Ericka Ann H.

Boniquit BSN 3A – Group 3 November 07, 2024 BGHMC Medical Ward

DRUG CLASSIFFICATION INDICATION NURSING RESPONSIBILITIES

• Confirm the patient is not pregnant, if yes, do not

administer; breastfeeding women are advised to avoid
breastfeeding while taking the drug.
• Monitor patient’s blood pressure closely.
- Antihypertensive
Valsartan - Hypertension • Assess potassium level, monitor if there is muscle
- Angiotensin Receptor Blocker
weakness, numbness, and/or arrythmia—signs of
hyperkalemia.
• Educate the patient to immediately notify the nurse if
there is dizziness, nausea, and vomiting experienced.
• Observe hypersensitivity reaction (e.g. rashes, DOB)
and angioedema.
• Monitor patient’s blood pressure before and after
intake/administration.
- Antihypertensive - Hypertension
Losartan • Watch for signs of hyperkalemia such as muscle
- Angiotensin Receptor Blocker
weakness, numbness, and/or arrythmia.
• Instruct the patient to report dizziness and avoid
potassium supplements.
• Do not administer to pregnant women.
• Ask and monitor the patient for angina episodes.
• Closely monitor the patient's blood pressure.
- Antihypertensive - Hypertension
Amlodipine • Assess heart rate, and watch out for arrhythmia.
- Calcium Channel Blocker - Chronic stable angina pectoris
• Give sublingual nitroglycerin, as prescribed, if patient
has signs or symptoms of acute myocardial infarction.
• Confirm if there is no antihypertensive drug taken for at
- Antihypertensive least 1 week before administering.
- Hypertension
Captopril - Angiotensin-converting • Administer 1 hour before meal on empty stomach.
- Congestive Heart Failure
enzyme (ACE) Inhibitor • Closely monitor blood pressure, and watch out for signs
of hypotension including blurring vision, dizziness, etc.
Ericka Ann H. Boniquit BSN 3A – Group 3 November 07, 2024 BGHMC Medical Ward

• Inform the patient that dizziness, fainting, and light-

headedness usually disappear after the body adjusts to
drug.
• Take apical pulse for 1 full minute, if bradycardia or
tachycardia is noted, withhold dose and notify
- Antianginal, Anti-arrhythmic
- Hypertension prescriber
II
Propranolol - Angina pectoris • Do not administer as continuous IV.
- Beta-adrenergic blocker
- Arrythmia • Watch out for signs of hypoglycemia such as sweating,
(nonselective)
dizziness, confusion, etc.
• Inform the patient not to stop taking the drug suddenly.
• Closely monitor the patient's blood pressure and pulse
rate.
- Antihypertensive • Monitor for hypersensitivity reactions (e.g. dysphagia,
Carvedilol - Beta-adrenergic blocker - Hypertension DOB, rashes).
(nonselective) • Make sure the patient has eaten exactly as prescribed
before intake of the drug.
• Assess I&O.
• Observe bleeding symptoms like bruising, melena, or
gum bleeding.
- Recent Myocardial Infarction
- Antiplatelet • Monitor signs of hypovolemia / shock (low blood
Clopidogrel or Stroke
- Platelet aggregation inhibitor pressure, increased heart rate).
- Acute Coronary Syndrome
• Advise the patient to eat small, frequent meals or
chewing gum to minimize adverse GI effects.
• Do not administer to child or adolescent with
chickenpox or flu-like illness. (Reye’s synd.)
• Watch out for signs of bleeding (bruising, melena,
- Mild fever
- Antiplatelet hematuria, bleeding gums) as well as hypovolemic
- Mild pain
Aspirin - Antipyretic shock signs (increased tachycardia, hypotension).
- Post Myocardial Infarction /
- NSAID • Stay alert for signs and symptoms of acute toxicity,
Post stroke
such as diplopia (double vision).
• Gather all current medications as it may cause serious
interactions with many common medications.
Ericka Ann H. Boniquit BSN 3A – Group 3 November 07, 2024 BGHMC Medical Ward

• Monitor PT (Prothrombin Time) and INR (International

Normalized Ratio) tests.
• Observe any signs of bleeding (bruising, melena,
- Myocardial Infarction hematuria, bleeding gums) and hypovolemic shock
Warfarin - Anticoagulant - Venous thrombosis signs (increased tachycardia, hypotension).
- Atrial fibrillation • Advise patient to inform all other health care providers
(including dentist) that he is taking warfarin.
• Tell patient not to vary his intake of foods high in
vitamin K.

