ILOILO DOCTORS’ COLLEGE

COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

DRUG STUDY

Drug Name Classification and Indications and Side Effects and Adverse Special Precautions Nursing Responsibilities
Mechanism of Action Contraindications Effects

Generic Name: Classifications Indications: Frequent (greater than ● Hepatic impairment, ● Assess baseline
Amlodipine ● Hypertension 5%): ● Severe aortic renal/hepatic function
PHARMACOTHERAPEU ● Angina & Coronary ● Peripheral edema, stenosis, tests, B/P, apical
TIC: Artery Disease ● Headache, ● Hypertrophic pulse.
Calcium channel blocker. ● Flushing. cardiomyopathy with ● Assess B/P (if systolic
CLINICAL: outflow tract B/P is less than 90
Trade/ Brand Name: Antihypertensive, Occasional (5%–1%): obstruction mm Hg, withhold
Norvasc antianginal. ● Dizziness, medication, contact
● Palpitations, physician).
● Nausea, ● Assess for peripheral
● Unusual fatigue or edema behind medial
Dosage: weakness malleolus (sacral area
5mg/tab (asthenia). in bedridden pts).
● Assess skin for
Rare (less than 1%): flushing. Question for
Contraindications ● Chest pain, headache, asthenia.
Route: ● Hypersensitivity to ● Bradycardia,
Oral Actions: amlodipine. ● Orthostatic Patient/family teaching
Inhibits calcium movement hypotension. ● Do not abruptly
across cardiac and vascular discontinue
smooth muscle cell Adverse effects/toxic medication.
Frequency and Timing membranes. reactions: ● Compliance with
PRN Q4H ● Overdose may therapy regimen is
Therapeutic Effect: produce excessive essential to control
Dilates coronary arteries, peripheral hypertension.
peripheral vasodilation, ● Avoid tasks that
arteries/arterioles. marked require alertness,
Decreases total peripheral hypotension with motor skills until
 vascular resistance and B/P
by vasodilation.
Drug Name Classification and
Mechanism of Action
Generic Name: Classifications
Clonidine
PHARMACOTHERAPEU
TIC:
Alpha2 -adrenergic
agonist. CLINICAL:
Trade/ Brand Name: Antihypertensive.
Catapres
Dosage:
75mg/tab
Route: Actions:
Sublingual Stimulates alpha2
-adrenergic receptors,
reducing sympathetic CNS
response.
Frequency and Timing
Therapeutic Effect:
Reduces peripheral
resistance; decreases B/P,
heart rate. Produces
analgesia.
reflex tachycardia, response to drug is
syncopy. established.
● Do not ingest
grapefruit products.
Indications and Side Effects and Adverse Special Precautions Nursing Responsibilities
Contraindications Effects
Indications: Frequent (40%–10%): ● Depression, ● Obtain B/P
● Hypertension ● Dry mouth, ● Elderly. immediately before
● Acute ● Drowsiness, ● Severe coronary each dose is
Hypertension ● Dizziness, insufficiency, administered, in
● Attention-Deficit ● Sedation, ● Recent MI, addition to regular
Hyperactivity ● Constipation. ● Cerebrovascular monitoring (be alert to
Disorder (ADHD) disease, B/P fluctuations).
● Severe Pain Occasional (5%–1%): ● Chronic renal ● Monitor B/P, pulse,
Tablets, Injection: impairment, mental status.
● Preexisting ● Monitor daily pattern
● Depression, bradycardia, of bowel activity,
● Pedal edema, ● Sinus node stool consistency.
● Loss of appetite, dysfunction, ● If clonidine is to be
● Decreased sexual ● Conduction withdrawn,
function, disturbances; discontinue
● Itching eyes, concurrent use with concurrent beta
● Dizziness, digoxin, diltiazem, blocker therapy
● Nausea, metoprolol, several days before
● Vomiting, verapamil. discontinuing
Contraindications ● Nervousness. clonidine (prevents
● Hypersensitivity to clonidine withdrawal
clonidine. Rare (less than 1%): hypertensive crisis).
● Nightmares, ● Slowly reduce
● Vivid dreams, clonidine dosage over
● Feeling of 2–4 days.
coldness in distal
extremities (esp. Patient/family teaching
the digits). ● Sugarless gum, sips of
water may relieve dry
mouth.
 Adverse effects/toxic ● Avoid tasks that
reactions: require alertness,
● Overdose motor skills until
produces profound response to drug is
hypotension, established.
● Irritability, ● To reduce hypotensive
● Bradycardia, effects, rise slowly
● Respiratory from lying to
depression, standing.
● Hypothermia, ● Skipping doses or
● Miosis (pupillary voluntarily
constriction), discontinuing drugs
● Arrhythmias, may produce severe
● Apnea. rebound hypertension.
● Abrupt withdrawal ● Avoid alcohol.
may result in ● If patch loosens
rebound during the 7-day
hypertension application period,
associated with secure with adhesive
nervousness, cover.
agitation, anxiety,
insomnia,
paresthesia,
tremor, flushing,
diaphoresis.
● May produce
sedation in pts
with acute CVA.

