DRUG STUDY

Name of Mechanism Dosage Indications Contraindication Adverse Nursing

the Drug of Action reaction considerations
/responsibilities
Isosorbide Thought to Tablets: 10 Prevention of Contraindicated in pts CNS: headache, To prevent tolerance,
Mononitrat reduce cardiac mg, 20mg variceal with hypersensitivity or dizziness, a nitrate-free interval
e oxygen rebleeding in idiosyncrasy to nitrates weakness. of 10 to 14 hours per
demand by Tablets combination and in those with CV: orthostatic day is recommended.
decreasing (extended with a beta- severe hypotension, hypotension, Monitor BP and HR
preload and release): adrenergic angle-closure tachycardia, and intensity and
afterload. Drug 30mg, blocker glaucoma, increased palpitations, ankle duration of drug
also may 60mg, intracranial pressure edema, flushing, response.
increase blood 120mg shock, or acute MI with fainting. Drug may cause
flow through low left ventricular EENT: sublingual headaches, especially
the collateral filling pressure. burning at the beginning of
coronary Use cautiously in therapy. Dosage may
vessels. patients with blood be reduced
volume depletion (such temporarily, but
as from diuretic tolerance usually
therapy) or mild develops. Treat
hypotension. headache with aspirin
or acetaminophen.

Name of the Mechanism of Dosage Indications Contraindicati Adverse Nursing

Drug Action on reaction considerations
/
responsibilitie
s
Rebamipide Rebamidipide is Oral Treatment for Contraindicated Dizziness, Monitor for
mucosal Gastritis, with patients drowsiness, dry
peptic ulcer resolution of
mouth, constipation,
protective agent Peptic ulcer disease who are diarrhea, abdominal GI symptom
and is Adult: 100mg Prevention of hypertensive to distention, nausea, Assess CBC in
postulated to TID, in the NSAID- the drug, vomiting, eructation; liver function
increase gastric morning, induced lactating, ALT, AST and BUN tests
elevation, edema,
blood flow, evening and gastropathy pregnant and Assess
hyperbilirubinaemia;
prostaglandin before bedtime children gynaecomastia, constipation
biosynthesis and induction of Monitor
decrease free lactation, menstrual electrolytes
oxygen radicals. disorders, hot
levels as
flushes; leucopenia,
leucocytosis, appropriate
 thrombocytopenia;
rash, urticaria,
eczema.
Name of the Mechanism of Dosage Indications Contraindicati Adverse Nursing
Drug Action on reaction Consideration/
Responsibilitie
s
Levetiraceta Appears to Minimum dose: Partial onset Hypersensitivity; CNS: suicidal 1. Ensure patient has
m inhibit burst 10mg/day seizures Lactation: thoughts, dizziness, fully swallowed
firing without Maximum dose: (adjunct). lactation. fatigue/somnolence, oral form of
affecting normal 3000mg/day Primary weakness, medication.
neuronal generalized behavioral 2. Observe patients
excitability and tonic-clonic abnormalities. behavior closely
may selectively seizures Neuro: coordination for at least 15-30
prevent (adjunct) difficulties (adults minutes after
hypersynchroniz (immediatereleas only) administration.
ation of e and injection 3. Instruct patient to
epileptiform only). Myoclinic slowly move to
burst firing and seizures in pts prevent dizziness.
propagation of with juvenile 4. Instruct patient to
seizure activity. myoclonic rest to decrease
epilepsy risk of falls.
(adjunct)
(immediate-
release and
injection only).

Name of Mechanism Dosage Indications Contraindica Adverse Nursing Consideration/

the Drug of Action tion reaction Responsibilities
Valproic Anticonvulsant Treatment of Pregnancy Hemorrhage Assess mental status.
acid activity may be generalized (Category D). Bruising Assess hepatic and
by increasing convulsive seizures, Hepatic Coagulation hematologic status.
levels of y- tonic-clonic (grand disease or disorders Advice patient to report
aminobutyric mal), absence (petit significant Hyperammone drug induced adverse
(GABA) in brain mal), partial (focal dysfunction. mia reactions.
which and motor). Sedation Advise patient not to
decreases Transient discontinue quickly after
seizure activity. alopecia long-term use.
Other Nausea Instruct patient to avoid
possibilities Vomiting activities that requires
include acting Indigestion mental alertness.
in the Increased Instruct patient no to
 postsynaptic appetite chew or crush extended
receptor sites Thrombocytope tablets.
to mimic or nia Tell patient that syrup
enhance the Anemia should not be mixed with
inhibitory Bone marrow carbonated drinks.
effect of GABA. suppression

