Research Project: Pharmacological Information for Nursing Students

This document presents a comprehensive research project completed by a nursing student, focusing on the pharmacological information of several medications. The project is divided into four groups, each responsible for researching specific drugs. Group 1 investigates Furosemide (Lasix) and Atorvastatin (Lipitor), providing details on pharmacodynamics, pharmacokinetics, adverse reactions, and contraindications. Group 2 explores Metformin (Glucophage) and Warfarin (Coumadin), covering similar aspects of their pharmacological profiles, including contraindications and side effects. Group 3 examines Cephalexin (Keflex) and Zoloft, while Group 4 focuses on Morphine and Salbutamol. Each medication's summary includes detailed information on its mechanism of action, absorption, distribution, metabolism, excretion, adverse reactions, contraindications, precautions, and potential side effects. The project aims to provide nursing students with a thorough understanding of the medications, aiding in their ability to administer and monitor medicines effectively, as required by the HLTENN007 unit of competency within the Diploma of Nursing program (HLT54115).

Assessment Details
Qualification Code: Title HLT54115 – Diploma of Nursing
Assessment Type Assessment 2 Research Work/Project work
Due Date
Location
Term-Year
Unit of Competency
Unit
Code/Title
HLTENN007 Administer and monitor medicines and intravenous therapy
Student Details
Student Name Student ID
Feedback to Student
RESULTS (Please Circle) SATISFACTORY NOT SATISFACTORY
Assessor Details
Assessors Name
Assessor Signature
Date
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Filename: HLTENN007 Administer and monitor medicines
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Assessment 2 -Research Work/Project Work
Instructions to the students
 Answer the questions below in the spaces provided
 Ensure all references are documented under each individual question.
 Answers are to be written in ink
Group Work
Research Project 1
Assessor will divide the large group into 4 smaller groups Each group will present back to the
larger group with a 5-minute presentation (can be written, oral, slide presentation) on the
information for each medication. The table of medications must be completed by all students
with the research information presented by each group. Please list group members names
GROUP
1
Lasix and Liptor
GROUP
2
Metformin and Warfrin
GROUP
3
Cephalexin and Zoloft
GROUP
4
Morphine and Salbutamol
Research the following medications listed in the table below and complete the pharmacological
information required. (Brief summary for the entire medication information Min 150 words)
GROUP 1
Medication: Furosemide
(Lasix)
Brief summary
 pharmacodynamics Furosemide, a sulfonamide-type loop diuretic structurally related
to bumetanide, is used to manage hypertension and edema
associated with congestive heart failure, cirrhosis, and renal
disease, including the nephrotic syndrome. ("Furosemide -
DrugBank", 2019)
 pharmacokinetics Absorption - 60–67% absorbed after oral administration (↓ in
acute HF and in renal failure); also absorbed from IM sites.
("furosemide | Davis’s Drug Guide", 2019)
Distribution- Crosses placenta, enters breast milk. ("furosemide |
Australian Harbour International College, 114-120 Castlereagh Street, Sydney NSW 2000, Australia
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Filename: HLTENN007 Administer and monitor medicines
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Davis’s Drug Guide", 2019)
Metabolism- Minimally metabolized by liver, some nonhepatic
metabolism ("furosemide | Davis’s Drug Guide", 2019)
Excretion- Furosemide is excreted in urine. Significantly more
furosemide is excreted in urine following the I.V. injection than
after the tablet or oral solution. ("Furosemide - DrugBank",
2019)
 adverse reactions  blurred vison
 hearing loss, hearing changes such as ringing in the ears.
 hyperglycemia
 paresthesia
 rapid weight loss
 jaundice (yellowing of skin and eyes). (furosemide & Lasix,
2019)
 stomach/abdominal pain
 allergic reaction like rash, itching, swelling
 trouble breathing(Cold et al., 2019)
 contraindications and
Precautions
Contraindicated in:
 Hypersensitivity;
 Cross-sensitivity with thiazides and sulfonamides may
occur;
 Hepatic coma or anuria;
 Some liquid products may contain alcohol, avoid in
patients with alcohol intolerance("furosemide | Davis’s
Drug Guide", 2019)
Precautions :
 Severe liver disease (may precipitate hepatic coma;
concurrent use with potassium-sparing diuretics may be
necessary);
 Using this medicine while being pregnant may cause the
unborn baby to be bigger than normal. The doctor should
be informed in such a case.
