DRUG STUDY

Name of Drugs

Generic Name:
Mannitol

Brand Name:
Osmitrol

Classification
and
Mechanism of Action
Classification:
Osmotic Diuretic
Mechanism of Action:
Increases osmotic
pressure
of
glomerular
filtrate,
thus inhibiting tubular
reabsorption of water
and electrolytes. Drug
elevates
plasma
osmolality
and
increases water flow
into extracellular fluid

Indication

Side Effects

Test
dose for marked
oliguria
or
suspected
inadequate
renal function

Oligur
ia

To
prevent oliguria
or acute renal
failure

To
reduce
intraocular
intracranial
pressure

or
or

Contraindications

patie
nts
hypersensitive to
drug

patie
nts with anuria;
severe
pulmonary
congestion;
frank pulmonary
edema;
active
intracranial
bleeding; severe
dehydration;
metabolic
edema; previous
progressive
renal
disease
after
starting
drug; or previous
progressive
heart failure or
pulmonary
congestion after

Nursing Responsibilities Monitoring

Parameters

Monitor
vital signs, including
central
venous
pressure and fluid
intake and output
hourly.
Report
increasing
oliguria.
Check weight, renal
function, fluid balance,
and serum and urine
sodium and potassium
levels daily.

If
patient
has urinary catheter,
use
an
hourly
urometer
collection
bag to evaluate output
accurately and easily.

thirst,

To relieve
give frequent

cerebral edema

drug.

mouth care or fluids

Diure
sis
in
drug
intoxication

Irrigati
solution

ng
during
transurethral
surgical
procedures

Name of Drugs

Generic Name:
Omeprarazole

Classification
and
Mechanism of Action
Classification:
Proton pump inhibitor

Indication

o Symptomatic
gastroesophageal
reflux
(GERD)

Side Effects

Contraindications

Nursing
Responsibilities

Monitoring
Parameters

o Monitor patients for o Monitor

o patients
signs and symptoms
hypersensitive
magnesium
of low magnesium
to drug or its
levels
before

Mechanism of Action:
Brand Names:
Inhibits proton pump
activity by binding to
hydrogen-potassium
adenosine
triphosphatase,
located at secretory
surface of gastric
parietal
cells.
to
suppress gastric acid
secretion.

o
o

o
o

Name of Drugs

Generic Name:
Phenytoin

Classification
and
Mechanism of Action
Classification:
Anticonvulsant

without
esopahageal
lesions
Erosive
esophagitis
Pathologic
hypersecretory
conditions
Duodenal
ulcer
(short-term
treatment)
H. Pylori infection
and
duodenal
ulcer disease, to
eradicate H. pylori
with clarithromycin
Short-term
of
active
benign
gastric ulcer
Frequent
heartburn (2 or
more days a week)
Laryngitis

Indication

o To control tonicclonic
(grand

Side Effects

components
o Use
cautiously in
patients with
Barter
syndrome,
hypokalemia,
and
respiratory
alkalosis and
in patients on
a low-sodium
diet.

level,
such
as
abnormal heart rate
or
rhythm,
palpitations, muscle
spasms, tremors, or
seizures

starting
treatment and
periodically
thereafter.

Contraindications

Nursing Responsibilities Monitoring

Parameters

o Patients

hypersensitive

to

Maintain
precautions,

seizure
as

Monitor drug level.

Therapeutic
level

(diphenylhydantoin)
Brand Name:
Dilantin

Name of Drugs

mal
and
Mechanism of Action:
complex partial
May stabilize
(temporal lobe)
neuronal membranes
seizures
patient
and
limit
seizure o For
requiring
a
activity
either
by
loading dose
increasing efflux or
o
To prevent and
decreasing influx of
treat
seizures
sodium ions across
occurring during
cell membranes in the
neurosurgery
motor cortex during
o
Status
generation of nerve
epilepticus
impulses.
o

Classification

Indication

Side Effects

hydantoin and in
those with sinus
bradycardia,
SA
block, second-or
third-degree
AV
block, or AdamsStrokes syndrome
Use cautiously in
patients
with
hepatic
dysfunction,
hypotension,
myocardial
insufficiency,
diabete,
or
respiratory
depression;
in
elderly
or
debilitated
patients; and in
those
receiving
other
hydantoin
.derivatives.

Contraindications

needed.

