Drug Name:
Classification
Ketalar
Dissociative/Anesthetic Agent
How supplied/usual dosage
Chemical Names
IV 1mg/kg to 4.5 mg/kg.
Ketamine Hydrochloride
Intramuscular 6.5 to 13 mg/kg,
Supplied in cartons of 10._
OR indication/Common Use
Selectively disrupts the associative pathways of the brain. Supplement
low-potency agents, such as nitrous oxide.
Contraindications
Significant elevation of blood pressure would constitute a serous hazard and in
those shown hypersensitivity to the drug._Should not be given with sever hypotension, sever coronary
disease, increased intracranial pressure, hx of cerebrovascular injury, increased intraocular pressure and
surgery of the pharynx, larynx and bronchial tree
Special Considerations Cardiac function should be continually monitored, Postoperative confused, and
Respiratory depression, hallucinations, delirium, muscular rigidity, increased intracranial pressure,
hypertension, arrhythmias, mild increase in intraocular pressure, nausea, vomiting, and laryngospasm.
-------------------------------------------------------------------------------Drug Name:
Classification
Anestacon, Xylocaine
Nerve Blockades, Amides__
How supplied/usual dosage
Chemical Names: Lidocaine Hydrochloride /
Lidocaine Topical
Lidocaine topical cream, lotion, spray, solution, film, and transdermal patch.
Use only small amounts needed to numb the skin or relieve pain.
Anesthesia: 0.50-1% solutions, Nerve and
epidural block 1-2% solution, Caudal: 1-1.5% solution, Spinal: 5% with glucose, saddle block: 1.5% with glucose,
Ventricular arrhythmias IV 50-100mg bolus or a rate of 20-50 mg/minute
OR indication/Common Use
Blocking nerve signals in your body, reduce pain or discomfort caused by skin
irritation such as sunburn, insect bites, poison ivy, poison oak, poison sumac, minor cyst, scratches, hemorrhoids,
and burns.
Contraindications
Allergic to any other type of numbing medicine, liver disease, broken, swollen, or damaged
skin and/or breast feeding. Patient with severe trauma or sepsis, arrhythmias, bradycardia, or heart block
Special Considerations Overdose of numbing medication can cause fatal side effects if too much absorbed
through skin and into your blood. Can cause dizziness, difficult breathing or swallowing, hypotension, bradycardia,
heart block, tinnitus, blurred vision, impaired color perception, nausea, vomiting and excessive perspiration
Drug Name:
Classification
Induction Agents
How supplied/usual dosage
Brevital Sodium
Chemical Names
Methohexial Sodium
IV in adults a concentration of no higher than 1%. In Pediatrics either
Rectal with 1% solution or Intramuscular with 5% concentration. Anesthesia induction: IV 5-12mL of 1%
solution at a rate of 1mL every 5 minutes and then 2-4 every 4 to 7 minutes as needed
OR indication/Common Use
Short-acting barbiturate-anesthetic. IV administration rapid uptake by
the brain (30 secs) and rapid induction of sleep. Intramuscular onset of sleep occurs in 2 to 20 mins, and
Rectal administration onset of sleep occurs in 5 to 15 mins.
Contraindications
Patients with latent or manifest porphyria, or in patients with a known
hypersensitivity to barbiturates. Not given to pregnant patients
Special Considerations Oxygen sensitive, only used in hospitals or ambulatory care with continuous
monitoring of respiratory and cardiac function. Laryngospasm is common during induction of
barbiturates.
-------------------------------------------------------------------------------Drug Name:
Classification
Inhalation Agents
How supplied/usual dosage
Nitrous Oxide
Chemical Names
N/A
N2O-O2 (Nitrous Oxide) fed through a tube to which nasal hood or
cannula is attached. Put over your nose. 70% Oxygen, 30% Nitrous Oxide.
OR indication/Common Use
Adjunct agent to other anesthetic gases that reduces the concentration
of more hazardous inhalation agents. Reaches brain in 20 seconds. Relaxation and pain killing properties
develop in 2 or 3 minutes.
Contraindications
M.S, emphysema, and some exotic chest problems. Not safe during first
trimester of pregnancy.
Special Considerations If prone to nausea make sure your stomach isn’t completely empty. Called
laughing gas and used in dentistry
Drug Name:
Floseal ™ Matrix Hemostatic Sealant
Classification : Coagulation Modifiers / Hemostatic Agents
How supplied/usual dosage
Chemical Names Thrombin Topical
Applied focally at target site of bleeding. Mix Thrombin in Gelatin Matrix
with a minimum of 20 passes between the two syringes.
OR indication/Common Use
Topical hemostatsis. Stops bleeding in 2 minutes. Achieving rapid
hemostatsis. Adjunct to hemostatsis when control of bleeding by ligature or conventional procedures is
ineffective or impractical.
Contraindications
Patients allergic to material of bovine origin, not in closure of skin incisions, not
in blood vessels, and can not be used in presence of infection.
Special Considerations Bio-Reabsorb, Biocompatible, and Latex Free. May be used up to 2 hours after
mixing with Thrombin solution. Never injected in blood vessels and on skin incisions and on patients
with allergy to material of bovine origin or thrombin
-------------------------------------------------------------------------------Drug Name:
Classification
Diuretic
Bumex
Chemical Names
How supplied/usual dosage
Bumetanide
Tablet 0.5mg light green, 1mg Yellow, and 2mg Peach. Oral
administration 0.5mg to 2mg, single dose, and maximum dose of 10mg. onset of diuresis occurs in 30 to
60 minutes. (1mg to 2mg) diuresis largely complete in 4 hours. IV reaches maximum levels in 15 to 30
minutes.
OR indication/Common Use
Loop diuretic with rapid onset and short duration of action. Major site
of action is ascending limb of loop of Henle. Treatment of edema associated with congestive heart
failure, hepatic and renal disease and nephritic syndrome.
Contraindications
Anuria, hepatic coma, severe electrolyte depletion, hypersensitivity to drug,
allergy to sulfonamides and women who are breast feeding.
Special Considerations potential diuretic, hypokalemia can occur and be observed for
thrombocytopenia.
Drug Name:
Classification
Vecuronium Bromide
Nondepolarizing neuromuscular blocker
Chemical Names
N/A
How supplied/usual dosage
IV dose only, 0.08 to 0.1mg/kg. Single use only.
OR indication/Common Use
Adjunct to general anesthesia to facilitate endotracheal intubation and
provide skeletal muscle relaxation during surgery or mechanical ventilation.
Contraindications
Hypersensitivity to vecuronium or bromides
Special Considerations Patient may have difficulty speaking when recovering postoperatively until
medication wears off. Postoperative urinary retention is possible. Enflurane and isoflurane enhances
the neuromuscular blocking action of the drug. Succinylcholine administered prior to the drug may
enhance the onset and increase the depth of the neuromuscular block from this drug
-------------------------------------------------------------------------------Drug Name:
Classification
Oxytocic
How supplied/usual dosage
Pitocin
Chemical Names
Oxytocin
10 to 40 units IV in 500 mL solution at 20 to 40 milliunits per minute.
Administered as an infusion.
OR indication/Common Use
Stimulation of labor contractions of the uterus during/following
childbirth or abortion.
Contraindications
Allergic to any ingredient in pitocin, birth canal is too small compared to fetus
head, fetus in difficult position within womb or in distress, bacteria in blood and cannot have child
through vaginal delivery.
Special Considerations
If a patient is on Droxidopa its actions and side effects may be increased
by Pitocin and possibly resulting in high blood pressure. May be given to promote uterine contractions
to deliver the placenta and reduce postpartum bleeding .
Drug Name:
Classification
Morphine Sulfate
Opioid Analgesics
How supplied/usual dosage
Chemical Names
Morphine
2.5 to 15mg IV every 4 hours as needed; intrathecal injection of 0.2 to
1mg for 24-hour pain relief. Im: 15-20mg every four hours
OR indication/Common Use
Severe pain, adjunct to general or regional anesthesia. Relieves pain by
stimulating opiate receptors in CNS, respiratory depression, peripheral vasodilatation, and inhibition of intestinal
peristalsis.
Contraindications
Hypersensitivity to opiates, upper airway obstruction, acute asthma, and diarrhea caused by
poisoning or toxins, intracranial pressure, convulsive disorders, respiratory depression, undiagnosed abdominal pain,
severe liver or kidney insufficiency, hypothyroidism or following biliary tract surgery and surgical anastomosis
Special Considerations Use drug with caution in patients with myxedema, acute alcoholism, acute abdominal
conditions, ulcerative colitis, head injury, hypoxia, supraventricular tachycardia, depleted blood volume or
circulatory shock. Can cause resp. depression, hypotension, bradycardia, drowsiness, urinary retention, and urticaria
-------------------------------------------------------------------------------Drug Name:
Classification
Opiate/Narcotic Analgesics
How supplied/usual dosage
Chemical Names
Fentanyl Citrate
IV dose of 100-150mcg/kg (0.1mg)(2.0mL) is approximately equivalent
to 10mg morphine or 75mg meperidine.
