ACTIVATED CHARCOAL

InstaChar, SuperChar, Actidose, Liqui-Char

CLASSIFICATION AND INDICATION AND CONTRAINDIC SIDE EFFECT/ NURSING

MECHANISM OF DOSAGE ATION ADVERSE EFFECT RESPONSIBILITY
ACTION

Classification: Oral Cyanide, Vomiting, -Alert: drug is commonly

Antidotes, Detoxifying mineral acids, constipation, diarrhea, used for treating
Agents & Drugs Used in ACUTE ORAL caustic alkalis, black stools, swelling poisoning or overdose
Substance Dependence POISONING organic of abdomen, bowel with acetaminophen,
solvents, iron, obstruction; platelet aspirin, atropine,
Action: Adult: 25-100 g as a ethanol, aggregation, charcoal barbiturates or
Charcoal due to its large single dose. For methanol embolism, antidepressant
surface area, inhibits the multiple-dose poisoning; thrombocytopenia,
GI absorption of toxic treatment: 50-100 g as lithium, hemorrhage, -Give after emesis
substances or irritants an initial dose followed methionine; hypoglycemia, complete because
ex., aromatic or by not <12.5 g every intestinal hypocalcaemia, Activated charcoal
benzenoid-type hr. Alternatively, 25 mg obstruction, hypothermia, absorbs and inactivates
substances through every 2 hr or 50 mg anatomically- hypotension, syrup.
adsorption. As a every 4 hr. broken GI tract, blackening of teeth
laxative, the addition of haemorrhage or and mouth; -Instruct patient to drink
sorbitol provides Child: <1 yr: 1 GI perforation. hypernatraemia, 6-8 glasses of liquid per
hyperosmotic g/kg/dose; 1-12 yr: 25- Concomitant hypokalaemia, day because It can cause
environment thus 50 g/dose. use of charcoal hypermagnesemia constipation
causing catharsis. with sorbitol: (with concomitant
Moreover, charcoal GI DISORDERS Patients with admin with
interferes with the Adult: 0.975–3.9 g tid. fructose cathartics).
enterohepatic circulation intolerance;
of bile acids resulting to Children <1 yr.
a lower cholesterol level.

FUROSEMIDE
Apo- Furosemide, Furoside, Lasix, Myrosemide

CLASSIFICATION INDICATION AND DOSAGE CONTRAINDIC SIDE EFFECT/ NURSING

AND MECHANISM ATION ADVERSE EFFECT RESPONSIBILITY
OF ACTION

Classification: Edema History of -CV: postural - Administer with food or

Diuretics Adult: PO 20-80 mg in 1 or
more divided doses up to 600
Action: mg/d if needed IV/IM 20-40
A potent loop mg in 1 or more divided
diuretic that inhibits doses up to 600 mg/d.
sodium and chloride Child: PO 2 mg/kg, may be
reabsorption at the increased by 1-2 mg/kg q 6-
proximal and distal 8h (max: 6 mg/kg/dose) IV/IM
tubules and the 1 mg/kg, may be increased
ascending loop of by 1 mg/kg q 2h if needed
Henle (max: mg/kg/dose)
Neonate: PO 1-4 mg/kg q 12-
24h IV/IM 1-2 mg/kg q 12-24h
Hypertension
Adult: PO 10-40 mg bid (max:
480 mg/d)
hypersensitivity hypotension, milk to prevent GI upset.
to furosemide or dizziness with - Reduce dosage if given
sulfonamides; excessive diuresis, with other
increasing Circulatory collapse antihypertensive; readjust
oliguria, anuria, -Metabolic: dosage gradually as BP
fluid and hypovolemia, responds.
electrolyte dehydration, - Give early in the day so
depletion state; hyponatremia, that increased urination
hepatic coma; hypokalemia, will not disturb sleep.
pregnancy hypochloremia - Measure and record
category c, metabolic alkalosis, weight to monitor fluid
lactation. hypomagnesemia, changes.
hypocalcemia, - Arrange to monitor
glycosuria, elevated serum electrolytes,
BUN, hyperuricemia hydration, liver function.
-GI: nausea, - Arrange for potassium-
vomiting, oral and rich diet or supplemental
gastric burning, potassium as needed.
-HEMA: anemia

NIFEDIPINE
Adalat, , Apo-Nifed , Gen-Nifedipine, Nifedical, Novo-Nifedin , Procardia,

