SCHOOL OF NURSING
General Luna Road, Baguio City Philippines 2600
Telefax No.: (074) 442-3071
DRUG NAME
Generic Name: Captopril
Brand Name: Apo-Capto ,
Capoten , Novo-Captoril
Dose: PO
Adults, Elderly: 12.5–25 mg
Maintenance: 25–150 mg
Maximum: 450 mg/day
Children: 0.3–0.5 mg
Maximum: 6 mg/kg/day
Infants: 0.15–0.3 mg/kg/dose
Maximum: 6 mg/kg/day
Neonates: 0.01–0.1 mg/kg/dose
Maximum: 0.5 mg/kg/dose
Frequency:
Adults, Elderly: 1-2 weeks
Maintenance: 2-3 times a days
Children: 3 times a day
Infants: once a day
Route: PO
Website: www.ubaguio.edu
DRUG STUDY
MODE OF ACTION
Drug Classification: Anti-
hypertensive
Therapeutic Action:
Suppresses renin-angiotensin-
aldosterone system (prevents
conversion of angiotensin I to
angiotensin II, a potent
vasoconstrictor; may inhibit
angiotensin II at local vascular
and renal sites). Decreases
plasma angiotensin II,
increases plasma renin activity,
decreases aldosterone
secretion. Therapeutic Effect:
Reduces peripheral arterial
resistance,
pulmonary capillary wedge
pressure; improves cardiac output,
exercise tolerance.
E-mail Address: ub@ubaguio.edu
DRUG EFFECTS
Side Effects: Rash, Pruritus, dysgeusia
(altered taste), Headache, cough,
insomnia, dizziness, fatigue,
paresthesia, malaise, nausea, diarrhea
or constipation, dry mouth, tachycardia
Adverse Effect: Excessive hypotension
(“first-dose syncope”) may occur in pts
with CHF and in those who are severely
sodium/ volume depleted. Angioedema
(swelling of face/tongue/lips),
hyperkalemia occur rarely.
Agranulocytosis, neutropenia may be
noted in those with collagen vascular
disease (scleroderma, systemic lupus
erythematosus), renal impairment.
Nephrotic syndrome may be noted in
those with history of renal disease.
RESPONSIBILITIES
Obtain B/P immediately before each
dose, in addition to regular monitoring
(be alert to fluctuations). If excessive
reduction in B/P occurs, place pt in
supine position with legs elevated. In
pts with prior renal disease or
receiving dosages greater than
150 mg/day, urine test for protein
by dipstick method should be
made with first urine of day before
therapy begins and periodically
thereafter. In pts with renal
impairment, autoimmune disease,
or taking drugs that affect
leukocytes or immune response,
CBC should be performed before
beginning therapy, q2wks for 3
mos, then periodically thereafter.
Assess skin for rash, pruritus.
Assist with ambulation if dizziness
occurs. Monitor urinalysis for
proteinuria. Assess for anorexia
secondary to altered taste
perception. Monitor serum
potassium levels in those on

Generic Name: Losartan
Brand Name: Cozaar
Dose:
Adults, Elderly: 50 mg
Maximum: 25–100 mg
Children 6 Mos –16 yrs: 0.7 mg/kg
Maximum: 50 mg/day
Frequency:
Adults, Elderly: once or twice a day
Children 6 Mos –12 yrs: once a day
Route: PO
Generic Name: Diltiazem
Brand Name: Apo-Diltiaz ,
Cardizem, Cardizem CD,
Cardizem LA, Cartia XT,
Dose:
PO
Adults, Elderly: 30 mg
Range: 120–320 mg/day.
IV PUSH
Adults, Elderly: 0.25 mg/kg
Average: 20 mg
IV INFUSION
Adults, Elderly: 5–10 mg
Drug Classification: Anti-
Inflammatory
Therapeutic Action: Potent
vasodilator. Blocks
vasoconstrictor, aldosterone
secreting effects of angiotensin
II, inhibiting binding of
angiotensin II to AT1 receptors.
Therapeutic
Effect: Causes vasodilation,
decreases peripheral resistance,
decreases B/P.
Drug Classification: Anti-
hypertensive
Therapeutic Action: Inhibits
calcium movement across
cardiac, vascular smooth-
muscle cell membranes
(causes dilation of coronary
arteries, peripheral arteries,
arterioles). Therapeutic Effect:
Decreases heart rate,
myocardial contractility; slows
SA,
Side Effects:
Upper respiratory tract infection, Dizziness,
diarrhea, cough, Insomnia, dyspepsia,
heartburn, back/leg pain, muscle cramps,
myalgia, nasal congestion, sinusitis,
depression.
Adverse Effect:
Overdosage may manifest as hypotension
and tachycardia. Bradycardia occurs less
often. Institute supportive measures.
Side Effects:
Peripheral edema, dizziness, light-
headedness, headache, bradycardia,
asthenia (loss of strength, energy), Nausea,
constipation, flushing, EKG changes, Rash,
micturition disorder (polyuria, nocturia,
dysuria, frequency of urination), abdominal
discomfort, drowsiness.
Adverse Effect:
Abrupt withdrawal may increase frequency,
duration of angina, CHF; secondand third-
degree AV block occur rarely. Overdose
produces nausea, drowsiness, confusion,
concurrent diuretic therapy.
Monitor B/P, BUN, serum
creatinine, CBC. Discontinue
medication, contact
physician if angioedema (swelling of
face, lips, tongue) occurs.
Obtain B/P, apical pulse immediately
before each dose, in addition to
regular monitoring (be alert to
fluctuations). Question for possibility
of pregnancy (see
Pregnancy/Lactation). Assess
medication history (esp. diuretic).
