DRUG STUDY

STUDENT NAME: Angenica Poleene O. De Leon

FINAL DIAGNOSIS: DMII, CVA, Diabetic Nephropathy, Chronic Kidney Disease stage 5, Anemia 2’

DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING

ACTION INTERVENTIONS

Generic Name: Inhibit phosphodiesterase, an Prevention of exercise-  Contraindicated in  CNS: insomnia, Patient monitoring-Monitor
enzyme that degrades cyclic induced bronchospasm, hypersensitivity to drug, headache, hyperactivity, vital signs, ECG, and fluid
Combivent adenosine mono- phosphate prevention and treatment of angina, arrhythmias asthenia, malaise, intake and output.
(cAMP) by stimulating bronchospasm in reversible dizziness, apprehension,
(albuterol sulfate, ipratropium associated with
cAMP release and inhibiting obstructive airway disease anxiety, restlessness,
bromide) release of slow-reacting tachycardia, ventricular CNS stimulation,
substance of anaphylaxis and arrhythmias that warrant nervousness,
histamine. These actions inotropic therapy, cardiac hyperkinesia, vertigo,
cause bronchodilation, dilatation or drowsiness, tremor
Drug Classification: produce CNS and cardiac insufficiency, cerebral
stimulation, promote diuresis, arteriosclerosis, organic  CV: hypertension,
Bronchodilator and increase gastric acid hypotension, tachy-
brain damage, angle-
secretion. cardia, angina, chest pain,
closure glaucoma, local
palpitations,
anesthesia of certain areas arrhythmias
Available Dosage: (such as toes or fingers),
and labor  EENT: nasal congestion,
Aerosol metered-dose inhaler
 Use cautiously in heart nasal dryness and
(Combivent Respimat)
failure or other cardiac or irritation, epistaxis, sore
 (100mcg/20mcg)/act circulatory impairment, throat (with inhaled
hypertension, chronic drug), hoarseness
uation
obstructive pulmonary
Nebulizer solution (generic)  GI: nausea, vomiting,
disease, renal or hepatic
heartburn, anorexia
disease, hyperthyroidism,
 (2.5mg/0.5mg)/3mL
pep- tic ulcer, severe  Metabolic: hypokalemia,
hypoxemia, diabetes hypoglycemia
mellitus, seizure
disorders, glaucoma,  Musculoskeletal: muscle
elderly patients, pregnant cramps
or breast- feeding
patients, young children,  Respiratory: cough,
wheezing, dyspnea,
and infants.
bronchitis, paradoxical
airway resistance (with
repeated, excessive use of
inhaled drug), increased
sputum, bronchospasm,
pulmonary edema

 Skin: pallor, flushing,

diaphoresis

 Other: unusual or bad

taste, increased appetite,
hypersensitivity reaction
 DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING
ACTION INTERVENTIONS

Generic Name: Allows the intake of essential Prevention & therapy of  Allergy and  Hypercalcemia  Evaluate for any
amino acids while damages due to hypersensitivity to any contraindications
Essential amino acids minimizing the amino- faulty/deficient protein content of this drug.  Take drug as prescribed
nitrogen intake. Following metabolism in chronic renal  Hypercalcemia  Warn the patient about
ingestion the keto-analogues insufficiency.  Disturbed amino acid possible side effects and
Brand name: are transaminated by taking metabolism how to recognize them
nitrogen from nonessential  Caution for patients with  Give with food if GI
Ketosteril amino acids, thereby phenylketonuria upset occurs frequently
decreasing the formation of  Assess for hypercalcemia
urea by reusing the amino
Drug Classification: group. The levels of
accumulating uremic toxins
Ketoanalogs; essential amino are decreased. Keto- and/or
acids hydroxy-acids do not elicit
hyperfiltration of residual
nephrons.
Available Dosage:

Tablet:

 600 mg
 DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING
ACTION INTERVENTIONS

