Name of Drug Indication Contraindication Mechanism of Action Side Effects Nursing

Responsibilities
Generic name: ● Treatment of ● Contraindicated Pharmacodynamic - Dizziness Interventions
hyperthyroidism with allergy to
methimazole Inhibits the synthesis - weakness · Instruct patient to
antithyroid products,
of thyroid hormones take medication as
Brand name: pregnancy, lactation. - vertigo
directed, around the
● Palliation of certain Pharmacokinetics
Tapdin ● Use cautiously with - drowsiness clock. Take missed
thyroid cancers
bone marrow Route: Oral doses as soon as
Classification: depression. - nausea remembered; take
Onset: 30–40 min both doses together if
Antithyroid drug - vomiting
Duration: 2–4 hr almost time for next
Dosage: - loss of appetite dose; check with
Absorption: Rapidly health care
Adults: Initial dose, - Rash
absorbed in GI tract; professional if more
15–60 mg/day PO in
Peak: 60 min - itching than 1 dose is missed.
three equal doses
every 8 hr. Metabolism: Hepatic; Consult health care
Maintenance dose, 5– T1/2: 6–13 hr professional prior to
15 mg/ day PO. discontinuing
Distribution: Crosses medication.
Route: placenta; enters breast
milk · Instruct patient to
Oral monitor weight 2–3
Excretion: times weekly. Notify
Pregnancy
Unchanged by health care
Classification:
kidneys; Urine professional of
Pregnancy Category significant changes.
D
· May cause
drowsiness. Caution
patient to avoid
driving or other
activities requiring
alertness until
response to
medication is known.
· Advise patient to
consult health care
professional regarding
dietary sources of
iodine (iodized salt,
shellfish).
· Advise patient to
report sore throat,
fever, chills,
headache, malaise,
weakness, yellowing
of eyes or skin,
unusual bleeding or
bruising, rash, or
symptoms of
hyperthyroidism or
hypothyroidism
promptly.
· Instruct patient to
notify health care
professional of all Rx
or OTC medications,
vitamins, or herbal
products being taken
and to consult with
health care
professional before
taking other
medications.
· Advise patient to
carry identification
describing medication
regimen at all times.
· Advise patient to
notify health care
professional of
medication regimen
prior to treatment or
surgery.
· Emphasize the
importance of routine
exams to monitor
progress and to check
for side effects
Name of Drug Indication Contraindication Mechanism of Action Side Effects Nursing
Responsibilities
Generic name: - Propranolol is used - History of bronchial Pharmacodynamic - Dizziness Interventions
to treat tremors, asthma, bronchospasm
propanolol A nonselective - nausea, ● Instruct patient to
angina (chest pain), chronic obstructive
ß-adrenergic blocker take medication as
Brand name: hypertension (high airways disease, - vomiting,
that competitively directed, at the same
blood pressure), heart bradycardia,
Inderal, Indirin blocks ß1 and - diarrhea, time each day, even if
rhythm disorders, and cardiogenic shock,
ß2-receptors
Classification: other heart or hypotension, - constipation, feeling well; do not
resulting in
circulatory conditions. metabolic acidosis, skip or double up on
Beta-blocker decreased heart rate, - stomach cramps;
It is also used to treat severe peripheral missed doses. Take
myocardial
Antimigraine or prevent heart attack, arterial circulatory - decreased sex drive, missed doses as soon
contractility, BP and
preparations and to reduce the disturbances, 2nd or impotence, or
myocardial oxygen as possible up to 4 hr
severity and frequency 3rd degree heart block, difficulty having an
Dosage: demand. before next dose (8 hr
of migraine sick sinus syndrome, orgasm;
headaches. untreated with extended-release
Hyperthyroidism Pharmacokinetics
pheochromocytoma, - sleep problems propranolol).
Adult: As Onset: 1-2 hours (insomnia); or
uncontrolled heart ● Inform patient that
conventional tab or failure, Prinzmetal’s (oral)..
- tired feeling. abrupt withdrawal
oral solution: 10-40 angina. Duration: Approx
can cause
mg 3-4 times daily. As 6-12 hours
Special precautions: - life-threatening ar
extended release cap: (immediate-release);
80 mg once daily, may Patient with approx. 24-27 hours rhythmias,
be increased to 160 Raynaud’s disease or (extended-release). hypertension, or
mg daily. Max: 240 intermittent myocardial ischemia.
claudication, 1st Absorption: Well
mg/day.
degree heart block, absorbed but ● Advise patient to
Route: Oral diabetes mellitus, undergoes extensive make sure enough
myasthenia gravis, first-pass hepatic medication is available
Pregnancy for weekends,
psoriasis, thyroid
Classification: disease. Avoid abrupt. metabolism. holidays, and
Hepatic and renal vacations. A written
Pregnancy Category C Distribution:Moderat
impairment. Elderly. prescription may be
e CNS penetration.
Pregnancy and kept in wallet in case
Crosses the placenta;
lactation. of emergency.
enters breast milk.
● Teach patient and
Metabolism and
family how to check
Excretion: Almost
pulse daily and BP
completely
biweekly. Advise
metabolized by the
patient to hold dose
liver (primarily for
and contact health care
CYP2D6 isoenzyme)
professional if pulse is
Half-life: 3.4– 6 hr. 50 bpm or BP
Changes significantly.
● May cause
drowsiness or
dizziness. Caution
patients to avoid
driving or other ac
tivities that require
alertness until
response to the drug is
known.
● Advise patients to
change positions
slowly to minimize
orthostatic
hypotension, es
pecially during
initiation of therapy or
when dose is
increased.
● Caution patient that
this medication may
increase sensitivity to
cold.
● Instruct patient to
ask a health care
professional before
taking any OTC
medications or herbal
products, especially
cold preparations,
when taking this
medication.
Hypertension:
Reinforce the need to
continue additional
therapies for
hypertension (weight
loss, sodium
restriction, stress
reduction, regular
exercise, moderation
of alcohol
consumption, and
smoking cessation).
Medication controls
but does not cure
hypertension.
References:

Karch, A. (2012) Lippincott’s Nursing Drug Guide. NY: Wolters Kluwer

MIMS (n.d.) Propanolol. Retrieved from https://www.mims.com/philippines/drug/info/propranolol/?type=brief&mtype=generic#Indications

Davis’s Drug Guide (n.d.) methimazole. Retrieved from

https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Drug-Guide/51486/all/methimazole

Davis Company (2015) propanolol.