Nicoleta C.
DRUG NAME
(GENERIC/TRA
DE)
DIGOXIN
(LANOXIN)
CLASSIFICATION
INDICATIONS FOR USE
Antiarrhythmics
Inotropics
HF
AFib
Paroxysmal Atrial
tachycardia
DIPHENHYDRA
MINE
(BENADRYL)
Allergy, cold, cough
remedy
Antihistamine
Antitussive
Relief of allergic
symptoms
→Anaphylaxis,
seasonal allergies,
allergic dermatoses
Parkinson’s dz,
dystonic reactions
from meds Mild
nighttime sedation
Prevent motion
sickness Antitussive
(syrup only)
DEXAMETHASO
NE
(DECADRON)
Long-acting
corticosteroids
inflammation
severe allergies
arthritis
asthma
MS
Cerebral edema
PERTINENT DIAGNOSTICS
Monitor apical pulse (1min)
before admin, ECG during IV
admin for bradycardia and new
arrhythmia, observe IV site for
infiltration, monitor I&O, daily
weights, assess for peripheral
edema, LS for crackles. Lytes:
K+, Mag, Calcium.
Renal/hepatic fx.
Why is med being used? Assess
for confusion and sedation in
elderly. BP
Anaphylaxis →urticaria, airway
patency
Allergic rhinitis →nasal
stuffiness, rhinorrhea, sneezing
Parkinsonism and
extrapyramidal → movement
d/o
Insomnia → sleep patterns
Motion sickness → N,V bowel
sounds, abd pain
Cough → frequency, LS,
sputum
Pruritus → itching, skin rash,
inflammation
Daily weights
Check for sign and symptoms
of infection.
Watch K levels
Watch for peripheral edema
d/t fluid retention; I& O
Q4 Blood sugar checks d/t
increase in blood sugar
Watch BP
NURSING CONSIDERATIONS:
MAJOR SIDE EFFECTS, TEACHING
POINTS
Therapeutic range: 0.5- 2ng/mL.
Older adults at ↑risk for toxicity.
S/S of toxicity abd pain, anorexia,
N&V, visual disturbances,
bradycardia, arrhythmias. S/E:
include above and fatigue.
DIGIBIND is AD. ↓K+ usually
precipitates toxicity. Monitor K+ if
on diuretic.
Drowsiness, dizziness, dry mouth,
constipation, dry eyes, urinary
retention, blurred vision
Stand up slowly
Increase fluids and fiber
Hard candy
Increase intraocular pressure.
Hyperglycemia
N/V
Decrease wound healing.
Hypertension
Fluid retention
Hypokalemia
Cushing appearance – moon face,
buffalo hump
SUGGESTED RATE OF ADMINISTRATION
IVP: May be admin diluted/undiluted
Dilution: 1mL of dig in 4mL of sterile water
(injection), D5W, or 0.9% NaCL. Use diluted
solution immediately. Admin: over @ LEAST
5 min
IVP: Max: 50mg
Rate: @ no faster than 25mg/min
0.75-9mg daily divided doses q6-12hr
Nicoleta C.
FAMOTIDINE
(PEPCID)
Antiulcer agent
FUROSEMIDE
(LASIX)
Diuretic
HEPARIN
Increase risk for infections
Confusion, ARRHYTHMIAS,
AGRANULOCYTOSIS, APLASTIC
ANEMIA.
Short term tx or
maintenance of active
duodenal ulcers and
benign gastric ulcers.
GERD, heartburn, acid
indigestion, sour
stomach. Prevent and
tx stress induced
upper GI bleeding in
critically ill pts.
Edema due to HF,
hepatic impairment,
or renal dz.
Hypertension
Assess for epigastric or abd
pain, frank or occult blood in
stool, emesis, or gastric
aspirate. Assess elderly and
debilitated patients for
confusion. Monitor CBC w/Diff,
BUN, creatinine, GFR, UO. BP
IVP: dilute 0.9% NaCl for injection
Concentration: not >4mg/mL Rate: rate of
10mg/min over @ least 10 mins.
Rapid adm can cause hypotension.
Assess fluid status (daily
weight, I&O, edema, LS, turgor,
MM)
Monitor BP ans pulse before
and during admin.
Assess for fall risks, hear loss,
allergy to sulfa drugs, skin rash.
***if patient is also on Dig
assess for s/s of toxicity as Lasix
depletes K+ ↑ risk***
Monitor lytes (K+), BUN,
creatinine, GFR, AST, ALT.
