Submitted by:
Alminar, Julia C.
4NU01
Submitted to:
Prof. Edward Caramanzana, RN, MAN
1. Aminophylline
2. Amiodarone HCL
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
Aspirin
Atropine Sulfate
Budesonide
Calcium Gluconate
Clonidine
Dexamethasone
Digoxin
Diphenhydramine
Dobutamine HCL
Dopamine HCL
Epinephrine
Furosemide
Hydralazine Hydrochloride
Hydrocortisone
Isosorbide Dinitrate
Magnesium Sulfate
Methylergonovine
Metoclopramide HCL
Nicardipine
Norepinephrine
Omeprazole
Phenytoin
Potassium Chloride KCL
Salbutamol Nebule
Sodium Bicarbonate
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
Terbutaline Sulfate - Erika
Tranexamic Acid - Erika
Hyoscine-N-Butylbromide - Erika
Paracetamol (ampule) - Erika
Phytomenadione - Erika
Lidocaine - Bea
Mannitol - Bea
Ketorolac - Bea
Clindamycin - Bea
Tramadol - Bea
5% Dextrose - agui
Isoxsuprine - agui
NaCl (Sodium Chloride) -Agui
Betahistine - agui
Vitamin B - Meg
Ranitidine - Meg
Ascorbic Acid - Meg
Mefenamic Acid - Meg
Lactated Ringer's - Meg
Aminophylline
Drug
Generic Name:
Theophylline
ethylenediamine
Brand Name:
Theo 24
Theochron
Elixophyllin
Aminophylline
Uniphyl.
Pharmacologic
Class: Xanthine
Therapeutic Class:
Bronchodilator
Dosage
Capsules: 250 mg,
500 mg.
Injection, Powder for
Reconstitution: 125
mg, 250 mg, 500 mg,
1 g, 2 g.
Powder for Oral
Suspension: 125 mg/5
mL, 250 mg/5 mL.
Mechanism of Action
Indication and
Contraindication
Side Effects and
Adverse Effects
Aside from the heart, this Indication
Side Effects
chemical works well on the ● To relieve acute ● Chest pain or
blood vessel system. By
bronchospasm
discomfort
dilating renal and coronary ● To prevent or ● Increase in urine
arteries, it improves cardiac
treat reversible
volume
contraction while also
bronchospasm
● Vomiting
relieving
bronchial
from
asthma,
obstruction and maintaining
chronic
Adverse Effects
healthy breathing patterns.
bronchitis, and ● Dizziness
emphysema and ● Fever
As a bronchodilator used in
to maintain patent ● headache
the treatment of asthma and
airways
● Insomnia
chronic
obstructive
● Irritability
pulmonary
disease, Contraindication
● Restlessness
aminophylline
has ● Active peptic
seizures
comparable effects and uses
ulcer disease
● Arrhythmias
to theophylline. In addition ● Hypersensitivity
(including sinus
to
relaxing
bronchial
to aminophylline,
tachycardia and
smooth
muscle
and ● Rectal or lower
life-threatening
relieving bronchospasm, the
intestine irritation
ventricular
xanthine
aminophylline
or infection
arrhythmias),
also stimulates breathing.
(suppository
● Hypotension
form)
● Palpitations
● Underlying
seizure disorder
Nursing Responsibility
●
●
Advise patient to avoid
excessive caffeine (in
coffee, tea, soft drinks,
and chocolate); it can
falsely
elevate
theophylline level.
Explain that blood tests
may be needed to
monitor
the
drug's
therapeutic effect.
Amiodarone
Drug
Generic Name:
Amiodarone
Brand Name:
Cordarone
Pacerone
Nexterone
Pharmacologic
Class:
Class III
antiarrhythmic
Therapeutic Class:
Class III
antiarrhythmic
Dosage
Infusion (Pre-Mix):
Nexterone:
150
mg/100
mL;
360
mg/200 mL.
Mechanism of Action
Acts on the membranes of
heart
cells, extending
repolarization and the
refractory
period
and
increasing the threshold for
Injection,
Solution ventricular
fibrillation.
(Cordarone IV): 50 Drug increases myocardial
mg/mL, 3 mL, 9 mL, blood flow by relaxing
18 mL.
vascular smooth muscles,
particularly in coronary
Tablets:
100
mg circulation. It reduces
(Pacerone), 200 mg peripheral
vascular
(Cordarone, Pacerone), resistance and myocardial
400 mg (Pacerone).
oxygen consumption by
relaxing
the
smooth
muscles of the peripheral
vascular system.
Indication and
Contraindication
Indication
● Supraventricular
arrhythmias
● Ventricular
arrhythmias
● Pulseless
ventricular
tachycardia
● Ventricular
fibrillation
Side Effects and
Adverse Effects
Side Effects
● Corneal
microdeposits
● Constipation
● Headache
● Decreased
appetite
● Nausea
● Vomiting
● Paresthesia
● Photosensitivity
Contraindications
● Muscular
● Sinus bradycardia
incoordination
● Sino-atrial heart ● Hypotension
block
● Nausea
● Severe
● Fever
conduction
● Bradycardia
disturbances (e.g.
high-grade
AV Adverse Effects
block,
● Bradycardia
bifascicular
or ● QT prolongation
trifascicular
● Hypotension
block) without a ● Peripheral
presence
of
neuropathy
pacemaker
● Photosensitivity
● Cardiogenic
● Optic neuropathy
shock
and/or optic
● Severe
neuritis.
Nursing Responsibility
●
●
●
●
Obtain baseline serum
ALT,
AST, alkaline
phosphatase,
EKG;
pulmonary function tests,
CXR
in pts with
pulmonary disease.
Assess B/P, apical pulse
immediately before drug
is administered (if pulse
is 60/min or less or
systolic B/P is less than
90 mm Hg, withhold
medication,
contact
physician).
Explain that the patient
will
need
frequent
monitoring
and
laboratory tests during
treatment.
Advise patient to report
swollen hands and feet,
wheezing,
dyspnea,
cough, nausea, vomiting,
dark
urine,
fatigue,
yellow skin or sclerae,
stomach
pain,
light-headedness,
fainting, or a rapid, slow,
hypotension
Severe
respiratory failure
Known or history
of
thyroid
dysfunction
Known
hypersensitivity
to iodine
Corneal
refractive laser
surgery
●
●
●
●
●
pounding, or irregular
heartbeat.
Instruct patient to report
abnormal bleeding or
bruising
Aspirin
Drug
Generic Name:
Acetylsalicylic acid
Brand Name:
Ascriptin
Bayer
Bufferin
Durlaza
Ecotrin
Pharmacologic
Class:
Salicylate
Therapeutic Class:
Dosage
Mechanism of Action
Indication and
Contraindication
Caplets: 325 mg, 500 Inhibits cyclo-oxygenase Indication
mg.
enzyme via acetylation. ● To relieve mild
Inhibits
formation of
pain or fever
Suppositories: 300 mg, prostaglandin derivative ● To relieve mild to
600 mg.
thromboxane A.
moderate
pain
from
Tablets: 325 mg.
Reduces
inflammatory
inflammation, as
response, intensity of pain;
in
rheumatoid
Tablets (Chewable): decreases fever; inhibits
arthritis
and
81 mg.
platelet aggregation.
osteoarthritis
● To treat juvenile
Capsule,
rheumatoid
Extended-Release:
arthritis
(Durlaza) 162.5 mg.
● To treat acute
rheumatic fever
Side Effects and
Adverse Effects
Side Effects
distress
● GI
(including
abdominal
distention,
cramping,
heartburn, mild
nausea)
● Allergic reaction
(including
bronchospasm,
pruritus,
urticaria).
Adverse Effects
Nursing Responsibility
●
●
●
●
Don’t crush timed-release
or controlled release
aspirin tablets unless
directed.
Assess history of GI
bleed,
peptic
ulcer
disease, OTC use of
products that may contain
aspirin.
Assess type, location,
duration
of
pain,
inflammation.
Inspect appearance of
affected
joints
for
immobility, deformities,
Anti-inflammatory,
antiplatelet,
antipyretic, nonopioid
analgesic
●
Tablets
(Enteric-Coated): 81
mg, 325 mg, 500 mg,
650 mg.
●
●
To reduce the risk
of
recurrent
transient
ischemic attacks
or stroke in men
To reduce the
severity of or
prevent acute MI
To reduce risk of
MI in patients
with previous MI
or
unstable
angina
●
●
●
●
●
●
●
●
●
●
●
●
●
Contraindication
●
to
● Allergy
tartrazine dye
● Asthma
● Bleeding
problems (such as
hemophilia),
hypersensitivity
to aspirin or its
components,
peptic
ulcer
disease
skin condition.
Confusion
CNS depression
Hearing loss
Tinnitus
Diarrhea
GI bleeding
Heartburn
Hepatotoxicity
Nausea
Stomach pain
Vomiting
Decreased blood
iron level
Leukopenia
Prolonged
bleeding time
Atropine Sulfate
Drug
Generic Name:
Atropine sulfate
Dosage
Intramuscular device
● 0.25mg/0.3mL
● 0.5mg/0.7mL
Mechanism of Action
Indication and
Contraindication
Side Effects and
Adverse Effects
Inhibits
acetylcholine’s Indication
Side Effects
muscarinic action at the ● To
correct ● Dryness of the
neuroeffector junctions of
bradycardia
mouth
Nursing Responsibility
●
Avoid using high-dose
atropine
sulfate
in
patients with ulcerative
Brand Name:
AtroPen
Pharmacologic
Class:
Belladonna alkaloid
Therapeutic Class:
Anticholinergic,
antimuscarinic
●
●
1mg/0.7mL
2mg/0.7mL
Injectable solution
● 0.05mg/mL
● 0.1mg/mL
● 0.4mg/mL
● 0.8mg/mL
● 1mg/mL
smooth muscles, cardiac ●
muscles, exocrine glands,
SA and AV nodes, and the
urinary bladder. In small
doses, atropine inhibits ●
salivary and bronchial
secretions and diaphoresis.
In moderate doses, it
increases
impulse
conduction through the AV
node and increases heart
rate. In large doses, it ●
decreases GI and urinary
tract motility and gastric
acid secretion
●
●
To
reduce
respiratory tract
secretions related
to anesthesia
To
treat
cholinesterase
inhibitor (such as
neostigmine,
pilocarpine, and
methacholine)
toxicity
To
treat
mushroom
(muscarine)
toxicity
To treat pesticide
(organophosphate
) toxicity
To treat known or
suspected
exposure
to
chemical nerve
agent
or
insecticide
Contraindication
● Angle-closure
glaucoma
● Asthma
● GI obstructive
disease
(achalasia,
pyloric
obstruction,
pyloroduodenal
stenosis)
●
●
●
●
●
●
●
●
●
●
●
●
●
●
●
●
Blurred vision
Dry eyes
Confusion
Headache
Dizziness
Fatigue
Tachycardia
Palpitation
Flushing,
Urinary hesitance
or retention
Constipation
Abdominal pain
Abdominal
distention
Nausea
Vomiting
Loss of libido
and impotence
Adverse Effects
● Agitation
● Amnesia
● Anxiety
● Ataxia
● Arrhythmias
● Bradycardia (at
low doses)
● Cardiac dilation
● Chest pain
● Hypertension
● Hypotension
● Left ventricular
failure
● MI
●
●
●
colitis because of risk of
toxic megacolon or in
patients with hiatal hernia
and reflux esophagitis
because of risk of
esophagitis
Assess bowel and bladder
elimination.
Notify
prescriber of diarrhea,
consti pation, urinary
hesitancy,
or
urine
retention.
Instruct patient to take
atropine sulfate 30 to 60
minutes before meals.
Advise patient to notify
prescriber if he has
persistent
or
severe
diarrhea, constipation, or
difficulty urinating.
●
●
●
●
●
●
●
●
●
●
●
●
Hepatic disease
Hypersensitivity
to atropine or its
components
Ileus
Intestinal atony
Myasthenia
gravis
Myocardial
ischemia
Obstructive
uropathy
Renal disease
Severe ulcerative
colitis
Tachycardia
Toxic megacolon
Unstable
cardiovascular
status in acute
hemorrhage
●
●
●
Palpitation
Tachycardia (at
high doses)
Weak
or
impalpable
peripheral pulses
Budesonide
Drug
Dosage
Mechanism of Action
Indication and
Contraindication
Side Effects and
Adverse Effects
Brand Name:
Pulmicort Flexhaler
Oral Inhalation
Powder (Pulmicort
Flexhaler): 90 mcg per
inhalation; 180 mcg per
inhalation.
Indication
● Rhinitis
● Bronchial
Asthma
● Crohn’s Disease
● Ulcerative Colitis
Pharmacologic
Inhalation Suspension
Inhibits accumulation of
inflammatory
cells;
controls rate of protein
synthesis;
decreases
migration
of
polymorphonuclear
leukocytes
(reverses
Side Effects
● Mild
nasopharyngeal
irritation burning,
stinging, dryness;
headache, cough.
● Flu-like
Generic Name:
Budesonide
Nursing Responsibility
●
Monitor
patient
for
evidence
of
hypersensitivity, such as
contact dermatitis, rash,
urticaria,
angioedema,
bronchospasm,
or
anaphylaxis. If present,
Class:
Glucocorticoid
Pulmicort
Rhinocort Aqua
Uceris
Therapeutic Class:
Antiasthmatic,
anti-inflammatory
for Nebulization
(Pulmicort): 0.25 mg/2
mL; 0.5 mg/2 mL; 1
mg/2 mL.
Nasal Spray
(Rhinocort Allergy,
Rhinocort Aqua): 32
mcg/spray.
