Drug Study Number II

Classification Common Generic and Indication Pharmacokinetics & Adverse Reactions Nursing Considerations
Brand Names Pharmacodynamics

Hypothalamic and o Goserelin Used as antineoplastic absorbed slowly when stimulation or blocking Assess:
pituitary Agents o Histrelin agent for treatment of given intramuscularly of regular hormone For possible
o Leuprolide specific cancers, (IM), subcutaneously, control contraindications or
o Nafarelin treatment of or in depot cautions: allergy to any
o Tesamorelin endometriosis and form. Agonists can lead to Drugs Affecting
precocious puberty that increased release of sex Hypothalamic Hormones
results from hormones, Agonists
hypothalamic tend to have very long leading to ovarian
GROUP activity half-lives of days to overstimulation, Perform a physical
weeks. flushing, increased assessment
Drugs Affecting temperature and
Hypothalamic metabolized by appetite, and fluid Perform culture and
Hormones endogenous hormonal retention sensitivity tests at the site
Agonists pathways. of infection
are hormones or similar Conduct orientation and

to hormones, reflex assessment
they cross the placenta Assess vital signs
and cross into breast
milk. Perform renal and liver
Actions Contraindications Drug to Drug function tests
Most of them are Interactions
inhibit pituitary Known allergies, renal excreted in the urine
gonadotropin or hepatic disease.
secretion, Patient with peripheral
with a resultant drop in vascular disorder,
the production of the pregnant and lactating
sex hormones. women
o degarelix Treatment of advanced absorbed slowly when lead to a decrease in Assess:
o ganirelix prostate cancer given intramuscularly testosterone levels, For possible
Hypothalamicand (IM), subcutaneously, leading to loss of contraindications or
pituitary Agents or in depot energy, decreased cautions: allergy to any
form. sperm count and Antagonists
activity,
and potential
tend to have very long alterations in secondary Perform a physical
half-lives of days to sex characteristics, assessment
GROUP weeks. or to a decrease in
female sex hormones, Perform culture and
Antagonists metabolized by leading to sensitivity tests at the site
endogenous hormonal lack of menstruation, of infection
pathways. fluid and electrolyte
changes, insomnia, Conduct orientation and
are hormones or similar and irritability. reflex assessment
to hormones, Assess vital signs
they cross the placenta
Actions Contraindications and cross into breast Drug to Drug Perform renal and liver
milk. Interactions function tests
Inhibition of premature Known allergies, renal
luteinizing hormone or hepatic disease. Most of them are
surge in Patient with peripheral excreted in the urine
women undergoing vascular disorder,
controlled ovarian pregnant and lactating
stimulation women
as part of a fertility
program
o somatropin Treatment of children It is widely distributed inflammation and Assess:
Hypothalamic and o somatropin with growth failure due in the body and autoimmune-type For possible
Pituitary Agents rDNA origin to lack localizes reactions, contraindications or
of growth hormone in highly perfused such as swelling and cautions: allergy to any
(GH) or to chronic renal tissues, particularly the joint pain, and the Drugs Affecting Anterior
failure liver and endocrine Pituitary Hormones
kidney. reactions of Growth Hormone
GROUP hypothyroidism and Agonists
Excretion occurs insulin resistance.
through the urine and Perform a physical
Drugs Affecting feces. assessment
Anterior
Pituitary Hormones Patients with liver or Assess height, weight,
Growth Hormone renal dysfunction may thyroid function tests,
Agonists experience glucose
reduced clearance and tolerance tests, and GH
increased levels
concentrations of the
drug.
Actions Contraindications Drug route IM,Subq Drug to Drug

Interactions
are used purely as a Known allergies, cytochrome P450 liver
replacement for pregnant and lactating enzyme
anterior pituitary women system
hormones are those
acting as GH—
somatropin and
somatropin rDNA
origin.
o bromocriptine Treatment of administered GI complaints (e.g., Assess:
mesylate Parkinson’s disease, subcutaneously and constipation or For possible
o lanreotide hyperprolactinemia oral diarrhea, flatulence, contraindications or
Hypothalamic and o octreotide associated with and nausea) cautions: allergy to any
Pituitary Agents acetate pituitary rapidly absorbed and Growth Hormone
o pegvisomant adenomas, female widely distributed Antagonists
infertility associated throughout the body,
with and it is metabolized in
hyperprolactinemia, the tissues with about Assess orientation, affect,
and acromegaly. 30% excreted and reflexes; blood
GROUP unchanged in the pressure,
urine. pulse, and orthostatic
Growth Hormone blood pressure;
Antagonists Oral type are abdominal
effectively examination
absorbed from the
gastrointestinal (GI)
tract and undergoes
extensive first-pass
metabolism in the liver
Actions Contraindications and is primarily Drug to Drug
excreted in the bile. Interactions
Acts directly on Known allergies,patient Erythromycin,
postsynaptic dopamine with endocrine phenothiazines,
receptors in the brain disorder,pregnant and
lactating women
Hypothalamic and o chorionic most commonly used rapidly absorbed and GI complaints (e.g.,
Pituitary Agents gonadotropin drugs metabolized; it is constipation or Assess:
o chorionic affecting anterior excreted in the liver diarrhea, flatulence, For possible
gonadotropinalph pituitary hormones. and kidneys and nausea) contraindications or
a cautions: allergy to any
o corticotropin available Growth Hormone
o cosyntropin for oral, IV, Antagonists
GROUP o menotropins subcutaneous, and
Drugs Affecting Other o thyrotropin alpha nasal administration.
Anterior Pituitary Assess orientation,
Hormones excreted in urine and affect, and reflexes;
feces blood pressure,
pulse, and orthostatic
blood pressure;
abdominal
examination
Actions Contraindications Drug to Drug

Interactions
Known allergies,patient
acts like LH and with endocrine
stimulates disorder,pregnant and
the production of lactating women
testosterone and
progesterone.
o conivaptan Treatment of rapidly absorbed and water intoxication Assess:
o desmopressin hypervolemic and metabolized; it is (drowsiness, light- For possible
Hypothalamic and o tolvaptan euvolemic excreted in the liver headedness, contraindications or
Pituitary Agents Hyponatremia, and kidneys headache, coma, cautions: allergy to any
neurogenic diabetes convulsions) related to Drugs Affecting Posterior
insipidus, von available the shift to water Pituitary Hormones
Willebrand’s for oral, IV, retention and resulting
disease,and hemophilia subcutaneous, and electrolyte imbalance; Assess skin for lesions;
nasal administration. tremor, sweating, orientation, affect, and
GROUP vertigo, and headache reflexes; blood pressure
excreted in urine and related to water and pulse; respiration
Drugs Affecting feces retention (a “hangover” and
Posterior effect); abdominal adventitious sounds;
Pituitary Hormones cramps, flatulence, abdominal examination;
nausea, and vomiting renal function tests; and
related to stimulation serum electrolytes
of GI motility; and local
nasal irritation related
to nasal administration.

Interactions
Has pressor and Known allergies, renal carbamazepine or
antidiuretic effects or hepatic chlorpropamide,
disease,pregnant and digoxin, angiotensin-
lactating women converting–enzyme
inhibitors,
angiotensin receptor
blockers, and
potassiumsparing
diuretics,and
telithromycin
Adrenocortical Agents o beclomethasone indicated for the short- absorbed well from Vertigo, headache, Assess:
o betamethasone term many sites hypotension, For possible
o budesonide treatment of many shock, sodium and fl contraindications or
o cortisone inflammatory metabolized by natural uid retention, cautions: allergy to any
o dexamethasone disorders, to relieve systems, mostly within amenorrhea, Glucocorticoids
o flunisolide discomfort, the liver, increased appetite,
o hydrocortisone and to give the body a and are excreted in the weight gain, Assess weight;
GROUP o methylprednisolon chance to heal from urine. immunosuppression, temperature;
e the aggravation or masking orientation and affect;
Glucocorticoids o prednisolone effects of known to cross the of infections, impaired grip strength; eye
o prednisone inflammation. placenta and to enter wound examination; blood
breast milk healing. pressure,
o triamcinolone
pulse, peripheral
available in the perfusion, and vessel
form of a respiratory evaluation;
inhalant,nasal, orally , respiration and
Actions Contraindications topical application , Drug to Drug adventitious breath
intra- Interactions sounds; glucose
target cells and bind to Known allergies, articular,retention erythromycin, tolerance, renal
cytoplasmic patient with acute enema preparations ketoconazole, or function, serum
receptors, initiating infection, diabetes, and inta articular troleandomycin, electrolytes, and
many complex acute peptic ulcers, injection. salicylates, endocrine function tests
reactions that are endocrine barbiturates, and
responsible for anti-infl disorders,pregnant phenytoin, or rifampin.
ammatory and and lactating women.
immunosuppressive
effects.
inhibit the
ability of lymphocytes
to act within the
immune system,
including a blocking of
the production of
antibodies.
o cortisone Partial replacement absorbed slowly and Frontal and occipital Assess:
o fludrocortisone therapy in cortical distributed headaches, For possible
Adrenocortical Agents o hydrocortisone insuffi ciency throughout the body arthralgia, weakness, contraindications or
conditions, treatment increased blood cautions: allergy to any
of salt-losing undergo hepatic volume, Mineralocorticoids
adrenogenital metabolism edema, hypertension,
syndrome to inactive forms. heart failure, rash,
anaphylaxis. Assess blood pressure,
GROUP known to cross the pulse, and adventitious
placenta breath
and to enter breast sounds; weight and
Mineralocorticoids milk. temperature; tissue
turgor;
avoided during refl exes and bilateral
pregnancy and lactation grip strength; and serum
electrolyte
Actions Contraindications Drug to Drug levels,
Interactions
Increases sodium Known allergies, salicylates,
reabsorption in the patients with barbiturates,
renal hypertension,cardiac hydantoins, rifampin,
tubules and increases disease,pregnant and and
potassium and lactating women. anticholinesterases,
hydrogen
excretion, leading to
water and sodium
retention.
function tests
Interactions
hormones replace the Known allergies, renal or Cholestyramine, oral
low hepatic disease, acute anticoagulants, digitalis
or absent levels of thyrotoxicosis, cardiac glycosides,
natural thyroid problems,pregnant and
hormone and suppress lactating women.
the overproduction of
TSH by the pituitary.
Thyroid and o methimazole indicated for the well absorbed from the effects of thyroid Assess:
parathyroid agents o propylthiouracil treatment of GI tract and are suppression: For possible
hyperthyroidism. then concentrated in drowsiness, contraindications or
the thyroid gland. lethargy, bradycardia, cautions: allergy to any
nausea, skin rash, Antithyroid Agents
The onset and nausea, vomiting, GI Thioamides
duration of PTU varies complaints, and
with each patient. severe liver toxicity.
GROUP Assess for skin lesions;
Some excretion can be orientation and affect;
Antithyroid Agents detected in the baseline
Thioamides urine. pulse, blood pressure,
and electrocardiogram;
Some crosses the respiration
placenta and is found in and adventitious sounds;
a high ratio in breast and thyroid function
milk. tests.