OR indication/Common Use
Sublimaze
(50 mcg = 0.05 mg = 1 mL)
Short-acting barbiturate for pain relief. Administrated with a neuroleptic
as an anesthetic premedication. Used as an anesthetic agent with oxygen in selected high risk patients.
Contraindications
In patients with known intolerance to the drug or other opioid agonists. Should
not be used in patients head injury, increase intracranial pressure, elderly, COPD and other respiratory
problems, liver and kidney dysfunction and bradycardia dysrhythmias
Special Considerations
Used with caution in patients who may be particularly susceptible to
respiratory depression, hypotension, sedation, dizziness and comatose patients who have a head injury
or brain tumor. Sublimaze may obscure clinical course of patients with head injuries.
Drug Name:
Ocufen
Classification Non-steroidal anti inflammatory (NSAID) Chemical Names fluribiprofen sodium
How supplied/usual dosage: 1 drop every 30 minutes in eyes for 4 doses two hours prior to surgery
depending on severity of underlying issues.
OR indication/Common Use: Sterile topical non steroidal anti inflammatory product for ophthalmic
surgery
Contraindications: It has not been established if this drug is safe for pregnant or nursing mothers
Special Considerations Be alert not to confuse Ocufen with Ocuflox
-------------------------------------------------------------------------------Drug Name:
Classification
Sched 4 Benzodiazepines
How supplied/usual dosage
Versed
Chemical Names Midazolam
70-80 mcg, or (0.07- 0.08 mg/kg)30-60 minutes before surgery. Reduce
50% for chronically ill and geriatric patients. IV 1-1.5 mg five minutes before surgery. IV induction for
general anesthesia: .30-.30mg/kg over 20 to 30 seconds
OR indication/Common Use
Contraindications
Procedural Sedation
Not recommended during pregnancy because of risks to the fetus. Should not
be given to patients with glaucoma, shock, coma and alcohol intoxication
Special Considerations Require frequent monitoring of vital signs and pulse oximetry. Commonly
causes retrograde amnesia, lightheadedness, and slurred speech. Can cause hypotension, PVC’s
tachycardia, coughing, dyspnea, hyperventilation and blurred vision
Drug Name:
Classification: Diuretic
Lasix
Chemical Names: Furosemide
How supplied/usual dosage: Adults usually 80 mg divided into 2 smaller doses. Children are based on
body weight
OR indication/Common Use : Treats fluid retention and high blood pressure, pulmonary edema, and
hypertension.
Contraindications : Always check with physician. Anuria and patients with a history of hypersensitivity to
furosmeide. Lasix during pregnancy requires monitoring
Special Considerations Patients with hepatic cirrhosis and Acites, Lasix is best administered in hospital.
-------------------------------------------------------------------------------Drug Name:
Classification
Diuretic
Osmitrol
Chemical Names:
Mannitol
How supplied/usual dosage : Adult 20-100g given Intravenously
OR indication/Common Use
Used to force urine production in people with acute kidney failure. Also
used to reduce swelling and pressure inside eye or around brain, treat oliguria and acute renal failure
Contraindications : Anuria due to severe renal disease, severe pulmonary congestion or pulmonary
edema, active intracranial bleeding except during craniotomy, severe dehydration and heart failure
Special Considerations
Should be administered 60 to 90 minutes preoperatively for maximum
effect for eye surgery. Foley catheter should be inserted when using this drug so that anesthesia can
monitor the patient’s urinary output during surgery
Drug Name:
Nubain
Classification: Analgesic (narcotic)
Chemical Names: Nalbuphine hydrochloride
How supplied/usual dosage: 10-20 mg for a 70 kg individual administered subcutaneous, IM or IV. (every
3-6 hours), maximum dosage of 160mg per day
OR indication/Common Use : Indicated for the relief of moderate to severe pain. Can also be used as a
supplement to balance anesthesia, Pre/Post Op Analgesia
Contraindications: Should not be administered to patients who are hypersensitive to nalbuphine
hydrochloride or to any of the other ingredients
Special Considerations:
Can cause dizziness, drowsiness, N&V, hypertension/hypotension,
bradycardia/tachycardia, and blurred vision
-------------------------------------------------------------------------------Drug Name:
Classification
Ultiva
Ultra-Short acting opioid
Chemical Names: Remifentanil
How supplied/usual dosage : Adult 0.5-1 mcg. 8 minutes after start of infusion additional 1 mcg can be
given
OR indication/Common Use : Analgesic for use during induction and maintenance of general anesthesia.
Contraindications:
Epidural or intrathecal administration
Special Considerations Have intubation, artificial respiration, oxygen therapy and reversal agents
available. Respiatory depression and apnea are associated with the administration of this drug.
Ventilation and cardiac resuscitation should be readily available with its use
Drug Name:
Marcaine/Sensorcaine
Classification: Local Anesthetic
Chemical Names: Bupivacaine
How supplied/usual dosage: Based on procedures. Single dose vials come 10 mL, 30 mL.
OR indication/Common Use: Production of local or regional anesthesia or analgesia for surgery, dental
and oral surgery procedures, theraputic diagnostic procedures
Contraindications: Obstetrical para cervical block. Patients with acidosis, heart block, severe
hemorrhage, hypotension, shock, cerebrospinal diseases and history of malignant hyperthermia.
Special Considerations: Notify patients because of loss of sensation to area, can cause dizziness, urinary
retention, hypotension, myocardial depression, bradycardia, N&V, blurred vision and pupillary
contriction
-------------------------------------------------------------------------------Drug Name:
Classification
Cetacaine
Topical Anesthesia
Chemical Names: Benzocaine
How supplied/usual dosage : Liquid- 200mg (6-7 drops) with cotton applicator. , Gel- 200mg (13mm
droplet) spread. Gel comes in a 5g tube, Liquid comes in 14 & 30 g bottle. Spray should be 1 second or
less
OR indication/Common Use : Topical anesthesia indicated for the production of anesthesia of all
accessible mucous membrane except eyes. Typically used for endoscopic procedures in the ear, nose,
mouthm larynx, pharynx, trachea, bronchi and esophagus. Indicated for in controlling gag reflex and
pain when introducing flexible endoscopes orally
Contraindications: Spray in excess of 2 seconds. Never use in the eye
Special Considerations Hypersensitivity is rare and when using spray form any spray longer than two
seconds is contraindicated
Drug Name:
Classification
Luminal
Sedative/Anti-convulsant (Barbiturate)
How supplied/usual dosage:
Chemical Names
phenobarbital
A trade name for the anti-epileptic drug phenobarbital. IM/IV 100-
200mg/day Take PO with or without food once daily at bedtime.
OR indication/Common Use:
Pediatric patients as preoperative and postoperative sedation and to
treat pylorospasm in infants
Contraindications:
Do Not take during pregnancy Should not be given to patient with hepatic
disease, respiratory disease and renal disease
Special Considerations: May lower your folic acid- may cause drowsiness, dizziness, in older adults it
may cause excitement or confusion, bradycardia, hypotension, nausea, vomiting, coughing, and possible
liver problem
--------------------------------------------------------------------------------
Drug Name:
Classification
Sedative/Hypnotic (Barbiturate
How supplied/usual dosage:
Nembutal
Chemical Names: Pentobarbital Sodium
Preoperative Sedation IM 150-200 mg in 2 doses or IV 100mg
Hypnotic: IM 150 to 200 mg
OR indication/Common Use:
CNS Depressants which are primarily used as sedative hypnotics and
also anti-convulsant. For pre-anesthetic medication induction for general anesthesia
Contraindications:
Dio not give to pregnant patients. Be careful to drive- may impair your thinking
or reactions. AVOID alcohol.
Special Considerations:
Could have an allergic reaction, confusion, hallucinations, weak
breathing. If given rapidly IV cause respiratory depression, laryngospasm, bronchospasm, apnea and
hypotension
Drug Name:
Methylene Blue
Classification: Dyes
Chemical Names:
N/A
How supplied/usual dosage:
IV
0.1 to 0.2 mL per kilogram of body weight
OR indication/Common Use:
Used for skin marking prior to surgery as well as intravenously for
urological and lymphatic surgery to ensure patency of structure.
Contraindications:
Serious CNS reactions if taken with certain psychriatric meds.
