[Type the document title] Room# 12
Generic/Trade Name
Classification/Dosage/
Route/Frequency
Generic: carvedilol
Trade: Coreg
Classification: Alpha1-Beta
Blocker
Patient Dose: 12.5 mg
Patient Route: PO
Frequency: Twice Daily
Usual Dosage
6.25-80 mg
Mechanism of
Action
Inhibits beta1 (myocardial) &
beta2 (pulmonary, vascular,
and uterine) – adrenergic
receptor sites & also has
alpha1 blocking action –
orthostatic hypotension
Side Effects &
Adverse Effects



Bradycardia
Heart Failure
Hypotension
Nursing Management
(Implications &
Teachings)

Monitor BP & pulse
Indication for
This Patient
Time
Hypertension
0900,1700
Hypertension
0900
Hyperaldosteronism
0900,1700
during dose
adjustment &
throughout therapy.

Check apical pulse
before administering
& if <60 bpm or if
arrhythmia present,
hold the medication
and notify HCP.
Generic: metoprolol
Trade: Lopressor
Classification: Beta-Adrenergic
Blocker or Beta Blocker
Patient Dose: 50 mg
Patient Route: PO
Frequency: Daily
25-100 mg
Generic: Spironolactone
Trade: Aldactone
Classification:
Therapeutic: diuretics, potassiumsparing diuretics.
Patient Dose: 100 mg
Patient Route: PO
Frequency: Twice Daily
25-400 mg
Blocks stimulation of beta1
(myocardial)-adrenergic
receptors.


Bradycardia
Pulmonary Edema


Causes loss of sodium
bicarbonate and calcium
while saving potassium and
hydrogen ions by
antagonizing aldosterone.



Arrythmia
Sedation
Dizziness



Monitor BP, ECG,
and pulse frequently
during dose
adjustment and
periodically during
therapy.
Assess routinely for
signs and symptoms
of HF (dyspnea,
weight gain, jugular
venous distention)
Monitor I&O output
ratios and daily
weight during
therapy.
Assess patient
frequently for
developing
hyperkalemia.
Periodic ECGs may
be recommended in
patients receiving
prolonged therapy.
[Type the document title] Room# 12
Generic/Trade Name
Classification/Dosage/
Route/Frequency
Generic: Potassium Chloride
Trade: K-Dur
Classification: Electrolyte
Potassium Supplement
Patient Dose: 40 mEq
Patient Route: PO
Frequency: Daily
Generic: Nitroglycerin
Trade: Nitrostat
Classification:
Therapeutic: antianginals
Pharmacologic: nitrates
Patient Dose: 0.4 mg
Patient Route: SL
Frequency: Every 5 minutes x 3
PRN for chest pressure
Generic: Reteplase
Trade: Retavase
Classification:
Therapeutic: thrombolytics
Pharmacologic: plasminogen
activators
Patient Dose: 10 units
Patient Route: IVP
Frequency: x1 PRN
Generic: Heparin
Trade:
Classification:
Therapeutic: anticoagulant
Pharmacologic: antithrombotics
Patient Dose: 5,000 units
Patient Route: SQ
Frequency: q8h
Usual Dosage
40-80 mEq/day
Mechanism of
Action
Provides extra boost to
enhance cellular metabolism
for heart, muscle, and nerves
to work properly
Side Effects &
Adverse Effects


Cardiac
dysrhythmias
Hyperkalemia
Nursing Management
(Implications &
Teachings)



0.3-0.6 mg
10 units,
followed 30 min
later by an
additional 10 units
Increases coronary blood
flow by dilating coronary
arteries and improving
collateral flow to ischemic
regions.



Hypotension
Tachycardia
Dizziness

Directly converts
plasminogen to plasmin,
which then degrades clotbound fibrin.



Arrythmia
Hypotension
Thromboelism



5,000 units IV,
followed by initial
subcut dose of
10,000-20,000
units
Acts as a catalytic template
for both antithrombin and
thrombin. Increases the rate
of reaction by 1000.




Drug-induced
hepatitis
Dizziness
Chest Pain
Hypotension




Monitor serum
potassium before and
during therapy.
Assess for signs and
symptoms of
hyperkalemia
Ensure voiding is
evident
Monitor BP and pulse
before and after
administration.
Assess location,
duration, intensity,
and precipitating
factors of patient’s
anginal pain.
Monitor vital signs,
including temperature
at least every 4 hr
during therapy.
Notify HCP if
systolic BP >180
mmHg or diastolic
BP >110 mmHg.
Assess patient for
bleeding
Assess for signs of
bleeding and
hemorrhage. Notify
HCP if these occur.
Observe injection
sites for hematomas
or inflammation.
Assess patient for
additional or
increased thrombosis.
Protamine sulfate is
the antidote.
Indication for
This Patient
Time
Hypokalemia
0900
Management of angina
pectoris
Every 5
minutes x 3
PRN
Acute Myocardial
Infarction (MI)
ASAP
Thromboembolic
disorders such as
Peripheral arterial
thromboembolism
q8h
[Type the document title] Room# 12
Generic/Trade Name
Classification/Dosage/
Route/Frequency
Usual Dosage
Generic: Ferrous Sulfate
Trade: Feosol
Classification:
Therapeutic: antianemics
Pharmacologic: iron supplements
Patient Dose: 325 mg
Patient Route: PO
Frequency: Daily
15-600 mg
Mechanism of
Action
Enters the bloodstream and is
transported to the organs to
the reticuloendothelial
system (liver, spleen, bone
marrow) where it becomes
part of iron stores.
Side Effects &
Adverse Effects



Syncope
Dizziness
Headache
Nursing Management
(Implications &
Teachings)



Generic: Cyanocobalamin
Trade: Nascobal
Classification:
Therapeutic: antianemics,
vitamins
Pharmacologic: water-soluble
vitamins
Patient Dose: 1 spray (each
contains 500 mcg)
Patient Route: PO
Frequency: Daily
30-1000 mcg
Generic: Clopidogrel
Trade: Plavix
Classification:
Therapeutic: antiplatelet agent
Pharmacologic: platelet
aggregation inhibitors
Patient Dose: 75 mg
Patient Route: PO
Frequency: Daily
75-325 mg
Necessary coenzyme for
metabolic processes,
including fat and
carbohydrate metabolism and
protein synthesis.



Inhibits platelet aggregation
by irreversibly inhibiting the
binding of ATP to platelet
receptors.



Heart Failure
Headache
Hyperkalemia


Hypotension
Chest pain
Edema
Dizziness


Assess nutritional and
dietary history to
determine possible
cause of anemia and
need for patient
teaching.
Assess bowel
function for
constipation or
diarrhea.
Deforoxamine is the
antidote.
Assess patient for
signs of vitamin B12
deficiency before and
during therapy.
Monitor plasma folic
acid, vitamin B12,
and iron levels before
treatment.
Assess patient for
symptoms of stroke,
peripheral vascular
disease, or MI during
therapy.
Monitor CBC with
differential and
platelet count during
therapy.
Indication for
This Patient
Time
Anemia
0900
Pernicious anemia
0900
Acute coronary
Syndrome
0900