PHARMACOLOGY FINAL

PROJECT
DRUG STUDY

NOVEMBER 24, 2019

BSN 211
 RONALDO P.
GANIBAN
Diagnosed with Hypertension and Gout
PATIENT DATA DAILY ACTIVITIES/ HOBBIES
Birth date: January 26, 1969 “Madalas ako nasa farm tinitingnan ko how things are doing, minsan
Age: 50 tumutulong rin ako pero madalas nahihilo ako at tumataas uric acid
Relation with patient: Father dahil daw sa mga nakakain ko na meals beforehand.”

DIET AND REST

MEDICATIONS
“Madalas naming kinakain is mga masabaw na ulam. Bawal na raw
Losartan Potassium kasi matataas sa protein na pagkain kaya more on gulay kami”
Allopurinol
“Sa pahinga naman, tuwing hapon sa bahay lang ako. Kapag naman
sinusumpong sakit ko, kahit nasa bukid pa ako or dapat pupunta ay
REASONS FOR TAKING hindi na ako umaalis, sa bahay na lang ako at nagpapahinga lang.”
MEDICATION
Patient has been diagnosed with
hypertension and gout which the
patient at times has increased level of
uric acid.
 ASSESSMENTS
DAY 1
Vital signs
Temperature: 36.8 degrees Celcius
Pulse Rate: 73 bpm
Respiratory Rate: 18
Blood Pressure: 116/57 mmhg
Physiological: “Ngayon medyo okay naman
ako and I feel fine and relaxed lang”
Emotional: “Minsan naiisip ko na sana kayanin
pa ng katawan ko para sa aking pamilya”
Economical: “Oo, ako parin bumibili ng gamut
ko, minsan pinapadalhan ako ng mga kapatid
kong doctor ng medisina.”
DAY 2
Vital signs
Temperature: 37.1 degrees Celcius
Pulse Rate: 80 bpm
Respiratory Rate: 14
Blood Pressure: 112/67 mmhg
Physiological: “Kanina medyo sumasakit paa
ko, siguro dahil tumaas uric acid ko.”
Emotional: “Nakakalungkot padin dahil di na
ako tulad ng dati na malakas lakas pa.”
Economical: “Wala naman problema sa
pagbili ng gamot, di naman nagkukulang satin
ang Panginoon.”
DAY 3
Vital signs
Temperature: 36.5 degrees Celcius
Pulse Rate: 80 bpm
Respiratory Rate: 16
Blood Pressure: 107/53 mmhg
Physiological: “Kanina nahihilo ako pero
ngayon medyo okay na. Yun lang naman”
Emotional: “Hindi ko kinakaya kanina yung
symptoms na naramdaman ko kaya
nagapasalamat ako sa misis ko sa pagalaga
saakin.”
Economical: “Kahapon pinabili ko mama mo
ng gamot good for one month na.”
DAY 4
Vital signs
Temperature: 36.5 degrees Celcius
Pulse Rate: 66 bpm
Respiratory Rate: 18
Blood Pressure: 117/77 mmhg
Physiological: “Normal naman tong araw na
to at wala naman ako gaano naramdaman
na symptomas”
Emotional: “Masaya ako ngayon dahil walang
sakit akong naramdaman hehe”
Economical: “May gamot pa naman ako rito”
DAY 5 DAY 6
Vital signs
Vital signs Temperature: 36.5 degrees Celcius
Temperature: 37.3 degrees Celcius
Pulse Rate: 77 bpm
Pulse Rate: 78 bpm
Respiratory Rate: 16
Respiratory Rate: 17
Blood Pressure: 127/78 mmhg
Blood Pressure: 136/68 mmhg
Physiological: “Nanghihina ako ngayong
Physiological: “Medyo nahihilo at sumasakit araw”
ulo ko”
Emotional: “Malungkot dahil hindi productive
Emotional: “Naawa ako sa mga trabahador tong araw na to.”
dahil di ako nakatulong ngayon sa bukid”
Economical: “Meron pa naman stock ng
Economical: “walang issue saakin yan” gamot dito.”

DAY 7

Vital signs
Temperature: 36.9 degrees Celcius

Pulse Rate: 84 bpm

Respiratory Rate: 18

Blood Pressure: 129/69 mmhg

Physiological: “Kanina nahilo ako habang nagtatrabaho.”

Emotional: “Wala ako matapos na gagawin dahil need ko magpahinga kaya medyo dismayado
ako”

Economical: “Ganun parin, God will provide always.”

Allopurinol (300 mg)
Taken once a day 7pm

Losartan Potassium (50 mg)

Taken once a day 7pm
Name of Indication Contraindicatio Mechanis Drug Nursing
Drug n m of Interaction Responsibiliti
action es
Generic Gout/hyperuricemi Contraindicate Reduces Drug to drug: Monitor uric
Name: a d in patients uric acid acid level to
Allupirnol hypertensive to productio Amoxicillin: May evaluate
Hyperuricemia drug n by increase drug’s
Brand Name: caused by inhibiting possibility of effectiveness
Zyloprim malignancies xanthine rash
oxidase Monitor fluid
Classification To prevent uric Anticoagulants: intake and
: Antigout acid nephropathy May increase output of at
Drugs during cancer anticoagulant least 2L and
Xanthine chemotherapy effect maintenance
oxidase of neutral or
inhibitors Recurrent calcium Antineoplastics: slightly
oxalate calculi May increase alkaline urine
Dosage: potential for are desirable
Gout or bone marrow
hyperuricemi suppression Periodically
a monitor CBC
Chlorpropamid and hepatic
Adults- Mild e: and renal
gout, 200 to May increase function,
300 mg PO hypoglycemic especially at
daily. effect start of
Moderately therapy
severe gout Ethacrynic
with large acid: Don’t restart
tophi, 400 to May increase drug in
600 mg PO risk for patients who
daily. allopurinol have a
Maximum, toxicity severe
800 mg daily. reaction
Dosage Uricosurics:
varies with May have
severity of additive effect
disease; can
be given as
single dose
or divided,
but doses
greater than
300mg
should be
divided.

