St.

Anthonys College
NURSING DEPARTMENT
San Jose, Antique
DRUG STUD
Na!e o"
D#ug
Dosage, Route,
$#equen%y,
Ti!ing
Me%hanis! o" A%tion In&i%ation Si&e E""e%ts S'e%ial P#e%autions Nu#sing Res'onsi(ilities
Gene#i%)
$u#ose!i&e
*#an&)
+asi,
Dosage) -.!g
Route) I/TT
$#equen%y) 0D
1ith *P
'#e%aution
Ti!ing) 2a!
Inhi(its so&iu! an&
1ate# #ea(so#'tion in
the loo' o" 3enle an&
4u#ine "o#!ation. As
the (o&ys 'las!a
5olu!e 6, al&oste#one
'#o&u%tion 4, 1hi%h
'#o!otes so&iu!
#ea(so#'tion an& loss
o" 'otassiu! an&
hy&#ogen ions.
$u#ose!i&e also 4 the
e,%#etion o" %al%iu!,
!agnesiu!,
(i%a#(onate,
a!!oniu! an&
'hos'hate. *y
#e&u%ing int#a%ellula#
an& e,t#a%ellula# "lui&
5olu!e, the &#ug
#e&u%es (loo& '#essu#e
an& 6%a#&ia% out'ut.
05e# ti!e, %a#&ia%
out'ut #etu#ns to
no#!al.
To #e&u%e e&e!a %ause&
(y %i##hosis, hea#t "ailu#e,
an& #enal &isease,
in%lu&ing ne'h#oti%
syn&#o!e
To !anage !il& to
!o&e#ate hy'e#tension,
as a&7un%t to t#eat a%ute
'ul!ona#ye&e!a an&
hy'e#tensi5e %#isis
Di88iness, "e5e#,
hea&a%he,
1ea9ness,
hy'otension,
7aun&i%e,
nausea,
'an%#eatitis,
5o!iting,
hea#ing
loss
E,%ess a!ount %an
lea& to '#o"oun&
&ie#esis 1ith 1ate#
an& ele%t#olyte
&e'letion.
Ge#iati% %lients !ay
(e !o#e sensiti5e to
the usual a&ult &ose.
Use "u#ose!i&e
%autiously in 'atients
1ith a&5an%e&
he'ati%
%i##hosis,es'e%ially
those 1ho also ha5e
a histo#y o"
ele%t#olyte
i!(alan%e o# he'ati%
en%e'halo'athy: &#ug
!ay lea& to lethal
he'ati% %o!a.
$ollo1 the ;. Rights)
- A&!iniste# the Right &#ug.
- The Right &#ug to the Right 'atient.
- Right &ose
- Right &#ug (y the Right #oute.
- Right &#ug at the Right ti!e.
- Do%u!ent ea%h &#ug you a&!iniste#.
- Tea%h you# 'atient a(out the &#ugs
he<she #e%ei5ing.
- Ta9e a %o!'lete 'atient &#ug histo#y.
- $in& out i" the 'atient has any &#ug
alle#gies.
- *e a1a#e o" the 'otential &#ug=&#ug o#
&#ug="oo& inte#a%tions.
0(tain 'atients 1eight (e"o#e an&
'e#io&i%ally
&u#ing "u#ose!i&e the#a'y to !onito# "lui& loss.
Monito# (loo& '#essu#e an& he'ati% an&
#enal "un%tion as 1ell as *UN, (loo& glu%ose,an&
se#u! %#eatinine, ele%t#olyte,an& u#i% a%i& le5els,
as a''#o'#iate.
A&5ise 'atient to %hange 'osition slo1ly
to !ini!i8e e""e%ts o" o#thostati%
hy'otension
an& to ta9e "u#ose!i&e 1ith "oo& o# !il9 to #e&u%e
GI &ist#ess.
Caution 'atient a(out &#in9ing al%oholi%
(e5e#ages, stan&ing "o# '#olonge& 'e#io&s, an&
e,e#%ising in hot 1eathe# (e%ause these a%tions
in%#ease the hy'otensi5e e""e%t o" "u#ose!i&e.
Classi"i%ation Cont#ain&i%ations A&5e#se E""e%ts
Diu#eti%s
Cont#ain&i%ate& to:
Anu#ia un#es'onsi5e to
"u#ose!i&e:hy'e#sensiti5ity
to "u#ose!i&e,
sul"ona!i&es, o# thei#
%o!'onents
Ag#anulo%ytosis
>#a#e?, ane!ia,
a'lasti% ane!ia
>#a#e?