Interactions
inhibit the conversion Known allergies, oral anticoagulants,
of T4 to T3 at the pregnant and lactating theophylline,
cellular women metoprolol,
level. propranolol,
and digitalis
lower thyroid hormone
levels by preventing
the formation of
thyroid hormone in the
thyroid cells,
which lowers the serum
levels of thyroid
hormone.
Inhibits the synthesis of

thyroid hormones
Thyroid and o sodium iodide I sometimes used to rapidly absorbed from metallic taste and Assess:
parathyroid agents o strong iodine treat hyperthyroidism the GI tract burning in the mouth, For possible
solution but and widely distributed sore teeth and gums, contraindications or
o potassium are not used as often as throughout the body diarrhea, cautions: allergy to any
iodide they once were in the fluids cold symptoms, and Antithyroid Agents
clinical stomach upset), Iodine Solutions
setting. staining of teeth,
Excretion occurs skin rash, and the Assess for skin lesions;
Adjunct therapy for through the urine development of goiter. orientation and affect;
GROUP hyperthyroidism baseline
taken pulse, blood pressure,
Antithyroid Agents orally and have a rapid and electrocardiogram;
Iodine Solutions onset of action, with respiration
effects and adventitious sounds;
seen within 24 hours and thyroid function
and peak effects seen in tests,
10 to 15
days.
cross the placenta and

Actions Contraindications are Drug to Drug
known to enter breast Interactions
The iodine solutions Known allergies, milk, but the effects on anticoagulants,
cause the thyroid cells pregnant and lactating the neonate theophylline, digoxin,
to become women are not known. metoprolol, and
oversaturated propranolol.
with iodine and stop
producing thyroid
hormone.
Inhibit the synthesis of

thyroid hormones
and inhibit the release
of these hormones into
the
circulation.
Thyroid and o calcitriol indicated for the absorbed from the GI GI effects: metallic Assess:
parathyroid agents o teriparatide management tract and widely taste, nausea, vomiting, For possible
of hypocalcemia in distributed throughout dry mouth, contraindications or
patients undergoing the body. constipation, and cautions: allergy to any
chronic renal anorexia. Parathyroid Agents
dialysis and for the stored in the liver, Antihypocalcemic Agents
treatment of fat, muscle, skin, and CNS effects such
hypoparathyroidism bones. as weakness, headache, Assess for the presence
somnolence, and of any skin lesions;
GROUP metabolized in the irritability may orientation
liver, it is primarily also occur. and affect; liver
excreted in the bile, evaluation; serum
with some found in the calcium, magnesium,
Parathyroid Agents urine and alkaline phosphate
Antihypocalcemic levels; and radiographs
Agents of bones
available in Oral and
subQ

Interactions
Vitamin D compounds Known allergies, renal magnesium-containing
regulate the absorption or hepatic disease, antacids,
of calcium hypercalcemia,pregnan cholestyramine or
and phosphate from t and lactating women mineral oil
the small intestine,
mineral resorption
in bone, and
reabsorption of
phosphate from the
renal tubules.
Thyroid and o alendronate treatment of Paget’s well absorbed from the seen with Assess:
parathyroid agents o etidronate disease and of small intestine bisphosphonates For possible
o ibandronate postmenopausal and do not undergo are headache, nausea, contraindications or
o pamidronate osteoporosis in women, metabolism. and diarrhea and bone cautions: allergy to any
o risedronate and alendronate is pain Antihypercalcemic Agents
o tiludronate also used to treat excreted relatively Bisphosphonates
o zoledronic acid osteoporosis in men. unchanged in the urine.
Assess for the presence
GROUP onset of action is slow, of any skin lesions;
and the duration of orientation
action is days to weeks. and affect; abdominal
examination; serum
Antihypercalcemic Patients electrolytes;
Agents with renal dysfunction and renal function tests
Bisphosphonates may experience toxic
levels of the
drug and should be
evaluated for a dose
reduction.
Contraindications and Interactions
act to slow or block Known allergies, renal Cautions for use of antacids, calcium
bone resorption; or hepatic disease, these drugs products, iron, or
by doing this, they help hypocalcemia, upper GI during pregnancy and multiple vitamins,and
to lower serum calcium disease, asthmatic lactation. aspirin
levels, but they do not patients,pregnant and
inhibit normal bone lactating women
formation
and mineralization.
Thyroid and o calcitonin Paget’s disease, metabolized in the flushing of the face and Assess:
parathyroid agents salmon postmenopausal body tissues to hands, skin rash, For possible
osteoporosis, inactive fragments, nausea contraindications or
emergency treatment which are excreted by and vomiting, urinary cautions: allergy to any
of hypercalcemia the kidney. frequency, and local Antihypercalcemic Agents
inflammation Calcitonin
cross the placenta and at the site of injection.
have been associated Assess for the presence
with adverse effects on of any skin lesions;
GROUP the fetus in animal orientation
studies and affect; abdominal
Antihypercalcemic examination; serum
Agents excreted in breast milk electrolytes;
Calcitonins and renal function tests
given by injection
or by nasal spray

Interactions
inhibits bone Known allergies, renal none
resorption, lowers or hepatic
serum calcium levels in disease,pregnant and
children and in patients lactating women
with
Paget’s disease, and
increases the excretion
of phosphate,
calcium, and sodium
from the kidney.
Agents to control blood o insulin Treatment of type 1 available to provide Hypersensitivity Assess:
glucose level diabetes mellitus short- and long-term reaction, local reactions For possible
coverage. at injection site, contraindications or
hypoglycemia, and cautions: allergy to any
processed within the ketoacidosis Insulin
GROUP body like endogenous Perform a physical
insulin. assessment
Insulin
the peak, onset, and Assess for presence of
duration of each vary any skin lesions;
because of the orientation and reflexes;
Actions Contraindications placement or addition Drug to Drug baseline pulse and blood
of glycine and/ Interactions pressure;
Replacement of Known or arginine chains. monoamine oxidase respiration or
endogenous insulin. allergies,pregnant and inhibitors, beta- adventitious breath
lactating women given by the blockers, sounds
subcutaneous route and salicylates, alcohol,
only, and injection sites and herbal therapies Assess body systems
need to be Investigate nutritional
rotated regularly to intake
avoid damage to
muscles and to prevent Assess activity level,
subcutaneous atrophy including amount and
degree of Exercise
Regular insulin is given Inspect skin areas that
intramuscularly will be used for injection
or intravenously in of insulin; note any areas
emergency situations. that are bruised,
thickened, or
does not cross scarred
the placenta
Obtain blood glucose
Insulin does enter levels as ordered
breast Monitor the results of
milk laboratory tests,
including
urinalysis
Agents to control blood o chlorpropamide Adjunct to diet and rapidly absorbed from GI discomfort, Assess:
glucose level o tolazamide exercise to lower blood the GI tract and anorexia, heartburn, For possible
o tolbutamide glucose level in type 2 undergo hepatic vomiting, nausea, and contraindications or
diabetics metabolism. hypoglycemia. cautions: allergy to any
Sulfonylureas
GROUP Given through oral
Perform a complete
Sulfonylureas and Other excreted in the physical assessing to
Antidiabetic Agents urine. establish
Sulfonylureas baseline status
First- peak effects and Assess for the presence
GenerationSulfonylureas duration of effects of any skin lesions
differ Assess body systems
because of the activity
of various metabolites Investigate nutritional
of the different intake, noting any
drugs. problems
with intake and
adherence to prescribed
Actions Contraindications Drug to Drug diet
Interactions Assess activity level,
Stimulates the release of Known allergies, renal beta-blockers, alcohol including amount and
insulin from or hepatic and herbal therapies degree
functioning cells in the disease,pregnant and of exercise
pancreas; may improve lactating women
the Monitor blood glucose
binding of insulin-to- levels as ordered
insulin receptor sites or Monitor results of
increase laboratory tests,
the number of insulin including urinalysis,
receptor sites. for evidence of
glucosuria, and renal and
liver
function test
Agents to control blood o glimepiride Adjunct to diet and rapidly absorbed from GI discomfort, anorexia, Assess:
glucose level o glipizide exercise in the the GI tract and heartburn, For possible
o glyburide management of type 2 undergo hepatic vomiting, nausea, and contraindications or
GROUP diabetes; with metabolism. hypoglycemia. cautions: allergy to any
metformin or Sulfonylureas
Second-Generation insulin for stabilization Given through oral
Sulfonylureas of diabetic patients. Perform a complete
excreted in the physical assessing to
urine. establish
Actions Contraindications Drug to Drug baseline status
peak effects and Interactions Assess for the presence
Stimulates insulin Known allergies, renal duration of effects beta-blockers, alcohol of any skin lesions
release from or hepatic differ and herbal therapies Assess body systems
functioning beta disease,pregnant and because of the activity
cells in the pancreas; lactating women of various metabolites Investigate nutritional
may improve insulin of the different intake, noting any
binding to drugs. problems
insulin receptor sites or with intake and
increase the number of adherence to prescribed
insulin diet
receptor sites. Assess activity level,
including amount and
degree
of exercise
Monitor blood glucose

levels as ordered
Monitor results of
laboratory tests,
including urinalysis,
for evidence of
liver
function tests
Agents to control blood o acarbose Adjunct to diet to lower rapidly absorbed from GI discomfort, anorexia, Assess:
glucose level o miglitol blood glucose in type 2 the GI tract and heartburn, For possible
diabetics undergo hepatic vomiting, nausea, and contraindications or
metabolism. hypoglycemia. cautions: allergy to any
GROUP Alpha-Glucosidase
Given through oral Inhibitors
Other Antidiabetic
Agents excreted in the Perform a complete
Alpha-Glucosidase urine. physical assessing to
Inhibitors establish
peak effects and baseline status
Actions Contraindications duration of effects Drug to Drug Assess for the presence
differ Interactions of any skin lesions
Stimulates insulin Known allergies, renal because of the activity beta-blockers, alcohol Assess body systems
release from or hepatic of various metabolites and herbal therapies
functioning beta disease,pregnant and of the different Investigate nutritional
cells in the pancreas; lactating women drugs. intake, noting any
may improve insulin problems
binding to with intake and
insulin receptor sites or adherence to prescribed
increase the number of diet
insulin Assess activity level,
receptor sites. including amount and
degree
of exercise

