Drug Name Dosage and Classification and Indication Contraindication Adverse Effect Nursing Considerations

Frequency Mode of Action

Generic Name: 25 mg/tab Classification: Diagnosis and Contraindicated CNS: Dizziness, Assessment
Spironolactone OD maintenance of with allergy to headache, drowsiness,
Potassium-sparing primary spironolactone, fatigue, ataxia, History: Allergy to
Brand Name: diuretic hyperaldosteronism hyperkalemia, confusion spironolactone;
Aldactone renal disease, hyperkalemia; renal
Adjunctive therapy in anuria, amiloride Dermatologic: Rash, disease; pregnancy,
Aldosterone or triamterene
antagonist edema associated urticaria lactation
with CHF, nephrotic use.
syndrome, hepatic GI: Cramping, Physical: Skin color,
MOA: cirrhosis when other Use cautiously diarrhea, dry mouth, lesions, edema; orientation,
therapies are with pregnancy, thirst, vomiting. reflexes, muscle strength;
Competitively inadequate or lactation. P, baseline ECG, BP; R,
blocks the effects inappropriate pattern, adventitious
of aldosterone in GU: Impotence,
irregular menses, sounds; liver evaluation,
the renal tubule, Treatment of bowel sounds; urinary
causing loss of amenorrhea,
hypokalemia or postmenopausal output patterns, menstrual
sodium and water prevention of cycle; CBC, serum
and retention of bleeding
hypokalemia in electrolytes, renal function
potassium. patients who would tests, urinalysis
be at high risk if Hematologic:
hypokalemia Hyperkalemia,
hyponatremia, Interventions
occurred: Digitalized
patients, patients agranulocytosis
with cardiac Mark calendars of edema
arrhythmias Other: Carcinogenic outpatients as reminders of
in animals, deepening alternate day or 3- to 5-
of the voice, hirsutism, day/wk therapy.
Essential
hypertension, usually gynecomastia
in combination with Give daily doses early so
other drugs that increased urination
does not interfere with
sleep.
Unlabeled uses:
Treatment of
hirsutism due to its Make suspension as follows:
antiandrogenic Tablets may be pulverized
properties, palliation and given in cherry syrup
of symptoms of PMS, for young children. This
treatment of familial suspension is stable for 1
male precocious mo if refrigerated.
puberty, short-term
treatment of acne Measure and record regular
vulgaris weight to monitor
mobilization of edema fluid.

Avoid giving food rich in

potassium.
Arrange for regular
evaluation of serum
electrolytes, BUN.

Teaching points

Record alternate-day
therapy on a calendar, or
prepare dated envelopes.
Take the drug early
because of increased
urination.

Weigh yourself on a regular

basis, at the same time and
in the same clothing, and
record the weight on your
calendar.

Avoid foods that are rich in

potassium (fruits, Sanka);
avoid licorice.

You may experience these

side effects: Increased
volume and frequency of
urination; dizziness,
confusion, feeling faint on
arising, drowsiness (avoid
rapid position changes,
hazardous activities:
driving, using alcohol);
increased thirst (suck on
sugarless lozenges; use
frequent mouth care);
changes in menstrual cycle,
deepening of the voice,
impotence, enlargement of
the breasts can occur
(reversible).

Report weight change of

more than 3 pounds in one
day, swelling in your ankles
or fingers, dizziness,
trembling, numbness,
fatigue, enlargement of
breasts, deepening of
 voice, impotence, muscle
weakness or cramps.
Generic Name: Given as 1 spray Classification: Management of Inhalation CNS: Headache, Assessment
in each nostril symptoms of dizziness, lethargy,
Budesonide morning and Corticosteroid seasonal or perennial Contraindicated fatigue, paresthesias, History: Untreated local
evening. allergic rhinitis in with nervousness nasal infections, nasal
Brand Name: adults and children; hypersensitivity to trauma, septal ulcers,
MOA: nonallergic perennial drug or for relief of Dermatologic: Rash, recent nasal surgery,
Symbicort rhinitis in adults acute asthma or edema, pruritus, lactation
Anti-inflammatory bronchospasm. alopecia
effect; local Turbuhaler
administration into Physical: BP, P,
nasal passages Use cautiously Endocrine: HPA auscultation; R,
maximizes Maintenance with TB, systemic suppression, Cushing's adventitious sounds;
beneficial effects treatment of asthma infections, syndrome with examination of nares
on these tissues, as prophylactic lactation. overdosage and
while decreasing therapy in adults and systemic absorption Interventions
the likelihood of children > 6 yr and Oral
adverse effects for patients requiring GI: Nausea,
corticosteroids for Inhalation
from systemic Contraindicated dyspepsia, dry mouth
absorption. asthma
with WARNING: Taper systemic
hypersensitivity to Local: Nasal irritation, steroids carefully during
Inhalation drug, lactation. fungal infection
suspension transfer to inhalational
steroids; deaths from
Use cautiously Respiratory: adrenal insufficiency have
Maintenance with TB, Epistaxis, rebound occurred.
treatment and hypertension, congestion,
prophylaxis therapy diabetes mellitus, pharyngitis, cough
of asthma in children Arrange for use of
osteoporosis, decongestant nose drops to
12 mo–8 yr peptic ulcer Other: Chest pain, facilitate penetration if
disease, asthenia, moon face, edema, excessive
Oral glaucoma, acne, bruising, back secretions are present.
cataracts, family pain
Treatment of mild to history of diabetes
or glaucoma, Prime unit before use for
moderate active Pulmicort Turbuhaler; have
Crohn's disease other conditions in
which patient rinse mouth after
involving the ileum or each use.
ascending colon glucocorticosteroi
ds may have
unwanted effects. Use aerosol within 6 mo of
opening. Shake well before
Nasal each use.