Maintain hydration (offer fluids
frequently). Assess for evidence of
upper respiratory infection, cough.
Monitor B/P, pulse. If excessive
reduction in B/P occurs, place pt in
supine position, feet slightly elevated.
Assist with ambulation if dizziness
occurs. Monitor daily pattern of bowel
activity, stool consistency.
Record onset, type (sharp, dull,
squeezing), radiation, location,
intensity, duration of anginal pain,
precipitating factors (exertion,
emotional stress). Assess baseline
renal/hepatic function tests. Assess
B/P, apical pulse immediately before
drug is administered. Assist with
ambulation if dizziness occurs.
Assess for peripheral edema behind
medial malleolus (sacral area in
bedridden pts). Monitor pulse rate for
bradycardia. Assess B/P,
Maximum: 15 mg AV conduction; decreases total slurred speech, profound bradycardia. renal/hepatic function tests, EKG with
Frequency: peripheral vascular resistance by Antidote: Glucagon (see Appendix K for IV therapy. Question for asthenia
PO vasodilation. dosage). (loss of strength, energy), headache.
Adults, Elderly: 4 times a day
IV PUSH
Adults, Elderly: 2 mins
IV INFUSION
Adults, Elderly: Every Hour
Route: IV and PO

Generic Name: Nitroprusside Drug Classification: Anti- Side Effects: Check with physician for desired B/P
Brand Name: Nipride , hypersensitive Flushing of skin, pruritus, pain/redness at parameters (B/P is normally
Nitropress Therapeutic Action: Inhibits injection site. maintained approximately 30%–40%
Dose: histamine action at histamine-2 Adverse Effect: below pretreatment levels).
IV INFUSION (H2) receptors of parietal cells. Too-rapid IV infusion rate reduces B/P too Medication should be discontinued if
Adults, Elderly, Children: 0.3–0.5 Therapeutic Effect: Inhibits quickly. Nausea, vomiting, diaphoresis, therapeutic response is not achieved
mcg/kg basal/nocturnal gastric acid apprehension, headache, restlessness, within 10 min after IV infusion at 10
Maximum: 10 mcg/kg (children: 8– secretion. muscle twitching, dizziness, palpitations, mcg/kg/min. Monitor EKG, B/P
10 mcg/kg) retrosternal pain, abdominal pain may continuously. Monitor blood acid-base
Frequency: occur. Symptoms disappear rapidly if rate balance, electrolytes, laboratory
Adults, Elderly, Children: Every of administration is slowed or temporarily results, I&O. Assess for metabolic
minute discontinued. Overdose produces metabolic acidosis (weakness, disorientation,
Route: IV acidosis, tolerance to therapeutic effect. headache, nausea, hyperventilation,
vomiting). Assess for therapeutic
response to medication. Monitor B/P
for potential rebound hypertension
after infusion is discontinued.

Generic Name: Milrinone Drug Classification: Side Effects: Obtain baseline lab studies, esp.
Brand Name: Primacor Cardiacinotropic agent Headache, hypotension, chest pain. BN peptide. Offer emotional
Dose: Therapeutic Action: Inhibits Adverse Effect: support (difficulty breathing may
IV phosphodiesterase, which Supraventricular/ventricular arrhythmias produce anxiety). Assess B/P,
Adults: 50 mcg/kg increases cyclic adenosine (12%), nonsustained ventricular tachycardia apical pulse rate before treatment
Maintenance infusion: 0.375–0.75 (2%), sustained ventricular tachycardia
monophosphate (cAMP), begins and during IV therapy.
mcg/kg (1%) may occur. Ventricular fibrillation
Frequency: potentiating delivery of calcium (0.2%) has been documented. Assess lung sounds; observe for
Adult: Over 10 mins to myocardial contractile edema. Monitor B/P, heart rate,
systems. Therapeutic Effect: cardiac output, EKG, serum
Route: IV Relaxes vascular muscle, potassium, renal function,
causing vasodilation. Increases signs/symptoms of CHF.
cardiac output; decreases
pulmonary capillary wedge
pressure, vascular resistance
Generic Name: Lidocaine Drug Classification: Anti- Side Effects: Question for hypersensitivity to
Brand Name: Anestacon, arrhythmic CNS effects generally dose-related and of lidocaine, amide anesthetics. Obtain
Betacaine , Lidoderm, Xylocaine Therapeutic Action: short duration. Occasional: IM: Pain at baseline B/P, pulse, respiratory rate,
Dose: Anesthetic: Inhibits conduction injection site. Topical: Burning, stinging, EKG, serum electrolytes. Monitor
IM tenderness at application site. Rare: EKG, vital signs closely during and
of nerve impulses. Therapeutic
Adults, Ederly: 300 mg or 4.3 mg/ Effect: Causes temporary loss Generally with high dose: Drowsiness; following drug administration for
dizziness; disorientation; light-headedness; cardiac performance. If EKG shows
kg of feeling/sensation. tremors; apprehension; euphoria; sensation arrhythmias, prolongation of PR
IV Antiarrhythmic: Decreases of heat, cold, numbness; blurred or double interval or QRS complex, inform
Adult, Elderly: 1–1.5 mg/ kg depolarization, automaticity, vision; tinnitus (ringing in ears); nausea. physician immediately. Assess pulse
Children, Infants: 1 mg/kg
excitability of ventricle during Adverse Effect: for rhythm, rate, and quality. Assess
Maximum: 100 mg
Maintenance: 20-50 mcg/kg
diastole by direct action. Serious adverse reactions to lidocaine are B/P for evidence of hypotension.