levels as ordered
Monitor results of
laboratory tests,
for evidence of
liver
function tests
Agents to control blood o metformin Adjunct to diet to lower rapidly absorbed from GI discomfort, anorexia, Assess:
glucose level blood glucose in type 2 the GI tract and heartburn, For possible
Biguanide
Given through oral
Perform a complete
urine. establish
GROUP baseline status
peak effects and Assess for the presence
duration of effects of any skin lesions
Biguanide differ Assess body systems
drugs. problems
with intake and
Actions Contraindications Drug to Drug adherence to prescribed
Interactions diet
May increase the Known allergies, renal beta-blockers, alcohol Assess activity level,
peripheral use of or hepatic and herbal therapies including amount and
glucose, disease,pregnant and degree
increase production of lactating women of exercise
insulin, decrease
hepatic Monitor blood glucose
glucose production, and levels as ordered
alter intestinal Monitor results of
absorption of laboratory tests,
glucose. including urinalysis,
for evidence of
liver
function tests
Agents to control blood o linagliptin Adjunct to diet to lower rapidly absorbed from GI discomfort, anorexia, Assess:
glucose level o saxagliptin blood glucose in type 2 the GI tract and heartburn, For possible
o sitagliptin diabetics undergo hepatic vomiting, nausea, and contraindications or
Dipeptidyl Peptidase-4
Given through oral Inhibitor
excreted in the Perform a complete

urine. physical assessing to
GROUP establish
peak effects and baseline status
Dipeptidyl Peptidase-4 duration of effects Assess for the presence
Inhibitor differ of any skin lesions
because of the activity Assess body systems
of various metabolites
Actions Contraindications of the different Drug to Drug Investigate nutritional
drugs. Interactions intake, noting any
Stimulates insulin Known allergies, renal beta-blockers, alcohol problems
release from or hepatic and herbal therapies with intake and
functioning beta disease,pregnant and adherence to prescribed
cells in the pancreas; lactating women diet
may improve insulin Assess activity level,
binding to including amount and
insulin receptor sites or degree
increase the number of of exercise
insulin
receptor sites. Monitor blood glucose
levels as ordered
Monitor results of
laboratory tests,
for evidence of
liver
function tests
Agents to control blood o pramlintide Adjunct to diet to lower rapidly absorbed from GI discomfort, anorexia, Assess:
glucose level blood glucose in type 2 the GI tract and heartburn, For possible
Human Amylin
Given through oral
Perform a complete
urine. establish
GROUP baseline status
Human Amylin duration of effects of any skin lesions
drugs. problems
with intake and
Actions Contraindications Drug to Drug adherence to prescribed
Interactions diet
Stimulates insulin Known allergies, renal beta-blockers, alcohol Assess activity level,
release from or hepatic and herbal therapies including amount and
functioning beta disease,pregnant and degree
cells in the pancreas; lactating women of exercise
may improve insulin
binding to Monitor blood glucose
insulin receptor sites or levels as ordered
increase the number of Monitor results of
insulin laboratory tests,
receptor sites. including urinalysis,
for evidence of
liver
function tests
Agents to control blood o exenatide Adjunct to diet to lower rapidly absorbed from GI discomfort, anorexia, Assess:
glucose level o liraglutide blood glucose in type 2 the GI tract and heartburn, For possible
Incretin Mimetic
Given through oral
GROUP Perform a complete
Incretin Mimetic urine. establish
baseline status
Actions Contraindications because of the activity Drug to Drug
of various metabolites Interactions Investigate nutritional
Stimulates insulin Known allergies, renal of the different beta-blockers, alcohol intake, noting any
release from or hepatic drugs. and herbal therapies problems
functioning beta disease,pregnant and with intake and
cells in the pancreas; lactating women adherence to prescribed
may improve insulin diet
binding to Assess activity level,
insulin receptor sites or including amount and
increase the number of degree
insulin of exercise
receptor sites.
levels as ordered
Monitor results of
laboratory tests,
for evidence of
liver
function tests
Agents to control blood o nateglinide Adjunct to diet to lower rapidly absorbed from GI discomfort, anorexia, Assess:
glucose level o repaglinide blood glucose in type 2 the GI tract and heartburn, For possible
Meglitinides
Perform a complete
Meglitinides excreted in the physical assessing to
urine. establish
baseline status
Actions Contraindications of various metabolites Drug to Drug Investigate nutritional
of the different Interactions intake, noting any
Stimulates insulin Known allergies, renal drugs. beta-blockers, alcohol problems
insulin
levels as ordered
Monitor results of
laboratory tests,
for evidence of
liver
function tests
Agents to control blood o pioglitazone Adjunct to diet to lower rapidly absorbed from GI discomfort, anorexia, Assess:
glucose level o rosiglitazone blood glucose in type 2 the GI tract and heartburn, For possible
Thiazolidinediones
Perform a complete
Thiazolidinediones excreted in the physical assessing to
urine. establish
baseline status
Actions Contraindications of various metabolites Drug to Drug Investigate nutritional
of the different Interactions intake, noting any
Stimulates insulin Known allergies, renal drugs. beta-blockers, alcohol problems
insulin
levels as ordered
Monitor results of
laboratory tests,
for evidence of
liver
function tests
Agents to control blood o diazoxide Counteracts severe rapidly absorbed Hypotension, Assess:
glucose level o glucagon hypoglycemic reactions and widely distributed hypertension, nausea, For possible
in throughout the body vomiting, respiratory contraindications or
diabetic patients distress with cautions: allergy to any
treated with insulin. They are hypersensitivity Glucose-Elevating Agents
excreted in the urine. reactions, and
hypokalemia with Perform a complete
Given orally,Subq,IM or overdose.. physical assessment
IV
GROUP Assess orientation and
Glucose-Elevating reflexes and baseline
Agents pulse,
blood pressure, and
adventitious sounds

levels as ordered
Actions Contraindications Drug to Drug Monitor the results of

Interactions laboratory tests,
Accelerates the Known allergies, renal thiazide diuretics, oral including
breakdown of glycogen or hepatic anticoagulants urinalysis,
to glucose disease,pregnant and
in the liver, causing an lactating women
increase in blood
glucose levels.
Bgsg
Drugs acting on
cardio vascular
Antihypertensive o benazepril treatment of administered orally Tachycardia, MI, rash, Assess:
Agents o captopril hypertension pruritus, gastric For possible
o enalapril not feasible or rapid irritation, aphthous contraindications or
o enalaprilat onset is desirable. ulcers, peptic ulcers, cautions: allergy to any
o fosinopril dysgeusia, Angiotensin-Converting-
o lisinopril well absorbed, widely proteinuria, bone Enzyme Inhibitors
o moexipril distributed, marrow suppression,
o perindopril metabolized in the cough. Assess baseline status;
GROUP o quinapril liver, and excreted in This includes
o ramipril the body temperature and
Angiotensin- urine and feces. weight; skin color,
o trandolapril
Converting- lesions, and
Enzyme Inhibitors detected in breast milk, temperature; pulse,
are known to cross the blood pressure, baseline
placenta, and have electrocardiogram,
been associated and perfusion;
with serious fetal respirations and
abnormalities, and so adventitious
they should breath sounds; bowel
Actions Contraindications not be used during Drug to Drug sounds and abdominal
pregnancy. Interactions examination; and renal
act in the lungs to Known allergies, renal Allopurinol, and anti- function tests, complete
prevent ACE from or hepatic disease, inflammatory drugs blood
converting angiotensin I heart failure,pregnant count with differential,
to angiotensin II, a and lactating women and serum electrolytes.
powerful
vasoconstrictor and
stimulator of
aldosterone release
o azilsartan treatment of all given orally Dizziness, headache, Assess:
o candesartan hypertension; diarrhea, For possible
o eprosartan treatment of diabetic well absorbed abdominal pain, contraindications or
Antihypertensive o irbesartan nephropathy with an and undergo symptoms of upper cautions: allergy to any
Agents o losartan elevated serum metabolism in the liver respiratory tract Angiotensin II–Receptor
o olmesartan creatinine and by the cytochrome infection, cough, back Blockers
o telmisartan proteinuria in patients P450 system. pain, fever, muscle
GROUP o valsartan with type 2 diabetes weakness,
and excreted in feces and in hypotension. Assess baseline status;
Angiotensin II–Receptor hypertension. urine. This includes
Blockers body temperature and
ARBs cross the placenta weight; skin color,
lesions, and
Actions Contraindications not known whether Drug to Drug temperature; pulse,
they Interactions blood pressure, baseline
bind with the Known allergies, renal enter breast milk during phenobarbital, electrocardiogram,
angiotensin II receptors or hepatic lactation indomethacin, or and perfusion;
in vascular smooth disease,pregnant and rifamycin, respirations and
muscle and in the lactating women. ketoconazole, adventitious
adrenal cortex fluconazole, or breath sounds; bowel
to block diltiazem sounds and abdominal
vasoconstriction and examination; and renal
the release of function tests, complete
aldosterone. blood
count with differential,
actions block the blood and serum electrolytes.
pressure–raising effects
of
the renin–angiotensin
system and lower blood
pressure.
o amlodipine Treatment of essential given orally and are Dizziness, light- Assess:
o clevidipine hypertension in the generally headedness, headache, For possible
o diltiazem extended-release form well absorbed, peripheral edema, contraindications or
Antihypertensive o felodipine metabolized in the bradycardia, cautions: allergy to any
Agents o isradipine liver, and excreted atrioventricular block, aminoglycoside
o nicardipine in the urine. flushing, nausea. Perform a physical
o nifedipine assessment
o nisoldipine drugs cross the Perform culture and
o verapamil placenta and enter sensitivity tests
breast milk
GROUP Note respiratory rate and
available in an auscultate lungs for
Calcium Channel intravenous adventitious
Blockers form for short-term use sounds
when oral
administration
is not feasible.

