In: Nursing
Rx
age: 30 years
Gender: female
Diagnosis: HTN in pregnancy
methyldopa T 500 mg bid
lasix T 40 mg, 1/2 tab od
valsartan 80 mg, 160 mg od
ferrous sulphate 200 mg , tid
Note: patient cannot tolerate ferrous sulphate.
according to this prescription find the mistakes, the interaction, dose of each medication , the toxicity level , antidotes and the counselling for all medication
Hypertension is a common disorders during pregnancy. These are a major cause of maternal and perinatal morbidity and mortality.
Treatment includes prescribing drugs such as Methyldopa, labetalol, beta blockers, slow release nifedipine and a diuretic mainly thiazide group.
The dose of Methyldopa is 500mg to 3gm per day in 2 divided doses depending upon the blood pressure.
Diuretics such as Hydrochlorothiazide is prescribed in a dose of 12.5mg to 25mg per day.
Mistakes/Errors:
Lasix 40mg containing Furosemide has be shown to cause unexplained maternal death. It should not be prescribed during pregnancy. It can be used in pregnancy only if the potential benefits justify the potential risk to the fetus.Thiazide diuretic like Hydrochlorothiazide is prescribed in HTN during pregnancy due to its low teratogenicity.
Valsartan 80mg, 160mg belongs to a class of medications called the angiotensin II receptor antagonists used to treat hypertension. Valsartan should never be taken while being pregnant as it leads to serious injury or death of the fetus.
Ferrous sulfate is an iron supplement used to treat anemia. Maternal anemia increases the risk of premature delivery, low birth weight and impaired behavioral development. The recommended dose 300mg of ferrous sulfate per day.
Interactions:
Methyldopa and ferrous sulfate – Taking these two medications together will decrease the body’s ability to absorb methyldopa.
Dose:
Antidotes:
Methyldopa – There is no antidote for methyldopa
Lasix- There is no antidote.
Valsartan- There is no antidote.
Ferrous sulfate - IV Deferoxamine in severe cases.
Counselling:
1. Methyldopa
2. Lasix
3. Valsartan
4. Ferrous sulfate