DRUG STUDY

Generic Name: Digoxin

Pregnancy risk category c

Classification

Action Indication Contraindication Adverse effects Nursing
responsibilities
Inotrope
Cardiac
glycoside
Inhibits
sodium
potassium
activated
adenosine
triphosphatase
,promoting
movement of
calcium from
extracellular
to intracellular
cytoplasm and
strengthening
the myocardial
contraction.
Also acts on
CNS to
enhance vagal
tone ,slowing
conduction
through SA
and AV nodes.
Management for
heart
failure,paroxysmal
supraventricular
tachycardia and
atrial fibrillation
and flutter
Contraindicated in patients hypersensitive to
drug and in those with digitalis-induced toxicity
,ventricular fibrillation or ventricular tachycardia.
Patients with Wolff-Parkinson-white syndrome
unless the conduction has been
pharmacologically or surgically disabled.
Extreme caution in elderly patients and in those
with acute MI ,incomplete AV blocks ,sinus
bradycardia
,PVcs,hypertrophiccardiomyaopathy,renalinsuffie
ncy ,severe pulmonary disease and
hypothyroidism

CNS: agitation,fatigue, generalized muscles
weakness,
Paresthesia,stupor
vertigo
CV: arythmias and heart blocks
EENT:blurredvision,diplopia,lightflashes,photophobia,
yelloe-green halos around visual images
GI: nausea,vomiting, diarrhea
Monitor
digoxin level.
Monitor
potassium
level
carefully.
Teach patient
and
responsible
family
member
about drug
action
,dosage
regimen
,how to take
pulse ,and
follow up
care.
Encourage
patient to eat
a consistent
amount of
potassium
rich food.
Instruct
oateient to
report
adverse
reaction
promptly.
Nausea and
vomiting and
diarrhea may
be indicators
of toxicity



Generic Name:Metoprolol
Pregnancy risk category C
Classification

Action Indication Contraindication Adverse effects Nursing
responsibilities
Antihypertensive
Selective beta
blocker
A selective beta
blocker that
selectively block
beta1 receptors
;decreases cardiac
output , peripheral
resistance and
cardiac onygen
consumption;
depresses renin
secretion.
Management for
hypertension,acuteMI,angina
pectoris and stable
symptomatic heart failure
Contraindicated in
patients
hypersensitive to
drug or other beta
blocker
Contraindicated in
patients with sinus
bradycardia ,
greater than first-
degreeheart block,
cardiogenic shock
CNS:fatigue,
dizziness,
Depression ,

CV: Hypotension,
bradycardia, heart
failure AV block,
edema

GI:nausea, diarrhea,
constipation, heart
Always check
patients apical
pulse rate before
giving drug,
withhold drug if less
than 60 bpm.
Monitor blood
pressure frequently
Monitor glucose
level closely
because drug masks
Use cautiously on
patient with heart
failure ,diabetes or
respiratory or
hepatic disease
burn

RESPIRATORY:
dyspnea, wheezing

SKIN: rash
common signs and
symptoms of
hypoglycemia.
Instruct to take
drug exactly as
prescribe and with
meals.
Watch out for
peripheral side
effect . beta
selectivity is lost at
higher doses



Generic Name:Furosemide40 MG /IV Q6H
Brand name:lasix
Pregnancy risk category C
Classification

Action Indication Contraindication Adverse effects Nursing
responsibilities
Antihypertensive
Loop diuretic
Inhibits sodium and
chloride
reabsorptionat the
proximal and distal
tubules and the
ascending loop of
Henley
Management for
acute pulmonary
edema and
hypertension
Contraindicated in
patients
hypersensitive to
drug and in those
with anuria
Use cautiously in
patient with hepatic
cirrhosis and those
allergic to
sulfonamide.
CNS: headache,
dizziness,
restlessness,fever,
paresthesia
CV: orthosthatic
hypotension,
thrombophlebitis
EENT: transient
deafness, tinnitus,
blurred or yellowed
Monitor weight ,BP
, and pulse rate
routinely with long
term use.
Monitor fluid
intake and output
and
electrolyte,BUN ,
and CO2 levels.
Watch for signs of
Use cautiously in
breast feeding
women.

vision
GI: abdominal
discomfort and pain,
n/v , pancreatitis
GU: polyuria,
oliguria,nocturia
HEMA:
thrombocytopenia,
aplastic anemia

MASCULOSKELETAL:
muscle spasm
HEPATIC: hepatic
dysfunction ,jaundice
METABOLIC:
hypokalemia,
hypocalcemia,
hypomagnesemia
SKIN:purpura,
dermatitis

hypokalemia.
Advice to take
drug with food to
prevent GI upset.
Instruct patient to
stand slowly to
prevent dizziness.
Monitor patient
with severe
symptom of urine
retention due to
bladder emptying




Generic Name:Atovastatin80 MG/TAB ODHS
Pregnancy risk category X


Classification

Action Indication Contraindication Adverse effects Nursing responsibilities
Antilipemic
HMG-CoA
reductase inhibitor
Inhibit HMG-CoA
reductase,an early
step in cholesterol
biosynthesis.
Management in
patient with
clinically evident
CAD, to reduce the
risk of non fatal MI
, angina, strokes
and heart failure
Use cautiously in
patient with hepatic
impairement .
Contraindicated in
patients
hypersensitive to
drug and in those
with active liver
disease or
unexplained
persistent elevations
of transaminase
levels
CNS: headache, insomia
CV:peripheral edema
EENT:pharyngitis, rhinitis,
sinusitis
GU:UTI
MASCULOSKELETAL:myalg
ia
,rhabdomyolysis,arthritis
RESPIRATORY:bronchitis
SKIN: allergic reaction,
flulike syndrome
Assess patient for
underlying causes for
hypercholesterolemia
and obtain a baseline
lipid profile
Teach patient about
proper dietary
management ,weight
control ,and exercise.
Watch out for signs od
myositis



