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DRUG STUDY Name of Drug (Generic Name) Carvedilol Brand Name Dilatrend Patient’s Dosage/Frequen cy 6.

25mg OD • Indication Mode of Action Side Effects Nursing Considerations Assessment: • History: Heart failure, bronchial asthma, heart block, cardiogenic shock, hypersensitivity to carvedilol, pregnancy, lactation, hepatic impairment, PVD, thyrotoxicosis, diabetes, anesthesia or major surgery. • Physical: Baseline weight, skin condition, neurologic status, LFTs,

Hypertensio n, alone or with other oral drugs, especially diuretics. Treatment of mild to severe heart failure of ischemic or cardio myopathic origin with digitalis, diuretics, ACE inhibitors. Left ventricular dysfunction after MI.

Competitivel y blocks alpha-beta& beta2 adrenergic receptors and has some sympathomi metics activity at beta 2 receptors. Both alpha and beta blocking actions contribute to the BP lowering effect; beta blockade prevents the reflex tachycardia seen with

Depresson, dizziness, lightheadedness

most alpha blocking drugs and decreases alpha rennin activity. Significantly reduces

renal and thyroid function tests, blood and urine glycoses. • Give with food to decrease orthostatic hypertension and adverse effects. Monitor for orthostatic hypertension and provide safety precaution.



2.5mg/tab (1/4 tab BID)

Treatment of hypertensio n alone or on combination with thiazidetype

Blocks ACE from converting angiotensin I to angiotensin II, a powerful vasoconstrict

Cough, GiI upset, loss of appetite, change in taste perception, mouth sores, rash, fast heart

Assessment: • History: Allergy to captopril, history of angioedema, impaired renal function, heart failure, salt or

diuretics. Treatment of heart failure in patients unresponsiv e to conventiona l therapy; used with diuretics and cardiac glycosides. Treatment of diabetic nephropathy . Treatment of left ventricular dysfunction after MI.

or, leading to decreased BP, decreased aldosterone secretion, a small increase in serum potassium levels, and sodium and fluid loss; increased prostaglandi n synthesis also maybe involved in the anti hypertensive action.

rate, dizziness, lightheadedness .

volume depletion, pregnancy, lactation. • Physical: Skin color, lesions, turgor, T; P, BP, peripheral perfusion, mucous membranes, bowel sounds, liver evaluation, urinalysis, LFTs, renal function tests, CBC and differential. • • Administer 1 hr. before meals. Monitor patient for drop in Bp secondary to reduction of fluid volume. Reduce



20mg/tab OD

Short tem treatment of active duodenal ulcer. Treatment of heart burn or symptoms of GERD. Short term treatment of active benign gastric ulcer.

Gastric acid pump inhibitor. Suppresses gastric acid secretion by specific inhibition of the hydrogen potassium ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid production.

Headache, dizziness, nausea, vomiting, diarrhea.

dosage in patients with impaired renal function. Assessment: • History: Hypersensitivity to omeprazole or any of its components, pregnancy, lactation. • Physical: Skin lesions, T; reflexes; affect; urinary output, abdominal examination; respiratory examination. • Administer before meals. Caution patient to swallow capsules

Enoxaparin Sodium


0.4cc q12

Prevention of DVT, which may lead to pulmonary embolism following hip replacement, knee replacement

Lowmolecularweight heparin that inhibits thrombus and clot formation by blocking factor Xa, factor IIa,

Bleeding tendencies

whole-not to cut, chew, or crush them. • If using oral suspensions, empty packet into a small cup containing 2 tbsp. water. Stir and have patient drink immediately; fill-up with water and have patient drink this water. Do not use any other diluents. Assessment: • History: Recent surgery or injury, sensitivity to heparin, pork products, enoxaparin, lactation, history of GI bleed;

surgery, abdominal surgery. Prevention of ischemic complicatio ns of unstable angina and non- Q wave MI. Treatment of DVT, pulmonary embolus with warfarin. Treatment of acute ST segment elevation MI, managed medically or with subsequent percutaneou s coronary intervention.

preventing the formation of clots.