Special Considerations:
(furoxone, marplan).
Do Not use if you have used an MAO inhibitor in the last 14 days
Methylene Blue (methylene blue injection) must be injected intravenously very
slowly over a period of several minutes to prevent local high concentration of the compound from
producing additional methemoglobin
-------------------------------------------------------------------------------Drug Name:
Visipaque
Classification: Contrast Media
Chemical Names:
Iodixanol
How supplied/usual dosage:
Injection 270 mg/ml and 320 mg/ml
OR indication/Common Use:
Angiocardiography, peripheral arteriography, visceral arteriography and
cerebral arteriography.
Contraindications:
Not indicated for intrathecal use or Pediatric population. Prolonged fasting and
administration of a laxative before visipague injection
Special Considerations: Serious adverse reactions-death-convulsions-cerebral hemorrhage if not
administered properly. Diluted in Normal Saline for use with fluoroscopy
Drug Name:
Classification
Inapsine
Antiemetic
Chemical Names: Droperidol
How supplied/usual dosage:
Injection- IV- or Intramuscular 2.5mg for an adult
OR indication/Common Use:
Sedative, Tranquilizer and anti-nausea. Used to reduce nausea&
vomiting caused by surgery or other medical procedures.
Contraindications:
Should not take during pregnancy, to patients with know hypersensitivity to
iodine, narrow-angle glaucoma and severe liver or cardiac disease
Special Considerations:
Some cases have been fatal. Drug produces sedative effect and the
patient should be monitored for conscious sedation
-------------------------------------------------------------------------------Drug Name:
Classification: Anesthetic/inhalant
How supplied/usual dosage:
Isoflurane
Chemical Names:
Forane
Used with other anesthetics, inhalant, non-flammable liquid
administered by inhaling and dosage is titrated to the patient’s weight and other drugs being
administered
OR indication/Common Use:
Used for induction and maintenance of general anesthesia and is mixed
with oxygen and possibly other inhalants for the desired effect. It also has a muscle relaxant effect for
abdominal procedures
Contraindications :
Known sensitivity to Isoflurane or suspected genetic susceptibility to malignant
hyperthermia.
Special Considerations: May cause slight decrease in intellectual function for 2-3 days following.
Respirations will rapidly decrease upon administration, and the patient will require respiratory care
Drug Name:
Cocaine
Classification CNS Stimulant
Chemical Names
Local Anesthetic
How supplied/usual dosage: Topical- solution or paste, Therapeutic use. 1-10% solution with a
maximum single dose of 1mg/kg
OR indication/Common Use:
Applied to certain areas of the body (nose, nose, mouth) to
cause less feeling. Used in small amounts. Cocaine was historically useful as a topical anesthetic in eye
and nasal surgery, although it is now predominantly used for nasal and lacrimal duct surgery.
Contraindications:
Over active thyroid may worsen, tourette’s syndrome may worsen
Special Considerations:
Can cause psychological dependence, CNS stimulation and depression,
tachycardia, ventricular fibrillation, runny nose, and N&V. Not likely during surgery. Will appear in your
blood or urine for 5 or so days after using
-------------------------------------------------------------------------------Drug Name:
Classification Anesthetic/Inhalant
How supplied/usual dosage:
Desflurane
Chemical Names
Suprane
General Anesthetics- loss of consciousness before and during surgery
Used with other anesthetics, inhalant, non-flammable liquid administered by inhaling and
dosage is titrated to the patient’s weight and other drugs being administered
OR indication/Common Use:
Used for induction and maintenance of general anesthesia and is mixed
with oxygen and possibly other inhalants for the desired effect. It also has a muscle relaxant effect for
abdominal procedures
Contraindications: It may cause tachycardia and airway irritability when administered at concentrations
greater than 10%. Due to this airway irritability, desflurane is infrequently used to induce anesthesia via
inhalation techniques.
Special Considerations:
Important to let Dr. know if you are taking cistriacurium ,
hydromorphone,oxycodone,St. John’s wort, It has most rapid onset and offset of all inhalants
Drug Name:
Classification Analgesic
Alfenta
Chemical Names
Alfentanil hydrochloride
How supplied/usual dosage:
Utilized intravenously, dosage determined by patient body weight
OR indication/Common Use:
Used as an adjunct for induction of general anesthesia and intubation, it
can also be utilized during conscious sedation as an analgesic agent.
Contraindications:
should not be used on patients under the age of twelve
Special Considerations:
Respiratory depression and muscle rigidity and muscle rigidity are the
most common side effects. Other lesser side effects that are possible are N&V, confusion agitation,
hypotension and confusion
Drug Name:
Classification Opioid analgesic
Stadol
Chemical Names
Butorphanol tartate
How supplied/usual dosage:
IM or IV 1-2 mg every four hours
OR indication/Common Use:
Utilized pre-operatively and post-operatively for pain relief,
intraoperative as an adjunct to general anesthesia, Also used with patients in labor at full term and
early labor.
Contraindications:
Should not be used in patients with head injuries or increased intracranial
pressure
Special Considerations:
Can cause drowsiness, dizziness , hypotension, bradycardia, respiratory
depression, N&V and blurred vision.
Drug Name:
Oxycel, Surgicel
Classification Hemostatic Agent
How supplied/usual dosage:
Chemical Names
Oxidized Cellulose
Pad or knitted fabric strip of oxidized cellulose. It can be wrapped
around structures or simply laid dry on a bleeding surface
OR indication/Common Use:
Utilized for oozing and bleeding surgical sites, bone, and raw surfaces.
Can be cut up or used whole.
Contraindications:
Must be removed from bone as it will cause degeneration of the bone if left in
contact. If autologous blood collection is being done during a surgical procedure then this product
should not be utilized.
Special Considerations:
The item is absorbable and can be left on the surgical site with the
exception of bone. It needs to be removed from bone.
Drug Name:
Classification Hemostatic agent
How supplied/usual dosage:
Thrombostat
Chemical Names
Thrombin
Supplied in a powder form and is reconstituted with a thrombin
solution or normal saline. It can be applied in liquid form or soaked into gelfoam. If the thrombin
powder is mixed with blood plasma it will become a fibrin glue substance which helps to form a clot.
OR indication/Common Use:
Can be used alone or in concert with other hemostatic agents to control
bleeding.
Contraindications:
This items should not be allowed to enter the large blood vessels because it will
cause an intravascular clot which can be detrimental up to and including death. It should only be
utilized for capillary and venule bleeding only.
Special Considerations:
bleeding
It can be left in the body only if it is used on capillary and venule
Drug Name:
Wydase
Classification Genetically designed enzyme protein
How supplied/usual dosage:
Chemical Names
hyaluronidase
150 unit vials, injected under the skin to enhance the performance of
certain drugs and contrast media
OR indication/Common Use:
used to aid body in absorbing other injected medications, helps contrast
media show more clearly on certain x-rays. It speeds up the chemical reaction of other medications.
Contraindications:
Should not be used with Lasix, Dilantin, aspirin, cortisone, estrogens and
antihistamines
Special Considerations:
Can cause hives, difficulty breathing. MD can do a skin test to test for
an allergy to the medication
Drug Name:
Classification Local anesthetic
How supplied/usual dosage:
Pontocaine
Chemical Names
tetracaine hydrochloride
small amounts with be effective, can be used on minor cuts not deep
wounds. Often used in ophthalmology procedures as a local
OR indication/Common Use:
topical cream, ointment or drops to reduce pain during surgery. It
blocks nerve signals in the body to the brain
Contraindications:
Blurred vision, dizziness, no blood pressure or pulse, respiratory depression,
unconsciousness, hearing loss, buzzing in the ears, hives, swelling, blistering, eye irritation
Special Considerations:
Topical treatment only no ingestion of drug in the body
Drug Name:
Classification Vasopressor
How supplied/usual dosage:
Norepinephrine
Chemical Names
levophed
4mg/4ml of levophed to 1,000 ml of 5% dextrose, injection into a large
vein. Can use Sodium Chloride as well for injection dilution
OR indication/Common Use:
Treats low blood pressure that is life threatening, cardiac arrest, shock.
It is an alpha-adrenergic medication, inotropic stimulator of the heart, dilator of coronary arteries
Contraindications:
pain at injection site, sudden numbness, slow/uneven heart rate, difficulty
breathing, very high blood pressure, cyanotic nail beds and lips, decreased renal perfusion and urine
output
Special Considerations:
Problem with speech, vision, balance, should not be given to patients
who are hypotensive from hypovolemia.
