DRUG STUDY

DOMINO, NIKKI Y.
DRUG INDICATION NURSING RESPONSIBILITY
1. ATORVASTATIN -To reduce the risk of MI, stroke, angina, and -Monitor patient’s lipid and liver
CALCIUM (Avamax) revascularization procedures in patients with no evidence of function levels at baseline and
20mg/tablet, one tablet CAD with multiple risk factors. periodically thereafter.
once a day, without -Heterozygous familial hypercholesterolemia. -Monitor patient for signs of
regard to meals -Adjunct to diet to reduce elevated LDL, total cholesterol, apo rhabdomyolyis, especially if taking
B, and triglyceride levels to increase HDL level in patients more than one class of lipid lowering
with primary hypercholesterolemia and mixed dyslipidemia. drugs.
-Asses patient’s and family’s
knowledge of drug therapy.

2. SODIUM -Treatment of metabolic acidosis, promotion of -Be aware that long-term use of oral
BICARBONATE (Uhp gastric, systemic and urine alkalinization in the case preparation with milk or calcium can
Supracid) 650mg/tablet, of intoxication with weak organic acids. cause milk-alkali syndrome:
one tablet once a day, Anorexia, nausea, vomiting,
taken after meals headache, mental confusion,
hypercalcemia, hypophosphatemia,
soft tissue calcification, renal and
ureteral calculi, renal insufficiency,
metabolic alkalosis.
-Lab tests: Urinary alkalinization:
Monitor urinary pH as a guide to
dosage (pH testing with nitrazine
paper may be done at intervals
throughout the day and dosage
adjustments made accordingly).
-Lab tests: Metabolic acidosis:
Monitor patient closely by
observations of clinical condition;
measurements of acid-base status
(blood pH, Po2, Pco2, Hco3-, and
other electrolytes, are usually made
several times daily during acute
period).
-Observe for signs of alkalosis (over
treatment)
-Observe for and report S&S of
improvement or reversal of metabolic
acidosis.

3. KETOANALOGUES & -Prevention and therapy of damages due to faulty or deficient -Instruct patient to report immediately
AMINO ACIDS protein metabolism in chronic renal insufficiency in if symptoms of hypercalcemia
(Ketosteril) 600mg/ tablet connection with limited protein. occurs like muscle weakness &
-Supplements indicated for patients having urologic problems constipation.
like chronic kidney disease. -Monitor calcium levels.
-Monitor for signs of hypercalcemia
and electrolyte levels.
4. IPRATROPIUM -Reversible airways obstruction, particularly in patients who -Check inhaler technique.
BROMIDE (Atroven) have COPD. -Ensure that patients are able to
500mcg/2ml Inhalation - Allergic and non-allergic rhinitis. correctly use the delivery device for
Solution their medication and consider use of
a space if appropriate.
-If administering by nebulizers use a
mouthpiece rather than face mask.
-If administered by nebulizer the
dilution of the solution should be
adjusted according to equipment and
length of administration.
-Paradoxical bronchospasm has
occurred with nebulized solution;
therefore first dose should be used
under medical supervision.
-Frequent drinks and the use of
sugar-free gum can help with dry
mouth.
-Keep delivery devices clean and dry.
-Take a missed dose as soon as
remembered unless it is almost time
for the next dose. Do not take a
 DRUG STUDY
DOMINO, NIKKI Y.
double dose.
5. FEBUXOSTAT -Chronic management of hyperuricemia in patients with gout. -Instruct patients to contact health
(Atenurix) 40mg/ tablet It is not recommended for the treatment of asymptomatic care provider if they experience chest
hyperuricemia. pain, rash, shortness of breath, or
neurologic symptoms suggesting a
stroke.
-Advise patients that product may be
taken without regard to meals.
-Advice patient that concomitant
prophylaxis with an NSAID or
colchicine for gout flares may be
used.
6. ACETYLCYSTEINE -Treatment of respiratory affections characterized by thick -Monitor effectiveness of therapy and
(Fluimucil) 600mg/tablet, and viscous hypersecretions: acute bronchitis, chronic advent of adverse effects.
dissolve in 30ml water bronchitis and its exacerbations; pulmonary emphysema, -Instruct patient in appropriate use
mucoviscidosis and bronchiectasis. and adverse effects to report.