Capsules,
Enteric-Coated
(Entocort EC): 3 mg.
capillary permeability and Contraindication
lysosomal stabilization at ● Hypersensitivity
cellular level).
to budesonide or
its components
Relieves symptoms of ● Recent septal
allergic rhinitis, asthma,
ulcers or nasal
Crohn’s disease.
surgery or trauma
(nasal spray)
● Status
asthmaticus or
other acute
asthma episodes
(oral inhalation)
Tablets,
Extended-Release:
(Uceris): 9 mg.
●
●
●
●
●
●
●
●
●
●
●
●
●
●
symptoms
Headache
Pharyngitis
Dry mouth
Dyspepsia
Rebound
congestion
Rhinorrhea
Loss of taste
Back pain
Vomiting
Altered taste
Voice changes
Abdominal pain
Nausea
Dyspepsia
●
●
notify the prescriber
immediately. Expect to
stop budesonide and
provide
emergency
supportive care
Auscultate lung sounds.
Monitor for relief of
symptoms.
Adverse Effects
● Acute
hypersensitivity
reaction
(urticaria,
angioedema,
severe
bronchospasm)
occurs rarely.
Calcium Gluconate
Drug
Generic Name:
Calcium Gluconate
Dosage
1 g = 93 mg calcium
Mechanism of Action
Indication and
Contraindication
Extracellular
calcium, Indication
which is needed to ● To
Side Effects and
Adverse Effects
Side Effects
prevent ● Chalky taste
Nursing Responsibility
●
Assess B/P, EKG and
cardiac rhythm, renal
Brand Name:
Gluconate
Ca
Injection Solution:
10%.
Pharmacologic
Class:
Electrolyte
replenisher
maintain
homeostasis,
especially in the nervous
and
musculoskeletal
systems.
Also plays a role in normal
cardiac and renal function,
respiration, coagulation,
and cell membrane and
capillary permeability.
Therapeutic Class:
Antacid
Antihyperglycemic
Antihyperkalemic
Antihypermagnesemi
c
Antihyperphosphatem
ic
Helps regulate the release
and
storage
of
neurotransmitters
and
hormones.
Oral forms also neutralize
or buffer stomach acid to
relieve discomfort caused
by hyperacidity.
hypocalcemia
● Pain, rash
To
replace ● Redness
calcium
in ● Burning at
hypocalcemia
injection site
● Flushing
Contraindication
● Nausea
● Hypercalcemia
● Vomiting
● Hypersensitivity
● Diaphoresis
to calcium salts
● Hypotension
or their
components
Adverse Effects
● Hypophosphatem ● Constipation
ia
● Headache
● Renal calculi
● Dry mouth
● Increased thirst
● Irritability
● Decreased
appetite
● Metallic taste
● Fatigue
● Weakness
● Depression
●
●
●
function,
serum
magnesium, phosphate,
calcium, ionized calcium.
Keep patient in a
recumbent position for 30
minutes after parenteral
administration to prevent
dizziness from
hypotension.
Be aware that calcium
chloride
injection
contains three times as
much
calcium
per
milliliter as calcium
gluconate injection.
Clonidine
Drug
Generic Name:
Clonidine
Brand Name:
Catapres-TTS
Dosage
Mechanism of Action
Indication and
Contraindication
Injection
Solution Stimulates
alpha2 Indication
(Duraclon):
100 -adrenergic
receptors, ● To
manage
mcg/mL, 500 mcg/mL. reducing sympathetic CNS
hypertension
response.
● To treat severe
Tablets
hypertension
Side Effects and
Adverse Effects
Side Effects
● Dry mouth
● Drowsiness
● Dizziness
● Sedation
Nursing Responsibility
●
Obtain B/P immediately
before each dose is
administered, in addition
to regular monitoring (be
alert to B/P fluctuations).
Duraclon
Kapvay
Pharmacologic
Class:
Alpha2 -adrenergic
agonist
Therapeutic Class:
Analgesic
Antihypertensive
(Catapres): 0.1 mg, 0.2
mg, 0.3 mg.
(Kapvay): 0.1 mg, 0.2
mg.
Transdermal
Patch
(Catapres-TTS): 2.5
mg (release at 0.1
mg/24 hrs), 5 mg
(release at 0.2
mg/24 hrs), 7.5 mg
(release at 0.3 mg/24
hrs).
Extended-Release
Tablets:(Kapvay): 0.1
mg.
Epidural: Prevents pain ●
signal transmission to the
brain
and
produces
analgesia at pre- and
post-alpha-adrenergic
receptors in the spinal
cord.
Therapeutic
Effect: ●
Reduces
peripheral
resistance; decreases B/P,
heart
rate.
Produces
analgesia.
To treat attention
deficit
hyperactivity
disorder (ADHD)
alone
or
as
adjunct therapy
with
stimulant
drugs
As adjunct to
relieve
severe
pain (in cancer
patients) that isn’t
adequately
relieved
by
opioid analgesics
alone
●
Constipation
Adverse Effects
● Overdose
produces
profound
hypotension
● Irritability
● Bradycardia
● Respiratory
depression
● Hypothermia
● Miosis (pupillary
constriction)
● Arrhythmias
● Apnea.
●
●
●
●
Contraindication
● Anticoagulant
therapy (epidural
infusion)
● Bleeding
diathesis
● Hypersensitivity
to clonidine or its
components
including
adhesive used in
transdermal patch
● Injection-site
infection
(epidural
infusion)
Be aware that clonidine
should not be used in
most patients with severe
cardiovascular disease or
in those who are not
hemodynamically stable
because of the potential
for severe hypotension.
Use clonidine cautiously
in elderly patients, who
may be more sensitive to
its hypotensive effect.
Expect
transdermal
clonidine to take 2 to 3
days to lower blood
pressure.
Inform patient who wears
contact
lenses
that
clonidine may cause dry
eyes.
Dexamethasone
Drug
Generic Name:
Dexamethasone
Brand Name:
Dexamethasone
Intensol
DexPak
Maxidex
Pharmacologic
Class:
Synthetic
adrenocortical steroid
Dosage
Elixir: 0.5 mg/5 mL.
Suppresses
neutrophil
migration,
decreases
Injection, Solution: 4 production
of
mg/mL, 10 mg/mL.
inflammatory mediators,
reverses
increased
Ophthalmic Solution: capillary permeability.
0.1%.
Therapeutic
Effect:
Ophthalmic
Decreases inflammation.
Suspension
Suppresses
normal
(Maxidex):
0.1%. immune response.
Solution,
Oral: 0.5 mg/5 mL.
Therapeutic Class:
Anti-inflammatory
Immunosuppressant
Mechanism of Action
Solution,
Oral
Concentrate
(Dexamethasone
Intensol): 1 mg/mL.
Tablets: 0.5 mg, 0.75
mg, 1 mg, 1.5 mg, 2
mg, 4 mg, 6 mg.
Tablets
(TaperPak
[DexPak]): 1.5 mg (35
or 51 tablets on taper
dose card).
Indication and
Contraindication
Indication
● Anti-Inflammator
y
● Cerebral Edema
● Nausea/Vomiting
in Chemotherapy
Patients
● Physiologic
Replacement
Side Effects and
Adverse Effects
Side Effects
● Cough
● Dry mouth
● Hoarseness
● Throat irritation
● Intranasal:
Burning
● Mucosal dryness
● Blurred vision
● Insomnia
Contraindication
● Facial edema
● Administration of
(cushingoid
live-virus vaccine
appearance
to patient or
["moon face"])
family member
● Moderate
● Hypersensitivity
abdominal
to dexamethasone
distention
or its components ● Indigestion
(including
● Increased
sulfites)
appetite
● Idiopathic
● Nervousness
thrombocytopeni ● Facial flushing
c purpura (I.M.
● Diaphoresis
administration)
● Localized fungal
● Systemic fungal
infection (thrush)
infections
● Crusting inside
nose
● Epistaxis
Nursing Responsibility
●
●
●
Question
for
hypersensitivity to any
corticosteroids. Obtain
baselines for height,
weight,
B/P,
serum
glucose, electrolytes.
Use
dexamethasone
cautiously in patients
with congestive heart
failure, hypertension, or
renal
insufficiency
because drug can cause
sodium retention, which
may lead to edema and
hypokalemia
Give a once-daily dose of
dexamethasone in the
morning to coincide with
the
body’s
natural
cortisol secretion.
●
Sore throat
Adverse Effects
● Muscle wasting
(esp. arms, legs)
● Osteoporosis
● Spontaneous
● Fractures
● Amenorrhea,
● Cataracts
● Glaucoma
● Peptic ulcer
disease
● Glaucoma
● Hypertension
● Cataracts
Digoxin
Drug
Generic Name:
Digoxin
Brand Name:
Lanoxin
Apo-Digoxin
Digitek
Digox
Pharmacologic
Class: Cardiac
glycoside
Dosage
Oral Solution
(Lanoxin): 50
mcg/mL.
Injection Solution
(Lanoxin): 100
mcg/mL, 250 mcg/mL.
Tablets (Lanoxin):
62.5 mcg, 125 mcg,
187.5 mcg, 250 mcg.
Mechanism of Action
Indication and
Contraindication
Increases the force and Indication
velocity of myocardial ● To treat heart
contraction, resulting in
failure, atrial
positive inotropic effects.
flutter, atrial
fibrillation, and
Digoxin
produces
paroxysmal atrial
antiarrhythmic effects by
tachycardia with
decreasing the conduction
rapid
rate and increasing the
digitalization
effective refractory period
of the AV node
Contraindication
● Hypersensitive
Side Effects and
Adverse Effects
Nursing Responsibility
Side Effects
● Dizziness
● Headache
● Diarrhea
● Rash
● Visual
disturbances
●
Adverse Effects
● Confusion
● Depression
● Drowsiness
●
Assess apical pulse. If the
pulse is 60 or less/min
(70 or less/min for
children), withhold drug,
contact a physician.
Blood samples are best
taken 6–8 hrs after dose
or just before next dose.
Monitor
pulse
for
bradycardia, EKG for
arrhythmias for 1–2 hrs
after
administration
●
Therapeutic Class:
Antiarrhythmic
Cardiotonic
●
●
●
carotid
sinus
syndrome
Hypersensitivity
to digoxin
Presence
or
history
of
digitalis toxicity
or idiosyncratic
reaction
to
digoxin
Ventricular
fibrillation
Ventricular
tachycardia
unless
heart
failure
occurs
unrelated
to
digoxin therapy
●
●
●
●
●
●
●
●
●
●
●
●
Extreme
weakness
Headache
●
Syncope
Arrhythmias
Heart block
Blurred vision,
Colored
halos
around
objects
●
digoxin
Abdominal
discomfort
or
pain,
Anorexia
Diarrhea
Nausea
Vomiting
(excessive slowing of
pulse may be first clinical
sign of toxicity).
Assess
for
GI
disturbances, neurologic
abnormalities (signs of
toxicity) q2–4h during
loading
dose
(daily
during maintenance).
Monitor
serum
potassium, magnesium,
calcium, renal function.
Diphenhydramine
Drug
Dosage
Generic Name:
Diphenhydramine
Capsules: 25 mg, 50
mg.
Brand Name:
Benadryl
Diphen
Diphenhist
Genahist
Nytol
Banophen
Cream: 1%, 2%.
Injection Solution: 50
mg/mL.
Syrup: 12.5 mg/5 mL.
Mechanism of Action
Indication and
Contraindication
Side Effects and
Adverse Effects
Side Effects
●
● Drowsiness
● Dizziness
● Muscle
weakness,
● Hypotension,
Therapeutic
Effect:
● Urinary retention,
Produces anticholinergic,
of ●
● Thickening
antipruritic,
antitussive, Contraindication
bronchial
antiemetic, antidyskinetic, ● Bladder
secretions
neck
Competes with histamine
for H-1 receptor site on
effector cells in GI tract,
blood vessels, respiratory
tract.
Indication
● Allergic Reaction
● Motion sickness
● Antitussive
● Nighttime Sleep
Aid
● Pruritus
Nursing Responsibility
If a patient is having an
acute allergic reaction,
obtain a history of
recently ingested foods,
drugs,
environmental
exposure,
emotional
stress.
Monitor B/P rate; depth,
rhythm,
type
of
respiration; quality, rate
Tablets: 25 mg, 50 mg.
Pharmacologic
Class:
Histamine-1
antagonist
sedative effects.
●
Tablets, Chewable:
12.5 mg.
●
Therapeutic Class:
Antihistamine
Anticholinergic
Antipruritic
Antitussive
Antiemetic
Antidyskinetic
●
●
●
●
●
obstruction
Hypersensitivity
to
diphenhydramine
or its components
Lower respiratory
tract symptoms
(including
asthma)
MAO inhibitor
therapy,
Narrow
Angle
glaucoma
Pyloroduodenal
obstruction
Stenosing peptic
ulcer
Symptomatic
benign prostatic
hyperplasia
●
Dry mouth, nose,
●
throat, lips
Adverse Effects
● Confusion
● Dizziness
● Drowsiness
● Arrhythmias
● Palpitations
● Tachycardia
● Blurred vision
● Diplopia
● Epigastric
distress
● Nausea
● Agranulocytosis
● Hemolytic
anemia
● Thrombocytopeni
a
● Thickened
bronchial
secretions
● Photosensitivity
●
●
of pulse.
Assess lung sounds for
rhonchi, wheezing, rales.
Expect to give parenteral
form of diphenhydramine
only when oral ingestion
isn’t possible.