Drug Name:
Classification Thrombolytics
Kabikinase, Strepase
Chemical Names
streptokinase
How supplied/usual dosage:
100,000U to 250,000U in 100-250 ml
OR indication/Common Use:
Used in vascular for the re-opening of coronary vessels for acute MI
within 12 hours of onset. Commonly used in embolectomy and thrombectomy procedures to prevent
thrombus formation posteratively.
Contraindications:
Recent head traumas, aneurysm, acute pancreatitis, uncontrollable
hypertension(220/100mgmg), severe liver or kidney damage and active internal bleeding
Special Considerations:
A percutaneous translumina can be performed simultaneously
angioplasty, Can be instilled into veins/arteries with small feeding tube and syringe
Drug Name:
Classification Antibiotic/Aminoglycoside
Garamycin
Chemical Names
Gentamicin
How supplied/usual dosage:
IV 1.5mg/kg 30 minutes before surgery, maximum dose 80mg
OR indication/Common Use:
Used to treat severe or serious bacteria infections, typically endocarditis
and prophylaxis in GI or GU surgery.
Contraindications:
Should not be given to patients with a hypersensitivity to aminoglycosides.
Special Considerations:
May cause damage to kidney and decreased renal function. Also cause
dizziness, numbness, skin tingling, twitching and possible seizures
Drug Name:
Classification Antibiotic/Aminoglycoside
Kantrex
Chemical Names
kanmycin
How supplied/usual dosage:
IV – 500mg diluted in I50 to 1000mL of normal saline
OR indication/Common Use:
Used to treat serious bacterial infections. Used prophylactically
irrigation solution during GI or GU surgical procedures. Can be instilled via wound drain – 500mg diluted
in 20ml of normal saline.
Contraindications:
Should not be used for patient with a known hypersensitivity to
aminoglycosides
Special Considerations:
Normal saline should be used for irrigation with Kantrex. It can cause
pain or irritation at the sight of an injection, mild rash, H/A, fever and N&V.
Drug Name:
Neo-Synephrine
Classification Cardiac Medication
Chemical Names
Antiarrhythmic, vasoconstrictor, Vassopressor
How supplied/usual dosage:
phenylephrine hydrochloride
Nasal spray or eye drops. IV – infusion – 100to 180mcg/min (0.1 to
.08mg) until BP stabilizes. Maintenance dosage 40-60mcg/min or according to patient condition
OR indication/Common Use:
To treat hypotension or maintain blood pressure during anesthesia and
to treat vascular failure in shock. Also used as nasal decongestant and to dilate pupils.
Contraindications:
Hypersensitivity to phenylephrine or sulfites, severe hypertension, ventricular
tachyvcardia, closed angle glaucoma, antagonizes antihypertensives, severe coronary disease, severe
hypertension, ventricular tachycardia, and pregnancy
Special Considerations:
BP and heart rate should be monitored when taking neo-synephrine.
Hyperthyroidism, diabetes, children, pregnancy, and nursing mothers
Drug Name:
Classification Coagulant/heparin antagonist
How supplied/usual dosage:
Protamine sulfate
Chemical Names
protamine sulfate
Injected IV slowly. Each mg of protamine sulfate will neutralize: 90 units
of beef lung heparin, 115 units of intestinal mucosa derived heparin, and 100 units of calcium heparin
OR indication/Common Use:
Usually used to reverse a large dose of heparin during certain surgery
(especially heart surgeries
Contraindications:
Should only be administered to patients who have received heparin. Even if a
patient has a hypersensitivity to the drug the allergic symptoms will be treated and the drug will
continue to be used for heparin reversal. Severe hypertension, ventricular tachycardia, closed angleglaucoma
Special Considerations: precautions – hyperthyroidism, diabetes, children, pregnancy, nursing mothers.
Can cause an abrupt drop in BP, urticarial, pulmonary edema, and anaphylaxis
Drug Name:
Gelfoam
Classification Hemostatic agent
How supplied/usual dosage:
Chemical Names
Absorbable Gelatin
Powder form can be mixed with Normal Saline to create a paste to be
applied to the bone. Compressed and uncompressed pad form in various sizes can be cut or applied
whole. Sterile technique should always be used
OR indication/Common Use:
Indicated for capillary bleeding and cancellous bone oozing. Pad is
placed over bleeding capillaries, and as fibrin is deposited into the interstitial tissue, the sponge swells
and forms a clot
Contraindications:
Should not be used with a cell saver.
Patients with ioscynate (organic
Compound) sensitization should not be exposed to this product. Symptoms can occur immediately or
within several hours
Special Considerations:
It can be left in the patient. It does not have to be removed. It can
cause stinging, burning, or tearing of eyes. May irritate skin, GI tract, and cause N&V, lethargy and
diarrhea
Drug Name:
Classification Hemostatic Agent
How supplied/usual dosage:
Avitene
Chemical Names
Microfibrillar Collagen
Comes in powder form, compressed sheets and foam. Apply directly to
bleeding source
OR indication/Common Use:
Indicated for control and stipping of bleeding in a wide range of surgical
procedures on raw surfaces, including bone and friable tissue. It can be molded and fit into tight areas
Contraindications:
Control and stop bleeding in a wide range of surgical procedures. Not to be used
with a cell saver
Special Considerations:
bleeding and oozing.
Can be left in the body if necessary. It can be used with surgical to stop
Drug Name:
Classification Iodinated Contrast Media
How supplied/usual dosage:
Omnipaque
Chemical Names
iohexol
Supplied in IV form with iodine concentration levels the include 140,
180, 240, 300 and 350mg/ml. Concentration and dilution amounts are determined by the area the
solution is injected into.
OR indication/Common Use:
Used to highlight parts of the body in x-ray. Used in surgical procedures
for viewing GU structures, the biliary tree including the common bile duct and vascular structures
Contraindications:
Should not be given to any patient with a hypersensitivity to iodine. Do not
administer with corticosteroids
Special Considerations:
Inhibits blood coagulation, patient should be well hydrated before and
after procedure, typically diluted in saline for use with fluoroscopy
Drug Name:
Indigo Carmine
Classification Dye
Chemical Names
How supplied/usual dosage:
Injected IV. Dispenses in 5mg ampule
OR indication/Common Use:
in surgery it is used intravenously to highlight the urinary tract. The
N/A
kidneys filter it quickly turning urine blue enabling urinary tract structures to be seen and indicate a
blockage or leak.
Contraindications:
Special Considerations:
contact with
Should not be given to patient with a hypersensitivity
Pregnancy and lactation. Will stain tissue and anything that comes in
Drug Name:
Gentian Violet
Classification Dye
Chemical Names
How supplied/usual dosage:
Topical solution in various dosages
OR indication/Common Use:
Used to mark the skin before skin prep. Antiseptic dye used to treat
N/A
fungal infections of the skin
Contraindications:
Should not be given to patient with known hypersensitivity
Special Considerations:
Topical solution only, never to be administered IV or orally.
Drug Name:
Classification Corticosteroid/Hormone
Decadron LA, Dexone LA
Chemical Names
dexamethasone acetate
How supplied/usual dosage:
IV – 8 to 16mg dor intraarticular injection. Also in oral tablets.
OR indication/Common Use:
For anti-inflammatory effect and may be combines with local anesthetic
for reduction of postoperative pain. Immunosuppressive properties and ability to penetrate the CNS
Contraindications:
Should not be given to patients with suppressed immune system.
Hypersensitivity to the medication
Special Considerations:
May increase glucose and cholesterol levels. Diabetic patient’s glucose
level should be monitored every two hours after injection.
Drug Name:
Levophed
Classification Cardiac Medication/Stimulant, Vasopressor
How supplied/usual dosage:
Chemical Names
norepinephrine
bitartate
IV infusion initially 0.5 to 1 mcg/kg/min, increasing as neded to reach
desired blood pressure. Maintenance dosage – 2 to 12 mcg/kg/min
OR indication/Common Use:
For blood pressure control in certain acute hypotensive states, cardiac
arrest, shock, and sometimes spinal anesthesia
Contraindications:
Should not be given to patients who are hypotensive from blood volume
deficits, or with mesenteric or peripheral vascular thrombosis and when using halothane as a general
anesthetic
Special Considerations:
Dosage should not exceed 30mcg/kg/min. Blood pressure and heart
rate should be monitored when using Levophed. Never use if patient is hypersensitive to medication
Drug Name:
Classification Vasodilator/Cardiac Med
Pavatine
Chemical Names
papaverine hydrochloride
How supplied/usual dosage:
IM/IV doses vary. Typically 30 to 120mg every three hours as needed
OR indication/Common Use:
For treatment of impotence and vasospasms. Used in cardiac bypass
surgery.
