide 12.5 mg1 tab OD POInhibitsreabsorption of sodium andchloride in distalrenal tubule,increasing theexcretion of sodium, chloride,and water by thekidney.
Indications
•
Adjunctive therapyin edemaassociated withCHF, cirrhosis,corticosteroid, andestrogen therapy;renal dysfunction
•
Hypertension assole therapy or incombination withotherantihypertensives
•
Unlabeled uses:
CNS:
Dizziness, vertigo,
paresthesias,weakness, headache,drowsiness, fatigue
CV:
Orthostatichypotension, venousthrombosis, volumedepletion, cardiacarrhythmias, chestpain
Dermatologic:
Photosensitivity, rash,purpura, exfoliativedermatitis, hives,Decreasebloodpressure
•
Assessimprovement inCVP q8h
•
Check for rashesand temperatureelevation daily
•
Assess forconfusion
•
Monitormanifestationsof hypokalemia:acidic urine,reduced urine,osmolality,
 
Calciumnephrolithiasisalone or withamiloride orallopurinol topreventrecurrences inhypercalciuric ornormal calciuricpatients; diabetesinsipidus,especiallynephrogenicdiabetes insipidus;osteoporosis
Contraindications
•
Contraindicatedwith
 
allergy tothiazides,sulfonamides; fluidor electrolyteimbalance; renaldisease (can leadto azotemia); liverdisease (risk of hepatic coma);anuria.alopecia
GI:
Nausea, anorexia,vomiting, dry mouth,
diarrhea, constipation, jaundice, hepatitis,pancreatitis
GU:
Polyuria, nocturia,
impotence, loss of libido
Hematologic:
Leukopenia,thrombocytopenia,agranulocytosis,aplastic anemia,neutropenia
Other:
Muscle crampsand muscle spasms,fever, gouty attacks,flushing, weight loss,rhinorrhea, electrolyteimbalances,hyperglycemianocturia,hypotension,tachycardia,weak pulse,weakness,altered LOC
•
Monitor formanifestationsof hypomagnesemia: agitation,muscletwitching,paresthesias,hyperactivereflexes,dysphagia,tetany, nausea,vomiting,diarrhea
•
Monitor formanifestationsof hyponatremia:increased BP,cold, clammyskin,hypovolemia,abdominalcramps, lethargy
•
Assess fluidvolume status
•
Monitorelectrolytes
Precautions:
•
gout (risk of attack); SLE;glucosetoleranceabnormalities,diabetesmellitus;hyperparathyroidism; manic-depressivedisorder
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