Drug Study

Colleen S.
De la Rosa
BSN III
Drug Study
Brand Name &
Generic Name
Indication
K-lyte(potassium
bicarbonate
and
potassium citrate)
Drug-induced
hypokalemia, liver
cirrhosis, nausea,
vomiting, cholera,
diarrhea, muscular
weakness, paralysis,
cardiac & CHF,
diabetic
ketoacidosis,
ulcerative colitis,
weakness, anorexia,
drowsiness,
Cushing's syndrome,
pyloric stenosis, low
BP.
Mechanism of Action
Dosage
Adverse Reaction
Description: Potassium
Adult Severe deficiencies 3-6 Nausea, vomiting, abdominal
pain & diarrhea; hyperkalemia.
chloride is a major cation of tab/day in divided doses.
the intracellular fluid. It plays
an active role in the
conduction of nerve impulses
in the heart, brain and skeletal
muscle; contraction of cardiac
skeletal and smooth muscles;
maintenance of normal renal
function, acid-base balance,
carbohydrate metabolism and
gastric
secretion.
Pharmacokinetics:
Absorption: Well absorbed
from the upper GI tract.
Distribution: Active
transport mechanism allows K
chloride to enter cells from
the
extracellular
fluid.
Excretion: Mainly via the
urine with small amounts via
the sweat and faeces.
Nursing Consideration
The tablets must not be masticated or
diluted. The active component of Aealka
is contained with a porous wax matrix.
Asthis matrix is insoluble; it can be
eliminated in visible.
Brand Name &

Generic Name
Klaz-OD
(Clarithromycin)
Indication
Mechanism of Action
Dosage
Adverse Reaction
Respiratory
tract
infections, Skin and
soft
tissue
infections,
Susceptible
infections
Description: Clarithromycin
inhibits protein synthesis in
susceptible
organisms
by
penetrating the cell wall and
binding to 50S ribosomal subunits .
It has activity against a variety of
aerobic and anaerobic gm+ve and
gm-ve
bacteria.
Pharmacokinetics:
Absorption: Rapidly
absorbed
from the GI tract. Food delays rate
of
absorption.
Bioavailability:
Approx 50%. Time to peak plasma
concentration: 2-3 hr (conventional
tab), 5-8 hr (extended-release tab).
Distribution: Widely
distributed
into most body tissues. Enters
breast milk and distributed into
CSF. Plasma protein binding:
Approx
42-70%.
Metabolism: Partially hepatic by
CYP3A4 isoenzyme, converted to
14-hydroxyclarithromycin (active
metabolite).
Excretion: Via urine (as unchanged
drug and metabolites) and faeces
(mostly as metabolites). Plasma
half-life: 3-7 hr (clarithromycin), 59 hr (14-hydroxyclarithromycin).
Adult : PO Resp
tract
infections;
Skin and soft
tissue infections;
Susceptible
infections 250 mg
bid, up to 500 mg
bid
for
severe
infections, for 7-14
days. H.
pylori infection W/
another
antibacterial
and
either a PPI or
H2 antagonist: 500
mg bid for 7-14
days. IV Resp
tract
infections;
Skin and soft
tissue infections;
Susceptible
infections 500 mg
bid for 2-5 days.
Smell
and
taste
disturbances,
stomatitis,
glossitis, tongue and tooth
discolorations, headache,
arthralgia, myalgia, hypo
glycaemia,
leucopenia,
thrombocytopenia,
interstitial
nephritis,
muscle
weakness,
agranulocytosis, elevated
serum amylase levels, QT
prolongation, torsades de
pointes, corneal opacities,
fever,
pulmonary
infiltration
w/
eosinophilia,
delirium,
visual
hallucinations,
pancreatitis.
Potentially Fatal: Hepatic
failure,
pseudomembranous
colitis,
anaphylaxis,
Stevens-Johnson
syndrome, toxic epidermal
necrolysis, drug rash w/
eosinophilia and systemic
symptoms
(DRESS)
syndrome and HenochSchonely purpura.
Assessment
History: Hypersensitivity to clarithromycin,
erythromycin, or
any macrolide antibiotic; pseudomembranous colitis,
hepatic or renal impairment, lactation, pregnancy
Physical: Site of infection; skin color, lesions;
orientation, GI output, bowel sounds, liver evaluation;
culture and sensitivity tests of infection, urinalysis, liver
and renal function tests
Interventions
Culture infection before therapy.
Do not cut or crush, and ensure that patient does not
chew ER tablets.
Monitor patient for anticipated response.
Administer without regard to meals; administer with food
if GI effects occur.
Teaching points
Take drug with food if GI effects occur. Take the full
course of therapy. Do not drink grapefruit juice while
taking this drug.
Shake suspension before use; do not refrigerate; do not
cut, crush, or chew ER tablets; swallow them whole.
You may experience these side effects: Stomach
cramping, discomfort, diarrhea; fatigue, headache
(medication may be ordered); additional infections in the
mouth or vagina (consult with care provider for
treatment).
Report severe or watery diarrhea, severe nausea or
vomiting, rash or itching, mouth sores, vaginal sores.
Brand Name &

