SUMAGUE, Maria Francheska O.

BSN 4 – NDA

DRUG ACTION NURSING CONSIDERATIONS

Generic Name: Stimulates CNS alpha-adrenergic receptors,  Tell patient that sedation usually occurs
Methyldopa decreasing sympathetic stimulation to heart when therapy starts and during dosage
Brand Name: and blood vessels. Also reduces arterial titration. To lessen this effect, advise him
Aldomet pressure and plasma renin. to begin dosage titration in evening.
Drug Classification:  Tell patient not to stop taking drug
Centrally acting antiadrenergic/ abruptly.
Antihypertensive  Instruct patient to report fever, yellowing
of skin or eyes, fatigue, abdominal pain,
flulike symptoms, swelling, or significant
weight gain.
 Inform patient that urine may darken
after exposure to air.
 Advise patient to move slowly when
changing position, to avoid dizziness
from sudden blood pressure decrease.
 Caution patient to avoid driving and
other hazardous activities until effects of
drug are known or dosage titration is
completed.
 DRUG ACTION NURSING CONSIDERATIONS
Generic Name: Relaxes vascular smooth muscles of arteries  Tell patient to take tablets with food.
Hydralazine and arterioles, causing peripheral vasodilation  Instruct patient to move slowly when
Brand Name: and decreasing peripheral vascular resistance. rising (especially in morning on
Apresoline These actions decrease blood pressure and awakening), to avoid dizziness from
Drug Classification: increase heart rate, stroke volume, and cardiac sudden blood pressure decrease.
Peripheral vasodilator/Antihypertensive output.  Instruct patient to immediately report
fever, muscle and joint aches, or sore
throat.
 Tell patient to report chest pain or
numbness or tingling of hands or feet.
 To minimize GI upset, advise patient to
eat small, frequent meals.
 Caution patient not to discontinue drug
abruptly, because severe hypertension
may result.
 DRUG ACTION NURSING CONSIDERATIONS
Generic Name: Reduces pain and inflammation by inhibiting  Tell patient to report ototoxicity
Aspirin prostaglandin production. Fever reduction symptoms, unusual bleeding, and
Brand Name: mechanism unknown; may be linked to bruising.
ASA decrease in endogenous pyrogens in  Caution patient to avoid activities that
Drug Classification: hypothalamus resulting from prostaglandin may cause injury. Advise him to use soft
Nonsteroidal anti-inflammatory drug (NSAID), inhibition. Exerts antiplatelet effect by inhibiting toothbrush and electric razor to avoid
Nonopioid analgesic, antipyretic, antiplatelet synthesis of prostacyclin and thromboxane A2. gum and skin injury.
drug  Instruct patient to tell all prescribers he’s
taking the drug, because it may cause
serious interactions with many common
medications.
 Tell patient not to take other over-the-
counter preparations containing aspirin.
 Inform patient that he may need to
undergo regular blood testing during
therapy.
 DRUG ACTION NURSING CONSIDERATIONS
Generic Name: Blocks aldosterone-producing and  Tell patient to take drug with or without
Candesartan cilexetil vasoconstrictive effects of angiotensin II at food.
Brand Name: various receptor sites, including vascular  Inform caregiver that pharmacist will
Biopress smooth muscle and adrenal glands prepare a suspension for child who can’t
Drug Classification: swallow tablets. Shake suspension well
Angiotensin II receptor antagonist/ before each dose.
Antihypertensive  Teach patient about lifestyle changes
that help control blood pressure, such as
proper diet, exercise, stress reduction,
smoking cessation, and moderation of
alcohol intake.
 Instruct patient to use reliable birth
control method and to contact prescriber
and discontinue drug if she suspects
she’s pregnant.
 Caution patient not to take herbs without
consulting prescriber.
 DRUG ACTION NURSING CONSIDERATIONS
Generic Name: Stimulates alpha-adrenergic receptors in CNS,  Instruct patient to move slowly when
Clonidine HCl decreasing sympathetic out- flow, inhibiting sitting up or standing, to avoid dizziness
Brand Name: vasoconstriction, and ultimately reducing blood or light-headedness caused by sudden
Catapres pressure. Also prevents transmission of pain blood pressure decrease.
Drug Classification: impulses by inhibiting pain pathway signals in  Caution patient not to stop taking drug
Centrally acting sympatholytic/ brain. abruptly.
Antihypertensive
 DRUG ACTION NURSING CONSIDERATIONS
Generic Name: Inhibits thrombus and clot formation by  If patient will self-administer drug, teach
Enoxaparin blocking factor Xa and factor IIa. This inhibition proper injection technique. 2Instruct
Brand Name: accelerates formation of antithrombin III- patient to promptly report irregular
Clexane thrombin complex (a coagulation inhibitor), heartbeat, unusual bleeding or bruising,
Drug Classification: thereby deactivating thrombin and preventing rash, or hives.