 Electrolyte depletion;
 Diabetes mellitus;
 Hypoproteinemia (↑ risk of ototoxicity);
 Severe renal impairment (↑ risk of ototoxicity);
("furosemide | Davis’s Drug Guide", 2019)
 Kidney problems
 side effects  increased urination
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 thirst
 headache
 muscle cramps
 itching or rash
 weakness
 dizziness
 spinning sensation
 diarrhea
 stomach pain
 constipation (furosemide & Lasix, 2019)
 fever
 vomiting
 loss of appetite
Medication: Atorvastatin
(Lipitor)
Brief summary
 pharmacodynamics Atorvastatin is used to treat high cholesterol and prevent from the
risk of stroke, heart disease. It helps to clear low density
lipoprotein cholesterol from the body by limiting ability to
produce new LDL cholesterol so live is the primary site of
action. (Lipitor ( atorvastatin Calcium tablets,2019)
 pharmacokinetics
Absorption: It is continuously absorbed after oral intake
maximum plasma concentrations occur within 1 to 2 hours. The
low systemic availability is attributed to presystemic clearance in
gastrointestinal mucosa and/or hepatic first-pass metabolism.
Although food decreases the rate and extent of drug absorption
by approximately 25% and 9%, respectively .Plasma LIPITOR
concentrations are lower (approximately 30% for Cmax and
AUC) following evening drug administration compared with
morning. However, LDL-C reduction is the same regardless of
the time of day of drug administration. (Lipitor ( atorvastatin
Calcium tablets,2019)
Disturbution:The volume of distribution of atorvastatin is 381
litre. It is 98>% bound to plasma protein. The plasma ratio of
0.25 denotes poor medication penetration into the red blood cell.
(Lipitor ( atorvastatin Calcium tablets,2019)
Metabolism: It is metabolized in the bile followed by the liver
and extra hepatically metabolism. The metabolism is performed
mainly by the activity of cytochrome P450 3A4 and its metabolic
pathway produces mainly active ortho- and para-hydroxylated
metabolites2 as well as various beta-oxidation minor
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metabolites.3 The metabolism of atorvastatin is ruled by reactions
of oxidation, lactonization and glucuronidation. The ortho- and
para-hydroxylated metabolites of atorvastatin account for about
70% of the activity against HMG-CoA reductase ("Atorvastatin -
DrugBank", 2019)
Route of elimination: It is eliminated primarily in bile following
hepatic metabolism with less than 2% of it recovered in the urine.
but the medicine doesn’t go through enter hepatic recirculation. It
has an approximate elimination half-life of 14 hours.
Noteworthy, the HMG-CoA reductase inhibitory activity appears
to have a half-life of 20–30 hours, which is thought to be due to
the active metabolites.
("Atorvastatin - DrugBank", 2019)
 adverse reactions The adverse reactions of atorvastatin are as follows:
 Kidney failure
 Liver problems like jaundice
 Lung Tissue Problems
 Muscle Inflammation
 Neck Stiffness
 Pancreatitis
 Rupture of tendon
 Depression
 Loss of memory
 Life threading Allergic Reaction
 Hepatitis
(Lipitor adverse effects by likelihood and severity,2019)
 contraindications &
precautions
Contra indication for atorvastatin are as follow:
 Pregnancy
 A person suffering from liver disease.
 Untreated decreased level of thyroid hormone
 Brain hemorrhage
 Loss of memory
 Breast feeding mother
 Allergies
 Recent operation
(Cold et al., 2019)
Precautions
 Use birth control methods to prevent pregnancy because
this medication can cause birth defects.
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 Always inform doctor about the medication you are
having and health problems like diabetes, liver disease,
kidney disease.
 Don’t breasts feed the child if you are taking this
medication.
 Avoid eating high cholesterol, foods as it taking
medication may not be effective.
 Don’t take alcohol as it can increase triglyceride levels
and elevate the risk of live damage.
