DRUG STUDY

MEDICATION INDICATION MECHANISM OF MECHANISM OF SIDE EFFECTS AND NURSING RESPONSIBILITIES

ACTION ACTION IN ADVERSE EFFECTS
RELATION TO
THE PATIENT’S
CASE
LOSARTAN + HCTZ Hypertension Hydrochlorothiazide The drug works Side Effects: BASELINE ASSESSMENT
50/12.5 MG increases renal in high blood dizziness or Obtain B/P, apical pulse
excretion of sodium pressure by lightheadedness as immediately before each
Generic Name: and chloride and relaxing and your body adjusts dose, in addition to regular
Losartan potassium- reduces cardiac widening blood to the medication, monitoring (be alert to
hydrochlorothiazide load. Losartan is an vessels. This stomach pain, fluctuations).
INTERVENTION/EVALUATI
Brand Name: angiotensin II lowers the back pain, tired ON
Hyzaar receptor (type AT1) patient’s blood feeling, skin rash, Maintain hydration (offer
antagonist pressure and runny or stuffy nose, fluids frequently).
antihypertensive makes it easier sore throat, or dry Assess for evidence of
which acts by for the heart to cough. upper respiratory infection,
blocking the pump blood Adverse Side cough.
actions of around your Effects: Monitor B/P, pulse. If
angiotensin II of body. Volume depletion excessive reduction in B/P
renin-angiotensin- and electrolyte occurs, place pt in supine
aldosterone system. imbalance position, feet
The drug and its (especially slightly elevated. Assist with
active metabolite hyperkalaemia); ambulation if dizziness
selectively block dry mouth, thirst; occurs.
the vasoconstrictor lethargy, Monitor daily pattern of
and aldosterone drowsiness; muscle bowel activity, stool
secreting effects of pain and cramps; consistency.
PATIENT/FAMILY
angiotensin II. The rashes, TEACHING
two drugs exert photosensitivity, • Report any sign of
additive effects in thrombocytopenia, infection (sore throat,
hypertension. jaundice, fever), chest pain.
Therapeutic pancreatitis; • Do not take OTC cold
indication: fatigue, weakness; preparations, nasal
Decrease B/P may precipitate an decongestants.
attack of gout; • Do not stop taking
impotence; medication.
hyperglycaemia; • Limit salt intake
anorexia, nausea,
vomiting,
constipation,
diarrhoea;
sialdenitis; raised
urinary calcium
concentration;
headache,
dizziness; back
pain, myalgia; first-
dose hypotension;
angiodema;
neutropenia; GI
disturbances;
transient elevation
of liver enzymes;
taste disturbances,
cough;
exacerbation or
activation of
systemic lupus
erythematous;
palpitations;
xanthopsia;
leucopenia,
agranulocytosis,
aplastic anaemia;
necrotising angiitis;
glucosuria; renal
dysfunction,
interstitial nephritis,
renal failure;
migraine;
hyponatraemia;
UTI; chest pain;
gastritis, wt gain,
dyspepsia,
abdominal pain;
bronchitis, upper
respiratory
infection, nasal
congestion, sinusitis;
rise in cholesterol
and/or
triglycerides.
MEDICATION INDICATION MECHANISM OF MECHANISM OF SIDE EFFECTS AND NURSING RESPONSIBILITIES
ACTION ACTION IN ADVERSE EFFECTS
RELATION TO THE
PATIENT’S CASE
AMLODIPINE Hypertension Inhibits influx of The drug works in Side Effects: BASELINE ASSESSMENT
Generic Name: extracellular high blood Peripheral Assess baseline
Amlodipine calcium ions, pressure by edema, renal/hepatic function
Brand Name: thereby relaxing and headache, tests, B/P, apical pulse.
INTERVENTION/EVALUATI
Apo-Amlodipine; decreasing widening blood flushing. Dizziness, ON
Norvasc; Katerzia myocardial vessels. This lowers palpitations, Assess B/P (if systolic B/P is
contractility, the patient’s nausea, unusual less than 90 mm Hg,
relaxing coronary blood pressure fatigue or withhold medication,
and vascular and makes it weakness contact physician). Assess
muscles, and easier for the (asthenia). for peripheral edema
decreasing heart to pump Adverse Side behind medial malleolus
peripheral blood around Effects: (sacral area in bedridden
resistance your body. Overdose may pts). Assess skin for flushing.
Therapeutic produce Question for headache,
outcome: excessive asthenia.64 amoxicillin
Decreased B/P peripheral underlined – top
vasodilation, prescribed drug
PATIENT/FAMILY
marked TEACHING
hypotension with • Do not abruptly
reflex discontinue medication.
tachycardia, • Compliance with
syncopy therapy regimen is
essential to control
hypertension.
• Avoid tasks that require
alertness, motor skills until
response to drug is
established.
• Do not ingest grapefruit
products.
• Advise patient to avoid
hazardous activities until
stabilized on product,
dizziness is no longer a
problem
• Instruct patient to avoid
alcohol and OTC products
unless directed by prescriber
• Advise patient to comply in
all areas of medical regimen:
diet, exercise, stress reduction,
smoking cessation, product
