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Zorpin

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Aspirin

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MI, Stroke (Risk Reduction) PO: ADULTS, ELDERLY: Durlaza: 162.5 mg once daily.

Revascularization PO: ADULTS, ELDERLY: 80–325 mg/day

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PHARMACOTHERAPEUTIC: Nonsteroidal salicylate

CLINICAL: Anti-inflammatory, antipyretic, anticoagulant

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Inhibits cyclo-oxygenase enzyme via acetylation. Inhibits formation of prostaglandin derivative thromboxane A.
Therapeutic Effect: Reduces inflammatory response, intensity of pain; decreases fever; inhibits platelet aggregation.

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Angina pectoris, angina pectoris prophylaxis, ankylosing spondylitis, cardiovascular risk reduction, colorectal cancer, fever, ischemic stroke. Ischemic stroke: Prophylaxis, myocardial infarction. Myocardial infarction: prophylaxis, osteoarthritis pain. Revascularization procedures: prophylaxis, rheumatoid arthritis, systemic lupus erythematosus

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Hypersensitivity to salicylates, NSAIDs. Aspirin triad (asthma, rhinitis [with or without nasal polyps], aspirin intolerance). Asthma, rhinitis, nasal polyps; inherited or acquired bleeding disorders
Cautions: Platelet/bleeding disorders, severe renal/hepatic impairment, dehydration, erosive gastritis, peptic ulcer disease, sensitivity to tartrazine dyes, elderly (chronic use of doses 325 mg or greater).

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Occasional: GI distress (including abdominal distention, cramping, heartburn, mild nausea); allergic reaction (including bronchospasm, pruritus, urticaria).

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High doses of aspirin may produce GI bleeding and/or gastric mucosal lesions. Dehydrated, febrile children may experience aspirin toxicity quickly. . Low-grade aspirin toxicity characterized by tinnitus, generalized pruritus (may be severe), headache, dizziness, flushing, tachycardia, hyperventilation, diaphoresis, thirst. Marked toxicity characterized by hyperthermia, restlessness, seizures, abnormal breathing patterns, respiratory failure, coma.

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Baseline assessment

Assess history of GI bleed, peptic ulcer disease, OTC use of products that may contain aspirin. Assess type, location, duration of pain, inflammation. Inspect appearance of affected joints for immobility, deformities, skin condition. Therapeutic serum level for antiarthritic effect: 20–30 mg/dL (toxicity occurs if level is greater than 30 mg/dL).

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Intervention/evaluation

Monitor urinary pH (sudden acidification, pH from 6.5 to 5.5, may result in toxicity). Assess skin for evidence of ecchymosis. If given as antipyretic, assess temperature directly before and 1 hr after giving medication. Evaluate for therapeutic response: relief of pain, stiffness, swelling; increased joint mobility; reduced joint tenderness; improved grip strength.

Patient/family teaching

Do not chew, crush, dissolve, or divide enteric-coated tablets.

Avoid alcohol, OTC pain/cold products that may contain aspirin.

Report ringing of the ears or persistent abdominal GI pain, bleeding.

Therapeutic anti-inflammatory effect noted in 1–3 wks.

Behavioral changes, persistent vomiting may be early signs of Reye’s syndrome; contact physician.

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Tenormin

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Tenormin

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Hypertension PO: ADULTS: Initially, 25–50 mg once daily. After 1–2 wks, may increase dose up to 100 mg once daily. ELDERLY: Usual initial dose, 25 mg/day.
Angina Pectoris

PO: ADULTS: Initially, 50 mg once daily. May increase dose up to 200 mg once daily. ELDERLY: Usual initial dose, 25 mg/day.

Post-MI PO: ADULTS: 100 mg once daily or 50 mg twice daily for 6–9 days post-MI.

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PHARMACOTHERAPEUTIC: Beta1 -adrenergic blocker.

CLINICAL: Antihypertensive, antianginal, antiarrhythmic

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Blocks beta1 -adrenergic receptors in cardiac tissue. Therapeutic Effect: Slows sinus node heart rate, decreasing cardiac output, B/P. Decreases myocardial oxygen demand.

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Hypertension, angina pectoris, acute myocardial infarction, alcohol withdrawal syndrome, and supraventricular arrhythmias

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Hypersensitivity to atenolol. Cardiogenic shock, uncompensated HF, second- or third-degree heart block (except with functioning pacemaker), sinus bradycardia, sinus node dysfunction, pulmonary edema. Cautions: Elderly, renal impairment, peripheral vascular disease, diabetes, thyroid disease, bronchospastic disease, compensated HF, myasthenia gravis, psychiatric disease, history of anaphylaxis to allergens, concurrent use with digoxin, verapamil, or diltiaZEM.

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Atenolol is generally well tolerated, with mild and transient side effects. Frequent: Hypotension manifested as cold extremities, constipation or diarrhea, diaphoresis, dizziness, fatigue, headache, nausea. Occasional: Insomnia, flatulence, urinary frequency, impotence or decreased libido, depression. Rare: Rash, arthralgia, myalgia, confusion (esp. in the elderly), altered taste.

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Overdose may produce profound bradycardia, hypotension. Abrupt withdrawal may result in diaphoresis, palpitations, headache, tremors. May precipitate HF, MI in pts with cardiac disease; thyroid storm in pts with thyrotoxicosis; peripheral ischemia in pts with existing peripheral vascular disease. Hypoglycemia may occur in previously controlled diabetes. Thrombocytopenia (unusual bruising, bleeding) occurs rarely. Antidote: Glucagon

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Baseline assessment

Assess B/P, apical pulse immediately before drug is administered (if pulse is 60/min or less, or systolic B/P is less than 90 mm Hg, withhold medication, contact physician). Antianginal: Record onset, quality (sharp, dull, squeezing), radiation, location, intensity, duration of anginal pain, precipitating factors (exertion, emotional stress). Assess baseline renal/hepatic function tests.

Intervention/evaluation

Monitor B/P for hypotension, pulse for bradycardia, respiration for difficulty in breathing, EKG. Monitor daily pattern of bowel activity, stool consistency. Assess for evidence of HF: dyspnea (particularly on exertion or lying down), nocturnal cough, peripheral edema, distended neck veins. Monitor I&O (increased weight, decreased urinary output may indicate HF). Assess extremities for pulse quality, changes in temperature (may indicate worsening peripheral vascular disease). Assist with ambulation if dizziness occurs.

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Patient/family teaching

Do not abruptly discontinue medication.

Compliance with therapy essential to control hypertension, angina.

To reduce hypotensive effects, go from lying to standing slowly.

Avoid tasks that require alertness, motor skills until response to drug is established. Advise diabetic pts to monitor blood glucose carefully (may mask signs of hypoglycemia).

Report dizziness, depression, confusion, rash, unusual bruising/bleeding.

Outpatients should monitor B/P, pulse before taking medication, following correct technique.

Restrict salt, alcohol intake.

Therapeutic antihypertensive effect noted in 1–2 wks.

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Bs, R. K. J., RPh, & Ccrn, H. K. R. B. (2020). Saunders Nursing Drug Handbook 2021, 1e (1st ed.). Saunders.

Bs, R. K. J., & Hodgson, K. (2019). Saunders Nursing Drug Handbook 2020 (1st ed.). Saunders.