St. Anthonys College
NURSING DEPARTMENT
San Jose, Antique
DRUG STUD
Na!e o" D#ug
Dosage,
Route,
$#equen%y,
Ti!ing
Me%hanis! o" A%tion In&i%ation Si&e E""e%ts S'e%ial P#e%autions Nu#sing Res'onsi(ilities
Generic:
digoxin
Brand:
Lanoxin
Dosage)
..-@!g
;ta(
Route)
P.0.
$#equen%y)
0D
Ti!ing)
Aa!
Increases the force
and velocity of
myocardial
contraction, resulting
in positive inotropic
effects. Digoxin
produces
antiarrhythmic effects
by decreasing the
conduction rate and
increasing the
effective refractory
period of the !
node.
"o treat heart failure, atrial
flutter, atrial fibrillation,
and paroxysmal atrial
tachycardia #ith rapid
digitali$ation
hea&a%he
&i88iness
!ental
&istu#(an%e
nausea B
5o!iting
&ia##hea
ano#e,ia
(lu##e&<
yello1 5ision
Use in %aution to
%lient 1ith is%he!i%
hea#t &isease, a%ute
!yo%a#&itis,
hy'e#t#o'hi% su(oa#ti%
stenosis, hy'o,i%.
*e"o#e gi5ing ea%h &ose, ta9e
'atients a'i%al 'ulse an& noti"y
'#es%#i(e# i" its (elo1 A.
(eats<!inute >o# othe# s'e%i"ie&
le5el?.
Monito# 'atient %losely "o# signs o"
&igitalis to,i%ity, su%h as alte#e&
!ental status,a##hyth!ias, hea#t
(lo%9, nausea, 5ision &istu#(an%es,
an& 5o!iting. I" they a''ea#, noti"y
'#es%#i(e#, %he%9 se#u! &igo,in
le5el as o#&e#e&, an& e,'e%t to
1ithhol& &#ug until le5el is
9no1n.Monito# ECG t#a%ing
%ontinuously.
Monito# 'a'tients se#u!
'otassiu! le5el
Tea%h 'atient ho1 to ta9e he#
'ulse, an& inst#u%t he# to &o so
(e"o#e ea%h &ose.
U#ge he# to noti"y '#es%#i(e# i"
'ulse "alls (elo1 A. (eats<!inute
o# su&&enly
in%#eases.
U#ge 'atient to noti"y '#es%#i(e# i"
she e,'e#ien%es a&5e#se
#ea%tions, su%h as GI
&ist#ess o# 'ulse %hanges.
Classi"i%ation Cont#ain&i%ations A&5e#se E""e%ts
ntiarrhythmic 3y'e#sensiti5e %a#oti&
sinus syn&#o!e,
hy'e#sensiti5ity to
&igo,in, '#esen%e o#
histo#y o" &igitalis to,i%ity
o# i&iosyn%#ati% #ea%tion
to &igo,in, 5ent#i%ula#
"i(#illation,5ent#i%ula#
ta%hy%a#&ia unless hea#t
"ailu#e o%%u#s un#elate&
to &igo,in the#a'y.
a%ute
he!o##hage
%on5ulsions
&eath !ost
o"ten #esults
"#o!
5ent#i%ula#
"i(#illition
St. Anthonys College
NURSING DEPARTMENT
San Jose, Antique
DRUG STUD
Na!e o" D#ug
Dosage,
Route,
$#equen%y,
Ti!ing
Me%hanis! o"
A%tion
In&i%ation Si&e E""e%ts S'e%ial P#e%autions Nu#sing Res'onsi(ilities
Gene#i%)
losa#tan
'otassiu!
*#an&)
Co8aa#
Dosage)
@.!g ;ta(
Route)
P.0.
$#equen%y)
0D
Ti!ing)
Aa!
*lo%9s (in&ing o"
angiotensin II to
#e%e'to# sites in
!any tissues,
in%lu&ing 5as%ula#
s!ooth !us%le an&
a&#enal glan&s.
Angiotensin II is a
'otent
5aso%onst#i%to# that
also sti!ulates the
a&#enal %o#te, to
se%#ete al&oste#one.
The inhi(iting e""e%ts
o" angiotensin II
#e&u%e (loo&
'#essu#e.