Interactions
inhibit the movement Known allergies, renal Diltiazem
of calcium or hepatic disease,
ions across the heart block or sick
membranes of sinus,pregnant and
myocardial and lactating women
arterial muscle cells,
altering the action
potential and
blocking muscle cell
contraction.
Antihypertensive o hydralazine Severe hypertension, Available on IV,IM and Apprehension, Assess:
Agents o minoxidil maintenance of oral. headache, retrosternal For possible
o nitroprusside controlled hypotension pressure, palpitations, contraindications or
during anesthesia, rapidly absorbed and cyanide toxicity, cautions: allergy to any
acute heart widely distributed diaphoresis, Vasodilators
failure. nausea, vomiting,
metabolized in the liver abdominal pain, Assess baseline status
and primarily excreted irritation at the this includes
in injection site. body temperature and
GROUP urine. weight; skin color,
lesions, and
Vasodilators cross the placenta and temperature; pulse,
enter breast milk blood pressure, baseline
electrocardiogram,
and perfusion;
respirations and
adventitious
breath sounds; bowel
Actions Contraindications Drug to Drug sounds and abdominal
Interactions examination; renal and
Acts directly on Known allergies, renal drugs works differently liver function tests; and
vascular smooth muscle or hepatic disease, in the body, so each blood
to peripheral vascular drug should be checked glucose.
cause vasodilation and disease, CAD, heart for potential drug–drug
drop of blood pressure; failure, or interactions
does tachycardia,pregnant before use.
not inhibit and lactating women
cardiovascular reflexes
and tachycardia;
renin release will occur.
Antihypertensive o ambrisentan Severe hypertension, Available on IV,IM and Apprehension, Assess:
Agents o bosentan maintenance of oral. headache, retrosternal For possible
o epoprostenol controlled hypotension pressure, palpitations, contraindications or
o iloprost during anesthesia, rapidly absorbed and cyanide toxicity, cautions: allergy to any
o sildenafil acute heart widely distributed diaphoresis, Vasodilators for
o tadalafil failure. nausea, vomiting, Pulmonary
o treprostinil metabolized in the liver abdominal pain, Artery Hypertension
and primarily excreted irritation at the
in injection site. Assess baseline status
GROUP urine. this includes
body temperature and
Vasodilators for cross the placenta and weight; skin color,
Pulmonary enter breast milk lesions, and
Artery Hypertension temperature; pulse,
blood pressure, baseline
electrocardiogram,
and perfusion;
respirations and
adventitious
breath sounds; bowel
Actions Contraindications Drug to Drug sounds and abdominal
Interactions examination; renal and
Acts directly on Known allergies, renal drugs works differently liver function tests; and
vascular smooth muscle or hepatic disease, in the body, so each blood
to peripheral vascular drug should be checked glucose.
cause vasodilation and disease, CAD, heart for potential drug–drug
drop of blood pressure; failure, or interactions
does tachycardia,pregnant before use.
not inhibit and lactating women
and tachycardia;
Antihypertensive o Thiazide and treatment of Available on IV,IM and Apprehension, Assess:
Agents Thiazide-Like hypertension. oral. headache, retrosternal For possible
o Diuretics pressure, palpitations, contraindications or
o bendrofl rapidly absorbed and cyanide toxicity, cautions: allergy to any
umethiazide widely distributed diaphoresis, Diuretic Agents
GROUP o chlorothiazide nausea, vomiting,
o hydrochlorothiazid metabolized in the liver abdominal pain, Assess baseline status
Other e and primarily excreted irritation at the this includes
Antihypertensive o hydrofl in injection site. body temperature and
Agents umethiazide urine. weight; skin color,
Diuretic Agents o methyclothiazide lesions, and
o chlorthalidone cross the placenta and temperature; pulse,
Actions o indapamide Contraindications enter breast milk Drug to Drug blood pressure, baseline
o metolazone Interactions electrocardiogram,
Acts directly on Known allergies, renal drugs works and perfusion;
o Potassium-Sparing
vascular smooth or hepatic differently in the body, respirations and
Diuretics
muscle to disease,pregnant and so each adventitious
o amiloride
cause vasodilation and lactating women drug should be breath sounds; bowel
o spironolactone
drop of blood checked for potential sounds and abdominal
o triamterene
pressure; does drug–drug interactions examination; renal and
not inhibit before use. liver function tests; and
cardiovascular reflexes blood
and tachycardia; glucose.
renin release will
occur.
Antihypertensive o aliskiren treatment of Available on IV,IM and Apprehension, Assess:
Agents hypertension. oral. headache, retrosternal For possible
pressure, palpitations, contraindications or
rapidly absorbed and cyanide toxicity, cautions: allergy to any
widely distributed diaphoresis, Renin Inhibitor
nausea, vomiting,
metabolized in the liver abdominal pain, Assess baseline status
and primarily excreted irritation at the this includes
in injection site. body temperature and
GROUP urine. weight; skin color,
lesions, and
Renin Inhibitor cross the placenta temperature; pulse,
and enter breast blood pressure, baseline
milk electrocardiogram,
and perfusion;
Actions Contraindications Drug to Drug respirations and
Interactions adventitious
Acts directly on Known allergies, renal drugs works differently breath sounds; bowel
vascular smooth muscle or hepatic in the body, so each sounds and abdominal
to disease,pregnant and drug should be checked examination; renal and
cause vasodilation and lactating women for potential drug–drug liver function tests; and
drop of blood pressure; interactions blood
does before use. glucose.
not inhibit
and tachycardia;
Classification Common Generic and Brand Indication Pharmacokinetics & Adverse Reactions Nursing Considerations
Names Pharmacodynamics
Antihypertensive o Beta-Blockers treatment of Available on IV,IM and Apprehension, Assess:
Agents o acebutolol hypertension. oral. headache, For possible
o atenolol retrosternal contraindications or
o betaxolol rapidly absorbed and pressure, cautions: allergy to any
o bisoprolol widely distributed palpitations, cyanide Sympathetic Nervous
o carteolol toxicity, diaphoresis, System Drugs
o metoprolol metabolized in the nausea, vomiting,
o nadolol liver and primarily abdominal pain, Assess baseline status
o nebivolol excreted in irritation at the this includes
GROUP o penbutolol urine. injection site. body temperature and
weight; skin color,
o pindolol
Sympathetic Nervous cross the placenta and lesions, and
o propranolol
System Drugs enter breast milk temperature; pulse,
o timolol
blood pressure,
o Alpha- and Beta-
baseline
Blockers
electrocardiogram,
o carvedilol
and perfusion;
o labetalol respirations and
o guanabenz adventitious
o Alpha-Adrenergic breath sounds; bowel
Interactions
Blockers sounds and abdominal
Acts directly on Known allergies, renal drugs works
o phenoxybenzamine examination; renal and
vascular smooth or hepatic differently in the
muscle to o phentolamine disease,pregnant and body, so each liver function tests; and
cause vasodilation o Alpha1-Blockers lactating women drug should be blood
and drop of blood o doxazosin checked for glucose.
pressure; does o prazosin potential drug–drug
not inhibit o terazosin interactions
cardiovascular o Alpha2-Blockers before use.
reflexes and o clonidine
tachycardia; o guanfacine
renin release will o methyldopa
occur.
Antihypotensive Agents o dobutamine First-choice drugs for rapidly absorbed from nausea and Assess:
o dopamine treatment of the GI tract, reaching constipation, increased For possible
o ephedrine hypotension or shock peak levels within 1 to respiratory contraindications or
o epinephrine 2 hours. rate and changes in cautions: allergy to any
o isoproterenol blood pressure, Sympathetic Adrenergic
o norepinephrine metabolized headache, and Agonists or Vasopressors
o phenylephrine in the liver and changes in peripheral
GROUP excreted in the urine blood flow with
with a half-life of numbness, tingling, Assess baseline status
3 to 4 hours. and even gangrene this includes
Sympathetic Adrenergic body temperature and
Agonists or enters breast milk weight; skin color,
Vasopressors lesions, and
temperature; pulse,
electrocardiogram,
and perfusion;
respirations and
Actions Contraindications Drug to Drug adventitious
Interactions breath sounds; bowel
react with sympathetic Known allergies, renal drugs works differently sounds and abdominal
adrenergic or hepatic in the body, so each examination; renal and
receptors to cause the disease,pregnant and drug should be checked liver function tests; and
effects of a sympathetic lactating women for potential drug–drug blood
stress interactions glucose.
response: increased before use.
blood pressure,
increased blood
volume, and increased
strength of cardiac
muscle contraction.
Antihypotensive Agents o midodrine Treatment of rapidly absorbed from piloerection, chills, and Assess:
orthostatic hypotension the GI tract, reaching rash; hypertension For possible
in adults peak levels within 1 to and bradycardia; contraindications or
2 hours. dizziness, vision cautions: allergy to any
changes, vertigo, and Alpha-Specifi c
metabolized headache; and Adrenergic
in the liver and problems with Agent
excreted in the urine urination.
with a half-life of
GROUP 3 to 4 hours.
Assess baseline status
Alpha-Specifi c enters breast milk this includes
Adrenergic body temperature and
Agent weight; skin color,
lesions, and
temperature; pulse,
electrocardiogram,
and perfusion;
respirations and
Actions Contraindications Drug to Drug adventitious
Interactions breath sounds; bowel
activates alpha- Known allergies, renal cardiac sounds and abdominal
receptors in arteries or hepatic glycosides, beta- examination; renal and
and veins disease,pregnant and blockers, alpha- liver function tests; and
to produce an increase lactating women adrenergic agents, and blood
in vascular tone and an corticosteroids glucose.
increase
in blood pressure.
Cardiotonic Agents o Digoxin Treatment of acute oral and parenteral headache, weakness, Assess:
GROUP heart failure (HF), atrial administration drowsiness, For possible
arrhythmias vision changes, GI upset contraindications or
Cardiac Glycoside rapid onset of action and anorexia cautions: allergy to any
and rapid Cardiac Glycoside
absorption (30–120
minutes when taken Perform a physical
Actions Contraindications orally, 5– Drug to Drug assessment
30 minutes when given Interactions
decrease in the Known allergies, renal intravenously) verapamil, amiodarone, Obtain the patient’s
myocardial workload or hepatic disease, quinidine, quinine, weight, noting any recent
and relief of HF ventricular tachycardia widely distributed erythromycin, increases or decreases
or fi brillation,pregnant throughout the body. tetracycline, or
and lactating women cyclosporine, Assess cardiac status
excreted potassium-losing closely, including pulse
unchanged in the urine. diuretics, thyroid and blood Pressure
hormones,
metoclopramide, or Inspect the skin and
penicillamine mucous membranes for
color, and check nail beds
and capillary refill
Monitor affect,
orientation, and reflexes
Assess the patient’s