-Do bronchial tapping before giving
the medication.
-Monitor for bronchospasm
7. SEVELAMER -Control of serum phosphorus in patients ≥6yrs with chronic -Tell the doctor if the patient have
CARBONATE (Renvela) kidney disease on dialysis. trouble swallowing, severe
80mg/ tablet constipation, a blockage in your
intestines, slow digestion,
a stomach or intestinal disorder, or if
the patient had stomach or intestinal
surgery.
- Tell your doctor if the patient is
pregnant or plan to become pregnant.
The dose needs may be different
during pregnancy because taking
sevelamer while pregnant can lower
blood levels.
8. DOMPERIDOME -Increases movement through the digestive system. It is used - Assess for nausea, vomiting,
(Motilium) tablet to treat symptoms of stomach disorders. It may also be used abdominal distention, and bowel
to prevent nausea and vomiting caused by certain sounds before and after
medications. Due to safety concerns, this medication is not to administration.
be used by breast-feeding women to increase production of -Monitor BP and pulse before and
breast milk. periodically during therapy. May
cause prolonged QT interval,
tachycardia, and orthostatic
hypotension, especially in patients
older than 60yrs or taking >30
mg/day.
-Monitor for symptoms related to
hyperprolactinemia (menstrual
abnormalities, galactorrhea, sexual
dysfunction).
-Lab Test Considerations: May cause
increase serum ALT, AST,
cholesterol and serum prolactin
levels.
9. DIAZEPAM (Valium) -Management of anxiety disorders or for short-term relief of -Monitor for therapeutic effectiveness.
5mg/ampule symptoms of anxiety. Maximum effect may require 1–2 wk;
-Acute alcohol withdrawal; may be useful in symptomatic patient tolerance to therapeutic
relief of acute agitation, tremor, delirium tremens, hallucinosis effects may develop after 4 wk of
-Muscle relaxant: Adjunct for relief of reflex skeletal muscle treatment.
spasm due to local pathology (inflammation of muscles or -Observe necessary preventive
joints) or secondary to trauma; spasticity caused by upper precautions for suicidal tendencies
motoneuron disorders (cerebral palsy and paraplegia); that may be present in anxiety states
athetosis, stiff-man syndrome accompanied by depression.
-Parenteral: Treatment of tetanus -Observe patient closely and monitor
-Antiepileptic: Adjunct in status epilepticus and severe vital signs when diazepam is given
recurrent convulsive seizures (parenteral); adjunct in seizure parenterally; hypotension, muscular
disorders (oral) weakness, tachycardia, and
-Preoperative (parenteral): Relief of anxiety and tension and respiratory depression may occur.
to lessen recall in patients prior to surgical procedures, -Lab tests: Periodic CBC and liver
cardioversion, and endoscopic procedures function tests during prolonged
-Rectal: Management of selected, refractory patients with therapy.
epilepsy who require intermittent use to control bouts of -Supervise ambulation. Adverse
increased seizure activity reactions such as drowsiness and
 DRUG STUDY
DOMINO, NIKKI Y.
-Unlabeled use: Treatment of panic attacks ataxia are more likely to occur in
older adults and debilitated or those
receiving larger doses. Dosage
adjustment may be necessary.
-Monitor I&O ratio, including urinary
and bowel elimination.
-Note: Smoking increases
metabolism of diazepam; lowering
clinical effectiveness. Heavy smokers
may need a higher dose than the
nonsmoker.
-Note: Psychic and physical
dependence may occur in patients on
long-term high dosage therapy, in
those with histories of alcohol or drug
addiction, or in those who self-
medicate.
10. CARVEDILOL -Hypertension, alone or with other oral drugs, especially -Do not discontinue drug abruptly
(Carvid) 25mg/tablet diuretics. after chronic therapy (hypersensitivity
-Treatment of mild to severe CHF of ischemic or to catecholamines may have
cardiomyopathic origin with digitalis, diuretics, ACE inhibitors. developed, causing exacerbation of
-Left ventricular dysfunction (LVD) after MI angina, MI, and ventricular
-Unlabeled uses: Angina (25–50 mg bid) arrhythmias); taper drug gradually
over 2 wk with monitoring.
