DRUG STUDY - LOSARTAN POTASSIUM | METOPROLOL by Mary Joy Garcia https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh The management of clients with myocardial infarction considers pharmacologic area an important aspect. Having a sufficient knowledge of the commonly administered medications in terms of classifications, actions, indications, and relevant nursing considerations is essential. en-us 2021-09-13 13:08:10 UTC 2021-09-14 23:48:51 UTC hello@padlet.com https://padlet.net/icons/png/1f48a.png garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1735994485 2021-09-13 13:12:35 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1735994485 Stock Dosage garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1735997572 Tablets:
 25 mg, 50 mg, 100 mg

Hypertension
  • Adults: Initially, 50 mg/day P.O.; range is 25 to 100 mg/day as a single dose or in two divided doses. May be used alone or with other drugs.
  • Children ages 6 and older: 0.7 mg/kg P.O. daily, up to total of 50 mg
 
To prevent cerebrovascular accident (stroke) in hypertensive patients with left ventricular hypertrophy (LVH)
  • Adults: Initially, 50 mg P.O. daily, increased to 100 mg P.O. daily. May be given concurrently with hydrochlorothiazide.
]]> 2021-09-13 13:13:29 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1735997572 garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736001886 2021-09-13 13:14:39 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736001886 Generic Name garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736016860 Losartan Potassium]]> 2021-09-13 13:18:32 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736016860 Brand Name garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736017253 Cozaar]]> 2021-09-13 13:18:39 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736017253 Classification garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736017917 Pharmacologic Class: Angiotensin II receptor antagonist
 
Therapeutic Class: Antihypertensive
 
Pregnancy Risk: Category C (first trimester), D (second and third trimesters)
]]> 2021-09-13 13:18:51 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736017917 Mechanism of Action garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736018358 Blocks vasoconstricting and aldosterone-secreting effects of angiotensin II at various receptor sites,including vascular smooth muscle and adrenal glands. 

Therapeutic  Effect:  causes vasodilation, decreases peripheral resistance, decreases B/P
]]> 2021-09-13 13:18:59 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736018358 Indication/s garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736018771
  • Hypertension
  • Stroke Prevention (Hypertension with Left Ventricular Hypertrophy)
    • ]]>     2021-09-13 13:19:05 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736018771     Contraindications garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736019233
  • Hypersensitivity to drug or its components
  • Pregnancy (second and third trimesters)
  • Concomitant use of aliskiren in patients with diabetes.
  • Renal/hepatic impairment, unstented renal arterial stenosis,  significant  aortic/mitral  stenosis.
  • Concurrent  use  of  potassium supplements.
  • Patients with history of angioedema
    • ]]>     2021-09-13 13:19:13 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736019233     Side Effects and Adverse Effects garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736019633 Side Effects:
    • Frequent  (8%):  Upper  respiratory  tract  infection. 
    • Occasional  (4%–2%): Dizziness, diarrhea, cough. 
    • Rare (1% or less): Insomnia, dyspepsia, heartburn,back/leg pain, muscle cramps, myalgia, nasal congestion, sinusitis, depression.

    Adverse Effects:
    • Hypotension
    • Tachycardia
    ]]>     2021-09-13 13:19:20 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736019633     Nursing Responsibilities garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736019956 Baseline Assessment:
    • Obtain B/P, apical pulse immediately before each dose, in addition to regular monitoring  (be  alert  to  fluctuations).  
    • Question  for  possibility  of  pregnancy.
    • Assess medication history (esp. diuretics).

    Intervention/Evaluation:
    • Maintain  hydration  (offer  fluids  frequently).  
    • Assess  for  evidence  of  upper respiratory  infection,  cough.
    • Monitor  B/P,  pulse.  Assist  with  ambulation  if dizziness occurs.
    • Monitor daily pattern of bowel activity, stool consistency.
    • Watch for angioedema and other hypersensitivity reactions.
    • Assess liver and kidney function tests and electrolyte levels.
    • Stay alert for oliguria, progressiveazotemia, and renal failure in patients with severe heart failure whose renal function depends on the renin-angiotensin-aldosterone system.