Therapeutic Effect: Inhibits uncommon, but high dosage by any route Monitor for therapeutic serum level
Frequency:
ventricular arrhythmias. may produce cardiovascular depression, (1.5–6 mcg/ml). For lidocaine given by
IM
Bradycardia, hypotension, arrhythmias, all routes, monitor vital signs, LOC.
Adults, Ederly: q60-90 min
heart block, cardiovascular collapse, Drowsiness should be considered a
IV
cardiac arrest. Potential for malignant warning sign of high serum levels of
Adult, Elderly: q10-15 min
hyperthermia, CNS toxicity may occur, esp. lidocaine. Therapeutic serum level:
Children, Infants: longer than 15 min
with regional anesthesia use, progressing 1.5–6 mcg/ml; toxic serum level:
Route: IM and IV rapidly from mild side effects to tremors, greater than 6 mcg/ml
drowsiness, seizures, and vomiting,
respiratory depression. Methemoglobinemia
(evidenced by cyanosis) has occurred
following topical application of lidocaine for
teething discomfort and laryngeal
anesthetic spray
Generic Name: Propranolol Drug Classification: Anti- Side Effects: Assess baseline renal/hepatic function
Brand Name: Apo-Propranolol , arrhythmic Diminished sexual function, tests. Assess B/P, apical pulse
Inderal, Inderal LA, InnoPran XL,Therapeutic Action:Blocks drowsiness, difficulty sleeping, unusual immediately before administering drug
Nu-Propranolol beta1-, beta2-adrenergic fatigue/weakness. Occasional: Bradycardia, (if pulse is 60/min or less or systolic
Dose: depression, sensation of coldness in B/P is less than 90 mm Hg, withhold
receptors. Decreases oxygen
PO extremities, diarrhea, constipation, anxiety, medication, contact physician).
requirements. Slows AV nasal congestion, nausea, vomiting. Anginal: Record onset, quality,
Adult, Elderly: 40 mg conduction, increases
Maximum: 640 mg/day Rare: Altered taste, dry eyes, pruritus, radiation, location, intensity, duration
refractory period in AV node. paresthesia. of anginal pain, precipitating factors
Children: 0.5–1 mg/kg/day
Maximum: 16 mg/kg/day.
Large doses increase airway Adverse Effect: (exertion, emotional stress). Assess
IV resistance. Therapeutic Effect: Overdose may produce profound pulse for quality, irregular rate,
Adult, Elderly: 1–3 mg Slows heart rate; decreases bradycardia, hypotension. Abrupt bradycardia. Monitor EKG for cardiac
Children: 0.01–0.1 mg/kg or 3 mg cardiac output, B/P, myocardial withdrawal may result in diaphoresis, arrhythmias. Assess fingers for color,
Infants: 1 mg, 3 mg ischemia severity. Exhibits palpitations, headache, tremulousness. numbness (Raynaud’s). Assess for
Frequency: antiarrhythmic activity. May precipitate CHF, MI in pts with cardiac evidence of CHF (dyspnea
PO disease; thyroid storm in those with [particularly on exertion or lying
Adult, Elderly: May increase dose thyrotoxicosis; peripheral ischemia in those down], night cough, peripheral
q3-7 days with existing peripheral vascular disease. edema, distended neck veins).
Children: q6-12h Hypoglycemia may occur in pts with Monitor I&O (increase in weight,
IV previously controlled diabetes. Antidote: decrease in urinary output may
Adult, Elderly: Repeat q5 min Glucagon (see Appendix K for dosage). indicate CHF). Assess for rash,
fatigue, behavioral changes.
Route: PO and IV
Therapeutic response ranges from a
few days to several wks. Measure B/P
near end of dosing interval
(determines if B/P is controlled
throughout day).
Generic Name: Amiodarone Drug Classification: Anti- Side Effects: Monitor ECG continuously during IV
Brand Name: : Pacerone arrhythmic Nausea, vomiting, fatigue, tremor, lack of therapy or initiation of oral therapy.
Dose: Therapeutic Action: This coordination, constipation, insomnia, Monitor heart rate and rhythm
PO medication is used to treat headache, stomach pain, decreased sex throughout therapy; PR prolongation,
Adult: 800-1600 mg, 600-800 mg drive or performance, uncontrollable or slight QRS widening, T-wave
certain types of serious
IV unusual movements of the body. amplitude reduction with T-wave
(possibly fatal) irregular widening and bifurcation, and U
Adult: 150 mg bolus Adverse Effect:: Easy
heartbeat (such as persistent waves may occur. QT prolongation
Frequency: bruising/bleeding, loss of coordination,
PO
ventricular may be associated with worsening of
tingling/numbness of the hands or feet,
Adult: once a day for 1-3 weeks, fibrillation/tachycardia). It is arrhythmias and should be monitored
uncontrolled movements, new or
once a day used to restore normal heart closely during IV therapy. Report
worsening symptoms of heart failure
Route: IV and PO rhythm and maintain a regular, bradycardia or increase in arrhythmias
(such as shortness of breath, swelling promptly; patients receiving IV therapy
steady heartbeat.
ankles/feet, unusual tiredness, may require slowing rate,
unusual/sudden weight gain). discontinuing infusion, or inserting a
temporary pacemaker. Assess pacing
and defibrillation threshold in patients
with pacemakers and implanted
defibrillators at beginning and
periodically during therapy. Assess for
signs of pulmonary toxicity
(rales/crackles, decreased breath
sounds, pleuritic friction rub, fatigue,
dyspnea, cough, wheezing, pleuritic
pain, fever, hemoptysis, and hypoxia).