-Consult with physician about
withdrawing drug if patient is to
undergo surgery (withdrawal is
controversial).
-Give with food to decrease
orthostatic hypotension and adverse
effects.
-Monitor for orthostatic hypotension
and provide safety precautions.
-Monitor diabetic patient closely; drug
may mask hypoglycemia or worsen
hyperglycemia.
-Monitor patient for any sign of
hepatic impairment (pruritus, dark
urine or stools, anorexia, jaundice,
pain); arrange for LFTs and
discontinue drug if tests indicate liver
injury. Do not restart carvedilol.
11. FURSOMIDE -Treatment of edema associated with CHF, cirrhosis of liver, Observe patients receiving parenteral
(Furoscan) 20mg/2ml and kidney disease, including nephrotic syndrome. May be drug carefully; closely monitor BP
Ampule used for management of hypertension, alone or in and vital signs. Sudden death from
combination with other antihypertensive agents, and for cardiac arrest has been reported.
treatment of hypercalcemia. Has been used concomitantly -Monitor BP during periods of diuresis
with mannitol for treatment of severe cerebral edema, and through period of dosage
particularly in meningitis. adjustment.
-Observe older adults closely during
period of brisk diuresis. Sudden
alteration in fluid and electrolyte
balance may precipitate significant
adverse reactions. Report symptoms
to physician.
-Lab tests: Obtain frequent blood
count, serum and urine electrolytes,
CO2, BUN, blood sugar, and uric acid
values during first few months of
therapy and periodically thereafter.
-Monitor for S&S of hypokalemia .
-Monitor I&O ratio and pattern. -
Report decrease or unusual increase
in output. Excessive diuresis can
result in dehydration and
hypovolemia, circulatory collapse,
and hypotension. Weigh patient daily
under standard conditions.
-Monitor urine and blood glucose &
HbA1C closely in diabetics and

12. LEVETIRACETAM -Used to treat partial onset seizures in adults and children
(Keppra) 50mg/tablet who are at least 1 month old. It is also used to treat tonic-
clonic seizures in people who are at least 6 years old, and
myoclonic seizures in people who are at least 12 years old.
13. METOCLOPRAMDE -Relief of symptoms of acute and recurrent diabetic
(Plasil) 10mg/ampule gastroparesis. Short-term therapy (4–12 wk) for adults with
symptomatic gastroesophageal reflux who fail to respond to
conventional therapy.
-Parenteral: Prevention of nausea and vomiting associated
with emetogenic cancer chemotherapy.
-Prophylaxis of postoperative nausea and vomiting when
nasogastric suction is undesirable.
-Single-dose parenteral use: Facilitation of small-bowel
intubation when tube does not pass the pylorus with
conventional maneuvers
-Single-dose parenteral use: Stimulation of gastric emptying
and intestinal transit of barium when delayed emptying
interferes with radiologic exam of the stomach or small
intestine.
-Unlabeled uses: Improvement of lactation (doses of 30–45
mg/day); treatment of nausea and vomiting of a variety of
etiologies: Emesis during pregnancy and labor, gastric ulcer,
anorexia nervosa.
14. EPOETIN BETA -Anemia: Stimulates erythropoesis (production of RBCs)
(Recormon) 5000 units
DRUG STUDY
DOMINO, NIKKI Y.
patients with decompensated hepatic
cirrhosis. Drug may cause
hyperglycemia.
-Note: Excessive dehydration is most
likely to occur in older adults, those
with chronic cardiac disease on
prolonged salt restriction, or those
receiving sympatholytic agents.
-Inform the doctor if there are signs of
an allergic reaction (hives, difficult
breathing, swelling in your face or
throat) or a severe skin reaction
(fever, sore throat, burning in your
eyes, skin pain, red or purple skin
rash that spreads and causes
blistering and peeling).