respiratory rate and
auscultate Lungs
Examine the abdomen

for distention;
auscultatebowel sounds
Assess voiding patterns

and urinary output
Obtain a baseline
electrocardiogram (ECG)
Monitor the results of
laboratory tests,
including
serum electrolyte levels
and renal function
Cardiotonic Agents o milrinone Short-term treatment available only for Arrhythmias, Assess:
of HF in patients intravenous hypotension, nausea, For possible
who have not vomiting, contraindications or
responded to digitalis, widely distributed after thrombocytopenia, cautions: allergy to any
diuretics, or injection. pericarditis, pleuritis, Phosphodiesterase
vasodilators fever, chest pain, Inhibitors
metabolized in the liver burning at injection
GROUP and excreted site. Perform a physical
primarily in the urine. assessment
Phosphodiesterase
Inhibitors Obtain the patient’s
weight, noting any recent
increases or decreases
Assess cardiac status

closely, including pulse
and blood Pressure
Interactions Inspect the skin and
Blocks the enzyme Known allergies, renal Furosemide mucous membranes for
phosphodiesterase, or hepatic disease, color, and check nail beds
which severe aortic and capillary refill
leads to an increase in or pulmonic valvular
myocardial cell cAMP, disease,pregnant and Monitor affect,
which lactating women orientation, and reflexes
increases calcium levels
in the cell, causing a Assess the patient’s
stronger respiratory rate and
contraction and auscultate Lungs
prolonged response to
sympathetic Examine the abdomen
stimulation; directly for distention;
relaxes vascular smooth auscultatebowel sounds
muscle.
Assess voiding patterns
and urinary output
Obtain a baseline
electrocardiogram (ECG)

laboratory tests,
including
serum electrolyte levels
and renal function
Antiarrhythmic Agents o disopyramide Management of acute Dizziness, light- Assess:
o procainamide ventricular arrhythmias available in headedness, fatigue, For possible
o quinidine during cardiac surgery intramuscular arrhythmias, cardiac contraindications or
or MI (IM),intravenous (IV) arrest, nausea, cautions: allergy to any
forms and oral. vomiting, Class Ia
anaphylactoid
reactions, hypotension, Perform a physical
GROUP rapid absorption vasodilation. assessment
through the Assess the patient’s
Class I Antiarrhythmics gastrointestinal (GI) neurological status,
Class Ia tract. including level
of alertness, speech and
excreted in urine vision, and refl exes
Interactions
cross the placenta Assess cardiac status
Decreases Known allergies, renal and are found in breast antiarrhythmic , digoxin closely, including pulse,
depolarization, or hepatic disease, milk and the beta-blockers blood
decreasing heart failure (HF), pressure, heart rate, and
automaticity of the hypotension, or rhythm
ventricular cells; shock,pregnant and
increases lactating women Monitor respiratory rate
ventricular fi brillation and depth and auscultate
threshold. lungs, for evidence of
adventitious sounds
Inspect abdomen for

evidence of distention;
auscultate
bowel sounds
Evaluate skin for color,

lesions, and temperature
Obtain a baseline
electrocardiogram
Antiarrhythmic Agents o lidocaine Management of acute available in Dizziness, light- Assess:
o mexiletine ventricular arrhythmias intramuscular headedness, fatigue, For possible
during cardiac surgery (IM),intravenous (IV) arrhythmias, cardiac contraindications or
or MI forms and oral. arrest, nausea, cautions: allergy to any
vomiting, Other
anaphylactoid Class Ib
rapid absorption reactions, hypotension,
through the vasodilation. Perform a physical
GROUP gastrointestinal (GI) assessment
tract. Assess the patient’s
Class I Antiarrhythmics neurological status,
excreted in urine including level
Class Ib of alertness, speech and
cross the placenta vision, and refl exes
and are found in breast
Actions Contraindications milk Drug to Drug Assess cardiac status
Interactions closely, including pulse,
Decreases depolarization, Known allergies, renal antiarrhythmic , digoxin blood
decreasing or hepatic disease, heart and the beta-blockers. pressure, heart rate, and
automaticity of the failure (HF), hypotension, rhythm
ventricular cells; increases or shock,pregnant and
ventricular fibrillation lactating women
threshold. Monitor respiratory rate
and depth and auscultate
lungs, for evidence of
adventitious sounds
Inspect abdomen for

auscultate
bowel sounds

Obtain a baseline
electrocardiogram
Classification Common Generic Indication Pharmacokinetics & Adverse Reactions Nursing Considerations
and Brand Names Pharmacodynamics
Antiarrhythmic Agents o flecainide Management of acute available in Dizziness, light- Assess:
o propafenone ventricular arrhythmias intramuscular headedness, fatigue, For possible
during cardiac surgery or (IM),intravenous (IV) arrhythmias, cardiac contraindications or
MI forms and oral. arrest, nausea, cautions: allergy to any
vomiting, Class Ic
anaphylactoid
rapid absorption reactions, hypotension,
through the vasodilation. Perform a physical
GROUP gastrointestinal (GI) assessment
tract. Assess the patient’s
neurological status,
Class I Antiarrhythmics excreted in urine including level
Class Ic of alertness, speech and
cross the placenta vision, and refl exes
and are found in breast
Actions Contraindications milk Drug to Drug Assess cardiac status
Decreases Known allergies, renal or antiarrhythmic , digoxin blood
depolarization, hepatic disease, heart and the beta-blockers. pressure, heart rate, and
decreasing failure (HF), hypotension, rhythm
automaticity of the or shock,pregnant and
ventricular cells; lactating women Monitor respiratory rate
increases and depth and auscultate
ventricular fi brillation lungs, for evidence of
threshold. adventitious sounds
Inspect abdomen for

auscultate
bowel sounds

Obtain a baseline
electrocardiogram
Antiarrhythmic Agents o acebutolol Treatment of cardiac Available in IV and oral Bradycardia, heart Assess:
o esmolol arrhythmias, especially failure, cardiac For possible
o propranolol supraventricular absorbed from the GI arrhythmias, heart contraindications or
tachycardia; treatment tract or have an blocks, cerebrovascular cautions: allergy to any
of ventricular immediate effect when accident, Class II Antiarrhythmics
tachycardia induced by given intravenously pulmonary edema,
digitalis or and undergo hepatic gastric pain, flatulence, Perform a physical
GROUP catecholamines. metabolism. nausea, assessment
vomiting, diarrhea, Assess the patient’s
Class II Antiarrhythmics excreted in impotence, decreased neurological status,
the urine. exercise including level
tolerance, antinuclear of alertness, speech and
antibody development. vision, and refl exes
Interactions Assess cardiac status
Competitively blocks sinus bradycardia , Verapamil and insulin closely, including pulse,
beta-adrenergic diabetes blood
receptors and thyroid pressure, heart rate, and
in the heart and kidney, dysfunction,pregnant rhythm
has a membrane- and lactating women
stabilizing Monitor respiratory rate
effect, and decrease and depth and auscultate
lungs, for evidence of
adventitious sounds
Inspect abdomen for

auscultate
bowel sounds

Obtain a baseline
electrocardiogram
Antiarrhythmic Agents o amiodarone Treatment of life- available in an oral or IV Malaise, fatigue, Assess:
o dofetilide threatening ventricular form dizziness, heart failure, For possible
o ibutilide arrhythmias. cardiac arrhythmias, contraindications or
o sotalol well absorbed after oral cardiac arrest, cautions: allergy to any
administration and are constipation, Class III Antiarrhythmics
immediately available nausea, vomiting,
after IV hepatotoxicity, Perform a physical
administration and pulmonary toxicity, assessment
GROUP widely distributed. corneal microdeposits, Assess the patient’s
and vision changes neurological status,
metabolized in the liver including level
Class III Antiarrhythmics and excreted in urine. of alertness, speech and
vision, and refl exes
Actions Contraindications Drug to Drug Assess cardiac status

Acts directly on heart shock, hypotension, digoxin or quinidine, blood
muscle cells to prolong or respiratory antihistamines, pressure, heart rate, and
repolarization and the depression, presence of phenothiazines, or rhythm
refractory period, AV block,pregnant and tricyclic
increasing lactating women antidepressants, Monitor respiratory rate
the threshold for ketoconazole, and depth and auscultate
ventricular fibrillation; cimetidine, lungs, for evidence of
also acts or verapamil, adventitious sounds
on peripheral smooth nonsteroidal anti-infl
muscle to decrease ammatory drugs, Inspect abdomen for
peripheral aspirin, or antacids. evidence of distention;
resistance. auscultate
bowel sounds

Obtain a baseline
electrocardiogram
Antiarrhythmic Agents o diltiazem Treatment of administered Dizziness, light- Assess:
o verapamil paroxysmal intravenously or Orally headedness, headache, For possible
supraventricular asthenia, peripheral contraindications or
tachycardia, atrial metabolized in the edema, bradycardia, AV cautions: allergy to any
fibrillation, and atrial liver, block, Class IV Antiarrhythmics
flutter and excreted in the flushing, nausea,
urine. hepatic injury Perform a physical
assessment
GROUP cross the placenta and Assess the patient’s
enter breast milk. neurological status,
including level
Class IV vision, and refl exes
Antiarrhythmics
closely, including pulse,
Actions Contraindications Drug to Drug blood
Interactions pressure, heart rate, and
Blocks the movement Known allergies, renal beta-blockers, calcium rhythm
of calcium ions across or hepatic disease, sick products or rifampin
the sinus syndrome or and beta-adrenergic Monitor respiratory rate
cell membrane, heart block,pregnant drugs and depth and auscultate
depressing the and lactating women lungs, for evidence of
generation of action adventitious sounds
potentials, delaying
phases 1 and 2 of Inspect abdomen for
repolarization, evidence of distention;
and slowing conduction auscultate
through the AV node. bowel sounds

