NAME OF DRUG DOSAGE/FREQUENCY/
TIMING/ROUTE ACTION
Generic Name: Dosage: 5mg. For adults,
Amlodipine initially 5mg of
amlodipine should be
Brand Name: taken PO;
Norvasc
Frequency: 1 tablet 2x a
Classification: day
Calcium channel- *note: Dosage may be
blocker, gradually increased over
Antianginal drug, 10-14 days to a maximum
cardiovascular dose of 10mg PO daily*
agent, Anti-
hypertensive
Timing: Amlodipine is
taken without regard to
meals; however, it is best
to take it as ordered by the
doctor.
Route: PO (oral)
MECHANISM OF
Amlodipine is a
dihydropyridine calcium
antagonist (slow-channel
blocker) that inhibits the
transmembrane influx of
calcium ions into vascular
smooth muscle and cardiac
muscle.
Amlodipine is a peripheral
vasodilator that acts directly
on vascular smooth muscle
to cause a reduction in
peripheral vascular
resistance and reduction in
blood pressure.
Amlodipine reduces
systolic, diastolic, and
mean arterial blood
pressure.
INDICATION CONTRAINDICATION
Amlodipine is used to Amlodipine is
treat mild to moderate contraindicated in patients
hypertension and with dihydropyridine
angina hypersensitivity.
. CV: Peripheral edema,
- Angina It is also contraindicated in
pectoris due to patients with allergy to
coronary artery amlodipine, impaired
spasm hepatic or renal function,
(Prinzmetal’s sick sinus syndrome, heart
variant angina) block (second or third
degree), lactation.
- Chronic stable
angina, alone Amlodipine must be used
or in cautiously with CHF,
combination pregnancy.
with other
agents Contraindication after
acute myocardial
infarction.
ADVERSE EFFECT
CNS: Dizziness, light-
headedness, headache,
asthenia, fatigue, lethargy
arrhythmias, palpitations,
flushing tachycardia,
peripheral or facial
edema, bradycardia,
chest pain, syncope,
postural hypotension.
Dermatologic: Flushing,
rash
GI: Nausea, abdominal
discomfort, anorexia,
constipation, dyspepsia,
dysphagia, diarrhea,
flatulence, vomiting.
Urogenital: Sexual
dysfunction, frequency,
nocturia.
Respiratory: Dyspnea.
Other: Arthralgia,
cramps, myalgia.
NURSING RESPONSIBILITIES
CLINICAL ALERT! Name confusion has
been reported between Norvasc
(amlodipine) and Navane (thiothixene); use
caution.
Assessment
History: Allergy to amlodipine, impaired
hepatic or renal function, sick sinus
syndrome, heart block, lactation, CHF
Physical: Skin lesions, color, edema; P, BP,
baseline ECG, peripheral perfusion,
auscultation; R, adventitious sounds; liver
evaluation, GI normal output; liver and renal
function tests, urinalysis
Interventions
WARNING: Monitor patient carefully while
adjusting drug to therapeutic dose; use
special caution if patient has CHF.
Monitor BP very carefully if patient is also
on nitrates.
Monitor cardiac rhythm regularly during
stabilization of dosage and periodically
during long-term therapy.
Administer drug without regard to meals.
Teaching points
Ask the patient to take amlodipine with
meals if upset stomach occurs.
Report irregular heartbeat, shortness of
breath, swelling of the hands or feet,
pronounced dizziness, constipation.