Chest x-ray and pulmonary function
tests are recommended before
therapy. Monitor chest x-ray every
3– 6 mo during therapy to detect
diffuse interstitial changes or alveolar
infiltrates. Bronchoscopy or gallium
radionuclide scan may also be used
for diagnosis. Usually reversible after
withdrawal, but fatalities have
occurred
Generic Name: Verapamil
Brand Name: Apo-Verap ,
Calan, Calan SR, Chronovera ,
Covera-HS, Isoptin SR, Novo-
Veramil SR , Verelan, Verelan
PM
Dose:
IV
Adult, Elderly: 2.5–5 mg
Maximum total dose: 20–30 mg
Children 1-15 yrs: 0.1–0.3 mg/kg
Maximum initial dose: 5 mg
PO
Adult: 80–120 mg
Maintenance: 240–480
Frequency:
IV
Adult, Elderly: Over 2 min
Children 1-15 yrs: Over 2 min
PO
Adult: 3 times a day
Route: IV and PO
Generic Name: Nitroglycerin
Brand Name: Minitran, Nitro-Bid,
Nitro-Dur, Nitrolingual, Nitrostat,
Nitro-Time, Trinipatch
Dose:
Translingual Spray
Adults, Elderly: 1–2 sprays onto or
under tongue
Sublingual:
Adults, Elderly: One tablet under
tongue
Drug Classification: Anti-
arrhythmic
Therapeutic Action: Inhibits
calcium ion entry across
cardiac, vascular smooth-
muscle cell membranes,
dilating coronary arteries,
peripheral arteries, arterioles.
Therapeutic Effect: Decreases
heart rate, myocardial
contractility; slows SA, AV
conduction. Decreases total
peripheral vascular resistance
by vasodilation.
Drug Classification:
Antianginal
Therapeutic Action: Dilates
coronary arteries, improves
collateral blood flow to ischemic
areas within myocardium. IV
form produces peripheral
vasodilation. Therapeutic
Effect: Decreases myocardial
oxygen demand. Reduces left
ventricular preload, afterload.
Side Effects:
Constipation, Dizziness, light-headedness,
headache, asthenia (loss of strength,
energy), nausea, peripheral edema,
hypotension, Bradycardia, dermatitis, rash.
Adverse Effect:
Rapid ventricular rate in atrial
flutter/fibrillation, marked hypotension,
extreme bradycardia, CHF, asystole,
second- or third-degree AV block occur
rarely. Antidote: Glucagon 5–10 mg over 1
min, then infuse 1–10 mg over 1 hour.
Side Effects:
Frequent: Headache (possibly severe;
occurs mostly in early therapy, diminishes
rapidly in intensity, usually disappears
during continued treatment), transient
flushing of face/neck, dizziness (esp. if pt is
standing immobile or is in a warm
environment), weakness, orthostatic
hypotension. Sublingual: Burning, tingling
sensation at oral point of dissolution.
Ointment: Erythema, pruritus. Occasional:
GI upset. Transdermal: Contact dermatitis.
Record onset, type (sharp, dull,
squeezing), radiation, location,
intensity, duration of anginal pain,
precipitating factors (exertion,
emotional stress). Check B/P for
hypotension, pulse for bradycardia
immediately before giving medication.
Assess pulse for quality, rate, and
rhythm. Monitor B/P. Monitor EKG for
cardiac changes, particularly
prolongation of PR interval. Notify
physician of any significant EKG
interval changes. Assist with
ambulation if dizziness occurs.
Assess for peripheral edema behind
medial malleolus (sacral area in
bedridden pts). For those taking oral
form, monitor daily pattern of bowel
activity, stool consistency.
Therapeutic serum level: 0.08–
0.3 mcg/ml; toxic serum level: N/A.
Record onset, type (sharp, dull,
squeezing), radiation, location,
intensity, duration of anginal pain;
precipitating factors (exertion,
emotional stress). Assess B/P, apical
pulse before administration and
periodically following dose. Pt must
have continuous EKG monitoring for
IV administration. Monitor B/P, heart
rate. Assess for facial, neck flushing.
Cardioverter/defibrillator must not be
discharged through paddle electrode
Frequency: overlying nitroglycerin system (may
Translingual Spray Adverse Effect: cause burns to pt or damage to
Adults, Elderly: q3–5min until relief Discontinue drug if blurred vision, dry paddle via arcing).
is noted mouth occurs. Severe orthostatic
Route: Translingual Spray and hypotension may occur, manifested by
Sublingual syncope, pulselessness, cold/clammy skin,
and diaphoresis. Tolerance may occur with
repeated, prolonged therapy; minor
tolerance may occur with intermittent use of
sublingual tablets. High doses tend to
produce severe headache.
Generic Name: Metoprolol Drug Classification: Side Effects: Assess baseline renal/hepatic function
Brand Name: Apo-Metoprolol, Antianginal Metoprolol is generally well tolerated, with tests. Assess B/P, apical pulse
Betaloc, Lopressor, Novo- Therapeutic Action: transient and mild side effects. Frequent: immediately before drug
Metoprolol, Nu-Metop , Toprol XL Selectively blocks beta1- Diminished sexual function, drowsiness, administration (if pulse is 60/min or
Dose: insomnia, unusual fatigue/ weakness. less or systolic B/P is less than 90 mm
adrenergic receptors; high
PO Occasional: Anxiety, diarrhea, constipation, Hg, withhold medication, contact
dosages may block beta2- nausea, vomiting, nasal congestion, physician). Antianginal: Record onset,
Adults: 50 mg adrenergic receptors.
