SARENO, PHOEBE JOY D. BSN4A-2b 1. DRUG GENERIC NAME: Epinephrine TRADE NAME: EpiPen CLASSIFICATIONS: alpha- and beta-adrenergic agonists (sympathomimetic agents) MECHANISM OF ACTION Stimulates alpha-adrenergic receptors (vasoconstriction, pressor effects), beta 1 adrenergic receptors (cardiac stimulation), beta2-adrenergic receptors (bronchial dilation, vasodilation). Relaxes smooth muscle of bronchial tree, produces cardiac stimulation, dilates skeletal muscle vasculature. INDICATION Treatment of allergic reactions including anaphylactic reactions and hypotension associated with septic shock. Also, for ventricular fibrillation or pulseless ventricular tachycardia unresponsive to initial defibrillatory shocks; pulseless electrical activity, asystole, hypotension unresponsive to volume resuscitation; bradycardia/hypotension unresponsive to atropine or pacing MECHANISM OF ACTION Binds to and inhibit muscarinic acetylcholine receptors, producing a wide range of anticholinergic effects. Competes with acetylcholine for common binding sites on muscarinic receptors located on exocrine glands, cardiac and smooth muscle ganglia, intramural neurons INDICATION Treatment of symptomatic sinus bradycardia, AV block, ventricular asystole. Adjuvant to decrease side effects during reversal neuromuscular blockage Therapeutic Effects Improve breathing, stimulate the heart, raise a dropping blood pressure, reverse hives, and reduce swelling of the face, lips, and throat. 2. DRUG GENERIC NAME: 2. Atropine Sulfate BRAND NAME: Lomotil Classifications: Acetylcholine antagonist, Antiarrhythmic, antidote Therapeutic Effects: Reduces secretions in the mouth and respiratory passages, relieves the constriction and spasm of the respiratory passages, and may reduce the paralysis of respiration that results from toxic nerve agents which increase anticholinesterase activity in the central nervous system. SARENO, PHOEBE JOY D. BSN4A-2b 3. DRUG GENERIC NAME: Amiodarone TRADE NAME: Nexterone Pacerone CLASSIFICATIONS: Class III antiarrhythmic Therapeutic Effects By direct action on smooth muscle, decreases peripheral resistance and increases coronary blood flow. Blocks effects of sympathetic stimulation. 4. DRUG GENERIC NAME: Nitroglycerin BRAND NAME: Gonitro, Minitran, Mylan-nitro Classifications: vasodilator Therapeutic Effects: Relaxing the smooth muscle and blood vessels. This increases the amount of blood and oxygen that reaches your heart. In turn, your heart doesn't work as hard. This reduces chest pain. MECHANISM OF ACTION It blocks potassium currents that cause repolarization of the heart muscle during the third phase of the cardiac action potential. As a result, amiodarone increases the duration of the action potential as well as the effective refractory period for cardiac cells (myocytes). Therefore, cardiac muscle cell excitability is reduced, preventing and treating abnormal heart rhythms. Amiodarone also interferes with the functioning of beta-adrenergic receptors, sodium channels, and calcium channels. INDICATION Prophylaxis and treatment of life-threatening ventricular arrhythmias and supraventricular arrhythmias, particularly with atrial fibrillation. MECHANISM OF ACTION Converted by mitochondrial aldehyde dehydrogenase (mtALDH) to nitric oxide (NO), an active substance which then activates the enzyme guanylate cyclase.2 The activation of this enzyme is followed by the synthesis of cyclic guanosine 3',5'-monophosphate (cGMP), activating a cascade of protein kinase-dependent phosphorylation events in smooth muscles. This process eventually leads to the dephosphorylation of the myosin light chain of smooth muscles, causing relaxation and increased blood flow in veins, arteries and cardiac tissue. INDICATION Prevent and treat angina or chest pain due to cardiovascular disease, as well as to treat perioperative hypertension or induce intraoperative hypotension. Also, to treat acute heart failure in patients with myocardial infarction.16 In the ointment form, nitroglycerin is indicated to treat pain caused by anal fissures.14 The transdermal form is applied directly to the skin to prevent acute anginal attacks.20 SARENO, PHOEBE JOY D. BSN4A-2b 5. DRUG GENERIC NAME: Morphine BRAND NAME: Roxanol MECHANISM OF ACTION Morphine and its metabolites act as agonists of the mu and kappa opioid receptors. The mu-opioid receptor is integral to morphine's effects on the ventral tegmental area of the brain. INDICATION Relief of severe acute and severe chronic pain. MECHANISM OF ACTION Slows impulse