DRUG STUDY

Name of Classification Mechanism of Contraindication Route and Side Effects Nursing

Drug Action Dosage Responsibilities
Generic
Name
Brand Name

Labetalol •Alpha- and Competitively *Contraindicated *Oral •CNS: Dizziness, Assessment

hydro beta blocks alpha1- with sinus vertigo, fatigue,
chloride adrenergic and beta1- and bradycardia, Initial dose depression, •History: Sinus
blocker beta2- second or third- 100 mg bid. paresthesias, sleep bradycardia, second-
Normodyne, adrenergic degree heart After 2–3 disturbances, or third-degree heart
Trandate •Anti- receptors, and block,cardiogenic days, using hallucinations, block,
hypertensive has some shock, CHF, standing BP disorientation, Cardiogenic shock,
sympathomimet asthma. as indicator, memory loss, CHF, asthma,
ic activity at adjust slurred speech pregnancy,lactation,
beta2- *Use cautiously dosage in diabetes or
receptors. with diabetes or increments •C V:CHF, cardiac hypoglycemia,
Alpha- and hypoglycemia of 100 mg arrhythmias, nonallergic
beta-blocking (can mask bid q 2–3 peripheral vascular bronchospasm,
actions cardiac signs of days. insufficiency, pheochromocytoma
contribute hypoglycemia), For claudication,
to the BP- nonallergic maintenanc CVA, pulmonary •Physical: Weight,
lowering effect; bronchospasm e, 200 to edema,hypotension skin condition,
beta blockade (oral drug—IV is 400 mg bid. neurologic status, P,
prevents the absolutely Up to 2,400 •Dermatologic: BP, ECG, respiratory
reflex contraindicated), mg/day may Rash, pruritus, status, kidney and
tachycardia pheochromocyto be required; sweating, dry skin thyroid function,
seen with most ma (paradoxical to improve blood and urine
alpha-blocking increases in BP tolerance, •EENT: Eye glucose.
drugs and have occurred), divide total irritation, dry eyes,
decreases pregnancy, daily dose conjunctivitis, TEACH CLIENT TO:
plasma renin lactation. and give tid. blurred vision •Take drug with
activity. meals.
•GI: Gastric pain,
flatulence, •Do not stop taking
constipation, unless instructed to
diarrhea, nausea, do so by a health
vomiting,anorex ia, care provider.
ischemic colitis,
renal and •If you have
mesenteric arterial diabetes, monitor
thrombosis, your blood glucose
retroperitoneal carefully. This drug
fibrosis, may mask
hepatomegaly, usual symptoms of
acute pancreatitis hypoglycemia.

•GU: Impotence, •These side effects

decreased libido, may occur:
Peyronie's disease, Dizziness, light-
dysuria, nocturia, headedness, loss of
polyuria, appetite,nightmares,
priapism, urinary depression, sexual
retention impotence.

•Respiratory: •Report difficulty

Bronchospasm, breathing, night
dyspnea, cough, cough, swelling of
bronchial extremities, slow
obstruction, nasal pulse,
stuffiness, rhinitis, confusion,
 pharyngitis depression, rash,
fever, sore throat.
•Other: Decreased
exercise tolerance,
development of
antinuclear
antibodies,
hyperglycemia or
hypoglycemia,
elevated liver
enzymes

Nifedipine *Calcium Inhibits the •Contraindicated Initial dose, •CNS:Dizziness, •Monitor patient
channel- movement of with allergy to 10 mg tid light-headedness, carefully (BP,cardiac
Adalat, blocker calcium ions nifedipine. PO. headache,asthenia, rhythm, and output)
Adalat CC, across the fatigue,nervousness while drug is being
Adalat XL *Antianginal membranes of •Use cautiously Maintenanc ,sleep disturbances, adjusted to
(CAN), cardiac and with lactation, e range, blurred vision therapeutic dose;
Aponifed *Anti- arterial muscle pregnancy. 10–20 mg the dosage may be
(CAN), Gen- hypertensive cells; inhibition tid. Higher •CV:Peripheral increased more
Nifedipine of doses (20– edema,angina, rapidly in
(CAN), transmembrane 30 mg tid– hypotension, hospitalized patients
Nifedical XL, calcium flow qid) may be arrhythmias,AV under close
Novo-Nifedin results in the required, block,asystole supervision. Do not
(CAN), depression of depending exceed 30 mg/dose
Procardia, impulse on patient •Dermatologic: increases.
Procardia XL formation in response. Flushing,rash,
specialized dermatitis, pruritus, •Ensure that
cardiac Adjust over urticaria patients do not chew
pacemaker 7–14 days. or divide sustained-
cells, in slowing More than •GI:Nausea, release tablets.
of the velocity 180 mg/day diarrhea,
of conduction of is not constipation,cramps •Taper dosage of
the cardiac recommend ,flatulence,hepatic beta-blockers before
impulse, in the ed. injury nifedipine therapy.
depression of
myocardial Sustained- •Other:Nasal •Protect drug from
contractility, release congestion, cough, light and moisture.
and in the 30–60 mg fever,chills,shortnes
dilation of PO once s of breath, muscle
coronary daily. cramps,joint TEACH CLENT:
arteries and Adjust over stiffness,sexual
arterioles and 7–14 days. difficulties. •Do not chew, cut,
peripheral or crush sustained-
arterioles; these Usual release tablets.
effects lead maximum Swallow whole.
to decreased dose is 90–
cardiac work, 120 •These side effects
decreased mg/day. may occur: Nausea,
cardiac energy vomiting (eat
consumption, frequent small
and increased meals);dizziness,
delivery of light-headedness,
oxygen to vertigo (avoid
myocardial driving, operating
cells. dangerous
machinery; take
special precautions
to avoid falling);
muscle cramps, joint
stiffness, sweating,
sexual difficulties
(reversible).
 •Report irregular
heartbeat, shortness
of breath, swelling
of the hands or feet,
pronounced
dizziness,
constipation.

1.The drug should

ALDOMET* Anti- Although the ALDOMET is ORAL: Sedation,usually be taken with
(Methyldopa) hypertensive mechanism of contraindicated transient,may occur or without food.
action has yet in patients: Initial dose: during the initial (May be taken
to be — with period oftherapy or with meals to reduce
conclusively activehepatic 250 mg two whenever the dose GI discomfort)
demonstrated, disease, such as or three is increased.Head
the anti- acutehepatit is times a day ache,asthenia, or 2.Tell patient to take
hypertensive and activecirrhos in the first weakness may be entire amount of
effect of is 48 hours. noted as early and drug exactly as
methyldopa — withliver transient prescribed.
probably is due disorders symptoms.
to its previously However,significant 3.monitor for
metabolism to associated with Maintenanc adverse effects due possible drug
alpha- methyldopathera e: to ALDOMET have induced adverse
methylnorepine py (seeWA RN I been infrequent reactions.
phrine, which N GS 500 mg to 2 and this agent
then lowers ) † with g in two to usually is well
arterial pressure hypersensitivity four doses. tolerated.
by stimulation to any The following
of central component of adverse reactions
inhibitory alpha- these products. have been reported
adrenergic — on therapy and, within each
receptors, false with monoamine category, are listed
neurotransmissi oxidase (MAO) in
on, and/or inhibitors order of decreasing
reduction of severity.
plasma renin
activity.
Methyldopa has
been shown to
cause a net
reduction in the
tissue
concentration of
serotonin,
dopamine,
norepinephrine,
and
epinephrine.