DRUG STUDY

MEDICATION INDICATION MECHANISM OF MECHANISM OF SIDE EFFECTS AND NURSING RESPONSIBILITIES

ACTION ACTION IN ADVERSE EFFECTS
RELATION TO
THE PATIENT’S
CASE
LOSARTAN + HCTZ Hypertension Hydrochlorothiazide The drug works Side Effects: BASELINE ASSESSMENT
50/12.5 MG increases renal in high blood dizziness or Obtain B/P, apical pulse
excretion of sodium pressure by lightheadedness as immediately before each
Generic Name: and chloride and relaxing and your body adjusts dose, in addition to regular
Losartan potassium- reduces cardiac widening blood to the medication, monitoring (be alert to
hydrochlorothiazide load. Losartan is an vessels. This stomach pain, fluctuations).
Brand Name: angiotensin II lowers the back pain, tired INTERVENTION/EVALUATION
Hyzaar receptor (type AT1) patient’s blood feeling, skin rash, Maintain hydration (offer
antagonist pressure and runny or stuffy nose, fluids frequently).
antihypertensive makes it easier sore throat, or dry Assess for evidence of
which acts by for the heart to cough. upper respiratory infection,
blocking the pump blood Adverse Side cough.
actions of around your Effects: Monitor B/P, pulse. If
angiotensin II of body. Volume depletion excessive reduction in B/P
renin-angiotensin- and electrolyte occurs, place pt in supine
aldosterone system. imbalance position, feet
The drug and its (especially slightly elevated. Assist with
active metabolite hyperkalaemia); ambulation if dizziness
selectively block dry mouth, thirst; occurs.
the vasoconstrictor lethargy, Monitor daily pattern of
and aldosterone drowsiness; muscle bowel activity, stool
secreting effects of pain and cramps; consistency.
angiotensin II. The rashes, PATIENT/FAMILY TEACHING
two drugs exert photosensitivity, • Report any sign of
additive effects in thrombocytopenia, infection (sore throat,
hypertension. jaundice, fever), chest pain.
Therapeutic pancreatitis; • Do not take OTC cold
indication: fatigue, weakness; preparations, nasal
Decrease B/P may precipitate an decongestants.
attack of gout; • Do not stop taking
impotence; medication.
hyperglycaemia; • Limit salt intake
anorexia, nausea,
vomiting,
constipation,
diarrhoea;
sialdenitis; raised
urinary calcium
concentration;
headache,
dizziness; back
pain, myalgia; first-
dose hypotension;
angiodema;
neutropenia; GI
disturbances;
transient elevation
of liver enzymes;
taste disturbances,
cough;
exacerbation or
activation of
systemic lupus
erythematous;
palpitations;
xanthopsia;
leucopenia,
agranulocytosis,
aplastic anaemia;
necrotising angiitis;
glucosuria; renal
dysfunction,
interstitial nephritis,
renal failure;
migraine;
hyponatraemia;
UTI; chest pain;
gastritis, wt gain,
dyspepsia,
abdominal pain;
bronchitis, upper
respiratory
infection, nasal
congestion, sinusitis;
rise in cholesterol
and/or
triglycerides.
MEDICATION INDICATION MECHANISM OF MECHANISM OF SIDE EFFECTS AND NURSING RESPONSIBILITIES
ACTION ACTION IN ADVERSE EFFECTS
RELATION TO THE
PATIENT’S CASE
AMLODIPINE Hypertension Inhibits influx of The drug works in Side Effects: BASELINE ASSESSMENT
Generic Name: extracellular high blood Peripheral Assess baseline
Amlodipine calcium ions, pressure by edema, renal/hepatic function
Brand Name: thereby relaxing and headache, tests, B/P, apical pulse.
Apo-Amlodipine; decreasing widening blood flushing. Dizziness, INTERVENTION/EVALUATION
Norvasc; Katerzia myocardial vessels. This lowers palpitations, Assess B/P (if systolic B/P is
contractility, the patient’s nausea, unusual less than 90 mm Hg,
relaxing coronary blood pressure fatigue or withhold medication,
and vascular and makes it weakness contact physician). Assess
muscles, and easier for the (asthenia). for peripheral edema
decreasing heart to pump Adverse Side behind medial malleolus
peripheral blood around Effects: (sacral area in bedridden
resistance your body. Overdose may pts). Assess skin for flushing.