    Patient/Family Teaching
    • Instruct patients to avoid potassium supplements and salt substitutes con-taining potassium, unless directed by prescriber.
    • Caution female patients not to take drugs during the second or third trimester of pregnancy. Advise her to contact the prescriber immediately if she suspects pregnancy.
    • Tell female patients to discuss breastfeeding with prescriber before taking. 
    • Instruct patients to immediately report hypersensitivity reactions, especially lip or eyelid swelling, throat tightness, and difficulty breathing.
    • Avoid  tasks  that  require  alertness,  motor  skills  until  response  to  drug  was established (possible dizziness effect).
    • Report any sign of infection (sore throat, fever), chest pain.
    • Do not take OTC cold preparations, nasal decongestants.
    • Do not stop taking medication.
    • As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.
    ]]>     2021-09-13 13:19:26 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736019956     Generic Name garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736022398 Metoprolol Tartrate]]> 2021-09-13 13:20:06 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736022398 Stock Dosage garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736023189 Injection Solution: 1 mg/mL. 
     
    Tablets (Immediate-Release):  25  mg,  50  mg,100 mg.
     
    Tablets (Extended-Release): 25 mg, 50 mg, 100 mg, 200 mg.
     
    Myocardial Infarction
    • IV:
      • ADULTS: 5 mg q5min for up to 3 doses, followed by 25–50 mg orally q6–12h for 48–72 hrs. Transition over 2–3 days to twice daily Lopressor or once daily Toprol XL. May increase up to a maximum of 200 mg/day.
     
    Angina Pectoris
    • PO(Immediate-Release): 
      • ADULTS:  Initially,  50  mg  twice  daily.  Increase  at weekly (or longer) intervals. Usual range: 50–200 mg twice daily. 
      • Maximum: 400 mg/day.PO
    • (Extended-Release):
      • ADULTS: Initially, 100 mg/day as a single dose. May Increase by at least at weekly intervals until optimum clinical response achieved.
      • Maximum: 400 mg/day
     
    Hypertension
    • PO (Immediate-Release): 
      • ADULTS, ELDERLY:  Initially,  50  mg  twice  daily.Increase at wkly (or longer) intervals. Maintenance: 100–450 mg/day in 2–3divided  doses. 
      • CHILDREN:  Initially,  0.5–1  mg/kg/dose. Maximum  InitialDose: 25 mg. Maximum Daily Dose: 6 mg/kg/day or 200 mg/day, whichever is less.
    • PO (Extended-Release):
      • ADULTS, ELDERLY:  Initially,  25–100  mg/day  as single dose. May increase at least at weekly intervals until optimum B/P obtained. Maximum: 400 mg/day.
      • CHILDREN 6 YRS OR OLDER: Initially, 1 mg/kg once daily. Maximum: 50 mg. May increase to 2 mg/kg/day or 200 mg/day,whichever is less.
    • Heart Failure
      • PO (Extended-Release):
        • ADULTS: Initially, 12.5–25 mg/day. May double doseq2wks up to target dose of 200 mg/day.
    ]]>     2021-09-13 13:20:20 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736023189     Classification garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736023511 Pharmacologic Class: Beta-adrenergic blocker 
     
    Therapeutic Class: Antihypertensive, antianginal, myocardial infarction adjunct
     
    Pregnancy Risk: Category C 
    ]]>     2021-09-13 13:20:26 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736023511     Mechanism of Action garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736023999 Blocks stimulation of beta 1 (myocardial) adrenergic receptors, usually without affecting beta 2 (pulmonary,vascular, uterine) adrenergic receptor sites

    Therapeutic Effect: Slows heart rate,  decreases  cardiac  output,  reduces  B/P.  Decreases  myocardial  ischemia severity.


    ]]>     2021-09-13 13:20:34 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736023999     Indication/s garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736024294
  • Hypertension
  • Angina pectoris
  • Myocardial infarction
  • Symptomatic heart failure
    • ]]>     2021-09-13 13:20:40 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736024294     Contraindications garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736024741
  • Sinus bradycardia, heart block greater than first degree, cardiogenic shock,overt cardiac failure (with Lopressor used for hypertension or angina)
  • Heart rate below 45 beats/minute,second- or third-degree heart block,significant first-degree heart block; sys-tolic pressure below 100 mm Hg; or moderate to severe cardiac failure(when Lopressor is used for MI)
  • Hypersensitivity to drug or its com-ponents, severe bradycardia, heart block greater than first degree, cardio-genic shock, decompensated cardiac failure, sick sinus syndrome (unless permanent pacemaker is in place)(with Toprol-XL)
    • ]]>     2021-09-13 13:20:46 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736024741     Side Effects and Adverse Effects garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736025296 Metoprolol  is  generally  well  tolerated,  with  transient  and  mild  side  effects.
    Side Effects:
    • Frequent:  Diminished  sexual  function,  drowsiness,  insomnia,  unusual fatigue/weakness.
    • Occasional:  Anxiety,  diarrhea,  constipation,  nausea,vomiting,  nasal  congestion,  abdominal  discomfort,  dizziness,  difficulty breathing,  cold  hands/feet. 
    • Rare:  Altered  taste,  dry  eyes,  nightmares,paresthesia, allergic reaction (rash, pruritus).

