Drug Study

Brand/Generic
Name
Lanoxin

Classification
cardiovascular
agent; cardiac
glycoside;
antiarrhythmic
Rapid digitalization
and for
maintenance
therapy in CHF,
atrial fibrillation,
atrial flutter,
paroxysmal atrial
tachycardia.

Omeprazole

gastrointestinal
agent; proton pump
inhibitor
An antisecretory
compound that is a
gastric acid pump
inhibitor.
Suppresses gastric
acid secretion by
inhibiting the H+,
K+-ATPase
enzyme system [the
acid (proton H+)
pump] in the
parietal cells.

Contraindication

Adverse Reaction

Nursing Considerations

Patient Teaching

Digitalis
hypersensitivity,
ventricular
fibrillation,
ventricular
tachycardia unless
due to CHF. Full
digitalizing dose
not given if patient
has received
digoxin during
previous week or
if slowly excreted
cardiotonic
glycoside has been
given during
previous 2 wk.

Fatigue, muscle
weakness, headache,
facial neuralgia,
mental depression,
paresthesias,
hallucinations,
confusion,
drowsiness, agitation,
dizziness.

Headache, dizziness,
fatigue.

Weigh each day under

standard conditions.
Report weight gain >1
kg (2 lb)/d.
Take digoxin
PRECISELY as
prescribed, do not to
skip or double a dose
or change dose
intervals, and take it
at same time each day.
Do not to take OTC
medications,
especially those for
coughs, colds, allergy,
GI upset, or obesity,
without prior approval
of physician
Report any changes in
urinary elimination
such as pain or
discomfort associated
with urination, or
blood in urine.
Report severe
diarrhea; drug may
need to be
discontinued.
Do not breast feed
while taking this drug.

Long-term use for

gastroesophageal
reflux disease,
duodenal ulcers;
lactation.

Diarrhea, abdominal
pain, nausea, mild
transient increases in
liver function tests.

Monitor I&O ratio

during digitalization,
particularly in patients
with impaired renal
function. Also

monitor for edema

daily and auscultate
chest for rales.
Monitor serum
digoxin levels closely
during concurrent
antibioticdigoxin

therapy, which can

precipitate toxicity
because of altered
intestinal flora

Lab tests: Monitor

urinalysis for
hematuria and
proteinuria. Periodic
liver function tests
with prolonged use.

Azithromycin

Menomas
Paracetamol

antiinfective;
Hypersensitivity to
macrolide antibiotic azithromycin,
erythromycin, or
Pneumonia, lower
any of the
respiratory tract
macrolide
infections,
antibiotics.
pharyngitis/tonsillit
is, gonorrhea,
nongonococcal
urethritis, skin and
skin structure
infections due to
susceptible
organisms, otitis
media,
intracellulare
complex infections.

Headache, dizziness.

Nausea, vomiting,
diarrhea, abdominal
pain; hepatotoxicity,
mild elevations in
liver function tests.

central nervous
system agent;
nonnarcotic
analgesic,
antipyretic

Anorexia, nausea,
vomiting, dizziness,
lethargy, diaphoresis,
chills, epigastric or
abdominal pain,
diarrhea;

Hypersensitivity to
acetaminophen or
phenacetin.

Fever reduction.
Temporary relief of
mild to moderate
pain. Generally as
substitute for
aspirin when the
latter is not
tolerated or is
contraindicated

Duphalac

gastrointestinal
agent;
hyperosmotic

Monitor for and report

loose stools or
diarrhea, since
pseudomembranous

colitis must be ruled

out.

Monitor PT and INR

closely with
concurrent warfarin
use.

Monitor for S&S of:

hepatotoxicity, even
with moderate
acetaminophen doses,
especially in
individuals with poor
nutrition or who have
ingested alcohol over
prolonged periods

Low galactose
diet; pregnancy
(category C). Safe

Flatulence,
borborygmi,
belching, abdominal

In children if the
initial dose causes

Take aluminum or
magnesium antacids 2
h before or after drug.
Report onset of loose
stools or diarrhea.
Do not breast feed
while taking this drug
without consulting
physician.

Do not self-medicate
adults for pain more
than 10 d (5 d in
children) without
consulting a
physician.
Do not use this
medication without
medical direction for:
fever persisting longer
than 3 d, fever over
39.5 C (103 F), or
recurrent fever.
Do not give children
more than 5 doses in
24 h unless prescribed
by physician
Laxative action is not
instituted until drug

laxative

Ranitidine

Prevention and
treatment of portalsystemic
encephalopathy
(PSE), including
stages of hepatic
precoma and coma,
and by prescription
for relief of chronic
constipation.
gastrointestinal
agent; antisecretory
Short-term
treatment of active
duodenal ulcer;
maintenance
therapy for
duodenal ulcer
patient after healing
of acute ulcer

Paracetamol

central nervous
system agent;
nonnarcotic
analgesic,
antipyretic
Fever reduction.
Temporary relief of
mild to moderate

use in lactation or
children is not
established.