formation in SA node and conduction time through AV node. Restores normal sinus rhythm. Agonism of adenosine receptors A1 and A2 reduces conduction time in the atrioventricular node of the heart. Conduction time is decreased by inducing potassium efflux and inhibiting calcium influx through channels in nerve cells, leading to hyperpolarization and increased threshold for calcium dependent action potentials. Decreased conduction time leads to an antiarrhythmic effect. INDICATION Treatment of paroxysmal supraventricular tachycardia (PSVT), including patient associated with accessory bypass tract (WolffParkinson-White syndrome). Also indicated as an adjunct to thallium-201 in myocardial perfusion scintigraphy in patients unable to adequately exercise.12 It is also indicated to convert sinus rhythm of paroxysmal supraventricular tachycardia.13 Classifications: opioid analgesic Therapeutic Effects: This medication is used to treat severe pain 6. DRUG GENERIC NAME: Adenosine BRAND NAME: Adenocard Classifications: Antiarrhythmic Therapeutic Effects: Relaxes and dilates blood vessels. Adenosine also affects the electrical activity of the heart. Adenosine is used to help restore normal heartbeats in people with certain heart rhythm disorders. Adenosine is also used during a stress test of the heart. SARENO, PHOEBE JOY D. BSN4A-2b 7. DRUG GENERIC NAME: Aspirin BRAND NAME: Durlaza, Novasen Classifications: Anticoagulant, antiinflammatory, Antipyretic MECHANISM OF ACTION Acts as an acetylating agent where an acetyl group is covalently attached to a serine residue in the active site of the COX enzyme. This makes aspirin different from other NSAIDs (such as diclofenac and ibuprofen), which are reversible inhibitors. Inhibits cyclo-oxygenase enzyme via acetylation. Inhibits formation of prostaglandin derivative thromboxane A INDICATION Used as platelet aggregation inhibitor in the prevention of transient ischemic attacks, cerebral thromboembolism, MI. Alternative therapy for preventing thromboembolism associated with atrial fibrillation when warfarin cannot be used; pericarditis associated with MI; prosthetic valve thromboprophylaxis. And treatment of mild to moderate pain, fever. MECHANISM OF ACTION Widely used cardiac glycoside of Digitalis lanata. Acts by increasing the force and velocity of myocardial systolic contraction (positive inotropic effect). It also decreases conduction velocity through the atrioventricular node. Action is more prompt and less prolonged than that of digitalis and digitoxin. INDICATION Rapid digitalization and for maintenance therapy in CHF, atrial fibrillation, atrial flutter, paroxysmal atrial tachycardia. Therapeutic Effects: reduce fever and relieve mild to moderate pain from conditions such as muscle aches, toothaches, common cold, and headaches. It may also be used to reduce pain and swelling in conditions such as arthritis 8. DRUG GENERIC NAME: Digoxin BRAND NAME: Lanoxin Classifications: CARDIOVASCULAR AGENT; CARDIAC GLYCOSIDE; ANTIARRHYTHMIC Pregnancy Category: A Therapeutic Effects: Increases the contractility of the heart muscle (positive inotropic effect). SARENO, PHOEBE JOY D. BSN4A-2b 9. DRUG GENERIC NAME: Verapamil BRAND NAME: Calan, Isoptin MECHANISM OF ACTION Inhibits the calcium ion (and possibly sodium ion) influx through slow channels into conductile and contractile myocardial cells and vascular smooth muscle cells. INDICATION Treatment of vasopastic (i.e. Prinzmetal's) angina, unstable angina, and chronic stable angina. It is also indicated to treat hypertension, for the prophylaxis of repetitive paroxysmal supraventricular tachycardia, and in combination with digoxin to control ventricular rate in patients with atrial fibrillation or atrial flutter MECHANISM OF ACTION A systemic alkalizer, which increases plasma bicarbonate, buffers excess hydrogen ion concentration, and raises blood pH, thereby reversing the clinical manifestations of acidosis. INDICATION Management of metabolic acidosis. Used to alkalinize urine and promote excretion of certain drugs in over dosage situation. And also used as an antacid. Classifications: calcium channel blockers Therapeutic Effects: Treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. 10. DRUG GENERIC NAME: Sodium Bicarbonate BRAND NAME: Neut, Bell/ans Classifications: Alkalinizing Agents Therapeutic Effects: Increasing plasma bicarbonate levels, which are known to buffer excess hydrogen ion concentration, thereby raising solution pH to combat clinical manifestations of acidosis.