Name of Mechanism of Dosage Indications Contraindicatio Adverse Nursing

the Drug Action n reaction Consideration/
Responsibilities
Telmisarta Blocks Adults: HPN (used Contraindicated CNS: dizziness, Monitor pt for
n vasoconstricting 40 mg P.O alone or with in patients pain, fatigue, hypotension after
and aldosterone- daily. BP other hypertensive to headache starting a drug.
secreting effects response is antihypertensi drugs or its CV: chest pain, Place patient
of angiotensin II dose-related on) components. HPN, peripheral supine if
by preventing over a range Use cautiously edema hypotension occurs
angiotensin II of 20 to 80 mg in pts with EENT: pharyngitis, and give I.V NSS, if
from binding to daily biliary sinusitis needed.
the angiotensin I Adults: obstruction GI: nausea, Most of the
receptor. age 55 and CV risk disorders or abdominal pain, hypertensive effect
older; 80mg reduction in renal and diarrhea, dyspepsia occurs within 2 wks.
P.O. once daily. pts at high hepatic GU: UTI Maximal BP
risk and insufficiency Musculoskeletal: reduction is usually
unable to take and in those back pain, myalgia reached after 4
ACE inhibitors with an Respiratory: weeks. Diuretic
activated renin- cough, upper may be added if BP
angiotensin respiratory tract isnt controlled by
system, such as infection drug alone.
volume of Other: flulike Drug isnt remove
sodium- symptoms by hemodialysis.
depleted Pts undergoing
patients(ex., dialysis may
those being develop orthostatic
treated with hypotension.
high doses of Closely monitor BP.
diuretics). Monitor pts with
impaired hepatic
function or biliary
obstruction
carefully. Start
telmisartan at low
 dose and titrate
slowly.

Name of the Mechanism of Dosage Indications Contraindication Adverse reaction Nursing Consideration/
Drug Action Responsibilities
Phenytoin May stabilize Oral To control Contraindicated in CNS: ataxia, decreased Therapeutic dose usually
(diphethydant neuronal suspension: tonic-clonic pts hypersensitive coordination, mental increases during
oin) membranes and 125mg/5m (grand mal) to hydantoin, in confusion, slurred pregnancy.
If rash appears, stop drug.
limit seizure L and complex those taking speech, dizziness,
If rash is scarlatiniform or
activity either by Tablets partial delavirdine, and in headache, insomnia,
morbilliform, resume drug
increasing efflux (chewable): (temporal those with sinus nervousness, twitching, after drug clears.
or decreasing 50mg lobe) bradycardia, SA peripheral neuropathy. Dont stop drug suddenly
influx of sodium seizures block, second or CV: bradycardia, because this may worsen
ions across cell For patients third degree AV periarteritis nodosa, seizures.
membranes in requiring a block, Adams-Stoke hypotension. Monitor drug level.
the motor cortex loading dose Syndrome EENT: diplopia, Therapeutic level of total
phenytoin is 10 to 20
during To prevent Use cautiously in nystagmus, blurred
mcg/mL.
generation of and treat pts in patients with vision, thickening of Monitor CBC and calcium
nerve impulses. seizures hepatic dysfunction, facial features. every 6 mos, and
occurring hypotension, GI: gingival hyperplasia, periodically monitor
during myocardial nausea, vomiting, hepatic function. If
neurosurgery insufficiency, constipation. megaloblastic anemia is
. diabetes, Hematologic: evident, prescriber may
Status respiratory agranulocytosis, order folic acid and Vit.
B12.
epilleptus depression; in leukopenia,
Maintain seizure
elderly or pancytopenia, precautions, as needed.
debilitated pts; and thrombocytopenia, Mononucleosis may
in those receiving macrocythemia, decrease level. Watch for
other hydantoin megaloblastic anemia. increased seizures.
derivatives. Watch for gingival
Elderly patients hyperplasia, especially in
tend to metabolize children.
If seizure control is
drug slowly and
established with divided
may need reduced doses, once-daily dosing
dosages. may be considered.
Avoid use during Because of the risks of
pregnancy due to cardiac and local toxicity
 fetal risk. Breast with parenteral phenytoin,
feeding isnt use oral form when
recommended. possible.

