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Drug Study
Drug Study
Drug Classification:
Anti-asthmatic & COPD Preparations
Indication:
Bronchial asthma & pulmonary disease w/ spastic bronchial component.
Mechanism of action:
Adrenergic bronchodilators and phosphodiesterase inhibitors both work by increasing intracellular level of cyclic-3,5- adenosine
monophosphate(cAMP); adrenergics by increasing production and phosphodiesterase inhibitors by decreasing breakdown. Increased
levels of cAMP produce bronchodilation.
Corticosteroids act by decreasing airway inflammation. Anticholinergics (ipratropium) produce bronchodilation by decreasing
intracellular levels of cyclic guanosine monophosphate (cGMP). Leukotriene receptor antagonists and mast cell stabilizers decrease
the release of substances that can contribute to bronchospasm.
Dosage:
Tab
Adult 1 tab bid- tid.
Syrup
Children >12 yr 10 mL once- tid, <12 yrs 6-9 mg/kg bid.
Contraindication:
Acute MI, hypotension, lactation
Special Precaution:
Liver disease, CHF, chronic obstructive lung disease, concomitant infections. Pregnancy
Adverse Reaction:
Nausea, vomiting, epigastric pain, cephalgia, irritability, insomnia, tachycardia, extra systole, tachypnea, hyperglycemia, albuminuria.
Form:
Tablet- 400 mg; syrup- 100mg/5mL
Pregnancy Risk Category:
(Not yet applicable)
Nursing Responsibilities:
Assess lung sounds, pulse and blood pressure before administration and during peak of medication. Not amount, color, and
character of sputum produced.
Monitor pulmonary function tests before initiating therapy and periodically during therapy to determine effectiveness of medication.
Observe for paradoxical bronchospasm (wheezing). If conditions occur, withhold medication and notify physician
of other health care professional immediately.
Name of General Specific Action Indications Contraindication Adverse Reaction Nursing
drugs Action s Responsibilities
Antiplatelet Inhibits platelet Reduction Contraindicated in: CNS: Assess patient for
Clopidogrel agents; aggregation by of atherosclerotic Hyper sensitivity Depression, symptoms of stroke,
Platelet irreversibly events (MI, stroke, Pathologic bleeding Dizziness, Fatigue, peripheral vascular
Aggregation inhibiting the vascular death) in (peptic ulcer, Headache. disease, or
75 mg 1 tab Inhibitors. binding of ATP to patients at risk for intracranial EENT: MI periodically
PO OD. platelet receptors. such events hemorrhage) Epistaxis. during therapy.
including recent Lactation. Respiratory: Monitor patient for
Therapeutic MI, acute coronary Cough, Dyspnea. signs of thrombotic
Effects: syndrome Use Cautiously in: CV: thrombocytic
(unstable Patients at risk Chest Pain, Edema, purpura
Decreased angina/non-Q- for bleeding (trauma, Hypertension. (thrombocytopenia,
occurrence wave MI), stroke, surgery, or GI: micro angiopathic
of atherosclerotic or peripheral other pathologic GI hemolytic anemia,
events in patients vascular disease. conditions) History of Bleeding, Abdominal neurologic findings,
at risk. GI bleeding/ulcer Pain, Diarrhea, renal dysfunction,
disease Severe hepatic Dyspepsia, Gastritis. fever).May rarely
impairment. Dermatology: occur, even after
Pruritus, Purpura, short exposure(<2
Rash. wk). Requires
Hematology: prompt treatment.
Bleeding, Implementation
Neutropenia, Discontinue
Thrombotic clopidogrel 5-7
Thrombocytopenic days before planned
Purpura. surgical procedures.
Metabolic: PO:
Hypercholesterolemia Administer
. once daily without
MS: regard to food.
Arthralgia, Back Pain.
Patient/Family
Miscellaneous: Teaching
Fever, Instruct patient to
Hypersensitivity take medication
Reactions. exactly as directed.
Take missed doses
as soon as possible
unless almost time
for next dose; do
not double
doses. Advise
patient to notify
health care
professional
promptly if fever,
chills, sore throat,
or unusual bleeding
or bruising
occurs. Advise
patient to notify
health care
professional of
medication regimen
prior to treatment or
surgery.
Drug Dosag Mechanism of Action Indication and Side Effect and Nursing
e Contraindication Adverse effect Consideration
Generic name: 125 Unbound glucocorticoids cross Indication Side effect Assessment
Methylprednisolon mg/2 cell membranes and bind with Arthritis Nausea/vomiting/stomach Hypersensitivity
high affinity to Blood disorders upset Assess for potassium
e ml vial specific cytoplasmic receptors, Severe allergic reactions Heartburn depletion (fatigue,
modifying transcription and Certain cancers Headache nausea, vomiting,
Brand name: protein synthesis. By this Immune system disorders Dizziness depression, polyuria,
Solu-Medrol mechanism, glucocorticoids Shock Appetite changes dysrhythmia and
can inhibit leukocyte Pain/redness/swelling at the weakness).
infiltration at the site Contraindication injection site Assess for
Functional Class: of inflammation, interfere with Hypersensitivity hypertension, edema
Corticosteroid mediators of inflammatory Hypokalemia/hypocalcemia Adverse effect and cardiac symptoms.
hormone response, and suppress Systemic fungal infections Hypertension Assess for mental
humoral immune responses. Latent or active TB Mental disorders status.
Chemical Class: The anti-inflammatory actions Herpes simplex Ulcer disease Rotate sites in
of corticosteroids are thought Latent or active peptic Exacerbation, pancreatitis; IM injection.
Anti-inflammatory to involve phospholipaseA2 ulcer Glucose tolerance disorders
steroid inhibitory proteins, lipocortins, Osteoporosis Glucose serum level elevation Patient teaching
which control the biosynthesis Hypertension Cushing-like syndrome, Increase potassium,
of potent mediators Avoid live virus vaccines Amenorrhea, calcium and protein
of inflammation such as Rash, contact intake.
prostaglandins and Do not discontinue
leukotrienes. suddenly (can
precipitate adrenal
crisis).
Avoid OTC products
unless cleared with
prescriber.
Methylprednisolone ca
n pass into breast milk
and may harm a nursing
baby.
Educate on symptoms
of adrenal insufficiency.