Maintenance: 100–450 mg abdominal discomfort, dizziness, difficulty type (sharp, dull, squeezing),
Decreases oxygen breathing, cold hands/ feet. Rare: Altered radiation, location, intensity, duration
Elderly: 25 mg
requirements. Large doses taste, dry eyes, nightmares, paresthesia, of anginal pain, precipitating factors
Range: 25–300 mg
Children: 1–2 mg/kg
increase airway resistance. allergic reaction (rash, pruritus). (exertion, emotional stress). Assess
Maximum: 6 mg/kg Therapeutic Effect: Slows heart Adverse Effect: baseline renal/hepatic function tests.
Frequency: rate, decreases cardiac output, Overdose may produce profound Assess B/P, apical pulse immediately
PO and reduces B/P. Decreases bradycardia, hypotension, and before drug administration (if pulse is
Adults: Twice a day myocardial ischemia severity. bronchospasm. Abrupt withdrawal may 60/min or less or systolic B/P is less
Elderly: Once a day result in diaphoresis, palpitations, than 90 mm Hg, withhold medication,
Children: Once a day headache, tremulousness, exacerbation of contact physician). Antianginal:
angina, MI, ventricular arrhythmias. May Record onset, type (sharp, dull,
Route: PO
precipitate CHF, MI in pts with heart squeezing), radiation, location,
disease; thyroid storm in those with intensity, duration of anginal pain,
thyrotoxicosis; peripheral ischemia in those precipitating factors (exertion,
with existing peripheral vascular disease. emotional stress).
Hypoglycemia may occur in pts with
previously controlled diabetes mellitus (may
mask signs of hypoglycemia).

Generic Name: Amlodipine
Brand Name: Norvasac
Adult: 2.5–10 mg
Frequency:
Adult: Once a day
Route: PO
Generic Name: Cholestyramine
Brand Name: Novo-Cholamine ,
Prevalite, Questran, Questran
Lite
Dose:
Adults, Elderly: 4g
Maintenance: 4–16g
Maximum: 24g
Children: 80 mg/kg
Maximum: 8 g
Frequency:
Adults, Elderly: 1–2
times a day
Children: 3 times a day
Route: PO
Drug Classification:
Antianginal
Therapeutic Action: Calcium
channel blocker and inhibits the
movement of calcium ions into
vascular smooth muscle cells
and cardiac muscle cells which
inhibits the contraction of
cardiac muscle and vascular
smooth muscle cells.
Drug Classification: Lipid
Lowering Agent
Therapeutic Action: Binds
with bile acids in intestine,
forming insoluble complex.
Binding results in partial
removal of bile acid from
enterohepatic circulation.
Therapeutic Effect:
Removes LDL cholesterol from
plasma.
Antidote: Glucagon (see Appendix K for
dosage).
Side Effects:
Abdominal pain, flushing, headaches,
peripheral edema
Adverse Effect: Swelling of your legs
or ankles, tiredness or extreme
sleepiness, stomach pain, Nausea,
dizziness. hot or warm feeling in your
face (flushing) irregular heart rate
(arrhythmia) very fast heart rate
(palpitations)
Side Effects:
Frequent: Constipation (may lead to
fecal impaction), nausea, vomiting,
abdominal pain, indigestion.
Occasional: Diarrhea, belching,
bloating, headache, dizziness. Rare:
Gallstones, peptic ulcer disease,
malabsorption syndrome.
Adverse Effect:
GI tract obstruction, hyperchloremic
acidosis, osteoporosis secondary to
calcium excretion may occur. High dosage
may interfere with fat absorption, resulting
in steatorrhea.
Monitor BP for therapeutic
effectiveness. BP reduction is greatest
after peak levels of amlodipine are
achieved 6–9 h following oral doses.
Monitor for S&S of dose-related
peripheral or facial edema that may
not be accompanied by weight gain;
rarely, severe edema may cause
discontinuation of drug. Monitor BP
with postural changes. Report
postural hypotension. Monitor more
frequently when additional
antihypertensive or diuretics are
added. Monitor heart rate; dose-
related palpitations (more common in
women) may occur.
Question for history of hypersensitivity
to cholestyramine, tartrazine, and
aspirin. Obtain baseline serum
cholesterol, triglycerides, electrolytes,
hepatic enzyme levels. Monitor daily
pattern of bowel activity, stool
consistency. Evaluate food tolerance,
abdominal discomfort, flatulence.
Monitor cholesterol, triglycerides, PT,
hepatic enzymes, CBC, serum
electrolytes. Encourage several
glasses of water between meals.
Generic Name: Atorvastatin Drug Classification: Lipid
Brand Name: Lipitor Lowering Agent
Dose: Therapeutic Action: For
10–80 mg proper diet to help lower "bad"
Frequency:
cholesterol and fats (such as
Once a day
LDL, triglycerides) and raise
Route: PO "good" cholesterol (HDL) in the
blood. It belongs to a group of
drugs known as "statins." It
works by reducing the amount
of cholesterol made by the
liver.
Generic Name: Ezetimibe Drug Classification: Lipid
Brand Name: Ezetrol, Zetia Lowering Agen
Dose: Therapeutic Action: Inhibits
Adults, Elderly, Children 10 yrs and cholesterol absorption in small
older: 10 mg
intestine, leading to decrease in
Frequency:
delivery of intestinal cholesterol
Adults, Elderly, Children 10 yrs and
to liver. Therapeutic Effect:
older: Once a day
Reduces total serum
Route: PO
cholesterol, LDL, triglyceride;
increases HDL.
Side Effects:
Myalgia, myopathy, rhabdomyolysis,
headache, chest pain, peripheral edema,
dizziness, rash, abdominal pain,
constipation, diarrhea, dyspepsia, nausea,
flatulence, increased hepatic function tests,
back pain, sinusitis
Adverse Effect:
cold symptoms such as runny nose,
sneezing, and coughing, diarrhea, gas,
heartburn, joint pain, forgetfulness,
confusion
Side Effects:
Back pain, diarrhea, arthralgia, sinusitis,
abdominal pain, Cough, pharyngitis,
fatigue, depression.