Obtain a baseline
electrocardiogram
Antiarrhythmic Agents o adenosine Treatment of life- absorbed from the GI Malaise, fatigue, Assess:
o digoxin threatening ventricular tract or have an dizziness, heart failure, For possible
o dronedarone arrhythmias. immediate effect when cardiac arrhythmias, contraindications or
given intravenously cardiac arrest, cautions: allergy to any
and undergo hepatic constipation, Other Antiarrhythmics
metabolism. nausea, vomiting,
hepatotoxicity, Perform a physical
excreted in pulmonary toxicity, assessment
GROUP the urine. corneal microdeposits, Assess the patient’s
and vision changes neurological status,
Other Antiarrhythmics including level
vision, and refl exes

closely, including pulse,
blood
Actions Contraindications Drug to Drug pressure, heart rate, and
Interactions rhythm
Acts directly on heart sinus bradycardia , antiarrhythmic , digoxin
muscle cells to prolong diabetes and the beta-blockers. Monitor respiratory rate
repolarization and the and thyroid and depth and auscultate
refractory period, dysfunction,pregnant lungs, for evidence of
increasing and lactating women adventitious sounds
the threshold for
ventricular fibrillation; Inspect abdomen for
also acts evidence of distention;
on peripheral smooth auscultate
muscle to decrease bowel sounds
peripheral
resistance Evaluate skin for color,
Obtain a baseline
electrocardiogram
Antianginal Agents o amyl nitrate Treatment of acute available as a Hypotension, Assess:
o isosorbide angina, prophylaxis of sublingual tablet, a headache, dizziness, For possible
dinitrate angina, intravenous translingual tachycardia, rash, contraindications or
o isosorbide treatment of angina spray, an intravenous flushing, nausea, cautions: allergy to any
unresponsive solution (for bolus vomiting, Perform a physical
mononitrate to beta-blockers or injection sweating, and chest assessment
o nitroglycerin organic nitrates, or infusion), a pain.
GROUP perioperative transdermal patch, a Inspect the skin for color,
hypertension, and topical ointment intactness, and any signs
Nitrates heart failure associated or paste, or a of redness, irritation, or
with transmucosal agent. breakdown
acute myocardial
infarction; to produce absorption, onset of Assess the patient’s
controlled action, and duration complaint of pain,
hypotension during vary with the form used including
surgery. onset, duration, intensity,
Actions Contraindications Drug to Drug location, and measures
Interactions
Relaxes vascular Known allergies, renal ergot derivatives, Assess the patient’s
smooth muscle with a or hepatic disease, heparin, sildenafil, neurological status,
resultant decrease in severe anemia, head tadalafil, or vardenafil including level of
venous return and trauma or cerebral alertness, affect, and
decrease in haemorrhage,pregnant reflexes,
arterial blood pressure, and lactating women. Monitor respirations and
reducing the left auscultate lungs
ventricular
workload and Assess cardiopulmonary
decreasing myocardial status closely, including
oxygen pulsemrate, blood
consumption. pressure, heart rate, and
rhythm,
Obtain an
electrocardiogram as
ordered
Monitor laboratory test
results, including liver
and
renal function tests
Antianginal Agents o metoprolol Treatment of stable absorbed from the GI Dizziness, vertigo, HF, Assess:
o nadolol angina pectoris; also tract after oral arrhythmias, For possible
o propranolol used for treatment of administration and gastric pain, fl atulence, contraindications or
hypertension, undergo hepatic diarrhea, vomiting, cautions: allergy to any
prevention of metabolism. impotence, Beta-Blockers
reinfarction in decreased exercise
myocardial infarction reach peak levels in 60 tolerance. Perform a physical
patients, and to 90 minutes and have assessment
GROUP treatment of stable, varying
symptomatic heart duration of effects, Inspect skin for color and
Beta-Blockers failure (HF). ranging from 6 to 19 integrity
hours.
complaint of pain,
including
onset, duration, intensity,
and location and
Actions Contraindications Drug to Drug measures
Interactions used to relieve the pain.
Competitively blocks Known allergies, renal Clonidine, nonsteroidal
beta-adrenergic or hepatic disease, anti- inflamatory Drugs, Assess cardiopulmonary
receptors bradycardia, heart epinephrine, ergot status closely, including
in the heart and block, and cardiogenic, alkaloids, insulin or pulse
kidneys, decreasing the diabetes, antidiabetic Agents rate, blood pressure,
infl uence peripheral vascular heart rate, and rhythm
of the sympathetic disease, asthma,
nervous system on chronic obstructive Obtain an
these tissues pulmonary electrocardiogram as
and the excitability of disease,pregnant and ordered
the heart; decreases lactating women
cardiac Monitor respirations and
output, which results in auscultate lungs
a lowered blood
pressure and Monitor laboratory test
decreased cardiac results, including liver
workload. and
Antianginal Agents o amlodipine Treatment of well absorbed after oral Inhibits the movement Assess:
o diltiazem Prinzmetal angina, administration, of calcium ions across For possible
effortassociated metabolized in the the membranes of contraindications or
o nicardipine angina, and chronic liver, and excreted in myocardial and arterial cautions: allegy to any
o nifedipine stable angina; also urine. muscle cells, Calcium Channel Blockers
o verapamil used to treat essential altering the action
hypertension and onset of action of 20 potential and blocking Perform a physical
paroxysmal minutes and a muscle cell assessment
GROUP supraventricular duration of action of 2 contraction, which
tachycardia. to 4 hours. depresses myocardial Inspect skin for color and
Calcium Channel contractility integrity
Blockers cross the placenta and
enter breast milk. Assess the patient’s
complaint of pain,
including
and location and
measures
Actions Contraindications Drug to Drug used to relieve the pain.
Interactions
Inhibits the movement Known allergies, renal Verapamil, digoxin, Assess cardiopulmonary
of calcium ions across or hepatic disease, status closely, including
the membranes of heart block or sick pulse
myocardial and arterial sinus rate, blood pressure,
muscle cells, syndrome,pregnant and heart rate, and rhythm
altering the action lactating women.
potential and blocking Obtain an
muscle cell electrocardiogram as
contraction, which ordered
depresses myocardial
contractility Monitor respirations and
auscultate lungs

and
Antianginal Agents o ranolazine Treatment for angina available in an Dizziness, headache, Assess:
and has the added extended-release nausea, and For possible
benefi ts of decreasing tablet form for oral use. constipation contraindications or
blood glucose levels cautions: allergy to any
when used in diabetic rapidly absorbed, Piperazineacetamide
patients and reaching peak levels in
decreasing the 2 to 5 hours Perform a physical
incidence of ventricular assessment
GROUP fi brillation, atrial metabolized in the liver
fi brillation, and Inspect skin for color and
bradycardia in chronic excreted in urine and integrity
Piperazineacetamide angina patients. feces.
complaint of pain,
including
Actions Contraindications Drug to Drug and location and
Interactions measures
The mechanism of Known allergies, renal ketoconazole, used to relieve the pain.
action of the or hepatic disease, diltiazem, verapamil,
drug is not understood. and lactation macrolide Assess cardiopulmonary
antibiotics, and HIV status closely, including
protease inhibitors pulse
rate, blood pressure,
heart rate, and rhythm
Obtain an
electrocardiogram as
ordered
Monitor respirations and

auscultate lungs

and
Lipid-Lowering Agents o cholestyramine Reduction of elevated not absorbed Rash, headache, Assess:
Bile Acid Sequestrants o colesevelam serum cholesterol in systemically anxiety, vertigo, For possible
o colestipol patients with primary dizziness, contraindications or
GROUP hypercholesterolemia; act while in the constipation due to cautions: allergy to any
pruritus intestine and are fecal impaction, BILE ACID
BILE ACID associated with partial excreted directly in the exacerbation of SEQUESTRANTS
SEQUESTRANTS biliary obstruction. feces. hemorrhoids, cramps,
flatulence, nausea, Perform a physical
action is limited to their increased assessment
effects while they bleeding tendencies,
are present in the vitamin A and D Weight the patient
intestine deficiencies,
muscle and joint pain. Inspect the patient’s skin
Actions Contraindications Drug to Drug for color, bruising, and
Interactions rash
Binds with bile acids in Known allergies, renal thiazide diuretics,
the intestine, allowing or hepatic disease, digoxin, Assess neurological
excretion in feces abnormal intestinal warfarin, thyroid status, including level of
instead of reabsorption, function,pregnant and hormones, and orientation and alertness
causing lacatating women corticosteroids.
cholesterol to be Monitor pulse and blood
oxidized in the liver and pressure
serum
cholesterol levels to Inspect the abdomen for
fall. distention and auscultate
bowel sounds
Assess bowel elimination

patterns, including
frequency of stool
passage and stool
characteristics

laboratory tests,
including
serum cholesterol and
lipid levels
Lipid-Lowering Agents o atorvastatin Tre Adjunct to diet in the absorbed from the GI Headache, flatulence, Assess:
o fluvastatin treatment of tract and undergo abdominal pain, For possible
o lovastatin elevated levels of first-pass metabolism cramps, constipation, contraindications or
o pitavastatin cholesterol, triglycerides, in the liver. rhabdomyolysis with cautions: allergy to any
o pravastatin and acute renal HMG-CoA Reductase
o rosuvastatin low-density lipoprotein excreted failure. Inhibitors
o simvastatin (LDL); to increase through feces and
GROUP highdensity urine. Perform a physical
lipoprotein (HDL) cholesterol assessment
HMG-CoA Reductase in patients peak effect of these
Inhibitors with primary drugs is Weigh the patient
hypercholesterolemiaatmen usually seen within 2
t of serious infections caused to 4 weeks. Assess the patient’s
by susceptible bacteria neurological status,
most including level
effective when taken at of orientation, affect,
night when the liver is and reflexes, which
Actions Contraindications processing Drug to Drug show early
the most lipids. Interactions changes related to
Inhibits HMG-CoA, Known allergies, renal or erythromycin, central nervous system
causing a decrease in hepatic disease, liver disease cross the placenta, and cyclosporine, (CNS) function
serum cholesterol or a history of alcoholic liver most gemfibrozil, niacin, or
levels, LDLs, and disease,pregnant and have been found in antifungal drugs, Obtain vital signs,
triglycerides lactating women breast milk. digoxin or warfarin, including pulse and
and an increase in oral contraceptives blood pressure
HDL levels. and grapefruit juice.
Inspect the abdomen
for distention and
auscultate
bowel sounds
characteristics,

