DRUG STUDY

Name of the Patient: Age: 52 Sex: Female Name of Student Casilao, Mike Arone H.
Civil Status: Religion: Rm/Bed No. _________________ Area: __________________________ Level/ Block: BSNII-B
Address: Date Submitted: 19/02/2022
Date of Admission: _____________________ Diagnosis: Diabetes Mellitus Type 2 Rating: ___________________________________________________

MEDICATION Classification/ Action
Generic name: Pharmacotherapeutic: Treatment of mild to
severe HF, left
Carvedilol Beta adrenergic blocker
Clinical:
Brand name:
Cardipres Anti-hypertensive
Usual dosage/
frequency: Drug action:
Possesses nonselective
10 to 20 mg once
daily. After 3 to 10 beta-blocking and alpha-
days, increased to 20 adrenergic blocking
to 40 mg once daily activity. Causes
Maximum: 80 mg OD vasodilation
Usual route: Therapeutic Effect:
Oral
Reduces cardiac output,
exercise-induced
tachycardia, reflex
Indications Contraindications Side Effects Adverse Effects Nursing Responsibilities
Frequent
This drug is  Overdose may produce Before:
contraindicated to  Fatigue profound bradycardia,  Verify doctor’s order in
ventricular patients with:  Dizziness hypotension, regards to the medication.
dysfunction The order should include the
bronchospasm, cardiac
following MI,  Asthma or related drug name, dosage,
Occasional insufficiency,
hypertension. bronchospastic frequency and route of
conditions cardiogenic shock, administration. If any element
 Cardiogenic Shock  Diarrhea cardiac arrest is missing, check with the
 Decompensated HF  Bradycardia  Abrupt withdrawal may practitioner.
 History of serious  Rhinitis result in diaphoresis,  Check the patient's medical
hypersensitivity  Back pain record for an allergy or
palpitations, headache,
reactions contraindication to the
tremors
 Steven-Johnsons prescribed medication. If an
Rare  May precipitate HF, MI allergy or contraindications
syndrome
in pts with cardiac exist, don't administer the
 Hypersensitivity to  Orthostatic
disease; thyroid storm medication and notify the
carvedilol
Hypotension in pts with practitioner.
 AV block
 Drowsiness  Observe the ten (10) rights of
 Severe bradycardia thyrotoxicosis;
 UTI medication administration
or hepatic peripheral ischemia in
 Obtain and record vital signs
impairment  Viral Infection pts with existing  Educate and explain the
peripheral vascular medication to the client and
Use cautiously in:
 orthostatic tachycardia; disease SO.
Drug order: reduces peripheral  Diabetes  Hypoglycemia may  Use carvedilol cautiously in
vascular resistance  Myasthenia gravis occur in pts with patients with peripheral
Carvedilol 12.5 mg PO  Mild to moderate vascular disease because it
previously controlled
OD for 2 days then hepatic impairment may aggravate symptoms of
increased to 25 mg Pharmacokinetics: diabetes arterial insufficiency. In
 Hypertension,
PO OD as and/or ischemia  May mask symptoms of patients with diabetes
maintenance Absorption: Rapidly, hypoglycemia. mellitus, it may mask signs of
 Prinzmetal’s angina
extensively, absorbed from  Pheochromocytoma hypoglycemia, such as
Drug interactions: GI tract tachycardia, and may delay
 Severe anaphylaxis
Protein Binding: 98% recovery
to allergens
 Calcium  Monitor patient’s blood
Metabolism: Metabolized
channel glucose level, as ordered,
blockers (e.g., in the liver during carvedilol therapy
diltiazem, Excretion: Via bile into because drug may alter blood
verapamil), feces glucose level
digoxin, Half-life: 7-10 hrs.  If patient has heart failure,
CYP2C9 expect to also give digoxin, a
inhibitors Pharmacodynamics: diuretic, and an ACE inhibitor
(e.g.,
amiodarone, During:
fluconazole) Onset: 30 min
increase risk Peak: 1-2 hrs.  Take the full course
of cardiac Duration: 24 hours prescribed.
conduction  Give without regard to food.
disturbances  Take with full glass of water.
 Diuretics (e.g.,  Stay with patient throughout
furosemide, whole duration of
HCTZ), other administration.
anti-
hypertensives After:
(e.g.,  Monitor the effect of the
amlodipine, drugs that are administered
lisinopril, to the patient
valsartan)  Discontinue drug if
may hypersensitivity reactions
potentiate occur.
hypotensive  Immediately report any side
effects.
  Cimetidine or adverse effects such as
may increase fatigue, dizziness, and
concentration diarrhea
of  Obtain and record vital signs.
cyclosporine,  Document the time, location,
digoxin dose, and medication given
 CYP2D6 to the client.
inhibitors
(e.g., Patient Teaching
Fluoxetine,  Instruct patient prescribed
Paroxetine) extended-release capsules
may increase to swallow them whole. If
concentration/ swallowing capsules is
side effects; difficult, tell patient he may
may enhance open capsule and sprinkle
slowing of HR beads on a spoonful of cold
or cardiac applesauce and then eat the
conduction. applesauce immediately
 May increase without chewing.
effects of  Warn patient that drug may
insulin, oral cause orthostatic
hypoglycemic hypotension, light-
s (e.g., headedness, and dizziness;
glyburide, advise him to take
metformin). precautions
 Rifampin  Tell patient with heart failure
decreases to notify prescriber if he
concentration. gains 5 lb or more in 2 days
HERBAL: or if shortness of breath
 Ephedra, increases, which may signal
ginseng, worsening heart failure
yohimbe may  Alert patient with diabetes to
worsen monitor his glycemic control
hypertension. closely because drug may
 Garlic may increase blood glucose level
increase or mask symptoms of
antihypertensi hypoglycemia
ve effect.  Stress the need to seek
 emergency care if patient
develops hives or swelling of
the face, lips, tongue, or
throat that causes trouble
swallowing or breathing.

References:
 Vallerand, A. H., & Sanoski, C. A. (2019) Davis’s Drug Guide for Nurses (6th Edition). F.A Davis Company.
 Kizior, R. J., & Hodgson, K. J. (2020). Saunders Nursing Drug Handbook 2020. Elsevier. (209-211)