DRUG STUDY

DRUG ORDER
ADVERSE DESIRED NURSING
(Generic name, PHARMACOLOGIC INDICATIONS AND
EFFECTS OF THE ACTION ON RESPONSIBILITIES/
Dosage, Route, ACTION OF DRUG CONTRAINDICATIONS
DRUG THE CLIENT PRECAUTIONS
Frequency, etc.)
Aspirin Exhibits antipyretic, Indications: GI: dyspepsia, Prevent blood  Assess for pain: type,
80mg/tab post-lunch anti-inflammatory and  For pain on heartburn, anorexia, coagulation due location and pattern
PO OD analgesic effects. The integumentary nausea, epigastric to hypertension  Note for asthma
(as indicated in the antipyretic effect is structures, myalgia, discomfort, (narrow blood  Monitor renal, LFTs
patient’s chart) due to an action on the potentiation of peptic vessels may
neuralgia, and CBC
-given to prevent
hypothalamus, headache, ulcer cause blood to  Determine history of
resulting in heat loss dysmenorrhea, Allergic: aggregate) peptic ulcers or
further coagulation by vasodilation of gout. Bronchospasm,
of blood and other bleeding tendencies.
peripheral blood  Arthritis, SLE, asthma-like
substances on vessels. Anti- symptoms,
acute rheumatic Precautions:
patient D.S. artery inflammatory effects anaphylaxis, skin
due to an ischemic
fever  Do not use in children
are mediated by a rashes, urticaria with chicken pox or
heart disease decrease in Hematologic:
Contraindications: flu symptoms
prostaglandin Hypersensitivity to prolongation of  Lactation
synthesis. It also salicylates, severe anemia, bleeding time,
 Mild diabetes, erosive
decreases platelet history of blood thrombocytopenia,
gastritis, bleeding
aggregation. coagulation defects, leucopenia,
tendencies, liver or
vitamin K deficiency, 1 Other: Thirst, fever,
kidney disease.
week before and after dimness of vision
surgery, pregnancy in the
last trimester
 DRUG ORDER
ADVERSE DESIRED NURSING
(Generic name, PHARMACOLOGIC INDICATIONS AND
EFFECTS OF THE ACTION ON RESPONSIBILITIES/
Dosage, Route, ACTION OF DRUG CONTRAINDICATIONS
DRUG THE CLIENT PRECAUTIONS
Frequency, etc.)
Clopidogrel Inhibits platelet Indications CNS: Headache, Prevent platelet  Assess for symptoms
75mg/tab 1 tab OD aggregation by  Treatment of dizziness, weakness, aggregation of stroke, MI during
(as indicated in the blocking ADP patients at risk for syncope, flushing treatment
patient’s chart) receptors on platelets, ischemic events— CV: Hypertension,  Monitor liver function
preventing clumping history of MI, edema studies: AST, ALT,
-given to prevent of platelets ischemic stroke, Dermatologic: Rash, bilirubin, creatinine if
further coagulation peripheral artery pruritus patient is on long-
of blood and other disease GI: Nausea, GI term therapy
substances on
 Treatment of distress, constipation,  Monitor blood
patient D.S. artery diarrhea, GI bleed
patients with acute studies: CBC,Hgb,
due to an ischemic Other: Increased
coronary syndrome Hct, protime,
heart disease bleeding risk cholesterol if the
Contraindications patient is on long-
 Contraindicated term therapy;
with allergy to thrombocytopenia
clopidogrel, active and neutropenia may
pathological occur.
bleeding such as
peptic ulcer or Precautions:
intracranial bleeding disorders,
hemorrhage, recent surgery, hepatic
lactation. impairment, pregnancy
 DRUG ORDER
ADVERSE DESIRED NURSING
(Generic name, PHARMACOLOGIC INDICATIONS AND
EFFECTS OF THE ACTION ON RESPONSIBILITIES/
Dosage, Route, ACTION OF DRUG CONTRAINDICATIONS
DRUG THE CLIENT PRECAUTIONS
Frequency, etc.)
Hydrochlorothiazide Inhibits reabsorption Indications CNS: Dizziness, Decrease blood  Assess improvement
12.5 mg 1 tab OD of sodium and chloride  Adjunctive therapy vertigo, pressure in CVP q8h
PO in distal renal tubule, in edema associated paresthesias,  Check for rashes and
(as indicated in the increasing the with CHF, weakness, temperature elevation
patient’s chart) excretion of sodium, headache,
cirrhosis, daily
chloride, and water by corticosteroid, and drowsiness,  Assess for confusion
the kidney. estrogen therapy; fatigue  Monitor
renal dysfunction CV: Orthostatic manifestations of
 Hypertension as hypotension, hypokalemia: acidic
sole therapy or in venous urine, reduced urine,
combination with thrombosis, osmolality, nocturia,
other volume depletion, hypotension,
antihypertensives cardiac tachycardia, weak
 Unlabeled uses: arrhythmias, chest pulse, weakness,
Calcium pain altered LOC
nephrolithiasis Dermatologic:  Monitor for
alone or with Photosensitivity, manifestations of
amiloride or rash, purpura, hypomagnesemia:
allopurinol to exfoliative agitation, muscle
prevent recurrences dermatitis, hives, twitching,
in hypercalciuric or alopecia paresthesias,
normal calciuric GI: Nausea, hyperactive reflexes,
patients; diabetes anorexia, dysphagia, tetany,
insipidus, especially vomiting, dry nausea, vomiting,
nephrogenic mouth, diarrhea, diarrhea
diabetes insipidus; constipation,  Monitor for
osteoporosis jaundice, hepatitis, manifestations of
pancreatitis hyponatremia:
Contraindications GU: Polyuria, increased BP, cold,
 Contraindicated nocturia, clammy skin,
with allergy to impotence, loss of hypovolemia,
thiazides, libido abdominal cramps,
sulfonamides; fluid Hematologic: lethargy
or electrolyte Leukopenia,  Assess fluid volume
imbalance; renal thrombocytopenia, status
disease (can lead to agranulocytosis,  Monitor electrolytes
azotemia); liver aplastic anemia,
disease (risk of neutropenia Precautions:
hepatic coma); Other: Muscle gout (risk of attack);
anuria. cramps and SLE; glucose tolerance
muscle spasms, abnormalities, diabetes
fever, gouty mellitus;
attacks, flushing, hyperparathyroidism;
weight loss, manic-depressive
rhinorrhea, disorder (aggravated by
electrolyte hypercalcemia);
imbalances, pregnancy; lactation,
hyperglycemia elevated triglyceride
levels.