laboratory tests,
including
renal and liver function
tests
Lipid-Lowering Agents o ezetimibe Adjunct to diet and well after oral Headache, dizziness, Assess:
exercise to lower serum administration, abdominal pain, For possible
cholesterol levels; in reaching peak levels in diarrhea, upper contraindications or
combination with 4 to 6 hours. respiratory tract cautions: allergy to any
atorvastatin or infection, back pain, Cholesterol Absorption
simvastatin for the metabolized in the myalgia, arthralgia. Inhibitor
treatment of liver and the small
GROUP homozygous familial intestine, with a half- Perform a physical
hypercholesterolemia; life of 22 hours. assessment
Cholesterol Absorption with diet for the
Inhibitor treatment of Excretion is through Monitor orientation and
homozygous feces and urine. reflexes
sitosterolemia to lower
sitosterol and not known Monitor respirations and
campesterol levels. whether the drug auscultate lungs
crosses the placenta or
enters breast milk. Inspect the abdomen for
Actions Contraindications Drug to Drug distention and auscultate
Interactions bowel Sounds
Works in the brush Known allergies, renal cholestyramine, fenofi
border of the small or hepatic disease, brate, gemfi brozil, Assess bowel elimination
intestine pregnant and lactating or antacids, patterns, including
to inhibit the women cholestyramine, fenofi frequency of stool
absorption of brate, gemfi brozil, passage and stool
cholesterol. or antacids,and fibrate characteristics

laboratory tests,
including
lipid levels
Other Lipid-Lowering o fenofi brate Treatment of very high absorbed from the GI headache, back Assess:
Agents o fenofi bric acid triglyceride levels in tract pain, nausea, diarrhea, For possible
o gemfi brozil adults muscle pain, runny contraindications or
who are at risk for metabolized in the liver nose, cautions: allergy to any
pancreatitis if not and excreted in and respiratory Fibrates
responsive to urine. infections.
dietary measures Perform a physical
assessment
GROUP
Fibrates Monitor orientation and
reflexes

auscultate lungs
Interactions Inspect the abdomen for
stimulate the Known allergies, renal Statins, warfarin and distention and auscultate
breakdown of or hepatic anticoagulants bowel Sounds
lipoproteins disease,pregnant and
from the tissues and lactating women Assess bowel elimination
their removal from the patterns, including
plasma. They frequency of stool
lead to a decrease in passage and stool
lipoprotein and characteristics
triglyceride synthesis
and secretion. Monitor the results of
laboratory tests,
including
lipid levels
Other Lipid-Lowering o niacin decrease the levels of absorbed from the GI cutaneous flushing, Assess:
Agents apoproteins needed to tract nausea, and abdominal For possible
form chylomicrons pain contraindications or
metabolized in the liver cautions: allergy to any
and excreted in Vitamin B
urine.
Perform a physical
assessment
GROUP
Vitamin B Monitor orientation and
reflexes

auscultate lungs
Inspect the abdomen for

Actions Contraindications Drug to Drug distention and auscultate
Interactions bowel Sounds
inhibits the release of Known allergies, renal bile acid
free fatty acids from or hepatic Assess bowel elimination
adipose tissue, disease,pregnant and patterns, including
increases the rate of lactating women frequency of stool
triglyceride removal passage and stool
from plasma, characteristics
and generally reduces
LDL and triglyceride Monitor the results of
levels and laboratory tests,
increases HDL levels. including
lipid levels
Drugs Affecting o abciximab Reduction of risk of Available in IV or Oral Acute aspirin toxicity Assess:
Clot Formation o anagrelide recurrent transient with hyperpnea, For possible
and Resolution o aspirin ischemic attacks (TIAs) well absorbed and possibly leading to contraindications or
o cilostazol or strokes in men with highly fever, coma, and cautions: allergy to any
o clopidogrel a history of TIA due to fi bound to plasma cardiovascular Antiplatelet Agents
o dipyridamole brin or platelet emboli; proteins. collapse; nausea,
o eptifi batide dyspepsia, heartburn, Assess baseline status
o ticlopidine metabolized in the epigastric includes body
o ticagrelor liver and excreted in discomfort, temperature; skin color,
GROUP o tirofi ban urine, and they tend to gastrointestinal lesions, and temperature;
enter breast bleeding, occult affect,
Antiplatelet Agents milk blood loss, dizziness, orientation, and refl exes;
tinnitus, diffi culty pulse, blood pressure,
hearing, and perfusion;
anaphylactoid reaction. respirations and
adventitious sounds

Interactions
Inhibits platelet Known allergies, renal another drug that
aggregation by or hepatic affects blood
inhibiting disease,pregnant and clotting.
platelet synthesis of lactating women,
thromboxane A2. history of
thrombocytopenia
Drugs Affecting o argatroban Prevention and treatment of Available in IV or Loss of hair, bruising, Assess:
Clot Formation o bivalirudin venous subcutaneously and chills, fever, For possible
and Resolution o dabigatran thrombosis and pulmonary has an osteoporosis, contraindications or
o desirudin emboli; treatment of almost immediate suppression of renal cautions: allergy to any
o fondaparinux atrial fi brillation with onset of action. function (with Anticoagulants
o heparin embolization long-term use). See
o rivaroxaban excreted in urine. the later section
o warfarin Anticoagulant Assess baseline status
metabolized in the Adjunctive Therapy includes
liver, and for information on body temperature; skin
GROUP excreted in urine and lepirudin color, lesions, and
feces. (Refludan), a drug temperature;
Anticoagulants developed for the affect, orientation, and
treatment of rare reflexes; pulse, blood
allergic reaction to pressure, and perfusion;
heparin. respirations and
adventitious
sounds; clotting studies,
renal and hepatic
Actions Contraindications Drug to Drug function
Interactions tests, complete blood
Inhibits thrombus Known allergies, renal or oral anticoagulants, count, and stool guaiac;
and clot production hepatic disease, salicylates, and
by hemorrhagic disorders, penicillins, or electrocardiogram
blocking the heart failure, cephalosporins,
conversion of thyrotoxicosis, senility, or antifungals,
prothrombin to psychosis,pregnant and erythromycin,
thrombin lactating women ritonavir,
and fi brinogen to fi phenytoin,and
brin. rifampin
Drugs Affecting o alteplase Lysis of pulmonary given IV and are cleared Headache, Assess:
Clot Formation reteplase emboli or from the angioneurotic edema, For possible
and Resolution tenecteplase pulmonary emboli with body after liver hypotension, skin rash, contraindications or
urokinase unstable metabolism. bleeding, breathing cautions: allergy to any
hemodynamics difficulties, Thrombolytic Agents
cross the placenta, bronchospasm, pain,
but it is not known fever, anaphylactic
whether they enter shock. Assess baseline status
breast milk Assess the
following: body
GROUP temperature; skin color,
lesions,
Thrombolytic Agents and temperature; affect,
orientation, and refl exes;
pulse, blood pressure,
and perfusion;
respirations and
adventitious sounds; and
clotting studies, renal and
Actions Contraindications Drug to Drug hepatic function tests,
Interactions CBC, guaiac test for
Converts endogenous Known allergies, renal anticoagulant or occult
plasminogen to or hepatic disease, antiplatelet drug blood in stool, and ECG.
plasmin, which breaks recent surgery, active
down fi brin clots, fi internal
brinogen, bleeding,
and other plasma cerebrovascular
proteins accident
(CVA),pregnant and
lactating women
Drugs Affecting o dalteparin indicated for very Assess:
Clot Formation o enoxaparin specifi c uses in the For possible
and Resolution o tinzaparin prevention of clots and contraindications or
emboli formation after cautions: allergy to any
certain Low-Molecular-Weight
surgeries or prolonged Heparins
bed rest.

Assess the
GROUP following: body
temperature; skin color,
Low-Molecular-Weight lesions,
Heparins and temperature; affect,
and perfusion;
respirations and
inhibit thrombus and Known allergies, renal heparin therapy occult
clot formation by or hepatic blood in stool, and ECG.
blocking factors Xa and disease,pregnant and
IIa. lactating women
Drugs Affecting o lepirudin treat a rare allergic Available in IV Assess:
Clot Formation o protamine reaction to heparin For possible
and Resolution sulfate contraindications or
o vitamin K cautions: allergy to any
Anticoagulant Adjunctive
Therapy

Assess the
GROUP following: body
Anticoagulant temperature; skin color,
Adjunctive lesions,
Therapy and temperature; affect,
and perfusion;
respirations and
inhibits thrombin, Known allergies, renal anticoagulant or occult
blocking the or hepatic antiplatelet drug blood in stool, and ECG.
thromboembolic effects disease,pregnant and
of this reaction. lactating women
Drugs Affecting o pentoxifylline treating taken orally three times headache, dizziness, Assess:
Clot Formation intermittent a day for at least nausea, and upset For possible
and Resolution claudication, a painful 8 weeks to evaluate its stomach. contraindications or
vascular problem effectiveness. cautions: allergy to any
of the legs. Hemorrheologic Agent

