INSTITUTE OF NURSING

DRUG STUDY
OMEPRAZOLE
GENERIC/BRAND CLASSIFICATION NAME DOSAGE MODE OF ACTION Gastric acidpump inhibitor: suppresses gastric acid secretion by specific inhibition of hydrogenpotassium ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid production. INDICATION CONTRAINDICATION DRUG INTERACTION SIDE/ADVERSE EFFECTS CNS: headache, dizziness, asthenia, vertigo Dermatologic: rash, inflammation, urticarial, pruritus, alopecia, dry skin Respiratory: URI symptoms, cough, epistaxis Others: cancer, back pain, fever NURSING CONSIDERATION Administer with meals. Caution the patient to swallow capsules whole and not crushed. Administer with antacid if needed. Have regular medical follow-up visits. Patient may experience dizziness (avoid driving or performing hazardous tasks), headache (request for medication), diarrhea (maintain proper nutrition), symptoms of URI, cough (do not self medicate, consult physician). Report severe headache, worsening symptoms, fever, chills, diarrhea

Omeprazole Prilosec

Antisecretory drug Proton pump inhibitor

70 mg TIV OD

Treatment of heartburn or symprom of GERD

Contraindicated with hypersensitivity to omeprazole or its components. Use cautiously with pregnancy and lactation

Drug-to-drug Increased serum levels and potential increase in toxicity of benzodiazipines , phenytoin, warfarin; if these combinations are used, monitor patient closely . Decreased absorption with sucralfate, give these drugs at least 30 minutes apart

INSTITUTE OF NURSING

DRUG STUDY
MANNITOL
GENERIC/BRAND CLASSIFICATION NAME DOSAGE MODE OF ACTION Elevates the osmolarity of the glomerular filtrate, thereby hindering the reabsorption of water and leading to a loss of water, sodium and chloride (use for diagnosis of GFR); creates an osmotic gradient in the eye between plasma and ocular fluids, thereby reducing IOP INDICATION CONTRAINDICATION DRUG INTERACTION SIDE/ADVERSE EFFECTS CNS: dizziness, headache, blurred vision, seizure CV: hypotension, hypertension, edema, HF, thrombophlebiti s, tachycardia Dermatologic: urticarial, skin necrosis with infiltration GI: nausea, anorexia, dry mouth, thirst GU: diuresis, urine retention Respiratory: pulmonary congestion, rhinitis NURSING CONSIDERATION Do not give electrolyte-free mannitol with blood. If blood must be given, add at least 20 mEq of sodium chloride to each liter of mannitol solution. Do not expose solution to low temperature, crystallization may occur. If crystals are seen, warm the bottle in a hot bath. For GI upset, eat frequent small meals; dry mouth, suck sugarless lozenges; blurred vision, use caution when moving. Report difficulty breathing, pain at the IV site, chest pain.

Mannitol Osmitrol

Diagnostic agent Osmotic diuretic Urinary irrigant

200 cc TIV

Promotion of urinary excretion for hypertensive clients

Contraindicated with anuria due to severe renal disease Use cautiously with pulmonary congestion, active intracranial bleeding (except craniotomy), dehydration, renal disease, heart failure, pregnancy and lactation.

No drug interaction, incompatible with blood products, dont add to blood products.

INSTITUTE OF NURSING

DRUG STUDY
METOCLOPRAMIDE
GENERIC/BRAND CLASSIFICATION NAME DOSAGE MODE OF ACTION Stimulates motility of upper GI tract without stimulating gastric, biliary, or pancreatic secretions, appears to sensitize tissue to action of acetylcholin e; relaxes pyloric sphincter, which when combined with effects on motility, accelerates gastric emptying and intestinal transit. INDICATION CONTRAINDICATION DRUG INTERACTION SIDE/ADVERSE EFFECTS CNS: restlessness, drowsiness, fatigue, lassitude, insomnia, extrapyramidal reactions, parkinsonismlike reactions, akathisia, dystonia, myoclonus, dizziness, anxiety CV: transient hypertension GI: nausea, diarrhea NURSING CONSIDERATION Monitor BP carefully during IV administration Keep diphenhydramine injection readyily available in case of EPS occur Have phentolamine readily available in case of hypertensive crisis Do not use alcohol, sleep remedies, or sedatives, serious sedation may occur Take this drug exactly as prescribed Report involuntary movement of the face, eyes or limbs, severe depression, severe diarrhea.