Adverse Effect:
Hepatitis, hypersensitivity reaction,
myopathy, rhabdomyolysis occur rarely.
Advise patient that this medication
should be used in conjunction with
diet restrictions (fat, cholesterol,
carbohydrates, and alcohol), exercise,
and cessation of smoking.
Obtain diet history, esp. fat
consumption. Obtain serum
cholesterol, triglycerides, and hepatic
function tests, blood counts during
initial therapy and periodically during
treatment. Treatment should be
discontinued if hepatic enzyme levels
persist more than 3 times normal limit.
Monitor daily pattern of bowel activity
and stool consistency. Question pt for
signs/symptoms of back pain,
abdominal disturbances. Monitor
serum cholesterol, triglycerides for
therapeutic response.
Generic Name: Ticagrelor Drug Classification:
Brand Name: Brilinta Antiplatelet
Dose: Therapeutic Action:
Adult: 180 mg Reversibly inhibits platelet
Frequency:
P2Y12 ADP receptor to prevent
Once a day
signal transduction and platelet
Route: PO activation. Therapeutic Effect:
Prevents platelet aggregation.
Side Effects:
Dyspnea, headache, Cough, dizziness,
nausea, diarrhea, back pain, fatigue.
Adverse Effect:
Life-threatening events including
intracranial bleeding, epistaxis,
intrapericardial bleeding with cardiac
tamponade, hypovolemic shock requiring
vasopressive support or blood transfusion
reported. Pts with history of sick sinus
syndrome, second- or third-degree AV
block, bradycardic syncope have increased
risk of bradycardia. May induce episodes of
atrial fibrillation, hypotension, and
hypertension. Gynecomastia reported in
less than 1% of men.
Obtain CBC, BMP, digoxin level if
applicable. Question for history of
bleeding, stomach ulcers, colon
polyps, head trauma, cardiac
arrhythmias, unstable angina, recent
MI, hepatic impairment, HIV,
hypertension, stroke. Receive full
medication history including herbal
products. Question for history of
COPD, chronic bronchitis,
emphysema, asthma, exertional
dyspnea, for bruising, hematoma.
Monitor creatinine, uric acid, digoxin
levels if applicable. Report hematuria,
epistaxis, coffee-ground emesis,
black/tarry stools. Monitor EKG for
chest pain, shortness of breath,
syncope.

Generic Name: Heparin
Brand Name: Hepalean ,
Hepalean Leo , Hep-Lock
Dose:
Adults, Elderly, Children: 100 units
Infants weighing less than 10 kg: 10
units
Frequency:
Adults, Elderly, Children: q6–8h
Infants weighing less than 10 kg:
q6–8h
Route: IV
Drug Classification:
Antiplatelet
Therapeutic Action: Interferes
with blood coagulation by
blocking conversion of
prothrombin to thrombin and
fibrinogen to fibrin. Therapeutic
Effect: Prevents further
extension of existing thrombi or
new clot formation. No effect on
existing clots.
Side Effects:
Occasional: Pruritus, burning (particularly
on soles of feet) caused by vasospastic
reaction. Rare: Pain, cyanosis of extremity
6–10 days after initial therapy lasting 4–6
hrs, hypersensitivity reaction (chills, fever,
pruritus, urticaria, asthma, rhinitis,
lacrimation, headache).
Adverse Effect:
Bleeding complications ranging from local
ecchymoses to major hemorrhage occur
more frequently in high-dose therapy,
intermittent IV infusion, women 60 yrs and
older. Antidote: Protamine sulfate 1–1.5
mg IV for every 100 units heparin
subcutaneous within 30 min of overdose,
0.5–
Cross-check dose with co-worker.
Determine aPTT before administration
and 24 hrs following initiation of
therapy, then q24–48hrs for first wk of
therapy or until maintenance dose is
established. Follow with aPTT
determinations 1–2 times weekly for
3–4 wks. In long-term therapy,
monitor 1–2 times a mo. Monitor
aPTT (therapeutic range at
1.5–2.5 times normal) diligently.
Assess Hct, platelet count, AST, ALT.
Monitor urine and stool for occult
blood. Assess for decrease in B/P,
increase in pulse rate, complaint of
abdominal/back pain, severe
headache (may be evidence of

Generic Name: Antihemophilic Drug Classification:
factor Antiplatelet
Brand Name: Advate, Kogenate, Therapeutic Action: Factor is
Recombinate increased in the plasma thus
Dose: enabling temporary correction
20 to 25 IU/kg
of the hemophilia A bleeding.
Frequency:
Its effect is reported as the
q8-12h normalization of the partial
Route: IV thromboplastin time. The
human antihemophilic factor
replaces the coagulation factor
VIII.
Generic Name: Urokinase Drug Classification:
Brand Name: Kinlytic Antiplatelet
Dose: Therapeutic Action: A
15 mL physiologic thrombolytic agent
Frequency:
that is produced in renal
q12h
parenchymal cells. Unlike
Route: IV streptokinase, urokinase
0.75 mg for every 100 units heparin
subcutaneous if within 30–60 min of
overdose, 0.25–0.375 mg for every 100
units heparin subcutaneous if 2 hrs have
elapsed since overdose, 25–50 mg if
heparin was given by IV infusion.
Side Effects:
swelling, stinging, or irritation where the
injection was given; chills; mild nausea; or
allergic reaction.
