Drug study

DRUG Classificati Mechanism of Indication Dosage Adverse Nursing Responsibilities

(Brand on action (Recommend Reactions
name and ed and
Generic Actual)
name)
Generic name: Pharmacologic Blocks stimulation Hypertensive Recommended CNS: fatigue, ● Monitor ECG and vital signs,
Labetalol class: Beta- of beta1- and crisis dose: asthenia, dizziness, especially blood pressure.
adrenergic beta2- adrenergic paresthesia,
Brand name: blocker receptor sites and : Initially, 20 mg drowsiness, ● Assess cardiovascular,
Normodyne (nonselective), alpha1- I.V. bolus over 2 insomnia, memory respiratory, and neurologic
Trandate alpha- adrenergic minutes, then loss, status closely to detect adverse
adrenergic receptors, I.V. injection of CV: orthostatic reactions.
blocker decreasing 40 to 80 mg q 10 hypotension,
(selective) myocardial minutes until peripheral ● Monitor CBC, blood glucose
contractile force blood pressure vasoconstriction, level, and liver function tests.
Therapeutic and enhancing falls to desired bradycardia,
class: coronary artery level arrhythmias, heart ●Instruct patient to
Antihypertensi blood flow and failure immediately report adverse
ve myocardial Actual dose: EENT: blurred vision, reactions, such as easy bruising
perfusion. Net dry eyes, or bleeding or respiratory
effect is decreased 1st dose: 10 mg GI: nausea, diarrhea, problems.
heart rate and 2nd dose: 20mg GU: erectile
blood pressure. dysfunction, ● Tell patient and the family
decreased libido that he may feel dizzy when
Hematologic: starting therapy.
purpura,
agranulocytosis, ● Monitor BP at 5 min intervals
thrombocytopenia for 30 min after IV
Metabolic: administration; then at 30 min
hyperglycemia, intervals for 2 h; then hourly
hypoglycemia for about 6 h; and as indicated
Skin: rash, pruritus thereafter.
● Maintain patient in supine
position for at least 3 h after IV
administration. Then determine
patient's ability to tolerate
elevated and upright positions
before allowing ambulation.
Manage this slowly.

● Make all position changes

slowly and in stages,
particularly from lying to
upright position. 

References:
McGraw-Hill, Nurse’s Drug
Handbook; 7th edition

Labetalol hydrochloride. (n.d.).

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 DRUG Classification Mechanism Indication Dosage Adverse Nursing
(Brand of action (Recommend Reactions Responsibilities
name and ed and
Generic Actual)
name)
Generic name: Pharmacologic Converts ➣ Acute Recommended CNS: cerebral ● Monitor vital signs, ECG,
Alteplase class: plasminogen to ischemic dose: hemorrhage, and neurologic status.
(tissue Plasminogen plasmin, which cerebrovascular cerebral edema,
plasminogen activator in turn breaks accident (CVA) 0.9 mg/kg I.V. CVA (with ● Maintain strict bed rest.
activator, down fibrin and over 1 hour, to a accelerated
recombinant) Therapeutic class: fibrinogen, maximum dosage infusion) ● Monitor for S&S of excess
Thrombolytic thereby of 90 mg, with CV: hypotension, bleeding q15min for the first
Brand name: dissolving 10% of total bradycardia, hour of therapy, q30min for
Cathflo thrombus. dosage given as recurrent ischemia, second to eighth hour, then
Activase I.V. bolus within pericardial effusion, q8h. Monitor neurological
first minute pericarditis, mitral checks throughout drug
regurgitation, infusion q30min and qh for
electromechanical the first 8 h after infusion.
dissociation,
arrhythmias, ● Monitor patient on
cardiogenic shock, Cathflo Activase for GI
heart failure, cardiac bleeding, venous
arrest, cardiac thrombosis, and sepsis.
tamponade,
myocardial rupture, ● Protect patient from
embolization, invasive procedures because
venous thrombosis spontaneous bleeding
GI: nausea, occurs twice as often with
vomiting, GI alteplase as with heparin.
bleeding IM injections are
GU: GU tract contraindicated. Also
bleeding prevent physical
Hematologic: manipulation of patient
spontaneous during thrombolytic therapy
bleeding, bone to prevent bruising.
marrow depression
Respiratory: ● Monitor Lab tests:
pulmonary edema Coagulation tests including
Skin: bruising, APTT, bleeding time, PT, TT,
flushing INR, must be done before
Other bleeding at administration of drug. Also
I.V., hypersensitivity check baseline Hct, Hgb, and
reaction (including platelet counts, in case of
rash, anaphylactic bleeding. Draw Hct
reaction, laryngeal following drug
edema), sepsis administration to detect
possible blood loss.

● Stop therapy immediately

if dysrhythmias occur.

● Report to attending
Physician if signs of
bleeding: gum bleeding,
epistaxis, hematoma,
spontaneous ecchymoses,
oozing at catheter site,
increased pain from internal
bleeding. Stop the infusion,
then resume when bleeding
stops.

● Use the radial artery to

draw ABGs. Pressure to
puncture sites, if necessary,
should be maintained for up
to 30 min.
● Continue monitoring vital
signs until laboratory
reports confirm
anticoagulant control;
patient is at risk for
postthrombolytic bleeding
for 2–4 d after intracoronary
alteplase treatment.

References:
McGraw-Hill, Nurse’s Drug
Handbook; 7th edition

Alteplase recombinant.
(n.d.).
https://robholland.com/Nur
sing/Drug_Guide/data/mon
ographframes/A033.htm
 DRUG Classificati Mechanism of Indication Dosage Adverse Nursing
(Brand on action (Recommended Reactions Responsibilities
name and and Actual)
Generic
name)
Generic name: Pharmacologic Inhibits calcium Short-term Recommended doses: CNS: dizziness, ● Establish baseline data
nicardipine class: Calcium transport into treatment of headache, before treatment is
hydrochloride channel myocardial and hypertension Continuous I.V. asthenia, started including BP,
blocker vascular smooth when oral infusion of 0.5 mg/hour drowsiness, pulse, and lab values of
brand name: muscle cells, causing therapy isn’t (equal to 20 mg P.O. q paresthesia liver and kidney function.
Cardene IV Therapeutic cardiac output and feasible or 8 hours), or 1.2 CV: hypotension,
class: myocardial desirable mg/hour (equal to 30 peripheral edema, ● Monitor BP during
Antianginal, contractions to mg P.O. q 8 hours), or chest pain, initiation and titration of
antihypertensi decrease. 2.2 mg/hour (equal to increased angina, dosage carefully.
ve 40 mg P.O. q 8 hours) palpitations, Hypotension with or
tachycardia without an increase in
GI: nausea, heart rate may occur,
dyspepsia, especially in patients who
Skin: flushing are hypertensive or who
are already taking
antihypertensive
medication.

● Avoid too rapid

reduction in either
systolic or diastolic
pressure during
parenteral
administration.

● Discontinue IV infusion
if hypotension or
tachycardia develop.
● Observe for large peak
and trough differences in
BP. Initially, measure BP
at peak effect (1–2 h
after dosing) and at
trough effect (8 h after
dosing).

● Inform the family to

notify physician if any of
the following occur:
Irregular heart beat,
shortness of breath,
swelling of the feet,
pronounced dizziness,
nausea, or drop in BP.

References:
McGraw-Hill, Nurse’s
Drug Handbook; 7th
edition

Nicardipine
hydrochloride. (n.d.).
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Holland's Personal
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