• Assess vital signs, particularly blood pressure.

• Closely monitor arterial blood gas values.
• In suspected overdose, assess for signs and symptoms
of increased ICP.
Isosorbide - Prophylaxis of angina pectoris
Mononitrate (ISMN)
- Antianginal
due to coronary artery disease • Teach patient to take oral drug 30 minutes before or 1
to 2 hours after a meal.
• Instruct patient to move slowly when sitting up or
standing, to avoid dizziness or light-headedness from
sudden blood pressure decrease.
• Do not administer to 18 years old and below.
• Instruct patient to avoid activities as this drug may
Trimetazidine - Coronary vasodilator - Angina pectoris cause dizziness, headache, and nausea.
• Monitor for tachycardia and extrapyramidal symptoms
(Parkinson's-like).
• Assess apical pulse regularly for 1 full minute. If rate is
less than 60 beats/ minute, withhold dose and notify
prescriber.
- Inotropic
- Heart failure • Monitor for signs of drug toxicity (nausea, vomiting,
Digoxin - Anti-arrhythmic
- Tachyarrhythmias visual disturbances, altered LOC).
- Cardiac glycoside
• Watch closely for hypokalemia (fatigue, muscle
weakness, etc.) and hypomagnesia (nausea, vomiting,
weakness, muscle twitches or tremors, etc.).
Ericka Ann H. Boniquit BSN 3A – Group 3 November 07, 2024 BGHMC Medical Ward

• Educate the patient about the side effects such as dark

colored stools, constipation, and stomach pain.
Ferrous Sulfate - Iron supplement - Iron-deficiency anemia • Monitor serum iron, total iron-binding capacity,
reticulocyte count, Hgb, ferritin.
• Assess nutritional and dietary history.
• Watch for hypersensitivity reactions like dysphagia,
- Folate deficiency rashes and DOB.
Folic Acid - Folate (B vitamin)
- Pregnancy • Assess for difficulty of breathing due to bronchospasm.
• Assess for GI disturbance such as constipation.
• Present the benefits of supplements.
• Monitor nutritional status.
Multivitamins - Vitamins - Vitamin deficiency
• Instruct the patient about the dosage and frequency of
multivitamins as prescribed.
• Present the benefits of supplements.
- B-complex deficiency • Monitor nutritional status.
Vit B Complex - Vitamins • Instruct the patient about the dosage and frequency of
vitamin b-complex as prescribed.

• During infusion via I.V., do not exceed a rate of 200

mg/minute.
- Dietary supplement - Hypocalcemia • Administer P.O. doses 1 to 1 ½ hours after meals.
Calcium Carbonate - Electrolyte replacement - Cardiac arrest • Monitor calcium levels frequently, especially in elderly
- Mineral - Magnesium intoxication patients.
• Advise the patient to consume plenty of milk and dairy
products during therapy.
• Since it is classified as a high-alert drug, write a note
that is visible at bedside.
• Give I.V. form as additive by infusion only. Never give
- Electrolyte replacement
Potassium Chloride - Hypokalemia undiluted or by I.V. push or I.M. route.
- Mineral
• Be aware that the maximum infusion rate without
cardiac monitoring is 20 mEq/hour. Rates above 20
mEq/hour require cardiac monitoring.
Ericka Ann H. Boniquit BSN 3A – Group 3 November 07, 2024 BGHMC Medical Ward

• Assess vital signs and ECG. Stay alert for arrhythmias.