Adverse Effect:
Stop using human antihemophilic factor and
call your doctor at once if you have: tingly
feeling in your face, ears, or arms;
headache, blurred vision, feeling jittery;
fever, chills, drowsiness, and runny nose
followed by skin rash and joint pain 2 weeks
later; or nausea, vomiting, upper stomach
pain, loss of appetite, dark urine, clay-
colored stools, jaundice (yellowing of the
skin or eyes).
Side Effects:
Easy bruising, bleeding, fever, stroke,
trouble breathing, blood in your stools,
coughing up blood, chest pain, problems
with speech, vision problems, swelling,
discoloration of your fingers or toes, severe
stomach pain, chills, or flu symptoms.
Adverse Effect:
hemorrhage). Question for increase in
amount of discharge during menses.
Assess peripheral pulses; skin for
ecchymosis, petechiae. Check for
excessive bleeding from minor cuts,
scratches. Assess gums for erythema,
gingival bleeding. Assess urine output
for hematuria. Avoid IM injections due
to potential for hematomas. When
converting to warfarin (Coumadin)
therapy, monitor PT results (will be
10%–20% higher while heparin is
given concurrently).
Replaces deficient antihemophilic
factor (AHF, Factor VIII). Produced via
recombinant DNA technology,
presence of fusion protein delays
degradation.
Monitor signs of allergic reactions or
anaphylaxis, including pulmonary
symptoms (tightness in the throat and
chest, bronchospasm, wheezing,
cough, dyspnea) or skin reactions
(rash, pruritus, urticaria). Notify
physician or nursing staff immediately
if these reactions occur.
 directly cleaves plasminogen to
produce plasmin. When it is
purified from human urine,
approximately 1500 L of urine
is needed to yield enough
urokinase to treat a single
patient.
Generic Name: Aminocaproic Drug Classification:
acid Antiplatelet
Brand Name: Amicar Therapeutic Action: A
Dose: derivative and analogue of the
IV
amino acid lysine, which makes
Adult: 250 mg/mL
it an effective inhibitor for
PO enzymes that bind that
Adult: 500 mg or 1,000 mg
particular residue. Such
Frequency:
IV
enzymes include proteolytic
Adult: q8h enzymes like plasmin, the
Route: IV enzyme responsible for
fibrinolysis.
The most serious adverse reactions after
administration include fatal hemorrhage,
anaphylaxis, nausea, vomiting,
bronchospasm, minor breathing difficulties,
rash, and phlebitis at injection site,
anaphylaxis, and chills.
Side Effects: Monitor for overt bleeding every 15–
Headache, stomach pain, loss of appetite, 30 min. occur. Assess for
nausea, vomiting, diarrhea, unusual thromboembolic complications
tiredness, dizziness, stuffy nose, or watery (especially in patients with history).
eyes may occur. If any of these effects last Notify health care professional of
or get worse, tell your doctor or pharmacist positive Homans' sign, leg pain and
promptly. edema, he- moptysis, dyspnea, or
Adverse Effect: chest pain.
Confusion, Vision decrease, Vomiting,
Headache, Convulsions, Malaise, Muscle
weakness, Dizziness, Tinnitus, Nausea,
Bradycardia, Thrombosis, Edema,
Hypotension, Stroke, Syncope, Intracranial
hypertension, Peripheral ischemia,
Pulmonary embolism, Dyspnea,
Congestion, Diarrhea, Abdominal pain,
Leukopenia, Agranulocytosis, Coagulation
disorder, Dry ejaculation, Injection site
reactions (pain/necrosis), Myopathy,
Pruritus, Rash, Renal failure, Anaphylaxis

Generic Name: Epoetin Alfa
Brand Name: Epogen, Eprex,
Procrit
Dose:
Subcutaneous:
Adult, Elderly: 150 units/kg
Children 5 yrs and older: 600
Drug Classification: Drugs
Used to Treat Anemia
Therapeutic Action:
Stimulates division,
differentiation of erythroid
progenitor cells in bone
marrow. Therapeutic Effect:
Side Effects:
Fever, diarrhea, nausea, vomiting, edema,
Asthenia (loss of strength, energy),
shortness of breath, paresthesia, Dizziness,
trunk pain.
Adverse Effect:
Hypertensive encephalopathy, thrombosis,
cerebrovascular accident, MI, seizures
Assess B/P before drug initiation
(80% of pts with chronic renal failure
have history of hypertension). B/P
often rises during early therapy in pts
with history of hypertension. Consider
that all pts eventually need
supplemental iron therapy. Assess
serum iron (should be greater than
units/kg
Maximum: 40,000 units.
IV
Adult, Elderly: 50–100 units/kg
Children: 50 units/kg
Frequency:
Subcutaneous:
Adult, Elderly: 3 times/wk
Children 5 yrs and older: once a
week
IV
Adult, Elderly: 3 times/wk
Children: 3 times/wk
Route: Subcutaneous and IV
Generic Name: Ferrous Sulfate
Brand Name: Apo-Ferrous
Sulfate, Fer-In-Sol, Fer-Iron,
Slow-Fe
Dose:
PO
Adult, Elderly: 65 mg
Children: 1–2 mg/kg
Frequency:
PO
Adult, Elderly: Once a day
Children: Once a day
Route: PO
Generic Name: Folic Acid
Brand Name: Apo-Folic ,
Folacin-800, Folvite
Dose:
Induces erythropoiesis,
releases reticulocytes from
bone marrow.
Drug Classification: Drugs
Used to Treat Anemia
Therapeutic Action: Essential
component in formation of Hgb,
myoglobin, enzymes. Promotes
effective erythropoiesis and
transport, utilization of oxygen.
Therapeutic Effect: Prevents
iron deficiency.
