Question

Identify the (a) therapeutic class, (b) drug form, (c) use, (d) action, (e) adverse reaction, (f) contraindication use and (g) nursing care and (h) teaching for the following drugs;

Magnesium sulfate

Calcium channel blocker

Beta adrenergic agonist

Glucocorticoids

Methotrexate

Epidural Anesthesia

Answer 1

1) Magnesium sulfate :

Therapeutic class is the categorization of drugs based on their similarities of chemical structure, action and the types of diseases treated. Magnesium sulfate comes under the therapeutic class of anti convulsants, drugs used to treat seizures,Antidysrhythmics i.e.., to control abnormal firing of electrical impulses in heart secondary to Bundle branch block,myocardial ischemia and infarction.  The available drug forms of MgS04 are tablet, injectable solution. The available doses are 40mg/ ml, 80 mg/ml. Mgso4 is used to treat hypomagnesemia (Serum magnesium level below 1.5 mEq/L), Torsades de points, epilepsy, Tocolytic agents to delay preterm labor in a pregnant women.

Action: Magnesium sulfate is a vasodilator acts primarily on arteries of intestine (mesenteric) and uterine and larger aorta. Mgso4 binds with calcium channels there by decreasing intracellular calcium levels and thus resulting in relaxation and vasodilation.

side effects : Hypotension, Drowsiness, Hypocalcemia, hypophosphatemia, Head ache, edema

contraindications: Allergic history with magnesium, hypermagnesemia, increased serum calcium levels (hypercalcemia)

Nursing considerations:

- Hourly monitoring of blood pressure. Assess for knee relaxes as Mgso4 leads to hypocalcemia.Monitoring for adverse reactions like headache, edema, pain in epigastric region. To keep Calcium gluconate ready incase of magnesium toxicity.

Patient education : Educate client that Mgso4 is used to treat low magnesium levels . Teach them to report if they experience dry mouth, palpitations, sluggishness, tachycardia, cramps.

2.Calcium channel blockers:

   Calcium channel blockers are medications commonly used to treat hypertension. It acts by preventing entry of calcium into heart and arteries. Used to treat angina, arrhythmias, hypertension and coronary artery disease. Common side effects are head ache, nausea, tiredness, rashes on the skin, palpitations.Nurses must educate client to avoid grape juice as it may interact with drug resulting in head ache and dizziness.

3) Beta adrenergic agonists:

B agonists are group of drugs helps to relax smooth muscles in the pulmonary airways. It is used as bronchodilators to treat bronchospasm occurs in bronchial asthma,bronchitis. The common side effects are hypotension, hypokalemia, flushing. Nurses must test for drug allergy. Assess pulmonary functions. Check for any underlying cardiac diseases before administering drugs. Teach patient the way of using inhalers.

4) Glucocorticoids:

It comes under the drug class corticosteroids. It is used to treat inflammatory diseases , autoimmune diseases, Psoriasis,ulcerative colitis, rheumatoid arthritis. The most common side effects are hyperglycemia, osteoporosis, hypercholestremia ,obesity,steroid induced diabetes. Nurses must educate client to protect from infections steroids will lowers the immune system, periodical monitoring of serum glucose levels and calcium levels.