Categorize the treatment options for patients with existing medical condition

Therapeutic class
Diuretics Spironolactone is commonly known as a potassium-
Spironolactone sparing diuretic, which means in exchange for
relieving the body of sodium and water, it makes the
body retain potassium.
Laxatives Lactulose is also used to reduce the amount of ammonia
Lactulose in the blood of patients with liver disease. It works by
drawing ammonia from the blood into the colon
where it is removed from the body.
Beta-blockers Carvedilol is known as a “non-selective beta blocker”
Carvedilol meaning it blocks all beta receptors throughout the
body. This effect lowers your heart rate, blood
pressure, and strain on your heart.
nucleoside reverse transcriptase Lamivudine rapidly reduces hepatitis B virus (HBV)-DNA
inhibitors (NRTIs) in serum to undetectable levels.
Lamivudine
Complications of cirrhosis, their prevention and treatment
COMPLICATION PREVENTION TREATMENT

Ascites Low Na diet Low Na diet

Diuretics
Large volume paracentesis
TIPSS
(LeVeen / Denver shunts)
Spontaneous bacterial Treat ascites Early diagnosic paracentesis:
 Neutrophils >250/cc →
peritonitis
 antibiotics iv
 Secondary prophlaxis with
a po antibiotic such as
Levofloxacin

REFERENCES:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2271178/
https://www.mims.com/philippines/drug/info/silymarin?mtype=generic
https://www.webmd.com/drugs/2/drug-5574/carvedilol-oral/details#:~:text=This%20drug%20works
%20by%20blocking,as%20alpha%20and%20beta%20blockers.&text=This%20drug%20works%20by
%20blocking,as%20alpha%20and%20beta%20blockers.
https://www.goodrx.com/blog/seven-uses-for-spironolactone-skin-hair-and-
heart/#:~:text=Spironolactone%20is%20commonly%20known%20as,a%20weak%20heart%20can
%20cause.
https://medlineplus.gov/druginfo/meds/a682338.html#:~:text=Lactulose%20is%20also%20used
%20to,or%20pharmacist%20for%20more%20information.&text=Lactulose%20is%20also%20used
%20to,or%20pharmacist%20for%20more%20information.
https://shop.healthyoptions.com.ph/products/healthy-options-liver-detox-complex-120-capsules
 DRUG MECHANISM OF INDICATION CONTRAINDICATION COMMON SIDE NURSING CONSIDERATIONS
ACTION EFFECTS
GENERIC NAME: Adrenergic receptor Management of Patients with class IV CNS: dizziness, fatigue, Monitor for therapeutic
Carvedilol blocking agent that essential decompensated cardiac weakness, anxiety, effectiveness which is indicated
combines selective hypertension failure, bronchial depression, drowsiness, by lessening of S&S of CHF and
BRAND NAME: alpha activity and asthma, or related insomnia, memory loss, improved BP control.
Not indicated in the nonselective beta- DRUG RATIONALE: bronchospastic mental status changes,
case scenario adrenergic blocking Decreased heart rate, conditions (e.g., chronic nervousness, Monitor pulse oximetry and
actions. Both activities blood pressure and bronchitis and nightmares. perform pulmonary function
CLASSIFICATION: contribute to blood improved cardiac emphysema), second- EENT: blurred vision, tests
Ther. Class. pressure reduction. output and third-degree AV dry eyes, nasal
antihypertensives Peripheral block, cardiogenic stuffiness. Resp: Monitor excessive fatigue or
vasodilatation and, shock or severe bronchospasm, weakness
Pharm. Class. therefore, decreased bradycardia; pregnancy wheezing.
beta blockers peripheral resistance (category C), lactation. CV: BRADYCARDIA, Assess vital signs, especially
results from alpha1- CHF, PULMONARY pulse and blood pressure to
DOSAGE: blocking activity of EDEMA. monitor for possible excess
Not indicated in the Coreg. It is 3–5 times GI: diarrhea, stimulation of the cardiac system
case scenario more potent than constipation, nausea.
labetalol in lowering GU: erectile Note respiratory rate and
FREQUENCY: blood pressure. dysfunction, decreased auscultate lungs for adventitious
Not indicated in the libido. sounds to evaluate effects on
case scenario Derm: itching, rashes. bronchi and respirations
Endo: hyperglycemia,
ROUTE: ORAL hypoglycemia. PATIENT TEACHING
Not indicated in the ONSET: within 1 hr MS: arthralgia, back Take drug with meals.
case scenario PEAK: 1–2 hr pain, muscle cramps.
DURATION: 12 hr Neuro: paresthesia. Do not stop taking drug unless
Misc: drug-induced instructed to do so by a health
lupus syndrome. care provider.

Do not engage in hazardous

activities while experiencing
dizziness.
You may experience these side
effects: Depression, dizziness,
light-headedness (avoid driving
or performing dangerous
activities; getting up and
changing positions slowly may
help ease dizziness).

Report difficulty breathing,

swelling of extremities, changes
in color of stool or urine, very
slow heart rate, continued
dizziness.