pregnancy. • Physical: Peripheral perfusion, R, stool, guaiac test, PTT or other tests of blood coagulation, platelet count, renal function test. • Give drug as soon as possible after hip surgery, within 12 hr. of knee surgery and within 2 hr. preoperativel y for abdominal surgery. Give deep subcutaneous injections; do not give enoxaparin

by IM injections. Apply pressure to aall injection sites after needle is withdrawn; inspect the injection sites for signs of hematoma; do not massage injection sites. Do not mix with other injections or infusions. Check patients for signs of bleeding. Alert all health care providers that patient is taking

Ciprofloxaci n

Ciproma x

500mg/tab BID

Treatment of RTI; UTI, skin and soft tissue, surgical, bone and joint, gynecologic al, GI infections, STD, bacteremia, septicemia, infection in immunocom promised patient.

Bactericidal; interferes with DNA replication in susceptible bacteria preventing cell reproduction.

Nausea, vomiting, abdominal pain, diarrhea or constipatio n, drowsiness, blurring of vision, dizziness.

enoxaparin. Assessment: • History: Allergy to ciprofloxacin, norfloxacin or other quinolones; renal impairment; seizures; lactation. • Physical: Skin color, lesions, T; orientation, reflexes, affect; mucous membranes, bowel sounds, LFTs, renal function tests. • Arrange for culture and sensitivity tests before beginning therapy.



20mg/tab OD

Oral; IV: • Edema associated with heart failure, cirrhosis, renal disease. IV: • Acute pulmonary edema. Oral: • Hypertensio n

Inhibits reabsorption of Na and Cl from the proximal and distal tubules and ascending limb of loop of Henle, leading to a Na-rich diuresis.

Increase volume and frequency of urination, dizziness, feeling faint on arising, drowsiness, sensitivity to sunlight, increase thirst, loss of body potassium.

Ensure that patient swallows ER tablets whole; do not cut, crush, or chew. • Ensure that patient is well hydrated. Assessment: • History Allergy to furosemide, sulfonamides. Tartrazine, electrolyte depletion anuria, severe renal failure, hepatic coma, SLE, gout, diabetes, lactation pregnancy. • Physical Skin color,

lesions, edema , orientation, refelexes, hearing pulses, baseline ECG, BP. Orthostatic BP, perfusion, K, pattern, urinary output pattern, adventitious sounds, liver evaluation, bowel sounds, CBC, serum electrolytes, blood sugar, renal function test, uric acid, urinalysis, weight. • Reduce dosage if given with other hypertensive, readjust dosage gradually as BP responds. Give early in



40mg/tab. OD

Adjunct to diet in the treatment of elevated total cholesterol and LDL cholesterol with primary hypercholest erolemia (type IIa & type IIb) in those unresponsiv e to dietary restriction of saturated fats and cholesterol and other nonpharmacolo gic measures.

Inhibits HMG-CoA reductase, the enzyme that catalyzes the first step in the cholesterol synthesis pathway, resulting in a decrease in serum cholesterol, serum LDLs, and either an increase or no change in serum HDLs.

Nausea, headache, muscle and joint aches and pains, sensitivity to light.

the day so that increase urination will not disturb sleep. Assessment: • History Allergy to simvastatin, fungal byproducts, impaired hepatic function, pregnancy, lactation. • Physical: Orientation, affect, liver evaluation, abdominal examination, lipid studies, LFTS. • Ensure that patient has tried cholesterol



30cc OD

• •

To reduce the risk of coronary disease, mortality, and cardiovascul ar events, including CVA, TIA, MI, and reduction in need for bypass surgery and angioplasty in patients with coronary heart disease and hypercholest erolemia. Treatment of constipation. Prevention and treatment of portal

lowering diet regimen for 3-6 months before beginning therapy. Give in the evening; highest rate of cholesterol synthesis are between midnight and 5am.

The drug passes unchanged into the colon where bacteria break it down to

Abdominal fullness, flatulence, belching.

Assessment: • History Allergy to lactulose. Lowgalactose diet diabetes, lactation,

systemic encephalopa thy.