Safe use during

pregnancy
(category B) or
lactation is not
established.

cramps, pain, and

distention (initial
dose); diarrhea
(excessive dose);
nausea, vomiting,
colon accumulation
of hydrogen gas;
hypernatremia.

Headache, malaise,
dizziness,
somnolence,
insomnia, vertigo,
mental confusion,
agitation, depression,
hallucinations in
older adults.

Hypersensitivity to
acetaminophen or
phenacetin.

Anorexia, nausea,
vomiting, dizziness,
lethargy, diaphoresis,
chills, epigastric or
abdominal pain,
diarrhea;

diarrhea, dosage is
reduced immediately.
Discontinue if
diarrhea persists.
Promote fluid intake
(>=15002000 mL/d)
during drug therapy
for constipation; older
adults often self-limit
liquids

Potential toxicity

results from decreased

clearance
(elimination) and
therefore prolonged
action; greatest in the
older adult patients or
those with hepatic or

renal dysfunction.
Lab tests: Periodic
liver functions.
Monitor creatinine

clearance if renal
dysfunction is present
or suspected.

Monitor for S&S of:

hepatotoxicity, even
with moderate
acetaminophen doses,
especially in
individuals with poor
nutrition or who have
ingested alcohol over

reaches the colon;

therefore, about 24
48 h is needed.
Do not self-medicate
with another laxative
due to slow onset of
drug action.
Notify physician if
diarrhea (i.e., more
than 2 or 3 soft
stools/d) persists more
than 2448 h.
Be aware that even if
symptomatic relief is
provided by
ranitidine, this should
not be interpreted as
absence of gastric
malignancy.
Adhere to scheduled
periodic laboratory
checkups during
ranitidine treatment.
Do not supplement
therapy with OTC
remedies for gastric
distress or pain
without physician's
advice
Do not self-medicate
adults for pain more
than 10 d (5 d in
children) without
consulting a
physician.
Do not use this
medication without

pain. Generally as
substitute for
aspirin when the
latter is not
tolerated or is
contraindicated

Metoclopramide gastrointestinal
agent; prokinetic
agent; antiemetic
Management of
diabetic gastric
stasis
(gastroparesis); to
prevent nausea and
vomiting associated
with emetogenic
cancer
chemotherapy

Imidapril

Anti-hypertensive

prolonged periods

Sensitivity or
intolerance to
metoclopramide;
allergy to sulfiting
agents; history of
seizure disorders;
concurrent use of
drugs that can
cause
extrapyramidal
symptoms;
pheochromocytom
a; mechanical GI
obstruction or
perforation
Aortic stenosis or
outflow tract
obstruction;
renovascular
disease; ascites.
Pregnancy and
lactation.

Mild sedation,
fatigue, restlessness,
agitation, headache,
insomnia,
disorientation,
extrapyramidal
symptoms (acute
dystonic type).

Lab tests: Periodic

serum electrolyte.
Monitor for possible
hypernatremia and
hypokalemia (see
Appendix F),
especially if patient
has CHF or cirrhosis.

Nausea, constipation,
diarrhea, dry mouth,
altered drug
absorption.
Dizziness, headache,
fatigue, GI and taste
disturbances,
persistent dry cough
and other upper
respiratory tract
symptoms, skin rash,
angioedema,
photosensitivity,
renal impairment,
hyperkalaemia,
hyponatraemia, blood
disorders, proteinuria,
chest pain

Assess renal function

before and during
therapy; monitor for
proteinuria. Conduct
regular WBC counts
in SLE and
scleroderma patients.
Liver cirrhosis.
Discontinue diuretics
2-3 days before
starting therapy and
resume later if
required. Elderly.

medical direction for:

fever persisting longer
than 3 d, fever over
39.5 C (103 F), or
recurrent fever.
Do not give children
more than 5 doses in
24 h unless prescribed
by physician
Avoid driving and
other potentially
hazardous activities
for a few hours after
drug administration.
Avoid alcohol and
other CNS
depressants.
Report S&S of acute
dystonia, such as
trembling hands and
facial grimacing,
immediately.
Should be taken on an
empty stomach. (Take
15 min before meals.
However, when
initiating therapy, 1st
dose should be given
at bedtime.)