Question

Drug Cards for the following medications that describe the MOA, Major Adverse Effects, Drug Interactions and Contraindications, and Nursing Implications.

Heparin

Enoxaparin

Warfarin

Aspirin

Clopidogrel

Streptokinase

Iron

Erythropoietin

Filgrastim

Answer 1

1) Heparin:

MOA:Heparin prevents thrombin from converting fibrnogen to fibrin and it prevents thromboembolism.The therapeutic dose does not dissolve clots but prevents new thrombous formation.The antidote is protamin sulphate

Major adverse effects:Bleeding,allergic reactions,hematuria,inceased ilver enzymes and so on

Drug interactions:Antihistamines,asprin and aspirin cintaning products,NSAIDS(Ibuprofen,aleve).

Contraindications:Hypersenstivity,thrombocytopenia,

Nursing implications:Monitor aPPT and platelet count.

Observe for bruises,nose bleeds

Instruct the client regarding mesures to prevent bleeding

2)Enoxoparin:

It is also known as low molecular weight heparin.

Enoxosparin has the same mechanism of action and use of heparin but is not interchangeable and it has longer haif life than heparin .Tne antidote of enoxaprin is protamin sulfate.

Major adverse effects:Bleeding,anaemia,black or tarry stool,bloody vomit and so on

Drug interactions:NSAIDS,platelet inhibitors, and herbal supplements

Contindications:Thrombocytopenia,GI bleeding,hemophila,Eye surgery

Nursing implications:Administer only to the recumbent patient by subcutenous injecion into anterolateral or posteriolaeral abdominal wall.

Moniteor aPPT and platelet count

3)Warfarin sodium

It is lso known as coumadian or jantoven

Warfarin suppress coagulation by acting as an antagonists of vitamink by inhibiting four dependant clotting factorsX,IX,VII,and II.Wararin prolongs clotting time and its monitired PT and the INR ratio.It is used for long term anticoagulation.

Mjor adverse effects:Nose bleeds,bleeding gums,brown urine.bloody vomit

Drug interactions:Anticoagulants ,antiplatelets like clopidogrel.NSAIDS like asprin

Contraindications:CLient should avoid tajking this during pregnancy,anaemia ,eye surgery

Nursing implications:Monitor PT nad INR

Observe for bleeding,bruises and so on,

Instruct regarding the measures to prevent bleeding.

4)Asprin:

It inhibit the synthesis of prostaglandins and it acta as an analgesic to reliev pain,an antipyretic to reduce temperature and to rlieve inflammation.

Major adverse effects:Dyssrthmias,tinntus,visual changes,reduced renal function

Drug interactions:Diclofenac,ibuprofen.indomethacin

Containdications:Asprin and NSAIDS donot take together because it decreases the blood level and its effectiveness

Nursing implications:Assess for allergies,Monitor edema,Monitor for signs of bleeding,Instruct the client to avoid taking alcoholic bevergees

5)Clopidogrel:It inhibit the aggregration of platelets in the clotting process there by prolonging the bleeding time

Major adverse effects:Bruising,Hematuria,Tarrystiools

Drug interactions:Atrovastin,Omeprazole

Contraindications:Bleding.Internal hemorrhage,

Nursing implications:Monitor vital signs

Monitor bleeding time

Monitor sideeffects of bleeding

6)Streptokinase:It is used to break down clots and it is given in IV injection

Major adverse effects:Hypotension,dizziness,rash,itching

Drug interactions:Warfarin,NSAIDS, Asprin

Contraindications:Active internal bleeding,hypertension

Nursing implications:Avoid any invasive procedures

Monitor any signs of bleding and allergic reaction

7)Iron:Used for patients with anaemia .The high iron intake replaces deficit from inadequarte intake or loss

Major sideeffects:Nausea,vomitting,diarrhoea

Drug interactions:levothyroxine,aldomet,armour

Containdications:Incresed iron overload,Gastritis ,ulcer

Nursing implications:Administere IM or IV

Perform sensitvity test before administering

Instruct the client to drink fluids adequately

Should check for constipation

8)Erythropoietin:It induce more rapid bone marrow recovery after suppression by chemotherapy

Major side effects:Hypertension,nausea ,fecer,dizziness

Drug interactions:Benazepril,captopril,lisnopril and so on

Contrindications:Red cell aplasia,hypertension,seizures

Nursing implications:Monitor BP

Use only one dose per vial

Donot mix with any other medications

9)Filgrastim:It is regulates the production of neutrophills in the bone marrow

Major adverse effects:Thrombocytopenia,Bone pain,nausea ,fever

Drug interactions:Asprin,aloprim.bleomycin and so on

Contrindications:Sickle cell anemia,glomerulonephritis,ARDS,lung disorder

Nursing implications:Monitor complete blood count twice weekly

Monitor neutrophill count

Monitor for potential drug intractions

Observe for any bleeding