Drugs Classification Mechanism of action
Contraindication
Generic: Calcium channel-blocker Inhibits the movement of calcium
Amlodipine Antianginal Drug ions across the membranes of
Antihypertensive cardiac and arterial muscle cells:
Brand: Norvasc
inhibits transmembrane calcium
Dose, Strength flow, which results in the
& Formulation depression of impulse formation
Ordered: Give 10 in specialized cardiac pacemaker
mg 1 tab, OD cells, slowing of the velocity of
specialized cardiac pacemaker
Timing: 8 am
cells, slowing of the velocity of
Duration: 24 conduction of the cardiac impulse,
hrs. depression of myocardial
contractility, and dilation of.
Other forms: coronary arteries and arterioles
Tablets: 2.5 mg. and peripheral arterioles; these
5 mg. 10 mg effects lead to decreased cardiac
work, decreased cardiac oxygen
consumption, and in patients with
vasospastic angina, increased
delivery of oxygen to cardiac
cells.
Generic: cardiovascular agent; Selectively blocks the binding of
LOSARTAN angiotensin II receptor angiotensin II to specific tissue
Brand: Cozaar antagonist; antihypertensive receptors found in the vascular
smooth muscle and adrenal gland:
Ordered: 150 mg this action blocks the
1 tab BID vasoconstriction effect of the
renin angiotensin system as well
as the release of aldosterone
leading to decreased blood
pressure.
Indication and
Indication:
Angina pectoris due to coronary
artery Spasm, Chronic stable
angina, alone or in combination
with other agents, Essential
hypertension, alone or in
combination with other
antihypertensive.
Contraindication:
Amlodipine tablets are
contraindicated in patients
with: hypersensitivity to
dihydropyridines, amlodipine
or any of the excipients listed in
section 6.1. severe hypotension.
shock (including cardiogenic
shock).
Indication:
Treatment of hypertension,
alone or in combination with
other antihypertensive Agents
Treatment of diabetic
neuropathy with an elevated
serum creatinine and
proteinuria in patients with type
2 (non-insulin-dependent)
diabetes and a history of
hypertension
Contraindication:
Losartan is contraindicated
in pregnancy: As losartan acts
Side effect
CNS: Dizziness,
lightheadedness, headache,
asthenia, fatigue, lethargy
CV: Peripheral edema,
arrhythmias
Dermatologic: Flushing.
rash
GI: Nausea, abdominal
Discomfort Interactions:
Drug-drug Possible
increased serum levels and
toxicity of cyclosporine if
taken concurrently
CNS: Headache, dizziness,
syncope, insomnia
CV: Hypotension
Dermatologic: Rash,
urticaria, pruritus, alopecia,
dry skin
GI: Diarrhea, abdominal
pain, nausea, constipation,
dry mouth
Respiratory: URI
symptoms, cough, sinus
Nursing Consideration
Assess patient for history of allergy to
amlodipine, impaired hepatic or renal
function, sick sinus syndrome, heart
block, or CHF.
Assess for adverse drug reactions,
report irregular heartbeat, swelling of
the hands and feet, shortness of breath,
pronounced dizziness, and
constipation.
Monitor BP and cardiac rhythm.
Instruct patient to take drug with meals
if abdominal discomfort occurs; advise
on eating small, frequent meals for
nausea and vomiting.
BEFORE:
• Assess patient's health history Assess
patient's blood pressure. Assess
patient's renal function
DURING:
• Monitor patient's intake and output.
Administer drug at daytime.
AFTER:
• Be alert for adverse reaction. Monitor
patient's sleeping pattern
 on the renin-angiotensin
system, it causes
oligohydramnios, thus resulting
in fetal lung hypoplasia and
skeletal deformities. Potential
neonatal adverse effects are
skull hypoplasia, hypotension,
anuria, renal failure, and death.
Generic Name Pharmacologic Class: It increases neuronal membrane General Indications:
Diazepam Benzodiazepine permeability to chloride ions by -Short-term management of
binding to stereospecific anxiety Insomnia associated
Trade Name Therapeutic Class: benzodiazepine receptors on the with anxiety Sleepwalking
Valium Antiepileptic Anxiolytic, postsynaptic GABA neuron - Night terrors
Skeletal muscle relaxant within the CNS and enhancing the - Premedication before
Ordered: GABA inhibitory effects resulting anesthesia
5mg IV PRN for Pregnancy Risk: Factor D in hyperpolarization and - Adjunct in the management of
frank seizures stabilization seizures
- Muscle spasms
- Acute symptoms of alcohol
withdrawal
- Premedication before
anesthesia
Contraindication:
contraindications to diazepam
include patients with severe
respiratory
insufficiency, myasthenia
gravis, sleep apnea syndrome,
and severe hepatic
insufficiency. It is permissible
in patients with open-
angle glaucoma who are
receiving appropriate therapy
but is contraindicated in acute
narrow-angle glaucoma.