("Lipitor (atorvastatin) Side Effects, Interactions, Uses
& Drug Imprint", 2019)
 side effects The side effect are as follows:
 Joint pain
 stuffy nose, sore throat
 diarrhea
 pain in your arms or legs
 Dizziness
 Rash
 Mild Muscle pain
 Headache
 Gas
 Nausea
(calcium & Lipitor, 2019)
GROUP 2
Medication: Metformin
(Glucophage)
Brief summary
 pharmacodynamics As body needs insulin hormone to regulate the blood glucose
levels, people with type 2 diabetes has decreased sensitivity to
insulin which causes elevation in blood glucose as pancreas can
no longer compensate. Metformin decreases production of
glucose in the liver (gluconeogenesis), it reduces absorption of
glucose from intestine and also enhances insulin sensitivity by
elevating both peripheral glucose intake and utilization. This
process helps to decrease the blood glucose, manages type 2
diabetes and has positive effects on glycemic control.
("Metformin – Drug Bank", 2019)
 pharmacokinetics
After ingestion, when metformin reaches to the liver cells, it
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builds up in cells and in the mitochondria where different
mechanisms regulate with the help of enzymes resulting in
gluconeogenesis and increases liver sensitivity to insulin.
Metformin is absorbed well when given with food and the
apparent volume of metformin after one oral dose is 850 mg of
metformin where it binds to plasma proteins and is excreted as
unchanged drugs in the urine and does not go hepatic metabolism
as no any metabolites have been identified in human.
("Metformin - Drug Bank", 2019)
 adverse reactions Adverse reactions of Metformin are as follows:
 Lactic acidosis which can be seen as being tired, weak,
unusual muscle pain, difficulty in breathing,, unusual
sleepiness, nausea, vomiting, dizziness, stomach pain and
slow or irregular heartbeat.
 Hypoglycemia, where symptoms include headache,
weakness, confusion, drowsiness, sweating, irritability,
shaking, extreme hunger and fast heartbeat.
("Metformin Adverse Effects – Drug Bank", 2019)
 contraindications &
precautions
Contradictions of Metformin:
 Renal impairment with increased serum creatine levels or
abnormal creatinine congestive heart failure.
 Increased risk of lactic acidosis which is known as a form
of metabolic acidosis due to insufficient clearance of
lactic acid from the blood.
(Dr. Tomislav Mestrovic, 2019)
Precautions:
 Avoid drinking large amount of alcohol on a regular basis
as drinking alcohol elevates the risk of lactic acidosis.
 If the lever is not functioning normally then metformin
should not be taken as liver disease increases the risk of
lactic acidosis.
 Monitoring kidney function test as metformin should not
be taken if the kidney is functioning poor.
 During most major surgeries, metformin should be
stopped temporarily and then should be restarted when
the patient is eating normally again.
 If there is infections, injuries or fever, metformin is not
enough to treat the diabetes, so insulin may be required.
 Metformin decreases the levels of vitamin B12, so if the
patient has deficiency of vitamin B12, it should be
monitored closely.
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(Clinaero, 2019)
 side effects Side effects of metformin are as follows:
 physical weakness (asthenia)
 diarrhea
 gas (flatulence)
 low blood sugar (hypoglycemia)
 abdominal pain
 low blood levels of vitamin B-12
 nausea and vomiting
 constipation
 chest discomfort
("Metformin Side Effects: Common, Severe, Long Term -
Drugs.com", 2019)
Medication: Warfarin
(Coumadin) Brief summary
 pharmacodynamics Warfarin is used to prevent and treat thromboembolic disease
which includes venous thrombosis, thromboembolism and
pulmonary embolism and also prevents ischemic strokes in
patients with atrial fibrillation. Warfarin inhibits vitamin K
reductase which helps to reduce the form of vitamin K and as a
result it reduces the thrombogenicity of clots. ("Warfarin - Drug
Bank", 2019)
 pharmacokinetics Absorption
It is absorbed rapidly when administered orally and also
absorbed percutaneous, however, it varies from individual.
Warfarin binds to blood plasma proteins and is metabolized in
the liver where warfarin is almost entirely excreted by
metabolism, little amount of warfarin is excreted in the urine and
metabolites are excreted into the bile in lesser amount.