Contraindications:
Patients who are hypotensive from hypovolemia, or with mesenteric or
peripheral vascular thrombosis. Never give to patient with complete AV block
Special Considerations:
Used primarily in bypass surgery to prevent vasospasms in harvested
vessels by flushing the vessel, letting it soak in papaverine solution and flushing again before attaching
vessel
Drug Name:
Classification Hormones
How supplied/usual dosage:
Insulin
Chemical Names
Various types human insulin
Supplied in rapid acting, short acting, intermediate acting, long acting
and premixed forms. The form used depends on the patients blood glucose level, weight, exercise and
diet. Anesthesia monitors the patients blood sugar level during surgery and determine the needed
dose.
OR indication/Common Use:
Prescribed for type 1 or 2 diabetes mellitus. Anesthesia maintains the
patient’s blood level during surgery with the use of heparin.
Contraindications:
Drugs such as alcohol, Nardil, MAOI, Inderal. Insulin should not be administered
in patient with normal or low blood glucose level.
Special Considerations:
MD need to be notified of the patient breastfeeding. Insulin should be
stored in a refrigerator between 36o to 46o F.
Drug Name:
Classification Volume Expander
Dextran 75
Chemical Names
dextran, high-molecular weight
How supplied/usual dosage:
6% Dextran in normal saline. IV
OR indication/Common Use:
To treat shock, or low cardiac output, casues increased intravascular
volume
Contraindications:
Should not be given to patients with cardiac decompensation, severe oliguria,
and hypervolemia, renal failure, hypersensitivity, CHF, and severe dehydration.
Special Considerations:
Not recommended during pregnancy or active hemorrhage.
Anaphylactic reaction will occur early in infusion if patient is hypersensitive to the drug. Will increase
blood glucose level. It is not a replacement for blood or blood products
Drug Name:
Classification Antiarrhythmic, Cardiotonic
How supplied/usual dosage:
Digoxin
Chemical Names
N/A
IV loading dose 10 to 15 mcg/kg in 3 divided doses every 6 to 8 hours
with the first dose equal to 50% of the total dose. Maintenance dose of 125 to 350 mcg/day every day
or twice daily
OR indication/Common Use:
Used to treat heart failure, atrial fibrillation, and atrial flutter,
supraventricular tachycardia, atrial flutter, cardiogenic shock and low cardiac output
Contraindications:
Pregnancy, breastfeeding, kidney disease, too much calcium in blood, or thyroid
disorder, recent heart attack or diarrhea, ventricular fibrillation and ventricular tachycardia
Special Considerations:
Toxicity could occur during dosing process, should be stopped several
day before surgery, medical tests and dental work. Patient needs to be weaned off of the medication.
Drug Name:
Intropin, Revmine
Classification Cardiac Stimulant, Vasopressor Chemical Names
How supplied/usual dosage:
dopamine, hydrochloride
IV infusion – 0.3 to 3 mcg/kg/min for vasodilation of renal arteries; 2 to
10mcg/kg/min for increased cardiac output. Dosage can be increased to 50 mcg/kg/min if necessary.
OR indication/Common Use:
Treat circulation problems caused by heart attack, kidney failure, low
blood pressure or surgery, also to treat shock and slow heartbeat, MI, trauma, open heart surgery.
Contraindications:
Should not be given to patients with uncorrected ventricular fibrillation,
ventricular tachycardia, and other tachycardia arrhythmias.
Special Considerations:
vascular disease
My cause peripheral ischemia in patients with history of occlusive
Drug Name:
Classification Antiemetic
Zofran
Chemical Names
ondansetron hydrochloride
How supplied/usual dosage:
IV 4mg undiluted over 2 to 5 minutes
OR indication/Common Use:
Prevent N&V caused by cancer treatments and postoperatively.
Contraindications:
Do not use if allergic to this or similar medicines such as Dolasetron,
granisetron, or Tropisetron. Do not use if you are taking Apomorphine.
Special Considerations:
MD should be made aware if patient is pregnant or breastfeeding, or if
have had liver disease, heart rhythm problems, stomach or bowel problems or phenylketonuria
Drug Name:
Classification Antiemetic
Compazine
Chemical Names
prochlorperazine
How supplied/usual dosage:
IV 5 to 10mg,, PO, rectal
OR indication/Common Use:
May treat N&V, schizophrenia psychosis, anxiety disorder, dementia
Contraindications:
not to be used inpatients with brain damage, bone marrow depression, or are
using large amounts of alcohol or medicine that make you sleepy. This may cause depression in the
CNS.
Special Considerations:
Elderly patients may be subject to an increased sensitivity to the
hypotensive effects of this drug. Drug has a sedative effect and patient should be monitored after
administration
Drug Name:
Classification Local Anesthetic
Novocaine
Chemical Names
procaine hydrochloride
How supplied/usual dosage:
Infiltration anesthesia/Peripheral nerve block: 0.25-0.50% solution
OR indication/Common Use:
10% solution for spinal anesthesia and epidural and peripheral nerve
block by injection and infiltration methods.
Contraindications:
SHould not be given to patients with general septicemia; diseases of
cerebrospinal system (i.e. meningitis & Syphilis), hypersensitivity to the medication, heart block,
hypotension, hypertension, and GI bleeding or hemorrhage.
Special Considerations:
Vasoconstrictor maybe added to solution for hemostasis effects; do not
use if it is cloudy in appearance. Can cause tinnitus, arrhythmias, hypotension, bradycardia, N&V,
sweating and urinary retention in spinal anesthesia
Drug Name:
Classification Anesthetic
How supplied/usual dosage:
Diprivan
Chemical Names
propofol
Induction: IV 2-2.5 mg/kg every 10 seconds until induction onset.
Maintenance: IV 100-200 mcg/kg/minute. Conscious Sedation: IV 5 mcg/kg/minute for at least 5
minutes
OR indication/Common Use:
Contraindications:
Induction and maintenance of anesthesia
Should not be given to patients with an allergy to eggs or egg products,
soybeans or soy products, increased intracranial pressure, impaired cerebral circulation or any obstetric
procedure
Special Considerations:
Strict aseptic technique when given, can cause twitching, bucking,
jerking, thrashing, hypotension, vomiting, coughing, and apnea. Drug will cause respiratory depression.
Drug Name:
Classification Inhalant/Anesthetic
How supplied/usual dosage:
Sevoflurane/Ultrane
Chemical Names
N/A
Supplied in colorless, non-flammable liquid form that utilizes a vaporizer
for inhalant administration and dosage is titrated to the patient’s weight and other anesthetic agents
being used. Sweet smelling scent.
OR indication/Common Use:
Used for induction and maintenance of general anesthesia and is
typically mixed with oxygen and inhalant agents for the desired anesthetic effect.
Contraindications:
suspected susceptibility to malignant hyperthermia, previous hypersensitivity;
pregnancy or lactation.
Special Considerations:
Raised intracranial pressure; cardiac, respiratory, renal or hepatic
impairment, elderly or obese patients. Maintenance of hemodynamic stability is important in patients
in CAD.
Drug Name:
Classification Isotonic Volume expander
How supplied/usual dosage:
Normal Saline
Chemical Names Sodium Chloride
Fluid and electrolyte replacement. Supplied in 50, 100, 250, 500, 1000
and 3000mL IV bags. Also available in bottles for irrigation only not IV use.
OR indication/Common Use:
Contraindications:
Special Considerations:
Irrigation of wounds, tissue, body cavities and bladder.
Should not be given to patients in fluid overload or in renal failure.
IV solutions should be the only type of saline to reconstitute powder
forms of drugs. Bottled forms of normal saline should not be used for the reconstitution of drugs. It is
strictly for irrigation.
Drug Name:
Classification Narcotic Antagonist
How supplied/usual dosage:
Romazicon
Chemical Names
flumazenil
IV administration, dose 0.4 -1 mg will wake up a patient. Do not give
more than 1mg in a single dose and no more than 3 mg in an hour
OR indication/Common Use:
Complete or partial reversal of sedative effects of benzodiazepines after
anesthesia and conscious sedation.
Contraindications:
Should not use in patients with a hypersensitivity to the drug, or patients who
have received benzodiazepines for a life threatening condition such as status epilepsy.
Special Considerations:
Patient should be monitored for re-sedation as the action of the drug is
shorter than any benzodiazepine. Can cause dizziness, seizures, arrhythmias, N&V, and hyperventilation
Drug Name:
Carboptic/Miostat
Classification ophthalmic/Miotic
How supplied/usual dosage:
Chemical Names
carbachol
Generally administered as an ophthalmic solution eye drops.
Intraocular injection – 0.5 mL instilled into the anterior chambers.
OR indication/Common Use:
Primarily used for various ophthalmic purposes such as for treating
glaucoma, or during ophthalmic surgeries. Used to produce pupillary miosis in ocular surgery and can
be instilled before or after sutures are secured.
