DRUG STUDY

Generic Brand Mechanism Frequency

Classification Indications Adverse Reaction Nursing consideration
Name Name of action and dosage
Altepla Activase, Therapeutic: Acute Directly 0.9 mg/kg CNS:  Assess for signs of bleeding and
se Activase thrombolytic myocardial converts IV; not to INTRACRANIAL hemorrhage (bleeding gums;
rt-PA, s infarction plasminoge exceed 90 HEMORRHAGE. nosebleed; unusual bruising;
Other Lysatec (MI). Acute n to mg total EENT: epistaxis, coughing up blood; black, tarry
names: rt-PA, Pharmacologi ischemic plasmin, dose; gingival bleeding. stools; hematuria; fall in
Tissue Cathflo c: stroke. which then administe RESP: hematocrit or blood pressure).
plasmi Activase plasminogen Pulmonary degrades r 10% of bronchospasm,  Be especially alert for signs of
nogen activators embolism clot-bound the total hemoptysis. intracranial bleeds, including
activato (PE). fibrin. dose as an CV: reperfusion sudden severe headache,
r (T- Occluded initial IV arrhythmias, confusion, nausea, vomiting,
PA) central Therapeutic bolus over hypotension, paralysis, numbness, speech
venous Effects: 1 min. and RECURRENT problems, visual disturbances.
access Lysis of the ISCHEMIA/THRO  Be alert for signs of recurrent
devices. thrombi in remainder MBOEMBOLISM. cardiac ischemia (chest pain,
coronary infused GI: GI BLEEDING, pain radiating into the arm or
Unlabeled arteries, over 60 nausea, jaw, shortness of breath,
Use: Deep with mins. RETROPERITONEA dizziness, sweating, anxiety) or
venous improveme L BLEEDING, recurrent cerebral ischemia
thrombosis nt of vomiting. (sudden dizziness, vertigo,
(DVT). ventricular GU: GU TRACT slurred speech, incoordination,
Acute function, BLEEDING. numbness).
peripheral and reduced DERM: ecchymoses,  Assess heart rate, ECG, and
arterial risk of heart flushing, urticaria. heart sounds when cardiac
thrombosis. failure or HEMAT: perfusion is restored. Report
death. Lysis BLEEDING. any rhythm disturbances or
of LOCAL: symptoms of increased
pulmonary hemorrhage at arrhythmias, including
emboli. injection site, palpitations, chest discomfort,
Lysis of phlebitis at injection shortness of breath, fainting,
thrombi site. and fatigue/weakness.
causing MS:  Assess blood pressure,
 ischemic musculoskeletal especially for the first few
stroke, pain. days after infusion. Report
reducing MISC: ALLERGIC low blood pressure
risk of REACTIONS, (hypotension), especially if
neurologic INCLUDING patient experiences
sequelae. ANAPHYLAXIS, dizziness or syncope.
Restoration fever.  Assess any muscle of joint
of cannula pain to rule out
or catheter musculoskeletal pathology
function. or hemorrhage; that is, try
to determine if pain is drug
induced rather than caused
by anatomic or
biomechanical problems. Be
especially concerned about
back pain that could
indicate retroperitoneal
bleeding.
 Assess injection site during
and after IV administration,
and report signs of bleeding
or phlebitis (local pain,
swelling, inflammation).
 Generic Brand Classifica Indication Mechanism of Dosage & Adverse
Nursing Considerations
Name Name tion Action Frequency Reactions

Atorvastat Lipitor Therapeut Adjunctive Inhibits 3- 20 mg 1 CNS: dizziness,  Assess any muscle pain,
in ic: lipid- management hydroxy-3- tab OD headache, tenderness, or weakness,
lowering of primary methylglutaryl insomnia, especially if accompanied by
agents hypercholeste coenzyme A weakness. fever, malaise, and dark-
rolemia and (HMG CoA) EENT: rhinitis. colored urine. R: Advise
Pharmaco mixed reductase, an RESP: patient that these symptoms
logic: dyslipidemia. enzyme which bronchitis. may represent drug-induced
HMG- Primary is responsible CV: chest pain, myopathy, and that myopathy
CoA prevention of for catalyzing peripheral can progress to severe muscle
reductase coronary an early step in edema. damage (rhabdomyolysis).
inhibitors heart disease the synthesis GI: abdominal Report any unexplained
(statins) (myocardial of cholesterol. cramps, musculoskeletal symptoms to the
infarction, constipation, physician immediately.
Therapeutic
stroke, diarrhea, flatus,
Effects:  Assess peripheral edema
angina, and heartburn,
Lowering of using girth measurements,
coronary nausea.
total and LDL volume displacement, and
revascularizat GU: erectile
cholesterol and measurement of pitting
ion) in dysfunction.
triglycerides. edema. R: Report increased
asymptomatic DERM: rashes,
Slightly swelling in feet and ankles or a
patients with pruritus.
increases HDL sudden increase in body weight
increased MS:
cholesterol. due to fluid retention.
total and low- rhabdomyolysis,
Reduction of
density arthralgia,  Advise patient that this
lipids/choleste
lipoprotein arthritis, medication should be used in
rol reduces the
(LDL) myalgia, conjunction with diet
risk of
cholesterol myositis. restrictions (fat, cholesterol,
myocardial
and decreased MISC: carbohydrates, alcohol),
infarction and
high-density hypersensitivity exercise, and cessation of
stroke
lipoprotein reactions, smoking.
sequelae.
(HDL) including
cholesterol. angioneurotic  Instruct patient to notify
edema. health care professional
promptly if unexplained
muscle pain, tenderness, or
weakness occurs, especially if
accompanied by fever or
malaise. Also notify health
care professional if signs of
liver problems (feeling tired
or weak; loss of appetite;
upper belly pain; dark urine;
or yellowing of skin or whites
of eyes).