disorders
Other: Back pain, fever,
gout, muscle weakness
> drowsiness
> dizziness - tiredness
> muscle weakness
headache
> dry mouth nausea
> constipation confusion
difficulty urinating frequent
urination
>changes in sex drive or
ability
>loss of control of bodily
movements uncontrollable
shaking of a part of the
body > slurred speech
>slowed breathing and
heartbeat
Before:
- Discuss risk of fetal abnormalities
with patients desiring to become
pregnant Instruct about side effects of
drug: Drowsiness, dizziness, Gl upset,
dreams, difficulty concentrating,
fatigue, nervousness, crying.
- Assess for hypersensitivity Reduce
dose of opioid analgesics with IV
diazepam; dose should be reduced by at
least one-third or eliminated.
- Instruct not to stop taking the drug
without consulting the health care
provider.
- Observe the 15 rights of drug
administration
During:
- Do not administer intrarterially, may
produce arteriospasm, gangrene.
Carefully monitor P. BP respiration
during IV administration
- Change from IV therapy to oral
therapy as soon as possible. Do not use
small veins for IV injection.
- Instruct to take drug exactly as
prescribed
After:
- Maintain patients receiving parenteral
benzodiazepines in bed for 3 hours.
- Do not permit ambulatory patients to
operate a vehicle following an
injection.

Generic name: Therapeutic category: Therapeutic actions Has
Phenytoin Anticonvulsants, Hydantoin, antiepileptic activity without
Anti-arrhythmic causing general CNS depression;
Brand Name:
stabilizes neuronal membranes
 Dilantin
and prevents hyperexcitability
caused by excessive stimulation;
Dosage: 100mg
limits the spread of seizure
10 caps NGT
activity from an active focus: also
Frequency: TID ( effective in treating cardiac
Three times a arrhythmias, especially those
day) induced by digitalis;
antiarrhythmic properties are very
similar to those of lidocaine: both
are class IB antiarrhythmics.
Indications
>Control of grand mal (tonic-
clonic) and psychomotor
seizures
>Prevention and treatment of
seizures occurring during or
following neurosurgery
>Control of status epilepticus of
the grand mal type (parenteral
administration)
>Unlabeled uses:
antiarrhythmic, particularly in
digitalis-induced arrhythmias
(IV preparations); treatment of
trigeminal neuralgia (tic
douloureux)
Contraindications:
Contraindicated with
hypersensitivity to hydantoins,
sinus bradycardia, sinoatrial
block, Stokes-Adams
syndrome, pregnancy (data
suggest an association between
antiepileptic drug use and an
elevated incidence of birth
defects; however, do not
CNS: ataxia, slurred
speech, dizziness,
nervousness, insomnia,
twitching, headache, mental
confusion, decreased
coordination
CV: periarteritisnodosa
EENT:nystagmus, diplopia
blurred vision
Gl: gingival hyperplasia,
N/V, constipation
Hematologic:
thrombocytopenia.
leukopenia,
agranulocytosis.
megaloblastic anemia
- Instruct patient to report adverse
reactions
- Monitor EEG in patients treated for
status epilepticus, seizures may recur
after initial control. Monitor liver and
renal function, CBC during long term
therapy.
- Taper dosage gradually after long-
term therapy. Document that drug has
been given
>Use only clear solution for injection
> Don't give IM unless dosage
adjustments are made;
>Divide doses given w/ or after meals
may decrease adverse GI reaction.
>Stop drug if rashes appear and resume
drug after rashes is clear.
>Don't stop this drug abruptly or
suddenly, it may worsen seizure. drug
level in the >Monitor blood
>Monitor CBC and Ca+ level every 6
months and periodically monitor
hepatic function. Take appropriate
safety precaution for seizure

Generic Name: Laxative, Ammonia Mechanism of Action: The drug
Lactulose reduction agent passes unchanged into the colon
where bacteria break it down to
Brand Name: organic acids that increase the
Duphalac osmotic pressure in the colon and
slightly acidify the colonic
Ordered: 30 cc contents, resulting in an increase
OD HS until in stool water content, stool
with regular softening, laxative action, and
bowel movement migration of blood ammonia into
the colon contents with
subsequent trapping and
expulsion in the feces.
Generic name Calcium channel blocker A calcium channel blocker that
nicardipine inhibits calcium ion influx across
hydrochloride cardiac and smooth muscle cells
but is more selective to vascular
Brand name: smooth muscle than cardiac
Cardene, SR muscle Also diabetes coronary
arteries and arterioles
Ordered:
Infuse in IVF +
10 cc PNSS
discontinue antiepileptic
therapy in pregnant women
who are receiving such therapy
to prevent major seizures, this
is likely to precipitate status
epilepticus, with attendant
hypoxia and risk to both mother
and fetus), lactation
Indications: Treatment of
constipation, Prevention and
treatment of portal-systemic
encephalopathy
Contraindications: allergy to
lactulose, low-galactose diet.
