Drug Study

DRUG NAME
GENERIC
NAME:
Omeprazole
BRAND NAME:
Prilosec,
Prilosec OTC,
Zegerid
(Original
Formulation)
, Omesec
DRUG
CLASSIFICATIO
N
Anti-Ulcer
Drugs
DOSAGE
40 mg
FREQUENCY:
OD
ROUTE:
Oral

MECHANISM
OF ACTION
Inhibits proton
pump activity by
binding to
hydrogen
potassium
adenosine
triphosphatase,
located at
secretory surface
of gastric
parietal cells to
suppress gastric
acid secretion

INDICATION
Erosive esophagitis

Duodenal ulcer
Frequent heart burn

CONTRAINDICA
TION
Contraindicated
in patients
hypersensitive to
drug or its
components
Use cautiously in
patients with
hypokalemia and
respiratory
alkalosis patients
on a low diet and
in breast feeding
women

ADVERSE
EFFECT
Abdominal
pain
Constipatio
n
Diarrhea
Flatulence
Nausea
Vomiting
Rash
Headache

NURSING
CONSIDERATION
Dosage adjustments
maybe necessary in
Asians and patients
with hepatic
impairment
Drug increases its
own bio availability
with repeated doses
Monitor patients for
signs and symptoms
of low magnesium

GENERIC
NAME:
Clopidogrel
BRAND NAME:
Plavix
DRUG
CLASSIFICATIO
N:
Adenosine
diphosphate
(ADP)
receptor
antagonist
Antiplatelet
Pregnancy
Category B
DOSAGE:
75 mg/tab
FREQUENCY:
OD
ROUTE:
Oral

Prevents blood
clots by
irreversibly
binding to the
P2Y12 receptor
on platelets,
preventing
adenosine
diphosphate
(ADP) from
activating
platelets. The
drug specifically
and irreversibly
inhibits the
P2Y12 subtype of
ADP receptor,
which is
important in
activation of
platelets and
eventual crosslinking by the
protein fibrin

This medication is an
anti-platelet agent, that
is, a drug that inhibits
the ability of platelets
to clump together as
part of a blood clot.
This medication is
prescribed either alone
or with other
medications for
prevention or treatment
of stroke and heart
attack (which are
usually caused by blood
clots) in persons who
are at high risk.

Plavix is
contraindicated
in patients with
active
pathological
bleeding such as
peptic ulcer or
intracranial
hemorrhage.
Hypersensitivity:
Plavix is
contraindicated
in patients with
hypersensitivity
(e.g.,
anaphylaxis) to
clopidogrel or
any component
of the product

Upper
respiratory
tract
infection
Chest pain
Headache
Flulike
syndrome
Arthralgia
Pain
Dizziness
Diarrhea
Rash
Rhinitis
Depression
Urinary
tract
infection

Assessment
History: Allergy
to clopidogrel,
pregnancy,
lactation,
bleeding
disorders, recent
surgery, hepatic
impairment,
peptic ulcer

Physical: Skin
color,
temperature,
lesions;
orientation,
reflexes, affect;
P, BP, orthostatic
BP, baseline
ECG, peripheral
perfusion; R,
adventitious
sounds

Interventions

Provide small,
frequent meals if
GI upset occurs
(not as common
as with aspirin).

GENERIC
NAME:
Atorvastati
n
BRAND
NAME:
Lipitor
DRUG
CLASSIFICATI
ON:
Antihyperli
pidemic,
HMG-CoA
reductase
inhibitor
Pregnancy
Category X
DOSAGE:
20 m/tab

Statins inhibit
cholesterol
synthesis in the
liver, significant
because most
circulating
cholesterol
comes from
internal
manufacture
rather than the
diet. As
cholesterol
synthesis occurs
mostly at night
during fasting,
statins with short
biologic half-lives
of activity are
taken at night to
maximize the

Therapy with lipidaltering agents should

be only one component
of multiple risk factor
intervention in
individuals at
significantly increased
risk for atherosclerotic
vascular disease due to
hypercholesterolemia.
Drug therapy is
indicated as an adjunct
to diet when the
response to a diet
restricted in saturated
fat and cholesterol and
other
nonpharmacologic
measures alone has
been inadequate.

Acute liver
disease or
unexplained
persistent
elevations of
serum
transaminases.