Cardiosta t

50mg (1/2 tab BID)

Hypertensio n alone or

organic acids that increase the osmotic pressure in the colon and slightly acidify the colonic contents, resulting in an increase in stool water content, stool softening, laxative action. This also results in migration of blood ammonia into the colon contents with subsequent trapping and expulsion in the feces. Competitivel y blocks

pregnancy. • Physical: Abdominal examination, bowel sounds, serum electrolytes, serum ammonia levels. • Give laxative syrup orally with fruit juice, water or milk to increase palatability. Do not administer other laxatives while using lactulose. Monitor Serum ammonia level.

Dizziness, Assessment: drowsiness,

with other drug, especially diuretics. Long term treatment of angina pectoris.

betaadrenergic receptors in the heart and juxtaglomeru lar apparatus, decreasing the influence of sympathetic nervous system on these tissues and the excitability of the heart, decreasing cardiac output and the release of rennin, and lowering BP, acts in the CNS to reduce sympathetic outflow and vasoconstrict or tone.

lightheadedness , blurred vision, nausea, loss of appetite, nightmares, depression, and sexual impotence.

• History Sinus bradycardia (HR < 45bpm), second or third degree heart block (PR interval > 0.24 sec.), cardiogenic shock, heart failure, systolic BP < 100mmHg, diabetes or thyrotoxicosis, asthma or COPD, lactation, pregnancy. • Physical: Weight, skin condition, neurologic status, P, BP, ECG, respiratory status, renal and thyroid function tests, blood and urine glucose.

Domperidon e

Dompen yl

10mg/tab TID

Symptomati c relief of acute nausea and vomiting. Treatment of nausea and vomiting caused by

Antagonized by anticholinerg ic drugs. CYP3A4 inhibitors.

Galactorrhe a, hysterorrhe a, anorexia, catharsis, constipatio n, dipsia, vomiting.

Ensure that the patient swallows the ER tab whole; do not cut, crush, or chew. Give oral drug with food to facilitate absorption. Provide continual cardiac monitoring for patients receiving IV metropolol. Take 15-30 min. before meals



100mg/tab (1/4 tab BID)

• • •

levodopa or bromocripti ne administrati on in parkinsons disease. Mild to moderate pain. Fever Inflammator y condition, rheumatic fever, rheumatoid arthritis. Reduction of risk of recurrent TIAs or CVA in patients with history of TIA due to fibrin platelet emboli or ischemic stroke.

Analgesic and antirheumati c effects are attributable to aspirin’s ability to inhibit the synthesis of prostaglandi ns, important mediators of inflammatio n. Antipyretic effects are not fully understood, but aspirin probably acts the thermoregula tory center of the

Nausea, GI upset, heartburn, easy bruising, gum bleeding.

Assessment: • History: Allergy to salicylates or NSAIDs; allergy totartrazine, hemophilia, bleeding ulcers, hemmorhagic states, blood coagulation defects, hypoprothrombi nemia, vitamin K deficiency, impaired hepatic function, chicken pox, influenza, children with fever accompanied by dehydration, surgery

hypothalamu s to block effects of endogenous pyrogen by inhibiting synthesis of the prostaglandi n intermediary. Inhibition of platelet aggregation is attributable to the inhibition of platelet synthesis of thromboxane A2, a potent vasoconstrict or and inducer of platelet aggregation. This effect occurs at low doses and lasts for the

scheduled within 1 week, pregnancy lactation. • Physical Skin color, lesions, T: eigth cranial nerve, orientation, reflexes, affect, P; BP; perfusion; R, adventitious sounds, liver evaluation, bowel sounds, CBC, clotting times, urinalysis, stool guaiac, LFTs, renal function tests. • Give drug with food or after meals if GI upset occurs. Give drug with full

life of the platelet (8 days). Higher doses inhibit the synthesis of prostacyclin, a potent vasodilator and inhibitor of platelet aggregator.

glass of water to reduce risk of tablet or capsule lodging in the esophagus. Do not crush, and ensure that patient does not chew SR preparation.