-Report any new or worsening
symptoms such as: mood or behavior
changes, depression, anxiety, panic
attacks, trouble sleeping, or if you
feel agitated, hostile, irritable,
hyperactive (mentally or physically),
or have thoughts about suicide or
hurting oneself, unusual changes in
mood or behavior (unusual risk-taking
behavior, being irritable or talkative),
confusion, hallucinations, loss of
balance or coordination, extreme
drowsiness, feeling very weak or
tired, problems with walking or
movement, the first sign of any skin
rash, no matter how mild, easy
bruising, unusual bleeding; or fever,
chills, weakness, or other signs of
infection. Common side effects may
include: dizziness, drowsiness,
tiredness, weakness, feeling
aggressive or irritable, loss of
appetite, stuffy nose or infection.
-Monitor BP carefully during IV
administration.
- Monitor for extrapyramidal reactions
and consult physician if they occur.
- Monitor diabetic patients.
- Give direct IV doses slowly over 1-2
minutes.
- For IV infusion, give over at least
15minutes.
-Report immediately the onset of
restlessness, involuntary movements,
facial grimacing, rigidity, or tremors.
-Be aware that during early treatment
period, serum aldosterone may be
elevated; after prolonged
administration periods, it returns to
pretreatment level.
Lab tests: Periodic serum electrolyte.
-Monitor for possible hypernatremia
and hypokalemia, especially if patient
has CHF or cirrhosis.
-Adverse reactions associated with
increased serum prolactin
concentration (galactorrhea,
menstrual disorders, gynecomastia)
usually disappear within a few weeks
or months after drug treatment is
stopped.
The most common side effects of
epoetin alfa in patients with kidney
failure on dialysis are:

15. ASPIRIN 80mg/tablet -Mild to moderate pain; Fever; Inflammatory conditions:
rheumatic fever, rheumatoid arthritis, osteoarthritis.
-Reduction of risk of recurrent TIAs or stroke in males with
history of TIA due to fibrin platelet emboli.
-Reduction of risk of death or nonfatal MI in patients with
history of infarction or unstable angina pectoris
-MI prophylaxis
-Unlabeled use: Prophylaxis against cataract formation with
long-term use.
16. LOSARTAN (Cozaar) -Hypertension,
100mg/tablet -Stroke prophylaxis
-Heart failure in elderly patients
17. CLOPIDOGREL - Reduce the rate of myocardial infarction (MI) and stroke in
(Plavix) 75mg/tablet patients with non–ST-segment elevation ACS (unstable
DRUG STUDY
DOMINO, NIKKI Y.
high blood pressure,
headache, joint-pain and clotting at
the injection site. Rare cases of
stinging at the injection site, skin rash
and flu-like symptoms (joint and
muscle pain) have occurred within a
few hours following administration.
Allergic reactions, seizures, and
thrombotic events (for example, heart
attacks, strokes, and pulmonary
embolism ) rarely occur. In HIV-
infected patients receiving
zidovudine, the most common side
effects with epoetin alfa are fever,
headache, rash, and nasal or chest
congestion. Rare cases of seizures or
severe rash have occurred in these
patients. The most common side
effects in patients undergoing surgery
with anemia are: fever,
nausea, constipation, skin reactions,
vomiting and headaches. Blood clots
in veins, referred to as a deep venous
thrombosis, also may occur. Among
patients with cancer receiving
chemotherapy, the most common
side effects of epoetin alfa are: fever,
diarrhea, tissue swelling, shortness of
breath, paresthesia (abnormal
sensations like burning or prickling
that may occur anywhere in the
body), and upper respiratory
infection. Treatment with epoetin alfa
may increase the growth of several
types of cancer and reduce survival,
and, therefore, its use should be
restricted to the conditions discussed
previously. If signs and symptoms
noted, inform the doctor right away.
- Do not use in children and
teenagers to treat chickenpox or flu
symptoms without review for Reye’s
syndrome, a rare but fatal disorder.
-Give drug with food or after meals if
GI upset occurs.
-Give drug with full glass of water to
reduce risk of tablet or capsule
lodging in the esophagus.
-Do not crush, and ensure that
patient does not chew SR
preparations.
-Do not use aspirin that has a strong
vinegar-like odor.
-WARNING: Institute emergency
procedures if overdose occurs:
Gastric lavage, induction of emesis,
activated charcoal, supportive
therapy.
-Avoid given first dose at night due to
increase hypotensive risk.
-Monitor blood pressure and pulse
frequently.
-Enquire the complete health history
of patient specially any renal disease
-Check patient s/s for angioedema.