Muscle
pain,
tenderness,
or
weakness;
fever,
unusual
tiredness
dark
colored
urine
pain or
burning
when you
urinate
hunger
dry mouth,
fruity
breath
odor,
drowsiness,
dry skin

Provide comfort
measures and
arrange for
analgesics if
headache occurs.

Assessment

History: Allergy
to simvastatin,
fungal
byproducts;
impaired hepatic
function;
pregnancy;
lactation
Physical:
Orientation,
affect; liver
evaluation,
abdominal
examination;
lipid studies,
LFTs

Interventions
Ensure that

FREQUENCY:
20 mg/tab
ROUTE:
Oral

GENERIC
NAME:
Citicoline
BRAND
NAME:
Zynapse,
Somazina,

inhibitory effect.
Short-acting
simvastatin
taken at night
shows greater
LDL and total
cholesterol
reduction than if
taken in the
morning,
whereas there is
no such
difference for the
long-acting
atorvastatin.

Citicoline
increases blood
flow and O2
consumption in
the brain

nausea
loss of
appetite,
claycolored
stools,
jaundice

Citicoline is indicated in
CVD in acute recovery
phase in severe s/sx of
cerebrovascular
insufficiency and incranial traumatism and
their sequellae.
Citicoline in CVA,

Hypersensitivity
Unconsciousness
Brain surgery
Patient with tend
and hepatic
damage

Insomnia
Headache
Diarrhea
Low and
high blood
pressure
Nausea
Blurred

patient has tried

a cholesterollowering diet
regimen for 36
mo before
beginning
therapy.
Give in the
evening; highest
rates of
cholesterol
synthesis are
between
midnight and 5
AM.
Advise patient
that this drug
cannot be taken
during
pregnancy;
advise patient to
use barrier
contraceptives.
Monitor patients
neurologic status
Titer medication
when
discontinuing
Note if there are
slurring of
speech

Cholinerv

stimulates brain
function.

vision
Chest pain

DRUG
CLASSIFICATI
ON:
Psychostim
ulants
DOSAGE:
1 g/tab
FREQUENCY:
Every 12
hours (8am5pm)
ROUTE:
Oral
GENERIC NAME:
Amlodipine
BRAND NAME:
Norvasc
DRUG
CLASSIFICATION:
Calcium
channel-blocker
Antianginal
drug

Amlodipine
inhibits the
movement of
calcium ions into
vascular smooth
muscle cells and
cardiac muscle
cells.
Stable angina:
amlodipine
reduces the total

Angina pectoris
due to coronary
artery spasm
(Prinzmetals
variant angina)
Chronic stable
angina, alone or
in combination
with other agents

Contraindicated
with allergy to
amlodipine,
impaired hepatic
or renal function,
sick sinus
syndrome, heart
block (second or
third degree),
lactation.

Essential

Use cautiously

More common
Swelling of the
ankles or feet
Less common
Difficult or
labored
breathing
dizziness
fast, irregular,
pounding, or
racing

Assessment

History:
Allergy to
amlodipine,
impaired
hepatic or
renal function,
sick sinus
syndrome,
heart block,
lactation, CHF

Antihypertensi
ve
DOSAGE:
5 mg/tab
FREQUENCY:
OD
ROUTE:
Oral

peripheral
resistance
(afterload)
against which the
heart works and
reduces the rate
pressure product,
thereby lowering
myocardial
oxygen demand,
at any given level
of exercise.
Prinzmetal's
angina:
amlodipine
blocks spasm of
the coronary
arteries and
restores blood
flow in coronary
arteries and
arterioles in
response to
calcium,
potassium,epinep
hrine, serotonin,
and thromboxane
A2 analog in

hypertension,
alone or in
combination with
other
antihypertensives

with CHF,
pregnancy.

heartbeat or
pulse
feeling of
warmth
redness of the
face, neck,
arms, and
occasionally,
upper chest
shortness of
breath
tightness in
the chest
wheezing

Physical: Skin
lesions, color,
edema; P, BP,
baseline ECG,
peripheral
perfusion,
auscultation;
R,
adventitious
sounds; liver
evaluation, GI
normal output;
liver and renal
function tests,
urinalysis

Interventions
WARNING:
Monitor
patient
carefully (BP,
cardiac
rhythm, and
output) while
adjusting drug
to therapeutic
dose; use
special
caution if
patient has
CHF.


experimental
animal models
and in human
coronary

vessels in vitro.