Contraindicated Store Respules upright and

with protected from light; gently
hypersensitivity to shake before use; open
drug, nasal envelopes should be
infections, nasal
trauma, nasal discarded after 2 wk.
septal ulcers,
recent nasal Oral
surgery.
Make sure patient does not
Use cautiously cut, crush, or chew
with lactation, TB, capsules; they must be
systemic infection. swallowed whole.

Administer the drug once

each day, in the morning;
do not administer with
grapefruit juice.

Encourage patient to
complete full 8 wk of drug
therapy.

WARNING: Monitor patient

for signs of hypercorticism
—acne, bruising, moon
face, swollen ankles,
hirsutism, skin striae,
buffalo hump—which could
indicate need to decrease
dosage.

Teaching points

Inhalation

Do not use more often than

prescribed; do not stop
without consulting your
health care provider.

It may take several days to

achieve good effects; do
not stop if effects are not
immediate.

Use decongestant nose

drops first if nasal passages
are blocked.

Prime unit before use for

Pulmicort Turbuhaler; rinse
mouth after each use.

Store Respules upright,

protect from light; discard
open envelopes after 2
weeks; gently shake before
use.

You may experience these

side effects: Local irritation
(use your device correctly),
dry mouth (suck sugarless
lozenges).

Report sore mouth, sore

throat, worsening of
symptoms, severe
sneezing, exposure to
chickenpox or measles, eye
infections.

Oral

Take the drug once a day in

the morning. Do not cut,
crush, or chew the
capsules, they must be
swallowed whole.

If you miss a day, take the

capsules as soon as you
remember them. Take the
next day's capsules at the
regular time. Do not take
more than three capsules in
a day.

Take the full course of the

drug therapy (8 weeks in
most cases).

Do not take this drug with

grapefruit juice; avoid
grapefruit juice entirely
while using this drug.
 Store Respules upright,
protected from light;
discard open envelopes
after 2 weeks. Shake before
use.

You may experience these

side effects: Dizziness,
headache (avoid driving or
operating dangerous
machinery if these effects
occur); nausea, flatulence
(frequent small meals may
help; try to maintain your
fluid and food intake).

Report chest pain, ankle

swelling, respiratory
infections, increased
bruising.

Generic Name: 20 mg/tab Classification: Adjunct to diet in the Contraindicated CNS: Headache, Assessment
OD treatment of elevated with allergy to asthenia, sleep
Simvastatin Antihyperlipidemic total cholestrol and simvastatin, disturbances History: Allergy to
LDL cholesterol with fungal byproducts, simvastatin, fungal
Brand Name: primary pregnancy, GI: Flatulence, byproducts; impaired
MOA: hypercholesterolemia lactation. diarrhea, abdominal hepatic function;
Zocor (types IIa and IIb) in pain, cramps, pregnancy; lactation
Inhibits HMG-CoA those unresponsive Use cautiously constipation, nausea,
reductase, the to dietary restriction with impaired dyspepsia, heartburn,
enzyme that of saturated fat and Physical: Orientation,
hepatic and renal liver failure affect; liver evaluation,
catalyzes the first cholesterol and other function,
step in the nonpharmacologic abdominal examination;
cataracts. Respiratory: lipid studies, LFTs
cholesterol measures
synthesis pathway, Sinusitis, pharyngitis
resulting in a To reduce the risk of Interventions
decrease in serum coronary disease, Other:
cholesterol, serum mortality, and CV Rhabdomyolysis, Ensure that patient has
LDLs, and either events, including acute renal failure, tried a cholesterol-lowering
an increase or no stroke, TIA, MI and arthralgia, myalgia diet regimen for 3–6 mo
change in serum reduction in need for before beginning therapy.
HDLs. bypass surgery and
angionplasty in Give in the evening;
patients with highest rates of cholesterol
coronary heart synthesis are between
disease and
hypercholesterolemia
Treatment of patients midnight and 5 AM.
with isolated
hypertriglyceridemia Advise patient that this
drug cannot be taken
Treatment of type III during pregnancy; advise
hyperlipoproteinemia patient to use barrier
contraceptives.
Treatment of
adolescents 10-17 yr Arrange for regular follow-
with heterozygous up during long-term
familial therapy. Consider reducing
hypercholesterolemia dose if cholesterol falls
below target.

Teaching points

Take drug in the evening.

Do not drink grapefruit
juice while using this drug.

Have periodic blood tests.

This drug cannot be taken

during pregnancy; using
barrier contraceptives is
recommended.

You may experience these

side effects: Nausea (eat
frequent small meals);
headache, muscle and joint
aches and pains (may
lessen); sensitivity to light
(use a suncreen and wear
protective clothing).

Report severe GI upset,

changes in vision, unusual
bleeding or bruising, dark
urine or light-colored stools,
fever, muscle pain, or
soreness.