Drug Study Guide | Analgesic | Opioid

DRUGS Generic name: Amlodipine Brand name: Norvasc Classification: Antianginals: Calcium channel blocker Generic name: Aspirin

(ASA.) Brand name: Ecotrin Classification: Antiplatelet drug: salicylate

MECHANISM OF ACTION Inhibits calcium ion influx across cardiac and smooth-muscle cells #, dilates coronary areteries and arterioles, and decreases blood pressure and myocardial oxygen demand. Thought to produce analgesia and exert its anti-inflammatory effect by inhibiting prostaglandin and other substances that sensitize pain receptors. Drug may relieve fever through central action in the hypothalamus heatregulating center. In low doses, drug also appears to interfere with clotting by keeping a plateletaggregating substance from forming. Inhibits platelet aggregation and is thought to promote repuerfusion and reduce the likelihood of rethrombosis.

INDICATION For chronic stable angina, vasospastic angina

CONTRAINDICATION

SIDE EFFECTS/ ADVERSE EFFECTS Contraindicated in Headache, fatigue, patient’s hypersensitive to somnolence, dizziness, drug, use cautiously in pts. flushing, palpitations, Receiving vasodilators nausea, abdominal and and reduce dosage in muscle pain, rash, dyspnea patients with severe and edema hepatic disease. Contraindicated in patients hypersensitive to drug and in those with NSAID-induced sensitivity reactions, bleeding disorders. Use cautiously in patient with GI lesions, impaired renal function, hypoprothrombinemia, Vitamin K deficiency, severe hepatic impairment. Adverse reactions include tinnitus, hearing loss, nausea, GI bleeding, thrombocytopenia, rash, prolonged bleeding time, hyprsensitivity reaction Common: dyspepsia, GI distress urticaria. For interactions with anticoagulants, it may increased risk for bleeding. Use with extreme caution if used together.

NURSES’ RESPONSIBILITY Monitor patient carefully. Monitor BP frequently during initiation of therapy.

To prevent thrombosis To reduce risk of MI in patients with previous MI or unstable angina

Monitor patients for hypersensitivity reactions, such as anaphylaxis and asthma. Advise patient on a low salt diet

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a potent vasoconstrictor less angiotensin II decreasing aldosterone secretion. Before starting treatment assess pt for underlying causes for hypercholesterolemia. at risk for renal failure caused by rhabdomyolysis resulting from trauma. hypersensitive to drug or ACE inhibitors use cautiously in pts. bactericidal. GI irritation & abdominal pain. Use cautiously in patients with CNS disorders. myalgia asthenia. If pain or inflammation occurs or if 43 . leucopenia. every 2 wks for the first 3 months of therapy and periodically thereafter. ĉ impaired renal function CNS: dizziness fatigue. bronchitis. Hypertension diabetic nephropathy Contraindicated in pts. Monitor patient’s blood pressure & pulse rate frequently elderly pts may be moiré sensitive to drug’s hypotensive effects in patients ĉ impaired renal function or collagen vascular disease. an early (and rale-limiting) step in cholesterol biosynsthesis Reduction of elevated total L LDL cholesterol. rash. stomatitis.. angioedema. flu like syndrome allergic reactions Generic name: Captopril Brand name: Capoten Classification: Antihypertensive: ACE inhibitor Inhibits ACE. which reduces sodium & water retention & lowers blood pressure. Monitor patient’s intake and ooutput and observe patient for signs of crystalluria. mainly by blocking DNA gyrase. unexplained joint pain. uncomplicatetd UTI. insomnia muscle cramps. ĉ primary hypercholesterolemia Withhold or stop drug in pts.g. headache. such as severe cerebral arteriosclerosis or seizure disorders and in those aar Advise patient for fluid intake of 2–3 L/d is advised. Tendon rupture may occur in patients receiving quinoones. nervousness. in serious acute conditions like myopathy GI disturbances.Generic name: Atorvastatin Brand name: Lipitor Classification: Antilipemics Inhibits HMG-COA reductase. preventing conversion of Angiotensin II.nosocomial pneumonia Contraindicated in patients sensitive to fluoroquinolones. prophylaxis. apolipoprotein B & triglycerides & increase HDL cholesterol in pts. Mild to moderate UTI. Restrict caffeine due to the following effects (e. flushing. cough Generic name: Ciprofloxacin Brand name: Cipro Classification: Anti-infectives: Inhibits bacterial DNA synthesis. pruritus. monitor WBC and differential counts before starting treatment. rash infection. if not contraindicated. Use only after diet & other condition therapy prove infective Pt should follow a standard low cholesterol diet before & during therapy. loss of taste perception. Ask report sudden.