 NAME OF DOSAGE/FREQUENCY/ MECHANISM INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING RESPONSIBILITIES
DRUG TIMING/ROUTE OF ACTION

Generic Name: Dosage: 50mg. For adults, Blocks beta- Atenolol is used for Contraindicated with Allergic reactions: Pharyngitis, Assessment
Atenolol initially 50 mg atenolol adrenergic treatment of angina sinus bradycardia, erythematous rash, fever, sore History: Sinus bradycardia, second- or
should be taken PO receptors of the pectoris due to second- or third-degree throat, laryngospasm, respiratory distress third-degree heart block, cardiogenic shock,
Brand Name: sympathetic coronary heart block, cardiogenic CHF, renal failure, diabetes or
Apo-Atenolol Frequency:1/2 tablet twice nervous system atherosclerosis. shock, CHF, pregnancy. CNS: Dizziness, vertigo, tinnitus, fatigue, thyrotoxicosis, lactation, pregnancy
(CAN), Gen- a day in the heart and emotional depression, paresthesias, sleep Physical: Baseline weight, skin condition,
Atenolol (CAN), juxtaglomerular It is also used for Use cautiously with disturbances, hallucinations, neurologic status, P, BP, ECG, respiratory
Novo-Atenol Timing: Since atenolol is apparatus treatment of renal failure, diabetes or disorientation, memory loss, slurred status, renal and thyroid function tests,
(CAN), twice a day, take it as (kidney), thus hypertension, as a thyrotoxicosis (atenolol speech blood and urine glucose, cholesterol,
Tenormin directed by the doctor. The decreasing the step 1 agent, alone can mask the usual triglycerides
dose may be increased to excitability of or with other drugs, cardiac signs of CV: Bradycardia, CHF, cardiac
100 mg/day, and the doctor the heart, especially diuretics. hypoglycemia and arrhythmias, sinoatrial or AV nodal block, Interventions
Classification: may advise to take it before decreasing thyrotoxicosis), tachycardia, peripheral vascular WARNING: Do not discontinue drug
Beta 1-selective bedtime once it is increased, cardiac output Another ruse of this lactation, respiratory insufficiency, claudication, CVA, abruptly after long-term therapy
adrenergic to first check if it causes and oxygen is for treatment of disease. pulmonary edema, hypotension (hypersensitivity to catecholamines may
blocker, Anti- dizziness. Otherwise, the consumption, MI (myocardial have developed, causing exacerbation of
anginal, Anti- patient can take it in the decreasing the infarction) Dermatologic: Rash, pruritus, sweating, angina, MI, and ventricular arrhythmias).
hyptertensive morning. release of renin dry skin Taper drug gradually over 2 wk with
from the kidney, Unlabeled uses: monitoring.
Route: PO (oral) and lowering Prevention of EENT: Eye irritation, dry eyes, Consult physician about withdrawing drug
BP. migraine headaches; conjunctivitis, blurred vision if patient is to undergo surgery (withdrawal
alcohol withdrawal is controversial).
syndrome, treatment GI: Gastric pain, flatulence, constipation,
of ventricular and diarrhea, nausea, vomiting, anorexia, Teaching points
supraventricular ischemic colitis, renal and mesenteric  Take drug with meals if GI upset
arrhythmias arterial thrombosis, retroperitoneal occurs.
fibrosis, hepatomegaly, acute pancreatitis  Do not stop taking this drug unless
told to do so by a health care provider.
GU: Impotence, decreased libido,  Avoid driving or dangerous
Peyronie’s disease, dysuria, nocturia, activities if dizziness or weakness
frequent urination occurs.
 You may experience these side
Musculoskeletal: Joint pain, arthralgia, effects: Dizziness, light-headedness, loss
muscle cramps of appetite, nightmares, depression,
sexual impotence.
Respiratory: Bronchospasm, dyspnea,  Report difficulty breathing, night
cough, bronchial obstruction, nasal cough, swelling of extremities, slow
stuffiness, rhinitis, pharyngitis (less likely pulse, confusion, depression, rash, fever,
than with propranolol) sore throat.
 NAME OF DRUG DOSAGE/FREQUENCY/ MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING RESPONSIBILITIES
TIMING/ROUTE ACTION

Generic Name: Dosage: 500mg. For Biguanide oral Treatment of type 2 Hypersensitivity to CNS: Headache, Assessment & Drug Effects
Metformin adults, initially 500 mg. hypoglycemic agent. diabetes mellitus in metformin; hepatic or dizziness, agitation,
metformin should be taken Unlike sulfonylureas, patients not controlled cardiopulmonary fatigue.  Lab tests: Obtain baseline and
Brand Name: PO. Note: The doctor may biguanides do not with diet alone. May be insufficiency; alcoholism; periodic kidney and liver function
Glucophage, increase the dosage. stimulate the release of used with an oral concurrent infection; acute Metabolic: Lactic tests; drug contraindicated in the
Glucophage XR, insulin from the beta sulfonylurea. MI, cardiogenic shock; acidosis.  presence of renal or hepatic
Fortamet, Glumetza, cells of the pancreas. diabetic ketoacidosis; insufficiency. Monitor blood
Riomet Frequency: 1 tablet twice hypoxemia, lactic acidosis; GI: Nausea, vomiting, glucose and HbA1C, and lipid
a day. Mechanism of action is radiographic contrast abdominal pain, bitter profile periodically.