Low-molecular weight heparin/ Anticoagulant conversion of fibrinogen to fibrin.  Teach patient safety measures to avoid
bruising or bleeding.
 Advise patient to weigh himself regularly
and to report gains.
 Instruct patient to inform dentists and
other health care professionals about
enoxaparin use.
 DRUG ACTION NURSING CONSIDERATIONS
Generic Name: Inhibits thrombus and clot formation by  If patient will self-administer drug, teach
Enoxaparin blocking factor Xa and factor IIa. This inhibition proper injection technique. 2Instruct
Brand Name: accelerates formation of antithrombin III- patient to promptly report irregular
Clexane thrombin complex (a coagulation inhibitor), heartbeat, unusual bleeding or bruising,
Drug Classification: thereby deactivating thrombin and preventing rash, or hives.
Low-molecular weight heparin/ Anticoagulant conversion of fibrinogen to fibrin.  Teach patient safety measures to avoid
bruising or bleeding.
 Advise patient to weigh himself regularly
and to report gains.
 Instruct patient to inform dentists and
other health care professionals about
enoxaparin use.
 DRUG ACTION NURSING CONSIDERATIONS
Generic Name: Decreases conduction of sinoatrial and  Instruct patient to avoid chewing,
Verapamil Hydrochloride atrioventricular (AV) nodes by inhibiting calcium breaking, or crushing extended-release
Brand Name: influx into cardiac and vascular smooth muscle form.
Isoptin cells, inhibiting excitatory contraction. These  Advise patient to immediately report
Drug Classification: effects prolong AV node refractoriness and rash, unusual bleeding or bruising,
Calcium channel blocker/Antianginal, anti- decrease myocardial oxygen consumption. fainting, and (in long-term use) fatigue,
arrhythmic (class IV), antihypertensive nausea, or yellowing of skin or eyes.
 Caution patient not to take with
grapefruit juice.
● Instruct patient to limit caffeine intake
and avoid alcohol.
 ● Advise patient to seek medical advice
before using over-the-counter
medications or herbs.
● Tell patient to avoid sun exposure and
to wear sunscreen and protective
clothing when going outdoors.
 DRUG ACTION NURSING CONSIDERATIONS
Generic Name: Interacts with opioid receptor sites, primarily in  Tell patient he may crush immediate
Morphine limbic system, thalamus, and spinal cord. This release form and mix with food or fluids.
Brand Name: interaction alters neurotransmitter release,  Advise patient not to crush or break
Sevredol altering perception of and tolerance for pain. extended-release form. Instruct him to
Drug Classification: swallow it whole.
Opioid agonist/Opioid analgesic  Tell patient he may open sustained-
release capsule (Kadian), sprinkle entire
contents of capsule onto a small amount
of food (such as applesauce), and
consume immediately. Stress
importance of not chewing, crushing, or
dissolving pellets.
 Advise patient to take drug at the first
sign of pain, because continuous dosing
is more effective than p.r.n. dosing.
 DRUG ACTION NURSING CONSIDERATIONS
Generic Name: Inhibits calcium transport into myocardial and  Instruct patient to place S.L. tablet
Nitroglycerin vascular smooth muscle cells, suppressing directly under tongue and hold it there
Brand Name: contractions. Dilates main coronary arteries as it dissolves. Caution him not to chew
Nitrostat and arterioles, inhibits coronary artery spasm, or swallow tablet.
Drug Classification: increases oxygen delivery to heart, and  Tell patient to use drug before physical
Nitrate/Antianginal reduces frequency and severity of angina activities that may cause angina.
attacks.  Instruct patient to take drug at pain
onset and repeat every 5 minutes for
three doses. If pain doesn’t subside,
advise him to seek medical attention.
 Tell patient not to chew or crush
sustained-release tablets.
 Advise patient to apply correct amount
of ointment using applicator. Caution
him to avoid rubbing site. Instruct him to
cover ointment with plastic wrap and
tape it, to wash hands after placement,
and to rotate sites.
 Advise patient to consult prescriber or
pharmacist before changing brands of
transdermal system. Different brands
may have different drug concentrations.
 DRUG ACTION NURSING CONSIDERATIONS
Generic Name: Converts plasminogen to plasmin, an enzyme  Tell patient why he’s receiving drug.
Streptokinase that degrades fibrin clots and lyses thrombi and  Teach patient to recognize and
Brand Name: emboli immediately report signs or symptoms of
Streptase hypersensitivity reaction or excessive
Drug Classification: bleeding.
Group C beta- hemolytic streptococcal  Instruct patient to report unusual
nonenzymatic protein/Thrombolytic bruising or bleeding. Teach him safety
measures to avoid bruising and
bleeding.
 Advise patient that he’ll undergo regular
blood testing during therapy.

Sources:

Schull, P. D. (2013). McGraw-Hill nurse's drug handbook. New York: McGraw-Hill Medical.