Encourage to report possible toxicity. apathy. stop drug.fluoroquinolones risk for seizure. In abrupt discontinuation of the preparation anxiety and aggressive conditions may appear. hypoalbuminemia. hematutia. coma. bradycardia. constipation. probably potentiates the muscle spasm effects of GABA. and the anxiety. pruritus patient ruptures a tendon. ataxia. depressive conditions. diarrhea. ĉ atherosderosis documented by recent MI. abdominal pain. It reduces the psychomotor agitation. psychosis. hematoma. rash. epistaxis. and change in mental status. Diazepam reduces the fear sensation. myasthenia gravis. dizziness. depress the CNS. Diazepam possesses hypotensive effect and Contraindicated in patients hypersensitive to drug or its components and in those with pathologic bleeding (such as peptic ulcer) use cautiously in patients at risk for increased bleeding from trauma or other pathologic conditions Diazepam should not be administered in patients with liver or kidney disorders. Instruct to use caution with hazardous activities until reaction to drug is known. Assess for S&S of superinfections Generic name: Clopidogrel bisulfate Brand name: Plavix Classification: Antiplatelet agents Generic name: Diazepam Brand name: Valium Classification: Anxiolytics: benzodiazepene Inhibits the binding of adenosine diphosphale to its platelet. collapse. GI Bleeding purpora. hyperkinesis. brain diseases. dyspepsia gastritis & constipation. depressive conditions. A benzodiazepine that Indicated for anxiety. vomiting. receptors infecting ADP-mediated activation and subsequent platelet aggregation clopedogrel irreversibly modifies the platelet ADP receptor To reduce thrombotic events with acute coronary syndrome. drug abuse or drug dependence. nausea. Patients are at an increased risk for falls. glaucoma. Monitor for dizziness. and suppresses the spread of seizure activity. reduced libido. anxiety. bruising. tremor. and abdominal pain or discomfort. MONItor periodic hepatic. tachycardia). or established peripheral artenal disease. headache. ocular hemorrhage intracranial bleeding. 44 . Drug may cause CNS stimulation. renal and hematopoietic function studies in patients receiving repeated or prolonged therapy. Platelet aggregation wont return normal for at least 5 days after drug has been stopped Don’t confuse plavix with Paxil Somnolence. shock. acute alcohol intoxication. insomnia. hypotension.

