DRUG Nifedipine

MECHANISM OF DRUG Inhibits calcium ion influx across cell membrane during cardiac depolarization, produces relaxation of coronary vascular smooth muscle and peripheral vascular smooth muscle, dilates coronary vascular arteries, increases myocardial oxygen delivery in patients with vasospastic angina.

INDICATION Treatment of vasospastic (Printzmetals or variant) angina, chronic stable angina, hypertension(sustainedrelease tablets only.

CONTRINDICATION Hypersensitivity. Cardiovascular shock. Combination w/ rifampici. Immediate release nifedipine contraindicated in unstable angina and after recent MI, severe aortic stenosis pressure <90mmHg, decompensated heart failure. Pregnancy and lactation.

NURSING RESPONSIBILITIES -use caution in severe aortic stenosis or hepatic impairment -monitor blood pressure and pulse before therapy, during dose titration, and periodically during therapy. Monitor ECG periodically during prolonged therapy. -assess location, duration, intensity, and precipitating factors of patients angina pain. -assess the therapeutic effectiveness of the drug.

PO route Cardiovascular Drugs

DRUG Metropolol 50mg PO Cardiovascular Drugs Hypertensive drug

MECHANISM OF DRUG Evert mainly beta-1adrenergic blocking activity but also blocks beta-2 receptors at high doses. It reversibly and competitively combines with beta-1adrenergic receptors to block sympathetic nerve impulses, resulting to decreased myocardial contractility, heart rate, cardiac output and myocardial oxygen consumption. These effects lead to low blood pressure and prevent damage from the tissues of myocardial.

INDICATION Moderate to severe congestive heart failure(CHF); migraine prophylaxis and hyperthyroidism. Hypertension; angina pectoris; cardiac arrhythmias especially supraventricular tachycardia, reduction of ventricular rate in atrial fibrillation and ventricular extrasystoles; myocardial infarction(MI); heart disorders w/ palpitation; migraine.

CONTRINDICATION Atrioventicular (AV) blocks2 and 3; marked clinically relevant sinus bradycardia; sick sinus syndrome and cardiogenic shock. Digitalis refractory heart failure; severe kidney/liver failure; gout; pregnancy; lithium therapy, uncompensated cardiac failure; bronchospasm. Congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), patients w/ inadequate myocardial infarction (MI).metabolic acidosis. Pregnancy and lactation.

NURSING RESPONSIBILITIES -assess patients blood pressure history before therapy and regularly thereafter to monitor drug effectiveness. Monitor pulse and blood pressure regularly and monitor drug effectiveness. -obtain baseline kidney and liver function tests before beginning therapy and monitor periodically thereafter. -monitor urine output, IandO ratio and weight daily. Assess for congestive heart failure: edema of feet/legs, jugular vein distention, bilateral rales and dyspnea.

DRUG Mefenamic Acid 500mg oral

MECHANISM OF DRUG

INDICATION Relief of pain including muscular rheumatic, traumatic, dental, postoperative and postpartum pain, headache, migraine, fever and dysmenorrhea, painfrom rheumatoid arthritis(RA) including Stills disease, soft tissue injuries. Therapy should not exceed 7days.

CONTRINDICATION Pregnancy and lactation hypersensitivity. Active ulceration or chronic inflammation of either the upper or lower gastrointestinal tract(GIT). Ifdiarrhea or skin rush appears, the drug should be stopped at once. Blood disorders, poor platelet function. Kidney or liver impairment. Children less than 14 yrs.

NURSING RESPONSIBILITIES -assess patients pain before therapy: location, duration, precipitating and alleviating factors. -monitor for possible drug induced adverse reactions: gastrointestinal (GI) discomfort, diarrhea, constipation, gas pain, nausea, vomiting, peptic ulceration, dyspepsia, CNS: drowsiness, dizziness, nervousness, visual disturbances Skin: rash Respiratory: bronchoconstriction, asthma nay be precipitated Hematologic: autoimmune hemolytic anemia Signs of hemolytic anemia should bewatched in cases when the drug is taken for prolonged period of time. -assess patients knowledge about the drug therapy.

Aspirin-like drug that has analgesic,antipyretic and anti-inflammatory Analgesic,antipyretics, activities.these activities muscle relaxant and appears to be due tp its uricosurics ability to inhibit cyclooxygenase and also antagonize certain effects of prostaglandins.mefenamic acid displays central and peripheral activities.