-Monitor electrolytes specially sodium
and potassium levels, uric acid levels
and CBC.
-Instruct patient to take medication
exactly as directed. ---Take missed

angina [UA]/ non–ST -elevation myocardial infarction
[NSTEMI]), including patients who are to be managed
medically and those who are to be managed with coronary
revascularization. Should be administered in conjunction with
aspirin.
-Reduce the rate of myocardial infarction and stroke in
patients with acute ST-elevation myocardial infarction
(STEMI) who are to be managed medically. Clopidogrel
should be administered in conjunction with aspirin.
Recent MI, Recent Stroke, or Established Peripheral Arterial
Disease. In patients with established peripheral arterial
disease or with a history of recent myocardial infarction (MI)
or recent stroke.
-Reduce the rate of MI and stroke.
18. CORALAN -Cardiotonic agent, prescribed for angina pectoris. It helps to
(Ivabradine) 5mg/tablet lower the heart rate.
19. AMIODARONE HCL -Premature ventricular fibrillation
200mg/tablet -Unstable ventricular tachycardia
-Atrial fibrillation
-Angina
-Hypertrophic cardiomyopathy
-Supraventricular arrhythmias
20. ALPRAZOLAM -Anxiety, panic disorder, manage symptoms of PMS,
(Xanax) 250mg/tablet insomnia, mania, psychosis.
-Works in CNS to produce anxiolytic effect causing CNS
depression.
DRUG STUDY
DOMINO, NIKKI Y.
doses as soon as possible unless
almost time for next dose; do not
double doses. Advise patient to notify
health care professional promptly if
fever, chills, sore throat, or unusual
bleeding or bruising occurs. Advise
patient to notify health carep
rofessional of medication regimen
prior to treatment or surgery.
-Instruct patient to take ivabradine as
directed.
-Advise patient to avoid taking
grapefruit juice during therapy; may
increase risk of side effects.
-Inform patient that ivabradine may
cause phosphenes or luminous
phenomena, a transiently enhanced
brightness in a limited area of the
visual field, halos, image
decomposition, colored bright lights,
or multiple images. Phosphenes are
usually triggered by sudden
variations in light intensity. Usually
begin within first 2 moc of therapy,
may occur repeatedly of mild to
moderate intensity, and resolve after
therapy is discontinued.
Instruct patient to notify health care
professional of all Rx or OTC
medications, vitamins, or herbal
products being taken and to consult
health care professional before taking
any other Rx, OTC, or herbal
products, especially St. John's wort.
-May be teratogenic. Advise female
patient to use effective contraception
during therapy and to notify health
care professional if pregnancy is
planned or suspected and to avoid
breast feeding.
-Monitor cardiac rhythm continuously;
-Monitor for an extended period when
dosage adjustments are made;
-Monitor for safe and effective serum
levels (0.5–2.5 mcg/mL);
-Doses of digoxin, quinidine,
procainamide, phenytoin, and
warfarin may need to be reduced
one-third to one-half when
amiodarone is started;
-Give drug with meals to decrease GI
problems;
- Arrange for ophthalmologic
examinations; reevaluate at any sign
of optic neuropathy;
- Arrange for periodic chest x-ray to
evaluate pulmonary status (every 3–6
mo); and
- Arrange for regular periodic blood
tests for liver enzymes, thyroid
hormone levels
-Instruct to take this drug exactly as
prescribed; take extended-release
form once a day in the AM; place
rapidly disintegrating tablet on top of
 DRUG STUDY
DOMINO, NIKKI Y.
tongue, where it will disintegrate and
can be swallowed with saliva.
- Do not drink grapefruit juice while
on this drug.
- Do not stop taking drug (in long-
term therapy) without consulting
health care provider.
- Avoid alcohol, sleep-inducing, or
over-the-counter drugs.
- Patient may experience these side
effects: Drowsiness, dizziness (these
effects will be less pronounced after a
few days, avoid driving a car or
engaging in other dangerous
activities if these occur); GI upset
(take drug with food); fatigue;
depression; dreams; crying;
nervousness.
- Report severe dizziness, weakness,
drowsiness that persists, rash or skin
lesions, difficulty voiding, palpitations,
swelling in the extremities.