dysphagia in childhood. petechiae. preventing conversion of fibrinogen to fibrin. and for severe ccases anaphylaxis Monitor and regularly inspect for bleeding gums. Contraindicated to patients hypersensitive to drug. Common side effect of furosemide include low blood pressure dehydration and electrolyte depletion (sodium and potasssium). Monitor also 45 Generic name: Furosemide Brand name: lasix Classification: Loop diuretic Inhibits sodium and Edema chloride reabsorption at the proximal and distal tubules and the ascending loop Henle. Monitor weight. Monitor fluid intake and output and electrolyte. pregnancy in the first and the last trimester. Instruct patient to watch signs for bleeding or abnormal bruising and to notify physician immediately if any occur. rash. lactation. rash. hypersensitivity to the benzodiazepines. Use ccautiously in patients with hepatic cirrhosis and in those allwrgic to sulfonamides. edema. apnea. and carbon dioxide levels frequently. heparin. BP and pulse rate routinely with long-term use and during rapid diuresis. Contraindicated in patients hypersensitive to drug and in those with anuria. pain. nausea. bruises on arms or legs. Watch for signs of hypokalemia. To prevent ischemic complications of unstable angina and non-Q-wave with oral aspirin therapy. pancreatitis. It is indicated also for acute ST-segment elevation MI. fever.prominent peripheral myorelaxing action. and in those with thrombocytopenia and antiplatelet antibodies in presence of drug Confusion. diarrhea ecchymoses. abdominal pain and dizziness. porphyria. nausea . nd erythema at injection site. tinnitus. tarry stools. hematuria. BUN. Drug has a higher antifactorXa-to-antifactor-IIa activity ratio than heparin. Generic name: Enoxaparin Na Brand name: Levonox Classification: Anticoagulant:lowmolecular-wight heparin Accelerates formation of antithrombin IIIthrombin complex and deactivates thrombin. diarrhea. in those active with major bleeding. bleeding complications irritation. melena. Less common side effects include jaundice. sensitivity to light. chronic obstructive pulmonary disease. hematemesis. nosebleeds. pain hematoma. or pork products. such as muscle weakness and cramps. Increase .

hypokalemia. Watch other thiazides or other vomiting. minimize GI upset. impaired hyponatremia. and monitor glucose level for diabetic patients. especially disease. muscle weakness and and in patients with severe imbalances. Monitor renal disease. Muscle spasm. nausea. uric acid level. these symptoms may indicate toxicity. and patients hypertensive to Diarrhea.. output. Contraindicated to Weakness. weight. Electrolyte. Advise to report immediately ringing of ears. uric acid level. Monitor also progressive hepatic Sensitivity to the sun. stomach cramps. of hypokalemia. BP. referred to Instruct patient to take as ED or impotence. severe abdominal pain or sore throut and fever. cramps. creatinine and BUN levels hepatic function. or and hypochloremia. such as Use cautiously in children hyperglycemia. . Hair loss . gout. electrolyte levels. Encourage to use 46 blood sugar and uric acid levels also may occur. especially in patients with history of gout. also level for diabetic patients. drug with food to Muscle cramps. dizziness. and for signs and symptoms sulphonamide derivative. hypotension. Instruct patient to stand slowly to prevent dizziness and to limit alcohol intake and strenuous exercise. Respiratory distress. Edema and hypertension. constipation. regularly. and monitor glucose Erectile dysfunction. or Monitor fluid intake and patients with anuria and vertigo.Generic name: Hydrochlorothiazide Brand name: hydroDIURIL Classification: Thiazide diuretic Increases sodium and water excretion by inhibiting sodium and chloride reabsorption in distal segment of the nephron. in patients with history of Pancreatitis .

hypertension. excitement. Quick relief for bronchospasm and for the prevention of exerciseinduced bronchospasm. atropine. prostatic hyperplasia. Dizziness. Lab tests: Periodic ABGs. It inhibits vagally mediated reflexes by antagonizing acetylcholine at muscarinic receptors on bronchial smooth muscle. rash. hypersensitivity sunblock to prevent photosensitivity reactions. GI distress. headache. GI symptoms. which may interfere with precision handwork. insomnia). nausea. Monitor for: S&S of fine tremor in fingers. 47 . Report promptly to physician. back pain. particularly in children 2–6 y. pulmonary functions. palpitations.Anaphylactic reactions for very severe cases. CNS stimulation. tachycardia. increased sputum. dry mouth. worst cases. and pulse oximetry. Monitor therapeutic effectiveness which is indicated by significant subjective improvement in pulmonary function within 60–90 min after drug administration. Generic name: iprotropium/albuterol (salbutamol) Brand name: Atrovent Classification: Bronchodilators It works in the airways by opening breathing passages and relaxing muscles. nervousness. Use cautiously inn patients with angle-closure glaucoma. It is also used to treat or prevent wheezing and shortness of breath caused by ongoing breathing problems Contraindicated in patients hypersensitive to drug. (hyperactivity.