Therapeutic produce Question for headache,
outcome: excessive asthenia.64 amoxicillin
Decreased B/P peripheral underlined – top
vasodilation, prescribed drug
marked PATIENT/FAMILY TEACHING
hypotension with • Do not abruptly
reflex discontinue medication.
tachycardia, • Compliance with
syncopy therapy regimen is
essential to control
hypertension.
• Avoid tasks that require
alertness, motor skills until
response to drug is
established.
• Do not ingest grapefruit
products.
• Advise patient to avoid
hazardous activities until
stabilized on product,
dizziness is no longer a
problem
• Instruct patient to avoid
alcohol and OTC
products unless directed
by prescriber
• Advise patient to
comply in all areas of
medical regimen: diet,
exercise, stress reduction,
smoking cessation,
product therapy; to notify
prescriber of irregular
heartbeat, shortness of
breath, swelling of feet,
face, and hands, severe
dizziness, constipation,
nausea, hypotension; use
nitroglycerin when angina
is severe
• Teach patient to use as
directed even if feeling
better; may be taken with
other cardiovascular
products (nitrates, b-
blockers)
• Advise to avoid large
amounts of grapefruit
juice or alcohol
MEDICATION INDICATION MECHANISM OF MECHANISM OF SIDE EFFECTS AND NURSING RESPONSIBILITIES
ACTION ACTION IN ADVERSE EFFECTS
RELATION TO THE
PATIENT’S CASE
TRAMADOL 50 MG Indication: Binds to mu-opioid In the spinal cord, Side Effects: BASELINE ASSESSMENT
Management of receptors, inhibits opioids act on Frequent: Assess onset, type,
Generic Name: moderate to reuptake of specific receptors Dizziness, vertigo, location, duration of pain.
Tramadol moderately norepinephrine, located in pre- nausea, Assess drug history, esp.
Brand Name: severe pain. serotonin, and postsynaptic constipation, carbamazepine,
Ultram, Tramadol Extended- inhibiting synapses in the headache, analgesics, CNS
Hydrochloride ER, Release: Around- ascending and dorsal horn. Pre drowsiness. depressants, MAOIs.
Tramal, Ultram ER the-clock descending pain synaptically, Occasional: Review past medical
management of pathways. opioids decrease Vomiting, pruritus, history, esp. epilepsy,
moderate to Therapeutic Effect: the release of CNS stimulation seizures. Assess renal
moderately Reduces pain. specific pain (e.g., nervousness, function, LFT.
severe pain for neurotransmitters anxiety, agitation, INTERVENTION/EVALUATION
extended period. (i.e. substance P), tremor, euphoria, Monitor pulse, B/P,
while in the mood swings, renal/hepatic function. Dry
postsynaptic hallucinations), crackers, cola may relieve
neuron they asthenia, nausea. Palpate bladder
decrease diaphoresis, for urinary retention.
excitability. Opioid dyspepsia, dry Monitor daily pattern of
receptors produce mouth, diarrhea. bowel activity, stool
their analgesic Rare: Malaise, consistency. Sips of water
effects in the vasodilation, may relieve dry mouth.
spinal cord by anorexia, Assess for clinical
coupling with G- flatulence, rash, improvement, record onset
proteins to both blurred vision, of relief of pain.
alter synaptic urinary retention/ PATIENT/FAMILY TEACHING
transmission at frequency, • May cause
pain pathways menopausal dependence.
and to decrease symptoms. • Avoid alcohol, OTC
neuronal medications (analgesics,
excitability via the Adverse Side sedatives).
inhibition of cyclic Effects: Seizures • May cause drowsiness,
adenosine reported in pts dizziness, blurred vision.
monophosphate receiving • Avoid tasks requiring
(cAMP). tramadol within alertness, motor skills until
recommended response to drug
dosage range. is established.
May have • Report severe
prolonged constipation, difficulty
duration of breathing, excessive
action, sedation, seizures, muscle
cumulative effect weakness, tremors, chest
in pts with pain, palpitations.
hepatic/renal
impairment,
serotonin
syndrome
(agitation,
hallucinations,
tachycardia,
hyperreflexia).
