Drug Name Generic Name: Metoprolol Brand Name: lopressor Class: Antihypertensi ve Beta1selective adrenergic blocker

Mechanism of Action Competitively blocks betaadrenergic receptors in the heart and juxtaglomerular apparatus, decreasing the sympathetic nervous system on these tissues and the excitability of the heart, Decreasing cardiac output and the release of rennin, and lowering BP; acts on the CNS to reduce sympathetic outflow and vasoconstrictor tone

Dosage Adults: HPN: initially, 100 mg/day PO in single or divided doses, gradually inc. doses at weekly intervals. ER tablets HPN: 25-100 mg/day PO as one dose, may inc. at weekly intervals to a max. of 400mg/day.

Indication HPN, alone or with other drugs especially diuretics

Contraindication Contraindicated with Sinus Bradycardia ( HR less than 45 beats/min). Second or third degree heart block, cardiogenic shock, HF, second and third trimester of pregnancy. Use cautiously with Diabetes or thyrotoxicosis: asthma or COPD;pregnancy

Side effect/ Adverse Reactions Allergy: Pharyngitis, erythematous rash, fever, sore throat, laryngospasm.

Nursing Resposibilities

Drug Name Generic Name: ciprofloxacin Brand Name: Ciloxan Class: Antibacterial Flouroquinolone Pregnancy Category: C

Mechanism of Action Bactericidal; Interferes with DNA replication in susceptible bacteria preventing cell reproduction.

Dosage Adults: Uncomplicated UTIs: 250 mg PO q12 for 3 days or 500 mg PO daily(ER Tablets) Mild to Moderate UTIs: 250 mg q12 PO for 7 Days nor 200 mg IV q12 for 7-14 days. Complicated UTIs: 500 mg q12 PO for 7-14 days or 400 mg IV q12 or 1000mg (ER Tablets) PO daily every 7-14 days.

Indication Treatment of uncomplicated UTIs Caused by E.coli, K. pneumonia as a one-time dose in patients at low risk of nausea, diarrhea.

Contraindication Contraindicated to person with allergy to ciprofloxacin, norfloxacin or other flouroquinolones, Pregnancy, lactation. Use cautiously with renal impairments, seizures, tendinitis or tendon rupture associated with flouroquinolones use.

Side effect/ Adverse Reactions CNS: Headache, dizziness, insomnia, fatigue,somnolence, depression, blurred vision, hallucination, ataxia, nightmares. CV: Arrythmias, Hypotension, angina EENT: Dry eyes, eye pain, keratopathy GI: Nausea, vomiting, dry mouth, diarrhea, abdominal pain. GU: Renal failure

Nursing Resposibilities
Assess for the hx of allergy to ciprofloxacin, norfloxacin and other quinolones, renal impairments, seizures; lactation Assess for skin color lesions, orientation, reflexes, affect, mucous membranes, bowel sound, renal function test Ensure that patient swallow ER tablets whole: do not cut or crush Give antacids at least 2 hrs after dosing Encourage px to complete full course of theraphy Take proquin XR with the main meal of the day Drink plenty of fluids while taking this drug

You may experience these side effects: nausea, vomiting, abdominal pain, diarrhea or constipation, drowsiness, blurring of vision, dizziness.

Drug Name Generic Name: Aspirin Brand Name: Aspergum Class: Analgesic Anti inflammatory

Mechanism of Action Analgesic effects are attributed to aspirins ability to inhibit synthesis of prostaglandins, important mediators of inflammation

Dosage Adults: SR forms: 1300 mg, then 6501300 mg q8, max 3900mg/day Arthritis nd rheumatic conditions: 3g/day in divided doses.

Indication Mild to moderate pain Fever Inflammatory conditions

Contraindication Contraindicated with allergy to salycilates or NSAIDS; hemophilia, bleeding ulcers, blood coagulation defects, hypothrombonem ia, Vitamin K deficiency. Usecautiously with impaired renal function, influenza, surgery scheduled within 1 week; pregnancy

Side effect/ Adverse Reactions

Acute aspirin toxicity:respi. Alkalosis, hyperpnea, tachypnea, hemorrhage, excitement, confusion, asterexis, and metabolic acidosis. Aspirin intolerance: Exacerbation of bronchospasm, rhinitis GI: Nausea, dyspepsia, heartburn, epigastric discomfort, anorexia, and hepatotoxicicty. Hamtologic: anaphulactic shock Salicylism: dizziness, tinnitus, difficulty bearing, nausea, vomiting, diarrhea, mental confusion.

Nursing Resposibilities Assess for the hx of allergy to salicylates or NSAIDS: allergy to tatrazine; hemophilia, bleeding ulcers, hemmorhagic states blood coagulationdefects, impaired hepatic function, impaired renal function. Assess for skin color, eigth cranial nerve function, orientation, reflexes, affect, CBC, renal function test. Do not use to children and teen agers to treat chickenpox Do not crush Report ringing of the ears, dizziness and confusion

Drug Name Generic Name: Clopidrogel Brand Name: Plavix Class: ADP receptor antagonist Pregnancy Category: B

Mechanism of Action Inhibits platelet aggregation by blocking ADP receptors on platelets, preventing clumping of platelets.

Dosage Adults: Recent MI, CVA or established peripheral arterial disease: 75 mg PO daily.

Indication Unlabeled use: AS loading dose with aspirin to prevent adverse cardiac events in coronary stent implantation. Treatment of Px at risk for ischemic events recent MI, recent ischemic CVA, peripheral artery disease.

Contraindication Contraindicated to person with allergy to clopidrogel, active pathological bleeding such as peptic ulcer or intracranial hemorrhage, lactation. Use cautiously with bleeding disorders, recent surgery, hepatic impairment, pregnancy.

Side effect/ Adverse Reactions CNS: Headache,dizziness, weakness,syncope, flushing CV: HPN, Edema Deramtologic: rash, pruritus GI: Nausea, Gi distress, constipation, diarrhea, GI bleed

Nursing Resposibilities Taper dose gradually after long term therapy, especially in epileptics. Do not stop taking drug without consulting you physician Avoid pregnancy while taking this drug Avoid alcohol, sleepinducing or over the counter drugs. Report severe dizziness, weakness, drowsiness that persists, rash or skin lesions, difficulty voiding, palpitations, swelling in the extremeties.

Incomplete voiding Urine stasis

Sexual intercourse Promote migration of pathogen in the urinary meatus

Female Short urethra

Good environment for pathogen proliferation

Invasion of pathogens in urinary tract S/sx: Back pain Burning sensation while urinating Passing frequent, small amounts of urine Cloudy urine Nausea and vomiting

Urinary Tract Infection

Pathogen entered the blood stream Pathogens produced toxins in the blood

Tissue damage Low BP Tachycardia Chills Inc. RR Very low/high temperature

Inflammatory response

Possible organ damage