Metoclopramide Maxolon

Antiemetic Dopaminergic blocker GI stimulant

10 mg TIV Q8

Prevention of nausea and vomiting

Contraindicated with allergy to metoclopramide; GI hemorrhage, mechanical obstruction or perforation; pheochromocytoma, epilepsy Use cautiously with previously detected breast cancer; lactation, pregnancy, fluid overload; renal impairment

Drug-to-drug Decreased absorption of digoxin from the stomach Increased toxicit and immunosuppress ive effects of cyclosporine Increased neuromuscular blocking effects with succinylcholine

INSTITUTE OF NURSING

DRUG STUDY
LOSARTAN POTASSIUM
GENERIC/BRAND CLASSIFICATION NAME DOSAGE MODE OF ACTION Selectively blocks the binding of angiotensin II to specific tissue receptors found in the vascular smooth muscle and adrenal gland; this action blocks the vasoconstric tion effect of the reninangiotensin system as well as the release of aldosterone leading to decreased BP. INDICATION CONTRAINDICATION DRUG INTERACTION SIDE/ADVERSE EFFECTS CNS: headache, dizziness, syncope, insomnia CV: hypotension Dermatologic: rash, urticarial, pruritus, GI: nausea, diarrhea, abdominal pain, constipation, dry mouth Respiratory: URI symptoms, cough, sinus disorders Others: back pain, fever, gout muscle weakness NURSING CONSIDERATION Ensure that the patient is not pregnant before beginning therapy Monitor patient closely in any situation that may lead to decrease in BP Take drug without regard to meals. Do not stop taking this drug without consulting your health care provider For dizziness, avoid driving a car; for headache, request medication; for cough, do not self-medicate Report fever, chills, dizziness, and pregnancy

Losartan Potassium Cozaar

Antihypertensive ARB

50mg/tab 1 tab OD

Treatment of hypertension, alone or in combination with other antihypertensi ves.

Contraindicated with hypersensitivity to losartan, pregnancy (use during the second and third trimester can cause injury or even death to the fetus), lactation Use cautiously with hepatic or renal impairment, hypovolemia, history of angioedema

Drug-to-drug Decreased serum levels and effectiveness if taken concurrently with phenobarbital, indomethacin, and rifamycin. Losartan is covered to an active metabolite by CYP450 3A4 and 2C9 (flucanozole); drugs that inhibit 3A4 (ketoconazole, fluconazole) may increase antihypertensive effect of losartan.

INSTITUTE OF NURSING

DRUG STUDY
AMLODIPINE BESYLATE
GENERIC/BRAND CLASSIFICATION NAME DOSAGE MODE OF ACTION Inhibits the movement of calcium ions across the membranes of cardiac and arterial muscle cells; inhibits transmembrane calcium flow, which results in depression of impulse formation in specialized cardiac pacemaker cells, slowing the velocity of conduction of cardiac impulse, depression of myocardial contractility, and dilation of coronary arteries and arterioles. INDICATION CONTRAINDICATION DRUG INTERACTION SIDE/ADVERSE EFFECTS CNS: dizziness, lightheadedness, headache, asthenia, fatigue, lethargy CV: peripheral edema, arrhytmias Dermatologic: flushing, rush GI: nausea, abdominal discomfort NURSING CONSIDERATION Monitor cardiac rhythm regularly Take with meals if upset stomach occurs You may experience theses side effects: nausea, vomiting (eat small frequent meals), headache (adjust lighting, noise, and temperature; medication may be ordered) Report irregular heartbeat, shortness of breath, swelling of the hands or feet, pronounced dizziness, constipation.

Amlodipine Besylate Norvasc

Antihypertensive Antianginal Calcium channel blocker

5mg/tab 1 tab OD

Essential hypertensio n, alone or in combinatio n with other antihyperte nsives

Contraindicated with Drug-to-drug allergy to amlodipine, Decreased impaired hepatic or serum levels renal function, sick and sinus syndrome, heart effectiveness block, lactation if taken concurrently with Use cautiously with phenobarbital, heart failure and indomethacin, pregnancy and rifamycin.