BRAND
NAME:
Clonidine
Hydrochlori
de
DRUG
CLASSIFICATI
ON:

Alpha-adrenergic
agonist; also has
some alphaadrenergic
antagonist
effects.
Antihypertensive
:

CATAPRES tablets are

indicated in the
treatment of
hypertension.
CATAPRES tablets may
be employed alone or
concomitantly with
other antihypertensive

Contraindicated
with
hypersensitivity
to clonidine or
any adhesive
layer
components of
the transdermal
system.

tiredness
lethargy
drowsiness
constipatio
n
dry mouth
headache
dizziness
fatigue

Monitor BP
very carefully
if patient is
also on
nitrates.
Monitor
cardiac
rhythm
regularly
during
stabilization of
dosage and
periodically
during longterm therapy.
Administer
drug without
regard to
meals.

Assessment

History:
Hypersensitivity
to clonidine or
adhesive layer
components of
the transdermal
system; severe

ApoClonidine
(CAN)
Catapres
Dixarit
(CAN)
NovoClonidine
(CAN)
NuClonidine
(CAN)
DOSAGE:
75 mg/tab
FREQUENCY:
For sbp
160/100
ROUTE:
Sublingual

agents.
Thought to be
due to central
alpha 2adrenergic
stimulation,
which results in a
decreased
sympathetic
outflow to the
heart, kidneys,
and peripheral
vasculature; this
results in
decreased
peripheral
vascular
resistance,
decreased
systolic and
diastolic blood
pressure, and
decreased heart
rate.

weakness
Use cautiously
with severe
coronary
insufficiency,
recent MI,
cerebrovascular
disease; chronic
renal failure;

coronary
insufficiency,
recent MI,
cerebrovascular
disease; chronic
renal failure;

Physical: skin
color, lesions,
temperature;
mucous
membranes
color, lesion;
orientation,
affect, reflexes;
BP, orthostatic
BP, perfusion,
edema,
auscultation;
bowel sounds,
normal output,
liver evaluation,
palpation of
salivary glands;
normal urinary
output, voiding
pattern; liver
function tests,
ECG
Interventions

WARNING: Do
not discontinue
abruptly;
discontinue
therapy by
reducing the
dosage gradually
over 24 days to
avoid rebound
hypertension,
tachycardia,
flushing, nausea,
vomiting, cardiac
arrhythmias
Do not
discontinue prior
to surgery;
monitor BP
carefully during
surgery; have
other BPcontrolling drugs
readily available.
Monitor BP
carefully when
discontinuing
clonidine;
hypertension
usually returns
within 48 hr.
WARNING:

Remove
transdermal
patch before
defibrillation to
prevent arcing.

GENERIC
NAME:
Imidapril
BRAND
NAME:
Hipertene,
Tanatril,
Cardipril,
Norten,
Tanapress,
Vascor
DRUG
CLASSIFICATI
ON:
Ace
inhibitors/D
irect
reninin
inhibitors

A prodrug of
imidaprilat,
inhibits ACE from
converting
angiotensin I to
angiotension II (a
potent
vasoconstrictor)
resulting in
increased plasma
renin activity and
reduced
aldosterone (a
hormone that
causes water
and Na
retention)
secretion. This
promotes
vasodilation and
BP reduction. It

This medication is an
ACE inhibitor,
prescribed for high
blood pressure. It
prevents the formation
of angiotensin II
through that it
decreases blood
pressure.

Contraindicated
in patients with
narrowing of
blood vessels,
obstruction in
blood flow,
ascites, and
hypersensitivity.

Dry cough
Discomfort
of throat
Palpitation
Headache
Rash
Rare:

Hypertension
should be
managed
according to
appropriate

guidelines.
Treatment with an
ACE inhibitor can

Fatigue
Dizziness
Hot flush
Diarrhea
Nausea
Vomiting

be started in the
community in the
majority of people

with heart failure.

In patients taking
diuretics, close
supervision is
needed when
commencing

DOSAGE:
5 mg/tab

may also inhibit

he degradation
of bradykinin

treatment.
The initial dose of
ACE has a risk of
first-dose

FREQUENCY:
OD

hypotension,
therefore patients

ROUTE:
Oral

should be advised
to sit or lie down for

2-4 hours after this.

Evaluate
therapeutic
response.