Furosemide
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Generic name: Furosemide (oral/injection)
Brand name: Lasix
Drug class: loop diuretic (water pill)
Indication: High blood pressure (hypertension) and edema
Route: Furosemide is taken by mouth and the injection is injected into the muscle or
given as an infusion into the vein
Adverse Effects: Taking more than recommended can cause irreversible hearing loss
Furosemide causes urination more often, so you can possibly get dehydrated easily
Avoid getting up too fast from a sitting or lying position, avoid becoming dehydrated,
drinking alcohol with this medicine can cause side effects
Nursing implications/patient teaching: recheck blood pressure, lung sounds, and
monitor weight, amount/location of edema, skin turgor, and mucous membranes. Place
patient on fall risk precautions, avoid prolonged exposure to sun (furosemide make skin
sensitive to sunlight).
IV Administration: Inject 20 to 40 mg of furosemide slowly over 1 to 2 minutes; in
pediatric patients inject no faster than 0.5 mg/kg/minute
IV compatibility: furosemide is compatible with bicarbonate solution, heparin, insulin,
morphine, and nitroglycerin. Furosemide is incompatible with amiodarone,
cisatracurium, haloperidol, midazolam, and urapidil.
IV dilution: dilute the dose with 50-250 mL of a compatible solution and infuse at a
maximum rate of 4mg/minute
Diltiazem
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Generic name: Diltiazem
Brand name: Cardizem, Cartia XT, Dilacor XR, Dilt-CD, Diltia XT, Matzim LA, Tiazac
Drug class: Calcium channel blocking agent, Group IV antiarrhythmics
Indication: hypertension (high blood pressure), angina (chest pain) and certain heart
rhythm disorders
Route/Frequency: Take PO; do not crush, chew, break or open an extended-release
diltiazem tablet or capsule. The tablets is usually taken 3 to 4 times a day. The extended –
release capsule and tablet are taking 1 or 2 times a day. Take the medicine around the
same time daily.
Adverse effects: Overdose symptoms include slow heartbeat, weakness, chest pain,
shortness of breath or fainting
Avoid grapefruit and grapefruit juice as it may interact with diltiazem and lead to side
effects. Diltiazem may impair your thinking or reactions, avoiding drinking alcohol,
avoid taking herbal supplements containing St. John’s wort
Nursing implications/patient teaching: check blood pressure, heart rate and cardiac
monitor, assess BUN/Creatine, liver function (AST, ALT) labs. Make position changes
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slowly to minimize orthostatic hypotension, patient should be listed as a fall risk, may
cause drowsiness or dizziness. Administer before meals and at bedtime. Direct patient to
take medicine at the same time daily. Avoid grapefruit and grapefruit juice.
IV administration: 0.25 mg/kg; may repeat in 15 mins with a dose of 0.35 mg/kg. may
follow with continuous infusion beginning at 10mg/hr. continuous IV infusion
immediately following the IV bolus
IV compatibility: Compatible with albumin, alemtuzumab, alfentanil
IV dilution: the common dilution is 125 mg of diltiazem injection added to 100mL of an
appropriate diluent which would give a final concentration of 125 mg/125mL (1mg/mL).
Digoxin
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Generic name: Digoxin
Brand name (Trade name): Lanoxin, Toloxin
Drug class: Antidysrhythmics, cardiac glycosides
Dose: 0.05 mg/mL
Route: Can be given PO, IM, IV
Indication: heart failure, atrial fibrillation and atrial flutter (slows ventricular rate),
paroxysmal atrial tachycardia
Action (what does the drug do): increases cardiac output (positive inotropic effect) and
slows the heart rate (negative chronotropic effect)
Side effects: CNS: fatigue, headache CV: arrhythmias (life threatening), bradycardia,
AV block, SA block EENT: blurred vision GI: anorexia, nausea, vomiting, diarrhea
HEMAT: thrombocytopenia
Nursing implication/patient teaching: check patient pulse and contact healthcare
professional if rate is less than 60 or greater than 100. Instruct patient to take medicine as
directed. Do not share medications. Inform health care professionals of any OTC
medications they take. Instruct patient to keep medicine if it’s original container and not
to mix in pill boxes with other medications. Review fall precautions with elderly patients
and families. Notify health care professionals if patient is pregnant or is planning
pregnancy.
IV administration: 0.5-1mg given as 50% of the dose initially and ¼ of the initial dose
in each of 2 subsequent doses at 6-12 hr. intervals
IV compatibility: acyclovir, alemtuzumab, alfentanil
IV dilution: may be administered undiluted; may also dilute with 1mL of digoxin in 4
mL of sterile water for injection, D5W, or 0.9% NaCl (sodium chloride). Use diluted
solution immediately.
Potassium Chloride
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Generic name: Potassium Chloride
Brand name: Klor-Con, Kal Potassium, K-Tab
Drug class: Minerals and electrolytes
Route: PO
Dosage: 40 to 100 mEq per day, orally, in 2 to 5 divided doses. Maximum single dose 20
mEq per dose. Maximum daily dose 200 mEq.
Indication: hypokalemia
Action (what does the drug do): used to prevent or to treat low blood levels of
potassium (hypokalemia). A normal level of potassium help your cells, kidneys, heart,
muscles and nerves work properly.
Side effects: upset stomach, nausea, vomiting, gas, diarrhea
Adverse effects: vomit that resemble coffee grounds, stomach/abdominal pain,
black/tarry stools, arrhythmias, bleeding, hyperkalemia
Nursing implications/patient teaching: note any allergies, history of heart or kidney
problems or high levels of potassium in the blood. Note if patient is take a diuretic (water
pill) or on heart/blood pressure medication.
IV administration: administration should be via a volumetric infusion pump. Iv
administration via a peripheral line should not exceed 40mEq/L
IV compatibility: aminophylline, amiodarone, Ca gluconate, cimetidine, clindamycin,
dobutamine, erythromycin, furosemide
IV dilution: always dilute KCI never give a bolus or IV push.