Drug Study

Medication

DRUG DOSE CLASSIFICATION MECHANISM OF ACTION INDICATIONS CONTRAINDICATI ADVERSE EFFECTS NURSING
ONS RESPONSIBILITIES
FREQUENCY

Isordil 5 mg Antianginal Relaxes vascular smooth Dinitrate: treatment Contraindicated CNS: headache, Assessment:
(Isosorbide muscle with a resultant and prevention of with allergy to apprehension.
Dinitrate) Sublingual Nitrate decrease in venous return angina pectoris. nitrates, severe Restlessness, weakness, History: allergy to
PRN F chest and decrease in arterial BP, anemia, head vertigo, dizziness, nitrates, severe anemia
Vasodilator GI hypermobility, head
which reduces left trauma, cerebral faintness.
ventricular workload and hemorrhage, trauma, cerebral
Mononitrate: hemorrhage,
decreases myocardial hypertrophic
prevention of angina hypertrophic
oxygen consumption. cardiomyopathy,
ISMN pectoris. CV: tachycardia,
narrow-angle cardiomyopathy.
(Isosorbide 60 mg 1 tab
retrosternal discomfort,
OD glaucoma,
Mononitrate) palpitations, hypotension, Physical: skin color,
orthostatic
syncope, collapse, T,P,R,BP, lesions,
Unlabeled use hypotension.
orthostatic hypotension, orthostatic BP, reflexe
(dinitrate): used with
angina, rebound HPN, atrial normal output, CBC.
hydralazine in black
fibrillation.
patients with
Use cautiously
advanced failure,
with acute MI,
acute angle-closure Dermatologic: rash, Interventions:
heart failure.
glaucoma in exfoliative dermatitis,
emergent situations; Guve sublingual
cutaneous vasodilation
achalasia. preparations under the
with flushing.
tongue or in the bucca
pouch; discourage the
client from swallowing
Unlabeled use GI: nausea, vomiting,
(mononitrate): used incontinence of feces,
with nadolol to abdominal pain, diarrhea.
prevent recurrent Give oral preparations
variceal bleeding. an empty stomach, 1 ho
before or 2 hours after
GU: dysuria, impotence, meals.
urinary frequency.

FELICIANO, Berlyn R.
BSN113 l Group 51
 Teaching Points:

Other: muscle twitching, Place sublingual tablet

pallor, perspiration, cold under your tongue or i
sweat, arthralgia, your cheek; do not che
bronchitis, swallow or crush the
tnrombocytopenia. tablet.

May experience these

side effects: dizziness,
light-headedness (use
care to change position
slowly); headache (lie
down on a cool
environment, rest; OTC
preparations may not
help; take drugs with
meals); flushing of the
neck or face.

Report blurred vision,

persistent or severe
headache, rash, more
frequent or more seve
angina attacks, fainting

Atorvastatin 80g ½ tab OD Antihypelipidemic Inhibits HMG-CoA Adjunct to diet in Contraindicated CNS: headache, asthenia Assessment:
Ca. @ HS reductase, enzyme that treatment of elevated with allergy to
HMG-CoA reductase catalyzes the first step in cholesterol, serum atorvastatin, GI: Flatulence, abdominal History: Allergy
(Lipitor) inhibitor the cholesterol synthesis triglycerides, and LDL fungal pain, cramps, constipation, atorvastatin, fun
pathway, resulting in a cholesterol in byproducts, active nausea, dyspepsia, byproducts, ac
decrease in serum patients with primary hepatic disease or heartburn, liver failure hepatic disease, ac
cholesterol synthesis hypercholesterolemia unexplained an serious illness
Respiratory: Sinusitis,
pathway, resulting in a and mixed persistent
pharyngitis Physical: orientat
decrease serum dislipidemia, primary elevation of
affet, muscle stren
cholesterol, serum LDLs dysbetalipoproteine transaminase

FELICIANO, Berlyn R.
BSN113 l Group 51
and increase in serum mia, and homozygous levels. Other: Rhabdomyolysis liver evaluat
HDLs ; increases hepatic familial with acute renal failure, abdominal examinat
LDL recapture sites, hypercholesterolemia Use cautiously arthralgia, myalgia lipid studies, LFTs, re
enhances reuptake and whose response to with impaired function test.
catabolism of LDL; lowers dietay restriction of endocrine
triglyceride level, saturated fat and function. Interventions:
cholesteroland other
Obtain LFTs as a base
non-pharmacologic
an periodically du
measures has not
therapy; discontinue d
been adequate.
if AST or ALT le
Reduction of risk MI, increase to 3 times nor
fatal and nonfatal levels.
stroke,
*Withhold atorvastatin
revascularization
any acute, seri
procedures, heart
condition that m
failure and angina in
suggest myopathy
patients with CAD.
serve as risk factor
development of re
failure.

Ensure that patient

tried cholesterol lowe
diet regimen for 3-6
before beginning thera

Administer drug with

regard to food but sa
time each day.

Teaching Points:

Take the drug with f

or meals if GI up
occurs.once a day,
about the same time e
day, preferably in
evening, maybe ta
with food. Do not d

FELICIANO, Berlyn R.
BSN113 l Group 51
 grapefruit juice w
taking this drug.

Institute dietary chang

Arrange to have perio

blood tests while you
taking this drug.

May experience
effects: nau
headache, muscle
joint aches and pains

Report muscle p
weakness, changes
color of urine or st
swelling.

Clopidogrel 75 mg Adenosine Inhibits platelet Treatment of patients Contraindicated CNS: headache, dizziness, Assessment:
Bisulfate Diphosphate (ADP) aggregation by blocking at risk for ischemic with allergy to weakness, syncope,
1 tab OD receptor antagonist ADP receptors on platelets, events-recent MI, clopidogrel, active flushing. History: allergy to
preventing clamping of recent ischemic CVA, pathological clopidogrel, recent
Antiplatelet platelets. peripheral artery bleeding such as surgery, hepatic
disease. peptic ulcer or impairment, peptic ulc
CV: HPN, edema
intracranial
Physical: skin color, T, P
hemorrhage.
R, BP, lesions, orientat
Treatment of patients affect, orthostatic BP.
Dermatologic: rash,
with acute coronary
pruritus.
syndrome. Use cautiously
with bleeding
Interventions:
disorders, recent
surgery, hepatic GI: nausea, GI distress,
Unlabeled use: as Provide frequent small
impairment. constipation, diarrhea, GI
loading dose with meals if GI upset occur
bleed.
aspirin to prevent
Provide comfort
adverse cardiac
measures and arrange
events in coronary
analgesics if headache
stent implantation.

FELICIANO, Berlyn R.
BSN113 l Group 51
Other: increased bleeding occurs.
risk.

Teaching Points:

Take daily as prescribe

May be taken with mea

May experience these

side effects: dizziness,
light-headedness (this
may pass as you adjust
the drug); headache (li
down in a cool
environment and rest;
OTC preparations may
help); nausea, gastric
distress (eat frequent a
small meals).

Report skin rash, chest

pain, fainting, sever
headache, abnormal
bleeding.

FELICIANO, Berlyn R.
BSN113 l Group 51