Lab Test Considerations:

 Evaluate serum cholesterol

and triglyceride levels before
initiating, after 2–4 week of
therapy, and periodically
thereafter.
 Monitor liver function tests
prior to initiation of therapy
and as clinically indicated. If
symptoms of serious liver
injury, or jaundice occur
discontinue atorvastatin and
do not restart.
 If patient develops muscle
tenderness during therapy,
CPK (Creatine
phosphokinase) levels should
be monitored. If CPK levels
are >10 times the upper limit
of normal or myopathy
occurs, therapy should be
discontinued.
Generic Brand Classifica Mechanism of Dosage & Adverse
Indication Nursing Considerations
Name Name tion Action Frequency Reactions

Warfarin Couma Therapeut Prophylaxis Interferes with 5 mg 1 GI: cramps,  Watch for signs of bleeding and
din, ic: and treatment hepatic tab OD nausea. hemorrhage, including
Warfilo anticoag of Venous synthesis of DERM: bleeding gums, nosebleeds,
ne ulants thrombosis, vitamin K– dermal unusual bruising, coughing up
Pulmonary dependent necrosis. blood, black/tarry stools,
Pharmaco embolism, clotting factors HEMAT: hematuria, or a fall in
logic: bleeding hematocrit or blood pressure.
Atrial (II, VII, IX, and
coumarin MISC: fever. Notify physician or nursing
fibrillation X).
s staff immediately if warfarin
with
Therapeutic causes excessive
embolization. anticoagulation.
Effects:
Management  Monitor any appreciable
Prevention of
of myocardial symptoms of DVT such as pain,
thromboembol
infarction: ↓ swelling, warmth, and redness
ic events.
risk of death, ↓ to determine if drug therapy is
risk of effective in preventing or
subsequent reducing venous thrombosis.
MI, ↓ risk of Request or administer objective
future tests (Doppler ultrasound) if
thromboembol symptoms increase.
ic events.  Use caution with any physical
Prevention of interventions that could
increase bleeding, including
thrombus
wound debridement, chest
formation and
percussion, joint mobilization,
embolization and application of local heat.
after prosthetic  Instruct patient to immediately
valve report signs of GI bleeding,
placement. including abdominal pain,
vomiting blood, blood in stools,
or black, tarry stools.
 Remind patient that excessive
vitamin K intake negates
warfarin's therapeutic effects.
Refer patient to the physician
or a nutritionist regarding
appropriate dietary intake of
foods rich in vitamin K (leafy
green vegetables, dairy
products, and so forth).
 Generic Brand Classificati Mechanism of Frequency Adverse
Indications Nursing consideration
Name Name on action and dosage Reaction
Captopril Capoten Therapeuti Alone or with Angiotensin- 25 mg PO CNS:  Watch for signs of
c: other agents in converting q8-12hr dizziness, angioedema, including
antihypert the management enzyme (ACE) fatigue, rashes, raised patches of red
ensives of hypertension. inhibitors block headache, or white skin (welts),
Management of the conversion insomnia. burning/itching skin,
Pharmacol heart failure. of angiotensin I RESP: swelling in the face, and
ogic: Reduction of risk to the cough. CV: difficulty breathing. Notify
ACE of death, heart vasoconstrictor hypotension, physician immediately of
inhibitors failure–related angiotensin II. chest pain, these signs.
hospitalizations, ACE inhibitors palpitations,  Monitor signs of
and also prevent the tachycardia. agranulocytosis and
development of degradation of GI: taste neutropenia (fever, sore
overt heart bradykinin and disturbances, throat, mucosal lesions, signs
failure following other abdominal of infection, bruising).
myocardial vasodilatory pain, Report these signs to the
infarction. prostaglandins. anorexia, physician immediately.
Treatment of ACE inhibitors constipation,  Assess blood pressure
diabetic also increase diarrhea, periodically and compare to
nephropathy in plasma renin nausea, normal values (See
patients with levels and vomiting. Appendix F) to help
type 1 diabetes reduce GU: determine antihypertensive
mellitus and aldosterone proteinuria, effects. Report low blood
retinopathy. levels. Net impaired pressure (hypotension),
result is renal especially if patient
systemic function. experiences dizziness,
vasodilation. DERM: fatigue, or syncope.
angioedema,  Assess signs and symptoms
Therapeutic rashes, of CHF (dyspnea,
Effects: pruritus. rales/crackles, peripheral
Lowering of F and E: edema, jugular venous
blood pressure hyperkalemi distention, exercise
in patients with a. intolerance) to help
hypertension. HEMAT:
 Improved agranulocyto document whether drug
survival and sis, therapy is effective in
reduced neutropenia. reducing these symptoms.
symptoms in Misc: fever.  Assess heart rate, ECG, and
patients with heart sounds, especially
heart failure. during exercise Report any
Improved rhythm disturbances or
survival and symptoms of increased
reduced arrhythmias, including
development of palpitations, chest
overt heart discomfort, shortness of
failure after breath, fainting, and
myocardial fatigue/weakness.
infarction.
Decreased
progression of
diabetic
nephropathy
with decreased
need for
transplantation
or dialysis.