Ototoxic, ERYTHEMA
MULTIFORME, SJ SYNDROME,
TOXIC EPIDERMAL NECROLYSIS,
dehydration, hypocalcemia,
hypochloremia, hypomag,
hyponatremia, hypovolemia,
metabolic alkalosis, APLASTIC
ANEMIA, AGRANULOCYTOSIS.
IVP: undiluted Concentration: 10mg/mL
Rate: @ rate of 20mg/min
anticoagulant
Afib
DVT
SCD
D/C if platelets<10000
Watch for signs of bleeding
Watch HBG/Hct and RBC;K
5000 units SC q8-12hr
HYDROMORPH
ONE
(DILAUDID)
Opioids
used to help relieve
moderate to severe
pain.
It works in the brain to
change how your body
feels and responds to
pain.
Watch for RR; HR; BP
Check for allergies
Check POSS scale
Check peak time
Induced thrombocytopenia
Hemorrhage
Hyperkalemia
Prolonged clotting time
Respiratory depression
N/V/HA
Pruritus; flushing
Constipation
Seizures
Bradycardia
hypotension
LORAZEPAM
Analgesic adjunct
PO: Anxiety D/O
Assess anxiety (orientation,
Dizziness, drowsiness, lethargy,
IVP: Dilute immediately before use w/ an
0.2-0.6 IV q2-3hr start
1-4 mg SC/IM/IV q3-6 hr
Nicoleta C.
(ATIVAN)
Antianxiety agent
Sedative/Hypnotic
IM, IV: Status
epilepticus.
Preanesthetic to
produce sedation, ↓
preop anxiety, and
induce amnesia.
mood, behavior)
Assess seizures (location,
duration, characteristics, and
frequency)
Monitor BUN, creatinine, GFR,
AST, ALT, albumin, WBC)
APNEA, CARDIAC ARREST.
**depresses CNS** Romazicon is
AD
equal amount of sterile H2O for injection,
D5W, 0.9% NaCl.
***do not use if solution is colored or
contains precipitate***
Rate: not to exceed 2mg/min or 0.05mg/kg
over 2-5 mins.
NALOXONE
(NARCAN)
Opioid antagonist
Rapid revere opioid
overdose
Check vital signs.
Check mental status.
Check for allergies.
0.4mg solution
ONDANSETRO
N
(ZOFRAN)
Antiemetic
Watch for chest pain bc can
cause MI
ECG
Monitor fluid and electrolytes.
SJS
METOCLOPRA
MIDE
(REGLAN)
Antiemetics and gut
stimulator
Nausea
Vomiting
Blocks serotonin that
causing vomiting
Specific for chemo
pts/postop surgery
GERD
N/V
Agitation
N/V/D
Irritability and anxious
Violence
Heart attack
HA
Drowsiness
Constipation
Lightheadedness
HA
Tardive dyskinesia
Dizziness, nervousness
Sleep pbs
Hypertension
Rash welling of the face
Trouble breathing
CNS: confusion,
sedation, dizziness, dysphoria,
euphoria
floating feeling, hallucinations,
headache, unusual dreams
 EENT: blurred vision, diplopia,
miosis
 Resp: RESPIRATORY DEPRESSION
 CV: hypotension, bradycardia
 Endo: adrenal insufficiency
 GI: constipation, nausea,
vomiting
Dose < 10mg given over 1-2 minutes
Dopamine
antagonist
MORPHINE
SULFATE
Opioid
used to help relieve
moderate to severe
pain.
It works in the brain to
change how your body
feels and responds to
pain.
Check BP/RR
Check for allergies
Assess bowel sounds
Assess for extrapyramidal side
effects PA symptoms
ALT/AST
Prolactin and aldosterone
Check vitals -Check allergies Check POSS scale -Check peak
time
4-16 mg base on pt’s weight 0.15mg/kg
Given at over at least 30sec
Dilute with at least 5 mL of sterile water or
0.9% NaCl for injection. Concentration: 0.5–
5 mg/mL.
Rate: High Alert: Administer 2.5–15 mg over
5 min.
Nicoleta C.
 GU: urinary retention
 Derm: flushing, itching, sweating
 Misc: physical dependence,
psychological dependence,
tolerance
NSAID
Non-opioid
analgesic
Short term pain
management
(not to exceed 5 days
– all routes)
Assess for asthma, aspirin
allergy, rhinitis, and urticaria.