Contraindications:
Should not be given to patients with asthma, coronary insufficiency, gastro-
duodenal ulcers, and incontinence. The parasympathetic action of this drug will exacerbate the
symptoms of these disorders.
Special Considerations:
Patients with dark irises (hazel and brown eyes) may require more of
the injection to be instilled because eye pigment may absorb the drug.
Drug Name:
Akarpine, Isopto Carpine, Micocarpine
Classification Ophthalmic /Miotic
Chemical Names
pilocarpine hydrochloride
How supplied/usual dosage:
Eye drop, 1 drop in the affected eye
OR indication/Common Use:
used to treat glaucoma, or ocular hypertension, may also be used during
certain eye surgeries and to reverse the effects of drugs used to dilate the pupil. Counteracts mydriatics
and cycloplegics
Contraindications:
Should not be used if patient has pupillary block glaucoma or uveitis. Should
not be used if the patient has a known hypersensitivity to the drug or where cholinergics effects such as
constriction are undesirable.
Special Considerations:
Can cause side effects that can make it harder for patients to see at
night or in low light. Be careful if you drive or do anything that requires you to be able to see clearly.
Patients with dark irises (hazel or brown) may require more of the injection to be instilled because eye
pigment may absorb drug.
Drug Name:
Classification Analgesic/Non-narcotic
Toradol
Chemical Names
ketorolac tromethamine
How supplied/usual dosage:
IM – 60mg or IV – 30 mg every hours Also available in oral form.
OR indication/Common Use:
Short term management of moderately severe acute pain that requires
analgesia at the opioid level and only as continuation treatment following IV or IM dosing of Toradol.
Contraindications:
Should not be used in patients with active peptic ulcer disease, recent GI
bleeding or perforation, CABG and renal impairment.
Should not be used in patients with a
hypersensitivity to NSAIDs (non-steroidal anti-inflammatory drugs).
Special Considerations:
Toradol is an excellent non-narcotic analgesic, but should not be used in
surgical patients preoperatively or with patients who have a high risk of bleeding. Can cause
drowsiness, GI pain, urticarial, and pain at the injection site.
Drug Name:
Classification Analgesic (Narcotic)
Demerol
Chemical Names
meperidine hydrochloride
How supplied/usual dosage:
IM/IV - 50 - 150mg every 3 – 4 hours
OR indication/Common Use:
Preoperatively to produce relaxation, postoperatively for moderate to
severe pain relief
Contraindications:
Should not be given to patients with convulsive disorders or with undiagnosed
abdominal pain, liver or kidney disease, history of seizures. Patients taking MAOI’s could suffer
agitation, delirium, H/A, convulsions and /or hyperthermia in the presence of Demerol.
Special Considerations:
Can cause respiratory depression, dizziness, hypotension, N&V, urinary
retention and urticaria.
Drug Name:
Classification Antibiotic
Flagyl
Chemical Names
metronidazole
How supplied/usual dosage:
IV – 15mg/kg infusion over 30 to 60minutes preoperatively
OR indication/Common Use:
Typically is administered IV for prophylactic effect before colorectal
surgical procedures. To treat infection of vagina, stomach, skin joints, and respiratory tract
Contraindications:
Special Considerations:
Should not be given to patients with hypersensitivity to the drug.
Do not give IV bolus of drug; it must be diluted in at least 100mL
lactated Ringers or Normal Saline. Could cause hives, difficulty breathing, swelling, numbness, diarrhea,
and stomach pain.
Drug Name:
Rocephin
Classification Antibiotic/Cephalosporin
Chemical Names
ceftriaxone
How supplied/usual dosage:
IV – 1 to 2gm injection or infusion
OR indication/Common Use:
Typically administered IV to treat most infections and serious intra-
abdominal infections and meningitis
Contraindications:
Special Considerations:
Should not be given to patients with know hypersensitivity to Cephalosporins.
If administered by IM injection; should be given in large muscle and
Lidocaine, or another topical anesthetic, can be diluted with the drug to reduce pain at the injections
site
Drug Name:
Classification:
Opioid Inverse Agonist
Narcan
Chemical Names:
Naloxone
How supplied/usual dosage: Intravenously (For fastest action) Intramuscular, or subcutaneously
IV – opiate overdose 0.4 – 2 mg, postoperative opiate depression 0.1 – 0.2 mg.
OR indication/Common Use: Part of an overdose response kit to heroin and other opioid drugs. Enteral
naloxone has been successfully used in reduction of gastritis and esophagitis.
Contraindications: Use with caution in narcotic-dependent patients who may experience withdrawal
syndrome. Should not be used in patients with respiratory depression to non-opioid drugs.
Special Considerations: Studies have shown that naloxone can be used to treat depersonalization
disorder. Can cause increase BP, hyperventilation, surgical site bleeding, and elevated partial
thromboplastin time. Too rapid reversal can cause N&V, sweating and tachycardia.
Drug Name:
Nalmefene Hydrochloride
Classification: Opioid Receptor Antagonist
How supplied/usual dosage:
Chemical Names
N/A
Oral, Intravenously, Initial dose: 0.25 mcg/kg IV once followed by 0.25
mcg/kg at 2 to 5 minute intervals until the desired degree of opioid reversal is obtained
OR indication/Common Use: Post-operatively used to counter act opioids in surgery. Also used in
management of alcohol dependence.
Administered after benzodiazides, inhalational anesthetics,
muscle relaxants and muscle relaxant antagonists administered in conjunction with general anesthesia
Contraindications:
Contraindicated with patients known to have a hypersensitivity to the product
Special Considerations:
Common side effects include drowsiness, hypertension, tachycardia,
dizziness, nausea, vomiting. IF no response after a cumulative dose of 1 mcg/kg administered,
additional dose are unlikely to provide an effect
Drug Name:
Classification: Opioid analgesic
How su1pplied/usual dosage:
Sufenta
Chemical Names:
Sufenta Citrate
Intravenous and epidural injection. IV 1-8mcg/kg as an analgesic
supplement to anesthesia. Primary anesthetic 1-30 mcg/kg administered with muscle relaxant IV and
100% oxygen
OR indication/Common Use: Intravenously to maintain general anesthesia in surgical procedures
requiring intubation and ventilation. When used as an epidural it is for post-operative pain.
Contraindications: Not to be used with patients who have an intolerance to morphinomimetics in
general, patients with pulmonary disease, redcued respiratory reserve, impaired hepatic or renal
function
Special Considerations:
Safety in pregnancy and lactation has not been established. Can cause
hypotension/hypertension, bradycardia/tachycardia, N&V, respiratory depression, apnea, skeletal
muscle relaxant, and urinary retention.
Drug Name:
Classification: Triarylmethane dye
How supplied/usual dosage:
OR indication/Common Use:
Gentian Violet
Chemical Names: hexamethyl pararosaniline chloride
Topical solution in various dosage supplies
Marking the skin. Has antibacterial, antifungal. and anathematic
properties
Contraindications:
Using on open sores or ulcerations can cause "tattooing"
Special Considerations: Generally Safe for use, but in large quantities can cause ulcerations, and is
linked to mouth cancer.
Drug Name:
Classification:
Fluoroquinolone Antibiotic
How supplied/usual dosage:
Cipro IV
Chemical Names:
Ciprofloxacin
Tablets, intravenous solutions, and eye and ear drops IV – 400mg
OR indication/Common Use: Activity fights most strains of bacterial pathogens responsible for
respiratory, urinary tract, gastrointestinal, and abdominal infections. Also used for complicated and
severe bone infections
Contraindications:
Concomitant administration with tizanidine is contraindicated. Local IV site
reactions are more frequent if the infusion time is less than 30 minutes. Contraindicated with people
who have a hypersensitivity to Ciprofloxacin.
Special Considerations: Not licensed by the FDA for use in children due to the risk of permanent injury
to the
musculoskeletal system
Drug Name:
Classification: Sulfonamide Antibiotic
Bactrim/Bactrim DS
Chemical Names: Trimethoprim/ Sulfamethoxazole
How supplied/usual dosage:
Orally, tablets or liquid IV – 8 to 10mg diluted in IV normal saline
OR indication/Common Use:
Effectively used to fight infections in the upper or lower respiratory,
renal and urinary tract infections, gastrointestinal tract infections, and skin and wound infections.
Contraindications: Pregnant woman and nursing mothers. Patients less than 2 months of age. Also
contraindicated in people with hepatic damage or with sever renal insufficiency.
Special Considerations: Prescribing Bactrim tablets in the absence of a proven or strongly suspected
bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases
the risk of the development of drug-resistant bacteria.