Nursing

is 10 to 20 mcg/ml/

Monitoring

Generic Name:
Digoxin

Brand Name:
Lanoxin

and
Mechanism of Action
Classification:
Cardiac glycoside

o Heart
failure,
paroxysmal
supraventricular
tachycardia,
Mechanism of Action:
atrial fibrillation
Inhibits sodiumand flutter
potassium-activated
adenosine triphosphatase,
promoting movement of
calcium from extracellular
to intracellular cytoplasm
and
strengthening
myocardial
contraction.
Also acts on CNS to
enhance
vagal
tone,
slowing
conduction
through the SA and AV
nodes.

Responsibilities

Parameters

o Before
giving o Monitor digoxin
o Patients
loading dose( obtain
hypersensitive
level.
baseline
date
to drug and in
Therapeutic
(cardiac
rate
and
those
with
level
ranges
rhythm,
blood
digitalis-induced
from 0.8 to 2
pressure,
and
toxicity,
nanograms/ml.
electrolytes) and ask
ventricular
patient about use of
fibrillation,
or
cardiac glycosides o Monitor
ventricular
potassium level
within the previous 2
tachycardia
carefully.
to 3 weeks.
o
Before
giving
drug,
unless caused
take
apical-radial
by heart failure.
pulse for 1 minute.
o Use
with
extreme caution
un
elderly
patients adnd in
those with acute
MI, incomplete
AV block, sinus
bradycardia,
PVCs, chronic
constrictive
pericarditis,
hypertropic
cardiomyopathy
,
renal
insufficiency,sev
ere pulmonary
or
hypothyroidism

Name of Drugs

Generic Name:
Furosimide

Brand Name:
Lasix

Classification
and
Mechanism of Action
Classification:
Loop Diuretic

Mechanism of Action:
Inhibits
sodium
and
chloride reabsorption at
the proximal and distal
tubules and the ascending
loop of Henle.

Indication

o Acute pulmonary
edema
o Edema
o Hypertension

Side Effects

Contraindications

Nursing
Responsibilities

Monitoring
Parameters

(IV) If discolored o Monitor

o Contraindicated o
fluid
yellow, dont use.
in
patients
intake
and
o Watch for of signs of
hypertensive to
output
and
hypokalemia such
drug and in
electrolyte,
as
muscle
those
with
BUN
and
weakness
and
anuria.
carbon dioxide
cramps/
o Use cautiously
levels
in patients with
frequently.
hepatic cirrhosis
and in those
allergic
to
sulfonamides.

Name of Drugs

Generic Name:
Atorvastatin Calcuim

Classification
and
Mechanism of Action
Classification:
Antilipemic

Indication

Brand Name:
Lipitor
Mechanism of Action:
Inhibits HMG-CoA
reductase, an early
(and rate-limiting) step o
in
cholesterol
biosynthesis.

In
patients
with
clinically
evident
coronary
artery
disease, to reduce
the risk of nonfatal
MI, fatal and nonfatal
strokes, angina, heart
failure,
and
revascularization
procedures
To reduce the risk of
MI, stroke, angina, or
revascularization
procedures
in
patients with multiple
risk factors for CAD
but who dont yet
have the disease.
To reduce the risk of
MI or stroke in
patients with type 2
diabetes and multiple
risk factors for CAD
but who dont yet
have the disease.
Adjunct to diet to
reduce LDL, total
cholesterol,
apolipoprotein B, and
triglyceride level and

Side Effects

Contraindications

Nursing
Responsibilities

Watch for
o Patients
myositis
hypersensitive
to drug and in
those
with
active
liver
disease
or
unexplained
persistent
elevations
of
transaminase
levels.
o Pregnant
and
breastfeeding
women and in
women
of
childbearing
age

signs

Monitoring
Parameters
of

to
increase
HDL
levels in patients with
primary
hypercholesterolemia
and
mixed
dyslipidemia.

