DRUG STUDY

DATE: June 19, 2018

Drug Indications Actions Side Effects Contraindications

Adverse Effects

Prevention, treatment of Essential component in

iron de ciency anemia formation of Hgb, myoglobin,
NAME: due to inadequate diet, enzymes. Promotes ef- fective SIDE EFFECTS: Hemochromatosis, hemolytic
malab- sorption, erythropoiesis and transport, anemias. Cautions: Peptic ul-
Ferrous sulfate Mid nausea cer, regional enteritis,
pregnancy, blood loss. utili- zation of oxygen.
THERAPEUTIC Therapeutic Effect: Prevents Heartburn, anorexia, ulcerative colitis, pts receiving
CLASS: iron de ciency. constipation, diarrhea. frequent blood transfu- sions.

Iron preparationn

DOCTOR’S ADVERSE EFFECTS:

ORDER:
Large doses may aggravate
OD existing GI tract disease (peptic
ulcer, regional enteritis,
ulcerative colitis).

Nursing Responsibilities:

 Encourage patient to drink plenty of fluid

 Drug Indications Actions Side Effects Contraindications
Adverse Effects

This drug has no effect in Coenzyme for metabolic Nevertheless, vitamin

case of real vitamin functions (fat, carbohydrate supplementation helps to
NAME: deficiency. metabolism, protein syn- SIDE EFFECTS: prevent some deficiencies in
Multi-vitamin thesis). Therapeutic Effect: Diarrhea, pruritus. people at risk (e.g. pregnant
Necessary for cell growth and women).
THERAPEUTIC replication, hemato- poiesis, ADVERSE EFFECTS:
CLASS: myelin synthesis.
Impurities in preparation may
Vitamin cause rare allergic reaction.
supplementation Peripheral vascular thrombosis,
pulmonary edema, hypoka-
lemia, HF occur rarely.
DOCTOR’S
ORDER:

Vitamin b-complex
OD

Nursing Responsibilities:

 Do not give to children or teenagers who have or recently had viral infections
 Drug Indications Actions Side Effects Contraindications
Adverse Effects

Treatment of mild to Possesses nonselective beta- Bronchial asthma or related

severe HF, left ven- blocking and alpha-adrenergic bronchospastic conditions,
NAME: tricular dysfunction blocking activity. Causes SIDE EFFECTS: cardio- genic shock,
carvedilol following MI, hyper- vasodilation. Therapeutic Ef- Fatigue, dizziness. decompensated HF requiring
tension. OFF-LABEL: fect: Hypertension: Reduces intravenous inotropic therapy,
Treatment of angina cardiac output, exercise- Diarrhea, bradycardia, rhinitis, severe he- patic impairment,
pectoris, idiopathic induced tachycardia, re ex back pain. second- or third-degree V
THERAPEUTIC
cardiomyopathy. orthostatic tachycardia; reduces block, severe bradycardia, or
CLASS: Orthostatic hypotension,
peripheral vascular resistance. sick sinus syndrome (except in
drowsiness, UTI, viral infection.
Anti-hypertension HF: De- creases pulmonary pts with pacemaker)
capillary wedge pres- sure, ADVERSE EFFECTS:
heart rate, systemic vascular
resis- tance; increases stroke Overdose may produce profound
DOCTOR’S brady- cardia, hypotension,
volume index.
ORDER: bronchospasm, car- diac insuf
Carvedilol 6.25mg ciency, cardiogenic shock, car-
OD diac arrest. Abrupt withdrawal
may result in diaphoresis,
palpitations, headache, tremors.
May precipitate HF, MI in pts with
cardiac disease; thyroid storm in
pts with thyrotoxicosis; peripheral
ischemia in pts with existing
peripheral vascular disease.
 Hypoglycemia may occur in pts
with previ- ously controlled
diabetes.

Nursing Responsibilities:

 Assess B/P, apical pulse immediately before drug is administered (if pulse is 60 beats/min or less or systolic B/P is less than 90 mm Hg,
withhold medica- tion, contact physician).
 Assess pulse for quality, regularity, rate; monitor for bradycardia. Monitor EKG for cardiac arrhythmias.
 Assist with ambulation if dizziness occurs.
 Assess for evidence of HF: dyspnea (particularly on exertion or lying down), night cough, peripheral edema, distended neck veins.
 Monitor I&O (increase in weight, de- crease in urine output may indicate HF). Monitor renal/hepatic function tests.

