Drug Sheets For Clinical

ASA (apirin) – antipyretic, nonopiod analgesic Indications: inflammatory disorders including RA, OA. Mild to moderate pain. Fever. Aspirin: prophylaxis of ischemic attacks and MI. Actions: - produce analgesia and reduce inflammation and fever by inhibiting the production of prostaglandins (only aspirin decreases platelet aggregation) Side effects: GI bleeding, dyspepsia, epigastric distress, nausea, exfoliative dermatitis, stevensjohnson syndrome, toxic epidermal necrolysis Digoxin (antiarrhythmics, inotropics) Indications: treatment of CHF. Tachyarrhythmias: atrial fibrillation and atrial flutter, paroxysmal atrial tachycardia Action: increases force of myocardial contraction. Prolongs refractory period of AV node. Decreases conduction through the SA and AV nodes Therapeutic effects: increased cardiac output (positive inotropic effect) and slowing the hrt rate (negative chronotropic effect) Side effects: Arrhythmias; fatigue, bradycardia, anorexia, nausea, vomiting Nursing Implications: Monitor apical pulse for one full minute before administration. Withhold dose and notify physician if pulse rate is <60 bpm in an adult Monitor ECG throughout IV administration and 6 hrs after each dose. Notify health care professional if bradycardia or new arrhythmias occur. Narrow therapeutic range. Plavix (Clopidogrel) – (antiplatelet agents) Indications: Reduction of atherosclerotic events in pts at risk for such events including recent MI, acute coronary syndrome, stroke, or peripheral vascular diseases Action: inhibits platelet aggregation by irreversibly inhibiting the binding of ATP to platelet receptors

Therapeutic effects: Decreased occurrence of atherosclerotic events in patients at risk Side effects: GI bleeding, bleeding, neutropenia, thrombocytopenic purpura (rare) Nursing implications: Monitor pt. for signs of thrombotic thrombocytic purpura (thrombocytopenia, microangiopathic hemolytic anemia, neurologic findings, renal dysfunction, fever) Monitor bleeding time during therapy and CBC with differential and platelet count Dalteparin, Enoxaparin (anticoagulants) Indications: prevention of venous thromboembolism (deep vein thrombosis) and/or pulmonary embolism or surgical or medical pts. Action: Potentiate the inhibitory effects of antithrombin on factor Xa and thrombin. Therapeutic effects: prevention of thrombus formation Nursing Implications: Assess for signs of bleeding and hemorrhage (bleeding gums; nosebleed; unusual bruising; black, tarry stools; hematuria; fall in hematocrit or BP; bleeding from surgical site. Metoprolol (antianginals, antihypertensive) (betablockers) Indications: Hypertension. Angina pectoris. Prevention of MI and decreased mortality in pts with recent MI. Management of stable, symptomatic heart failure due to ischemic, hypertensive and cardiomyopathic origin Actions: Blocks stimulation of beta1- adrenergic receptors. Therapeutic effects: Decreased BP and hrt rate. Decreased frequency of attacks of angina pectoris. Decreased rate of cardiovascular mortality and hospitalization in pts with heart failure. Side effects: bradycardia, CHF, pulmonary edema, erectile dysfunction. Nursing Implications: Monitor vital signs and ECG every 5-15 mins during and for several hrs after parenteral administration. If heart rate is <40bpm, especially if cardiac output is also decreased, adminster atropine IV

Monitor intake and output ratios and daily wts. Assess routinely for signs and symptoms of CHF (dyspnea, rales/crackles, weight gain, peripheral edema, JVD)

Diltiazem (anti – anginals, antiarrhythmics, antihypertensives) (calcium channel blockers) Indications: Hypertension. Angina pectoris. Supraventricular tachyarrhythmias and rapid ventricular rates in atrial flutter or fibrillation. Action: inhibits transport of calcium into myocardial and vascular smooth muscle cells, resulting in inhibition of excitation-contraction coupling and subsequent contraction. Therapeutic effects: Systemic vasodilation resulting in decreased blood pressure. Coronary vasodilation resulting in decreasing frequency and severity of attacks of angina. Suppression of arrhythmias. Side effects: Arrhythmias, CHF, Stevens-Johnsons syndrome (sloughing of skin because of drug rxns); peripheral edema Nursing Implications: Monitor I/O ‘s, BP and pulse. Assess for signs of CHF Hydrochlorthiazide (anti-hypertensive, diuretics, thiazide diuretics) Indications: management of mild to moderate hypertension. Treatment of edema associated with CHF, renal dysfunction, cirrhosis, g