Y?

Therapeutic Effect

Brand Name: Aspirin Decreased incidence of transient ischemic attacks and MI

Generic name: Contraindications: Hypersensitivity, bleeding disorders or thrombocytopenia, children or adolescents with viral infections. Toxic/SE: Dyspepsia, epigastric distress, nausea, abdominal pain, anemia, hemolysis

Action/ Pharmakinetics!

Intervention/ Nursing implications

Safe Dose

Produce analgesia and reduce inflammation and fever by inhibiting the production of prostaglandins. Decreases platelet aggregation. Patients who have asthma, allergies, and nasal polyps or who are allergic to tartrazine are at an increased risk for developing hypersensitivity. Prolongs bleeding time for 47 days and, in large doses, may cause prolonged prothrombin time. Monitor hematocrit periodically in prolonged high-dose therapy to assess for GI blood loss. Caution patient to avoid taking concurrently with acetaminophen or NSAIDs for more than a few days, unless directed by health care professional to prevent analgesic nephropathy. Advise patients receiving aspiring prophylactically to take only prescribed dose. 50-325 mg once daily (prevention of transient ischemic attacks) Peak 1-3 hr Duration 3-6 hour

Time Onset /Therapeutic level 5-30 min

Y? Therapeutic Effect

Brand Name: nitroglycerin Relief or prevention of angina attacks. Increased cardiac output. Reduction of blood pressure Acute and long-term prophylactic management of angina pectoris. Increases coronary blood flow by dilating coronary arteries and improving collateral flow to ischemic regions. Produces vasodilation. Decreases left ventricular enddiastolic pressure and left ventricular end-diastolic volume (preload).

Generic name: Contraindications: Hypersensitivity, server anemia, pericardial tampanade. Use cautiously in head trauma or cerebral hemorrhage, glaucoma, hypertrophic cardiomyopathy. Toxic/SE: Dizziness, headache, hypotension, tachycardia, syncope. Use with any other nitrates in any form in contraindicated. May cause increase urine catecholamine and vanillylmadelic acid concentrations.

Action/ Pharmakinetics!

Intervention/ Nursing implications

Safe Dose Time /Therapeutic level 1-3 min

Assess location, duration, intensity, and precipitating factors of patients angina pain. Monitor blood pressure and pulse before and after administration. For acute angina attacks: advise patient to sit down and use medication at first fign of attack. Relief usually occurs within 5 min. dose may be repeated within 5-10 min. SL adults: 0.3-0.6 mg, may repeat every 5 min for 2 additional doses. Onset Peak Duration Unknown 30-60 min

Y? Therapeutic Effect

Brand Name: Morphine Decrease in severity of pain.

Generic name: morphine Contraindications: Some products contain tartrazine, bisulfites, or alcohol and should be avoided in patients with hypersensitivity. Toxic/SE: Confusion, sedation, hypotension, constipation, N & V, itching, sweating.

Action/ Pharmakinetics!

Intervention/ Nursing implications

Safe Dose Time /Therapeutic level PO: unknown IM: 10-30 min IV: rapid

Binds to opiate receptors in CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression Use with extreme caution for patients on MAOI. Assess pain (type, location, level of pain) prior to and 1 hour following administration, 20 min for IV. Assess level of consciousness, and vital signs before and periodically during administration. Assess bowel function routinely. For PO, give with food or milk to minimize GI irritation. For IV: administer with at least 5 mL of sterile H2o or 0.9% NaCl and administer 2.5 15 mg over 5 min. rapid administration may lead to respiratory depression, hypotension, and circulatory collapse. Instruct family not to administer PCA to sleeping patient PO: starting dose 30mg q 3-4 hr. IV: 4-10 mg q 3-4 hr. Onset Peak Duration 60 min 30-60 min 20 min 4-5 hr 4-5 hr 4-5 hr

Morphine IV administration: administer 2.5-15 mg over 5 min. rapid administration may lead to increased respiratory depression, hypotension, and circulatory collapse. Concentration: 0.5-5mg/ml