Ben Drugs
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Digoxin Digitek, digoxin, lanoxicaps, lanoxin
INDICATIONS & DOSAGE:
heart failure, paroxysmal supraventricular tachycardia, atrial fibrillation and flutter
ADULTS:
for rapid digitalization, give 0.4 to 0.6 mg P.O initially, followed by 0.1 to 0.3 mg every 6-8 hours, as needed and tolerated, for 24 hours. For slow digitalization, give 0.05 to 0.35 mg daily in two divided doses for 7 to 22 days, p.r.n. until therapeutic levels are reached. Maintenance dose is 0.05 to 0.35 mg daily in one or two divided doses.
ACTION:
inhibits sodium potassium activated adenosine triphosphatase , promoting movement of calcium from extracellular to intracellular cytoplasm and strengthening myocardial contraction. Also acts on CNS to enhance vagal tone, slowing conduction through the SA and AV nodes.
ADVERSE REACTION:
CNS: fatigue, generalized muscle weakness, agitation., hallucinations, headache,
malaise, dizziness, vertigo, stupor, paresthesia. CV: arrhythmias. GI: anorexia, nausea, vomiting, diarrhea.
CONTRAINDICATIONS & CAUTIONS:
Contraindicated in patients hypersensitive to drugs and in those with digitalis induced toxicity, ventricular fibrillation, or ventricular tachycardia unless caused by heart failure. Used with extreme caution in elderly patients and in those with acute MI, incomplete AV block, sinus bradycardia, PVC’s chronic constrictive pericarditis, hypertrophic cardiomyopathy, renal insufficiency, severe pulmonary disease, or hypothyridsm.
NURSING CONSIDERATION:
drug induced arrhythmias may increase the severity of heart failure and hypotension. Toxic effects on the heart maybe life threatening and require immediate attention. Patients with hypothyroidism are extremely sensitive to cardiac glycosides and may need lower doses.monitor digoxin level. Therapeutic level ranges from 0.8 to 2 ng/ml. obtain blood for digoxin level at least 6 to 8 hours after last oral dose, preferably just before next schedule dose.
Spironolactone Aldactone, novosriroton, spiractin
INDICATIONS:
edema hypertension diuretic induced hypokalemia to direct primary hyperaldosteronism heart failure hirsutism in women premenstrual syndrome
ACTION:
potassium sparing diuretic, antagonizes aldosterone in the distal tubules, inceasing in sodium and water excretion.
ADVERSE REACTION:
CNS: headache drowsiness, lethargy, confusion, ataxia. GI: diarrhea, gastric bleeding, ulceration, cramping, gastritis, vomiting. GU: inability to maintain erection, menstrual disturbances Skin: urticaria, hirsutism, maculopapular eruption.
CONTRAINDICATIONS & CAUTIONS:
contraindicated in patients with hypersensitive to drugs. In those with anuria, acute or progressive renal insufficiency, or hypercalemia With extreme caution in pregnant women Used cautiously in patients with fluid or electrolyte imbalances, impaired renal function, or hepatic disease.
NURSING CONSIDERATION: To enhance absorption give drugs with meals. Protect drugs from light Monitor electrolyte level Monitor elderly patient closely
Captopril Acenorm, capoten enzace, novo- captopril INDICATIONS:
hypertension diabetic nephropathy heart failure left ventricular dysfunction after acute MI
ACTION:
inhibits ACE, preventing conversion of angiotensin I to angiotensin II a potent vasoconstrictor. Less angiotensin II decreases peripheral arterial resistance, decreasing aldosterone secretion, which reduces sodium and water retention and lowers blood pressure.
ADVERSE REACTION:
CNS: dizziness, fainting, headache, malaise, fatigue, fever CV: Tachycardia, hypotension, angina pectoris GI: abdominal pain. Anorexia, constipation, diarrhea, dry mouth, n/v METABOLIC” hyperkalemia
CONTRAINDICATIONS & CAUTIONS:
In patients with hypersensitive to drugs or other ACE inhibitors. Used cautiously in patients with impaired renal function or serious auto immune disease.
NURSING CONSIDERATION:
monitor patients blood pressure and pulse rate frequently asses patients for signs of angioedema compaired with other ACE inhibitors, captopril is the most likely to cause cough.