Name of Drugs

Generic Name:
Verapamil Hydrochloride

Brand Name:
Isoptin

Classification
Indication
Side Effects
and
Mechanism
of
Action
Classification:
o Vasopastic
Calcium Channel
angina;unstable
Blocker
angina;
classic
chronic,
stable
angina
Mechanism
of
pectoris;chronic
Action:
atrial fibrillation
prevent
Not
clearly o To
defined. A calcium
paroxysmal
channel
blocker
supraventricular
that inhibits calcium
tachycardia
o
Supraventricular
blocker that inhibits
Arrhythmias
calcium ion influx
o
Digitalized
across cardiac and
patients
with
smooth-muscle
chronic
atrial
cells,
thus
fibrillation
or
decreasing
flutter
myocardial
contractility
and o Hypertension
prevent
oxygen demand; it o To

Contraindications

Nursing
Responsibilities

o In
patients Monitor blood pressure.
hypersensitive
to derug and in
those
with
severe
left
ventricular
dysfunction,
cardiogenic
shock, secondor third-degree
AV block or sicl
sinus syndrome
except
in
presence
of
functioning
pacemaker,
atrial flutter or
fibrillation and
accessory
bypass
tract

Monitoring
Parameters

Monitor
liver
and
kidney
function
test
results during
prolonged
treatment.

also
dilates
coronary
arteries
and arterioles.

migraine

syndrome,
severe
heart
failure
and
severe
hypotension/

OPD MEDS
Name of Drugs

Generic Name:
Losartan

Brand Name:
Cozaar

Classification
Indication
and
Mechanism
of
Action
Classification:
o Hypertension
o Nephropathy
Antihypertensive
o Stroke prevention
o Hepatic
impairment
Mechanism
of
Action:
Potent vasodilator.
Blocks
vasoconstriction,
aldosteronesecreting effects of
angiotensin
II,
inhibiting binding of

Side Effects

Contraindications

o Upper
o In
patients
respiratory
hypertensive to
infection
drug.
o Dizziness,
o Use cautiously
diarrhea,
in patients with
cough,
impaired renal
o Insomia,
or
hepatic
dyspepsia,
function.
heartburn,
back legpain,
muscle
crmaps,
myalgia,
depression

Nursing
Responsibilities

Monitoring
Parameters

Obtain blood pressure,

immediately
before
each dose, in addition to
regular monitoring.

o
o

Monitor
blood
pressure.
Monitor
creatinine
and
BUN levels

angiotensin II to AT1
receptors.

Name of Drugs

Generic Name:
Carvedilol
Brand Name:
Coreg

Classification
Indication
Side Effects
and
Mechanism
of
Action
Classification:
o Hypertension
o Left
ventricular
Antihypertensive
dysfunction after
MI
o Mild to severe
heart failure
Mechanism
of
o
Chronic,
stable
Action:
angina

Contraindications

o In
patients
hypertensive to
drug.
o In those with
bronchial
asthma
or
related

Nursing
Responsibilities

Monitoring
Parameters

o
o

Monitor
blood
pressure.

Nonselective beta o Idiopathic

blocker with alphacardiomyopathy
blocking activity

Name of Drugs

Generic Name:
Spironolactone

Classification
Indication
Side Effects
and
Mechanism
of
Action
Classification:
o Edema due to heart
Potassium-sparing
failure,
hepatic
diuretic
cirrhosis,
or

bronchospastic
conditions,
second-or thirddegree AV block
, sick sinus
syndrome
(unless
a
permanent
pacemaker is in
place),
cardiogenic
shock, severe
bradycardia, or
symptomatic
hepatic
impairment

Contraindications

Nursing
Responsibilities

Monitoring
Parameters

o In
patients o Instruct the patient o Monitor
to take drug in
electrolyte
hypertensive to
morning
to
prevent
levels,
drug and in
need to urinate at

intake

fluid
and

Brand Name:
Aldactone
Mechanism
of
Action:
Antagonizes
aldosterone in the
distal
tubules,
increasing sodium
and
water
excretion.

o
o
o
o
o

nephrotic
syndrome.
Hypertension
Diuretic-induced
hypokalemia
To detect primary
hyperaldosteronism
To manage primary
hyperaldosteronism
Severe heart failure
(class III or IV), as
adjunct to ACE
inhibitor or loop
diuretic with or
without
cardiac
glycoside
Hirsutism

night.
those
with
o
To prevent serious
anuria, acute or
hyperkalemia, warn
progressive
patient to avoid
renal
excessive ingestion
insufficiency, or
of potassium-rich
hyperkalemia
foods, salt
o Use cautiously
substitutes
in patients with
containing
fluid
or
potassium, and
electrolyte
potassium
imbalances,
supplements
impaired renal
or
hepatic
function, or in
pregnant
women.

output,
weight
and
blood
pressure.
o