Drug Classification: Drugs
Used to Treat Anemia
Therapeutic Action:
Stimulates production of
occur rarely. Hyperkalemia occurs
occasionally in pts with chronic renal failure,
usually in those who do not comply with
medication regimen, dietary guidelines,
frequency of dialysis regimen.
Side Effects:
Mild, transient nausea, Heartburn, anorexia,
constipation, diarrhea.
Adverse Effect:
Large doses may aggravate existing GI
tract disease (peptic ulcer, regional
enteritis, ulcerative colitis). Severe iron
poisoning occurs most often in children,
manifested as vomiting, severe abdominal
pain, diarrhea, dehydration, followed by
hyperventilation, pallor, cyanosis,
cardiovascular collapse.
Side Effects:
None known.
Adverse Effect:
Allergic hypersensitivity occurs rarely with
20%), serum ferritin (should be
greater than 100 ng/ml) before and
during therapy. Establish baseline
CBC (esp. note Hct). Monitor
aggressively for increased B/P (25%
of pts on medication require
antihypertensive therapy, dietary
restrictions).
Assess nutritional status, dietary
history. To prevent mucous
membrane and teeth staining with
liquid preparation, use dropper or
straw and allow solution to drop on
back of tongue. Monitor serum iron,
total iron-binding capacity, reticulocyte
count, Hgb, ferritin. Monitor daily
pattern of bowel activity, stool
consistency. Assess for clinical
improvement, record relief of iron
deficiency symptoms (fatigue,
irritability, pallor, paresthesia of
extremities, headache).
Pernicious anemia should be ruled
out with Schilling test and vitamin B12
blood level before initiating therapy
(may produce irreversible neurologic
IM/IV/Subcutaneous/PO platelets, RBCs, parenteral form. Oral folic acid is nontoxic. damage). Resistance to treatment
Adult, Elderly, Children 4 yrs and WBCs. Therapeutic Effect: may occur if decreased
older: 0.4 mg Essential for nucleoprotein hematopoiesis, alcoholism,
Children younger than 4 yrs: Up to synthesis, maintenance of normal antimetabolic drugs, deficiency of
0.3 mg erythropoiesis. vitamin B6, B12, C, E is evident.
Infants: 0.1 mg Assess for therapeutic improvement:
Pregnant/Lactating women: 0.8 mg improved sense of well-being, relief
Frequency: from iron deficiency symptoms
IM/IV/Subcutaneous/PO (fatigue, shortness of breath, sore
Adult, Elderly, Children 4 yrs and tongue, headache, pallor).
older: Once a day
Children younger than 4 yrs: Once a
day
Infants: Once a day
Pregnant/Lactating women: Once a
day
Route: IM, IV, Subcutaneous,
PO

Generic Name: Drug Classification: Drugs
Hydroxocobalamin Used to Treat Anemia
Brand Name: Cyanokit Therapeutic Action: A vitamin
Dose: found in food and used as a
Adult: 30 mcg
dietary supplement. As a
Maintenance dose: 100 to 200 mcg
supplement it is used to treat
Frequency:
vitamin B12 deficiency
Adult: 5 to 10 days
including pernicious anemia.
Maintenance: Monthly
Other uses include treatment
Route: IM
for cyanide poisoning, Leber's
optic atrophy, and toxic
amblyopia.
Side Effects: Monitor vital signs in patients with
Red coloring of your skin or urine (this cardiac disease and in those receiving
may last up to 2 to 5 weeks), nausea, parenteral cyanocobalamin, and be
vomiting, diarrhea, stomach pain, acne, alert to symptoms of pulmonary
skin rash or itching, warmth or redness edema; generally occur early in
therapy. Note: Some patients
under your skin, dry throat, trouble
experience mild pain at injection site
swallowing, headache, dizziness,
after administration. Monitor bowel
memory problems, restlessness, hot function.
flashes, injection site reactions (pain,
swelling, or irritation of your skin), or
eye redness or irritation
Adverse Effect:
Nausea; headache; acne, skin rash or
redness; red coloring of your urine (may
 last 2 to 5 weeks); or Pain, swelling, or
irritation of your skin where the injection
was given.
Generic Name: Hydoxyurea Drug Classification: Drugs Side Effects: Obtain bone marrow studies,
Brand Name: Apo- Used to Treat Anemia Nausea, vomiting, anorexia, constipation or hepatic/renal function tests before
Hydroxyurea , Droxia, Hydrea Therapeutic Action: Inhibits diarrhea. Occasional: Mild, reversible rash; therapy begins, periodically thereafter.
Dose: DNA synthesis without facial flushing; pruritus; fever; chills; Obtain Hgb, WBC, platelet count,
Adults, Elderly: 80 mg/kg or 20–30 malaise. Rare: Alopecia, headache, serum uric acid at baseline and
interfering with RNA synthesis
mg/kg drowsiness, dizziness, disorientation. weekly during therapy. Those with
or protein. Therapeutic Effect:
Frequency: Adverse Effect: marked renal impairment may develop
Interferes with normal repair Myelosuppression manifested as visual or auditory hallucinations,
Adult: Every 3 days or once a day process of cancer cells hematologic toxicity (leukopenia and, to a marked hematologic toxicity. Monitor
as a single dose
damaged by irradiation. lesser extent, thrombocytopenia, anemia). daily pattern of bowel activity, stool
Route: PO
consistency. Monitor for hematologic
toxicity (fever, sore throat, signs of
local infection, unusual
bleeding/bruising at any site),
symptoms of anemia (excessive
fatigue, weakness). Assess skin for
rash, erythema. Monitor CBC with
differential, platelet count, Hgb, renal/
hepatic function, uric acid.