INDICATIONS & DOSAGE:
heart failure, paroxysmal supraventricular tachycardia, atrial fibrillation and flutter
ADULTS:
for rapid digitalization, give 0.4 to 0.6 mg P.O initially, followed by 0.1 to 0.3 mg every 6-8 hours, as needed and tolerated, for 24 hours. For slow digitalization, give 0.05 to 0.35 mg daily in two divided doses for 7 to 22 days, p.r.n. until therapeutic levels are reached. Maintenance dose is 0.05 to 0.35 mg daily in one or two divided doses.
ACTION:
inhibits sodium potassium activated adenosine triphosphatase , promoting movement of calcium from extracellular to intracellular cytoplasm and strengthening myocardial contraction. Also acts on CNS to enhance vagal tone, slowing conduction through the SA and AV nodes.
ADVERSE REACTION:
CNS: fatigue, generalized muscle weakness, agitation., hallucinations, headache,
malaise, dizziness, vertigo, stupor, paresthesia. CV: arrhythmias. GI: anorexia, nausea, vomiting, diarrhea.
CONTRAINDICATIONS & CAUTIONS:
Contraindicated in patients hypersensitive to drugs and in those with digitalis induced toxicity, ventricular fibrillation, or ventricular tachycardia unless caused by heart failure. Used with extreme caution in elderly patients and in those with acute MI, incomplete AV block, sinus bradycardia, PVC’s chronic constrictive pericarditis, hypertrophic cardiomyopathy, renal insufficiency, severe pulmonary disease, or hypothyridsm.
NURSING CONSIDERATION:
drug induced arrhythmias may increase the severity of heart failure and hypotension. Toxic effects on the heart maybe life threatening and require immediate attention. Patients with hypothyroidism are extremely sensitive to cardiac glycosides and may need lower doses.monitor digoxin level. Therapeutic level ranges from 0.8 to 2 ng/ml. obtain blood for digoxin level at least 6 to 8 hours after last oral dose, preferably just before next schedule dose.
Spironolactone Aldactone, novosriroton, spiractin
INDICATIONS:
edema hypertension diuretic induced hypokalemia to direct primary hyperaldosteronism heart failure hirsutism in women premenstrual syndrome
ACTION:
potassium sparing diuretic, antagonizes aldosterone in the distal tubules, inceasing in sodium and water excretion.
ADVERSE REACTION:
CNS: headache drowsiness, lethargy, confusion, ataxia. GI: diarrhea, gastric bleeding, ulceration, cramping, gastritis, vomiting. GU: inability to maintain erection, menstrual disturbances Skin: urticaria, hirsutism, maculopapular eruption.
CONTRAINDICATIONS & CAUTIONS:
contraindicated in patients with hypersensitive to drugs. In those with anuria, acute or progressive renal insufficiency, or hypercalemia With extreme caution in pregnant women Used cautiously in patients with fluid or electrolyte imbalances, impaired renal function, or hepatic disease.
NURSING CONSIDERATION: To enhance absorption give drugs with meals. Protect drugs from light Monitor electrolyte level Monitor elderly patient closely
Captopril Acenorm, capoten enzace, novo- captopril INDICATIONS:
hypertension diabetic nephropathy heart failure left ventricular dysfunction after acute MI
ACTION:
inhibits ACE, preventing conversion of angiotensin I to angiotensin II a potent vasoconstrictor. Less angiotensin II decreases peripheral arterial resistance, decreasing aldosterone secretion, which reduces sodium and water retention and lowers blood pressure.
ADVERSE REACTION:
CNS: dizziness, fainting, headache, malaise, fatigue, fever CV: Tachycardia, hypotension, angina pectoris GI: abdominal pain. Anorexia, constipation, diarrhea, dry mouth, n/v METABOLIC” hyperkalemia
CONTRAINDICATIONS & CAUTIONS:
In patients with hypersensitive to drugs or other ACE inhibitors. Used cautiously in patients with impaired renal function or serious auto immune disease.
NURSING CONSIDERATION:
monitor patients blood pressure and pulse rate frequently asses patients for signs of angioedema compaired with other ACE inhibitors, captopril is the most likely to cause cough.
