DRUG STUDY

Drug # 1. GENERIC NAME *

Nitroglycerin

Drug # 1. BRAND NAME *

Nitrostat

Drug # 1. STOCK DOSAGE *

Capsule (sustained release):

- 2.5mg ,6.5mg, 9mg, 13mg

Tablet:

- 0.2 - 0.6mg SL q 5 mins or maximum 3 doses in 15 minutes

Topical:

- 0.2% ointment

Transdermal:

- 0.1 mg/hr, 0.2 mg/hr, 0.3 mg/hr, 0.4 mg/hr, 0.6 mg/hr, 0.8 mg/hr release rate

Drug # 1. CLASSIFICATION *

Nitrates Drug, Anti-anginal

Drug # 1. MECHANISM OF ACTION *

A nitrate reduces cardiac oxygen demand by decreasing left ventricular end diastolic pressure(preload)
and to a lesser extent, systemic vascular resistance (after load). Also increases blood flow through the
collateral coronary vessels.

Drug # 1. INDICATION *

To prevent chronic angina attacks, acute angina pectoris, to prevent or minimize angina attacks before
stressful events, hypertension from surgery, heart failure after MI, angina pectoris in acute situations, to
produce controlled hypotension during surgery.

Drug # 1. CONTRAINDICATIONS *

Hypersensitive to nitrates and in those with early MI, severe anemia, increased ICP, angle-closure-
glaucoma, orthostatic HPN, allergy to adhesives (transdermal), or hypersensitive to nitrates IV.
Drug # 1. SIDE EFFECTS AND ADVERSE AFFECTS *

CNS: headache, dizziness, weakness

CV: orthostatic hypotension, tachycardia, flushing, palpitations, fainting

EENT: burning

GI: nausea, vomiting

SKIN: cutaneous vasodilation, contact dermatitis, rash

OTHER: hypersensitivity

Drug # 1. NURSING RESPONSIBILITIES *

1. Monitor blood pressure and heart rate on a regular basis.

2. Instruct patient to take medication while sitting down and to change positions slowly.

3. Instruct patient to allow tablets to dissolve under tongue, and not to chew or swallow sublingual
tablets.

4. Instruct patient to seek emergency help promptly if chest pain is unresolved after 15 minutes.

5. Instruct patient not to change brands without consulting prescriber. Instruct patient to keep tablets in
original, airtight container.

6. Advise patient to use caution when engaging in activities requiring mental alertness.

7. Advise patient to report acute headache, rapid heartbeat, unusual restlessness or dizziness, or
blurring of vision

Drug # 2. GENERIC NAME *

Propranolol Hydrochloride

Drug # 2. BRAND NAME *

Hemangeol

Drug # 2. STOCK DOSAGE *

Capsules: 60 mg, 80 mg, 120 mg, 160 mg

Injection: 1mg/mL

Oral solution:4mg/mL 4.28 mg/ML 8mg/mL

Tablets: 10mg, 20mg, 40mg, 60mg, 80mg

Drug # 2. CLASSIFICATION *

Nonselective beta blockers

Drug # 2. MECHANISM OF ACTION *

Reduces cardiac oxygen demand by blocking catecholamine-induced increases in HR, BP, and forces
myocardial contraction. Drug depresses renin secretion and prevents vasodilation of cerebral arteries.

Drug # 1. INDICATION *

For Angina pectoris, To decrease risk of death after MI, Hypertension

Drug # 2. CONTRAINDICATIONS *

Contraindicated in patients with known hypersensitivity to drug, bronchial asthma, sinus bradycardia
and heart block greater than first-degree, cardiogenic shock, and overt and decompensated HF (unless
failure is secondary to a tachyarrhythmia that can be treated with propranolol.

Drug # 2. SIDE EFFECTS & ADVERSE AFFECTS *

CNS: Fatigue, lethargy, fever, vivid dreams, hallucinations, mental depression, light-headedness,
dizziness, insomnia.

CV: Hypotension, bradycardia, HF, intensification of AV block, intermittent claudication.

GI: Abdominal cramping, constipation, diarrhea, nausea, vomiting.

Hematologic: Agranulocytosis.

Respiratory: Bronchospasm.

Skin: Rash

Drug # 2. NURSING RESPONSIBILITIES *

1. Drugs masks common signs and symptoms of shock and hypoglycemia.

2. Don't stop drug before surgery for pheochromocytoma. Before any surgical procedure, tell
anesthesiologist that patient is receiving propranolol.

3.Advise patient that propranolol may interfere with glaucoma screening because it can reduce IOP.

4. Caution patient not to stop drug without advice from prescriber because abruptly stopping drug can
worsen chest pain or cause an MI.

5. Advise patient to avoid smoking and alcohol.