Drug Mechanism of Action Indications & Side Effects
Contraindications
Generic Name: Inhibits reabsorption of Indications:
Furosemide sodium and chloride Treatment of edema
  from the proximal and associated with CHF,
Brand Name:Lasix distal tubules and cirrhosis of liver, and
  ascending limb of the kidney disease, including
Stock Dose: loop of Henle, leading to nephrotic syndrome. May
40 mg/1 tab pc lunch a sodium-rich dieresis. be used for management
  of hypertension, alone or
Classifications: in combination with
Loop Diuretic other antihypertensive
agents, and for treatment
of hyperkalemia.
Contraindications:
History of
hypersensitivity to
furosemide or
sulfonamides; increasing
oliguria, anuria, fluid and
electrolyte depletion
states; hepatic coma;
pregnancy (category C),
lactation.
Drug
Nursing Considerations
Common side effects of Assessment:
furosemide include low - Observe patients
blood pressure, receiving parenteral drug
dehydration and carefully; closely monitor
electrolyte depletion (for BP and vital signs.
example, sodium, - Observe older adults
potassium). Less closely during period of
common side effects brisk diuresis. Sudden
include jaundice, ringing alteration in fluid and
in the ears (tinnitus), electrolyte balance may
sensitivity to light precipitate significant
(photophobia), rash, adverse reactions. Report
pancreatitis, nausea, symptoms to physician.
diarrhea, abdominal
pain, and dizziness. - Monitor for S&S of
Increased blood sugar hypokalemia.
and uric acid levels also
may occur. - Monitor I&O ratio and
pattern. Report decrease or
unusual increase in output.
 Mechanism of Action

Indications & Contraindications

Side Effects

Nursing Considerations

Generic Name: Warfarin

Brand Name:Coumadin

  

Stock Dose:

2.5 mg/1 tab OD

Classifications:

Oral Anticoagulant
Warfarin interferes with hepatic synthesis of vitamin K-dependent clotting factors, resulting in depletion of coagulation factors II, VII,
IX, and X. Prevents further extension of formed existing clot, prevention of new clot formation, and secondary thromboembolic
complications.

Indications:

- Warfarin is used to treat blood clots (such as in deep vein thrombosis-DVT or pulmonary embolus-PE) and/or to prevent new clots
from forming in your body. Preventing harmful blood clots helps to reduce the risk of a stroke or heart attack.

- Warfarin can be used as a prophylaxis for recurrent cerebral embolism, myocardial infarction, and treatment adjunct in transient
ischemic attacks.

Contraindications:

- Warfarin is contraindicated in pregnancy, as it passes through the placental barrier and may cause bleeding in the fetus.
- Peptic ulcer.
- Severe hypertension.
- Bacterial endocarditis.

- GI distress: nausea, anorexia, abdominal cramps, and diarrhea.

- Hypersensitivity reaction: dermatitis and urticaria. (Especially in patients sensitive to aspirin.)

- Hepatotoxicity

- Blood dyscrasias

- Necrosis

- Vasculitis

- Local thrombosis

- Baseline blood tests should be taken before treatment starts, but treatment should not be delayed by waiting for the results.
- Warfarin's effect can be altered by sudden increases or decreases in body weight.
Health Teaching:
- Patients need to be careful to avoid making sudden major changes to their diet, particularly consumption of green tea, salad and
green vegetables.
- Cranberry juice should be avoided, as should large amounts of alcohol, as these may increase warfarin's potency.
- It is essential patients contact their doctor if they experience any bruising, bleeding, dark stools, blood in the urine, vomiting,
diarrhea, fever or acute illness.

Drug

Mechanism of Action

Indications & Contraindications

Side Effects

Nursing Considerations

Generic Name: Spironolactone

Brand Name:Aldactone
  

Stock Dose:

25 mg/1 tab OD

Classifications:

Potassium-Sparing Diuretic

Spironolactone inhibits the action of aldosterone thereby causing the kidneys to excrete salt and fluid in the urine while retaining
potassium.

