Name: Mrs.

Mulan
Name
Generic

Diagnosis: CVD cerebral infarction Left hemiparesis

Classification

Therapeutic:

Brand

Indication

Contraindication

Adverse Effect

Nursing Consideration

Inhibits

To manage

Acute heart failure;

CNS: Anxiety,

Use cautiously in

stimulation of

hypertension,

pulse less than 45

confusion,

patients with

Antihypertensive beta1-receptor

alone or with

beats/minute;

depression,

hypertension

Antiangina

sites,

cardiogenic shock;

CV: Angina,

or angina who have

pectoris

located mainly

other
antihypertensiv
es

hypersensitivity to

arrhythmias,

congestive heart

Name:
Metoprolol

Mechanism of
Action

Name:

in the heart,

metoprolol, its

heart failure,

failure

Cadiosel

resulting in

components, or

EENT: Nasal

heart failure.

decreased

other beta

congestion,

Instruct patient to

cardiac

blockers;

rhinitis

take metoprolol with

excitability,

pheochromocytom

GI:

food at the same time

cardiac output,

a; second or

Constipation,

each dayonce

and myocardial

third-degree AV

diarrhea,

daily for E.R. tablets.

oxygen

block; severe

nausea,

Advise patient to

July 28, 2014

demand,

peripheral

vomiting

notify prescriber if

(during

reduce blood

arterial disorders

pulse

admission)

pressure by

SKIN:
Diaphoresis,
rash,

50mg tab; 1

decreasing

beats/minute or is

tab BID

renal release
of renin.

significantly

Pharmacologic:
Dose &
frequency
prescribed

Beta1adrenergic
antagonist

rate falls below 60

lower than usual.

Check BP before
and after.

August 2,2014
(Home
meds.)
47.5mg OD

Reference: Nurses drug handbook 10th edition; Jones and Barlett

Monitor bowel
movement

Monitor side
effects and refer
to the physician

Ensure that pt.

swallow the whole
tablet

Do not cut, crush

or chew the tablet

Instruct to report
difficulty of
breathing, night
cough, swelling of
extremities ,slow
pulse, confusion
,depression
,fever, and rash.

Name: Mrs.Mulan
Name
Ec asa

Diagnosis: CVD cerebral infarction Left hemiparesis

Classification

Therapeutic:

Dose &
frequency
prescribed:

(nonopioid)
elet

80mg 1 tab

count

OD PO

Date

Pharmacologic:

Ordered:
NSAID
August
2,2014

Mechanism of
Action
inhibit the
synthesis of
prostaglandins,
important
mediators of
inflammation.
Antipyretic
effects are not
fully understood,
but aspirin
probably acts in
the
thermoregulatory
center of the
hypothalamus to
block effects of
endogenous
pyrogen by
inhibiting
synthesis of the
prostaglandin.

Indication

moderate
pain

Reduction of
risk of death
or nonfatal MI
in patients
with history of
infarction or
unstable
angina
pectoris

Contraindication
allergy to salicylates
or NSAIDs (more
common with nasal
polyps, asthma,
chronic urticaria);
allergy to tartrazine
(cross-sensitivity to
aspirin is common);
hemophilia, bleeding
ulcers, hemorrhagic
states, blood
coagulation defects,
hypoprothrombinemi
a, vitamin K
deficiency

Adverse Effect
Acute aspirin

Nursing Consideration

Take the drug

toxicity:

with food or after

tachypnea,

meals if GI upset

hemorrhage,

occurs.

excitement,

Do not cut,

confusion

crush, or chew

GI: Nausea,

sustained-

dyspepsia,

release

heartburn,

products.

epigastric

Pt. may

discomfort,

experience these

Salicylism:
Dizziness,
tinnitus,
nausea,
vomiting,
diarrhea,
mental
confusion

side effects:
Nausea, GI
upset, heartburn
(take drug with
food); easy
bruising, gum
bleeding (related
to aspirins
effects on blood
clotting).

