DRUG STUDY

Patient’s Initials: J.B,__ Date of Admission: _____ Diagnosis: Severe anemia, invasive ductal breast CA
Age: 54 Height: ___Weight.: Clinical Intervention:
Sex: Female Ward: VND Bed No.: 301E Name of Physician:

Drug Information Classification Mechanism of Action Indication Contraindications Side Effects Nursing Responsibilities
Generic Name: Pharmacologic Pharmacodynamics or General Indication/s: ● Hypersensitivity (per system preferably) Before Drug Administration:
Spironolactone Classification: Mechanism of Action: Counteract ● Hyperkalemia ● If medication is given as an adjunc
Trade Name: Potassium-sparing Interferes with sodium potassium loss ● Anuria CNS: dizziness; to antihypertensive therapy, monitor
Aldactone diuretics reabsorption by caused by other ● Acute renal clumsiness, headache. BP before administering
competitively inhibiting diuretics. Used with insufficiency CV: arrhythmias.
Minimum Dose:
action of aldosterone in other agents Significant GU: erectile dysfunction;
12.5mg distal tubule, promoting (thiazides) to treat During Drug Administration:
renal dysfunction Derm: Stevens-Johnson
Maximum Dose: sodium and water excretion, edema or ● PO: Administer in AM to avoid
Therapeutic Syndrome, Toxic
400mg increasing hypertension. interrupting sleep pattern.
Classification: Use Cautiously in: Epidermal Necrolysis;
Patient’s Dose: potassium retention. May Primary ● Administer with food or milk to
diuretics ● Hepatic dysfunction Endo: breast
25mg decrease effect of hyperaldosteronism minimize gastric irritation and to
● Geri: Presence of tenderness,
aldosterone on arteriolar (spironolactone increase bioavailability.
Route: gynecomastia, irregular
smooth muscle. only). age-related renal
PO menses, voice
dysfunction may lead
deepening.
Frequency: Therapeutic Effect: Unlabeled Use: to increased risk of After Drug Administration:
F and E: hyperkalemia,
OD Produces diuresis, lowers Management of HF hyperkalemia
hyponatremia.
Availability/Form: B/P (low doses). ● Diabetes (increased ● Monitor intake and output ratios
Hemat: agranulocytosis;
Tablets: 25 mg, 50 risk of hyperkalemia) and daily weight during therapy.
thrombocytopenia.
mg, 100 mg.
Oral Suspension: Pharmacokinetics: Patient’s Indication: ● Concurrent use MS: muscle cramps. ● Assess patient frequently for
25 mg/5 mL Absorption: >90% For management of of potassium Misc: allergic reactions. development of hyperkalemia
Contents: absorbed CHF. supplements or (fatigue, muscle weakness,
calcium sulfate, Protein Binding: >90%. potassium-containing paresthesia, confusion, dyspnea,
corn starch, flavor, Metabolism and salt substitutes ECG changes, cardiac
hypromellose, iron Excretion: arrhythmias). Patients who have
oxide, magnesium converted by the liver to its diabetes mellitus or kidney
stearate, active diuretic compound disease and geriatric patients are
polyethylene (canrenone) at increased risk of developing
glycol, povidone, these symptoms.
and titanium ● Periodic ECGs are recommended
dioxide. in patients receiving prolonged
therapy.
● Assess patient for skin rash
frequently during therapy.
Discontinue diuretic at first sign of
rash.
● Monitor BUN, serum creatinine,
and electrolytes before and
periodically during therapy.
● Emphasize the importance of
continuing to take this medication,
even if feeling well. Instruct
patient to take medication at the
same time each day. Take missed
doses as soon as remembered
unless almost time for next dose.
Do not double doses.
 ● Caution patient to avoid salt
substitutes and foods that contain
high levels of potassium or
sodium unless prescribed by
health care professional.
● Instruct patient to notify health
care professional of all Rx or OTC
medications, vitamins, or herbal
products being taken and to
consult health care professional
before taking any OTC
medications concurrently with this
therapy, especially OTC
decongestants, cough or cold
preparations, or appetite
suppressants due to potential for
increased BP.
● Advise patient to notify health
care professional if rash, muscle
weakness or cramps; fatigue; or
severe nausea, vomiting, or
diarrhea occurs.

References

Karch, A. M. (2014). 2014 Lippincott's Nursing Drug Guide. Wolters Kluwer/Lippincott Williams & Wilkins Health.
Vallerand, A.H. & Sanoski, C.A. (2013). Davis’s drug guide for nurses. Philadelphia, PA: F.A Davis Company
Kizior, R., & Hodgson, K. Saunders Nursing Drug Handbook 2021 (29th ed.). Elsevier, Inc.