Instruct patient to take
diphenhydramine at least
30
minutes
before
exposure to situations
that may cause motion
sickness.
Dobutamine Hydrochloride
Drug
Generic Name:
Dobutamine
hydrochloride
Dosage
Infusion
(Ready-to-Use):
1
mg/mL (250 mL), 2
mg/mL (250 mL), 4
Mechanism of Action
Indication and
Contraindication
Side Effects and
Adverse Effects
Direct-action
inotropic Indication
Side Effects
agent acting primarily on ● To treat low ● Increased heart
beta1
-adrenergic
cardiac
output
rate, B/P
receptors.
and heart failure
● Pain at injection
Nursing Responsibility
●
●
Patient must be on
continuous
cardiac
monitoring.
Determine weight (for
Brand Name:
Dobutrex
Pharmacologic
Class:
Synthetic
catecholamine
mg/mL (250 mL).
Therapeutic
Injection
Solution: Enhances
12.5-mg/mL vial.
contractility,
heart rate.
Therapeutic Class:
Cardiac stimulant
● Cardiac
Effect:
Decompensation
myocardial
increases Contraindication
● Hypersensitivity
to dobutamine or
its components
● Idiopathic
hypertrophic
subaortic stenosis
●
●
●
●
●
site
Nausea
Headache
Anginal pain
Shortness
breath
Fever
●
of
●
Adverse Effects
may
● Overdose
produce severe
tachycardia,
severe
hypertension.
dosage calculation).
Obtain initial B/P, heart
rate, respirations. Correct
hypovolemia before drug
therapy
Dobutamine
isn’t
indicated for long-term
treatment of heart failure
because it may not be
effective
and
may
increase the risk of
hospitalization and death.
Dopamine Hydrochloride
Drug
Generic Name:
Dopamine
hydrochloride
Brand Name:
Intropin
Revimine
Pharmacologic
Class:
Catecholamine
Therapeutic Class:
Cardiac stimulant
Vasopressor
Dosage
Injection Solution: 40
mg/mL, 80 mg/mL, 160
mg/mL.
Mechanism of Action
Indication and
Contraindication
Stimulates adrenergic and Indication
dopaminergic receptors. ● To
correct
Effects
are
dose
hypotension
dependent. Lower dosage
that’s
Injection (Premix with stimulates dopaminergic
unresponsive to
Dextrose): 0.8 mg/mL receptors, causing renal
adequate
fluid
(250 mL, 500 mL), 1.6 vasodilation. Higher doses
volume
mg/mL (250 mL, 500 stimulate
both
replacement or
mL), 3.2 mg/mL (250 dopaminergic and beta1
occurs as part of
mL)
-adrenergic
receptors,
shock syndrome
causing
cardiac
caused
by
stimulation and renal
bacteremia
vasodilation.
● Chronic cardiac
decompensation
Side Effects and
Adverse Effects
Side Effects
● Headache
● Arrhythmias
● Tachycardia
● Anginal pain
● Palpitations
● Vasoconstriction
● Hypotension
● Nausea
● Vomiting
● Dyspnea.
Adverse Effects
● High doses may
Nursing Responsibility
●
●
●
●
●
Patients must be on
continuous
cardiac
monitoring.
Determine weight (for
dosage calculation).
Obtain initial B/P, heart
rate, respirations.
Assess patency of IV
access.
Titrate
dopamine
gradually to minimize
hypotension, especially
after a high infusion rate.
●
●
●
●
●
●
Drug overdose
Myocardial
Infarction
Open-heart
●
surgery
Renal failure
Trauma
Other
major
systemic
illnesses;
to
improve
low
cardiac output
Contraindication
● Pheochromocyto
ma
● Uncorrected
ventricular
fibrillation
● Ventricular
tachycardia
●
produce
ventricular
arrhythmias,
tachycardia
Patients
with
occlusive
vascular disease
are at high risk
for
further
compromise of
circulation
to
extremities,
which may result
in gangrene.
Tissue necrosis
with sloughing
may occur with
extravasation of
IV solution.
Epinephrine
Drug
Generic Name:
Epinephrine
Brand Name:
Adrenalin
EpiPen
EpiPen Jr.
Dosage
Mechanism of Action
Injection,
Solution
(Prefilled Syringes):
(EpiPen): 0.3 mg/0.3
mL
(EpiPen Jr.):
mg/0.3 mL
Stimulates
alpha-adrenergic receptors
(vasoconstriction, pressor
effects), beta1 - adrenergic
receptors
(cardiac
0.15 stimulation),
beta2
-adrenergic
receptors
Indication and
Contraindication
Side Effects and
Adverse Effects
Indication
treat
● To
bronchospasm
● Anaphylaxis
● Hypotension
(Shock)
● Cardiac Arrest
Side Effects
● Tachycardia
● Palpitations
● Anxiety
● Headache
● Eye irritation
● Watering of eyes
Nursing Responsibility
●
●
●
Monitor changes of B/P,
HR.
Assess lung sounds for
rhonchi, wheezing, and
rales.
Monitor
ABGs.
In
cardiac arrest, adhere to
Twinject
Pharmacologic
Class:
Sympathomimetic
(alpha-,
beta-adrenergic
agonist)
Therapeutic Class:
Antianaphylactic
Bronchodilator
Cardiac stimulant
Vasopressor
(Twinject):
mg/0.15 mL.
0.15
(bronchial
vasodilation).
dilation,
Contraindication
● Cerebral
Therapeutic
Effect:
arteriosclerosis
Injection,
Solution: Relaxes smooth muscle of ● Coronary
0.1 mg/mL (1:10,000), bronchial tree, produces
insufficiency
1 mg/mL (1:1,000).
cardiac stimulation, dilates ● Counteraction of
skeletal
muscle
phenothiazine-ind
vasculature.
uced hypotension
● Dilated
cardiomyopathy
● General
anesthesia with
halogenated
hydro carbons
or cyclopropane
● Hypersensitivity
to epinephrine or
its components,
● Angle-closure
glaucoma,
brain
● Organic
damage
● Shock
(nonanaphylactic)
●
●
●
●
●
●
●
●
●
●
●
●
●
Dizziness
Light-headedness
Facial flushing
Headache
Diaphoresis
Increased B/P
Nausea
Trembling
Insomnia
Vomiting
Fatigue
Blurred/decrease
d vision
Eye pain
Adverse Effects
● Excessive doses
may cause acute
hypertension,
arrhythmias.
● Prolonged/excess
ive use may
result
in
metabolic
acidosis due to
increased serum
lactic acid.
● Metabolic
acidosis
may
cause
disorientation,
fatigue,
hyperventilation,
headache, nausea,
vomiting,
ACLS protocols
diarrhea.
Furosemide
Drug
Generic Name:
Furosemide
Brand Name:
Apo-Furosemide
Lasix
Novo-Semide
Pharmacologic
Class:
Sulfonamide
Therapeutic Class:
Antihypertensive
Loop diuretic
Dosage
Mechanism of Action
Injection Solution: 10 Enhances excretion of
mg/mL. Oral
sodium,
chloride,
potassium by direct action
Solution: 10 mg/mL, at ascending limb of loop
40 mg/5 mL.
of Henle.
Indication and
Contraindication
Indication
● Edema
● Heart failure
● Hypertension
Side Effects and
Adverse Effects
Side Effects
● Increased urinary
frequency/volum
e.
● Nausea
● Dyspepsia
Contraindication
Tablets: 20 mg, 40 mg, Therapeutic
Effect: ● Anuria
● Abdominal
80 mg.
Produces diuresis, lowers
unresponsive to
cramps
B/P.
furosemide
or
● Diarrhea
constipation
● Hypersensitivity
to
furosemide ● Electrolyte
Sulfonamides, or
disturbances
their components
Adverse Effects
● Vigorous diuresis
may
lead to
profound water
loss/electrolyte
depletion
resulting
in
hypokalemia,
hyponatremia,
● Dehydration
● Increased risk of
thrombosis,
circulatory
collapse
Nursing Responsibility
●
●
●
●
●
●
●
Use
furosemide
cautiously in patients
with advanced hepatic
cirrhosis, especially those
who also have a history
of electrolyte imbalance
or
hepatic
encephalopathy;
drug
may lead to lethal hepatic
coma.
Check vital signs, esp.
B/P,
pulse,
for
hypotension
before
administration.
Assess baseline renal
function,
serum
electrolytes, esp. serum
sodium, potassium.
Assess
skin
turgor,
mucous membranes for
hydration status; observe
for edema.
Assess muscle strength,
mental status. Note skin
temperature, moisture.
Obtain baseline weight.
Initiate I&O monitoring.
●
●
●
Sudden death.
Acute
hypotensive
Ototoxicity
(deafness,
vertigo, tinnitus)
●
Auscultate lung sounds.
Hydralazine Hydrochloride
Drug
Generic Name:
Hydralazine
Hydrochloride
Brand Name:
Apo-Hydralazine
Apresoline
Novo-Hylazin
Pharmacologic
Class:
Phthalazine derivative
Therapeutic Class:
Antihypertensive
Vasodilator
Dosage
Mechanism of Action
Indication and
Contraindication
Injection Solution: 20
mg/mL.
Direct vasodilating effects Indication
on arterioles.
manage
● To
essential
Tablets: 10 mg, 25 mg, Therapeutic
Effect:
hypertension,
50 mg, 100 mg.
Decreases B/P, systemic
alone or with
vascular resistance.
other
antihypertensives
● To manage severe
essential
hypertension
when drug can’t
be taken orally or
when need to
reduce
blood
pressure is urgent
Contraindication
Side Effects and
Adverse Effects
Side Effects
● Headache
● Anorexia
● Nausea
● Vomiting
● Diarrhea
● Palpitations
● Tachycardia
● Angina pectoris
Nursing Responsibility
●
●
Adverse Effects
● High dosage may
produce
lupus ●
erythematosus–li
ke
reaction
(fever,
facial
rash, muscle/joint
aches,
glomerulonephriti
s, splenomegaly).
● Severe orthostatic
hypotension
Obtain
B/P,
pulse
immediately before each
dose, in addition to
regular monitoring (be
alert to fluctuations).
Monitor CBC, lupus
erythematosus
cell
preparation, and ANA
titer before therapy and
periodically
as
appropriate
during
long-term treatment.
Give tablets with food to
increase bioavailability.
●
●
●
●
●
Skin flushing
Severe headache
Myocardial
ischemia
Cardiac
arrhythmias may
develop
Profound shock
may occur with
severe overdose.
Hydrocortisone
Drug
Generic Name:
Hydrocortisone
(cortisol)
Brand Name:
Cortef
Cortenema
Hydrocortone
Solu-Cortef
Anusol HC
Colocort
Pharmacologic
Class:
Glucocorticoid
Therapeutic Class:
Adrenocorticoid
Dosage
Mechanism of Action
Cream, Rectal: 1%, Inhibits accumulation of
2.5%.
inflammatory cells at
inflammation
sites,
Cream, Topical: 0.5%, phagocytosis, lysosomal
1%, 2.5%.
enzyme release, synthesis
and/or release of mediators
Injection, Powder for of inflammation. Reverses
Reconstitution
increased
capillary
(Solu-Cortef): 100 mg, permeability.
250 mg, 500 mg, 1 g.
Therapeutic
Effect:
Ointment,
Topical: Prevents/suppresses
0.5%, 1%, 2.5%.
cell-mediated
immune
reactions.
Suppository (Anusol Decreases/prevents tissue
HC): 25 mg.
response to inflammatory
processes.
Suspension,
Rectal
Indication and
Contraindication
Side Effects and
Adverse Effects
Indication
● Anti-Inflammatio
n,
Immunosuppressi
on
● To treat severe
inflammation or
acute
adrenal
insufficiency
● As adjunct to
treat ulcerative
proctitis of the
distal portion of
the rectum in
patients
who
can’t
retain
hydrocortisone or
other
Side Effects
● Insomnia
● Heartburn
● Anxiety
● Abdominal
distention
● Diaphoresis
● Acne
● Mood swings
● Increased
appetite
● facial flushing
● Delayed wound
healing
● Increased
susceptibility to
infection,
diarrhea
or
Nursing Responsibility
●
●
●
●
Obtain baseline weight,
B/P, serum glucose,
cholesterol, electrolytes.
Screen for infections
including
fungal
infections, TB, viral skin
lesions.
Obtain baseline weight,
B/P, serum glucose,
cholesterol, electrolytes.
Screen for infections
including
fungal
infections, TB, viral skin
lesions.
replacement
Anti-inflammatory
(Colocort,
Cortenema):
mg/60 mL.
100
Tablets (Cortef): 5 mg,
10 mg, 20 mg.
corticosteroid
enemas
constipation.
Contraindication
● Hypersensitivity
to hydrocortisone
or its components
● Idiopathic
thrombocytopeni
c purpura (I.M.)
● Intestinal
conditions
prohibiting
intrarectal
steroids (P.R.)
● Recent live-virus
vaccination
● Systemic fungal
infection
Adverse Effects
● Hypocalcemia
● Hypokalemia
● Muscle wasting
(esp. arms, legs)
● Osteoporosis
● Spontaneous
fractures
● Amenorrhea
● Cataracts
● Glaucoma
● Peptic ulcer
● Heart Failure
Isosorbide Dinitrate
Drug
Generic Name:
Isosorbide dinitrate
Brand Name:
IsoDitrate ER
Dilatrate-SR
Isordil
Pharmacologic
Dosage
Mechanism of Action
Tablets: 5 mg, 10 mg, Stimulates
intracellular
20 mg, 30 mg, 40 mg.
cyclic
guanosine
monophosphate.