Drug Indications Actions Side Effects Contraindications

Adverse Effects

NAME: Diabetes Mellitus Decreases hepatic production SIDE EFFECTS: Contraindicated in pts with
of glucose. Decreases intestinal serum creatinine greater than
Metformin absorption of glucose, improves GI disturbances (diarrhea, 1.5 mg/dL (males) or greater
insulin sensitivity. Therapeutic nausea, vomiting, abdominal than 1.4 mg/dL (females).
THERAPEUTIC bloating, flatulence, anorexia)
CLASS: Effect: Improves glycemic Clinically not recommended in
control, stabilizes/decreases that are transient and resolve
Anti-hyperglycemic spontaneously during therapy.
 body weight, improves lipid Unpleasant/metallic taste that pts with creatinine clearance
profile. resolves spontaneously during less than 60–70 ml/min.
DOCTOR’S therapy.
ORDER: Metformin
850mg HS ADVERSE EFFECTS:

Lactic acidosis occurs rarely

(0.03 cases/1,000 pts)

Nursing Responsibilities:

 Assess baseline glucose, Hgb A1c, CBC, renal function tests.

 Monitor fasting serum glucose, Hgb A1c, renal function, CBC.
 Monitor folic acid, renal function tests for evidence of early lactic acidosis

Drug Indications Actions Side Effects Contraindications

Adverse Effects

NAME: Severe Nausea/Vomiting Blocks dopamine SIDE EFFECTS: Comatose states, severe CNS
neurotransmission at depression, phenothiazine
Chlorpromazine Psychotic Disorders postsynaptic receptor sites. Drowsiness, blurred vision, hypersensitivity.
Possesses strong hypotension, color vision or night
anticholinergic, sedative, vision disturbances, dizziness,
antiemetic effects; moderate decreased diaphoresis,
extrapyramidal effects; slight
THERAPEUTIC antihistamine action. constipation, dry mouth, nasal
CLASS: Therapeutic Effect: Improves congestion.
psychotic conditions; relieves
Antipsychotic, nausea/vomiting; controls ADVERSE EFFECTS:
antiemetic, intractable hiccups, porphyria.
antianxiety, anti- Extrapyramidal symptoms
neuralgia adjunct. appear to be dose related
(particularly high dosage)
DOCTOR’S
ORDER:

Laractyl 100mg HS

Nursing Responsibilities:

 Avoid skin contact with solution (contact dermatitis).

 Assess behavior, appearance, emotional status, response to environment, speech pattern, thought content.
 Monitor B/P for hypotension.
 Do not abruptly withdraw from long-term drug therapy.

Drug Indications Actions Side Effects Contraindications

Adverse Effects

NAME: Diabetes Mellitus Promotes release of insulin from SIDE EFFECTS:

beta cells of pancreas,
Glimepiride decreases glucose output from
THERAPEUTIC liver, increases insulin Altered taste, dizziness, Diabetic complications
CLASS: sensitivity at peripheral sites. drowsiness, weight gain, (diabetic ketoacidosis),
Therapeutic Effect: Lowers constipation, diarrhea, heartburn, Sulfonamide allergy
Antidiabetic agent. serum glucose. nausea, vomiting, stomach
DOCTOR’S fullness, headache,
ORDER: photosensitivity, peeling of skin,
pruritus, rash
Glimpepiride 2mg
OD ADVERSE EFFECTS:

Overdose or insufficient food

intake may produce
hypoglycemia

Nursing Responsibilities:

 Monitor serum glucose level, food intake.

 Assess for hypoglycemia
 Avoid alcohol.
 Carry candy, sugar packets, other quick-acting sugar supplements for immediate response to hypoglycemia.

Drug Indications Actions Side Effects Contraindications

Adverse Effects

NAME:  Seizure Control Decreases sodium ion influx SIDE EFFECTS: Concomitant use or within 14
into neuronal membranes, days of use of MAOIs,
Carbamazepine  Trigeminal reducing post- tetanic Vertigo, somnolence, ataxia, myelosuppression.
Neuralgia, potentiation at synapses. fatigue, leucopenia, rash, Concomitant use of
Diabetic Therapeutic Effect: Produces urticaria, nausea, vomiting. delavirdine or other NNRT
THERAPEUTIC Neuropathy anticonvulsant effect. inhibitors, hypersensitivity to
Headache, diplopia, blurred
CLASS:  Bipolar Disorder tricyclic antidepressants.
vision, thrombocytopenia, dry
Anticonvulsant, mouth, edema, fluid retention,
antineuralgic, increased weight.
antimanic, ADVERSE EFFECTS:
antipsychotic.
Abrupt withdrawal may
precipitate status epilepticus
DOCTOR’S
ORDER:

Tegretol 200mg HS

Nursing Responsibilities:

 CBC, serum iron determination, urinalysis, BUN should be performed before therapy begins and periodically during therapy.
 Do not abruptly discontinue medication after long-term use (may precipitate seizures).
 Strict maintenance of therapy is essential for seizure control.
 Avoid tasks that require alertness, motor skills until response to drug is established.
 Report visual disturbances.