 DRUG ORDER
ADVERSE DESIRED NURSING
(Generic name, PHARMACOLOGIC INDICATIONS AND
EFFECTS OF ACTION ON RESPONSIBILITIES/
Dosage, Route, ACTION OF DRUG CONTRAINDICATIONS
THE DRUG THE CLIENT PRECAUTIONS
Frequency, etc.)
Isosorbide Relaxes vascular Indications CNS: Headache, Relief of angina  Assess for pain:
mononitrate smooth muscle with a  Dinitrate: apprehension, pectoris duration, time started,
60mg/tab 1 tab OD resultant decrease in Treatment and restlessness, activity being
at HS PO venous return and prevention of weakness, vertigo, performed, character,
(as indicated in the decrease in arterial BP, angina pectoris dizziness, intensity
patient’s chart) which reduces left  Mononitrate: faintness  Assess orthostatic
ventricular workload Prevention of CV: Tachycardia, hypotension, blood
Isosorbide dinitrate and decreases retrosternal
angina pectoris pressure at baseline
5 mg PRN for chest myocardial oxygen discomfort, and during treatment
pain consumption. palpitations,
(as indicated in the
Contraindications
patient’s chart)  Contraindicated hypotension, Precautions:
with allergy to syncope, collapse, pregnancy, lactation,
-to treat Patient nitrates, severe orthostatic acute MI, CHF, postural
D.S.’ pain during anemia, head hypotension, hypotension, severe
anginal episodes trauma, cerebral angina, rebound renal, hepatic disease
and to prevent it hemorrhage, hypertension,
from reoccurring hypertrophic atrial fibrillation,
cardiomyopathy, postdural
narrow-angle hypertension
glaucoma, postdural Dermatologic: Rash,
hypotension exfoliative
dermatitis,
cutaneous
vasodilation with
flushing
GI: Nausea,
vomiting,
incontinence of
 urine and feces,
abdominal pain,
diarrhea
GU: Dysuria,
impotence,
urinary frequency
Other: Muscle
twitching, pallor,
perspiration, cold
sweat, arthralgia,
bronchitis
 DRUG ORDER
ADVERSE DESIRED NURSING
(Generic name, PHARMACOLOGIC INDICATIONS AND
EFFECTS OF ACTION ON RESPONSIBILITIES/
Dosage, Route, ACTION OF DRUG CONTRAINDICATIONS
THE DRUG THE CLIENT PRECAUTIONS
Frequency, etc.)
ALLOPURINOL Inhibits xanthine  Treatment of primary or CNS: Fever, To regulate uric  Assess patient’s
250 mg/tab oxidase, an enzyme secondary gout drowsiness, acid level to history, gout may be
PRN involved in the  hyperuricemia resulting headache, normal range secondary to disease
(as indicated in the synthesis of uric acid from chemotherapy for paresthesia,
patient’s chart) such as acute or
without disrupting the malignancies peripheral
chronic leukemia,
-to stabilize high
biosynthesis of  recurrent calcium neuropathy,
essential purine. oxalate neuritis. polycythemia vera,
uric acid level based multiple myeloma or
on the laboratory
Results in decreased  renal calculi CV: Hypersensitivity
acid level. Recurrent trophaceous vasculitis, psoriasis.
result of Patient necrotizing
D.S. deposits or uric acid stones.  Assess for pain
angiitis.
including location,
EENT: Epistaxis.
GI: Diarrhea, nausea, characteristics,
vomiting, onset/duration,
abdominal pain, frequency, quality,
gastritis, taste intensity or severity
loss, or of pain, precipitating
perversion, factors.
dyspepsia.
GU: Renal failure,  Monitor uric acid
uremia. levels every 2 weeks.
Hematologic: Monitor renal
Agranulocytosis, function; check
anemia, aplastic intake-output ratio,
anemia, increase fluids to 2
thrombocytpenis,
L/day to prevent
leucopenia,
stone formation,
 leukocytosis, toxicity, BUN,
eosinophilia. creatinine.
Hepatic: Hepatitis,  Monitor CBC and
hepatic necrosis,
hepatic function at the
hepatomegaly,
cholestatic start of therapy and
jaundice. periodically
Musculoskeletal: thereafter.
Arthralgia,  Be alert for adverse
myopathy. reaction and drug
interaction, anemia,
hepatitis.
 Advaic patient to
avoid hazardous
activities requiring
mental alertness until
CNS effect are
known.
 Advice patient to
avoid taking large
dose of vitamin C, it
may cause kidney
stone formation.
Maintain a diet
enhancing urine
alkalinity, and if
taking drug for
calcium oxalate
stones, reduce dairy
 products, refined
sugar, sodium and
meat.
 Tell patient to stop
drug and report if skin
rash, stomatitis,
malaise, and fever
occur, this may
precede
hypersensitivity or
adverse reaction.