Assess for rash (SJ syndrome)
Monitor BP. Monitor for
edema and FVE. Mental Status,
May ↑AST, ALT, BUN, Serum
Creatinine, K+. Can prolong
bleeding time. PT, PTT
Can prolong bleeding time. Should
be used cautiously in patients with
CV disease (↑risk of stroke, MI) ↑
risk of GI bleeding. Contraindicated
in peptic ulcers, GI bleeding,
advanced renal impairment.
Drowsiness, Hypersensitivity
reactions.
IVP: Do not dilute. Concentration: 1530mg/mL.
Rate: over at least 15 secs.
PANTOPRAZOL
E
(PROTONIX)
Antiulcer agent
Erosive esophagitis
assoc with GERD
(maintenance of
healing)
Pathologic gastric
hypersecretory
conditions
Duodenal ulcer r/t H.
Pylori
Assess for epigastric or abd
pain and frank or occult blood
in the stool, emesis, or gastric
aspirate.
Can ↑AST, ALT, alkaline phos,
and bilirubin.
May ↓Mag. Monitor prior and
during therapy.
Monitor bowel function.
Diarrhea, abd pain, fever,
blood stools →C.Diff
C.DIFF.
Pts on ↑dose for >1yr are at
greater risk for spinal, wrist, and
hip fx. Can cause Vit B deficiency in
pts taking for >3yrs.
Can be given w/wo food. Do not
chew, break, or crush tablets.
IVP: Do not dilute
Concentration: 4mg/ml
Rate: over @ LEAST 2 min
METHYLPREDNI
SOLONE
(SOLUMEDROL)
Intermediate acting
corticosteroids
inflammation
severe allergies
arthritis
asthma
MS
Cerebral edema
Used with
immunosuppressants
in prevent organ
Daily weights
Check for sign and symptoms
of infection.
Watch K levels
Watch for peripheral edema
d/t fluid retention; I& O
Q4 Blood sugar checks d/t
increase in blood sugar
Watch BP
weight gain
menstrual period changes,
bone/joint pain
easy bruising/bleeding
mental/mood changes
muscle weakness/pain
slow wound healing
swelling of the ankles/feet/hands
0–250 mg q 4–6 hr
KETOLORAC
(TORADOL)
Nicoleta C.
rejection in
transplants
DEXTROSE 50%
AMPULE
Glucose-Elevating
Agents
Hypoglycemia
Check blood sugar after each
dose given
DIAZEPAM
(VALIUM)
antianxiety agents,
anticonvulsants,
sedative/hypnotics,
Anxiety
Muscle relaxation
Decrease seizures
activity
Monitor BP/HR/RR
Assess IV bc may cause
phlebitis and venous
thrombosis.
Increase risk for falls.
skeletal muscle
relaxants (centrally
acting)
HYDRALAZINE
(APRESOLINE)
vasodilator
Hypertension
CHF
Assess VS- BP/HR
NA, BUN, Cr
METOPROLOL
(TENORMIN)
Antihypertensive
Hypertension
MI
CHF
Migraine HA
Take apical pulse prior to
administration.
Assess VS- BP/HR
I&O
Daily W
Hyperglycemia
Blurred vision
Changes in skin color
Cough
Fast and slow HR
HA
Sleep apnea
Hypersensitivity
Hepatic dysfunction -AST/ALT
Dependence
Hypotension
Hypersensitivity
Tachycardia
fluid retention
Diz/drow/HA/N/V/D
Bronchospasm
HF
Arrythmias
Dizi/ drossiness
Dry mouth
Hyperglycemia
Bradycardia
Fatigue/weakness
Mask signs of hypoglycemia
Hypoglycemia protocol for BS <70 adm
25 – 50 mL slowly, over at least 1 to 5
minutes
2–10 mg, may repeat in 3–4 hr as needed(
for anxiety)
5–10 mg, may repeat q 10–15 min to a total
of 30 mg) status epilepticus/acute seizures)
Diluent: For IV administration do not dilute
or mix with any other drug. If direct IV push
is not feasible, administer IV push into
tubing as close to insertion site as possible.
Concentration: 5 mg/mL.
Rate: Administer slowly at a rate of 5
mg/min in adults
Dose may be titrated rapidly over 3 – 5
days, but may need to decrease if side
effects occur.
Hold if HR<50
Diluent:Administer undiluted.
Concentration: 1 mg/mL. Rate: Administer
over 1 min.
Nicoleta C.