Reference: Nurses drug handbook 10th edition; Jones and Barlett

Report ringing in
the ears;
dizziness,
confusion
Monitor for signs
of bleeding
Monitor RR
Monitor bowel
movement
Monitor for any
adverse effects

Name: Mrs.Mulan
Name

Diagnosis: CVD cerebral infarction Left hemiparesis

Classification

Mechanism of
Action

Twynsta

- Manage
Therapeutic:

Dose &
frequency
prescribed:

40mg 1 tab
OD PO

Indication

Blocks
angiotensin II
from binding to
receptor sites in
many tissues,
antihypertensive
including
vascular smooth
muscles and
adrenal glands.
This action
inhibits the
Pharmacologic:
vasoconstriction
& aldosterone
secreting effects
Nonpeptide
of angiotensin II,
angiotensin II
which reduces
antagonist
BP.

HTN
Reduce risk of
MI, stroke, or
death from
cardiovascular
causes in
patients at high
risk

Contraindication

Adverse Effect

Nursing Consideration

Hypersensitivity
to telmisartan
or its
component

>dizziness

Check BP regularly

>headache

Treat symptomatic

>fatigue

hypotension by

>chest pain

placing pt. in supine

>N/V

position

>muscle

cramps
>myalgia

output

>URTI

August 2,2014

Reference: Nurses drug handbook 10th edition; Jones and Barlett

Change position
slowly to minimize
effect of orthostatic
hypotension

Drink adequate
amount of fluid

Date
Ordered:

Measure urine

during hot weather

Monitor for any

adverse effects

Name: Mrs.Mulan
Name
Synapse

Diagnosis: CVD cerebral infarction Left hemiparesis

Classification

Therapeutic:

anti-angina

Mechanism of
Action

Indication

Selectively

>manage

blocks alpha, &

hypertension

beta2 receptors

>manage

in vascular

angina pectoris

antihypertensive smooth muscle

&beta1 receptors

as long term
therapy

Contraindication
>asthma,
bronchospasm,
HF,
hypersensetivity
& other betablocker, severe
COPD

Adverse Effect

Nursing Consideration

>anxiety

Take radial pulse

>dizziness

Review signs of

>fatigue
>hypotension

impending HF

>nasal
congestion

Check for signs

of hypoglycemia

Anticipate that

Dose &

in the heart,

>N/V

drug may worsen

frequency

thereby reducing

>Impotence

fatigue

peripheral

>cough

vascular

>dyspnea

prescribed:

500mg 1 cap
OD PO

Pharmacologic:

Nonselected
beta-blocker

intake to manage

resistance &
blood pressure

Date
Ordered:

July 29,2014

Reference: Nurses drug handbook 10th edition; Jones and Barlett

Increase fluid

cough

Monitor BP

Monitor RR

Monitor adverse
effects

Name: Mrs.Mulan
Name

Diagnosis: CVD cerebral infarction Left hemiparesis

Classification

Mechanism of
Action

Indication

Contraindication

Adverse Effect

Nursing Consideration

To control lipid

Active hepatic

CNS:

Reduces

levels as

disease,

acial paralysis,

drug at the same

Anti-

plasma

adjunct to diet

hypersensitivity

fever,

time

hyperlipidemic

cholesterol and

in primary

to

headache

lipoprotein

(heterozygous

atorvastatin or

CV:

maintain its

Dose &

levels by

familial and

its components,

orthostatic

effects.

frequency

inhibiting HMG-

nonfamilial)

unexplained

hypotension,

CoA reductase

hypercholester

palpitations

take a missed

and cholesterol

olemia and

ENDO:

dose as

synthesis in the

mixed
dyslipidemia

persistent rise in
serum
transaminase
level

Atorvastatin

prescribed:

July 31,2014
(during

Therapeutic:

Pharmacologic:

HMG-CoA
reductase
inhibitor

liver and by

Tell patient to take

Instruct patient to

Hyperglycemia

each day to

or hypoglycemia

soon as
possible.

admission)

increasing the

GI:

45mg 1 tab

number of LDL

Abdominal or

notify prescriber

HS

receptors on

biliary pain,

immediately

liver cells to

anorexia,

enhance LDL

colitis,

unexplained

uptake and

constipation,

muscle

breakdown

diarrhea

August
2,2014

RESP: Dyspnea,
pneumonia

Advise patient to

if he develops

pain,
tenderness, or
weakness,
especially if

(Home

accompanied

meds.)

by fatigue or

daily

fever.

Reinforce the
benefits of
therapy, and
urge

Reference: Nurses drug handbook 10th edition; Jones and Barlett

patient to
comply if
possible.

Monitor BP

Monitor bowel
movement

Check for any

adverse effects