 MEDICATION INDICATION MECHANISM OF MECHANISM OF SIDE EFFECTS AND NURSING
ACTION ACTION IN ADVERSE EFFECTS RESPONSIBILITIES
RELATION TO THE
PATIENT’S CASE
CARVEDILOL Hypertension. HF Block’s stimulation Carvedilol promotes CNS: dizziness, •Monitor BP and
with digoxin, of beta 1 neurological fatigue, weakness, pulse frequently
Generic Name: diuretics, and ACE (myocardial) and function, reduces anxiety, depression, during dose
Carvedilol inhibitors. Left beta 2 (pulmonary, bone loss and drowsiness, adjustment period
Brand Name: ventricular vascular, and attenuates cell insomnia, memory and periodically
Coreg, Coreg CR dysfunction after MI. uterine)-adrenergic damage after loss, mental status during therapy.
receptor sites. Also acute spinal cord changes, •Assess for
has alpha 1 injury. nervousness, orthostatic
blocking activity, nightmares. EENT: hypotension when
which may result in blurred vision, dry assisting
orthostatic eyes, intraoperative patient up from
hypotension. floppy iris syndrome, supine position.
Therapeutic Effects: nasal stuffiness. •Monitor intake and
Decreased heart Resp: output ratios and
rate and BP. bronchospasm, daily weight.
Improved cardiac wheezing. CV: •Assess patient
output, slowing of BRADYCARDIA, HF, routinely for
the progression of PULMONARY evidence of fluid
HF and decreased EDEMA. GI: overload
risk of death. diarrhea, (peripheral edema,
constipation, dyspnea,
nausea. GU: rales/crackles,
erectile dysfunction, fatigue, weight
libido. gain, jugular venous
distention). Patients
may experience
worsening of
symptoms during
initiation of therapy
for HF.
 MEDICATION INDICATION MECHANISM OF MECHANISM OF SIDE EFFECTS AND NURSING
ACTION ACTION IN ADVERSE EFFECTS RESPONSIBILITIES
RELATION TO THE
PATIENT’S CASE
TAMSULOSIN Management of Decreases Tamsulosin is used CNS: dizziness, •Assess patient for
outflow obstruction contractions in in men to treat the headache. EENT: symptoms of
Generic Name: in male patients with smooth muscle of symptoms of an rhinitis. CV: orthostatic prostatic
Carvedilol prostatic the prostatic enlarged prostate hypotension. GU: hyperplasia (urinary
Brand Name: hyperplasia. capsule by (benign prostatic priapism, hesitancy, feeling
Flomax preferentially hyperplasia or BPH) retrograde/diminished of incomplete
binding to alpha1- which include ejaculation. bladder emptying,
adrenergic difficulty urinating. interruption of
receptors. urinary stream,
Therapeutic Effects: impairment of size
Decreased and force of urinary
symptoms of stream, terminal
prostatic urinary dribbling,
hyperplasia. straining to start
flow, dysuria,
urgency) before
and periodically
during therapy.
•Assess patient for
first-dose orthostatic
hypotension and
syncope. Incidence
may be dose
related. Observe
patient closely
during this period
and take
precautions to
prevent injury.
•Monitor intake
and output ratios
and daily weight,
and assess for
edema daily,
 especially at
beginning of
therapy. Report
weight gain or
edema.

MEDICATION INDICATION MECHANISM OF MECHANISM OF SIDE EFFECTS AND ADVERSE NURSING

ACTION ACTION IN EFFECTS RESPONSIBILITIES
RELATION TO THE
PATIENT’S CASE
PREGABALIN Neuropathic Binds to calcium Pregabalin is an CNS: SUICIDAL THOUGHTS, •Monitor closely
pain associated channels in CNS anticonvulsant dizziness, drowsiness, impaired for notable
Generic Name: with diabetic tissues which drug used to attention/concentration/thinking. changes in
Pregabalin peripheral regulate treat neuropathic CV: edema. EENT: blurred vision. behavior that
Brand Name: neuropathy. neurotransmitter pain conditions GI: dry mouth, abdominal pain, could indicate
Lyrica Postherpetic release. Does not and fibromyalgia constipation the emergence or
neuralgia. bind to opioid worsening of
Fibromyalgia. receptors. suicidal thoughts
Neuropathic Therapeutic or behavior or
pain associated Effects: depression.
with spinal cord Decreased •Seizures: Assess
injury. Adjunctive neuropathic or location,
therapy of post-herpetic duration, and
partial-onset pain. Decreased characteristics of
seizures in adults. partial-onset seizure activity.
seizures. •Caution patient
to avoid driving or
activities requiring
alertness until
response to
medication is
known.