Drug Name:
Innovar
Classification
Antiemetic, antipsychotic
Chemical Names Inapsine
How supplied/usual dosage
Ampules and vials 2.5mg of Innovar in an aqueous solution.
OR indication/Common Use
Used to reduce nausea and vomiting caused by surgery or other medical
procedures.
Contraindications: patients who have heart disease, hypertension, low potassium, heart arrhythmia,
liver or kidney disease, adrenal gland cancer ,or history of alcohol abuse.
Special Considerations The initial dose of Innovar should be appropriately reduced in elderly, debilitated
and other poor- risk patients. The effect of the initial dose should be considered in determining
incremental doses.
Drug Name: Dilaudid
Classification Opioid analgesic
Chemical Names hydromorphone
How supplied/usual dosage ampules of 1mg/mL, 2mg/mL or 4mg/mL
OR indication/Common Use An opioid used to treat moderate to severe pain.
Contraindications In patients with respiratory depression in the absence of resuscitative equipment or
in unmonitored settings, or patients with acute or severe bronchial asthma, In patients with or at risk of
developing, gastrointestinal obstruction especially paralytic ileus because hydromorphone diminishes
the propulsive peristaltic wave in the gastrointestinal tract may prolong the obstruction.
Special Considerations Selection of patients and administration of Dilaudid should be governed by the
same principles that apply to the use of similar opioid analgesics to treat patients with acute chronic
pain, and depends upon a comprehensive assessment of patient.
Drug Name:
Classification: Antihistamine, Antiemetic
How supplied/usual dosage:
OR indication/Common Use:
Phenergan
Chemical Names:
Promethazine Hydrochloride
Tablets and Suppositories 12.5mg, 25mg and 50mg
Antiemetic in post-op. Used for seasonal rhinitis. Pre-op, post-op or
obstetric sedation. Amelioration of allergic reactions to blood or plasma and anaphylactic
reactions motion sickness, nausea and vomiting.
Contraindications: Caution of use in patients with bone marrow depression, cardiovascular disease or
with impairment of liver function.
Special Considerations: May lead to potential fatal respiratory depression. Do not use in children
younger than 2 years of age. Do not use with Epinephrine, Anticholinergics or MAOI's.
Drug Name:
Classification:
Prokinetic
Reglan
Chemical Names: Metodopramide Hydrochloride
How supplied/usual dosage: IV or IM 10mg 2m1 single dose vials; 10mL and 30 mL single dose vials.
OR indication/Common Use: Stimulates motility of upper GI tract without stimulating gastric, biliary or
pancreatic secretions.
Contraindications:
Should not be used whenever there is the presence of gastrointestinal
hemorrhage, mechanical obstruction or perforation.
Special Considerations:
Can cause tardive dyskinesia, a serious movement disorder that is often
irreversible. Do not mix with Cephalothin Sodium, Chloramphenicol Sodium or Sodium Bicarbonate.
Drug Name:
1.5% Glycine
Classification: Irrigation
Chemical Names:
Glycine
How supplied/usual dosage:
3000 ml per bag — single dose.
OR indication/Common Use:
For urologic irrigation during transurethral prostatic resection and other
transurethral procedures.
Contraindications:
Use caution when using on patients with severe cardiopulmonary or renal
dysfunction. Do not use on patients with anuria.
Special Considerations: Not for injection use. Avoid excessive heat and protect from freezing.
Drug Name:
Classification:
Amylopectin Derivative
Hespan
Chemical Names:
Hydroxyethyl
How supplied/usual dosage: IV 500ml in 1 container.
OR indication/Common Use:
For treatment of hypovolemia. Adjunctive use in leukapheresis in
improving the harvesting and increasing the yield of granulocytes by centrifugal means.
Contraindications:
caution in
CHF or renal disease with anuria or oliguria not related to hypovolemia. Use
patients who have been anticoagulated.
Special Considerations:
Do not remove plastic infusion container from its overwrap until immediately
before use. Not a substitute for blood or plasma. Do not use if patient is allergic
Drug Name:
Classification:
Dantrolene
Muscle Relaxant
Chemical Names:
Dantrolene Sodium
How supplied/usual dosage:
IV 65 ml Vial or Capsules 25mg, 50mg and 100mg
OR indication/Common Use:
IV pre-op and post-op to prevent malignant hyperthermia. Used to
control spasticity from upper motor neuron disorders.
Contraindications:
Hepatic Disease. Use caution in patients with COPD. Do not use for nursing
mothers.
Special Considerations:
Long term safety in children 5 years or younger have not been established.
For pregnant mothers or planning on getting pregnant it should only be given when the potential
benefits have been weighed against possible hazards to mother and child.
Drug Name:
Classification:
Antiemetic
How supplied/usual dosage:
Inapsine
Chemical Names:
IV or IM ampoules or vials 2.5mg
Droperidol
OR indication/Common Use: Pre-operative for nausea and vomiting.
Contraindications:
Serious arrhythmias, known or suspected QT prolongation, syncope and
hypotension.
Special Considerations:
Patient should undergo a 12 Lead ECG prior to use. Do not use if patient has
an electrolyte imbalance. Do not use in labor and delivery as there is insufficient data to support the use.
For children ages 2-12 the maximum dosage is 0.1 mg/kg.
Drug Name: Vancomycin
Classification:
Antabiotic
Chemical Names: Vancocin HCL Pulvules
How supplied/usual dosage: Must be given intravenously (IV) for systemic therapy, Oral therapy must
be given orally to reach the site of infection in the colon. Fecal concentration is around 500 mg/mL
(sensitive strains of C. difficile have a mean inhibitory concentration of mg/mL Inhaled therapy via
nebulizer, for treatment of upper and lower respiratory tract.
OR indication/Common Use: Treatment of serious infections caused by susceptible organisms resistant
to penicillins (methicillin-resistant Staphylococcus aureus and multi-resistant Staohvlococcus
epidermidis (MRSE)) or in individuals with serious allergy to penicillins, Treatment of
Pseudomembranous colitis caused by the bacterium Clostridium difficile, For treatment of infections
caused by gram-positive microorganisms with serious allergies to beta-lactam antimicrobials.
Antibacterial prophylaxis for endocarditis, Surgical prophylaxis for major procedures involving
implantation of prostheses with a high rate of MRSA or MRSE. Early in treatment as an empiric antibiotic
for possible MRSA infection while waiting for culture identification.
Contraindications: Common adverse drug reactions (1% of patients) associated with IV vancomycin
include: local pain, which may be severe and/or thrombophiebitis. Damage to the kidneys and to the
hearing, anaphylaxis, toxic epidermal necroty.51, erythema multiformed, red man syndrome, suoer
infection, thrombocytopenia, neutropenia, leucopenia, tin thus, dizziness and/or ototoxicity. Induce
platelet reactive antibodies in the patient, leading to severe thrombopenia and bleeding with florid
petechiai hemorrhages, ecchymoses, and we purpura.
Special Considerations: Should not be used to treat methicillin-sensitive Starthytococcus aureus
because it is inferior to penicillin such as nafrillin.
Drug Name: atropine
Classification: acetylcholine
How supplied/usual dosage:
Pediatric dose
sulfate
Chemical Names:
N/A
The usual dosage is 0.4 to 1 mg IV push in an adult preoperatively.
0.01mg/kg up to a total of 0.4mg given preoperatively.
OR indication/Common Use: Used as a cycloplegic Degrades slowly, typically wearing off in 7 to 14 days,
generally used as a therapeutic mydriatic, induces mydriasis by blocking contraction of the circular
pupillary sphincter muscle, which is normally stimulated by acetylcholine release, thereby allowing the
radial pupillary dilator musc`r to contract and dilate the pupa. Treats ciliary block (malignant) glaucoma.
useful in treating second-degree heart block Mobitz Type 1 (Wenckebach block), and also
thirct7clegree. _hears block with a high IDLiLkirrig or AvnQctat f..sc_ape rhythm. It is usually not
effective in second-degree heart block Mobitz type 2, and in third-degree heart block with a low
Purkinje or ventricular escape rhythm.
Contraindications: contraindicated in ischemia-induced conduction block, because the drug increases
demand of the AV nodal tissue, thereby aggravating ischemia and the resulting heart block. In patients
pre-disposed to narrow angle glaucoma.
Special Considerations: Adverse reactions include ventricular fibrillation, supraventricular or ventricular
tachycardia, dizziness, nausea, blurred vision, loss of balance, dilated pupils, photophobia, dry mouth
and potentially extreme confusion, dissociative haucinations and excitation. In overdoses, atropine is
poisonous. Potentially addictive, particularly anti-diarrhea opioid drugs such as diphenoxylate or
.:,,ifznoxin, wherein the secretion-reducing effects of the atropine can also aid the antidiarrheal effects.