Capsules,
Extended-Release: 40 Therapeutic
Effect:
mg.
Relaxes vascular smooth
muscle of arterial, venous
Tablets,
vasculature.
Decreases
Extended-Release: 40 preload, afterload, cardiac
Indication and
Contraindication
Indication
● Angina
Contraindication
● Closed-angle
glaucoma
● Severe anemia
Side Effects and
Adverse Effects
Side Effects
●
● Headache (may
be severe) occurs
mostly in early
therapy,
● Diminishes
rapidly
in
intensity, usually
disappears during ●
Nursing Responsibility
Record
onset,
type
(sharp, dull, squeezing),
radiation,
location,
intensity, duration of
anginal
pain;
precipitating
factors
(exertion,
emotional
stress).
If headache occurs during
Class:
Nitrate
mg.
oxygen demand.
continued
treatment.
Therapeutic Class:
Antianginal
Adverse Effects
●
●
●
management
therapy,
administer
medication
with meals.
Assist with ambulation if
light-headedness,
dizziness occurs.
Assess for facial/neck
flushing.
Monitor
number
of
anginal
episodes,
orthostatic B/P.
Magnesium Sulfate
Drug
Generic Name:
Magnesium Sulfate
Dosage
Mechanism of Action
Indication and
Contraindication
Infusion Solution: 10 Antacid: Acts in the Indication
mg/mL, 20 mg/mL, 40 stomach to neutralize ● Hypomagnesemia
mg/mL, 80 mg/mL.
gastric acid.
● Severe
Brand Name:
Deficiency
Epsom salt
Injection
Solution: Therapeutic
Effect: ● Eclampsia/Preecl
Magnesium
sulfate 125
mg/mL,
500 Increases pH.
ampsia
injection
mg/mL.
● Dietary
Laxative: Osmotic effect
Supplement
Pharmacologic
primarily in the small ● Laxative
Class:
intestine, draws water into
Cation
intestinal lumen.
Contraindication
Electrolyte
● Heart block
Therapeutic
Effect: ● Myocardial
Therapeutic Class:
Promotes
peristalsis,
Infarction
Antacid
bowel evacuation.
● Preeclampsia 2
Antiarrhythmic
hours or less
Anticonvulsant
Systemic
(dietary
before delivery
Side Effects and
Adverse Effects
Side Effects
● Chalky taste
● Diarrhea
● Laxative effect
● Nausea
● Vomiting
● Stomach cramps
Nursing Responsibility
●
●
●
Adverse Effects
PR
● Prolonged
interval
● Widening of QRS
●
interval
● May cause loss of
deep
tendon
reflexes
● Heart block
Assess sensitivity to
magnesium. Antacid:
Assess GI pain (duration,
location, quality, time of
occurrence, relief with
food,
causative/exacerbative
factors).
Laxative: Assess for
weight loss, nausea,
vomiting, history of
recent abdominal surgery.
Systemic: Assess renal
function,
serum
magnesium.
Electrolyte
replacement
Laxative
●
supplement
replacement):
Found
primarily in intracellular
fluids.
●
Respiratory
paralysis
Cardiac arrest
*Antidote:
10–20
mL 10% calcium
gluconate (5–10 mEq
of calcium).
Therapeutic
Effect:
Essential
for enzyme
activity, nerve conduction,
muscle
contraction.
Maintains and restores
magnesium levels.
Anticonvulsant: Blocks
neuromuscular
transmission, amount of
acetylcholine released at
motor end plate.
Therapeutic
Effect:
Produces seizure control.
Methylergonovine
Drug
Dosage
Generic Name:
Methylergonovine
Injection Solution: 0.2
mg/mL.
Brand Name:
Methergine
Tablets: 0.2 mg.
Pharmacologic
Class:
Mechanism of Action
Indication and
Contraindication
Increases
tone,
rate, Indication
amplitude of contraction of ● Prevention/Treat
uterine smooth muscle.
ment
of
Postpartum/Posta
Therapeutic
Effect:
bortion
Shortens third stage of
Hemorrhage
labor, reduces blood loss.
Side Effects and
Adverse Effects
Side Effects
● Nausea, uterine
cramping
● Vomiting
● Abdominal pain
● Diarrhea,
● Dizziness
● Diaphoresis
Nursing Responsibility
●
●
●
Determine
baseline
serum calcium level, B/P,
pulse.
Assess for any evidence
of
bleeding
before
administration.
Monitor uterine tone,
bleeding, B/P, pulse
Ergot alkaloid
Contraindication
● Hypersensitivity
to
methylergonovin
e. Hypertension,
pregnancy,
toxemia.
Therapeutic Class:
Oxytoxic agent
Uterine stimulant.
●
●
●
Tinnitus
Bradycardia
Chest pain
●
Adverse Effects
●
● Severe
hypertensive
●
● Serious
arrhythmias
● Seizures
● Peripheral
ischemia
may
lead to gangrene.
q15min
until
stable
(about 1–2 hrs).
Assess extremities for
color,
warmth,
movement, pain.
Report
chest
pain
promptly.
Provide support with
ambulation if dizziness
occurs.
Metoclopramide Hydrochloride
Drug
Generic Name:
Metoclopramide
Hydrochloride
Brand Name:
Apo-Metoclop
Maxeran
Metoclopramide
Intensol
Octamide
PMS-Metoclopramide
Reglan
Pharmacologic
Dosage
Mechanism of Action
Injection Solution: 5 Stimulates motility of
mg/mL.
upper GI tract. Blocks
dopamine/serotonin
Solution, Oral: 5 mg/5 receptors
in
the
mL. Tablets: 5 mg, 10 chemoreceptor
trigger
mg. Tablets, Orally zone.
Disintegrating: 5 mg,
10 mg
Enhances
acetylcholine
response in upper GI tract;
increases lower esophageal
sphincter tone.
Therapeutic
Accelerates
Effect:
intestinal
Indication and
Contraindication
Indication
treat
● To
gastroesophageal
reflux disease
prevent
● To
chemotherapy-in
duced vomiting
● To treat diabetic
gastroparesis
prevent
● To
postoperative
nausea
and
vomiting
Side Effects and
Adverse Effects
Side Effects
● Drowsiness
● Restlessness
● Fatigue
● Lethargy
Nursing Responsibility
●
●
Adverse Effects
● Extrapyramidal
●
reactions
● Neuroleptic
●
malignant
syndrome
●
(diaphoresis,
fever,
unstable
Assess for dehydration
(poor skin turgor, dry
mucous
membranes,
longitudinal furrows in
tongue).
Assess
for
nausea,
vomiting,
abdominal
distention, bowel sounds.
Use
metoclopramide
cautiously in patients
with
hypertension
because it may increase
catecholamine levels
Class:
Dopamine
antagonist
transit, promotes gastric
emptying.
Relieves
nausea, vomiting
receptor
Therapeutic Class:
Antiemetic
Upper GI stimulant
Contraindication
● Hypersensitivity
to
metoclopramide.
● Concurrent use of
medications
likely to produce
extrapyramidal
reactions
in
● Situations
which GI motility
may
be
dangerous (e.g.,
GI hemorrhage,
GI
perforation/obstru
ction)
● History of seizure
disorder,
pheochromocyto
ma.
● Renal impairment
● Heart Failure
● Cirrhosis
● Hypertension
● Depression
B/P,
muscular
rigidity) has been
reported.
Nicardipine Hydrochloride
Drug
Generic Name:
Nicardipine
Dosage
Mechanism of Action
Capsules: 20 mg, 30 Inhibits
calcium
mg.
movement across
Indication and
Contraindication
ion Indication
cell ● Chronic
Side Effects and
Adverse Effects
Side Effects
Stable ● Headache
Nursing Responsibility
●
Concurrent therapy with
sublingual nitroglycerin
Hydrochloride
membranes,
depressing
Infusion, Ready to contraction of cardiac,
Brand Name:
Use: 20 mg/200 mL, 40 vascular smooth muscle.
Cardene
mg/200 mL.
Cardene IV
Therapeutic
Effect:
Cardene SR
Injection Solution: 2.5 Increases
heart
rate,
mg/mL (10-mL vial).
cardiac output, myocardial
Pharmacologic
oxygen
delivery.
Class:
Capsules
Decreases
systemic
Calcium
channel (Sustained-Release):
vascular resistance, B/P.
blocker
30 mg, 60 mg.
Therapeutic Class:
Antianginal
Antihypertensive
●
●
Angina
Hypertension
Acute
Hypertension
Contraindication
● Advanced aortic
stenosis
● Hypersensitivity
to any calcium
channel blocker
or
● Secondthird-degree AV
block in patient
without artificial
pacemaker
●
●
●
●
Facial flushing
Peripheral edema
Lightheadedness
Dizziness
Adverse Effects
● Confusion
● Slurred speech
● Drowsiness
● Marked
hypotension
● Bradycardia
●
●
●
●
●
●
●
may be used for relief of
anginal pain.
Record
onset,
type
(sharp, dull, squeezing),
radiation,
location,
intensity, duration of
anginal
pain,
precipitating
factors
(exertion,
emotional
stress).
Monitor B/P, heart rate
during and following IV
infusion.
Assess for peripheral
edema.
Assess skin for facial
flushing, dermatitis, rash.
Question for asthenia,
headache.
Monitor LFT results.
Assess EKG, pulse for
tachycardia.
Norepinephrine Bitartrate
Drug
Generic Name:
Norepinephrine
bitartrate
Brand Name:
Levophed
Dosage
Injection Solution: 1
mg/mL.
Mechanism of Action
Indication and
Contraindication
Stimulates
beta1 Indication
-adrenergic
receptors, ● To treat acute
alpha-adrenergic receptors,
hypotension,
increasing
contractility,
cardiogenic
heart rate and producing
shock, and septic
vasoconstriction.
shock
Side Effects and
Adverse Effects
Side Effects
● Anxiety
● Bradycardia
● Palpitations
● Nausea
● Anginal pain
Nursing Responsibility
●
●
●
Assess
EKG,
B/P
continuously (be alert to
precipitous B/P drop).
Be alert to patient
complaint of headache.
Check blood pressure
●
Pharmacologic
Class:
Alpha, beta agonist
Therapeutic
Effect:
Increases systemic B/P,
coronary blood flow.
Therapeutic Class:
Cardiac stimulant
Vasopressor
To
treat ● Shortness
of
refractory shock
breath
● Fever
Contraindication
● Concurrent use of Adverse Effects
●
hydrocarbon
● Extravasation
inhalation
may
produce
anesthetics
tissue necrosis,
sloughing.
● Hypersensitivity
to norepinephrine ● Arrhythmias
●
or its components ● Photophobia
● Hypovolemia
● Retrosternal or
●
or
● Mesenteric
pharyngeal pain
peripheral
● Pallor
vascular
● Diaphoresis
thrombosis
● Vomiting
● Prolonged
therapy
may
result in plasma
volume depletion.
● Hypotension may
recur if plasma
volume is not
maintained.
every 2 to 3 minutes,
preferably by direct intra
arterial monitoring, until
stabilized and then every
5 minutes
Dilute
norepinephrine
concentrate for infusion
in D5W, dextrose 5% in
normal saline solution, or
normal saline solution.
Dilutions typically range
from 16 to 32 mcg/ml
Make sure the solution
contains no particles and
isn’t discolored before
administering.
Omeprazole
Drug
Generic Name:
Omeprazole
Brand Name:
Dosage
Granules for
Suspension:
mg/packet,
mg/packet.
Mechanism of Action
Indication and
Contraindication
Oral Inhibits
Indication
2.5 hydrogen-potassium
treat
● To
10 adenosine triphosphatase
gastroesophageal
(H+ /K+ ATP pump), an
reflux
disease
Side Effects and
Adverse Effects
Side Effects
● Headache.
● Diarrhea,
● Abdominal pain
Nursing Responsibility
●
●
Evaluate for therapeutic
response (relief of GI
symptoms).
Question
if
GI
Losec
Prilosec
Zegerid
Pharmacologic
Class:
Benzimidazole
Therapeutic Class:
Proton pump inhibitor
enzyme on the surface of
Powder
for
Oral gastric parietal cells.
Suspension: 2 mg/mL.
Therapeutic
Effect:
Capsules
Increases
gastric pH,
(Delayed-Release
reduces
gastric
acid ●
[PriLOSEC]): 10 mg, production.
20 mg, 40 mg.
●
Tablets
(Delayed-Release
[PriLOSEC OTC]): 20
mg.
(GERD) without
esophageal
lesions,
to
prevent erosive
esophagitis
To treat GERD
with
erosive
esophagitis
To
provide
short-term
treatment
of
active
benign
gastric ulcer
Contraindication
● Hypersensitivity
to omeprazole,
other
proton
pump inhibitors.
● Concomitant use
with
products
containing
rilpivirine.
●
●
●
●
●
●
●
●
●
Nausea
Dizziness
●
Asthenia
Vomiting
Constipation
Upper respiratory
tract infection
Back pain
Rash
Cough
discomfort,
nausea,
diarrhea occurs.
Give omeprazole before
meals, preferably in the
morning for once-daily
dosing. If needed, also
give an antacid, as
prescribed.
Adverse Effects
● Pancreatitis
● Hepatotoxicity
● Interstitial
nephritis occur
rarely
Phenytoin
Drug
Generic Name:
Phenytoin
Brand Name:
Dosage
Capsules,
Extended-Release: 30
mg, 100 mg, 200 mg,
300 mg.