To !anage
hy'e#tension
To t#eat ne'h#o'athy in
'atients 1ith ty'e -
&ia(etes an&
hy'e#tension
To #e&u%e st#o9e #is9 in
'atients 1ith
hy'e#tension an& le"t
5ent#i%ula# hy'e#t#o'hy
Di88iness,
%ough,
&ia##hea, sinus
&iso#&e#, nasal
%ongestion,
'ain, hea#t(u#n
*e a1a#e that 'atients
1ho ha5e se5e#e
hea#t "ailu#e o# #enal
a#te#y stenosis !ay
e,'e#ien%e a%ute
#enal "ailu#e "#o!
losa#tan the#a'y
(e%ause losa#tan
inhi(its the
angiotensin=
al&oste#one syste!,
on
1hi%h #enal "un%tion
&e'en&s.
Monito# (loo& '#essu#e an& #enal
"un%tion stu&ies to e5aluate &#ug
e""e%ti5eness.
Pe#io&i%ally !onito# 'atients
se#u!
'otassiu! le5el, as a''#o'#iate, to
&ete%t hy'e#9ale!ia.
Monito# 'atient "o# !us%le 'ain:
#a#ely, #ha(&o!yolysis &e5elo's in
'atients ta9ing othe# angiotensin II
#e%e'to# (lo%9e#s.
Inst#u%t 'atient to a5oi& 'otassiu!
%ontaining salt su(stitutes (e%ause
that !ay in%#ease #is9 o"
hy'e#9ale!ia.
A&5ise 'atient to a5oi& e,e#%ising
in hot 1eathe# an& &#in9ing
e,%essi5e a!ounts o" al%ohol:
inst#u%t he# to noti"y '#es%#i(e# i"
she has '#olonge& &ia##hea,
nausea, o# 5o!iting.
Classi"i%ation Cont#ain&i%ations A&5e#se
E""e%ts
Antihy'e#tensi5e 3y'e#sensiti5ity to
losa#tan o# its %o!'onents
MI, 5ent#i%ula#
ta%hy%a#&ia
an& "i(#illation
St. Anthonys College
NURSING DEPARTMENT
San Jose, Antique
DRUG STUD
Na!e o" D#ug
Dosage,
Route,
$#equen%y
, Ti!ing
Me%hanis! o"
A%tion
In&i%ation Si&e E""e%ts S'e%ial P#e%autions Nu#sing Res'onsi(ilities
Gene#i%)
Sal(uta!ol
Sul"ate
*#an&)
P#o5entil
Dosage)
; ne(ule
Route)
$#equen%y
)
Ti!ing)
Rela,es
(#on%hial,
ute#ine, an&
5as%ula#
s!ooth
!us%le (y
sti!ulating
(eta-
#e%e'to#s.
C To '#e5ent o# t#eat (#on%hos'as! in
'atients 1ith #e5e#si(le o(st#u%ti5e ai#1ay
&isease
C To '#e5ent e,e#%ise=in&u%e&
(#on%hos'as!
C A%ute asth!a
C Sy!'to! #elie" &u#ing !aintenan%e
the#a'y o" asth!a an& othe# %on&itions
1ith #e5e#si(le o# i##e5e#si(le ai#1ays
o(st#u%tion >in%lu&ing C0PD an&
(#on%hitis?
C Can (e ae#osoli8e& 1ith a ne(uli8e# "o#
'atients 1ith %ysti% "i(#osis, along 1ith
i'#at#o'iu! (#o!i&e, a%etyl%ysteine, an&
'ul!o8y!e.
C May (e use& as a to%olyti% to #ela, the
ute#ine s!ooth !us%le to &elay
'#e!atu#e la(ou#.
C To t#eat o# i!'#o5e !us%le 'a#alysis in
'atients 1ith a %on&ition that %auses
o%%asional 'a#alysis.
C To t#eat high 'otassiu! le5els in
'atients 1ith 9i&ney "ailu#e.
ne#5ousness,
&i88iness,
inso!nia,
hea&a%he,
hy'e#a%ti5ity,
1ea9ness,
hea#t(u#n,
nausea,
5o!iting,
ano#e,ia, alte#e&
taste, in%#ease&
a''etite
Use 1ith %aution in
'atients 1ith C/
&iso#&e#s >in%lu&ing
%o#ona#y
insu""i%ien%y an&
hy'e#tension?,
hy'e#thy#oi&is!,
&ia(etes !ellitus,
an& those 1ho a#e
unusually #es'onsi5e
to a&#ene#gi%s
D#ug !ay &e%#ease sensiti5ity
o" s'i#o!et#y use& "o#
&iagnosis o" asth!a.
Dait "o# atleast t1o !inutes
(e"o#e #e'eating inhalation i"
you# '#es%#i(e# o#&e#s !o#e
than one inhalation.
