·   Brand Name: Bayer® Aspirin

·   Stock Dosage: 150-300 mg tab 

·   Classification: Antiplatelet Agents; NSAIDs; Salicylates

·   Mechanism of Action:

- It prevents the production of prostaglandins. It doesn't discriminate between COX-1 and COX-2 enzymes. Platelet aggregation is inhibited for about 7-10 days when COX-1 is inhibited (average platelet lifespan). Acetylsalicylic acid's acetyl group binds to a serine residue in the cyclooxygenase-1 (COX-1) enzyme, causing irreversible inhibition. This stops pain-inducing prostaglandins from being produced. This process also prevents arachidonic acid from being converted to thromboxane A2 (TXA2), a potent inducer of platelet aggregation. Platelet aggregation can lead to clots and dangerous venous and arterial thromboembolism, which can lead to pulmonary embolism and stroke.

·   Indications:

- To relieve pain, fever, and inflammation associated with many conditions, including the flu, the common cold, neck and back pain, dysmenorrhea, headache, tooth pain, sprains, fractures, myositis, neuralgia, synovitis, arthritis, bursitis, burns, and various injuries. 

- Reducing the risk of cardiovascular death in suspected cases of myocardial infarction (MI).

- Reducing the risk of a first non-fatal myocardial infarction in patients, and reducing the risk of morbidity and mortality in cases of unstable angina and in those who have had a prior myocardial infarction.

·   Contraindications:

- Have an aspirin allergy or intolerance

- Are at risk for gastrointestinal bleeding or hemorrhagic stroke

- Drink alcohol regularly

- Are undergoing any simple medical or dental procedures

- Are over the age of 70

·   Side Effects:

- Increased risk of renal insufficiency and worsening of hypertension control owing to an inhibition of renal vasodilatory prostaglandins

- Indigestion, nausea, vomiting, heartburn, and constipation

- Skin swelling/problems, bronchospasm, liver damage, hearing loss, rash, kidney damage, ringing in the ears, and hives.

- Upper-gastrointestinal (GI) toxicity, extracranial and intracranial hemorrhage

·   Nursing Responsibilities:

- Possible gastric irritation is limited by taking aspirin after food. It should be taken with food or 8-12 oz. of water

- Keep the medication in the container it came in, tightly closed, and out of reach of children.

- Store it at room temperature and away from excess heat and moisture.

- Store aspirin suppositories in a cool place or in a refrigerator but keep it out from freezing.

- Take any missed doses as soon as you remember but do not take a double dose to make up for a missed one.

- Do not break, crush, or chew extended-release tablets, and do not open extended-release capsules. Swallow them whole.

- Always read the label of any over-the-counter medications to check for aspirin content.

- Do not keep outdated medicine or medicine no longer needed.

- Restrict alcohol intake.

- Report any tinnitus, sweating, or hyperventilation.

- Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription OTC medicines and herbal or vitamin supplements.

-  Assess for other types of allergies, such as to foods, dyes, preservatives, or animals.

- For patients who have had oral or dental surgery or tonsillectomy in the last seven days avoid chewable or dispersible aspirin tablets or aspirin in crushed tablets or gargles.

- Assess other medication for possible interactions - especially warfarin which is a special hazard.

- The dose of this medicine will be different for different patients. Follow the doctor's orders or the directions on the label.

- Assess pain and/or pyrexia one hour before or after medication.

- In long-term therapy monitor renal and liver function and ototoxicity.

- Be aware that aspirin is a common constituent of a variety of over-the-counter medications.

- Check the progress of the patient to see if the medicine is working properly and to decide if it should be continued to be taken.

 

Aspirin (Oral Route). (n.d). Mayo Clinic.  Retrieved on September 13, 2021 from https://www.mayoclinic.org/drugs-supplements/aspirin-oral-route/precautions/drg-20152665

Cunha, P. (2021). Aspirin. RxList. Retrieved on September 13, 2021 from https://www.rxlist.com/consumer_aspirin/drugs-condition.htm

·   Brand Name: Tenormin

·   Stock Dosage: 100 mg once daily or 50 mg twice a day for a further 6-9 days

·   Classification: Beta-blockers, Beta-1 Selective

·   Mechanism of Action:

- Blocks response to beta-adrenergic stimulation; cardioselective for beta1 receptors at low doses, with little or no effect on beta2 receptors. It causes decreased oxygen demand due to the reductions in heart rate, blood pressure, and contractility, and the consequent relief of ischemic chest pain.

·   Indications:

-Hypertension, Angina Pectoris Due To Coronary Atherosclerosis, Acute Myocardial Infarction

·   Contraindications:

- Certain types of heart rhythm problems, breathing problems, blood circulation problems, kidney disease, heart failure, serious allergic reactions including those needing treatment with epinephrine, a certain muscle disease.

·   Side Effects:

- Dizziness, lightheadedness, tiredness, and nausea 

- Shortness of breath, unusual/sudden weight gain, very slow heartbeat, severe dizziness, fainting, trouble breathing, blue fingers/toes, mental/mood change

·   Adverse Effects:

- Hypotension, cold extremities, diarrhea, fatigue, leg pain, and vertigo 

·   Nursing Responsibilities:

- Store the medication at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

- Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company. Do not share this medication with others.

- Lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase the effectiveness of this medicine. 

- How to monitor your own blood pressure and pulse at home, and share the results with your doctor.

- If there is miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take the next dose at the regular time. Do not double the dose to catch up.

-  Obtain complete health history including allergies, drug history, and possible drug interactions.

- Assess the patient’s apical pulse and blood pressure to confirm they are within normal range. 

- Observe for changes in heart rate and mood.

- Monitor effects of exercise on heart rate.

- Advise patient to monitor blood sugar frequently until accustomed to the medication.

- Advise patient to report any changes in sexual abilities or depression to the health care provider.

 

RxList. (2020). Atenolol. Retrieved on September 13, 2021 from https://www.rxlist.com/atenolol-drug.htm#description

WebMD. (n.d). Atenolol. Retrieved on September 13, 2021 from https://www.webmd.com/drugs/2/drug-11035/atenolol-oral/details