Generic Name:ISMN(ISOSOR MONONITRATEBIDE )30MG/TAB
Pregnancy risk category B
Classification

Action Indication Contraindication Adverse effects Nursing responsibilities
Antianginal
Nitrate
Thought to reduce
cardiac oxygen
demand by
decreasing preload
and afterload . Drug
also may increase
blood flow through
the collateral
coronary vessels.
Management for
acute angina attacts
Contraindicated in
patients with
hypersensitivity or
idiosyncrasy to
nitrates and in those
with severe
hypotension ,angle
closure glaucoma or
acute MI .
CNS: headache,dizziness,
weakness
CV: orthostatic
hypotension
,tachycardia,palpitation
,ankle edema ,fainting
EENT: sublingual burning
GI: nausea and vomitting
SKIN: cutaneous
Monitor BP and heart
rate and intensity and
duration of drug
response.
Caution patient to take
drug regularly ,as
prescribed and to
keep it accessible at all
times.
vasodilation ,rash. Treat headache caused
by the drug with
aspirin or
acetaminophen.



Generic Name: LACTULOSE 20 cc ODHS
Pregnancy risk category B

Classification

Action Indication Contraindication Adverse effects Nursing responsibilities
Laxative
Disaccharide

Produces an
osmotic effect in
colon ;also decrease
ammonia ,probably
as a result of
bacterial
degredation ,which
lowers the pH of
colon contents.
Management for
constipation,hepatic
encephalopathy
,including hepatic
precoma and coma in
patients with severe
hepatic disease.
Contraindicated in
patients on a low
galactose diet.
Use cautiously in
patients with
diabetes .
GI:abdominal
cramps, belching,
diarrhea, gaseous
distention, nausea
and vomitting
Monitor Na level for
hypernatremia,especially
when giving in higher
dose to treat hepatic
encephalopathy.
Monitor mental status
and potassium levels
when giving to patients
with hepatic
encephalopathy .
Replace fluid loss .
Instruct patient not to
take other laxatives
during lactulose therapy.







Generic Name: CEFTRIAXONE 1g/IV
Pregnancy risk category B

Classification

Action Indication Contraindication Adverse effects Nursing
responsibilities
Antibiotic
Third generation
cephalosporin
Inhibits cell wall
synthesis,promoting
osmotic
instability;usually
bactericidal
Management for
UTI,lower respiratory
tract
infection,meningitis,a
cute bacterial otitis
media and lyme
disease
Contraindicated in
patients hypersensitive
to drug or other
cephalosporins.
Use cautiously in
patients hypersensitive
to penicillin because of
possibility of cross
sensitivity with other
beta lactam antibiotics.
Use cautiously in
breast-feeding women
and in patients with
history of colitis and
renal insufficiency.

GI: diarrhea,
pseudomembranous
colitis

HEMATOLOGIC:
thrombocytosis

SKIN: pain
,tenderness at
injection site

OTHER: anaphylaxis
Monitor PT and
INR with impaired
vit. K synthesis or
low vit. K stores.
Vit . k therapy
needed
Tell patient to
report adverse
reactions
promptly
Tell patient to
notify prescriber
about loose stools
or diarrhea






Generic Name: AZYTHROMYCIN 500 mg/tab OD tid
Pregnancy risk category B

Classification

Action Indication Contraindication Adverse effects Nursing
responsibilities
Antibiotic
Macrolide
Binds to the 50s
subunit of bacterial
ribosomes , blocking
protein synthesis
;bacteriostatic or
bactericidal
depending on
concentration
Management for
acute bacterial
worsening of COPD
,CAP and acute
bacterial sinusitis
Contraindicated in
patients hypersensitive
to erythromycin or
other macrolide or
ketolideantibiotics .
Use cautiously in
patients with impaired
hepatic function.
CNS:
fatigue,headache,so
mnolence
CV: chest pain,
palpitation
GI: abdominal pain
,anorexia,diarrhea
GU: nephritis
HEPATIC:cholestatic
jaundice
SKIN: rash ,pain
pruritus,photosensiti
vity reaction
Angioedema
Monitor patient
for superinfection .
Monitor patient for
clostridium
deficileinfection
which may range
from mild diarrhea
to fatal colitis.
Advice patient to
avoid excessive
sunlight and to
wear protective
clothing .



Generic name:DOBUTAMINE HYDROCHLORIDE
Pregnancy risk category B
Classification

Action Indication Contraindication Adverse effects Nursing
responsibilities
Inotrope

Adrenergic, beta1
agonist
Stimulates hearts
beta1 receptors to
increase myocardial
contractility and
stroke volume.
Decrease cardiac
output by decreasing
peripheral vascular
resistance ,reducing
ventricular filling
pressure ,and
facilitating AV node
conduction
To increase cardiac
output in short term
treatment of cardiac
decompensation
caused by depressed
contractility during
feractory heart
failure.