Drug
Action - Target
ADVERSE/se:
Dose
Acetaminophen Inhibits the synthesis of
HEPATIC
PO 325 – 650mg Q 4(Tyleonol)
prostaglandins that mediate FAILURE,
6hr (max 4g/24hr or 2.5
O .5-1hr
pain in CNS – has no anti- HEPATOTOXICITY in geriatric) Take w/full
P 1-3hr
inflammatory prop. or GI
(OVERDOSE)
glass water. May be
D 3-8hr
toxicity.
taken w/food or not.
Nursing considerations: Acetylcysteine (Acetadote) is the antidote.
Drug
Action - Target
ADVERSE/se:
diphenhydrAMINE antihistamines/relief of allergic drowsiness,
(Benadryl )
symptoms. Antagonizes the anorexia, dry
R O
P D
effects of histamine at
mouth
P 15-60 2-4 4-8 hr receptor sites. CNS
O min hr
depressant and anticholinergic
IM 20-30 2-4 4-8 hr properties.
min hr
IV rapid UK 4-8 hr
N
Dose
PO 25-50mg q 4-6 hr,
MAX 300mg/day.
w/meals/milk
IM, IV 25-50mg q 4 hr
(may need 100mg –
MAX 300mg/day)
Nursing considerations: May cause sedation and confusion due to increased sensitivity to
anticholinergic effects. Monitor carefully, assess for confusion, delirium, other
anticholinergic side effects and fall risk. Institute measures to prevent falls. PO:
Administer with meals or milk to minimize GI irritation. Capsule may be emptied and
contents taken with water or food. IM: Administer 50 mg/ml into well-developed muscle.
Avoid SQ injections.
Drug
Corticosteroids
Action - Target
ADVERSE/se:
Dose
antiasthmatic,
PEPTIC ULCERATION,
PO
Immunosupressant.
THROMBOEMBOLISM, depression, Dependent upon type of
depending on type of
euphoria, hypertension, anorexia, corticosteroid – Use
corticosteroid:
nausea, acne, decreased wound
Drug book
systemically and locally in healing, ecchymosis, fagility,
wide variety of chronic
hirsutism, Petechiae, adrenal
diseases: Inflammatory, suppression, muscle wasting,
Allergic, Hematologic,
osteoporosis, cushingoid
Neoplastic, Autoimmune appearance
disorders.
Nursing Implications: Instruct patient to inform health care professional promptly if severe abdominal pain or
tarry stools occur Do not double doses. immunosuppression and may mask symptoms of infection. Discuss
possible effects on body image. Lab Test Considerations: Monitor serum electrolytes and glucose. May
cause hyperglycemia, especially in persons with diabetes. May cause hypokalemia. Patients on prolonged
therapy should routinely have CBC, serum electrolytes, and serum and urine glucose evaluated. May ↓
WBCs. May cause hyperglycemia, especially in persons with diabetes. May ↓ serum potassium and calcium
and ↑ serum sodium concentrations.
Drug
Epinephrine
R O PP D
IN 1
U 1-3 hr
HL min K
N
SQ 5-10 20 <1-4 hr
min mi
n
IM 6-12 U <1-4 hr
min K
N
IV rapi 20 20-30
d
mi min
n
Action - Target
Antiasthmatic,
bronchodilator,
vasopressor./
inhibits release of
mediators of
immediate
hypersensititivy
reactions from
mast cells and
results in accum.
of cAMP
ADVERSE/se:
Dose
nervousness, SQ, IM (anaphylactic reactions/asthma
restlessness, 0.1 – 0.5 mg. may repeat q 10-15 min
tremor,
(anaphylactic react. or q 20 min – 4 hr
angina,
(asthma)
arrhythmias, IV Severe anaphylaxis 0.1-0.25 mg q
hypertension, 5-15 min; may be followed by 1-4
tachycardia mcg/min continuous infusion.
cardio res 1mg q 3-5 min
Bradycardia 2-10 mcg/min
Inhaln 1 inhalation (160-250 mcg)
repeated after 1-2 min.
Nursing Implications: Assess lung sounds/rep patt/pulse /BP. Lab Test Considerations:
May cause transient ↓ in serum potassium concentrations with nebulization or at higher
than recommended doses.
Drug
Action - Target
ADVERSE/se:
Dose
May cause an ↑ in blood glucose and serum lactic acid concentrations.
Toxicity and Overdose:
Symptoms of overdose include persistent agitation, chest pain or discomfort, decreased
blood pressure, dizziness, hyperglycemia, hypokalemia, seizures, tachyarrhythmias,
persistent trembling, and vomiting.
Treatment includes discontinuing adrenergic bronchodilator and other beta-adrenergic
agonists and symptomatic, supportive therapy. Cardioselective beta blockers are used
cautiously, because they may induce bronchospasm. For anaphylactic shock, volume
replacement should be administered concurrently with epinephrine. Antihistamines and
corticosteroids may be used in conjunction with epinephrine. Use a tuberculin syringe
with a 26-gauge 1/2-in. needle for subcut injection to ensure that correct amount of
medication is administered. Prior to administration, have second practitioner independently
check original order, dose calculations, concentration, route of administration, and infusion
pump settings. IM, Subcut: Medication can cause irritation of tissue. Rotate injection sites
to prevent tissue necrosis. Massage injection sites well after administration to enhance
absorption and to decrease local vasoconstriction. Avoid IM administration in gluteal
muscle.
Drug
Furosemide
RO
P D
P 30-60 1-2 6-8
O min hr hr
I 10-30 UK 4-8
M min N hr
I 5 min 30 2 hr
V
min
Action - Target
ADVERSE/se:
loop diuretic/inhibits APLASTIC ANEMIA,
the reabsorption of AGRANULOCYTOSIS,
sodium an dchloride dehydration,
from the loop of
hypochloremia,
Henle and distal renal hypokalemia,
tubule. Increases
hypomagnesemia,
renal excretion of
hyponatremia,
water, sodium,
hypovolemia, metabolic
chloride, Mg, K, Ca. alkalosis.
Dose
Edema
PO 20-80 mg/day sinele dose, may
repeat 6-8hr, may increase by 20-40
mg q 6-8 hr until desired response.
hypertension – 40 twice daily initially
Hypercalcemia – 120 mg/day in 1-3
doses
May be taken w/food/milk to reduce GI
irritation.
IM, IV 20-40mg
Nursing Implications: NSAIDS decrease effects. Many commopn drug interactions-check book! Assess fluid
status, weight, I/O amount/location of edema, lung sounds, skin Turgor and mucous membranes. BP, P
before and after. Assess fall risk in geriatrics. Assess for tinnitus and hearing loss. Lab Test
Considerations: Monitor electrolytes, renal and hepatic function, serum glucose, and uric acid levels before
and periodically throughout therapy. Commonly ↓ serum potassium. May cause ↓ serum sodium, calcium,
and magnesium concentrations. May also cause ↑ BUN, serum glucose, creatinine, and uric acid levels.
Caution patient to change positions slowly to minimize orthostatic hypotension. Advise diabetic patients to
monitor blood glucose closely; may cause increased blood glucose levels.