("Warfarin - Drug Bank", 2019)
 adverse reactions  Skin necrosis or gangrene
 Bleeding strokes or brain strokes(Hemorrhagic strokes)
 Aortic Valve stenosis or hardening of arteries which means
the calcium accumulates in the arteries and narrows the aortic
valve that goes from heart and carries oxygen to the body.
 If the warfarin is used for a long term, the risk of Alzheimer’s
and dementia is increased
 Purple toes syndrome where the toes is seen in purple for
dark colors with extreme pain.
("3 Dangerous Warfarin Side Effects Long Term Effects of
Warfarin", 2019)
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 contraindications &
precautions
Contraindications:
 Blood dyscrasias
 Bleeding tendency
 Active ulceration
 Threatened abortion
 Eclampsia and pre-eclampsia
 Unsupervised dementia
 Alcoholism
 Psychosis
 Spinal puncture
 Major lumbar block anesthesia
 Malignant hypertension
 Pregnancy
Precautions:
 In order to ensure if the medicine is working properly and
is creating progress or not, regular doctor visit is very
important.
 To get rid of unwanted side effects, blood tests such as
INR are needed to be checked and monitored properly.
 It can harm the unborn baby, so it should not be taken
during pregnancy and if the patient think she is pregnant,
doctor should be informed right way.
 As this medication needs to be stopped several days
before surgery or medical test, doctors must be informed
if the patient is using this medication.
 The identification which denotes that the patient is using
warfarin should be carried by the patient.
("Warfarin (Oral Route) Precautions - Mayo Clinic",
2019)
 side effects Side effects of warfarin
 Unusual bruising
 Nosebleeds
 Bleeding gums
 Heavy menstrual or vaginal bleeding
 Pink or brown urine
 Red or black stools
 Coughing up blood
 Vomiting blood
("Warfarin: Side Effects, Dosage, Uses, and More", 2019)
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GROUP 3
Medication: Cephalexin (Keflex) Brief summary.
 pharmacodynamics Cephalexin also commonly known as Cefalexin is a first
generation cephalosporin antibiotic. It is one of the most widely
prescribed antibiotics, often used for the treatment of superficial
infections which results as complications of minor wounds or
lacerations. It is effective against most gram positive bacteria
("Cephalexin-Drugbank’, 2019)
 pharmacokinetics Cephalexin also commonly known as Cefalexin is a first
generation cephalosporin antibiotic. It is one of the most widely
prescribed antibiotics, often used for the treatment of superficial
infections which results as complications of minor wounds or
lacerations. It is effective against most gram positive bacteria
("Cephalexin-Drugbank’, 2019)
 adverse reactions Severe- Mild, Interstitial nephritis, Bleeding, Confusion,
Dizziness, Fever, Headache, Vomiting, Abdominal pain, seizures
etc (Meyers, Kaplan & Weinstein, 1969). Sensitivity, Super
infection
 contraindications &
precautions
 Antimicrobial resistance, viral infection- Cephalexin does not
treat viral infection i.e. common cold. If this is prescribed in
case of viral infection rather that providing the benefit to the
patient if increase the risk of development of drug-resistant
bacteria. Patients should be recommended to complete whole
session of treatment even if they feel better earlier.
 Pregnancy- Data published by epidemiologic studies and
pharmacovigilance case reports over several decades with
cephalosporin use, including cephalexin, in human pregnancy
have not established drug associated risks or major birth
defects, miscarriage, or adverse maternal or fetal outcomes
("Cephalexin (cephalexin) dose, indications, adverse effects,
interactions... from PDR.net", 2019).
The precautions are:
If the symptoms don’t show any improvement, it is needed to
visit the doctor ("Cephalexin (Oral Route) Precautions - Mayo
Clinic", 2019).
Lactation.
 side effects Joint pain, Vaginal itching, Rash, Swelling etc (Fung-Herrera,
1974).
Medication: Sertraline (Zoloft) Brief summary.
 pharmacodynamics Sertraline, an antidepressant drug which is identical to
citalopram, fluoxetine, and paroxetine, is of the selective
serotonin reuptake inhibitor(SSRI) type. It mediates a weak
inhibitory actions on the neuronal uptake of norepinephrine or
dopamine and exhibits no inhibitory action on monoamine
oxidase. Chronic administration of sertraline resulted in down
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regulation of brain norepinephrine receptors. It displays affinity
for sigma-1 and 2 receptors binding sites (A31941), but binds
with more affinity to sigma-1 binding sites. The pharmacological
role of sigma receptors in the mechanism of action of sertraline
in unclear.