Mechanism of Action
Indication and
Contraindication
Stabilizes
neuronal Indication
membranes in the motor ● To prevent or
cortex. Decreases influx of
treat
seizures
sodium during generation
during
Side Effects and
Adverse Effects
Side Effects
● Drowsiness
● Lethargy
● Confusion
Nursing Responsibility
●
Review history of seizure
disorder
(intensity,
frequency,
duration,
LOC).
Dilantin
Novo-Phenytoin
Phenytek
Pharmacologic
Class:
Hydantoin derivative
of nerve impulses.
Injection, Solution: 50
mg/mL.
Therapeutic
Effect:
Decreases seizure activity.
Suspension, Oral: 125
mg/5 mL.
Therapeutic Class:
Anticonvulsant
Antiarrhythmic
Tablets, Chewable: 50
mg.
●
neurosurgery
To
treat
tonic-clonic,
simple,
or
complex partial
seizures
in
patients who have
had no prior
treatment
●
●
●
●
●
●
●
Slurred speech
Irritability
Gingival
hyperplasia
Hypersensitivity
reaction
Constipation
Dizziness
Nausea
Contraindication
Adverse Effects
● Hypersensitivity
● Abrupt
to
phenytoin,
withdrawal may
other hydantoins.
precipitate status
● Concurrent use of
epilepticus.
delavirdine.
● Blood dyscrasias,
● Lymphadenopath
y
● Osteomalacia
(due
to
interference
of
vitamin
D
metabolism) may
occur.
●
●
●
●
●
●
Initiate
seizure
precautions. LFT, CBC
should be performed
before beginning therapy
and periodically during
therapy.
Repeat CBC 2 wks
following initiation of
therapy and 2 wks
following administration
of maintenance dose.
Observe frequently for
recurrence of seizure
activity.
Monitor ECG for cardiac
arrhythmia.
Assess
for
clinical
improvement (decrease
in intensity/frequency of
seizures).
Monitor
for
signs/symptoms
of
depression,
suicidal
tendencies,
unusual
behavior.
Potassium Chloride
Drug
Generic Name:
Potassium Chloride
Dosage
Mechanism of Action
Indication and
Contraindication
Side Effects and
Adverse Effects
Injection, Solution: 2 Necessary for multiple Indication
Side Effects
mEq/mL.
Oral cellular
metabolic ● Treatment
of ● Nausea
Solution: 20 mEq/15 processes. Primary action
Hypokalemia
● Vomiting
Nursing Responsibility
●
Assess for hypokalemia
(weakness,
fatigue,
polyuria, polydipsia). PO
Brand Name:
Apo-K
Kaon-Cl
Klor-Con
Micro-K
Pharmacologic
Class:
Electrolyte.
Therapeutic Class:
Potassium replenisher.
mL, 40 mEq/15 mL.
is intracellular.
Powder
for
Solution:
mEq/packet,
mEq/packet.
Oral Therapeutic
Effect:
20 Required
for
nerve
25 impulse
conduction,
contraction of cardiac,
skeletal, smooth muscle;
Capsules,
maintains normal renal
Extended-Release
function,
acid-base
(Micro-K): 8 mEq, 10 balance.
mEq.
Tablets,
Extended-Release: 8
mEq, 10 mEq, 15 mEq,
20 mEq.
Contraindication
● Renal failure
● Hyperkalemia
in
● Conditions
which potassium
retention
is
present.
● Solid oral dosage
form in pts in
whom there is
structural,
● Pathologic cause
for
delay
in
passage through
GI tract.
●
●
●
●
●
Diarrhea
Flatulence
Abdominal
discomfort with
Distention
Phlebitis with IV
administration
●
Adverse Effects
● Hyperkalemia
of
● feeling
heaviness
in ●
lower extremities
● Cold skin
● Grayish
●
● Pallor
● Hypotension
● Confusion
●
● Irritability
● Flaccid paralysis
● Cardiac
arrhythmias
●
should be given with
food or after meals with
full glass of water, fruit
juice (minimizes GI
irritation).
Monitor serum potassium
(particularly in renal
impairment).
If
GI
disturbance is noted,
dilute preparation further
or give with meals.
Be alert to decreased
urinary output (may be
indication
of
renal
insufficiency).
Monitor daily pattern of
bowel activity, stool
consistency.
Assess I&O diligently
during diuresis, IV site
for
extravasation,
phlebitis.
Be alert to evidence of
hyperkalemia
(skin
pallor/coldness,
complaints
of
paresthesia, feeling of
heaviness
of
lower
extremities).
Salbutamol
Drug
Dosage
Mechanism of Action
Indication and
Contraindication
Side Effects and
Adverse Effects
Nursing Responsibility
Generic Name:
Albuterol
Brand Name:
PMS-Salbutamol
ProAir HFA
ProAir
RespiClick
Proventil HFA
Ventolin HFA
VoSpire ER
Pharmacologic
Class:
Adrenergic agonist
Therapeutic Class:
Bronchodilator
Aerosol,
Powder
Breath
Activated
Inhalation
(ProAir
RespiClick):
90
mcg/actuation.
Aerosol
Solution,
Inhalation
(ProAir
HFA, Proventil HFA,
Ventolin HFA): 90
mcg/spray. Solution
for Nebulization: 0.63
mg/3 mL (0.021%),
1.25
mg/3
mL
(0.042%), 2.5 mg/3 mL
(0.084%), 5 mg/mL
(0.5%).
Stimulates
beta2 Indication
-adrenergic receptors in ● Acute
lungs,
resulting
in
Bronchospasm,
relaxation of bronchial ● Exacerbation of
smooth muscle.
Asthma
● Chronic
Therapeutic
Effect:
Bronchospasm
Relieves
bronchospasm ● Exercise-Induced
and
reduces
airway
Bronchospasm
resistance.
Contraindication
● Hypersensitivity
to albuterol.
● Severe
hypersensitivity
to milk protein
(powder
for
inhalation).
Syrup: 2 mg/5 mL.
Tablets: 2 mg, 4 mg.
Tablets
(Extended-Release
[VoSpire ER]): 4 mg, 8
mg.
Side Effects
●
● Headache
● Restlessness
● Nervousness
●
● Tremors
● Nausea
● Dizziness
● Throat dryness
and irritation
● Pharyngitis
●
● Hypertension
● Heartburn
● Transient
wheezing
Adverse Effects
● Excessive
sympathomimetic ●
stimulation may
produce
palpitations
● Ectopy
● Tachycardia
● Chest pain
Assess lung sounds,
pulse,
B/P,
color,
characteristics of sputum
noted.
Offer emotional support
(high
incidence
of
anxiety due to difficulty
in
breathing
and
sympathomimetic
response to drug).
Monitor rate, depth,
rhythm,
type
of
respiration; quality and
rate of pulse; EKG;
serum
potassium,
glucose;
ABG
determinations.
Assess lung sounds for
wheezing
(bronchoconstriction),
rales.
Sodium Bicarbonate
Drug
Generic Name:
Sodium Bicarbonate
Dosage
Injection
(Rx): 0.5
Mechanism of Action
Solution Dissociates
provide
mEq/mL bicarbonate ions.
Indication and
Contraindication
Indication
● Cardiac Arrest
Side Effects and
Adverse Effects
Side Effects
● Abdominal
Nursing Responsibility
●
Assess for signs and
symptoms of acidosis,
Pharmacologic
Class:
Electrolyte
Therapeutic Class:
Antacid, electrolyte
replenisher, systemic
and urinary alkalizer
●
Therapeutic
Effect:
Neutralizes hydrogen ion
Tablets (OTC): 325 concentration,
raises ●
mg, 650 mg.
blood, urinary pH
(4.2%),
(8.4%).
1
mEq/mL
●
●
●
●
●
Metabolic
Acidosis (Mild to
Moderate)
Prevention
of
Contrast-Induced
Nephropathy
Metabolic
Acidosis
(Associated with
Chronic
Renal
Failure
Renal
Tubular
Acidosis (Distal)
Renal
Tubular
Acidosis
(Proximal)
Urine
Alkalinization
Hyperkalemia
Contraindication
● Hypersensitivity
to
sodium
bicarbonate
● Hypernatremia
● Alkalosis
● Unknown
abdominal pain
● Hypocalcemia
● Severe
pulmonary edema
Terbutaline Sulfate
●
●
distention
Flatulence
Belching
●
Adverse Effects
● Excessive,
chronic use may
produce
metabolic
alkalosis
● Headache
● Weakness
● Blurred vision
● Behavioral
changes
● Incoordination
● Muscle twitching
● Elevated B/P
● Bradycardia
● Tachypnea
● Wheezing
● Coughing
● Distended neck
veins
●
●
●
●
●
alkalosis. Do not give PO
medication within 1 hr of
antacids.
Monitor serum, urinary
pH, CO2 level, serum
electrolytes,
plasma
bicarbonate levels.
Watch for signs of
metabolic alkalosis, fluid
overload.
Assess
for
clinical
improvement
of
metabolic acidosis (relief
from
hyperventilation,
weakness,
disorientation).
Monitor daily pattern of
bowel activity, stool
consistency.
Monitor
serum
phosphate, calcium, uric
acid levels.
Assess for relief of
gastric distress
Drug
Generic Name:
Terbutaline Sulfate
Brand Name:
Monovent
Dosage
Injection:1 mg/ml
Tablets: 2.5 mg, 5 mg
Pharmacologic
Class:
Sympathomimetic
amines
Therapeutic Class:
Bronchodilator
Mechanism of Action
Indication and
Contraindication
Relaxes bronchial smooth Indication
muscle by
● Bronchospasm in
stimulating
beta2
reversible
-adrenergic
receptors;
obstructive
inhibits
release
of
airway disease
hypersensitivity mediators,
especially from mast cells Contraindication
● Hypersensitivity
to
drug,
its
components, or
sympathomimetic
amines
Side Effects and
Adverse Effects
Adverse Effects
● Tremors
● Anxiety
● Nervousness
● Insomnia
● Headache
● Dizziness
● Drowsiness
● Stimulation
● Palpitations
● Chest discomfort
● Tachycardia
● Nausea
● Vomiting
● Diaphoresis
● Flushing
Nursing Responsibility
●
●
●
●
●
Monitor vital signs.
Assess neurologic status.
Tell patient s/he may take
with or without food
Advise patient or parents
to establish effective
bedtime
routine
to
minimize insomnia
Instruct
patients
or
parents to space doses
evenly during waking
hours, to avoid taking
drug at bedtime.
Tranexamic Acid
Drug
Generic Name:
Tranexamic Acid
Brand Name:
Cyklokapron
Lysteda
Pharmacologic
Class:
Dosage
Injection:1 mg/ml
Tablets: 2.5 mg, 5 mg
Mechanism of Action
Indication and
Contraindication
Side Effects and
Adverse Effects
Tranexamic
acid Indication
Adverse Effects
competitively
and ● For the treatment ● Dizziness
reversibly inhibits the
of
excessive ● Visual
activation of plasminogen
bleeding resulting
abnormalities
via binding at several
from systemic or ● Hypotension
distinct sites, thereby
local
● Thromboembolis
reducing conversion of
hyperfibrinolysis
m
plasminogen to plasmin ● Prophylaxis with ● Thrombosis
Nursing Responsibility
●
●
●
Caution patient to avoid
products
containing
aspirin or NSAIDs.
Unusual
change
in
bleeding pattern should
be reported to the
physician.
Report severe allergic
(fibrinolysin), an enzyme
coagulopathy
●
that degrades fibrin clots,
undergoing
●
fibrinogen, and other
surgical
●
plasma proteins, including
procedures
the procoagulant factors V
and VIII.
Contraindication
● Hypersensitivity
The
binding
of ● Active
plasminogen to fibrin
intravascular
induces fibrinolysis - by
clotting
occupying the necessary ● Acquired
binding sites tranexamic
defective color
acid
prevents
this
vision
dissolution
of
fibrin, ● Subarachnoid
thereby stabilizing the clot
hemorrhage
and
preventing
hemorrhage.
Antifibrinolytic
Therapeutic Class:
Hemostatic Agent
Diarrhea
Nausea
Vomiting
●
reactions
If the patient missed a
dose, let the patient take
when remembered, then
take next dose at least 6
hours later.
Hyoscine-N-Butylbromide
Drug
Dosage
Generic Name:
Hyoscine-N-Butylbro
mide
Brand Name:
Buscopan
Intravenous: 20 mg in
1 ml solution, Normal
saline, 5% glucose, and
Sodium Chloride
PO: 10 mg
Pharmacologic
Class:
Anticholinergic
Mechanism of Action
Indication and
Contraindication
Interfering
with
the Indication
transmission of nerve ● Relief of spasm
impulses by acetylcholine
of GU tract and
in the parasympathetic
GI tract
nervous system.
● Symptomatic
relief of Irritable
Bowel Syndrome
Contraindication
Side Effects and
Adverse Effects
Adverse Effects
● Xerostomia
● Tachycardia
● Urinary retention
● Allergic and skil
reactions
● Dyspnea (rarely)
● Visual
accommodation
Nursing Responsibility
●
●
●
●
●
●
Assess for eye pain.
Monitor fluid input and
output.
Assess for parkinsonism
and RPS
Assess
for
urinary
hesitancy
Assess for constipation
Assess for tolerance over
●
Therapeutic Class:
Antispasmodic
●
●
Hypersensitivity
to HNBB and ●
other components
of the product
Myasthenia
Gravis
Megacolon and
narrow angle
disturbance
Anaphylactic
reactions
long term therapy
Paracetamol
Drug
Generic Name:
Acetaminophen
Brand Name:
Paracetamol
Biogesic
Tylenol
Panadol
Tempra
Dssprol
Pharmacologic
Class:
Synthetic non-opioid
p-aminophenol
derivative
Therapeutic Class:
Analgesic, antipyretic
Dosage
Mechanism of Action
Liquid: 160 mg/5 ml, Unclear. Pain relief may
500 mg/15 ml
result from inhibition of
prostaglandin synthesis in
Solution: 80 mg/1.66 CNS, with subsequent
ml, 100 mg/1 ml,
blockage of pain impulses.