Dont %on"use al(ute#ol 1ith
atenolol o# Al(utein, o# $lo!a,
1ith /ol!a,.
Da#n a(out #is9 o" 'a#a&o,i%al
(#on%hos'as!: sto' &#ug
i!!e&iately i" it o%%u#s.
Classi"i%ation Cont#ain&i%ations A&5e#se E""e%ts
Sy!'ath!i!eti% Cont#ain&i%ate& in 'atients
hy'e#sensiti5e to &#ug o# its
ing#e&ients.
Angioe&e!a,
(#on%hos'as!
St. Anthonys College
NURSING DEPARTMENT
San Jose, Antique
DRUG STUD
Na!e o" D#ug
Dosage,
Route,
$#equen%y,
Ti!ing
Me%hanis! o" A%tion In&i%ation Si&e E""e%ts S'e%ial P#e%autions Nu#sing Res'onsi(ilities
Gene#i%)
Ca#5e&ilol
*#an&)
A'o= Ca#5e&ilol
Dosage)
;-.@!g
Route)
P0
$#equen%y)
*ID
Ti!ing)
AAM,APM
Co!'etiti5ely (lo%9s
al'ha= ,(eta=, an&
(eta-= a&#ene#gi%
#e%e'to#s an& has
so!e
sy!'atho!i!eti%
a%ti5ity at (eta-=
#e%e'to#s.*oth al'ha
an& (eta (lo%9ing
a%tions %ont#i(ute to
the *P= lo1e#ing e""e%t:
(eta (lo%9a&e '#e5ents
the #e"le, ta%hy%a#&ia
seen 1ith !ost al'ha=
(lo%9ing &#ugs an&
&e%#eases 'las!a
#enin a%ti5ity.
Signi"i%antly #e&u%es
'las!a #enin a%ti5ity.
3y'e#tension, alone o# 1ith
othe# o#al &#ugs, es'e%ially
&iu#eti%s.
T#eat!ent o" !il& to se5e#e
hea#t "ailu#e o" is%he!i% o#
%a#&io!yo'hathi% o#igin
1ith &igitalis, &iu#eti%s, ACE
inhi(ito#
Di88iness,
5e#tigo, tinnitus,
"atique,
e!otional&e'#es
sion,
'a#esthesia,
slee'
&istu#(an%es.
*a%9 'ain,
Use %autiously 1ith
he'ati% i!'ai#!ent,
'e#i'he#al 5as%ula#
&isease, anesthesia,
!a7o# su#ge#y.
E0(se#5e ;. #ights in gi5ing !e&i%ation.
EMonito# 'atients (loo& glu%ose le5el, as
o#&e#e&, &u#ing %a#5e&ilol the#a'y (e%ause
&#ug !ay alte# (loo& glu%ose le5el.
A5oi& sto''ing &#ug a(#u'tly in
'atients 1ith hy'e#thy#oi&is! (e%ause
thy#oi& sto#! !ay o%%u# an& in 'atients
1ith angina (e%ause it !ay 1o#sen o# MI
!ay o%%u#.
E I" 'atient has hea#t "ailu#e, e,'e%t to also
gi5e &igo,in, a &iu#eti%, an& an ACE
inhi(ito#.
E Inst#u%t 'atient '#es%#i(e& e,ten&e&#elease
%a'sules to s1allo1 the! 1hole.
EDa#n 'atient that &#ug !ay %ause o#thostati%
hy'otension, light=hea&e&ness, an&
&i88iness: a&5ise hi! to ta9e '#e%autions.
E Tell 'atient 1ith hea#t "ailu#e to noti"y
'#es%#i(e# i" he gains @ l( o# !o#e in
- &ays o# i" sho#tness o" (#eath in%#eases,
1<% !ay signal 1o#sening hea#t "ailu#e.
E Ale#t 'atient 1ith &ia(etes to !onito# his
gly%e!i% %ont#ol %losely (e%ause &#ug !ay
in%#ease (loo& glu%ose le5el o# !as9
sy!'to!s o" hy'ogly%e!ia.
Classi"i%ation Cont#ain&i%ations A&5e#se E""e%ts
Antihy'e#tensi5
e
Al'ha=an& (eta
a&#ene#gi%
(lo%9e#
Cont#ain&i%ate& 1ith
&e%o!'ensate& hea#t
"ailu#e, (#on%hial asth!a,
hea#th (lo%9, %a#&iogeni%
sho%9, hy'e#sensiti5ity to
%a#5e&ilol, '#egnan%y,
la%tation.
3e'ati% "ailu#e