DRUG NAME MECHANISM OF INDICATION / ADVERSE EFFECT NURSING RESPONSIBILITIES

ACTION CONTRAINDICATION

GENERIC: Metoprolol is a INDICATION: CNS: BEFORE:

Metropolol cardioselective Lopressor ampules are indicated Tiredness and dizziness, Dx:
BRAND: competitive beta-1 in the treatment of confusion and short-term memory a. Check for drug allergies.
Lopressor adrenergic receptor hemodynamically stable patients loss, headache, nightmares, and b. Check vital signs
CLASS: antagonist with with definite or suspected acute insomnia have also been reported. Tx:
Beta blockers/ antihypertensive properties myocardial infarction to reduce CVS: a. Ensure that patient swallows the ER
Anti-hypertensive and devoid of intrinsic cardiovascular mortality when Shortness of breath, bradycardia, tablets whole; do not cut, crush, or chew.
sympathomimetic activity. used in conjunction with oral arterial insufficiency, palpitations;
PATIENT’S Metoprolol antagonizes Lopressor maintenance therapy. congestive heart failure, b. Thorough physical assessment to
DOSE: beta 1-adrenergic receptors Treatment with intravenous peripheral edema, hypertension, establish baseline data before drug
50 mg daily in the myocardium, Lopressor can be initiated as soon angina therapy begins, to determine the
thereby reducing the rate as the patient's clinical condition RES: effectiveness of therapy, and to evaluate
ROUTE: and force of myocardial allows Wheezing, bronchospasm and for the occurrence of any adverse effects
ORAL contraction leading to a CONTRAINDICATION: dyspnea, rhinitis. associated with drug therapy.
INTRAVENOUS reduction in cardiac Hypersensitivity to Lopressor and GIT: EDx:
output. This agent may related derivatives, or to any of Diarrhea, nausea and vomiting, a. Instruct patient to verbalize feelings and
also reduce the secretion the excipients; hypersensitivity to dry mouth, gastric pain, concerns about the medication
of renin with a subsequent other beta blockers (cross constipation, flatulence, and
reduction in levels sensitivity between beta blockers heartburn. b. Instruct the patient about the side effect of
of angiotensin II thereby can occur). the drugs.
preventing DRUG TO DRUG Hypersensitivity:
vasoconstriction INTERACTION: Pruritus or rash and DURING:
and aldosterone secretion. There is a moderate drug photosensitivity Dx:
interaction between Benadryl a. Monitor patient carefully during the first
Source: (diphenhydramine) and 30 min after initiation of IV therapy for
Heart Disease: Causes of a metoprolol succinate (Toprol XL). signs of hypersensitivity and
Heart Attack. (2019, Benadryl can inhibit the enzyme anaphylactoid reaction.
September 18).Retrieved (CYP2D6) that breaks down
October 26, 2020, From metoprolol. This can cause an b. Asses the patient for changes in level of
https://www.rxlist.com/hea increase in exposure to metoprolol consciousness and headache
rt_disease_slideshow_pict which could lead to increased
ures_a_visual_guide/articl risk of bradycardia (low heart
e.htm rate) and hypotension (low Tx:
blood pressure). a. Explain purpose of medication to patient
and family.
b. Assist the patient in taking the
medication.
EDx:
a. Instruct the patient about the side effect of
the drugs.

b. Instruct patient to verbalize feelings and

concerns.

AFTER:
Dx:
a. Assess the knowledge of the patient and
teach them the appropriate use, and the
effect of the drug and also the
interventions to reduce side effects, of the
drug.
b. Monitor the effectiveness of the drug or
medication as exhibited by the decrease of
the symptoms.
Tx:
a. Provide safety measures (e.g. adequate
lighting, raised side rails, etc.) to prevent
injuries.
b. Provide comfort measures (e.g. voiding
before dosing, taking food with drug, etc.)
to help patient tolerate drug effects.
 EDx:
a. Instruct the patient to Report to physician
immediately.

b. Instruct the patient to Increase fluid intake

c. Instruct patient to verbalize feelings and

concerns about the medication

DRUG NAME MECHANISM OF ACTION INDICATION / ADVERSE EFFECT NURSING RESPONSIBILITIES

CONTRAINDICATION

GENERIC: Prednisone is biologically inert INDICATION: Cardiovascular System BEFORE:

Prednisone and converted to the Prednisone is used as Bradycardia, cardiac arrest, Dx:
BRAND: predominantly prednisolone in an anti-inflammatory or an cardiac arrhythmias, cardiac  Monitor for neuroleptic malignant
Deltasone the liver. It decreases immunosuppressant enlargement, circulatory collapse, syndrome, confusion, sedation.
CLASS: inflammation by suppression of medication. Prednisone congestive heart failure, edema,  Assess sedation level and anticholinergic
Corticosteroid, migration of polymorphonuclear treats many different fat embolism, hypertension or effects
Glucocorticoid, leukocytes and reversal of conditions such as allergic aggravation of hypertension,
Hormone increased capillary permeability; disorders, skin conditions, myocardial rupture following Tx:
PATIENT’S suppresses the immune system ulcerative colitis, arthritis, recent myocardial infarction,  Ensure that patient swallows the ER
DOSE: by reducing activity and vol of lupus, psoriasis, or necrotizing angiitis, pulmonary tablets whole; do not cut, crush, or chew.
20 mg daily the lymphatic system; breathing disorders edema, syncope, tachycardia,
suppresses adrenal function at CONTRAINDICATION: thromboembolism (blood clot  Thorough physical assessment to establish
ROUTE: high doses. Indications and Prednisone Tablets are commonly in legs), baseline data before drug therapy begins,
Oral dosage are the same as those for contraindicated in systemic thrombophlebitis, vasculitis. to determine the effectiveness of therapy,
prednisolone. fungal infections and Dermatologic and to evaluate for the occurrence of any
known hypersensitivity to Acne, acneiform eruptions, adverse effects associated with drug
Source: components. Rare instances allergic dermatitis, alopecia, therapy.
Drug Genius, Genius, W., of anaphylactoid reactions angioedema (swelling of
Bossung, M., Bossung, P., have occurred in patients face/surrounding areas, even in
Delgado, A., Ferrara, D., & receiving corticosteroid arms or tongue), angioneurotic EDx:
Hetzler, L. (2020, August 10). therapy. edema, atrophy and thinning of  Instruct patient to verbalize feelings and
Prednisone Interactions with DRUG TO DRUG skin, dry scaly skin, ecchymoses concerns about the medication
Drugs, Food & Conditions - INTERACTION: and petechiae (bruising),
Drug, Food & Alcohol. These medications may erythema, facial edema, hirsutism,  Instruct the patient about the side effect of
Retrieved October 26, 2020, interact and cause very impaired wound healing, the drugs.
from harmful effects. increased sweating, Karposi’s
https://druggenius.com/interactio sarcoma, lupus erythematosus-like DURING:
ns/prednisone/ Amphotericin B lesions, Dx:
InjectionThere have been Endocrine  Administer once-a-day doses before 9
cases reported in which Adrenal insufficiency-greatest AM to mimic normal peak corticosteroid
concomitant use of potential caused by high potency blood levels.
Amphotericin B and glucocorticoids with long duration
hydrocortisone was followed of action (associated symptoms  Monitor the patient carefully during the
by cardiac enlargement and include: arthralgias, buffalo hump, first 30 min after drinking the drug for
congestive heart failure. dizziness, life-threatening signs of hypersensitivity and
hypotension, nausea, severe anaphylactoid reaction.
Anticholinesterase Agents tiredness or weakness),
Concomitant use of amenorrhea, postmenopausal
anticholinesterase agents and bleeding or other menstrual  Assess the patient for changes in the level
corticosteroids may produce irregularities, decreased of consciousness and headache
severe weakness in patients carbohydrate and glucose
with myasthenia gravis. tolerance, development of Tx:
cushingoid state, diabetes mellitus  Explain the purpose of medication to
Anticoagulant Agents– (new onset or manifestations of patient and family.
administration of latent), glycosuria, hyperglycemia
corticosteroids and warfarin  Assist the patient in taking the
usually results in inhibition of Fluid and Electrolyte medication.
response to warfarin, Disturbances
although there have been congestive heart failure in
 susceptible patients, fluid  Do not give live virus vaccines with
some conflicting reports. retention, hypokalemia (low immunosuppressive doses of
Therefore, coagulation potassium), hypokalemic corticosteroids.
indices should be monitored alkalosis, metabolic alkalosis,
frequently to maintain the hypotension or shock-like EDx:
desired anticoagulant effect. reaction, potassium loss, sodium  Instruct the patient about the side effect of
retention with resulting edema the drugs.
Toxoids and Live or (swelling commonly in the legs or
Attenuated Vaccines feet).  Instruct patient to verbalize feelings and
Gastrointestinal concerns.
Patients on corticosteroid abdominal distention abdominal
therapy may exhibit a pain, anorexia which may result in AFTER:
diminished response to weight loss, constipation, Dx:
toxoids and live or diarrhea, elevation in serum liver  Assess the knowledge of the patient and
inactivated vaccines due to enzyme levels (usually reversible teach them the appropriate use, and the
inhibition of antibody upon discontinuation), gastric effect of the drug and also the
response. Corticosteroids irritation, hepatomegaly interventions to reduce side effects, of the
may also potentiate the (abnormal increase in liver size), drug.
replication of some increased appetite and weight
organisms contained in live gain, nausea.  Monitor the effectiveness of the drug or
attenuated vaccines. Routine medication as exhibited by the decrease of
administration of vaccines or Hematologic the symptoms.
toxoids should be deferred anemia, neutropenia (including
until corticosteroid therapy is febrile neutropenia). Tx:
discontinued if possible. Metabolic  Provide safety measures (e.g. adequate
negative nitrogen balance due to lighting, raised side rails, etc.) to prevent
FOOD TO DRUG protein catabolism. injuries.
INTERACTION: Musculoskeletal
arthralgias (joint pain), aseptic  Provide comfort measures (e.g. voiding
necrosis of femoral and humeral before dosing, taking food with drug, etc.)
heads, increase risk of fracture, to help patient tolerate drug effects.
loss of muscle mass, muscle
weakness.  Increase dosage when patient is subject to
stress.

EDx:
 Instruct the patient to Report to physician
immediately.
 Advise the patient to avoid exposure to
infections.
 Encourage client to report unusual weight
gain, swelling of the extremities, muscle
weakness, black or tarry stools, fever,
prolonged sore throat, colds or other
infections, worsening of the disorder for
which the drug is being taken.

 Instruct patient to verbalize feelings and

concerns about the medication