• Monitor renal function, fluid I&O, and potassium,
creatinine, and blood urea nitrogen levels.
• Monitor neurologic status.
• Monitor site of IV for irritation.
• Avoid rapid infusion as it may cause tetany.
• Closely monitor ABG results.
• Assess and monitor I&O.
- Alkalinizing Agent - Metabolic acidosis
Sodium Bicarbonate
- Antacid - Acid • Advise the patient not to take oral form with milk.
• Stay alert for signs and symptoms of metabolic
alkalosis (dizziness or lightheadedness, nausea and
vomiting, hypoventilation, paresthesia, etc.)
• Ask the patient if there are existing conditions such as
asthma, if yes, do not administer.
- Cough (productive and non-
Butamirate - Antitussive • Instruct patient about side effects such as drowsiness.
productive)
• Take the history of coughing.
• Assess respiration of the patient.
• Monitor respirations, cough, and ask the patient to
describe the character of secretions.
- Cough (productive)
• Instruct the patient to report worsening cough and other
Acetylcysteine - Mucolytic - Chronic bronchopulmonary
respiratory symptoms.
diseases
• Monitor for common GI adverse reactions like nausea,
vomiting, and diarrhea.
• Know that I.V. or I.M. injection is given when a patient
requires rapid onset of diuresis.
• Be aware that I.V. dose may be given by direct injection
over 1 to 2 minutes.
- Acute pulmonary edema
Furosemide - Loop Diuretic • For I.V. infusion, dilute in dextrose % in water, normal
- Edema caused by heart failure
saline solution, or lactated Ringer’s solution.
• Don’t infuse more than 4 mg/minute.
• Monitor blood pressure, pulse, fluid intake and output,
and weight.
Ericka Ann H. Boniquit BSN 3A – Group 3 November 07, 2024 BGHMC Medical Ward

• Watch for signs and symptoms of hypokalemia (fatigue,

muscle weakness, etc.).
• Monitor electrolyte levels (especially potassium),
particularly in patients with severe heart failure.
• Monitor signs of hyperkalemia (muscle weakness,
- Edema caused by heart failure
Spironolactone - Potassium-sparing Diuretic numbness, arrythmia).
- Hypokalemia
• Monitor weight and I&O.
• Educate the patient not to increase potassium-
containing foods in their diet.
• Monitor for signs and symptoms of allergic response.
- Controlling LDL • Inform the patient that it can be taken with or without a
Atorvastatin - Lipid-lowering agent - Increased Cholesterol levels meal.
(LDL) • Educate the patient about a healthy diet, particularly
foods high in mono/polyunsaturated fats.
• Reconstitute drug in vial with sterile water for
injection.
- Moderate to severe infection • Monitor patient for life-threatening adverse effects,
- Gonorrhea including anaphylaxis.
Cefuroxime - Antibiotic
- Bacterial meningitis • Advise patient to immediately report rash or bleeding
- Ottis media tendency.
• Ensure and instruct that the antibiotic must be taken
within prescribed days.
• Observe signs of allergic reaction (hives, DOB,
swelling of face and lips)
- Hypocalcemia • Watch out for adverse reactions such as dysphagia and
Sevelamer - Phosphate binder
- Chronic Kidney Disease black tarry stool.
• Instruct the patient to notify nurses for any GI
disturbances.
• Watch for adverse GI reactions.
Lactulose - Laxative - Constipation • Ask the stool’s frequency and let the patient describe
the characteristic.
Ericka Ann H. Boniquit BSN 3A – Group 3 November 07, 2024 BGHMC Medical Ward

• Tell patient drug may cause flatulence and intestinal

cramps at first, but these symptoms usually subside.
• Encourage increased fluid intake and monitor for
dehydration signs.
• Check for abdominal pain, emesis, diarrhea, or
constipation.
- GERD
- Antiulcer • Evaluate fluid intake and output.
Omeprazole - Gastric ulcer
- Proton pump inhibitor
- Frequent heartburn • Monitor magnesium level before starting drug and
periodically thereafter in patients expected to be on
long-term treatment.
• Monitor temperature.
• Monitor liver function tests such as ALT, AST, alkaline
phosphatase, and bilirubin.
- Primary biliary cholangitis
Ursodeoxycholic - Naturally-occurring bile acid • Watch for GI disturbances like nausea, diarrhea, and
- Gallstones
indigestion.
• Instruct the patient to immediately report bladder pain,
dysuria, or hematuria.