therapy; to notify prescriber of
irregular heartbeat, shortness of
breath, swelling of feet, face,
and hands, severe dizziness,
constipation, nausea,
hypotension; use nitroglycerin
when angina is severe
• Teach patient to use as
directed even if feeling better;
may be taken with other
cardiovascular products
(nitrates, b-blockers)
• Advise to avoid large
amounts of grapefruit juice or
alcohol
MEDICATION INDICATION MECHANISM OF MECHANISM OF SIDE EFFECTS AND NURSING RESPONSIBILITIES
ACTION ACTION IN ADVERSE EFFECTS
RELATION TO THE
PATIENT’S CASE
TRAMADOL 50 MG Indication: Binds to mu-opioid In the spinal cord, Side Effects: BASELINE ASSESSMENT
Management of receptors, inhibits opioids act on Frequent: Assess onset, type,
Generic Name: moderate to reuptake of specific receptors Dizziness, vertigo, location, duration of pain.
Tramadol moderately norepinephrine, located in pre- nausea, Assess drug history, esp.
Brand Name: severe pain. serotonin, and postsynaptic constipation, carbamazepine,
Ultram, Tramadol Extended- inhibiting synapses in the headache, analgesics, CNS
Hydrochloride ER, Release: Around- ascending and dorsal horn. Pre drowsiness. depressants, MAOIs.
Tramal, Ultram ER the-clock descending pain synaptically, Occasional: Review past medical
management of pathways. opioids decrease Vomiting, pruritus, history, esp. epilepsy,
moderate to Therapeutic Effect: the release of CNS stimulation seizures. Assess renal
moderately Reduces pain. specific pain (e.g., nervousness, function, LFT.
INTERVENTION/EVALUATI
severe pain for neurotransmitters anxiety, agitation, ON
extended period. (i.e. substance P), tremor, euphoria, Monitor pulse, B/P,
while in the mood swings, renal/hepatic function. Dry
postsynaptic hallucinations), crackers, cola may relieve
neuron they asthenia, nausea. Palpate bladder
decrease diaphoresis, for urinary retention.
excitability. Opioid dyspepsia, dry Monitor daily pattern of
receptors produce mouth, diarrhea. bowel activity, stool
their analgesic Rare: Malaise, consistency. Sips of water
effects in the vasodilation, may relieve dry mouth.
spinal cord by anorexia, Assess for clinical
coupling with G- flatulence, rash, improvement, record onset
proteins to both blurred vision, of relief of pain.
PATIENT/FAMILY
alter synaptic urinary retention/ TEACHING
transmission at frequency, • May cause
pain pathways menopausal dependence.
and to decrease symptoms. • Avoid alcohol, OTC
neuronal medications (analgesics,
excitability via the Adverse Side sedatives).
inhibition of cyclic Effects: Seizures • May cause drowsiness,
adenosine reported in pts dizziness, blurred vision.
monophosphate receiving • Avoid tasks requiring
(cAMP). tramadol within alertness, motor skills until
recommended response to drug is
dosage range. established.
May have • Report severe constipation,
prolonged difficulty breathing, excessive
duration of sedation, seizures, muscle
action, weakness, tremors, chest pain,
cumulative effect palpitations.
in pts with
hepatic/renal
impairment,
serotonin
syndrome
(agitation,
hallucinations,
tachycardia,
hyperreflexia).
 MEDICATION INDICATION MECHANISM OF MECHANISM OF SIDE EFFECTS AND NURSING
ACTION ACTION IN ADVERSE EFFECTS RESPONSIBILITIES
RELATION TO THE
PATIENT’S CASE
CARVEDILOL Hypertension. HF with Block’s stimulation of Carvedilol promotes CNS: dizziness, fatigue, •Monitor BP and pulse
digoxin, diuretics, and beta 1 (myocardial) and neurological function, weakness, anxiety, frequently during dose
Generic Name: ACE inhibitors. Left beta 2 (pulmonary, reduces bone loss and depression, drowsiness, adjustment period and
Carvedilol ventricular dysfunction vascular, and uterine)- attenuates cell damage insomnia, memory loss, periodically during
Brand Name: after MI. adrenergic receptor after acute spinal cord mental status changes, therapy.
Coreg, Coreg CR sites. Also has alpha 1 injury. nervousness, •Assess for orthostatic
blocking activity, which nightmares. EENT: hypotension when
may result in orthostatic blurred vision, dry eyes, assisting
hypotension. intraoperative floppy patient up from supine
Therapeutic Effects: iris syndrome, nasal position.
Decreased heart rate stuffiness. Resp: •Monitor intake and
and BP. Improved bronchospasm, output ratios and daily
cardiac output, slowing wheezing. CV: weight.
of the progression of BRADYCARDIA, HF, •Assess patient
HF and decreased risk PULMONARY routinely for evidence
of death. EDEMA. GI: diarrhea, of fluid overload
constipation, nausea. (peripheral edema,
GU: erectile dyspnea, rales/crackles,
dysfunction, libido. fatigue, weight gain,
jugular venous
distention). Patients
may experience
worsening of symptoms
during initiation of
therapy for HF.

