ASA (apirin) – antipyretic, nonopiod analgesic

Indications: inflammatory disorders including RA, OA. Mild to moderate pain. Fever.
Aspirin: prophylaxis of ischemic attacks and MI.

Actions: - produce analgesia and reduce inflammation and fever by inhibiting the
production of prostaglandins (only aspirin decreases platelet aggregation)

Side effects:

GI bleeding, dyspepsia, epigastric distress, nausea, exfoliative dermatitis, stevens-

johnson syndrome, toxic epidermal necrolysis

Digoxin (antiarrhythmics, inotropics)

Indications: treatment of CHF. Tachyarrhythmias: atrial fibrillation and atrial flutter,

paroxysmal atrial tachycardia

Action: increases force of myocardial contraction. Prolongs refractory period of AV

node. Decreases conduction through the SA and AV nodes

Therapeutic effects: increased cardiac output (positive inotropic effect) and slowing
the hrt rate (negative chronotropic effect)

Side effects:

Arrhythmias; fatigue, bradycardia, anorexia, nausea, vomiting

Nursing Implications:

Monitor apical pulse for one full minute before administration. Withhold dose and
notify physician if pulse rate is <60 bpm in an adult

Monitor ECG throughout IV administration and 6 hrs after each dose. Notify health
care professional if bradycardia or new arrhythmias occur.

Narrow therapeutic range.

Plavix (Clopidogrel) – (antiplatelet agents)

Indications: Reduction of atherosclerotic events in pts at risk for such events

including recent MI, acute coronary syndrome, stroke, or peripheral vascular
diseases

Action: inhibits platelet aggregation by irreversibly inhibiting the binding of ATP to

platelet receptors
Therapeutic effects: Decreased occurrence of atherosclerotic events in patients at
risk

Side effects:

GI bleeding, bleeding, neutropenia, thrombocytopenic purpura (rare)

Nursing implications:

Monitor pt. for signs of thrombotic thrombocytic purpura (thrombocytopenia,

microangiopathic hemolytic anemia, neurologic findings, renal dysfunction, fever)

Monitor bleeding time during therapy and CBC with differential and platelet count

Dalteparin, Enoxaparin (anticoagulants)

Indications: prevention of venous thromboembolism (deep vein thrombosis) and/or

pulmonary embolism or surgical or medical pts.

Action: Potentiate the inhibitory effects of antithrombin on factor Xa and thrombin.

Therapeutic effects: prevention of thrombus formation

Nursing Implications:

Assess for signs of bleeding and hemorrhage (bleeding gums; nosebleed; unusual
bruising; black, tarry stools; hematuria; fall in hematocrit or BP; bleeding from
surgical site.

Metoprolol (antianginals, antihypertensive) (betablockers)

Indications: Hypertension. Angina pectoris. Prevention of MI and decreased

mortality in pts with recent MI. Management of stable, symptomatic heart failure
due to ischemic, hypertensive and cardiomyopathic origin

Actions: Blocks stimulation of beta1- adrenergic receptors.

Therapeutic effects: Decreased BP and hrt rate. Decreased frequency of attacks of

angina pectoris. Decreased rate of cardiovascular mortality and hospitalization in
pts with heart failure.

Side effects: bradycardia, CHF, pulmonary edema, erectile dysfunction.

Nursing Implications:

Monitor vital signs and ECG every 5-15 mins during and for several hrs after
parenteral administration. If heart rate is <40bpm, especially if cardiac output is
also decreased, adminster atropine IV
Monitor intake and output ratios and daily wts. Assess routinely for signs and
symptoms of CHF (dyspnea, rales/crackles, weight gain, peripheral edema, JVD)

Diltiazem (anti – anginals, antiarrhythmics, antihypertensives) (calcium

channel blockers)

Indications: Hypertension. Angina pectoris. Supraventricular tachyarrhythmias and

rapid ventricular rates in atrial flutter or fibrillation.

Action: inhibits transport of calcium into myocardial and vascular smooth muscle
cells, resulting in inhibition of excitation-contraction coupling and subsequent
contraction.

Therapeutic effects: Systemic vasodilation resulting in decreased blood pressure.

Coronary vasodilation resulting in decreasing frequency and severity of attacks of
angina. Suppression of arrhythmias.

Side effects:

Arrhythmias, CHF, Stevens-Johnsons syndrome (sloughing of skin because of drug

rxns); peripheral edema

Nursing Implications:

Monitor I/O ‘s, BP and pulse.

Assess for signs of CHF

Hydrochlorthiazide (anti-hypertensive, diuretics, thiazide diuretics)

Indications: management of mild to moderate hypertension. Treatment of edema

associated with CHF, renal dysfunction, cirrhosis, g