    Adverse Effects:
    • Overdose  may  produce  profound  bradycardia,  hypotension,  bronchospasm.
    • Abrupt  withdrawal  may  result  in  diaphoresis,  palpitations,  headache,tremulousness,  exacerbation  of  angina,  MI,  ventricular  arrhythmias.  
    • May Precipitate  HF,  MI  in  pts  with  heart  disease,  thyroid  storm  in  those  with thyrotoxicosis,  peripheral  ischemia  in  those  with  existing  peripheral  vascular disease.  
    • Hypoglycemia  may  occur  in  pts  with  previously  controlled  diabetes(may mask signs of hypoglycemia). 

    Antidote: Glucagon 
    ]]>     2021-09-13 13:20:56 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736025296     Nursing Responsibilities garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736025540 Baseline Assessment
    • Assess baseline renal function, LFT. 
    • Assess B/P, apical pulse immediately before drug administration (if pulse is 60/min or less or systolic B/P is less than 90 mmHg, withhold medication, contact physician). 
    • Antianginal: Record onset, type(sharp, dull, squeezing), radiation, location, intensity, duration of anginal pain,precipitating factors (exertion, emotional stress)

    Intervention/Evaluation
    • Measure blood pressure closely when starting therapy and titrating dosage. Once the patient stabilizes, measure blood pressure every 3 to 6 months.
    • Monitor blood pressure and pulse before I.V. administration. If the patient is hypotensive or has bradycardia, consult the prescriber before giving the dose.
    • Watch for orthostatic hypotension in at risk patients, particularly the elderly.
    • Assess  pulse  for  quality,  rate,  rhythm.  
    • Assess  for  evidence  of  HF:dyspnea  (esp.  on  exertion,  lying  down),  night  cough,  peripheral  edema,distended neck veins. 
    • Monitor I&O (increased weight, decreased urinary outputmay indicate HF). 
    • Therapeutic response to hypertension noted in 1–2 wks
    • When discontinuing drug, reduce dosage gradually over 1 to 2 weeks.

    Patient/Family Teaching 
    • Advise the patient to take with or immediately after meals.
    • Tell the patient that extended release tablets are scored and can be divided,but that he should swallow tablets orhalf-tablets whole and not crush or chew them.
    • Advise the patient with heart failure to report signs or symptoms of worsening condition, including weight gain and increasing shortness of breath.
    • Caution the patient to avoid driving and other hazardous activities until drug effects are known.
    • Compliance  with  therapy  regimens  is  essential  to  control  hypertension,arrhythmias.
    • If dose is missed, take the next scheduled dose (do not double dose).
    • Do not use nasal decongestants, OTC cold preparations (stimulants) without physician approval.
    • Restrict salt, alcohol intake
    • As appropriate, review all other significant and life-threatening adverse reactions and interactions,especially those related to the drugs,tests, foods, and behaviors mentioned above
    ]]>     2021-09-13 13:21:00 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736025540     Brand Name garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736147697 Neosartan]]> 2021-09-13 13:52:51 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736147697 Brand Name garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736150774 Kenzar]]> 2021-09-13 13:53:44 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736150774 Brand Name garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736253749 Prometin]]> 2021-09-13 14:21:19 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736253749 Brand Name garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736255359 Neobloc]]> 2021-09-13 14:21:45 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736255359 Hodgson, B. B., & Kizior, R. J. (2020). Saunders Nursing Drug Handbook 2020 (1st Edition). Saunders. garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736497455 2021-09-13 15:26:06 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736497455 Schull, P. (2013). McGraw-Hill Nurses Drug Handbook, Seventh Edition (McGraw-Hill’s Nurses Drug Handbook) (7th ed.). McGraw-Hill Education /Medical. garciamaryjoy https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736497871 2021-09-13 15:26:14 UTC https://padlet.com/garciamaryjoy/4ecwmqiy3bnormlh/wish/1736497871