Generic Name
Vastarel
MR(Trimetazidine)
Indication
Mechanism of Action
Preventive treatment
of
episodes
of
angina
pectoris.
Adjuvant
symptomatic
treatment of vertigo
& tinnitus. Adjuvant
treatment of visual
disorders
of
circulatory origin.
Pharmacokinetics: After oral administration,

maximum concentration is found on average, 5
hrs after taking the tablet. Over 24 hrs, the
plasma concentration remains at levels 75% of
the maximum concentration for 11 hrs.
Steady state is reached by the 60th hour, at the
latest. The pharmacokinetic characteristics of
Vastarel MR are not influenced by meals. The
apparent distribution volume is 4.8 L/kg; proteinbinding is low: In vitro measurements give value
of 16%. Trimetazidine is eliminated primarily in
the urine, mainly in the unchanged form. The
elimination half-life of Vastarel MR is an average
of 7 hrs in healthy young volunteers and 12 hrs
in subjects >65 years. Total clearance of
trimetazidine is the result of major renal
clearance which is directly correlated to
creatinine clearance and, to a lesser extent, to
liver clearance which is reduced with age.
Dosage
Adverse Reaction
1 tab morning & Commonly,

dizziness,
evening.
headache,
abdominal
pain, diarrhea, dyspepsia,
nausea, vomiting, rash,
pruritus,
urticaria,
asthenia.
Rarely,
palpitations,
extrasystoles,
tachycardia,
arterial
hypotension, orthostatic
hypotension that may be
associated w/ malaise,
dizziness or fall, in
particular in patients
taking antihypertensive
treatment, flushing.
Nursing Responsibilities
Assess for hypersensitivity to
trimetazidine, with heart failure and
pregnancy.
Administer drug after patient has
eaten with a full glass of water.
Encourage patient to continue efforts
at smoking cessation.
Provide safety measures if lethargy
occurs.
Brand Name& Generic

Name
Ambroxol
Hydrochloride (
Mucosolvan and
Mucoangin)
Indication
Mechanism of Action
Dosage
Side Effects
Secretolytic therapy in acute

and
chronic
bronchopulmonary diseases
associated with abnormal
mucus
secretion
and
impaired mucus transport..
Mucolytic; Ambroxol is used for

infections of the upper respiratory
tract. It clears airways and eases
cough. Properties: Ambroxol is used
for infections of the upper respiratory
tract. It clears airways and eases
cough. Pre clinically, ambroxol, the
active ingredient of MUCOSOLVAN,
has been shown to increase respiratory
tract secretion. It enhances pulmonary
surfactant production and stimulates
ciliary activity. These actions result in
improved mucus flow and transport
(mucociliary clearance). Improvement
of mucociliary clearance has been
shown in clinical pharmacologic
studies.
Enhancement
of
fluid
secretion and mucociliary clearance
facilitates expectoration and eases
cough.
Adults : 1 prolonged
action capsule once daily,
either in the morning or
evening after a meal
MUCOSOLVAN
is
generally well tolerated.
Mild upper gastro-intestinal
side effects (primarily
pyrosis, dyspepsia, and
occasionally
nausea,
vomiting)
have
been
reported,
principally
following
parenteral
administration.
Allergic
reactions have occurred
rarely,
primarily
skin
rashes. There have been
extremely rare case reports
of
severe
acute
anaphylactic-type reactions
but their relationship to
ambroxol is uncertain.
Some of these patients have
also
shown
allergic
reactions
to
other
substances.
Assessment & Drug Effects