Drug Name Classification and Indications and Side Effects and Adverse Special Precautions Nursing Responsibilities
Mechanism of Action Contraindications Effects

Generic Name: Classifications Indications: Rare: ● Sensitivity to ● If given for analgesia,

Paracetamol/ ● Analgesia ● Hypersensitivity acetaminophen; assess onset, type,
Acetaminophen PHARMACOTHERAPE ● Antipyresis reaction. severe renal location, duration of
UTIC: impairment; alcohol pain.
Central analgesic. Adverse effects/toxic dependency, hepatic ● Effect of medication is
reactions impairment, or active reduced if full pain
 Early Signs of hepatic disease; response recurs prior
Trade/ Brand Name: CLINICAL: Acetaminophen Toxicity: chronic malnutrition to the next dose.
Tylenol Non-narcotic analgesic, ● Anorexia, and hypovolemia ● Assess for fever.
antipyretic. ● Nausea, (Ofirmev); G6PD ● Assess LFT in pts
● Diaphoresis, deficiency with chronic usage or
● Fatigue within the (hemolysis may history of hepatic
Dosage: first 12–24 hrs. occur). impairment, alcohol
500mg/tab ● Limit dose to less abuse.
Contraindications Later Signs of Toxicity: than 4 g/day. ● Assess for clinical
● Hypersensitivity to ● Vomiting, improvement and
acetaminophen. ● Right upper relief of pain, fever.
Route: (Ofirmev): severe quadrant
Oral hepatic impairment tenderness, Patient/family teaching
or severe active ● Elevated LFTs ● Consult a physician
liver disease. within 48–72 hrs for use longer than 10
Actions: after ingestion. days (adults), or fever
Frequency and Timing Appears to inhibit Antidote: lasting longer than 3
PRN Q4H prostaglandin synthesis in Acetylcysteine days.
the CNS and, to a lesser ● Severe/recurrent pain
extent, block pain or high/continuous
impulses through fever may indicate
peripheral action. Acts serious illness.
centrally on ● Do not take more than
hypothalamic heat 4 g/day (3 g/day if
regulating center, using OTC
producing peripheral [over-the-counter]).
vasodilation (heat Actual OTC dosing
loss, skin erythema, recommendations may
diaphoresis). vary by product
and/or manufacturer.
Therapeutic Effect: Many nonprescription
Results in antipyresis. combination products
Produces analgesic effect. contain
acetaminophen. Avoid
alcohol.
 Drug Name Classification and Indications and Side Effects and Adverse Special Precautions Nursing Responsibilities
Mechanism of Action Contraindications Effects

Generic Name: Classifications Indications: Expected: ● Hepatic cirrhosis, ● Check vital signs, esp.
Furosemide ● Edema, ● Increased urinary ● Hepatic coma, B/P, pulse, for
PHARMACOTHERAPEU ● HF frequency/volume. ● Severe electrolyte hypotension before
TIC: ● Hypertension depletion, administration.
Loop diuretic. Frequent: ● Prediabetes, ● Assess baseline renal
CLINICAL: ● Nausea, ● Diabetes, function, serum
Trade/ Brand Name: Diuretic. ● dyspepsia, ● Systemic lupus electrolytes, esp.
Lasix ● abdominal cramps, erythematosus. serum sodium,
● diarrhea or ● Pts with prostatic potassium.
constipation, hyperplasia/urinary ● Assess skin turgor,
● electrolyte stricture. mucous membranes
Dosage: disturbances. for hydration status;
20mg observe for edema.
Occasional: ● Assess muscle
● Dizziness, strength, mental
● Light-headedness, status.
Route: Actions: Contraindications ● Headache, ● Note skin
IVTT Enhances excretion of ● Hypersensitivity to ● Blurred vision, temperature, moisture.
sodium, chloride, furosemide. ● Paresthesia, ● Obtain baseline
potassium by direct action ● Anuria. ● Photosensitivity, weight.
at ascending limb of loop ● Rash, ● Initiate I&O
Frequency and Timing of Henle. ● Fatigue, monitoring.
Q8H as ordered ● Bladder spasm, ● Auscultate lung
Therapeutic Effect: ● Restlessness, sounds.
Produces diuresis, lowers ● Diaphoresis. ● In pts with hepatic
B/P cirrhosis and ascites,
Rare: consider giving initial
● Flank pain. doses in a hospital
setting.
Adverse effects/toxic ● Monitor B/P, vital
reactions: signs, serum
● Vigorous diuresis electrolytes, I&O,
may lead to weight.
profound water ● Note extent of
loss/electrolyte diuresis.
 depletion, ● Watch for symptoms
resulting in of electrolyte
hypokalemia, imbalance:
hyponatremia, Hypokalemia may
dehydration. result in changes in
● Sudden volume muscle strength,
depletion may tremor, muscle
result in increased cramps, altered mental
risk of thrombosis, status, cardiac
circulatory arrhythmias;
collapse, and hyponatremia may
sudden death. result in confusion,
● Acute hypotensive thirst, cold/clammy
episodes may skin.
occur, sometimes ● Consider potassium
several days after supplementation if
beginning therapy. hypokalemia occurs.
● Ototoxicity
(deafness, vertigo, Patient/family teaching: •
tinnitus) may ● Expect increased
occur, esp. in pts frequency, volume of
with severe renal urination. •
impairment. ● Report palpitations,
● Can exacerbate signs of electrolyte
diabetes mellitus, imbalances (noted
systemic lupus previously), hearing
erythematosus, abnormalities (sense
gout, pancreatitis. of fullness in ears,
● Blood dyscrasias tinnitus). •
have been ● Eat foods high in
reported. potassium such as
whole grains (cereals),
legumes, meat,
bananas, apricots,
orange juice, potatoes
(white, sweet), raisins.
● Avoid sunlight,
sunlamps.