Indications:

Aldactone (spironolactone) is indicated in the management of:

- Edematous conditions for patients withcongestive heart failure for the management of edema and sodium retention when the patient
is only partially responsive to, or is intolerant of, other therapeutic measures.

Contraindications:

Aldactone is contraindicated for patients with anuria, acute renal insufficiency, significant impairment of renal excretory function, or
hyperkalemia.
Side effects of spironolactone include headache, diarrhea, cramps, drowsiness, rash, nausea, vomiting, impotence, irregular menstrual
periods, and irregular hair growth. Fluid and electrolytes imbalance (for example, low sodium, low magnesium, and high potassium)
may occur, so patients should be monitored carefully. Enlargement of the breasts (gynecomastia) may also occur and is related to dose
and duration of therapy.

Assessment & Drug Effects

- Check blood pressure before initiation of therapy and at regular intervals throughout therapy.
- Lab tests: Monitor serum electrolytes (sodium and potassium) especially during early therapy; monitor digoxin level when used
concurrently.
- Assess for signs of fluid and electrolyte imbalance, and signs of digoxin toxicity.
- Monitor daily I&O and check for edema. Report lack of diuretic response or development of edema; both may indicate tolerance to
drug.
-Observe for& report immediately the onset of mental changes, lethargy, or stupor in patients with liverdisease.
- Adverse reactions are generally reversible with discontinuation of drug.

Health Teaching:
- Be aware that the maximal diuretic effect may not occur until third day of therapy and that diuresis may continue for 2–3 d after drug
is withdrawn.
-Avoid replacing fluid losses with large amounts of free water (can result in dilutionalhyponatremia).
- Do not drive or engage in potentially hazardous activities until response to the drug is known.

- Avoid excessive intake of high-potassium foods and salt substitutes.

 Drug

Mechanism of Action

Indications & Contraindications

Side Effects

Nursing Considerations

Generic Name: Empirin

Brand Name:Aspirin
 

Stock Dose:

80 mg/1 tab OD

Classifications:

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)&Antipyretic

Inhibition of platelet aggregation is attributable to the inhibition of platelet synthesis of thromboxane A2, potent vasoconstrictor and
inducer of platelet aggregation. This effect occurs at low doses and lasts for life of the platelet (8 days).Higher doses inhibit the
synthesis of prostacyclin, a potent vasodilator and inhibitor of platelet aggregation.

Indications:

- Mild to moderate pain

- Pyrexia

- Secondary cerebrovascular or cardiovascular disease prevention

Contraindications:

- Age under 16 years.

- Breastfeeding.
- Previous peptic ulceration.
- Hemophilia.
- Hypersensitivity, including asthma, angioedema urticaria or rhinitis linked to aspirin or non-steroidal anti-inflammatory drugs
(NSAIDs).

Side-effects are few and are mainly mild except for:

- A high incidence of gastro-intestinal irritation with slight asymptomatic blood loss;
- Bronchospasm;
- Increased bleeding time;
- Possible skin reactions in hypersensitive patients.

- When given as an antipyretic, assess body temperature before and 1 hour after giving medication.
- Assess other medication for possible interactions - especially warfarin which is a special hazard.
HealthTeaching:
- Possible gastric irritation is limited by taking aspirin after food.
- Take any missed doses as soon as you remember. But do not take a double dose to make up for a missed one.
- Always read the label of any over-the-counter medications to check for aspirin content.
- Restrict alcohol intake.
- Report any tinnitus, sweating or hyperventilation to the prescribing health care professional.

Drug

Mechanism of Action

Indications & Contraindications

Side Effects

Nursing Considerations
Generic Name:

Isosorbide Dinitrate

Brand Name:Imdur

Stock Dose:

30 mg/1 tab OD

Classifications:

Vasodilator

Relaxes vascular smooth muscle with a resultant decrease in venous return and decrease in arterial BP, which reduces left ventricular
workload and decrease myocardial oxygen consumption.

Indications:

-Treatment and prevention of angina pectoris.

Contraindications:

-Contraindicated with allergy to nitrates, severe anemia, head trauma, cerebral hemorrhage, hypertrophic cardiomyopathy, narrow-
angle, glaucoma, orthostatic hypertension.
- Use cautiously with pregnancy, lactation, acute MI, heart failure.

CNS: Headache, apprehension, restlessness, weakness, vertigo, dizziness, faintness.

CV: Tachycardia, retrosternal discomfort, hypotension, syncope, collapse, orthostatic hypotension, rebound hypotension, arterial
fibrillation.
Dermatologic: Rash, exfoliative dermatitis, cutaneous vasodilatations with flushing.
GI: Nausea, Vomiting, Incontinence of feces, abdominal pain, diarrhea, ulcer.
Patient Teaching:
-Place sublingual tablets under your tongue or in your cheek; do not chew, swallow, or crush the tablet. Take medication before chest
pain begins, when activities or situation may precipitate an attack. Take it on an empty stomach, 1 hour before or 2 hours after meals.

-Report blurred vision, persistent or severe headache, rash, more frequent or more severe angina attacks, fainting.
 Drug

Mechanism of Action
 Indications & Contraindications

Side Effects

Nursing Considerations

Generic Name: Omeprazole

Brand Name:Losec

Stock Dose:

20 mg/1 cap OD

Classifications:

Proton Pump Inhibitor

Inhibits activity of acid (proton) pump and binds to hydrogen- potassium adenosine triphosphatase at secretory surface of gastric
parietal cells to block formation of gastric acid.
Indications:

- frequent heartburn ( 2 or more days a week)

Contraindications:

-contraindicated in patients hypersensitive to drug or its components

- zegerid is contraindicated in patients with metabolic alkalosis and hypokalemia.

-long term administration of bicarbonate with calcium or milk can cause milk alkali syndrome.
CNS: asthenia, dizziness, headache,

GI: abdominal pain, constipation, diarrhea, flatulence, nausea, vomiting.

Musculoskeletal:

Back pain

Respiratory:

Cough upper respiratory tract infection.

-Gastrin level rises in most pt. during the first 2 weeks of therapy.

- Dosage adjustment may be necessary in patients with hepatic impairment.

-Advice patient that prilosec OTC isn’t intendedto treat infrequent heartburn (one episode of heartburn a week or less), or for those
who want immediate relief of heartburn.
 Drug

Mechanism of Action

Indications & Contraindications

Side Effects

Nursing Considerations

Generic Name: Simvastatin

 

Brand Name:Lapex, Zocor

Stock Dose:

20 mg/ 1 tab/ OD @ HS

Classifications:

HMG-CoA Reductase Inhibitor

Inhibits HMG- COA reductase, an early (and rate limiting) step in cholesterol biosynthesis.

Indications:

-To reduce risk of death from CV disease and CV events in patients at high- risk for coronary events.

Contraindications:

-Contraindicated in patients hypersensitive to drug and in those with active liver disease or conditions that cause unexplained
persistent elevations

- Use cautiously in patients who consume large amounts of alcohol or have a history of liver disease.
CNS: asthenia, headache

GI: abdominal pain, constipation, diarrhea, flatulence, nausea, vomiting.

Musculoskeletal:

Myalgia

Respiratory:

Upper respiratory tract infection.

- Use drug only after diet and other non-drug therapies prove ineffective. Patient should follow a standard low- cholesterol diet during
therapy.

- 40 mg daily significantly reduces risk of death from coronary heart disease, non-fatal MIs, stroke, and revascularization.

Drug

Mechanism of Action

Indications & Contraindications

 Side Effects

Nursing Considerations

Generic Name: Metropolol

Brand Name:Toprol

Stock Dose:

50 mg / 1 tab /BID

Classifications:

Beta Blockers

Unknown. A selective beta blocker that selectively blocks beta, receptors: decreases cardiac output, peripheral resistance, and cardiac
oxygen consumption: and depresses rennin secretion.
Indications:

- Hypertension

- Early intervention in acute MI

- Angina pectoris

-Stable symptomatic heart failure resulting from ischemia, hypertension or cardiomyopathy.

Contraindications:

- Contraindicated in patients hypersensitive to drug or other beta blockers.

- Use cautiously in patients with heart failure, diabetes, or respiratory or hepatic disease.

CNS: Fatigue, dizziness, depression

CV: Hypotension, bradycardia, heart failure, AV block, edema.

GI: Nausea, diarrhea.

Respiratory: Dyspnea

Skin: Rash.

-Always check patients apical pulse rate before giving drug. If it’s slower than 60 beats/ minute, withhold drug and call prescriber
immediately.

- Monitor blood pressure frequently, drug masks common signs and symptoms of shock.
- When stopping therapy, taper dose over 1 to 2 weeks

Drug Mechanism of Action Indications & Side Effects Nursing Considerations

Contraindications
Generic Name: Inhibits the binding of Indications: CNS: Depression, -Platelet aggregation
Clopidogrel Bisulfate Adenosine Disphosphate To reduce thrombotic dizziness, fatigue, won’t return to normal for
(ADP) to its platelet events with headache, pain. at least 5 days after drug
Brand Name:Plavix receptor, impeding atherosclerosis CV: Edema, has been stopped.
  ADP- mediated documented by recent hypertension. -Drug may cause fatal
Stock Dose: activation and stroke, MI, or peripheral EENT: Epistaxis, thrombotic
75 mg/ 1 tab/ OD subsequent platelet arterial disease. rhinitis. thrombocytopenic Purpura
  aggregation and Contraindications: GI: Hemorrhage, (thrombocytopenia,
Classifications: irreversibly modifies the -Contraindicated in abdominal pain, hemolytic anemia,
Inhibitor of Adenosine platelet ADP receptor. patients hypersensitive to constipation, diarrhea, neurologic findings, renal
Diphosphate (ADP) drug or its components dyspepsia, gastritis, dysfunction, and fever)
induced platelet and in those with ulcers. that requires urgent
aggregation. pathologic bleeding GU: UTI treatment, including
( such as peptic ulcer or HEMATOLOGIC: plasmapheresis.
intracranial hemorrhage) Purpura - Instruct patient to notify
- Use cautiously in SKIN: Rash, pruritus. prescriber if unusual
patients at risk for bleeding or bruishing
increased bleeding from occurs.
trauma, surgery or other -Instruct patient that drug
pathologic conditions and may be taken without
in those with renal or regard to meals.
hepatic impairment.

Drug Mechanism of Action Indications & Side Effects Nursing Considerations

Contraindications
Generic Name: Inhibits Indications: CNS: Dizziness, - Drug can be used alone or
Losartan vasoconstrictive and - Hypertension asthenia, fatigue, with other antihypertensive.
  aldosterone secreting - To reduce risk of stroke headache, insomnia. - If antihypertensive effect is
Brand action of angiotensin in patients with CV: Edema, chest pain. inadequate using once daily
Name:Cozaar II by blocking hypertension and left EENT: Nasal doses, a twice- daily regimen
  angiotensin II receptor ventricular hypertrophy. congestion, sinusitis, using the same or increased
Stock Dose: on the surface of Contraindications: pharyngitis, sinus total daily dose may give a
50 mg/1 tab OD vascular smooth - Contraindicated in disorder. more satisfactory response.
  muscle and other patients hypersensitive to GI: Abdominal pain, - Monitor patient BP closely
Classifications: tissue cells. drug. Breast feeding isn’t nausea, diarrhea, to evaluate effectiveness of
Angiotensin II recommended during dyspepsia. therapy. When used alone,
receptor antagonist losartan therapy. Musculoskeletal: drug has less of an effect on
- Use cautiously in patients Muscle cramps, blood pressure in black pt.
with impaired renal or myalgia, back or leg than in pt. of other races.
hepatic function. pain. - Monitor patients who are
Respiratory: also taking diuretics for
Cough upper respiratory symptomatic hypotension.
infection.