Monitor for S&S of aspiration of
excess secretions, and for
bronchospasm (unpredictable);
withhold drug and notify physician
immediately if either reoccur.
Lab tests: Monitor ABGs,
pulmonary functions and pulse
oximetry as indicated. Have suction
apparatus immediately available.
Increased volume of respiratory trac
fluid may be liberated; suction or
endotracheal aspiration may be
necessary to establish and maintain
an open airway. Patient & Family
Education
Report difficulty with clearing the
airway or any other respiratory
distress
Brand Name&
Generic Name
Norvasc (amlodipine
besylate)
Indication
Mechanism of Action
Dosage
1st-line treatment of HTN

& myocardial ischemia.
Reduce the risk of
coronary
revascularization & the
need for hospitalization
due to angina in patients
w/ CHD; reduce the risk
of fatal CHD, nonfatal MI
& to reduce the risk of
stroke.
Amlodipine is a dihydropyridine calcium

antagonist (calcium ion antagonist or
slow-channel blocker) that inhibits the
transmembrane influx of calcium ions
into vascular smooth muscle and cardiac
muscle. Experimental data suggest that
amlodipine binds to both dihydropyridine
and nondihydropyridine binding sites. The
contractile processes of cardiac muscle
and vascular smooth muscle are
dependent upon the movement of
extracellular calcium ions into these cells
through specific ion channels. Amlodipine
inhibits calcium ion influx across cell
membranes selectively, with a greater
effect on vascular smooth muscle cells
than on cardiac muscle cells. Negative
inotropic effects can be detected in
vitro but such effects have not been seen
in intact animals at therapeutic doses.
Serum calcium concentration is not
affected by amlodipine. Within the
physiologic pH range, amlodipine is an
ionized compound (pKa=8.6), and its
kinetic interaction with the calcium
channel receptor is characterized by a
gradual rate of association and
dissociation with the receptor binding site,
resulting in a gradual onset of effect.
HTN, chronic stable

angina Initial dose: 5
mg once daily & may
be increased to a max
of 10 mg. Patients w/
CAD Recommended
dosage range: 5-10
mg once daily. Ped
patients
6-17
yr Initial dose: 2.5-5
mg once daily. Dose
should not exceed 5
mg daily.
Adverse Reaction
Flushing,
edema,
headache,
pain,
palpitations
somnolence
fatigue,
dizziness,
abdominal
nausea,
&
Assessment
History: Allergy to amlodipine, impaire
hepatic or renal function, sick sinu
syndrome, heart block, lactation, CHF
Physical: Skin lesions, color, edema; P, B
baseline
ECG,
peripheral
perfusion
auscultation; R, adventitious sounds; live
evaluation, GI normal output; liver and ren
function tests, urinalysis
Interventions
WARNING: Monitor patient carefully (B
cardiac rhythm, and output) while adjustin
drug to therapeutic dose; use special cautio
if patient has CHF.
Monitor BP very carefully if patient is als
on nitrates.
Monitor cardiac rhythm regularly durin
stabilization of dosage and periodicall
during long-term therapy.
Administer drug without regard to meals.
Teaching points
Take with meals if upset stomach occurs.
You may experience these side effect
Nausea, vomiting (eat frequent small meals
headache (adjust lighting, noise, an
temperature; medication may be ordered).
Report irregular heartbeat, shortness o
breath, swelling of the hands or fee
pronounced dizziness, constipation.

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Colleen S.

Brand Name &

Brand Name &

Pharmacokinetics: After oral administration,

1 tab morning & Commonly,

Brand Name& Generic

Secretolytic therapy in acute

Mucolytic; Ambroxol is used for

Assessment & Drug Effects

1st-line treatment of HTN

Amlodipine is a dihydropyridine calcium

HTN, chronic stable

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