Drug Analysis

Drug Classification Indication Adverse Effect Pharmacokinetics Nursing intervention

Digoxin Antiarrhytmic, To treat HF, atrial -Confusion Absorption: 70-80% -Before giving each
Lanoxin cardiotonic flutter, atrial -Depression of an oral dose is dose, take patient’s
fibrillation, and -Drowsiness absorbed, mainly in the apical pulse and notify
paroxysmal atrial -Extreme weakness proximal part of small prescriber if its below
tachycardia with rapid -Headache intestine. 60bpm
digitalization -Syncope Elimination: renal -Monitor patient
-Arrhytmias excretion of digoxin, closely for signs of
-Heart block which is closely digitalis toxicity
-Blurred vision correlated with the -If patient has acute or
-Abdominal glomerular filtration unstable chronic atrial
discomfort/ pain rate. Nearly all of fibrillation, assess for
-Diarrhea digoxin in the urine is drug effectiveness.
-Nausea excreted unchanged -Frequently obtain
-Vomiting with a small part as ECG tracings as
-Electrolyte imbalances active metabolites. 25 ordered in elderly
to 28% of digoxin is patients because of
eliminated by nonrenal their smaller body mass
routes. Biliary and reduced renal
excretion may rise up clearance.
to 30% of a given dose.

Dosage Mechanism of Action Contraindication Drug Interaction

25 mg, 1tab M-W-F Increases the force and Hypersensitive carotid Adsorbent
velocity of myocardial sinus syndrome, antidiarrheals,
contraction, resulting in hyoersensitivity to colestipol, amiodarone,
positive inotropic digoxin, presence or hx propafenone, antacids,
effects. Digoxin of digitalis toxicity or antiarrhythmics,
produces idiosyncratic reaction to pancuronium,
antiarrhythmic effects digoxin, ventricular parenteral calcium
by decreasing the fibrilation, ventricular salts, rauwolfia
Drug Analysis

conduction rate and tachycardia unless HF alkaloids,

increasing the effective occurs unrelated to sympathomimetics,
refractory period of the digoxin. beta blockers,
AV node. carvedilol, diltiazem,
erythromycin,
neomycine,
tetracycline,
hypokalemia causing
drugs, potassium
wasting diuretics,
indomethacin,
magnesium sulfate,
spironolactone,
succinylcholine,
sucralfate

Drug Classification Indication Adverse Effect Pharmacokinetics Nursing intervention

Carvedilol Antihypertensive, heart -To control -Asthenia Onset: In 30m -Monitor patient’s
failure treatment hypertension -Depression Peak: 1.5- 7 hr blood glucose level, as
adjunct -As adjunct to treat -Dizziness Duration: Unknown ordered, during
mild to severe HF os -Fatigue carvedilol therapy
ischemic or -Fever because drug may alter
cardiomyopathic origin -Headache blood glucose level
-To reduce CV -Hypesthesia -If patient has HF,
mortality after acute -Hypotonia expect to also give
phase of MI in px with -Insomia digoxin, a diuretic, and
left ventricular ejection -Light headedness an ACE inihibitor
fraction of 40% or less -Malaise -Warn px that drug may
Dosage Mechanism of Action Contraindication -Paresthesia Drug Interaction cause orthosatic
-Somnloence hypotension
25mg, 1tab BID Readuces cardiac Asthma or related -Stroke Amiodarone,
Drug Analysis

output and tachycardia, bronchospastic -Syncope Betablockers- digoxin,

causes vasodilation, conditions, cardiogenic -Vertigo Calcium channel
and decreases shock, decompensated blockers- dilitiazem,
peripheral vascular heart failure that verapamil,
resistance, which requires I.V. inotropics, Catecholamine-
reduces BP and cardiac hx of serious depleting drugs-
workload. When given hypersensitivity reserpine,
for at least 4 weeks, reactions, such as cimetidine, clonidine,
carvedilol reduces anaphylaxis, rifampin
plasma renin activity angiodema, or Stevens-
Johnson syndrome,
hypersensitivity to
carvedilol, 2nd or 3rd
degree AV block,
severe bradycardia or
hepatic impairment,or
sick sinus syndrome
unless pacemaker is in
place.

Drug Classification Indication Adverse Effect Pharmacokinetics Nursing intervention