Route:
Name of Drug Indication Contraindicati Mechanism of Drug Nursing
on action Interaction Responsibiliti
es
Generic Name: Hypertensio Contraindicate Inhibits Drug-drug Monitor
Losartan n d in patients vasoconstrictiv patient’s BP
hypertensive to e and Aliskiren: closely to
Brand Name: Nephropat drug aldosterone- may increase evaluate
Cozaar hy in secreting risk of renal effectiveness
patients Concomitant action of impairment, of therapy.
Drug with type 2 use with angiotensin II hypotension,
Classification: diabetes aliskiren is by blocking and Monitor
Antihypertensives; contraindicate angiotensin II hyperkalemia patients who
Angiotensin II Reduce risk d in diabetic receptor on in diabetic are also
receptor of stroke in patients the surface of patients and taking
antagonists patients vascular those with diuretics for
with HTN Use cautiously smooth moderate to symptomatic
Dosage/Frequen and left in patients with muscles and severe renal hypotension.
cy: ventricular impaired renal other tissue impairment.
50 mg 1 tab hypertropla or hepatic cells Concomitant Regularly
y function use is assess
Once a day contraindicate patient’s
d in diabetic renal
Route: patients. Avoid function via
P.O concomitant creatinine
use in those and BUN
with moderate levels.
to severe renal
impairment. Closely
monitor
Drug-herb. patient’
May decrease potassium
antihypertensi level
ve effects. especially
Discourage during first
use together. few weeks of
therapy and
Drug-food. Salt after dosage
substitutes adjustments.
containing
potassium: Tell patient to
May cause avoid salt
hyperkalemia. substitutes
Monitor
patient closely. Provide a
calm
environment;
minimizing
noise; limiting
visitors and
length of
stay.
Cues Analysis Goals and Intervention Evaluation
Objectives
Subjective: The patient will Monitor patient’s Was the patient
“Medyo nahihilo participate in BP closely to able to
ako and activities that evaluate participate in
nanghihina.” reduce cardiac effectiveness of activities that
“nanlalabo rin workload after a therapy reduce cardiac
ang aking few hours of workload?
paningin” nursing Tell patient to _Partially Met
intervention avoid salt
Objective: substitutes Did the patient
BP- 142/87 mmhg The patient will maintain blood
PR- 110 bpm maintain blood Provide a calm pressure within
pressure within environment; acceptable
acceptable range minimizing noise; range?
after 2 days of limiting visitors and _Met
nursing length of stay
intervention Can the patient
Maintain activity demonstrate
The patient will restrictions (bed stable cardiac
demonstrate rest) and assist rhythm and rate
stable cardiac patient with self- Within patient’s
rhythm and rate care activities. normal range?
within patient’s _Met
normal range
after 2 days of
nursing
intervention

Cues Analysis Goals and Intervention Evaluation

Objectives
Subjective: Relieve acute Monitor uric acid Was the patient
“Sumasakit attack level to evaluate relieved of pain
nanaman paa ko drug’s from acute
di ako Prevent future effectiveness attack?
makalakad” attacks _Partially Met
Monitor fluid
“Sumasakit rin Promote optimal intake and output Was the client
mga joints ko” excretion of of at least 2L and able to prevent
urates maintenance of future attacks?
Objective: neutral or slightly _Met
Lab Results alkaline urine are
showing above desirable Is there optimal
normal level of excretion of
uric acid Assess and urates?
manage pain _Met
through the
administer of
medications,
 applying cool
cloths as
tolerable, and
assist with
positioning to
avoid pressure on
the affected joint

After performing both nursing interventions, patient seems pleased by how it relieved his
comfortless feeling. He was also thankful for he have learned plenty and will now know what to do
during these cases.

Lab results show that after implementation of nursing interventions, blood tests went down
to normal. The only exception was his uric acid which lowered down but did not meet the normal
range for his health. He still needs to continue living healthy and continue his check up appointments
with health care providers.
DAY 7

Vital signs
Temperature: 36.9 degrees Celcius

Pulse Rate: 84 bpm

Respiratory Rate: 18

Blood Pressure: 129/69 mmhg taken at 7pm

Physiological: “Kanina nahilo ako habang nagtatrabaho.”

Emotional: “Wala ako matapos na gagawin dahil need ko magpahinga kaya medyo dismayado
ako”

Economical: “Ganun parin, God will provide always.”

After a week of nursing intervention, client showed a huge amount of progress on his results
for his blood pressure and uric acid. His blood pressure may seem that of low blood, but this may vary
due to the effect of the losartan potassium and the activities done earlier. Another factor would
include his diet and his psychological well being (relaxed, calm, and no worries). His uric acid was
also greatly affected due to his diet and also the activities done through out the week.