Inhibits HMG-CoA  Adjunct to diet for  Hypersensitivity to drug  CNS: amnesia, abnormal  Monitor patient for signs
reductase, which catalyzes controlling LDL, total or its components dreams, emotional and symptoms of allergic
first step in cholesterol cholesterol, apo-  Active hepatic disease or lability, headache, response.
synthesis; this action reduces hyperactivity, poor
Generic Name: lipoprotein B, and unexplained, persistent
coordination, malaise,  Evaluate for muscle
concentrations of serum triglyceride levels and to serum transaminase paresthesia, peripheral weakness (a symptom of
atorvastatin calcium cholesterol and low-density increase HDL levels in elevations neuropathy, drowsiness, myositis and possibly
lipoproteins (LDLs), linked to patients with primary  Pregnancy or syncope, weakness rhabdomyolysis).
increased risk of coronary hypercholesterolemia and breastfeeding
artery disease (CAD). Also mixed dyslipidemia;  CV: orthostatic  Be aware that reduction
Drug Classification:
moderately increases primary hypotension, palpitations, in dosage and periodic
Lipid-lowering agent concentration of high-density dysbetalipoproteinemia in phlebitis, vasodilation, monitoring of creatine
lipoproteins (HDLs), arrhythmias kinase level may be
patients unresponsive to
associated with decreased diet alone; adjunct to diet considered for patients
 EENT: amblyopia, taking drugs that may
risk of CAD. to reduce elevated
altered refraction, increase atorvastatin
triglyceride levels glaucoma, eye level.
 Adjunct to other lipid- hemorrhage, dry eyes,
lowering treatments in hearing loss, tinnitus,  Monitor liver function
patients with epistaxis, sinusitis, test results and blood
homozygous familial pharyngitis lipid levels.
hypercholesterolemia
 GI: nausea, vomiting,
 Adjunct to diet to
diarrhea, constipation,
decrease total cholesterol, abdominal cramps,
Available Dosage: LDL, and apo-lipoprotein abdominal or biliary pain,
B levels in boys and colitis, indigestion,
Tablets:
postmenarchal girls ages dyspepsia, flatulence,
10 to 17 with familial and stomach ulcers,
 10 mg
nonfamilial heterozygous gastroenteritis, melena,
 20 mg tenesmus, glossitis,
 40 mg hypercholesterolemia mouth sores, dry mouth,
 80 mg  Prevention of dysphagia, esophagitis,
cardiovascular dis- ease pancreatitis, rectal
in patients without hemorrhage
clinically evident
coronary heart disease  GU: hematuria, nocturia,
(CHD) but with multiple dysuria, urinary
 CHD risk factors
 Prevention of stroke and frequency or urgency,
myocardial infarction in urinary retention, cystitis,
patients with type 2 nephritis, renal calculi,
abnormal ejaculation,
diabetes who have
decreased libido, erectile
multiple risk fac- tors for dysfunction, epididymitis
CHD but without
clinically evident CHD  Hematologic: anemia,
thrombocytopenia

 Hepatic: jaundice,
hepatic failure, hepatitis

 Metabolic:
hyperglycemia,
hypoglycemia

 Musculoskeletal:
bursitis, joint pain, back
pain, leg cramps, gout,
muscle pain or aches,
myositis, myasthenia
gravis, neck rigidity,
torticollis,
rhabdomyolysis

 Respiratory: dyspnea,
pneumonia, bronchitis

 Skin: alopecia, acne,

contact dermatitis,
eczema, dry skin,
pruritus, rash, urticaria,
skin ulcers, seborrhea,
photo- sensitivity,
diaphoresis, toxic
epidermal necrolysis

 Other: taste loss,

gingival bleeding, fever,
facial paralysis, facial or
generalized edema,
flulike symptoms,
infection, appetite
changes, weight gain,
allergic reaction,
Stevens-Johnson
syndrome
 DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING
ACTION INTERVENTIONS

Generic Name: Suppresses inflammatory and  Replacement therapy in  hypertension,  CNS: headache,  In high-dose therapy
immune responses, mainly by adrenocortical osteoporosis, glaucoma, nervousness, depression, (which should not exceed
Hydrocortisone inhibiting migration of insufficiency; renal or GI disease, euphoria, personality 48 hours), watch closely
leukocytes and phagocytes hypothyroidism, cirrhosis, changes, psychoses,
hypercalcemia due to for signs and symptoms
thromboembolic vertigo, paresthesia,
and decreasing inflammatory cancer; arthritis; collagen of depression or
disorders, myasthenia insomnia, restlessness,
Drug Classification: mediators diseases; dermatologic gravis, heart failure conus medullaris psychotic episodes.
diseases; autoimmune syndrome, meningitis,  Monitor blood pressure,
Anti-inflammatory (steroidal) and hematologic increased intracranial
 pregnant or breastfeeding weight, and electrolyte
disorders; trichinosis; patients pressure, seizures levels regularly.
ulcerative colitis;  Assess blood glucose
Available Dosage: multiple sclerosis;  children ages 6 and  CV: hypotension, levels in diabetic patients.
younger (safety not hypertension,
proctitis; nephrotic Expect to increase insulin
Cream, gel, lotion, ointment, established). thrombophlebitis, heart
syndrome; aspiration failure, shock, fat or oral hypoglycemic
solution: pneumonia dosage.
embolism,
hydrocortisone, thromboembolism,  Monitor patient’s
 various strengths
hydrocortisone cypionate arrhythmias response during weaning
Injection:  Itching and inflammation from drug. Watch for
caused by skin conditions  EENT: cataracts, adrenal crisis, which may
 25 mg/ml glaucoma, increased
occur if drug is dis-
intraocular pressure,
 50 mg/ml continued too quickly.
epistaxis, nasal
 100 mg/ vial congestion, perforated
 250 mg/vial nasal septum, dysphonia,
 500 mg/vial hoarseness,
 1,000 mg/vial nasopharyngeal or
oropharyngeal fungal
Intrarectal aerosol foam: infections