Use cautiously with diabetes
and lactation. Pregnancy
category C
Indication:
Decrease BP in hypertension
Contraindication:
Nicardipine is contraindicated
in patients
with hypersensitivity to the
drug, in patients with advanced
aortic stenosis. Reduction of
diastolic pressure in these
patients may worsen rather than
GI: Transient flatulence,
distension, intestinal
cramps, belching, diarrhea,
nausea; Category C.
Hematologic Acid-base
imbalances
CNS: headache, dizziness,
anxiety, depression,
confusion, paresthesia,
somnolence
CV: edema, bradycardia
hypotension, palpitations,
pulmonary edema, chest
pain, tachycardia, increased
angina
GI: nausea, vomiting,
gastric upset, constipation,
>Assess for Allergy to lactulose, low-
galactose diet, diabetes, lactation.
> Do not freeze laxative form.
Extremely dark or cloudy syrup may be
unsafe; do not use.
> Give laxative syrup orally with fruit
juice, water or milk to increase
palatability.
> Monitor for adverse drug effects.
Report diarrhea, severe belching,
abdominal fullness.
> Do not administer other laxatives
while using lactulose.
>Monitor serum ammonia levels.
>The following side effects. May
occur: abdominal fullness, flatulence,
belching
>assure ready access to bathroom
bowel movements will be increased to
2-3 per day
Monitor for CHF, weight gain, rates,
jugular venous distension dyspnea
Monitor BP and pulse
Assess surgical pain intensity location
duration alleviating factors
Monitor potassium, liver function test
renal studies periodically
Assess fluid volume status & O ratio)&
records weight
 improve myocardial oxygen
balance. Caution in liver
impairment, extensively
metabolized by liver.
hepatitis, abdominal cramps
GU: nocturia polyuria
INTEG: rash
MISC: blurred vision
flushing, sweating
shortness of breath

Generic Name: Hypertonic Balance Multiple Maintenance Indication:  Infection of the site Monitor patient frequently or:
Solution With Dextrose Infusion D5NM solution is indicated for of injection
Balanced works by providing the hypotonic parenteral maintenance of  Febrile response > Signs of infiltration /sluggish flow
Multiple concentration of electrolytes with routine daily fluid and  Venous thrombosis >signs of phlebitis/infection
Maintenance dextrose; restoring blood glucose electrolytes requirements with  Hypervolemia >well time of catheter and need tube
Solution with 5% levels in patients with minimal carbohydrate calories  Hyperosmolar replaced
Dextrose hypoglycemia and providing a from dextrose Magnesium in syndrome >Condition of catheter dressing Check
source of carbohydrate calories the help to prevent prolonged  Phlebitis extending the level of the IVF.
Brand Name: when needed parenteral therapy. from the site of >Correct solution, medication and
Endusol-Imb injection volume.
Contraindication:  Extravasation >Check and regulate the drop rate.
Dosage Strength: Caution: may Patient receiving  Balance Multiple >Change the IVF solution if needed.
0.05 corticosteroids, patient with Maintenance
diabetes mellitus and heart Solution With
Dosage Form: problems Dextrose
Solution for IV Infusion may also
Infusion Warning: Contains Sodium cause side-effects
Metabisulfite, a sulfite that may not listed here.
cause allergic-type reactions
including anaphylactoid
symptoms and life-threatening
or less severe asthmatic
episodes in certain susceptible
persons

Brand name: Isotonic Intravenous - Normal Saline is a sterile, Indication: -hypotension Monitor patient frequently or:
Plain NSS Solution nonpyrogenic solution for fluid Used because it has little to no
and electrolyte replenishment. effect on the tissues and Make > Signs of infiltration /sluggish flow
Other name: -It contains no antimicrobial the person feel hydrated >signs of phlebitis/infection
0.9% Sodium agents. preventing hypovolemic shock >well time of catheter and need tobe
Chloride -The pH 7.0). is 5.0 (4.5 to -It or hypotension replaced
contains 9g / L Sodium Chloride >Condition of catheter dressing Check
Solution Form: with an osmolarity of 308 Contraindication: the level of the IVF.
IV fluid mOsmol / L -Heart failure -Pulmonary >Correct solution, medication and
 -It contains 154 nEq / L Sodium edema -Renal impairment volume.
Route: IV and Chloride. -Sodium retention >Check and regulate the drop rate.
>Change the IVF solution if needed.
Dose:1000 ml
@25 atts/min
Frequency: