Drug Study 2

XAVIER UNIVERSITY ATENEO DE CAGAYAN
COLLEGE OF NURSING
4th Floor Faber Hall Building, Xavier Ateneo Main Campus
73 Corrales Avenue 9000 Cagayan de Oro City, Philippines
DRUG STUDY
Generic Name Ivabradine

Brand Name Corlanor, Lancora, Procoralan
Dosage
Route
Frequency
Preparation
Classification Anti-Anginal Drugs
Indication Ivabradine is indicated by the FDA to reduce the risk of hospitalization for
worsening heart failure in adult patients with stable, symptomatic chronic
heart failure with left ventricular ejection fraction ≤35%, who are in sinus
rhythm with resting heart rate ≥70 beats per minute and either are on
maximally tolerated doses of beta-blockers or have a contraindication to
beta-blocker use. It is also indicated for treatment of stable symptomatic
heart failure as a result of dilated cardiomyopathy for pediatric patients 6
months of age or more
Mechanism of
Action
Ivabradine is a heart rate lowering agent that works through
selective and specific inhibition of the cardiac pacemaker If
current that controls the spontaneous diastolic depolarisation
in the sinus node and regulates heart rate.
Contraindications
Resting heart rate <70 beats/min prior to treatment,
cardiogenic shock, acute MI, severe hypotension (<90/50
mmHg), sick sinus syndrome, SA block, unstable or acute
heart failure, pacemaker dependent, unstable angina, 3rd
degree AV block. Severe hepatic impairment. Pregnancy and
lactation. Concurrent use w/ potent CYP3A4 inhibitors (e.g.
azole antifungals, macrolides, HIV protease inhibitors or
nefazodone), moderate CYP3A4 inhibitors (e.g. verapamil or
diltiazem).
Adverse
Reactions Luminous phenomena in the visual field (phosphenes), blurred
vision, bradycardia, other cardiac arrhythmias, syncope,
hypotension, asthenia, fatigue, headache, dizziness, nausea,
constipation, diarrhoea, dyspnoea, muscle cramps, skin
reactions, angioedema, hyperuricaemia, eosinophilia, elevated
blood-creatinine concentrations.
Men and Women for Others.

Official Website: http://www.xu.edu.ph/college-of-nursingOfficial Email Address: nursing@xu.edu.ph Official Phone Number: (088) 853-9800 local 9817, 9446, 9447, 9448, 9449
COLLEGE OF NURSING
Side Effects
o Blurred vision.
o chest pain or discomfort.
o fast or irregular heartbeat.
o headache.
o lightheadedness, dizziness, or fainting.
o pounding in the ears.
o slow or irregular heartbeat.
o unusual tiredness.
Nursing
Responsibilities Monitor heart rate prior to initiation of treatment, prior to
increasing dose or after decreasing dose; BP, cardiac rhythm.
Should be taken with food. Avoid excessive consumption of

grapefruit juice.
DRUG STUDY
Generic Name Trimetazidine

Brand Name
Dosage
Route
Frequency
Preparation
Classification Anti-Anginal Drugs
Indication
Stable angina
Adult: As adjunctive therapy for the symptomatic treatment of
patients who are inadequately controlled by or intolerant of 1st-
line antianginal therapies:

COLLEGE OF NURSING
Mechanism of
Action Trimetazidine inhibits β-oxidation of fatty acids by blocking
long-chain 3-ketoacyl-CoA thiolase, with the effect of
enhancing glucose oxidation, resulting in more efficient
production of ATP with less oxygen demand. It prevents a
decrease in intracellular ATP levels by preserving energy
metabolism in cells exposed to ischaemia or hypoxia, thus
ensuring the proper functioning of ionic pumps and
transmembrane Na-K flow without changing haemodynamic
parameters.
Contraindications
Parkinson's disease, parkinsonian symptoms, restless leg
syndrome, tremors, and other related movement disorders.
Severe renal impairment (CrCl <30 mL/min). Lactation.
Adverse
Reactions Significant: New-onset or worsening of parkinsonian symptoms
(e.g. akinesia, hypertonia, tremor).
Cardiac disorders: Rarely, palpitations, extrasystoles, tachycardia.
Gastrointestinal disorders: Nausea, vomiting, abdominal pain,
diarrhoea, dyspepsia.
General disorders and administration site conditions: Asthenia.
Nervous system disorders: Headache, dizziness.
Skin and subcutaneous tissue disorders: Rash, urticaria, pruritus.
Vascular disorders: Rarely, arterial hypotension, orthostatic
hypotension, flushing.
Side Effects
 Nausea, vomiting.
 Abdominal pain, indigestion.
 Diarrhoea.
 Dizziness.
 Headache.
 Feeling weak.
 Rashes.

COLLEGE OF NURSING
Nursing
Responsibilities Inform patient that this drug may cause drowsiness or
dizziness. Do not drive or operate machinery
DRUG STUDY
Generic Name Salbutamol + Ipratropium

Brand Name Duavent
Dosage
Route Inhalation
Frequency
Preparation
Classification Functional: Belongs to the class of adrenergic in combination
with anticholinergics
Therapeutic: Bronchodilator
Indication
Management of reversible bronchospasm
Mechanism of Ipratropium is a nonselective competitive antimuscarinic agent.

Action It causes bronchodilation by blocking the action of
acetylcholine-induced stimulation of guanyl cyclase, hence
reducing formation of cyclic guanosine monophosphate at
parasympathetic site. Salbutamol activates adenyl cyclase, the
enzyme that stimulates the production of cyclic adenosine- 3’,
5’- monophosphate. Increased cAMP leads to activation of
protein kinase A, which inhibits phosphorylation of myosin and
lower intracellular ionic Ca concentrations, resulting in smooth
muscle relaxation.
Contraindications Hypersensitivity to salbutamol, ipratropium or fenoterol,

atropine or its derivatives. Hypertrophic obstructive
cardiomyopathy, tachyarrhythmia
Adverse CNS: Tremors

COLLEGE OF NURSING
Reactions CV: Arrhythmias, tachycardia
GU: Urinary retention
General: Urinary Retention
CNS: Nervousness, dizziness, headache

Side Effects GI: Nausea, vomiting, dry mouth, throat irritation
Nursing
Responsibilities
o Assess vital signs before and after administration
o Assess client history for any contraindications
o Assess for any hypersensitivity to any component of the
drug Assess drugs already being taken for any
adverse drug interactions
o Explain the side effects that may occur and also danger
signs for adverse reactions
o Instruct patients/ SO with the proper use or steps of the
procedure
DRUG STUDY
Generic Name Aspirin (acetylsalicylic acid)

Brand Name Asphen
Dosage
Route PO
Frequency
Preparation Tablet
Classification Therapeutic: NSAIDs
Pharmacologic: Salicylates
Indication o To reduce risk of MI in patients with previous MI,

unstable angina, chronic stable angina pectoris.
o To reduce risks of recurrent TIAs and stroke or death to
patients at risk

COLLEGE OF NURSING
Mechanism of
Action Thought to produce analgesia and exert its anti-inflammatory
effect by inhibiting prostaglandin and other substances that
sensitize pain receptors. Drug may relieve fever through
central action in the hypothalamic heat-regulating center. In
low doses, drug also appears to interfere with clotting by on
keeping a platelet-aggregating substance so from forming.
Contraindicated in patients hypersensitive to drug and in those

Contraindications with NSAID-induced sensitivity reactions, G6PD deficiency, or
bleeding disorders, such as hemophilia, von Willebrand
disease, telangiectasia, bleeding ulcers, and hemorrhagic
states.
© Alert: Carefully weigh the risks and bene. fits of using drug
during pregnancy.
• Use cautiously in patients with Gl lesions, impaired renal
function, hypoprothrombinemia, vitamin K deficiency,
thrombocytopenia, or thrombotic thrombocytopenic.
Avoid use in patients with severe hepatic impairment or history

of active peptic ulcer disease.
© Alert: Oral and rectal OTC products containing aspirin and
no aspirin salicylates shouldn't be given to children or
teenagers who have or are recovering from chickenpox or
flulike symptoms with or without fever because of the risk of
Reye syndrome.
Adverse CNS: Agitation, cerebral edema, coma, confusion, dizziness,

Reactions headache, lethargy, seizures, subdural or intracranial
hemorrhage.
CV: arrhythmias, hypotension, tachycardia.
EENT: tinnitus, hearing loss.
GI: nausea, GI bleeding, dyspepsia, GI distress, occult
bleeding, pancreatitis, vomiting.
Side Effects o Stomach or gut irritation

o Indigestion

COLLEGE OF NURSING
o Nausea
Nursing o For inflammatory conditions, rheumatic fever, and

Responsibilities thrombosis, give aspirin on a schedule rather than as
needed.
o Because enteric-coated and sustained-release tablets
are slowly absorbed, they aren't suitable for rapid relief
of acute pain, fever, or inflammation. They cause less
GI bleeding and may be better suited for long-term
therapy, such as for arthritis.
o For patients who can't tolerate oral drugs, ask prescriber
about using aspirin rectal suppositories. Watch for rectal
mucosal irritation or bleeding.
o Febrile, dehydrated children can develop toxicity rapidly.
o Monitor elderly patients closely because they may be
more susceptible to aspirin's toxic effects.
o Monitor salicylate level. Therapeutic salicylate level for
arthritis is 150 to 300 mcg/mL. Tinnitus may occur at
levels a above 200 mcg/mL, but this isn't a reliable
indicator of toxicity, especially in very young patients
and those older than age 60. With long-term therapy,
severe toxic effects may occur with levels exceeding
400 mcg/mL.
o During prolonged therapy, assess hematocrit, Hb level,
PI, INR, and renal function periodically. 19719
o Drug irreversibly inhibits platelet aggregation. Stop drug
5 to 7 days before elective surgery to allow time for
production and is release of new platelets.
o Monitor patient for hypersensitivity reactions, such as
anaphylaxis and asthma.
o Look alike-sound alike: Don't confuse bi aspirin with
Asendin or Afrin.


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XAVIER UNIVERSITY ATENEO DE CAGAYAN

Generic Name Ivabradine

Men and Women for Others.

Should be taken with food. Avoid excessive consumption of

Generic Name Trimetazidine

Men and Women for Others.

Men and Women for Others.

Generic Name Salbutamol + Ipratropium

Mechanism of Ipratropium is a nonselective competitive antimuscarinic agent.

Contraindications Hypersensitivity to salbutamol, ipratropium or fenoterol,

Adverse CNS: Tremors

CNS: Nervousness, dizziness, headache

Generic Name Aspirin (acetylsalicylic acid)

Indication o To reduce risk of MI in patients with previous MI,

Men and Women for Others.

Contraindicated in patients hypersensitive to drug and in those

Avoid use in patients with severe hepatic impairment or history

Adverse CNS: Agitation, cerebral edema, coma, confusion, dizziness,

Side Effects o Stomach or gut irritation

Men and Women for Others.

Nursing o For inflammatory conditions, rheumatic fever, and

Men and Women for Others.

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