XIII.

DRUG STUDY

Drug feature
Generic name:
Lercanidipine
Brand name:
Zanidip
Therapeutic
classification:
Antihypertensiv
e
Dosage:
20 mg/ tab
Route:
Oral
Frequency:
Once daily
Form:
Tablet

Mechanism
of action
Blocks the
movement of
calcium ions
across the
cell
membrane,
depressing
the
generation of
action
potentials
and delaying
phases 1 and
2 of
repolarizatio
n which
slows
automaticity
and
conduction.

Indication

Hypertensio
n

Contraindication
Allergic to lercanidipine
or any of the other
ingredients of this
medicine, allergic
reactions to medicines
that are closely related to
Lercanidipine
hydrochloride tablets
(such as amlodipine,
nicardipine, felodipine,
isradipine, nifedipine or
lacidipine)
Suffering from
certain heart diseases:
uncontrolled cardiac
failure
an obstruction to flow of
blood from the heart
unstable angina (angina
at rest or progressively
increasing)
have had a heart attack

Side effect and

adverse effect
Headache
Dizziness
Ankle swelling
Feeling and
being sick
Fainting
Lightheadedness

Nursing
responsibilities
Instruct
patient to
avoid doing
strenuous or
alertness
needing
activities.
Inform patient
not to stop
medication
abruptly.
Do not take
dose twice if
missed the
previous dose.

less than one month ago

have severe
liver or kidney problems
are taking drugs that are
inhibitors of CYP3A4
isoenzyme: antifungal
medicines (such as
ketoconazole or
intraconazole), macrolide
antibiotics (such as
erythromycin or
troleandomycin)
Drug
feature
Generic
name:
Carvedilol
Brand
name:
Coreg,
Coreg CR

Mechanism
of action
Reduces
cardiac
output and
tachycardia,
causes
vasodilation,
and
decreases
peripheral

Indication
Heart
failure
Hyperten
sion
Heart
attack

Contraindication

Asthma
Bronchitis
Emphysema
severe liver disease
serious heart condition
such as heart block, "sick
sinus syndrome,"
slow heart rate
Drinking alcohol or
medicines that contain

Side effect and

adverse effect
Fatigue
headache
light headedness
malaise
paresthesia

Nursing
responsibilities
Inform patient it
may cause fluid
retention, but can
be relieved by
diuretics
prescribed by a
doctor.
Monitor patient
blood glucose

Therapeutic
class:
Antihyperten
sive, heart
failure
treatment
adjunct.

vascular
resistance,
which
reduces
blood
pressure and
cardiac
workload.

Avoid stopping
drug abruptly.
If patient has
heart failure,
expect to also
give digoxin,
diuretic, and an
ACE inhibitor
Inform patient to
avoid activities
that needs
energy.

alcohol

Dosage:
6.25 mg/ tab
Route:
Oral
Frequency:
Twice daily
Generic name

Genreric
name:
Clonidine
Brand
name:

Mechanism of
action

Stimulates
peripheral
alphaadrenergic
receptors in
the CNS to

Indication

The Catapres
brand of
clonidine is
used to treat
hypertension
(high blood

Contraindication

Hypersensitivity to
clonidine
heart disease or severe
coronary artery disease;
heart rhythm disorder,
slow heartbeats;

Side effect and

adverse effect
dizziness
fatigue
headache
malaise
paresthesia
syncope

Nursing
responsibilities

Clonidine is
usually taken in
the morning and
at bedtime. If you
take different
doses of this

produce
pressure).
transient
Therapeuti vasoconstricti
c class:
on and then
Antihyperte stimulates
nsive
central alphaadrenergic
Dosage:
receptor in the
75 mcg/ tab brainstem to
reduce
Route:
peripheral
Oral
vascular
resistance
Frequency: heart rate,
Thrice daily systolic and
diastolic blood
Form:
pressure.
Tablet

low blood pressure, or a

history of fainting spells;
a history of heart attack
or stroke;
kidney disease; or
if you have ever had an
allergic reaction to a
Catapres TTS skin patch.
Pregnant mothers

weakness

medicine at each
dosing time, it
may be best to
take the larger
dose at bedtime.

Clonidine may b
taken with or
without food.

