SYSTEMS PLUS COLLEGE FOUNDATION

Angeles City
COLLEGE OF NURSING

DRUG STUDY

Student’s Name: _______________________________ Clinical Area: _________________

Group: ________________________________

Patient’s Initial:
Admitting Diagnosis:
Date of Admission:

Indication/ Specific Action/

Generic and Classification/s Mechanism of Action Dosage, Frequency and Side Effects and Actual Desired Nursing
Brand Name Preparation Adverse Reactions Effects Considerations
Therapeutic class: Hypervolemic and euvolemic Adults: Initially, 15 mg PO Hyponatremia; thirst, -During initiation of
Vasopressin hyponatremia (serum sodium once daily. After 24 hours, dry mouth, asthenia, therapy and dosage
Brand name : antagonists level less than 125 mEq/L may increase to 30 mg PO constipation, pollakiuria titration, frequently
Samsca and symptomatic once daily, to or polyuria, monitor patients for
Pharmacologic class: hyponatremia) in maximum dosage of 60 mg hyperglycemia. changes in serum
Generic Name: Selective vasopressin hospitalized patients, PO once daily for no more electrolytes, volume
Tolvaptan receptor antagonists including those with HF or than 30 days. Titrate dosage status, and neurologic
SIADH (Samsca only) at 24-hour status.
intervals to desired serum
sodium concentration. -Monitor serum
potassium
concentrations in
To slow kidney function Adults: Initially, 60 mg PO patients with a serum
decline in patients at risk for daily as 45 mg taken on potassium greater than
rapidly progressing waking and 15 mg taken 8 5 mEq/L, and in
autosomal hours later. patients also being
dominant polycystic kidney Titrate to 60 mg plus 30 mg, treated with
disease (ADPKD) (Jynarque then to 90 mg plus 30 mg per medications known to
only) day if tolerated, with at least increase serum
Mechanism of Action:  weekly potassium
Tolvaptan is a selective and intervals between titrations.
competitive arginine May be down-titrated based concentrations (such
vasopressin receptor 2 on tolerability. as potassium-sparing
antagonist. Vasopressin acts diuretics, angiotensin-
on the V2 receptors found in
converting enzyme
the walls of the vasculature
and luminal membranes of
inhibitors, and
renal collecting ducts. By angiotensin receptor
blocking V2 receptors in the blockers).
renal collecting ducts,
aquaporins do not insert -Encourage patients to
themselves into the walls thus drink fluid in response
preventing water absorption. to thirst. Avoid fluid
This action ultimately results in restriction during the
an increase in urine volume, first 24 hours of
decrease urine osmolality, and therapy.
increase electrolyte-free water
clearance to reduce
intravascular volume and an -Tell patients not to
increase serum sodium levels. drink grapefruit juice
Tolvaptan is especially useful because it may
for heart failure patients as increase the drug's
they have higher serum levels concentration.
of vasopressin.
-When tolvaptan
treatment is
discontinued, teach
patients to resume
fluid restriction as
directed by the
healthcare provider.