Assess the
following: body
GROUP temperature; skin color,
lesions,
Hemorrheologic Agent and temperature; affect,
and perfusion;
respirations and
decreases Known allergies, renal anticoagulant or occult
platelet aggregation or hepatic antiplatelet drug blood in stool, and ECG.
and decreases the fi disease,pregnant
brinogen concentration women
in the blood.
decrease blood
clot formation and
increase blood fl ow
through narrowed
or damaged vessels.
Drugs Used to Control o antihemophilic Treatment of classic replace normal clotting Allergic reaction, Assess:
Bleeding factor hemophilia to provide factors and are stinging at injection For possible
o antiinhibitor temporary replacement processed site, contraindications or
coagulant of clotting factors to as such by the body. headache, rash, chills, cautions: allergy to any
o complex correct or nausea, hepatitis, AIDS Antihemophilic Agents
o coagulation prevent bleeding given intravenously (risks
factor VIIa episodes or to allow and are processed by associated with the use
o factor IX necessary surgery the body in the same of blood products). Assess baseline status
GROUP o factor IX way Assess the
complex that naturally occurring following: body
Antihemophilic Agents o factor XIII clotting factors are temperature; skin color,
concentrate processed in lesions,
the plasma, usually and temperature; affect,
with a half-life of 24 to orientation, and refl exes;
36 hours. pulse, blood pressure,
and perfusion;
respirations and
Actions Contraindications Drug to Drug adventitious sounds; and
Interactions clotting studies, renal and
Normal plasma protein Known allergies, renal none hepatic function tests,
that is needed for the or hepatic CBC, guaiac test for
transformation of disease,pregnant and occult
prothrombin to lactating women blood in stool, and ECG.
thrombin, the fi nal
step in the clotting
pathway.
Drugs Used to Control o aminocaproic Treatment of excessive available in oral and IV Dizziness, tinnitus, Assess:
Bleeding acid bleeding resulting from forms. It is headache, weakness, For possible
hyperfi brinolysis; also rapidly absorbed and hypotension, nausea, contraindications or
used to prevent the widely distributed cramps, diarrhea, cautions: allergy to any
recurrence throughout the fertility problems, Hemostatic Agents
of subarachnoid body. malaise, elevated Systemic
hemorrhage, for serum creatine
management of It is excreted largely phosphokinase.
megakaryocytic unchanged in urine, Assess baseline status
GROUP thrombocytopenia, to with a Assess the
decrease the half-life of 2 hours. following: body
Hemostatic Agents need for platelet temperature; skin color,
Systemic administration, and to lesions,
abort and treat and temperature; affect,
attacks of hereditary orientation, and refl exes;
angioneurotic edema. pulse, blood pressure,
and perfusion;
respirations and
Actions Contraindications Drug to Drug clotting studies, renal and
Interactions hepatic function tests,
Inhibits plasminogen Known allergies, renal oral contraceptives or CBC, guaiac test for
activator substances or hepatic estrogens occult
and disease,pregnant and blood in stool, and ECG.
has antiplasmin activity lactating women
that inhibits fi brinolysis
and
prevents the
breakdown of clots.
Drugs Used to Control o absorbable Treatment of excessive available Dizziness, tinnitus, Assess:
Bleeding gelatin bleeding resulting from in sponge form, spray headache, weakness, For possible
o human fi brin hyperfi brinolysis; also form,oral and IV. hypotension, nausea, contraindications or
sealant used to prevent the cramps, diarrhea, cautions: allergy to any
o microfi brillar recurrence fertility problems, Hemostatic Agents
collagen of subarachnoid malaise, elevated Topical
o thrombin hemorrhage, for serum creatine
o thrombin, management of phosphokinase.
recombinant megakaryocytic Assess baseline status
GROUP thrombocytopenia, to Assess the
decrease the following: body
Hemostatic Agents need for platelet temperature; skin color,
administration, and to lesions,
Topical abort and treat and temperature; affect,
attacks of hereditary orientation, and refl exes;
angioneurotic edema. pulse, blood pressure,
and perfusion;
respirations and
Inhibits plasminogen Known allergies, renal none occult
activator substances or hepatic blood in stool, and ECG.
and disease,pregnant and
has antiplasmin activity lactating women
that inhibits fi brinolysis
and
prevents the
breakdown of clots.
Drugs used to treat o darbepoetin Treatment of anemia given IV or by Headache, arthralgias, Assess:
anemia alfa associated with chronic subcutaneous fatigue, asthenia, For possible
o epoetin alfa renal failure, related to injection. dizziness, hypertension, contraindications or
o peginesatide treatment of HIV edema, chest pain, cautions: allergy to any
(Omontys) infection or cleared in the nausea, Erythropoiesis-
to chemotherapy in serum and excreted in vomiting, diarrhea. Stimulating Agents
cancer patients; to the urine.
GROUP reduce the need Perform a physical
for allogenic blood not known whether assessment
Erythropoiesis- transfusions in surgical epoetin alfa or Assess neurological
Stimulating Agents patients peginesatide enters status, including affect,
breast milk. orientation,
and muscle strength
Monitor vital signs,

including pulse and blood
pressure,
for changes, and assess
Actions Contraindications Drug to Drug cardiovascular status
Interactions
Natural glycoprotein Known allergies, renal never be mixed in Assess respirations and
that stimulates red or hepatic solution with auscultate lungs sounds
blood disease,pregnant and any other drugs for
cell production in the lactating women because of a risk of adventitious breath
bone marrow. interactions in the sounds
solution.
laboratory tests,
including
renal function tests,
complete blood count,
hematocrit,
iron concentration,
transferrin, and
electrolyte
levels
Drugs used to treat o ferrous Prevention and available for oral or IV Gastrointestinal upset, Assess:
anemia fumarate treatment of iron defi administration. anorexia, nausea, For possible
o ferrous ciency vomiting, constipation, contraindications or
GROUP gluconate anemia; dietary oral drug that is diarrhea, central cautions: allergy to any
Agents Used for Iron o ferrous sulfate supplement for iron. taken is lost in the nervous Agents Used for Iron
Deficiency Anemia o ferrous sulfate feces, but slowly some system toxicity Deficiency Anemia
o exsiccated of the metal is progressing to coma
o ferumoxytol absorbed into the and death with Perform a physical
o iron dextran intestine and overdose. assessment
Actions o iron sucrose Contraindications transported to the bone Drug to Drug Inspect the color and
o sodium ferric marrow. Interactions integrity of the skin and
Elevates the serum iron gluconate Known allergies, antacids, tetracyclines, mucousMembranes
concentration and is o complex hemochromatosis take 2 to 3 weeks to see or cimetidine, ciprofl
then converted into improvement and oxacin, norfl oxacin, or Assess patient’s
hemoglobin or stored up to 6 to 10 months ofloxacin, neurological status,
for eventual for a return to a stable chloramphenicol and including level of
conversion to a usable iron level levodopa orientation, affect, and
form of iron. once a defi ciency reflexes
exists.
Monitor pulse, blood
pressure, and perfusion,
and respirations and
adventitious sounds
Inspect abdomen for
distention and auscultate
bowel Sounds
Inspect the skin integrity

of the intended
parenteral
administration site.
laboratory tests,
including
complete blood count,
hematocrit, hemoglobin,
and
serum ferritin assays
Agents Used for Other o folic acid Treatment of given in oral, IM, IV, Allergic reactions, pain Assess:
Anemias o leucovorin megaloblastic anemia and subcutaneous and discomfort at For possible
o levoleucovorin due to forms. injection site. contraindications or
sprue, nutritional defi cautions: allergy to any
ciency. The parenteral drugs Folic Acid Derivatives
are preferred for
patients with potential
absorption problems;
GROUP all other Assess baseline status
patients should be This includes
Agents for given the oral form if at affect, orientation, and
Megaloblastic all possible. reflexes; pulse, blood
Anemias pressure,
Folic Acid Derivatives well absorbed after and perfusion;
injection, metabolized respirations and
mainly in the liver, and adventitious sounds;
excreted and complete blood
in urine. count, hematocrit, and
iron levels

Interactions
Reduced form of folic Known allergies, nasal
acid, required for erosion or
nucleoprotein synthesis ulcers,pregnant and
and maintenance of lactating women
normal
erythropoiesis.
Agents Used for Other o cyanocobalamin Treatment of vitamin primarily Itching, transitory
Anemias o hydroxocobalami B12 defi ciency; to stored in the liver and exanthema, mild Assess:
n meet slowly released as diarrhea, anaphylactic For possible
GROUP increased vitamin B12 needed for reaction, heart failure, contraindications or
requirements related metabolic functions. pulmonary edema, cautions: allergy to any
Agents for to disease, hypokalemia, pain at Vitamin B12
Megaloblastic pregnancy, or blood absorption directly injection site.
Anemias loss. through the
Vitamin B12 nasal mucosa
Actions Contraindications Drug to Drug Assess baseline status
Interactions
Essential for nucleic Known allergies, metabolized in the liver This includes
acid and protein pregnant and lactating and affect, orientation, and
synthesis; women. excreted in urine. reflexes; pulse, blood
used for growth, cell pressure,
reproduction, and perfusion;
hematopoiesis, and respirations and
nucleoprotein and adventitious sounds;
myelin synthesis. and complete blood
count, hematocrit, and
iron levels
Agents Used for Other o hydroxyurea Reduction of frequency Given orally Dizziness, headache, Assess:
Anemias of painful crisis and rash, erythema, For possible
need for blood absorbed well from the anorexia, nausea, contraindications or
transfusions in adult GI tract, reaching peak vomiting, stomatitis, cautions: allergy to any a
patients with levels in 1 to 4 hours. bone marrow Agent for Sickle Cell
sickle cell anemia. depression, cancer. Anemia
metabolized
in the liver and Perform a physical
excreted in the urine assessment
GROUP with a half-life of 3 to 4
hours. Assess orientation and
Agent for Sickle Cell reflexes to evaluate any
Anemia cross the placenta and central
to enter breast milk. nervous system (CNS)
effects; respiratory rate
and
adventitious sounds

Actions Contraindications Drug to Drug laboratory tests such as
Interactions complete
InhiIncreases fetal Known allergies, renal uricosuric agents blood count with
hemoglobin production or hepatic differential to identify
in the disease,pregnant and possible
bone marrow and lactating women bone marrow
dilutes the formation of suppression and toxic
abnormal drug effects, as
hemoglobin S.bits well as renal and liver
protein synthesis in function tests
susceptible strains of
gram-negative bacteria
causing cell death

Drug Study Number II

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Classification Common Generic and Indication Pharmacokinetics & Adverse Reactions Nursing Considerations

Brand Names Pharmacodynamics

are hormones or similar Conduct orientation and

Actions Contraindications Drug route IM,Subq Drug to Drug

Actions Contraindications Drug to Drug

Actions Contraindications Drug to Drug

Actions Contraindications Drug to Drug

Inhibits the synthesis of

cross the placenta and

Inhibit the synthesis of

Actions Contraindications Drug to Drug

Actions Contraindications Drug to Drug

Monitor blood glucose

Monitor blood glucose

excreted in the Perform a complete

Monitor blood glucose

Actions Contraindications Drug to Drug Monitor the results of

Actions Contraindications Drug to Drug

Assess the patient’s

Examine the abdomen

Assess voiding patterns

Assess cardiac status

Monitor the results of

Inspect abdomen for

Evaluate skin for color,

Inspect abdomen for

Evaluate skin for color,

Inspect abdomen for

Evaluate skin for color,

Inspect abdomen for

Evaluate skin for color,

Actions Contraindications Drug to Drug Assess cardiac status

Evaluate skin for color,

Evaluate skin for color,

Assess cardiac status

Monitor laboratory test

Monitor respirations and

Monitor laboratory test

Assess bowel elimination

Monitor the results of

Monitor the results of

Monitor the results of

Monitor respirations and

Monitor respirations and

Inspect the abdomen for

Actions Contraindications Drug to Drug

Assess baseline status

Assess baseline status

Assess baseline status

Monitor vital signs,

Inspect the skin integrity

Actions Contraindications Drug to Drug

Monitor the results of

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