Inform patient no
to crush, chew, o
break an
extended-release
tablet. Swallow i
whole.
Do not stop using
clonidine
suddenly, or you
could have
unpleasant
withdrawal
symptoms.
Avoid drinking

alcohol
Avoid doing
activities that
require alertness
Drug
features
Generic
name:
Tradjenta

Mechanism
of action

Inhibits the
enzyme,
dipeptidyl
peptidase-4,
that degrades
Brand
incretin
name:
hormones
Linagliptin
responsible
for glucose
Therapeutic elevation. This
classificatio allows the
n:
levels of
Antidiabetic incretin
hormones to
Dosage:
rise,

Indication
Type 2
diabetes

Contraindication
State of diabetic
ketoacidosis
Hypersensitivity to
linagliptin

Side effect and adverse Nursing

effect
Responsibilities
CNS: Headache,
Monitor patient
Dizziness
for hypoglycemia
Monitor patients
blood glucose
routinely
Monitor patient
for signs and
symptoms of
pancreatitis such
as abdominal pain
Urge patient to
report evidence of
hypoglycemia
Encourage patient
to carry hard
candy or other

3mg/ day
Route:
Oral
Frequency:
Once daily
Form:
Tablet

stimulating
the release of
insulin in a
glucose
dependent
manner while
decreasing the
glucagon level
in the blood.
Glucagon
secretion from
pancreatic
alpha cells is
reduced,
resulting in a
reduction in
the amount of
glucose
released by
the liver.

Drug features

Generic name:

Mechanism of
action
Increases levels
of intracellular

simple sugars
Urge patient to
carry an ID
indicating that he
has diabetes
Instruct patient
about exercise,
diet, signs of
hyper/hypoglycem
ia, hygiene, foot
care and ways to
avoid infection.
Tell patient to stop
drug if he
experiences signs
and symptoms of
an allergic
reaction such as a
rash, skin flaking.

Indication
Treat
hyperphosphatemi

Contraindication
Hypercalcemia

Side effect and

adverse effect

Nursing
Responsibilities

Calcium carbonate
Brand name:
Titralac. Calsan
Therapeutic class:
Antihypermagnesemic,
antihyperphosphatemic
, antihypocalcemis,
calcium replacement,
cardiotonic
Dosage:
500 mg/tab
Frequency:
Thrice daily
Route:
Oral
Form:
Tablet

and extracellular a
calcium which is
needed to
maintain
homeostasis,
especially in the
nervous and
musculoskeletal
systems. Also
plays a role in
normal cardiac
and renal
function,
respiration,
coagulation, and
cell membrane
and capillary
permeability.
Aids to regulate
the release and
storage of
neurotransmitter
s and hormones,
it also neutralize
or buffer

Hypersensitivity to
calcium salts or
their components
Hypophosphatemia
Renal calculi

Paresthesia
Headache

For
chewable
tablets, urge
patient to
chew
thoroughly
before
swallowing
and to drink
a glass of
water
afterward.
If suspension
is
prescribed,
tell patient to
shake bottle
well before
each use.
Inform
patient to
avoid
excessive
use of
tobacco and

stomach acid to
relieve
discomfort
caused by
hyperacidity.

excessive
consumption
of alcoholic
beverages,
and caffeine
containing
products.

Drug features

Mechanism of
action

Contraindication

Side effect and

adverse effect

Nursing
Responsibilities

Generic name:
Calcitriol

Binds to specific Treat hypocalcemia Hypercalcemia

receptors on
in dialysis patients Vitamin D toxicity
intestinal
mucosa to
increase calcium
absorption from
intestine. Drug
also may
regulate calcium
ion transfer from
bone to blood
and stimulate
calcium
reabsorption in

Skin: Erythema

Inform
patient not to
take other
forms of vit.
D while
taking
calcitriol
Instruct a
patient to
take a
missed dose
as soon as
possible

Brand name:
Calcijex, Rocaltrol
Therapeutic class:
Antihypocalcemic,
Antihypoparathyroid
Dosage:
0.25 mcg/ tab
Route:

Indication

Oral
Frequency:
Once daily
Form:
Tablet

Drug features

Mechanism of
action

Indication

Generic name:
Metolazone

Promotes renal
excretion of water
and sodium by
inhibiting their
reabsorption in
distal convoluted

Manage mild
to moderate
hypertension

Brand name:
Diulo

Notify
subscriber
immediately
about
possible
toxicity, such
as headache,
irritability,
nausea,
photophobia,
vomiting,
weakness,
and weight
loss.

the distal renal

tubules, making
more calcium
available in the
body.

Contraindication

Anuria
Hepatic coma
Hypersensitivity to
metolazone and
other sulfonamide
derivatives

Side effect and

adverse effect

Dizziness
Headache
Paresthesia
Syncope
Weakness
Dry skin

Nursing
Responsibilities
Monitor drugs
diuretic effect,
measure fluid
intake and output
and daily weight.
Monitor blood

Therapeutic
class:
Antihypertensive,
diuretic
Dosage:
50 mg/ tab
Route:
Oral
Frequency:
Once daily
Form:
Tablet

tubules. The
resulting reduction
in plasma and
extracellular fluid
volume reduces
blood pressure.