120 mg/2.5 ml, 160 Fever reduction may result
mg/5 ml, 167 mg/5 ml
from vasodilation and
increased peripheral blood
flow in hypothalamus,
which dissipates heat and
lowers body temperature.
Indication and
Contraindication
Side Effects and
Adverse Effects
Indication
Side Effects
● Mild to moderate ● Jaundice
pain
● Rash
● Urticaria
Contraindication
● Hypersensitivity
● Hypersensitivity
reactions
to drug
Adverse Effects
● Thrombocytopeni
a
● Hemolytic
anemia
● Neutropenia
● Leukopenia
● Pancytopenia
● Hepatotoxicity
● Hypoglycemic
coma
Nursing Responsibility
●
Observe acute toxicity
and overdose. Signs and
symptoms
of
acute
toxicity are as follows—
○ Phase 1: Nausea,
vomiting,
anorexia,
malaise, diaphoresis.
○ Phase 2: Right upper
quadrant
pain or
tenderness,
liver
enlargement, elevated
bilirubin and hepatic
enzyme
levels,
prolonged
prothrombin
time,
oliguria (occasional).
○ Phase 3: Recurrent
anorexia,
nausea,
vomiting, and malaise;
jaundice;
○
hypoglycemia;
coagulopathy;
encephalopathy;
possible renal failure
and cardiomyopathy.
Phase
4:
Either
recovery
or
progression to fatal
complete
hepatic
failure.
Phytomenadione
Drug
Generic Name:
Phytomenadione/
Vitamin K
Brand Name:
Aquamephyton,
Mephyton
Pharmacologic
Class:
Fat-soluble vitamin
Therapeutic Class:
Antihemorrhagic
Dosage
Aqueous
colloidal
solution for injection:
2 mg/ml
Tablets: 5 mg
Mechanism of Action
Indication and
Contraindication
Promotes hepatic synthesis Indication
of active prothrombin, ● Hypoprothrombin
proconvertin,
plasma
emia
thromboplastin
● Prevention and
component, and Stuart
treatment
of
factor.
hemorrhagic
disease
of
newborn
Contraindication
● Hypersensitivity
to drugs or its
components.
Side Effects and
Adverse Effects
Nursing Responsibility
Side Effects
● Pain
● Soreness
● Swelling at IM
injection site
● Pruritus
● Erythema (with
repeated
injections)
● Facial flushing
● Altered taste
●
Adverse Effects
● Hyperbilirubinem
ia (in infants)
●
●
●
●
●
Monitor PT and INR
routinely in those who
are taking anticoagulants
Assess
skin
for
ecchymoses
and
petechiae
Assess gums for gingival
bleeding
Assess
urine
for
hematuria.
Assess Hct, platelet
count, urine/ stool culture
for occult blood.
Assess for decrease in
B/P, increase in pulse
rate,
complaint
of
abdominal/ back pain,
severe headache (may be
evidence of hemorrhage).
Lidocaine
Drug
Generic Name:
Lidocaine
Hydrochloride
Brand Name:
Anestin, Xylocaine
Pharmacologic
Class:
Amide
Dosage
Injection: 300mg/3ml
Mechanism of Action
Suppresses automaticity of
ventricular
cells,
Intravenous infusion: decreasing
diastolic
2mg/ml,
4mg/ml, depolarization
and
8mg/ml
increasing
ventricular
fibrillation.
Topical
liquid,
ointment:
Produces local anesthesia
2.5%, 5%
by
reducing
sodium
Therapeutic Class:
permeability of sensory
Antiarrhythmic (class Topical cream:
nerves, which blocks
IB), local anesthetic
0.5%, 4%
impulse generation and
conduction.
Topical solution:
4%
Indication and
Contraindication
Side Effects and
Adverse Effects
Indication
● Ventricular
arrhythmias
● Caudal anesthesia
(w/o epinephrine)
● Epidural
anesthesia (w/o
epinephrine)
local
&
● IV
regional
infiltration
&
● Peripheral
sympathetic
nerve block
● Topical
anesthesia
for
skin or mucous
membranes
or
● Prevention
treatment of pain
during
procedures
involving male or
female urethra
● Local anesthesia
● Dental anesthesia
Side Effects
● Blurred or double
vision
● Chest pain or
discomfort
clammy,
● Cold,
pale skin
● Unexplained
noise in the ears
● Difficulty
breathing
● Difficulty
swallowing
or
● Dizziness
lightheadedness
● Fever, headache
● Sore throat
● Sweating
Adverse Effects
● Seizures, septic
meningitis,
or
automatic deficit
of lower spinal
segment
● Arrhythmias,
Nursing Responsibility
●
●
●
●
●
Monitor vital signs and
ECG
continuously.
Watch
for
cardiac
depression.
Evaluate
level
of
consciousness closely.
Watch for anaphylaxis
and seizures.
Monitor
neurological
status for lower spinal
segment deficits.
Instruct
patient
to
promptly
report
discomfort at IV site as
well as adverse effects,
especially cardiovascular,
respiratory, or neurologic
problems or allergic
reactions.
Contraindication
●
● Hypersensitivity
to drug
●
failure,
● Heart
cardiogenic
shock,
●
intraventricular
block in absence
of a pacemaker
● Wolff-ParkinsonWhite
or
Adams-Stokes
syndrome
● Severe
hemorrhage,
shock, or heart
block
● Local infection at
puncture site
● Septicemia
cardiac arrest
Methemoglobine
mia
Respiratory
depression
or
arrest
Anaphylaxis
Mannitol
Drug
Generic Name:
Mannitol
Brand Name:
Osmitrol
Resectisol
Pharmacologic
Class:
Dosage
Mechanism of Action
Indication and
Contraindication
Injection:
Increases osmotic pressure Indication
5%. 10%, 15%, 20%, of plasma in glomerular ● To
prevent
25%
filtrate, inhibiting tubular
oliguria during
reabsorption of water and
cardiovascular
Solution:
electrolytes.
Enhances
and
other
5g/100ml
water flow from various
surgeries
tissues
ultimately ● Acute oliguria
Side Effects and
Adverse Effects
Side Effects
●
● Headache,
dizziness
● Chest pain, hypo- ●
& hypertension
&
● Nausea
vomiting,
Nursing Responsibility
Monitor IV site carefully
to avoid extravasation
and tissue necrosis.
Watch for excessive fluid
loss and signs and
symptoms
of
hypovolemia.
Osmotic diuretic
Therapeutic Class:
Diuretic
decreases intracranial and ●
intraocular pressures. Also
protects
kidneys
by
preventing toxins from
forming and blocking
tubules.
●
●
To
reduce
intracranial
pressure
and
intraocular
pressure
To
promote
diuresis in drug
toxicity
Irrigation during
transurethral
resection
of
prostate
Contraindication
● Active
intracranial
bleeding
● Anuria secondary
to severe renal
disease
● Progressive heart
failure,
pulmonary
congestion, renal
damage, or renal
dysfunction after
mannitol therapy
begins
● Severe
pulmonary
congestion
or
pulmonary edema
● Severe
dehydration
●
●
diarrhea,
dry ●
mouth
Dehydration
Chills, fever
Adverse Effects
●
● Seizures
● Thrombophlebiti,
heart
failure,
vascular overload
● Osmotic
nephrosis
● Hyperkalemia,
metabolic
acidosis
Assess for evidence of
circulatory
overload,
including
pulmonary
edema,
water
intoxication, and heart
failure.
Advise patient to report
pain at infusion site as
well as adverse reactions,
such
as
increased
shortness of breath or
pain in back, legs, or
chest.
Ketorolac
Drug
Dosage
Generic Name:
Ketorolac trometamol
Brand Name:
Ketodol
Pharmacologic
Class:
Nonsteroidal
anti-inflammatory
drug (NSAID)
Injection:
15mg/ml
in
1-ml
preloaded
syringes,
30mg/ml on 1- and 2ml preloaded syringes
Therapeutic Class:
Analgesic,
antipyretic,
anti-inflammatory
Ophthalmic solution:
0.4%, 0.5%
Tablets:
10mg
Mechanism of Action
Indication and
Contraindication
Interferes
with Indication
prostaglandin biosynthesis ● Moderately
by
inhibiting
severe acute pain
cyclooxygenase pathway ● Ocular
itching
of
arachidonic
acid
caused
by
metabolism.
seasonal allergic
conjunctivitis
Acts as a potent inhibitor ● Postoperative
of platelet aggregation.
ocular
inflammation
related to cataract
extraction
● To reduce ocular
pain
Contraindication
● Hypersensitivity
to
drug
(or
NSAIDs)
● Concurrent use of
aspirins
or
NSAIDs
● PUD
● GI bleeding
● Renal failure
● Prophylactic use
and
● Labor
delivery
● Breastfeeding
Side Effects and
Adverse Effects
Side Effects
● Headache,
dizziness,
drowsiness
● Hypertension
&
● Nausea
vomiting,
diarrhea,
constipation, or
dyspepsia
● Injection site pain
Adverse Effects
● Thrombocytopeni
a
Nursing Responsibility
●
●
●
●
●
●
Monitor for adverse
reactions,
especially
prolonged bleeding time
and CNS reactions.
Monitor fluid intake and
output.
Inform patient that the
drug is meant only for
short-term
pain
management.
Advise
patient
to
minimize GI upset by
eating small, frequent
servings of healthy foods.
Caution female patient
not to take drug if she is
breastfeeding.
Advise patient to avoid
driving or any other
hazardous activities.
Clindamycin
Drug
Generic Name:
Clindamycin
Brand Name:
Clindamycin
phosphate
Pharmacologic
Class:
Lincosamide
Therapeutic Class:
Anti-infective
Dosage
Capsule:
75mg, 150mg, 300mg
Oral suspension:
75mg/5ml
Injection:
150mg base/ml
Mechanism of Action
Indication and
Contraindication
Side Effects and
Adverse Effects
Inhibits protein synthesis Indication
Side Effects
in susceptible bacteria at ● Severe infections ● Nausea
&
level of 50s ribosome,
caused
by
vomiting,
thereby inhibiting peptide
sensitive
abdominal pain
bond
formation
and
organisms
● Bitter taste (with
causing cell death
IV use)
pelvic
● Acute
inflammatory
● Phlebitis at IV
disease
site
● Acne vulgaris
Adverse Effects
Contraindication
● Pseudomembrano
us
colitis,
● Hypersensitivity
to
drug
or
diarrhea
lincomycin
● Neutropenia,
leukopenia,
agranulocytosis,
thrombocytopeni
a purpura
● Hepatic
dysfunction
● Anaphylaxis
Nursing Responsibility
●
●
●
●
●
●
●
Monitor creatinine level
closely in patients with
renal insufficiency.
Assess for signs and
symptoms
of
hypersensitivity
reactions,
including
anaphylaxis.
Assess for diarrhea and
signs and symptoms of
colitis.
Tell patient to take drug
with food if it causes
stomach upset.
Urge patient to contact
prescriber immediately if
rash develops, unusual
fatigue, or yellowing of
skin or eyes or if diarrhea
occurs during or after
treatment.
Tell patient to expect
bitter taste and reassure it
resolves on its own.
Tell patient may reduce
hormonal contraceptive
efficacy.
Tramadol
Drug
Generic Name:
Tramadol
hydrochloride
Brand Name:
Tramal
Dolcet
Pharmacologic
Class:
Opioid agonist
Therapeutic Class:
Analgesic
Dosage
Tablets:
50mg, 100mg, 200mg,
300mg
Mechanism of Action
Indication and
Contraindication
Inhibits
reuptake
of Indication
serotonin
and ● Moderate
to
norepinephrine in CNS.
moderately
severe pain in
patients
who
require
round-the-clock
treatment of pain
for an extended
period
Contraindication
● Hypersensitivity
to drug or opioids
● Acute
intoxication with
alcohol,
sedative-hypnotic
s, centrally acting
analgesics, opioid
analgesics,
or
psychotropic
agents
● Physical opioid
dependence
● Significant
respiratory
depression, acute
or
severe
bronchial asthma
Side Effects and
Adverse Effects
Side Effects
● Headache,
dizziness,
confusion
● Nausea
vomiting,
dyspepsia,
mouth
● Sweating
Nursing Responsibility
●
&
dry
Adverse Effects
● Vertigo, anxiety,
seizures, suicides
● Vasodilation
● Visual
disturbances
● Diarrhea,
constipation,
anorexia,
flatulence
● Respiratory
depression,
bronchospasm
● Pruritus,
angioedema,
toxic epidermal
necrolysis,
Stevens-Johnson
syndrome
● Serotonin
●
●
●
●
Monitor patient for signs
and
symptoms
of
potentially
life-threatening serotonin
syndrome, which may
range from shivering and
diarrhea
to
muscle
rigidity,
fever,
mental-status
changes,
and seizures.
Assess patient’s response
to the drug 30 minutes
after administration.
Monitor
respiratory
status.
Tell patient drug works
best when taken before
pain becomes severe.
