IX.
DRUG STUDIES
DRUG NAME ACTION INDICATION
Generic: Digoxin is a cardiac  CHF
glycoside which has  Atrial
Digoxin positive inotropic
activity characterized
Brand: by an increase in the
force of myocardial
Lanoxin contraction. It also
reduces the
Classification: conductivity of the
heart through the
Cardiac Glycoside atrioventricular (AV)
node. Digoxin also
Dose: exerts direct action
on vascular smooth
Loading dose, 0.75– muscle and indirect
1.25 mg PO effects mediated
primarily by the
Maintenance dose, autonomic nervous
0.125–0.25 mg/day system and an
PO. increase in vagal
activity.
CONTRAINDICAT SIDE EFFECTS NURSING CONSIDERATIONS
IONS
 Digitalis  Extra  History: Allergy to digitalis
toxicity, beats, preparations, ventricular
fibrillatio ventricular anorexia, tachycardia, ventricular fibrillation,
n tachycardia nausea heart block, sick sinus syndrome,
/fibrillation, and IHSS, acute MI, renal insufficiency,
obstructive vomiting. decreased K+, decreased Mg2+
cardiomyop increased Ca2+, pregnancy,
athy. lactation
 Arrhythmias  Physical: Weight; orientation, affect,
due to reflexes, vision; P, BP, baseline
accessory ECG, cardiac auscultation,
pathways peripheral pulses, peripheral
(e.g. Wolff- perfusion, edema; R, adventitious
Parkinson- sounds; abdominal percussion,
White bowel sounds, liver evaluation;
syndrome). urinary output; electrolyte levels,
LFTs, renal function tests
 Report unusually slow pulse,
irregular pulse, rapid weight gain,
loss of appetite, nausea, diarrhea,
vomiting, blurred or “yellow” vision,
unusual tiredness and weakness,
swelling of the ankles, legs or
fingers, difficulty breathing.
 DRUG NAME ACTION INDICATION CONTRAINDICAT SIDE EFFECTS NURSING CONSIDERATIONS
IONS
Generic: Blocks ACE from  Treatment of  Contraindicate  Tachycardi Assessment
converting hypertension d with allergy a
Captopril angiotensin I to alone or in to captopril,  Dry mouth  History: Allergy to captopril, history
angiotensin II, a combination history of  GI Upset of angioedema, impaired renal
Brand: powerful with thiazide- angiodema. function, CHF, salt or volume
vasoconstrictor, type \u2022 Use depletion, pregnancy, lactation
Capoten, leading to diuretics cautiously  Physical: Skin color, lesions, turgor;
decreased blood with impaired T; P, BP, peripheral perfusion;
Classification: pressure, decreased renal mucous membranes, bowel
aldosterone function; sounds, liver evaluation; urinalysis,
ACE inhibitor, secretion, a small  Treatment of  CHF; salt or LFTs, renal function tests, CBC
Antihypertensive increase in serum CHF in volume and differential
potassium levels, patients depletion,
Dose: and sodium and fluid unresponsiv Administer 1 hr before meals
loss; increased e to
Heart failure Initial: prostaglandin conventional  Monitor patient closely for fall in BP
6.25-12.5 mg 2-3 synthesis also may therapy; secondary to reduction in fluid
times/day. be involved in the used with volume (due to excessive
antihypertensive diuretics and perspiration, and dehydration,
Max: 50 mg 3 action. digitalis vomiting, or diarrhea); excessive
times/day. hypotension may occur.
 Reduce dosage in patients with
impaired renal function
DRUG NAME ACTION INDICATION CONTRAINDI SIDE NURSING CONSIDERATION
CATIONS EFFECTS

Inhibits reabsorption of -CHF -Allergy to - decreased BP 1. increased risk of photosensitivity, use

Na & Cl in the ascending
Generic loop of henle and distal
Name: renal tubule, interfering
Furosemide with the Cl-binding co-
transport system, hence,
causing increase
excretion of water,
Brand Name:
sodium, chloride,
Lasix magnesium, and calcium.
Classification Absorption: Fairly rapidly
absorbed from the GI
Loop Diuretic tract (oral).
Distribution: Crosses the
placenta and enters
Dosing: breast milk. Protein-
binding: 99%.
14 mg per tab, Excretion: Via urine (as
1 tab OD PO unchanged); 2 hr
(elimination half-life), may
be prolonged in neonates
and renal and hepatic
impairment.
sulfonylureas sunscreens
-Hypertension -
-anuria Hyperglycemia 2. high dosages of IV may cause ototoxicity
-Edema
-hepatic coma - Decreased 3. A precipitate may form if mixed with gentamicin,
potassium netilmicin, milnirone, in either D5W or PNSS
-severe levels
electrolyte 4. Note closely for signs and symptoms of vascular
depletion thrombosis, embolism, circulatory collapse
5. take on the morning with empty stomach to
enhance absorption and avoid interruption of sleep.
May take with food or milk to lessen GI upset.
7. Report if presence of adverse reaction
8. Record BP and wights; report any gain of
>2lb/day or >5-10 lb per week.
9. supplement with vegetables and fruits that are
high in potassium such as banana, potatoes,
mangoes, oranges, peaches or dried dates.
10. NSAIDs and Beta-blockers may cause sodium
retention.