Name of the Mechanism of Dosage Indications Contraindicatio Adverse Nursing

Drug Action n reaction Consideration/
Responsibilities
Domperidom Selectively blocks 10mg 1 tab TID Dyspeptic GI hemorrhage Intestinal cramps, Assess for GI
e peripheral symptom complex mechanical drowsiness, complaints,
dopamine associated with obstruction of lashes & other before & after
receptors in the GI delayed gastric perforation. Pt allergic reaction. administration
wall in the emptying. with epilepsy. Assess for change
chemoreceptor in bowel habits
trigger zone thus Symptomatic Inform the pt to
enhancing normal relief of N&V take the
synchronized GI medication before
peristalsis & meals. If taken
motility in the after meals
proximal region of absorption is
GIT counteract somewhat
anti-cholinergic delayed.
induced relaxation Instruct the pt to
of lower inform physician if
esophageal transient
sphincter. intestinal cramps
occur.
Name of Mechanism
the Drug of Action Dosage Indications Contraindication Adverse reaction Nursing
Consideration/
Responsibilities
Metformin Decreases Oral Adjunct to diet Contraindicated in CNS: asthenia, headache, Before therapy
hepatic solution: to lower patients : dizziness, chills, light- begins and at least
glucose 500mg/5m glucose level Hypersensitive to headedness. annually thereafter,
production and L in patients drug and in those CV: chest discomfort, assess pts renal
with type 2 with hepatic function. If renal
intestinal Tablets: palpitations, hypertension.
diabetes disease or impairment is
absorption of 500mg, Adjunct to diet metabolic
EENT: ear pain, rhinitis, detected, a different
glucose and 850mg, and exercise in acidosis. seasonal allergy, tootache, antidiabetic may be
improves 1000mg type 2 With renal tooth abscess, tonsillitis. indicated.
insulin Tablets diabetes as disease and in GI: diarrhea, nausea, When switching pts
sensitivity (extended- monotherapy those with a vomiting, abdominal from
(increases release): or with a serum creatinine bloating, flatulence, chlorpropamide to
peripheral 500mg, sulfonylurea or level greater anorexia, taste disorder, metformin, take
glucose uptake 750mg, insulin than or equal to abnormal stools, care during the first
(Fortamet) 1.5 mg/dL(males) 2 wks of metformin
and use. 1000mg constipation, dyspepsia.
Adjunct to diet or greater than therapy because
and exercise in or equal to 1.4
Metabolic: lactic acidosis, the prolonged
type 2 mg/dL(females). hypoglycemia. retention of
diabetes as With acute heart Musculoskeletal: myalgia, chlorpropomide
monotherapy failure requiring limb pain. increases the risk of
or with a pharmacologic Respiratory: rhinitis, upper hypoglycemia
sulfonylurea or intervention and respiratory tract infection. during this time.
insulin in patients with Monitor patients
(Glumetza) conditions glucose level
Polycystic predisposing to regularly to
ovary renal evaluate
 syndrome dysfunction, CV effectiveness of
Antipsychotic- collapse, MI, therapy. Notify
induced hypoxia, and prescriber if glucose
weight gain. septicemia. level increases
Temporarily despite therapy.
withhold from pts Monitor patient
having radiologic closely during times
studies involving of increased stress,
use of contrast such as infection,
media containing fever, surgery, or
iodine. trauma. Insulin
therapy may be
needed in these
situations.

Name of Mechanism
the Drug of Action Dosage Indications Contraindication Adverse reaction Nursing
Consideration/
Responsibilities
Losartan Inhibits Tablets: Hypertension Patients Patients with HPN or left Drug can be used
vasoconstrictiv 25mg, Neuropathy hypersensitive to ventricular hypertrophy. alone or with other
e and 50mg, in pts with drug. Breast- CNS: dizziness, asthenia, antihypertensive.
aldosterone 100mg type 2 feeding isnt fatigue, headache, insomnia If hypertensive
secreting diabetes recommended CV: edema, chest pain effect is
action of To reduce during losartan EENT: nasal congestion inadequate using
angiotensin II therapy. sinusitis, pharyngitis, sinus
risk of stroke once-daily doses,
disorder.
by blocking in patients twice-daily
GI: abdominal pain, nausea,
angiotensin II with regimen using the
diarrhea, dyspepsia
receptor on the hypertension same or increased
Musculoskeletal: muscle
surface of and left total daily dose
cramps, myalgia, back or leg
vascular ventricular pain may give a more
smooth muscle hypertrophy Respiratory: cough, upper satisfactory
and other respiratory tract infection response.
tissue. Other: angioedema Monitor pts BP
closely to evaluate
Patients with neuropathy effectiveness of
CNS: asthenia, fatigue, fever, the therapy.
hypoesthesia Monitor pts who
CV: chest pain, hypotension, are also taking
orthostatic hypotension. diuretics for
EENT: sinusitis, cataract symptomatic
GI: diarrhea, dyspepsia, hypotension.
gastritis, nausea. Regularly assess
GU: UTI the pts renal
Hematologic: anemia function (via
Metabolic: hyperkalemia, creatinine and BUN
hypoglycemia, hyponatremia,
levels).
weight gain
Musculoskeletal: back pain,
leg or knee pain, muscle
weakness.
Respiratory: cough,
bronchitis.
Skin: cellulitis
Other: flulike syndrome,
diabetic vascular, disease,
angioedema, infection,
trauma, diabetic neuropathy.