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Drug Study

Name of the drug Captopril

Specific Action Antihypertensive ACE inhibitor

Mechanism of Action Thought to inhibit ACE, preventing conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. Reduced formation of angiotensin II decreases peripheral arterial resistance, decreasing aldosterone secretion, which reduces sodium and water retention and lowers BP

Indication Hypertension Heart failure Diabetic nephropathy Left ventricular dysfunction after MI

Adverse Effects/ Side Effects Tachycardia Gastric irritations Rash Pruritus ulcers Peptic ulcers Proteinuria Cough

Contraindications Hypersensitivity

Nursing Responsibilities

Monitor BP and RR frequently Assess for signs and symptoms of angioedema Take drug 1 hour before meals Inform to patient that lightheadedness is possible Report fever, skin rash, sore throat, mouth sores, fast/irregular heartbeat, chest pain, and cough. May develop dizziness, fainting, lightheadedness; usually disappear once body adjust. Avoid sudden changes is posture, activities/exercise in hot weather; prevent dizziness/fainting. Consume of plenty of fluids; prevent

dehydration. Avoid OTC agents without approval. Provide client with small frequent feedings if GI upset occurs Provide comfort measures and arrange for analgesics if headaches occurs May develop dizziness, lightheadedness; headache which usually disappear in a cool environment and rest; nausea which disappear with small frequent meals; gastric distress and prolonged bleeding Observe the 10 rights upon giving medication. Give with meals; arrange for small, frequent feedings if GI complications occur. Perform skin testing prior to drug administration.

Clopidogrel

Antiplatelet Adenosine diphosphate (ADP) inhibitor

Inhibits plateltes aggregation by blocking ADP receptors on platelets, preventing clumping of platelets

Ischemic events Acute coronary syndrome

Headache Dizziness Rash Pruritus Nausea GI distress

Allergy to clopidogrel, active pathological bleeding such as peptic ulcer or intracranial hemorrahge

Cefuroxime

Inhibits bacterial cell wall synthesis

Antibiotic; Cephalosporin (2nd generation)

Treatment of infection caused by susceptible organism in the lower resp. tract

Hypersensitivity to cephalosporin and penicillin

Stomach upset, diarrhea, anorexia nausea, headache, dizziness

Acalka (Potassium Citrate)

Antiurolithic

to restore the level of the urinary citrate and to increase the pH of urine to 6-7

Treatment of patients with renal lithiasis and hypocitraturia, chronic formers of calcium oxalate, phospate calculia.

Slight gastrointestinal disorders may appear which can be palliated by means of the joint administration of food.

Ketorolac

Nonsteroidal antiinflammatory agents, nonopioid

Inhibits prostaglandin synthesis, producing

Short term management of pain (not to

Hypersensitivity History of GI bleeding

Renal insufficiency Persistent alkaline urinary infections - Obstruction of the urinary tract - HyperpotassemiaAdrenal insufficiency - Respiratory or metabolic alkalosis - Active peptic ulcer - Intestinal obstruction - Patients submitted to anticholinergic therapy - Patients with slow gastric emptying CNS: drowsiness abnormal thinking

Take full course of therapy. Avoid foods, beverages or medicines that contain alcohol while taking this drug. Report severe diarrhea with blood, pus or mucus; rash, DOB, unusual tiredness, fatigue, unusual bleeding or bruising, unusual itching or irritation. The tablets must not be masticated or diluted It is recommended that the patients in treatment with Acalka follow a diet w/o salt and increase the intake of fluids. Must not be administered to patients receiving potassium-sparing diuretics (traimterene, spirolactone, or amyloride) Assess for hypersensitivity reactions

analagesics

peripherally exceed 5 days mediated analgesia total for all routes - Also has antipyretic combined) and antiinflammatory properties. - Therapeutic effect:Decreased pain

Renal impairment (dosage reduction may be required) Cardiovascular disease

dizziness euphoria headache- RESP: asthma dyspnea - CV: edema pallor vasodilation - GI: GI Bleeding abnormal taste diarrhea dry mouth dyspepsia

HNBB (Hyoscine-nbutylbromide)

Antispasmodic; Anticholinergic

Hyoscine-Nbutylbromide (HNBB) acts by interfering with the transmission of nerve impulses by acetylcholine in the parasympathetic nervous system. Buscopan exerts a spasmolytic action on the smooth muscle of the gastrointestinal,

Buscopan Tablets are indicated for the relief of spasm of the genito-urinary tract or gastrointestinal tract and for the symptomatic relief of Irritable Bowel Syndrome

CNS: dizziness, anaphylactic reactions, anaphylactic shock, increased ICP, disorientation, restlessness, irritability, dizziness, drowsiness, headache, confusion, hallucination, delirium, impaired memory CV: hypotension, tachycardia,

Buscopan Tablets should not be administered to patients with myasthenia gravis, megacolon and narrow angle glaucoma. In addition, they should not be given to patients with a known hypersensitivity to hyoscine-N-butylbromide or any other component of the product.

Assess pain (note type, location, and intensity) prior to and 1-2 hr following administration. Oral therapy should be used only as a continuation of parenteral therapy. Caution patient to avoid concurrent use of alcohol, aspirin, NSAIDs, acetaminophen, or other OTC medications without consulting health care professional.. Avoid driving & operating machinery after parenteral administration. Avoid strict heat Raise side rails as a precaution because some patients become temporarily excited or disoriented and some develop amnesia or become drowsy. Reorient patient, as needed, Tolerance may develop when therapy

biliary and urinary tracts.

palpitations, flushing GI: Dry mouth, constipation, nausea, epigastric distress DERM: flushing, dyshidrosis GU: Urinary retention, urinary hesitancy Resp: dyspnea, bronchial plugging, depressed respiration EENT: mydriasis, dilated pupils, blurred vision, photopobia, increased intraocular pressure, difficulty of swallowing.

is prolonged Atropinelike toxicity may cause dose related adverse reactions. Individual tolerance varies greatly Overdose may cause curare-like effects, such as respiratory paralysis. Keep emergency equipment available.