 90 mg  GI: nausea, vomiting,

esophageal candidiasis or
Oral suspension: ulcer, abdominal
distention, dry mouth,
 10 mg/5 ml rectal bleeding, peptic
ulceration, pancreatitis
Retention enema:
 Hematologic: purpura
 100 mg/60 ml
 Metabolic: sodium and
Spray (topical): fluid retention,
hypokalemia,
 1% hypocalcemia,
hyperglycemia,
Tablets:
hypercholesterolemia,
amenorrhea, growth
 5 mg
retardation, diabetes
 10 mg mellitus, cushingoid
 20 mg appearance,
hypothalamic-pituitary-
adrenal suppression
with secondary adrenal
insufficiency (with
abrupt withdrawal or
high-dose, prolonged
use)

 Musculoskeletal:
osteoporosis, aseptic joint
necrosis, muscle pain or
weakness, steroid
myopathy, loss of muscle
mass, tendon rupture,
spontaneous fractures

 Respiratory: cough,
wheezing, rebound
congestion,
bronchospasm

 Skin: rash, pruritus,

urticaria, contact
dermatitis, acne, bruising,
hirsutism, petechiae,
striae, acneiform lesions,
skin fragility and
thinness, angioedema
 Other: altered taste;
anosmia; appetite
changes; weight gain;
facial edema; increased
susceptibility to
infection; masking or
aggravation of infection;
adhesive arachnoiditis;
injection site pain,
burning, or atrophy;
immuno- suppression;
hypersensitivity reactions
including anaphylaxis
 DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING
ACTION INTERVENTIONS

Generic Name: Inhibits calcium transport  Chronic stable angina,  Hypersensitivity to drug  CNS: dizziness,  Assess vital signs and
into myocardial and vascular given alone or with beta-  Advanced aortic stenosis headache, asthenia, cardiovascular status.
Nicardipine hydrochloride smooth muscle cells, causing drowsiness, paresthesia
adrenergic blockers  Monitor fluid intake and
cardiac output and
myocardial contractions to  Hypertension, given output. Assess for signs
 CV: hypotension,
decrease alone or with other and symptoms of heart
peripheral edema, chest
Drug Classification: antihypertensives failure.
pain, increased angina,
 Short-term treatment of palpitations, tachycardia
Antianginal, antihypertensive
hypertension when oral
therapy isn’t feasible or  GI: nausea, dyspepsia,
desirable dry mouth
Available Dosage:
 Musculoskeletal:
Capsules: myalgia

 20 mg  Skin: flushing
 30 mg

Capsules (sustained-release):

 30 mg
 45mg
 60mg

Injection:

 2.5 mg/ml in 10-ml

ampules
 DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING
ACTION INTERVENTIONS

