DRUG STUDY

Drug Name Action/ Dosage Indication/ contraindication Adverse Effects Nursing Responsibility

Generic Name: Action: Antagonizes Indication : For edema, Adverse Reaction: CNS:
spironolactone aldosterone in the distal Hypertention and diuretic headache, drowsiness,  To enhance absorption, give drug
tubules, increasing induced hypokalemia lethargy, confusion, ataxia. with meals.
Brandname: sodium and water  Protect drug from light.
 Monitor electrolyte levels, fluid
Aldactone excretion. GI: diarrhea, gastric bleeding,
intake and output, weight, and blood
Contraindications:  ulceration, cramping, gastritis, pressure.
Contraindicated in patients vomiting.  Monitor elderly patients closely, who
Classification: Dosage: are more susceptible to excessive
hypersensitive to drug and in
diuretic, GU: inability to maintain diuresis.
those with anuria, acute or  Inform laboratory that patient is
antihypertensive, Edema erection, menstrual
antihyperkalemic progressive renal insufficiency, or disturbances. taking spironolactone because drug
hyperkalemia. may interfere with tests that
Adults: Initially, 100 mg
measure digoxin level.
P.O. daily given as a Hematologic: agranulocytosis.  Drug is less potent than thiazide and
single dose or in divided
doses. Usual range is 25 loop diuretics and is useful as an
to 200 mg P.O. daily. Metabolic: hyponatremia, adjunct to other diuretic therapy.
Pregnancy hyperkalemia, dehydration, Diuretic effect is delayed 2 to 3 days
Category D Hypertension mild acidosis. when used alone.
 Maximum antihypertensive response
Adults: 50 to 100 mg P.O. may be delayed for up to 2 weeks.
Skin: urticaria, hirsutism,
daily or in divided doses.  Watch for hyperchloremic metabolic
maculopapular eruptions. acidosis, especially in patients with
Some practitioners use a
Other: gynecomastia, breast hepatic cirrhosis.
lower dose range of 25 to
50 mg daily soreness, drug fever,
anaphylaxis.
 DRUG STUDY

CNS: vertigo, headache,

Furosemide dizziness, paresthesia, To prevent nocturia, give P.O. and I.M.
Action: weakness, restlessness, fever. preparations in the morning. Give second
Brand Names A potent drug that Indication: For Acute Pulmonary CV: orthostatic hypotension, dose in early afternoon.
inhibits sodium and Edema, edema and hypertension thrombophlebitis with I.V.
Lasix
chloride reabsorption at administration. : Monitor weight, blood pressure, and pulse
the proximal and distal Contraindication: EENT: transient deafness, rate routinely with long-term use and during
tubules and the blurred or yellowed vision, rapid diuresis. Use can lead to profound
Classification: ascending loop of Henle. tinnitus. water and electrolyte depletion.
Contraindicated in patients
loop diuretic hypersensitive to drug and in GI: abdominal discomfort and
Therapeutic Class: pain, diarrhea, anorexia, Monitor fluid intake and output and
those with anuria.
antihypertensive Dosage. nausea, vomiting, constipation, electrolyte, BUN, and carbon dioxide levels
Injection: 10 mg/ml Use cautiously in patients with pancreatitis. frequently.
hepatic cirrhosis and in those GU: nocturia, polyuria,
Pregnancy risk frequent urination, oliguria. Watch for signs of hypokalemia, such as
allergic to sulfonamides
category C  Hematologic: agranulocytosis, muscle weakness and cramps.
leukopenia, thrombocytopenia,
azotemia, anemia, aplastic Consult prescriber and dietitian about a high-
anemia. potassium diet or potassium supplements.
Foods rich in potassium include citrus fruits,
Musculoskeletal: muscle tomatoes, bananas.
spasm.
Skin: dermatitis, purpura, Monitor glucose level in diabetic patients.
photosensitivity reactions,
transient pain at I.M. injection
site.
 DRUG STUDY

Action: Decreases Indication: Before therapy begins and at least annually

metformin hepatic glucose Adjunct to diet to lower glucose Adverse Reactions: thereafter, assess patient's renal function. If
hydrochloride production and intestinal level in patients with type 2 (non- GI: diarrhea, nausea, vomiting, renal impairment is detected, a different
insulin-dependent) diabetes abdominal bloating, flatulence, antidiabetic may be indicated.
absorption of glucose and
improves insulin anorexia, taste perversion.
Give with meals. Maximum doses may be
Brand name: sensitivity (increases better tolerated if total dose is divided into
Fortamet peripheral glucose Contraindication: Hematologic: megaloblastic t.i.d. dosing and given with meals.
uptake and use). Contraindicated in patients anemia.
hypersensitive to drug and in Monitor patient's glucose level regularly to
Classification: those with hepatic disease or Metabolic: lactic acidosis, evaluate effectiveness of therapy. Notify
Anti diabetic metabolic acidosis. HYPOGLYCEMIA. prescriber if glucose level increases despite
Dosage: therapy.
Tablets: 500 mg, 850 mg, Contraindicated in patients with
renal disease and in those with a Stop drug immediately and notify prescriber
1,000 mg
creatinine clearance greater than if patient develops a condition related to
or equal to 1.5 mg/dl (males) or hypoxemia or dehydration because of risk of
greater than or equal to 1.4 lactic acidosis.
mg/dl (females).

Contraindicated in patients older

than age 80, unless creatinine
clearance indicates normal renal
function.
DRUG STUDY