MEDICATION INDICATION MECHANISM OF MECHANISM OF SIDE EFFECTS AND NURSING

ACTION ACTION IN ADVERSE EFFECTS RESPONSIBILITIES
RELATION TO THE
PATIENT’S CASE
TAMSULOSIN Management of outflow Decreases contractions Tamsulosin is used in CNS: dizziness, headache. •Assess patient for
obstruction in male in smooth muscle of men to treat the EENT: rhinitis. CV: symptoms of prostatic
Generic Name: patients with prostatic the prostatic capsule by symptoms of an orthostatic hypotension. hyperplasia (urinary
Carvedilol hyperplasia. preferentially binding enlarged prostate GU: priapism, hesitancy, feeling of
Brand Name: to alpha1-adrenergic (benign prostatic retrograde/diminished incomplete bladder
Flomax receptors. Therapeutic hyperplasia or BPH) ejaculation. emptying, interruption
Effects: Decreased which include of urinary stream,
symptoms of prostatic difficulty urinating. impairment of size and
hyperplasia. force of urinary stream,
terminal urinary
dribbling, straining to
start flow, dysuria,
urgency) before and
periodically during
therapy.
•Assess patient for first-
dose orthostatic
hypotension and
syncope. Incidence may
be dose related.
Observe patient closely
during this period and
take precautions to
prevent injury.
•Monitor intake and
output ratios and daily
weight, and assess for
edema daily, especially
at beginning of therapy.
Report weight gain or
edema.

MEDICATION INDICATION MECHANISM OF MECHANISM OF SIDE EFFECTS AND ADVERSE NURSING

ACTION ACTION IN EFFECTS RESPONSIBILITIES
RELATION TO
THE PATIENT’S
CASE
PREGABALIN Neuropathic pain Binds to calcium Pregabalin is an CNS: SUICIDAL THOUGHTS, •Monitor closely for
associated with channels in CNS anticonvulsant drug dizziness, drowsiness, impaired notable changes in
Generic Name: diabetic peripheral tissues which regulate used to treat attention/concentration/thinking. CV: behavior that could
Pregabalin neuropathy. neurotransmitter neuropathic pain edema. EENT: blurred vision. GI: dry indicate the
Brand Name: Postherpetic release. Does not bind conditions and mouth, abdominal pain, constipation emergence or
Lyrica neuralgia. to opioid receptors. fibromyalgia worsening of suicidal
Fibromyalgia. Therapeutic Effects: thoughts or behavior
Neuropathic pain Decreased or depression.
associated with neuropathic or post- •Seizures: Assess
spinal cord injury. herpetic pain. location, duration,
Adjunctive therapy Decreased partial- and characteristics of
of partial-onset onset seizures. seizure activity.
seizures in adults. •Caution patient to
avoid driving or
activities requiring
alertness until
response to
medication is known.