Instruct
patient
to
immediately
report
seizure,
suicidal
behavior,
serotonon
syndrome, or allergic
reaction.
or hypercapnia in
unmonitored
settings
or
absence
or
resuscitative
equipment
syndrome,
anaphylaxis
5% Dextrose
Drug
Dosage
Generic Name:
Sodium Chloride
Oral liquid:
55%
Brand Name:
D50W, DGlucose
IV:
2.5%
5%
10%
20%
30%
50%
70%
Pharmacologic
Class:
Glucose-Elevating
Agents
Therapeutic Class:
Electrolytes
Hypoglycemia:
IV:
20-50 mL 50% solution
PO:
4-20 g single dose q 15
mins
Mechanism of Action
Indication and
Contraindication
Dextrose provides a source
of calories. Dextrose is
readily metabolized, may
decrease losses of body
protein
and nitrogen,
promotes
glycogen
deposition and decreases
or prevents ketosis if
sufficient
doses
are
provided
Indication
● Source of water
of
● Source
electrolytes
● Source of calories
● Alkalinizing
agent
Side Effects and
Adverse Effects
Side Effects
● itching,
● hives,
● swelling of the
face,
● puffy eyes,
● coughing,
● sneezing,
Contraindication
● sore throat,
● Allergic
● difficulty
reaction
to
breathing,
corn or corn ● fever, and
products.
site
● injection
reaction
(infection,
swelling, redness)
Adverse Effects
● abdominal pain,
● swelling of the
face, arms, hands,
Nursing Responsibility
●
●
●
●
Suspend container from
eyelet support.
Remove plastic protector
from outlet port at
bottom of container.
Attach administration set.
Refer
to
complete
directions accompanying
set
Clinical evaluation and
periodic
laboratory
determinations
are
necessary to monitor
changes in fluid balance,
electrolyte
concentrations, and acid
base balance during
prolonged
parenteral
therapy or whenever the
condition of the patient
warrants such evaluation.
●
●
●
●
●
●
●
●
●
●
●
●
●
●
●
●
●
●
●
●
●
●
●
●
lower legs, or
feet,
blurry vision,
body aches,
chills,
confusion,
cough,
little
or
no
urination,
dizziness,
lightheadedness,
dry mouth,
ear pain,
fever,
headache,
increased thirst or
urination,
irregular or rapid
heartbeats,
loss of appetite,
loss of voice,
muscle pain or
cramps,
nausea,
vomiting,
nervousness,
tingling
and
numbness in the
hands, feet, or
lips,
pale skin,
pounding in the
ears,
rapid
weight
gain,
●
●
●
●
Lactated Ringer’s and
5% Dextrose Injection,
USP should be used with
caution.
Excess
administration may result
in metabolic alkalosis.
Caution
must
be
exercised
in
the
administration
of
parenteral
fluids,
especially
those
containing sodium ions to
patients
receiving
corticosteroids
or
corticotrophin.
Solution
containing
acetate should be used
with caution as excess
administration may result
in metabolic alkalosis.
If an adverse reaction
does occur, discontinue
the infusion, evaluate the
patient,
institute
appropriate therapeutic
countermeasures
●
●
●
●
●
●
●
●
●
●
●
●
●
●
runny or stuffy
nose,
sneezing,
sore throat,
sweating,
difficulty
breathing,
unusual bleeding
or bruising,
tiredness,
weakness,
weight gain or
loss,
chest pain,
flushed or dry
skin,
fruity
breath
odor,
increased hunger,
and
unexplained
weight loss
NaCl (Sodium Chloride)
Drug
Dosage
Generic Name:
Sodium
Chloride
injection
Brand Name:
Normal saline
Injection:
0.5 - 1 g with 8 oz
water up to 10 times/
day
Mechanism of Action
Indication and
Contraindication
Sodium is a major cation Indication
in extracellular fluid and ● Source of water
helps
maintain water
and electrolytes
distribution, fluid and ● Priming solution
electrolyte balance.
in hemodialysis
Side Effects and
Adverse Effects
Side Effects
● Fever
● Injection
swelling
● Redness
Nursing Responsibility
●
site
●
●
Monitor vital signs. Input
and output
Assess heart and lung
sounds
Assess LOC
Pharmacologic
Class:
procedures
Contraindication
● Congestive heart
failure
● Severly impaired
renal function
● Hypernatremia
● Fluid retentionn
Therapeutic Class:
Mineral
and
electrolyte
replacements/supplem
ents
●
●
Infection
Adverse Effects
● Fast heartbeat
●
● Fever
● Rash
●
● Joint pain
of
● Shortness
breath
Monitor
electrolytes,
ECG, liver and renal
function test
Assess urine specific
gravity
and
serum
sodium levels
Watch out for signs and
symptoms
of
hypernatremia, flushed
skin,
elevated
temperature, rough dry
tongue, and edema
Betahistine
Drug
Generic Name:
Betahistine
Dihydrochloride
Brand Name:
Serc
Pharmacologic
Class:
Dosage
Tablets:
8mg, 16mg, 24mg
Mechanism of Action
Unknown. Histamine-like
action.
Indication and
Contraindication
Side Effects and
Adverse Effects
Nursing Responsibility
●
Indication
● Meniere’s
Disease
● Vertigo
● Tinnitus
● Sensorineural
deafness.
Side Effects
● bloating
● headache
● heartburn
indigestion
● nausea
● vomiting
Contraindication
● Hypertensive to
drug components
Adverse Effects
● Urticaria
● Pruritus
gastric
● Mild
complaints
● False heartbeat
● Insomnia
●
or
●
●
Therapeutic Class:
Antiemetic
and
antivertigo
●
●
This drug should be
taken with food.
Advise
relatives
to
support
patient’s
ambulation.
Protect medication from
moisture.
Do
not
give
this
medication to children.
Swallow tablet whole
with one full glass of
water.
Never take a double dose
if you missed one
medication.
If
you
missed
one,
take
medication immediately.
Metoclopramide HCL
Drug
Generic Name:
Metoclopramide
Hydrochloride
Brand Name:
Clopra,
Emex
,
Maxeran , Maxolon,
Reglan
Pharmacologic
Class:
Direct-acting
cholinergic
Therapeutic Class:
GI stimulant
Dosage
Tablets:
5 mg, 10 mg
IV:
5 mg/5 mL solution
IM:
5 mg/mL injection
Mechanism of Action
Indication and
Contraindication
Side Effects and
Adverse Effects
Potent central dopamine
receptor
antagonist.
Structurally related to
procainamide but has little
antiarrhythmic
or
anesthetic activity. Exact
mechanism of action not
clear but appears to
sensitize
GI
smooth
muscle to effects of
acetylcholine by direct
action.
Indication
● gastroparesis
● to prevent nausea
and
vomiting
associated with
emetogenic
cancer
chemotherapy
facilitate
● to
intubation
of
small bowel
● symptomatic
treatment
of
gastroesophageal
reflux.
Side Effects
● Diarrhea
● drowsiness
● loss of strength or
energy
● muscle pain or
weakness
● restlessness
weak
● unusual
feeling
●
●
Adverse Effects
● Confusion
● drowsiness
(severe)
●
Contraindication
or
● Sensitivity
intolerance
to
metoclopromide
to
● Allergy
sulfiting agents
● History of seizure
● History of breast
cancer
● Mechanical GI
obstruction
or
Nursing Responsibility
●
●
Monitor VS
Watch out for facial
grimacing
and
restlessness
Instruct patient to avoid
driving
or
other
hazardous activities after
drug administration
Instruct patient to avoid
drinking alcohol and
other CNS depressants
Do not breastfeed while
taking this medication
perforation.
Nicardipine
Drug
Generic Name:
Nicardipine
Brand Name:
Cardene IV
Pharmacologic
Class:
Dihydropyridine
Dosage
Tablets:
20mg
30mg
Infusion solution
20mg/200mL
40mg/200mL
Therapeutic Class:
Injectable solution
Calcium
channel 2.5mg/mL
blockers
Mechanism of Action
Calcium entry blocker that
inhibits the transmembrane
influx of calcium ions into
cardiac muscle and smooth
muscle, thus affecting
contractility.
More
selectively affects vascular
smooth
muscle
than
cardiac muscle; relaxes
coronary vascular smooth
muscle with little or no
negative inotropic effect.
Indication and
Contraindication
Side Effects and
Adverse Effects
Side Effects
●
● headache,
● dizziness,
●
● swelling in your
Contraindication
feet,
● Lactation
● weakness,
● Advanced aortic ● flushing (warmth, ●
stenosis
redness, or tingly
● Hypersensitivity
feeling), and
● nausea
●
Adverse Effects
● hives,
● difficulty
breathing,
● swelling of your
face, lips, tongue,
or throat,
● lightheadedness,
● pounding
heartbeats,
● fluttering in your
chest, and
● severe or ongoing
chest pain
Indication
● Hypertension
● Angina
Nursing Responsibility
Monitor initial vital signs
with latest
Watch out for peak blood
pressure values (BP
peaks usually 1-2 hours
after dosing)
Instruct patient to slowly
change positions from
lying to sitting or
standing
Report to the physician
immediately
if
any
adverse effect occurs
Norepinephrine
Drug
Generic Name:
Norepinephrine
Brand Name:
Levophed,
Nortriptyline
Hydrochloride
Pharmacologic
Class:
Alpha/Beta
Adrenergic Agonists
Therapeutic Class:
Autonomic nervous
system agent
Dosage
Injectible solution:
1 mg/mL
Mechanism of Action
Indication and
Contraindication
Direct-acting
sympathomimetic amine
identical
to
body
catecholamine
norepinephrine.
Acts
directly and predominantly
on
alpha-adrenergic
receptors; little action on
beta receptors except in
heart (beta1 receptors).
Vasoconstriction
and
cardiac stimulation; also
powerful constrictor action
on
resistance
and
capacitance blood vessels.
Indication
of
● treatment
cardiac arrest and
profound
hypotension.
Side Effects and
Adverse Effects
Side Effects
● Slow heart rate
blood
● High
pressure
● Irregular
heartbeats
Contraindication
● Confusion
or ● Shortness
● mesenteric
of
peripheral
breath
vascular
and
● Nausea
thrombosis
vomiting
● profound hypoxia ● Sweating
or hypercarbia
● Tremor
● pregnancy
● Dizziness
● Weakness
and
● Redness
swelling at the
injection site
Adverse Effects
● Pain or burning
where
the
injection is given
● Sudden
numbness/weakn
ess/cold feeling
lips or
● Blue
fingernails
less
● Urinating
Nursing Responsibility
●
●
●
●
Monitor vital signs and
input and output
Adjust flow rate to
maintain BP at low
normal (usually 80–100
mm Hg systolic) in
normotensive patients.
Be alert to patient's
complaints of headache,
vomiting,
palpitation,
arrhythmias, chest pain,
photophobia, and blurred
vision
as
possible
symptoms of overdosage.
Reflex bradycardia may
occur as a result of rise in
BP.
Continue to monitor vital
signs and observe patient
closely after cessation of
therapy for clinical sign
of
circulatory
inadequacy.
●
●
than usual or not
at all
Trouble breathing
Dangerously high
blood pressure
Omeprazole
Drug
Generic Name:
Omeprazole
Brand Name:
Losec, Prilosec
Pharmacologic
Class:
Proton pump inhibitor
Therapeutic Class:
H. pylori agents
Dosage
Tablets:
10 mg, 20 mg, 40 mg
Oral suspension:
20 mg powder
Mechanism of Action
Indication and
Contraindication
Side Effects and
Adverse Effects
An
antisecretory
compound that is a gastric
acid
pump
inhibitor.
Suppresses gastric acid
secretion by inhibiting the
H+, K+-ATPase enzyme
system [the acid (proton
H+) pump] in the parietal
cells.
Indication
and
● Duodenal
gastric ulcer.
● Gastroesophageal
reflux disease
Contraindication
use
● Long-term
for
gastroesophageal
reflux disease
● Hypersensitivity
● Lactation.
Side Effects
● headache
● abdominal pain
● diarrhea
● nausea
● vomiting
● gas (flatulence)
● dizziness
● upper respiratory
infection
● acid reflux
● constipation
● rash
● cough
Adverse Effects
fracture
● bone
(osteoporosis-rela
ted)
of
● deficiency
granulocytes in
the blood
Nursing Responsibility
●
●
●
●
●
Monitor
vital
signs
especially patient’s input
and output
Monitor urinalysis for
hematuria or proteinuria
Instruct patient to report
diarrhea because drug
might need to be
discountinued
Instruct patient to report
pain or discomfort while
urinating
Instruct patient to not
breast feed while taking
this drug
●
●
●
●
●
●
●
●
loss of appetite
gastric polyps
hip fracture
hair loss
chronic
inflammation of
the stomach
destruction
of
skeletal muscle
taste changes
abnormal dreams
Phenytoin
Drug
Generic Name:
Phenytoin
Brand Name:
Dilantin
125,
Dilantin, Phenytek
Pharmacologic
Class:
Anti-convulsants
Therapeutic Class:
Central
nervous
system agent
Dosage
Capsule:
100 mg
200 mg
300 mg
Tablet:
50 mg
Oral:
125 mg/5mL
Injectable:
50 mg/mL
Mechanism of Action
Indication and
Contraindication
Hydantoin
derivative
chemically
related to
phenobarbital.
Precise
mechanism
of
anticonvulsant action is
not known, but drug use is
accompanied by reduced
voltage, frequency, and
spread
of
electrical
discharges within the
motor cortex. Class IB
antiarrhythmic properties
similar to those of
lidocaine and tocainide.
Has
class
IB
antiarrhythmic properties.