Although treats bradycardia (slow heart rate) in emergency settings, it can cause paradoxical heart rate
slowing when given at very low doses, presumably as
a result of central action in the CNS.
Drug Name:
Classification: sugar substitute
Sorbitol
Chemical Names: glucitol
How supplied/usual dosage: Referred to as a nutritive sweetener because ii has 2.6 Kilocalories
(11 kilojoules) per gram sugar versus the average 4 kilocalories (17 kilojoules) for carbohydrates.
OR indication/Common Use: Used in diet fopsts , mints, glygli.syrups, and sugar-free chewing
gum. Naturally in many stone fruits and berries from trees of the genus Sorbt.15. Used in
bacterial culture media to distinguish the pathogenic Escherichia, coli 0157:F17. Combined with
kayexalate, helps body rid itself of excess potassium in a riberkalaernic state, in the bowel, while
sorbitol helps eliminate it.
Contraindications: Too much trapped in retinal cells, the cells of the lens, and the Schwann cells
That myelinate peripheral nerves can damage these cells, leading to cataracts and peripheral
neuropathy, respectively. Frequently occur in the setting of long-term hyperglycemia that
accompanies poorly-controlled diabetes. May help prevent accumulation of intracellular
sorbitol. Leads to cellular damage in diabetics.
Special Considerations: May aggravate irritable bowel syndrome,[14l and similar
Gastrointestinal conditions, resulting in severe abdominal pain for those affected, even from small
amounts ingested. Added to SPS can cause complications in the GI tract, including bleeding,
perforated colonic ulcers, ischemic colitis and colonic necrosis, particularly in patients with
uremia. Ingesting large amounts can lead to abdominal pain, liatuience, and mild to severe
diarrhea Ingestion of 20 grams (0.7 oz) per day led to severe diarrhea leading to unintended
weight loss of 11 kilograms (24 lb) in eight months, in a woman originally weighing 52
kilograms (110 lb); another patient required hospitalization after habitually consuming 30 grams
(1 oz) per day.
Drug Name: Methergine
Classification: synthetic analogue
Chemical Names: methylergonovine,
How supplied/usual dosage: It is available as tablets or injection (IM or IV) or in liquid form to be
taken orally.
OR indication/Common Use: Used to prevent or control excessive bleeding following childbirth
and spontaneous or elective abortion, and also to aid in expulsion of retained products of
conception after a missed abortion and to help deliver the placenta after childbirth. Used for both
prevention and acute treatment of migraine.
Contraindications: in patients with hypertension and preeclampsia, and also during pregnancy and
birth.
Special Considerations: Adverse effects include: Cholinergic effects such as nausea, vomiting,
diarrhea, Dizziness, Pulmonary hypertension, Coronary artery vasoconstriction, Severe systemic
hypertension (especially in patients with Convulsions in excessive doses and ead to cramping,
respiratory depression and coma.
Drug Name: Lactated Ringers Solution
Classification: solution isotonic
Chemical Names: N/A
How supplied/usual dosage: usually given intravenously, IV bag dose is usually calculated by estimated
fluid loss and presumed fluid deficit. Fluid resuscitation rate of administration is 20 to 30 ml/kg body
weight/hour. If a vein is not found. it can be taken orally (although it has an unpleasant taste)
OR indication/Common Use: Treatment of serious, life-threatening infections by Gram-positive bacteria
that are unresponsive to other less-toxic antibiotics. Should not be used to treat methicillin-sensitive
staphylococcus aureus because it's inferior to penicillins.
Contraindications: used for fluid resuscitation after a blood loss due to trauma, surgery, or a burn injury.
Previously, used to induce urine output in patients with Another common use is the treatment of chronic
renal failure in small animalsLactated Ringer's solution is used because the by-products of lactate failure.
metabolism in the liver counteract acidosis, which is a chemical imbalance that occurs with acute fluid
loss or renal failure.
Special Considerations: used because the by-products of lactate metabolism in the liver counteract
acidosis, which is a chemical imbalance that occurs with acute fluid loss or renal failure.
Drug Name: Sodium Bicarbonate
Chemical Names: N/A
Classification: antacid
How supplied/usual dosage: Intravenous sodium bicarbonate aqueous solution used for acidosis,
insufficient sodium or bicarbonate ions in blood. Respiratory acidosis, infused bicarbonate ion drives
carbonic acid/bicarbonate buffer of plasma to left and, raises the pH. Infusion is indicated only when
blood pH is markedly (<7.1-7.0) low. Used as a paste, with three parts baking soda to one part water.
OR indication/Common Use: Used in medically supervised cardiopulmonary resuscitation and for
treatment of hyperkalemia. Sometimes used to treat aspirin overdoses. Used in the treatment of
tricyclic antidepressant overdose. Can also be applied topically as a paste
Contraindications: Adverse reactions can include metabolic alkalosis, edema due to sodium overload,
congestive heart failure, hyperosmolar syndrome, hypervolemic hypernatremia, and hypertension due to
increased sodium.
Special Considerations:
In patients consuming a high-calcium or dairy-rich diet, calcium supplements,
calcium carbonate (e.g..Turns), the use of sodium bicarbonate can cause or calcium-containing antacids
such as milk-alkali syndrome, which can result in metastatic calcification, kidney stones, and kidney
failure. renal
Drug Name: Robinul
Classification: muscarinic anticholinergic Chemical Names: Glycopyrroniurn
How supplied/usual dosage: ln anesthesia in the form of an injection
OR indication/Common Use: used as a preoperative medication in order to reduce salixary, ttacheobronchial,
and ohawnoeal secretions, as well as decreasing the acidity of gastric secretion. It is also used in conjunction with
neostigmine, a neuromuscular Necking reversataclent, to prevent neostigmine's muscarinic effects such as
bradycardia. It is also used to reduce excessive saliva (sialorrhea). It decreases acid secretion in the stomach and so
may be used for treating stomach ulcers, in combination with other medications. Use in treating asthma and COPD
has been described. Used tpically and orally to treat
Contraindications: Reduces the body's sweating ability, it can even cause fever and heat stroKe in hot
environments. Dry mouth, difficulty urinating, headaches, diarrhea and constipation are also observed
side effects of the medication.
Special Considerations: Induces drowsiness or blurred visions, an effect exacerbated by the consumption
of alcohol.
Drug Name: heparin calcium/heparin sodium
Classification: anticoagulant
Chemical Names:
N/A
How supplied/usual dosage: One unit of heparin equivalent to 0.002 mg of pure heparin, which is the quantity
required to keep 1 mL of cat's blood fluid for 24 hours at 0 °C. Can be injected intravenously or subcutaneously
intramuscular injections. Must be given frequently or as a continuous infusion. If long-term anticoagulation is
required it is often used only to commence anticoagulation therapy until the oral anticoagulant - takes effect.
OR indication/Common Use: Is given because it is not absorbed from the gut, due to its high negative charge and
large size. Is a naturally occurring anticoagulant produced by basophils and mast cells. ''cts as an anticoagulant,
preventing the formation of clots and extension of existing clots within the blood. While heparin does not break
down clots that have already formed (unlike tissue plasminogen activator), it allows the body's natural clot lysis
mechanisms to work normally to break down clots that have formed . Heparin is generally used for anticoagulation
for the following conditions Acute coronary syndrome, fibrillation, Deep-vein thrombosis, pulmonary embolism,
Cardiopulmonary bypass for heart syirnerv, ECMO circuit for extracorporeal life support, Hemofiltration,
indwelling central or peripheral venous catheters
Contraindications: A serious side-effect is heparin-induced thrombocytopenia (HIT). HIT is immunological
reaction makes Platelets a target of immunological response, resulting in degradation of platelets. What causes
thrombocytopenia. There are two nonhemorrhagic side effects of treatment. The first is elevation of serum
aminotransfesase levels, abnormality is not associated with liver dysfunction, and it disappears after the drug is
discontinued. The other complication is can appear within a few days after the onset of heparin therapy. More sideeffects include alopecia and osteoporosis can occur with chronic use.
Special Considerations: Measured in the lab by the partial thromboplastin time (aPTT), one of the measures of
the time it takes the blood plasma to clot. Partial thromboplastin time should not be confused with Prothrombin
time, or PT, which measures blood clotting time through a different pathway of the coagulation cascade.
Drug Name:
Classification
Chemical Names
How supplied/usual dosage:
OR indication/Common Use:
Contraindications:
Special Considerations:
Drug Name:
Classification
How supplied/usual dosage:
OR indication/Common Use:
Contraindications:
Special Considerations:
Chemical Names