Renal failure

Hyponatremia

chemistry test
results and assess
for evidence of
hypochloremia,
hypokalemia, and
possible, mild
metabolic
alkalosis.
Inform patient to
take drug at the
same time each
day.
Direct patient to
take drug with
food or milk to
minimize adverse
GI reactions.
Advise patient to
change position
slowly to
minimize
orthostatic
hypotension.
Urge patient to
notify prescriber

about persistent,
severe, diarrhea,
nausea or
vomiting.

Drug features
Generic name:
Furosemide

Mechanism of
action

Inhibits sodium
and water
Brand name:
reabsorption in the
Lasix special
loop of henle and
increases urine
Therapeutic
formation. As the
class:
bodys plasma
Antihypertensive, volume decreases,
antidiuretic
aldosterone
production
Dosage:
increases, which
40 mg/ tab
promotes sodium
reabsorption and
Route:
the loss of
Oral
potassium and
hydrogen ions. It

Indication

Contraindication

Side effect and

adverse effect

Edema caused
by cirrhosis,
Heart failure
and renal
disease
Nephrotic
syndrome

Anuria unresponsive
to furosemide
Hypersensitivity to
furosemide,
sulfonamides or their
components

Dizziness
Headache
Paresthesia
Weakness
Hyponatremia

Nursing
Responsibilities
Monitor patients
who are allergic
to sulfonamides,
because they can
also be allergic to
furosemide.
Obtain patients
weight before and
periodically
during
furosemide
therapy to
monitor fluid
loss.
Prepare drug for

Frequency:
Twice daily

also increses the

excretion of
calcium,
magnesium,
bicarbonate,
ammonium, and
phosphate.

infusion with
normal saline.
If patient is high
risk for
hypokalemia,
provide
potassium
supplements
along with
furosemide as
prescribed.
Instruct patient to
take furosemide
at the same time
each day to
maintain
therapeutic
effects.
Take last dose
several hours
before bedtime to
avoid interruption
of sleep from
diuresis.
Take medication

with food or milk

to reduce GI
distress.

Drug features

Mechanism of
action

Indication

Contraindication

Side effect and

adverse effect

Nursing
Responsibilities

Generic name:
Levothyroxine
sodium

Replaces
endogenous
thyroid hormone,
which may exert
its physiologic
effects by
controllingDNA
transcription and
protein synthesis.

To treat mild
hypothyroidis
m

Acute myocardial
infarction
Hypersensitivity to
levothyroxine
Uncorrected renal
insufficiency
Untreated
thyrotoxicosis

Fatigue
headache

Monitor blood
glucose level of
diabetic patient.
Expect patient to
undergo thyroid
function tests
regularly during
levothyroxine
therapy.
Instruct patient to
take drug 30
minutes before
breakfast.
Emphasize the
need to take
levothyroxine with

Brand name:
Levothroid
Therapeutic
class:
Thyroid hormone
replacement
Dosage:
25 mcg+ 12.5 mg/
tab

Route:
Oral

a full glass of
water to avoid
choking, gagging,
having tablet stick
in throat.
Do not stop drug
or decrease doses
unless instructed
by prescriber.

Frequency:
Once daily

Drug features

Mechanism of
action

Generic name:
Pantoprazole

Interferes with
To treat
gastric acid
gastroesophagea
secretio by
l reflux disease
inhibiting the
hydrogenpotassiumadenosine
triphosphatase
enzyme system,
or proton pump in
gastric parietal
cells.

Brand name:
Pantoloc
Therapeutic
class:
Antiulcer, proton
pump inhibitor
Dosage:

Indication

Contraindication

Hypersensitivity to
pantoprazole
Substitute
benzimidazoles

Side effect and

adverse effect
Malaise
Fatigue
Elevated
serum
creatinine
levels

Nursing
Responsibilities
Instruct patient to
swallow tablets
whole and not to
chew or crush
them.
Monitor the
patient especially
the patient on
long term therapy
for
hypomagnesemia

 Follow bleeding
precautions,
specially for
patient who takes
warfarin.

40 mg/tab
Route:
Oral
Frequency:
Once daily
Drug features

Mechanism of
action

Indication

Contraindication

Generic name:
Domperidone

Blocks the
dopamine
receptors found
in the upper end
of the digestive
system thus
tightening the
muscles at entry
to the stomach,
and relaxes the
exit at the end of
the stomach and
increases
contraction at the

Nausea and
vomiting
Parkinsons
disease

Hypersensitivity to
domperidone

Brand name:
Generic
motilium
Therapeutic
class:
Antiemetic
Dosage:
30 mg/tab

Side effect and

adverse effect

Nausea and
vomitting

Nursing
Responsibilities
Inform patient to
take
domperidone 15
30 mins before
meals.
Used cautiously
to patients with
hepatic and renal
impairment.
Do not take a
double dose.

Route:
Oral
Frequency:
Once daily

stomach.