Drugbank.ca. (2019). Sertraline - DrugBank. [online] Available
at: https://www.drugbank.ca/drugs/DB01104 [Accessed 7 May
2019].
 pharmacokinetics The mechanism of action sertraline is not fully known, but the
drug appears to selectively inhibit the reuptake of serotonin at the
presynaptic membrane. This results in an increases synaptic
concentration of serotonin in the CNS, which leads to numerous
functional changes associated with enhanced serotonergic
neurotransmission. This modifications are responsible for the
antidepressant action observed during long term administration
of antidepressants. It has also been hypothesized that obsessive
compulsive disorder is caused by the dysregulation of serotonin,
as it is preserved by sertraline, and the drug corrects this
disproportion.
Drugbank.ca. (2019). Sertraline - DrugBank. [online] Available
at: https://www.drugbank.ca/drugs/DB01104 [Accessed 7 May
2019].
 adverse reactions GI upset including nausea, diarrhea, dyspepsia; decr libido;
tremor; dizziness, insomnia; agitation, somnolence; sweating; dry
mouth, male sexual dysfunction, in children, headache, insomnia,
hyperkinesia, weight loss; other.
Mims.com.au. (2019). page 102. [online] Available at:
http://mims.com.au/ [Accessed 7 May 2019].
 contraindications &
precautions
- before taking sertraline, inform your doctor if you are
allergic to it, any other allergies you have. Because this
product contains inactive ingredients ( such as latex found
in the medicine dropper) which can cause allergic
reactions or other problems
- before having surgery, notify your doctor or dentist about
all the products that you have used including prescription
drugs, nonprescription drugs and herbal products as well.
- During pregnancy, this medication should be used only
when clearly required. It may harm an unborn baby. Also,
babies born to mothers who have used this during the last
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3 months of pregnancy may rarely develop withdrawal
symptoms such as feeding/breathing difficulties, seizure,
muscle stiffness, or constant crying.
- Children can be more sensitive to the side effects of the
drug, especially loss of appetite and weight loss. Observe
weight and height in children who are taking this drug.
Cold, F., Health, E., Disease, H., Disease, L., Management, P.,
Conditions, S., Problems, S. and Disorder, S. (2019). Drugs &
Medications. [online] Webmd.com. Available at:
https://www.webmd.com/drugs/2/drug-35/zoloft-oral/details
[Accessed 7 May 2019].
 side effects Nausea, dizziness, drowsiness, dry mouth, loss of appetite,
increased sweating, diarrhea, upset stomach, or trouble sleeping
and so on . if any of these effects last long or get worse, then visit
the doctor or pharmacist quickly.
Similarly, if you notice any symptoms of a serious allergic
reaction such as rash, itching/swelling (especially of the face,
tongue or throat) severe dizziness and trouble breathing then get
a medical help right way.
Cold, F., Health, E., Disease, H., Disease, L., Management, P.,
Conditions, S., Problems, S. and Disorde, S. (2019). Drugs &
Medications. [online] Webmd.com. Available at:
https://www.webmd.com/drugs/2/drug-35/zoloft-oral/details
[Accessed 7 May 2019].
GROUP 4
Medication: Morphine
(Sevredol)
Brief summary.
 Pharmacodynamics It is scheduled 8 drug which is used to treat moderate to extreme
pain. It can be used to treat acute as well as chronic pain.
Morphine directly acts in the central nervous system and blocks
the pain signals from travelling along the nerves to the brain.
("Morphine - DrugBank", 2019)
 pharmacokinetics Morphine is absorbed from all routes of administration, except
transdermal. Moreover it can be injected spinally. The most
effective ways of administration are intramuscular and
subcutaneous as it takes 15-20 minutes reach the peak effect,
where as 30-90 minutes after oral administration. However oral
is the most common route of administration.
As it goes through the metabolism in the liver, the peak effect of
oral administration are much lower than after parenteral routes.
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