Generic Name: Inhibits bacterial DNA  Acute sinusitis  Hypersensitivity to drug  CNS: agitation,  In patients with renal
synthesis by inhibiting DNA  Prostatitis or other fluoroquinolones headache, restlessness, insufficiency, assess
ciprofloxacin hydrochloride gyrase in susceptible gram- confusion, delirium,
 Intra-abdominal  Concomitant creatinine level before
negative and gram-positive peripheral neuropathy,
infections administration of giving first dose and at
toxic psychosis
organisms  Febrile neutropenic tizanidine least once a week during
Drug Classification: patients prolonged therapy.
 CV: orthostatic
 Gonorrhea hypotension, vasculitis Monitor drug blood level
Anti-infective closely.
 Infectious diarrhea
 Inhalation anthrax  EENT: nystagmus; with  Watch for signs and
(postexposure) ophthalmic use—blurred symptoms of serious
Available Dosage: vision; burning, stinging, adverse reactions,
 Infections of lower irritation, itching, tearing, including GI problems,
Injection: respiratory tract, skin and and redness of eyes;
jaundice, tendon
skin structures, bones, eyelid itching, swelling,
or crusting; sensitivity to problems, and
 200 mg/20 ml and joints
light hypersensitivity reactions.
 400 mg/40 ml  Nosocomial pneumonia
 200 mg/100 ml  Typhoid fever
 GI: nausea, vomiting,
premixed in dextrose  Urinary tract infections
diarrhea, con- stipation,
5% in water (D5W),  Complicated urinary tract abdominal pain or
400 mg/200 ml infections or discom- fort, dyspepsia,
premixed in D5W, pyelonephritis dysphagia, flatulence,
1,200 mg/120-ml  Acute otitis externa pancreatitis,
bulk package pseudomembranous
 Bacterial conjunctivitis
colitis
caused by susceptible
Ophthalmic ointment:
organisms  GU: albuminuria,
3.5-g tube  Corneal ulcers caused by candiduria, renal calculi
susceptible organisms Hematologic:
Ophthalmic solution: methemoglobinemia,
agranulocytosis,
 2.5 ml hemolytic anemia
 5 ml plastic Hepatic: jaundice,
dispensers hepatic necrosis
Metabolic:
Otic solution: hyperglycemia, hyper-
kalemia
  0.2% (0.5 mg in 0.25
ml) in single-use  Musculoskeletal:
container myalgia, myoclonus,
tendinitis, tendon rupture
Tablets: Skin: rash, exfoliative
dermatitis, toxic
 250 mg epidermal necrolysis,
 500 mg erythema multiforme
photosensitivity
 750 mg
 Other: injection-site
reaction, altered taste,
anosmia, exacerbation of
myas- thenia gravis,
overgrowth of nonsus-
ceptible organisms,
hypersensitivity reactions
including anaphylaxis
and Stevens-Johnson
syndrome
 DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING
ACTION INTERVENTIONS

Generic Name: Promotes glucose transport,  Type 1 (insulin-  Hypersensitivity to drug  Metabolic: hypokalemia,  Monitor glucose level
which stimulates dependent) diabetes or its components sodium retention, frequently to assess drug
Rapid Acting Insulin carbohydrate metabolism in mellitus; type 2 (non- hypoglycemia, rebound efficacy and
skeletal and cardiac muscle Hypoglycemia hyperglycemia
insulin dependent) appropriateness of
(Somogyi effect)
and adipose tissue. Also diabetes mellitus dosage.
Brand name: promotes phosphorylation of unresponsive to diet and  Watch blood glucose
 Skin: urticaria, rash,
glucose in liver, where it is oral hypoglycemics pruritus level closely if patient is
Humalog converted to glycogen. converting from one
Directly affects fat and Diabetic ketoacidosis insulin type to another or
 Other: edema;
protein metabolism, lipodystrophy; is under unusual stress (as
Drug Classification: stimulates protein synthesis, lipohypertrophy; from surgery or trauma).
inhibits release of free fatty erythema, stinging, or  Monitor for signs and
Hypoglycemic acids, and indirectly warmth at injection site;
symptoms of
allergic reactions
decreases phosphate and hypoglycemia. Keep
including anaphylaxis
potassium. glucose source at hand in
Available Dosage: case hypoglycemia
occurs.
Glulisine, recombinant:  Assess for signs and
symptoms of
 100 units/ml in 10-ml
hyperglycemia, such as
vials
polydipsia, polyphagia,
 100 units/ml in 3-ml
polyuria, and diabetic
cartridge system
ketoacidosis (as shown by
 100 units/ml in 3-ml
blood and urinary
prefilled pen
ketones, metabolic
Isophane suspension, acidosis, extremely
injection (regular): elevated blood glucose
level).
 70 units NPH and 30  Monitor for glycosuria.
units regular  Closely evaluate kidney
insulin/ml (100 and liver function test
units/ml total) results in patients with
 50 units NPH and 50 renal or hepatic
units regular
 insulin/ml (100 impairment.
units/ml total)
Isophane suspension
(NPH insulin): 100
units/ml

Lispro:

 100 units/ml in 10-ml

vials and 1.5-ml
cartridges

Regular insulin injection:

 100 units/ml

Regular U-500
(concentrated), insulin
human injection:

 500 units/ml

Zinc suspension, extended

(ultralente):

 100 units/ml

Zinc suspension (lente

insulin):

 100 units/ml