Drug Analysis

Atorvastatin Cardiovascular Agent Adjunct to diet for the -Constipation Absorption: Rapidly -Monitor for therapeutic
reduction of LDL -Diarrhea absorbed but undergoes effectiveness which is
cholesterol and extensive indicated by reduction
triglycerides in patients -Nausea gastrointestinal and in the level of LDL- C.
with primary -Fatigue hepatic metabolism -Assess for muscle pain,
hypercholesterolemia resulting in 14% tenderness, or
and mixed dyslipidemia -Gas bioavailability. weakness. If present,
-Heartburn Protein Binding: 98% monitor CPK level.
-Headache Metabolism and -Instruct patient to
-Mild muscle pain Excretion: Extensively notify health care
metabolized by the professional if
-Muscle wasting and
liver, most during first unexplained muscle
muscle breakdown
pass; excreted in bile pain, tenderness, or
-Confusion or memory and feces. 2% excreted weakness occurs,
problems unchanged by the especially if
-Fever kidneys. 2 metabolites accompanied by fever
have lipid-lowering or malaise.
-Dark urine activity. -Advise patient that this
-Increased thirst or Half-life: 14 hr medication should be
hunger used in conjuction with
Dosage Mechanism of Action Contraindication Drug Interaction
-Drowsiness diet restriction.
40 mg, 1 tab OD Hypersensitivity to Digoxin,
atorvastatin, myopathy, -Loss of appetite Norethindrone and -Emphasize the
active liver disease, Ethinyl, Estradiol, importance of follow-up
-Jaundice
unexplained persistent Erythromycin, exams to determine
transaminase elevation Cyclosporine, effectiveness and to
Delaviradine, monitor for side effects.
Gemfibrozil, Niacin,
Clofibrate and
Nelfinavir.
Drug Analysis

Drug Classification Indication Adverse Effect Pharmacokinetics Nursing intervention

Iberet folic Antianemics Treatment & prevention -Allergic reactions Absorption: Readily -Obtain a careful hx of
of Fe-deficiency & -GI effects absorbed from dietary intake and drug
concomitant folic acid -hyperbilirubinemia proximal small and alcohol usage prior
deficiency with -acneiform exanthema intestine. to start of therapy.
associated deficient eruption Peak: 30-60m PO -Keep physcician
intake or increased -bright yellow urine Distribution: informed of patient’s
need for vit B complex discoloration Distributed to all body response to therapy
in non pregnant adults. -flushing tissues -Monitor patients on
-diziness or faintness Metabolism: phenytoin for
-peripheral sensory Metabolized in liver to subtherapeutic plasma
neuropathies active metabolites levels
-stone formation Elimination: Small
-crystalluria & oxalosis amounts eliminated in
-black discoloration of urine in folate-deficient
stool patients
Dosage Mechanism of Action Contraindication Drug Interaction
1 tab OD Vit B complex essential Hypersensitivity. Mg trisilicate, antacids
for nucleoprotein Thalassemia, or cholestyramine,
synthesis and sideroblastic anemia, alcohol, tetracyclines,
maintenance of normal hemochromatosis & nicotine, levodopa,
erythropoeisis. Acts hemosiderosis anticoagulants,
against folic acid quinolones
deficiency that impairs
thymidylate synthesis
and results in
production of defective
DNA that leads to
megaloblast formation
and arrest of bone
Drug Analysis

marrow maturation
Drug Analysis

Drug Classification Indication Adverse Effect Pharmacokinetics Nursing

Fluimucil Acetylcystein- Mucolytics
Dosage Mechanism of Action
600mg, 1 tab OD Acetylcysteine acts by
disrupting disulfide linkages of Children <2 yr
mucoproteins in purulent and
non purulent secretions
intervention
Acute & chronic respiratory -Anaphylactic Onset: 1min after -During IV
tract infections with abundant shock inhalation or infusion, carefully
mucus secretions due to acute -Anaphylactoid instillation. monitor for fluid
bronchitis, chronic bronchitis reaction Peak 5- 10 min overload and signs
& its exacerbations, -Bronchospasm Metabolism: of hyponatremia
plumonary emphysema, -Angioedema Deacetylated in -Monitor for S&S
mucoviscidosis & -Rash & Pruritus liver to cysteine and
of aspiration of
bronchiectasis -Inhalant rhinitis subsequently excess secretions,
-Stomatitis metabolized and for
Contraindication Drug Interaction bronchospasm
-Have suction
Hypersensitivity. Antitussive drugs apparatus
Nitroglycerin immmediately
Carbamazepine available
Activated charcoal -Nausea and
vomiting may occur

Drug Classification Indication Adverse Effect Pharmacokinetics Nursing intervention

Omeprazole Antiulcer agent Duodenal and gastric Abdominal pain Absorption: Poorly -Assess patient
ulcer. Gastroesophageal absorbed from GI tract; routinely for epigastric
reflux disease including 30-40% reaches or abdominal pain and
severe erosive systemic circulation. frank or occult blood in
esophagitis Onset: 0.5- 3.5h the stool, emesis, or
Peak: Peak inhibition gastrioc aspirate.
of gastric acid -Monitor bowel
secretion: 5 days function, diarrhea,
Metabolism: abdominal cramping,
Drug Analysis

Metabolized in liver fever, and bloody stools

Elimination: should be reported to
Dosage Contraindication Drug Interaction health care professional
promptly as a sign of
40 mg, 1 tab BID Hypoersensitivity, Diazepam, phenytoin pseudomembranous
duodenal ulcers colitis.
-Advise patient to avoid
alcohol, products
containing aspirin or
NSAIDs, and foods that
may cause an increase
in GI irritation.
-Instruct patient to take
medication as directed
for the full course of
therapy, even if feeling
better.
-Instruct patient to
notify health care
professional of onset of
black tarry stools,
diarrhea, abdominal
pain, or persistent
headache.