Classification: thought to be due to both administration; renal or metallic taste,  Monitor known or suspected
Hormones and increasing the binding of disease, renal failure, renal diarrhea, bloatedness, alcoholics carefully for decreased
synthetic substitutes, Timing: Metformin is best insulin to its receptor and impairment; sepsis; anorexia; malabsorption liver function.
antidiabetic agent, taken with the morning potentiating insulin surgery; children <10 y, of amino acids, vitamin  Monitor cardiopulmonary status
biguanides and evening meals for action. lactation.. B12, and folic acid throughout course of therapy;
500mg dose. possible. cardiopulmonary insufficiency may
Metformin improves predispose to lactic acidosis.
tissue sensitivity to
Route: PO (oral) insulin, increases glucose Patient & Family Education
transport into skeletal
muscles and fat, and  Be aware that hypoglycemia is not
suppresses a risk when drug is taken in
gluconeogenesis and recommended therapeutic doses
hepatic production of unless combined with other drugs
glucose, thus lowering which lower blood glucose.
blood glucose levels.  Report to physician immediately
S&S of infection, which increase
the risk of lactic acidosis (e.g.,
abdominal pains, nausea, and
vomiting, anorexia).
 Do not breast feed while taking this
drug without consulting physician.
 NAME OF DRUG DOSAGE/FREQUENCY/
TIMING/ROUTE
Generic Name: Dosage: 4mg. For adults,
Glimepiride initially 4mg glimepiride
is taken PO.
Brand Name:
Amaryl Frequency: 1 tablet once a
day
Classification:
Anti-diabetic, Timing: Glimepiride is
Sulfonylurea (second taken exactly as the doctor
generation), hormones tells you so. It is usually
and synthetic prescribed once a day-
substitutes daily dose to be taken
shortly before , or with
first meal of the day
(usually breakfast)
Route: PO (oral)
MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING RESPONSIBILITIES
ACTION
Second-generation Adjunct to diet and Hypersensitivity to CNS: Dizziness, Assessment & Drug Effects
sulfonylurea exercise in patients with glimepiride, diabetic asthenia, headache,
hypoglycemic agent used type 2 diabetes, may ketoacidosis, pregnancy blurred vision,  Lab tests: monitor fasting and
for once-a-day dosing. also be used in (category C), lactation, changes in
postprandial blood glucose and
combination with insulin nondiabetic patients with accommodation.
Directly stimulates in type 2 diabetes. renal glycosuria. urinary glucose frequently.
functioning pancreatic GI: Nausea, Monitor glycosylated hemoglobin
beta cells to secrete vomiting, diarrhea, every 3–6 mo. Monitor
insulin, leading to direct abdominal pain. periodically during long-term
drop in blood glucose. therapy: Liver function tests,
Indirect action leads to Hematologic: serum osmolarity, serum sodium,
increased sensitivity of Leukopenia, and CBC with differential.
peripheral insulin agranulocytosis  Monitor for hypoglycemia
receptors, resulting in (rare), especially with concurrent drugs
increased insulin binding thrombocytopenia.
which enhance hypoglycemic
in peripheral tissues.
Glimepiride improves Metabolic: effects.
postprandial glycemic Hypoglycemia.
control. Patient & Family Education
Skin: Rash, pruritus,
erythema, urticaria,  Take a missed dose as soon as
maculopapular possible unless it is almost time
eruptions. for next dose; NEVER take two
doses at the same time.
 Avoid drinking alcohol or using
OTC drugs without informing
physician.
 Use sunscreen and avoid
sunlamps.
 Learn about adverse reactions and
drug interactions.
 Do not breast feed while taking
this drug.