https://fadavispt.mhmedical.com/content.aspx?bookid=1873&sectionid=139004119
Generic Brand Classificati Mechanism of Frequency Adverse
Indications Nursing consideration
Name Name on action and dosage Reaction
Acetyls Aspirin Therapeutic: Inflammatory Produce 325 mg 1 EENT:  Monitor signs of allergic
alicylic antipyretic disorders, analgesia and tab OD tinnitus. reactions and anaphylaxis,
acid s, including reduce GI: GI including pulmonary
nonopioid Rheumatoid inflammation bleeding, symptoms (laryngeal edema,
analgesics arthritis, and fever by dyspepsia, wheezing, cough, dyspnea) or
Osteoarthritis. inhibiting the epigastric skin reactions (rash, pruritus,
Pharmacolo Mild-to- production of distress, urticaria). Notify physician
gic: moderate pain. prostaglandins. nausea, immediately if these reactions
salicylates Fever. Decreases abdominal occur. Allergic reactions are
Prophylaxis of platelet pain, more common in people with
transient aggregation. anorexia, asthma, nasal polyps, or
ischemic attacks hepatotoxicity aspirin-induced allergies.
and MI. Therapeutic , vomiting.  Be alert for signs of GI
Unlabeled Use: Effects: HEMAT: bleeding, including abdominal
Adjunctive Analgesia. anemia, pain, vomiting blood, blood in
treatment of Reduction of hemolysis. stools, or black, tarry stools.
Kawasaki's inflammation. DERM: rash, Report these signs to the
disease. Reduction of urticaria. physician immediately.
fever. Decreased MISC:  Watch for signs of hemolysis
incidence of allergic and anemia, including unusual
transient reactions, fatigue, shortness of breath,
ischemic attacks including dizziness, headache, coldness
and MI. anaphylaxis in your hands and feet, pale
and laryngeal skin, and chest pain. Report
edema. these signs to the physician.
 Assess pain and other variables
(range of motion, muscle
strength) to document whether
this drug is successful in
helping manage the patient's
pain and decreasing
impairments.
Reference:
F.A Davis PT Collection (2015). Davis's Drug Guide. Alteplase. Retrieved from https://fadavispt.mhmedical.com/content.aspx?
bookid=1873&sectionid=139001028, last December 2021

F.A Davis PT Collection (2015). Davis's Drug Guide. Atorvastatin. Retrieved from https://fadavispt.mhmedical.com/content.aspx?
bookid=1873&sectionid=139002293, last December 2021

F.A Davis PT Collection (2015). Davis's Drug Guide. Warfarin. Retrieved from https://fadavispt.mhmedical.com/content.aspx?
bookid=1873&sectionid=139030264, last December 2021

F.A Davis PT Collection (2015). Davis's Drug Guide. Captopril. Retrieved from https://fadavispt.mhmedical.com/content.aspx?
bookid=1873&sectionid=139004119, last December 2021

F.A Davis PT Collection (2015). Davis's Drug Guide. Aspirin. Retrieved from https://fadavispt.mhmedical.com/content.aspx?
bookid=1873&sectionid=139002142, last December 2021

Medscape (2016). Alteplase (Rx). Retrieved from https://reference.medscape.com/drug/activase-tpa-alteplase-342287, last December 2021

Nursing Central (2015). Davis's Drug Guide. Atorvastatin/Ezetimibe. Retrieved from

https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Drug-Guide/110148/all/atorvastatin_ezetimibe, last December 2021