JERALD SILVA OLALO,RN

DRUG ORDER MECHANISM OF ACTION

RENAL UNIT
INDICATION CONTRAINDICATIONS ADVERSE EFFECT NURSING RESPONSIBILITIES Assess pt allergies to drugs and medications Observe the ten rights of the pt Asssespt V/s esp BP Not for use in patients with uncontrolled hypertension; control BP adequately before initiation of therapy. Inform patients of the need to have regular laboratory tests for Hgb Monitor for any sever adverse effects and report to the doctor

Generic name Erythropoietin

Stmulates the division and differentiation of Brand name committed red blood cells Epogen, Procrit, progenitors in the bone Eprex marrow

Anemiawith chronic kidney failure in patients who are or will be receiving renal dialysis

Uncontrolled hypertension; pure red cell aplasia (PRCA) that begins after treatment with epoetinalfa or other erythropoietin protein drugs; serious allergic reactions to epoetinalfa

pain or burning at the site of the injection Hypertension Headache Dizziness Pruritus Nausea and vomitting

Classification Biologic Response Modifier Route SC Dosage 400mg Frequency 2x a day Source:http://www.medi cinenet.com/epoetin_alfa /article.htm

DRUG ORDER

MECHANISM OF ACTION

INDICATION

CONTRAINDICATIONS

ADVERSE EFFECT

NURSING RESPONSIBILITIES

Generic name Nifedipine Brand name Adalat

Classification Calcium Channel Blocker(AntiHypertensive) Route OD Dosage 300 mg Frequency pc lunch

Thought toinhibit calciumion influx acrosscardiac andsmooth-musclecells, decreasingcontractility andoxygendemand. Alsomay dilate coronary arteries andarteriole

Vasospasticangi na, classicchronic stableangina pectoris Hypertension

Contraindicated inpatientshypersensitive todrug Use cautiously inpatients with heartfailure orhypotension and inelderly patients. Useextendedreleasetablets cautiously inpatients with severeGI narrowing

Source: LippincotsNursingDrug Guide, 2009

Dizziness, lightDont giveimmediate-releaseform headedness,head within 1 week of acute MI or in ache,weaknessper acutecoronary syndrome ipheraledema, flushing,nausea,S Alert: yncope,nervousne Despitethe previouslywidespread SL ss,hypotension,pa usenifedipine capsule,avoid this lpitations,nasal route of administration.Excessive congestion,diarrh hypotension,MI, and death mayresult ea,constipation,ab dominaldiscomfort Monitor bloodpressure ,muscle regularly,especially in patientswho cramps,dyspnea,p take beta blockersor antihypertensive ulmonaryedema, cough,rash, Watch forsymptoms of heartfailure puritus

DRUG ORDER Generic name Nimodipine

MECHANISM OF ACTION

INDICATION >Angina Pectoris dueto coronary arteryspasm >Chronic unstableangina >SR preparation only: Treatment of hypertension.

CONTRAINDICATIONS Contraindicated inpatients who areallergic to nifedipine

ADVERSE EFFECT CNS: headache,astheni a, dizziness,fatigue, nervousness,slee p disturbances. CV: peripheral edema,angina, hypotension,arrhy thmias, AV block,asystole Dermatologic: Flushing, rash,pruritus, dermatitis GI: nausea,Constipati on, diarrhea,cramps, flatulence

NURSING RESPONSIBILITIES >Assess the history of allergies to nifedipine and also pregnancy and lactation >Assess physical: weight, temperature, skin color, lesions, mucous membranes, perfusion, and edema. IPPA >Monitor patients Blood Pressure and cardiac input and output carefully. >Ensure that patient does not chew or divide sustained-release of tablet >Taper dosage for beta blockers before nifedipine therapy Monitor BP carefully during titration period. Patient may become severely hypotensive, especially if also taking other drugs known to lower BP. Withhold drug and notify physician if systolic BP <90. Monitor blood sugar in diabetic patients. Nifedipine has diabetogenic properties. Monitor for gingival hyperplasia and report promptly. This is a rare but serious adverse effect (similar to phenytoin-induced hyperplasia).

Inhibits the movementof calcium ions acrossthe membranes of cardiac Brand name and arterialmuscle cells, Adalat CC, Adalat inhibitionof XL(CAN), Apo- transmembranecalcium Nifed(CAN), flow results inthe NifedicalXL, depression of impulse Procardia formation inspecialized cardiacpacemaker cells, Classification inslowing of the Anti-hypertensive velocityof the conduction of the cardiac muscleimpulse, Route in thedepression of the nasogastric of myocardial contractilityand in the dilation of coronary Dosage arteries,arterioles. 2 tabs30 mg Theseeffects lead todecreased Frequency cardiacwork, Q 4hours decreasedcardiac energyconsumption, andincreased delivery of oxygen to myocardialcells. SOURCE: Lippincots NursingDrug Guide, 2009