Monitor sodium level for hypernatremia. Generic name: Acetaminophen / Paracetamol Brand name: Panadol Thought to produce analgesia by inhibiting prostaglandin and other substances that sensitixze pain receptors. neutropenia. probably as a result of bacterial degredation. Consult physician if needed for children < 3 yr. may increase blood flow through the collateral coronary vessels Acute anginal attacks Contraindicated potentials ĉ hypersensitivity or idiosyncrasy to nitrates & in those ĉ severe hypotension Flushing. pallor. especially when giving in higher doses to treat hepatic encephalopathy. N/V weakness. Contraindicated in patients on a lowgalactose diet. Drug may relieve fever through For mild pain and fever Contraindicated in patients hypersensitive to drug. Acute constipation preparation. Abdominal cramps. resulting distention promotes peristalsis. urticaria. Especially indicated for MI patients to avoid straining and workload. nausea. gaseous distention. belching. diarrhea.Generic name: Isosorbide dinitrale Brand name: Isordil Classification: Antianginals Generic name: Lactulose Brand name: Cholac. vomiting. Informs patient about adverse reactions and tell him to notify physician if reactions become bothersome or if diarrhea occurs. Use cautiously in patients with diabetes mellitus. if needed for 48 . restless. which lowers the pH of colon contents. jaundice. persipiration & collapse To prevent tolerance a nitrate-free interval of 8 to 12 hours per day is recommended. rash. Produces an osmotic effect in colon.. Cephulac Classification: Laxative: disaccharide Thought to reduce cardiac oxygen demand by decreasing preload & afterload: also. Also decreases ammonia. hypoglycaemia. Do not exceed the recommended dosage. Monitor mental status and potassium levels when giving to patients with hepatic encephalopathy. pancytopenia. for bowel elimination. Haemolytic anemia. vascular headache. leukopenia. cerebral ischemia associated ĉ postural hypotension. flatulence.

Carefully check all OTC products. N-acetylcysteine should be available as a specific antidote. longer than 10 days. Give drug with food if GI upset occurs. Avoid using multiple preparations containing acetaminophen. Treatment of overdose: Monitor serum levels regularly. Discontinue drug if hypersensitivity reactions occur. basic life support measures may be necessary. severe or recurrent pain occurs (possible serious illness). 49 .Classification: Non-opiod analgesic and antipyretic central action in the hypothalamic heatregulating center. if continued fever.

after administration. decrease in BP. for abdominal pain. skin rash. excessive bronchial secretions Assess pt. GI distention. nausea. urticaria. in breast feeding women and in those ĉ acute intoxication from alcohol use cautiously in pts. ĉ impaired renal function Occasionally. Note presence of blood in emesis. arrhythmia. borborygymi. stool or gastric aspirate A centrally acting synthetic analgesic compound not chemically related to opioid. vomiting.Nursing Drug Handbook. chills. reversible hepatitis. at risk for renal or hepatic impairment Releases pt’s level of pain at least 30 min. Monitor bowel & bladder function anticipate need for laxative for better analgesic effect give drug before onset of pain. palpitations. headache Respiratory depression. acute pancreatic.Generic name: Ranitidine HCL Brand name: Zantac Classification: Anti-ulcer drug:H2 recceptor drug Generic name: Tramadol Brand name: Dolmal Classification: Opioid Analgesics Completely inhibits action of histamine on the H2 at receptors sites of parietal cells. decreasing gastric acid secretion NSAID-associated peptic ulceration Contraindicated in patients hypersensitive to drug and those ĉ acute porphyria acute dosage in pt. Thought to bind to opioid receptors & of norepinephrine & serotonin For moderate to severe pain Contraindicated in patients hypersensitive to drug or other opioids. reversible mental confusion. 2009. Source:. Rarely agranulocytosis. 50 . chest pain. hypersensitivity. Monitor CV and respiratory status w/hold dose & notify prescribe if RR is below 12 cm.

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