Metoprolol (Lopressor) Beta blocker

HydrALAZINE - vasodilators

Indications: Hypertension. Angina pectoris. Prevention of MI and

decreased mortality in patients with recent MI.
Action: Blocks stimulation of beta1(myocardial)-adrenergic receptors.

Indications: Moderate to severe hypertension (with a

diuretic).
Action: Direct-acting peripheral arteriolar vasodilator.

Adverse Reactions/Side Effects: CNS: fatigue, weakness, anxiety,

depression, dizziness, drowsiness, insomnia, memory loss, mental
status changes, nervousness, nightmares. EENT: blurred vision,
stuffy nose.Resp: bronchospasm,
wheezing. CV: BRADYCARDIA, HF, PULMONARY EDEMA, hypotension,
peripheral vasoconstriction. GI: constipation, diarrhea, drug-induced
hepatitis, dry mouth, flatulence, gastric pain, heartburn, liver
enzymes, nausea, vomiting. GU: erectile dysfunction, libido,
urinary frequency. Derm: rashes. Endo: hyperglycemia,
hypoglycemia.MS: arthralgia, back pain, joint pain. Misc: druginduced lupus syndrome.
Nursing Implications: Monitor BP, ECG, and pulse frequently during
dose adjustment and periodically during therapy. Monitor vital signs
and ECG every 515 min during and for several hours after
parenteral administration. If heart rate <40 bpm, especially if cardiac
output is also decreased, administer atropine 0.250.5 mg IV. Monitor
intake and output ratios and daily weights. Assess routinely for signs
and symptoms of HF (dyspnea, rales/crackles, weight gain,
peripheral edema, jugular venous distention). PO: Take apical pulse
before administering. If <50 bpm or if arrhythmia occurs, withhold
medication and notify health care professional.

Adverse Reactions/Side Effects: CNS: dizziness, drowsiness,

headache. CV: tachycardia, angina, arrhythmias, edema,
orthostatic hypotension. GI: diarrhea, nausea,
vomiting. Derm: rash. F and E sodium
retention. MS: arthralgias, arthritis. Neuro: peripheral
neuropathy. Misc: drug-induced lupus syndrome.

Nursing Implications: Monitor BP and pulse frequently during

initial dose adjustment and periodically during therapy. May
cause a positive direct Coombs test result. PO: Administer
with meals consistently to enhance absorption Emphasize the
importance of continuing to take this medication, even if
feeling well. Instruct patient to take medication at the same
time each day; last dose of the day should be taken at
bedtime. Take missed doses as soon as remembered; do not
double doses. If more than 2 doses in a row are missed,
consult health care professional. Must be discontinued
gradually to avoid sudden increase in BP. Hydralazine controls
but does not cure hypertension.

HYDROmorphone (Dilaudid)- opioid agonists

Indications: Moderate to severe pain (alone and in combination with
nonopioid analgesics);
Adverse Reactions/Side Effects: CNS: CNS: confusion, sedation,
dizziness, dysphoria, euphoria, floating feeling, hallucinations,
headache, unusual dreams. EENT: blurred vision, diplopia,
miosis. Resp: respiratory depression. CV: hypotension,
bradycardia. GI: constipation, dry mouth, nausea,
vomiting.GU: urinary retention. Derm: flushing,
sweating. Misc: physical dependence, psychological dependence,
tolerance.
Nursing Implications: Note baseline RR, rate, depth, rhythm, size of
pupils. 12 RR/min or less sign of toxicity. withhold drug contact AP.

Indications:
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Nursing implications:

Monitor VS at regular intervals, assess effectiveness 30 mins after

dose. Monitor bowel habits as may cause constipation.
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