Drug Study

Francisco Tampos Jr.

Memantine (Namenda)
Classifications:
Anti-Alzheimer's agent

Dosage:
10mg/tab 1 tab
P.O. BID
Mechanism of Action
Binds to CNS N-methyl-D-aspartate
(NMDA) receptor sites, preventing
binding of glutamate, an excitatory
neurotransmitter.
Indications
Decreased symptoms of dementia.
Does not slow progression.
Cognitive enhancement.
Does not cure disease
Contraindication
Contraindicated to patient with severe renal
impairment

Use cautiously in patient with moderate renal

impairment; Concurrent use of other NMDA
antagonists (amantadine, rimantadine,
ketamine, dextromethorphan); Concurrent use of
drugs or diet that cause alkaline urine; Condition
that increase urine pH including severe urinary
tract infections or renal tubular acidosis.
Adverse Effects
Dizziness, fatigue, headache, sedation
Hypertension
Rash
Weight gain
Urinary frequenncy
Anemia
Nursing Responsibilities
Vigocid (Piperacillin/Tazobactam)
Classifications:
Anti-Infectives

Dosage:
4.5mg IV Infusion
8hrs ANST for 2days
Mechanism of Action
Piperaceillin binds to bacterial cell wall
membrane, causing cell death. Spectrum
is extended compared with other
penicillin. Tazobactam inhibits beta-
lactamase, an enzyme that can destroy
penicillin.
Indications
Community-acquired and nocosomial
pneumonia caused by piperacillin-
resistant, beta-lactamase - producing
bacteria.
Contraindication
Contraindicated to patient with
hypersensitivity to penicillin, beta-
lactams, cephalosporins or tazobactam.

Use cautiously to patient with renal

impairment; sodium restriction
Adverse Effects
Seizure; confusion, dizziness, headache, insomnia,
lethargy
Pseudomembranous colitis, diarrhea, constipation; drug
induced hepatitis, nausea, vomiting, interstitial nephritis
Rashes, urticaria
Bleeding, leukopenia, neutropenia, thrombocytopenia
Nursing Responsibilities
Rivastigmine (Exelon Patch)
Classifications:
Anti-Alzheimer's agents
Dosage:
OD to Upper Back
Mechanism of Action
Enhances cholinergic function by
reversible inhibition of
cholinesterase.

Does not cure the disease.

Indications
Decreased dementia (temporary)
associated with Alzheimer's disease
and Parkinson's disease.

Enhanced cognitive ability.

Contraindication
Contraindicated to patient with hypersensitivity to rivastigmine or
other carbamates.

Use cautiously with patient with history of asthma or obstructive

pulmonary disease; history of GI bleeding; Sick sinus syndrome or

other supraventricular cardiac conduction abnormalities.

Adverse Effects
Weakness, dizziness, drowsiness headache,
sedation (unusual)Edema, heart failure;
hypotension

Anorexia; dyspepsia, nausea, vomiting, abdominal

pain, diarrhea, flatulence

Tremors
Nursing Responsibilities
Losartan (Lifevar)
Classifications:
Angiotensin II receptor antagonists
Dosage:
100mg/tab 1 tab
P.O. OD
Mechanism of Action
Inhibits vasoconstrictive and
aldosterone-secreting action of
angiotensin II by blocking angiotensin
II receptor on the surface of vascular
smooth muscle and other tissue cells
Indications
Hypertension, Nephepatically in type
2 diabetic patients, to reduce risk of
CVA in patients with hypertension
and left ventricular hypertrophy
Contraindication
Patient's hypersensitivity to drug,
breast-feeding is not recommended,
causes fetal and neonatal morbidity
and death.
Adverse Effects
Dizziness, asthenia, fatigue, headache, insomnia

Edema, Chest pain

Nasal congestion, sinusitis, pharyngitis, sinus disorder

Abdominal pain, nausea, diarrhea, dyspepsia

Muscle cramps, myalgia, back or leg pain

Cough, upper respiratory infection.

Nursing Responsibilities
5 Drug Rights
Monitor BP
Monitor patient's who are also
taking diuretics for symptoms for
symptomatic hypotension
Assess patients renal function
Tell patient to avoid salt substitutes
Aspirin
Classifications:
Antiplatelet Agents, Cardiovascular;
Antiplatelet Agents, Hematologic;
NSAIDs; Salicylates
Dosage:
80mg/tab 1 tab
P.O. OD
Mechanism of Action
Exhibits antipyretic, anti-inflammatory and
analgesic effects. The antipyretic effect is due to
an action on the hypothalamus, resulting in heat
loss by vasodilation of peripheral blood vessels.
Anti-inflammatory effects are mediated by a
decrease in prostaglandin synthesis. It also
decreases platelet aggregation.
Indications
For pain on integumentary structures,
myalgia, neuralgia, headache, dysmenorrhea,
gout.

Arthritis, Systemic Lupus Erythematosus,

acute rheumatic fever

Contraindication
Hypersensitivity to salicylates, severe
anemia, history of blood coagulation
defects, vitamin K deficiency, 1 week
before and after surgery, pregnancy
in the last trimester
Adverse Effects
dyspepsia, heartburn, anorexia, nausea, epigastric discomfort,
potentiation of peptic ulcer

Bronchospasm, asthma-like symptoms, anaphylaxis, skin rashes,

urticaria

prolongation of bleeding time, thrombocytopenia, leucopenia

Thirst, fever, dimness of vision

Nursing Responsibilities
5 Drug Rights
Assess for pain: type, location and pattern
Note for asthma
Monitor renal, LFTs and CBC
Determine history of peptic ulcers or bleeding
tendencies.

Precautions:
Do not use in children with chicken pox or flu symptoms
Lactation
Mild diabetes, erosive gastritis, bleeding tendencies,
liver or kidney disease.
Clopidogrel
Classifications:
Anti-platelet Agents

Dosage:
75mg/tab 1 tab
P.O. OD
Mechanism of Action
Inhibits platelet aggregation by
blocking ADP receptors on platelets,
preventing clumping of platelets
Indications
Treatment of patients at risk for ischemic
events—history of MI, ischemic stroke,
peripheral artery disease

Treatment of patients with acute coronary

syndrome
Contraindication
Contraindicated with allergy to
clopidogrel, active pathological
bleeding such as peptic ulcer or
intracranial hemorrhage, lactation.
Adverse Effects
Headache, dizziness, weakness, syncope, flushing

Hypertension, edema

Rash, pruritus

Nausea, GI distress, constipation, diarrhea, GI bleed

Increased bleeding risk

Nursing Responsibilities
5 Drug Rights
Assess for symptoms of stroke, MI during treatment
Monitor liver function studies: AST, ALT, bilirubin, creatinine if
patient is on long-term therapy
Monitor blood studies: CBC,Hgb, Hct, protime, cholesterol if the
patient is on long-term therapy; thrombocytopenia and
neutropenia may occur.

Precautions:
Bleeding disorders, recent surgery, hepatic impairment,
pregnancy