Indication
control
● To
seizures during or
after
neurosurgery
Side Effects and
Adverse Effects
Side Effects
● Drowsiness
● Fatigue
● Loss of control of
bodily
movements
Contraindication
● Loss of balance
● Hypersensitivity
or coordination
to
hydantoin ● Irritability
products
● Headache
● seizures due to ● Restlessness
hypoglycemia
● Nervousness
● Adams-Stokes
● Slurred or slow
syndrome
speech
● Pregnancy
and
● Numbness
tingling
Nursing Responsibility
●
●
●
●
●
Monitor vital signs
Monitor diabetics for loss
of glycemic control.
Observe for symptoms of
folic acid deficiency:
neuropathy,
mental
dysfunction.
Make sure patients on
prolonged therapy have
adequate
intake
of
vitamin
D-containing
foods and sufficient
exposure to sunlight
Instruct patient that urine
may turn pink or
red-brown.
●
●
Rash
Itching
Adverse Effects
● Involuntary
muscle
movements
or
● Weakness
paralysis of eye
muscles
● Kidney damage
● Stevens-Johnson
syndrome
● Lupus
erythematosus
● Rickets
● Softening of the
bones
Vitamin B
Drug
Generic Name:
Cyanocobalamin
Brand Name:
Vitamin B12
Pharmacologic
Class:
Vitamin
Dosage
Mechanism of Action
Indication and
Contraindication
Side Effects and
Adverse Effects
Tablets:
.Vitamin
B12
is
a Indication
Side Effects
●
5 mcg, 50 mcg, 100 cobalt-containing
B ● Vitamin
B12 ● Headache,
mcg, 250 mcg tablets
complex vitamin produced
deficiency due to
nausea, vomiting,
by Streptomyces griseus.
malabsorption
fatigue, tingling
Essential
for
normal
syndrome as in
sensation
in
growth, cell reproduction,
pernicious
hands and feet
maturation
of
RBCs,
(Addison) anemia
nucleoprotein synthesis, ● Fish tapeworm Adverse Effects
Nursing Responsibility
Before
initiation
of
therapy, reticulocyte and
erythrocyte counts, Hgb,
Hct, vitamin B12, and
serum
folate
levels
should be determined;
then repeated between 5
and 7 d after start of
Therapeutic Class:
Therapeutic Nutrient
maintenance of nervous
system (myelin synthesis),
and believed to be
involved in protein and ●
carbohydrate metabolism.
Also acts as coenzyme in
various biologic reactions.
Vitamin B12 deficiency
results in megaloblastic
anemia, dysfunction of
spinal cord with paralysis, ●
GI lesions.
infestation
and ●
Gluten
enteropathy
B12 deficiency
test caused by
increased
physiologic
●
requirements or
inadequate
dietary intake
Vitamin
B12
absorption
●
(Schilling) test
Contraindication
of
● History
sensitivity to
vitamin B12,
other
cobalamins,
or
cobalt; ●
early Leber's
disease
(hereditary
optic nerve
atrophy),
indiscriminat
e use in folic
acid
deficiency.
use
● Safe
during
pregnancy,
lactation.
Body as a Whole:
Feeling
of
swelling of body,
anaphylactic
shock,
sudden ●
death.
CV: Peripheral ●
vascular
thrombosis,
pulmonary
edema, CHF.
GI: Mild transient
diarrhea.
Hematologic:
Unmasking
of
polycythemia
●
vera
(with
correction
of
vitamin
B12
deficiency).
Metabolic:
Hypokalemia.
Skin:
Itching,
rash,
flushing.
Special Senses:
Severe
optic
nerve
atrophy
(patients
with
Leber's disease).
therapy and at regular
intervals during therapy.
Monitor potassium levels
during the first 48 h.
Obtain a careful history
of sensitivities.
Therapeutic response to
drug therapy is usually
dramatic,
occurring
within
48
h.
Effectiveness is measured
by laboratory values and
improvement
in
manifestations of vitamin
B12 deficiency.
Inform the patient and
family about vitamin B,
which
include
nutrient-added breakfast
cereals,
vitamin
B12-fortified soy milk,
organ meats, clams,
oysters, egg yolk, crab,
salmon, sardines, muscle
meat, milk, and dairy
products.
Ranitidine
Drug
Generic Name:
Ranitidine
Hydrochloride
Brand Name:
Zantac
Pharmacologic
Class:
Gastrointestinal agent
Therapeutic Class:
H2 blockers
Dosage
Tablets:
75–150 mg
Mechanism of Action
Indication and
Contraindication
Side Effects and
Adverse Effects
.Potent anti-ulcer drug that Indication
Side Effects
●
competitively
and ● Short-term
● Abdominal pain,
reversibly
inhibits
treatment
of
headache,
histamine
action
at
active duodenal
agitation,
hair
H2-receptor
sites
on
ulcer;
loss, confusion, ●
parietal
cells,
thus
maintenance
constipation,
blocking
gastric acid
therapy
for
dizziness
secretion.
Indirectly
duodenal
ulcer
reduces pepsin secretion
patient
after Adverse Effects
but appears to have
healing of acute ● CNS: Headache,
minimal effect on fasting
ulcer; treatment
malaise,
and postprandial serum
of
dizziness,
●
gastrin concentrations or
gastroesophageal
somnolence,
secretion
of
gastric
reflux
disease;
insomnia,
intrinsic factor or mucus.
short-term
vertigo, mental
treatment
of
confusion,
active,
benign
agitation,
gastric
ulcer;
depression,
treatment
of
hallucinations in
pathologic
GI
older adults.
hypersecretory
● CV: Bradycardia
conditions;
(with rapid IV
heartburn.
push).
● GI: Constipation,
Contraindication
nausea,
● Hypersensitiv
abdominal pain,
ity
to
diarrhea.
Skin:
ranitidine;
Rash.
Nursing Responsibility
Monitor
creatinine
clearance
if
renal
dysfunction is present or
suspected.
Be alert for early signs of
hepatotoxicity: jaundice
(dark urine, pruritus,
yellow sclera and skin),
elevated transaminases
(especially ALT) and
LDH.
Instruct the patient to
adhere to scheduled
periodic
laboratory
checkups
during
ranitidine treatment.
acute
porphyria;
OTC
administratio
n in children
<12 y.
●
●
Hematologic:
Reversible
decrease in WBC
count,
thrombocytopeni
a.
Body as a Whole:
Hypersensitivity
reactions,
anaphylaxis
Ascorbic Acid
Drug
Dosage
Generic Name:
Ascorbic Acid
Brand Name:
Ascorbic Acid, Ascor
Pharmacologic
Class:
Vitamin
Tablets:
Therapeutic- 150–500
mg/d in 1–2 doses
Prophylactic45–60
mg/d
Therapeutic Class:
Therapeutic Nutrient
Mechanism of Action
Indication and
Contraindication
Water-soluble
vitamin Indication
essential for synthesis and ● Prophylaxis and
maintenance of collagen
treatment
of
and intercellular ground
scurvy and as a
substance of body tissue
dietary
cells,
blood
vessels,
supplement.
cartilage, bones, teeth,
skin,
and
tendons. Contraindications
Increases the protection
of
● Use
mechanism of the immune
sodium
system, thus supporting
ascorbate in
wound healing.
patients on
sodium
restriction.
of
● Use
calcium
Side Effects and
Adverse Effects
Side Effects
●
● Fatigue, flushing,
flatulence
●
Adverse Effects
Nausea,
● GI:
vomiting,
●
heartburn,
diarrhea,
or
abdominal
cramps
(high
doses).
● Hematologic:
Acute hemolytic
anemia (patients
with deficiency
Nursing Responsibility
Inform the patient that
they should take the drug
with food.
Monitor for S&S of acute
hemolytic anemia, sickle
cell crisis.
Instruct the patient to not
breastfeed while taking
this
drug
without
consulting a physician.
●
ascorbate in
patients
receiving
●
digitalis.
Safety during
pregnancy
●
(category C)
or lactation is
not
established.
●
of G6PD); sickle
cell crisis.
CNS: Headache
or insomnia (high
doses).
Urogenital:
Urethritis,
dysuria,
crystalluria,
hyperoxaluria, or
hyperuricemia
(high doses).
Other:
Mild
soreness
at
injection
site;
dizziness
and
temporary
faintness
with
rapid
IV
administration.
Mefenamic Acid
Drug
Generic Name:
Mefenamic Acid
Brand Name:
Ponstan
Pharmacologic
Class:
Dosage
Tablets:
PO Loading Dose- 500
mg
PO Maintenance Dose250 mg q6h prn
Mechanism of Action
Indication and
Contraindication
Side Effects and
Adverse Effects
Anthranilic
acid Indication
Side Effects
●
derivative.
It inhibits ● Short-term relief ● Ringing in the
prostaglandin
synthesis
of
mild
to
ears, headache,
and
affects
platelet
moderate
pain
heartburn,
●
function.
including primary
drowsiness
dysmenorrhea.
Nursing Responsibility
Give with meals, food, or
milk to minimize GI
adverse effects.
Assess patients who
develop severe diarrhea
and
vomiting
for
Nonsteroidal
anti-inflammatory
drug
Therapeutic Class:
Analgesic
Adverse Effects
Contraindication
● CNS:
● Hypersensitiv
●
Drowsiness,
ity to drug
insomnia,
dizziness,
● GI
nervousness,
inflammation
confusion,
,
or
headache.
ulceration.
Severe ●
in ● GI:
● Safety
diarrhea,
children <14
ulceration, and
y,
during
bleeding; nausea,
pregnancy
vomiting,
(category C),
abdominal
●
or lactation is
cramps,
flatus,
not
constipation,
established.
hepatic toxicity.
● Hematologic:
Prolonged
prothrombin
time,
severe
autoimmune
hemolytic anemia
(long-term use),
leukopenia,
eosinophilia,
agranulocytosis,
thrombocytopeni
c
purpura,
megaloblastic
anemia,
pancytopenia,
bone
marrow
hypoplasia.
● Urogenital:
Nephrotoxicity,
dehydration
and
electrolyte imbalance.
Discontinue
drug
promptly if diarrhea, dark
stools,
hematemesis,
ecchymoses, epistaxis, or
rash occur and inform the
physician.
Instruct the patient to not
drive or engage in
potentially
hazardous
activities until response
to drug is known.
Instruct the patient to not
breastfeed while taking
this drug.
●
●
●
●
dysuria,
albuminuria,
hematuria,
elevation
of
BUN.
Skin: Urticaria,
rash,
facial
edema.
Special Senses:
Eye
irritation,
loss of color
vision
(reversible),
blurred
vision,
ear pain.
Body as a Whole:
Perspiration.
CV: Palpitation.
Respiratory:
Dyspnea; acute
exacerbation of
asthma;
bronchoconstricti
on (in patients
sensitive
to
aspirin).
Lactated Ringer’s
Drug
Generic Name:
Dosage
Tablets:
Mechanism of Action
Short-acting,
Indication and
Contraindication
potent Indication
Side Effects and
Adverse Effects
Side Effects
Nursing Responsibility
●
Urinary
alkalinization:
Sodium Bicarbonate
NA(HCO3)
Brand Name:
Lactated
Ringer’s
Solution
Pharmacologic
Class:
Fluid and electrolyte
balance agent
Therapeutic Class:
Gastrointestinal agent
systemic antacid. Rapidly ●
neutralizes gastric acid to
form sodium chloride,
carbon dioxide, and water.
After absorption of sodium
bicarbonate, plasma alkali
reserve is increased and
excess
sodium
and
IV 2–5 mEq/kg by IV bicarbonate
ions
are
infusion over 4–8 h
excreted in urine, thus
rendering urine less acid.
As antacid- 0.3–2 g 1–4
times/d or ½ tsp of
powder in glass of
water
As urinary alkalizer- 4
g initially, then 1–2 g
q4h
●
●
●
Systemic
alkalizer
to
correct metabolic
acidosis
(as
occurs in diabetes
mellitus, shock,
cardiac arrest, or
vascular
collapse),
to
minimize
uric
acid
crystallization
associated with
uricosuric agents.
Home remedy for
relief
of
occasional
heartburn,
indigestion,
or
sour stomach.
Used topically as
paste, bath, or
soak to relieve
itching and minor
skin
irritations
such as sunburn,
insect
bites,
prickly
heat,
poison
ivy,
sumac, or oak.
Sterile solutions
are used to buffer
acidic parenteral
solutions
to
prevent acidosis.
●
Hives,
itching,
fever, difficulty
●
breathing
Adverse Effects
Belching,
● GI:
gastric distention, ●
flatulence.
● Metabolic:
Metabolic
alkalosis;
electrolyte
●
imbalance:
sodium overload
(pulmonary
edema),
hypocalcemia
(tetany),
●
hypokalemia,
milk-alkali
syndrome,
dehydration.
● Other: Rapid IV
in
neonates
(Hypernatremia,
reduction in CSF
pressure,
intracranial
hemorrhage).
Severe
● Skin:
tissue
damage
following
extravasation of
IV solution.
● Urogenital: Renal
calculi
or
Monitor urinary pH as a
guide to dosage.
Observe for and report
S&S of improvement or
reversal of metabolic
acidosis.
Inform the patient to not
use sodium bicarbonate
as
antacid.
A
nonabsorbable
OTC
alternative for repeated
use is safer.
Inform the patient to not
take antacids longer than
2 wk except under advice
and supervision of the
physician.
Instruct the patient to not
breastfeed while taking
this
drug
without
consulting
their
physician.
Contraindications
● Prolonged
therapy with
sodium
bicarbonate
● Patients
losing
chloride (as
from
vomiting, GI
suction,
diuresis)
● Heart
disease,
hypertension
● Renal
insufficiency
● Peptic ulcer
● Pregnancy
(category C).
crystals, impaired
kidney function.