CLASSIFICATION AND INDICATION CONTRAINDICA SIDE EFFECT/ NURSING

MECHANISM OF ACTION AND DOSAGE TION ADVERSE RESPONSIBILITY
EFFECT
Classification: Management of CNS: Dizziness, -Monitor blood
-Calcium channel-blocker hypertension, -Acute MI, light-headedness, pressure impulse
-Antianginal Angina cardiogenic headache, before therapy, during
-Antihypertensive pectoris, shock, acute asthenia, fatigue, dose titration and
interstitial unstable angina, nervousness, sleep periodically during
Action: cystitis treatment of disturbances, therapy.
Inhibits the movement of anginal attack in blurred vision -Monitor intake and
calcium ions across the Initial dose, chronic stable CV: Peripheral output ratio and daily
membranes of cardiac and 10 mg tid PO. angina. edema, angina, weight.
arterial muscle cells; inhibition Maintenance hypotension, -Assess for signs of
of transmembrane calcium flow range, 10–20 mg -Contraindicated arrhythmias, AV CHF (peripheral
results in the depression of tid. Higher doses with allergy to block, asystole edema, rales/cracles,
impulse formation in specialized (20–30 mg tid– nifedipine Dermatologic: dyspnea, weight gain.
cardiac pacemaker cells, in qid) may be Flushing, rash, -Caution patient to
slowing of the velocity of required, dermatitis, change position slowly
conduction of the cardiac depending on pruritus, urticaria to minimize orthostatic
impulse, in the depression of patient response. GI: Nausea, pressure
myocardial contractility, and in Adjust over 7–14 diarrhea, -Instruct patient on
the dilation of coronary arteries days. More than constipation, importance of
and arterioles and peripheral 180 mg/day is cramps, flatulence, maintaining dental
arterioles; these effects lead to not hepatic injury hygiene
decreased cardiac work, recommended. Other: Nasal - Instruct patient not to
decreased cardiac energy Sustained- congestion, cough, chew, cut, or crush
consumption, and increased release fever, chills, sustained-release
deliver of oxygen to myocardial 30–60 mg PO shortness of tablets. Swallow whole.
once daily. Adjust breath, muscle
cells. over 7–14 days. cramps, joint
Usual maximum stiffness, sexual
dose is 90– difficulties
120 mg/day.

SCOPOLAMINE BUTYLBROMIDE
Hyoscine Butylbromide

CLASSIFICATION AND INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

MECHANISM OF DOSAGE N ADVERSE EFFECT RESPONSIBILITY
ACTION

PHARMACOLOGIC SPASTIC STATES. -Contraindicated in CNS: disorientation, - Assess pt’s condition

CLASS: anticholinergic
THERAPEUTIC CLASS:
antimuscarinic,
antiemetic, antivertigo
drug, antiparkinsonian
Action:
Inhibits muscarinic
actions of acetylcholine
in the autonomic
nervous system. It also
may affect neural
pathways originating in
the labyrinth to inhibit
nausea and vomiting.
Relieves spasticity,
nausea and vomiting,
reduces secretions, and
blocks cardiac vagal
reflexes
Adults: 0.4 to 0.8mg patients with angle- restlessness, before therapy and
Scopace PO daily. closure glaucoma, irritability, dizziness regularly thereafter.
Or, 10 to 20mg obstructive CV: palpitations, - Be alert for adverse
scopolamine uropathy, tachycardia reactions and drug
butylbromide SC, IM obstructive disease EENT: dilated interactions.
or IV tid or qid. of GI tract, asthma, pupils, blurred - Advise patient to
CPD, myasthenia vision, photophobia, refrain from activities
gravis, paralytic increased IOP, that require alertness
ileus, intestinal difficulty swallowing until drug’s CNS effects
atony, unstable CV GI: constipation, dry are known.
status in acute mouth, nausea, - Instruct patient to
hemorrhage, or toxic vomiting report signs of urinary
megacolon. GU: urinary hesitancy or urine
hesitancy, urine retention.
retention - Recommend use of
RESPI: bronchial sugarless gum or hard
plugging, depressed candy to help minimize
respirations dry mouth
SKIN: rash, dryness

CALCIUM GLUCONATE

CLASSIFICATION INDICATION AND CONTRAINDIC SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE ATION ADVERSE EFFECT RESPONSIBILITY
OF ACTION

Classification: Hypocalcaemia and Contraindicated GI irritation; soft- -note indications for

Calcium Salt, calcium deficiency in patients with tissue calcification, therapy, other
Electrolytes and states calcium renal skin sloughing agents trialed, serum
Replacement Adult: oral, 10-50 mmol calculi or history Hypercalcemia levels and desired
solution daily, adjusted according of renal calculi. characterized by levels
to patient's needs Conditions anorexia, nausea,
Action: associated with vomiting, -monitor calcium
Calcium is essential Hypocalcaemic tetany hypercalcemia constipation, levels and renal
for maintaining Adult: 2.25 mmol by slow and abdominal pain, function; assess for
normal function of IV inj over 10 minutes, hypercalciuria. muscle weakness, renal or parathyroid
 nerves, muscles, followed by 58-77 ml of mental disturbances, disease. Vitamin D
the skeletal system, 10% calcium gluconate polydipsia, polyuria, facilitates
and permeability of solution in 0.5-1L of 5% nephrocalcinosis, absorption.
cell membranes and dextrose solution as renal calculi; chalky
capillaries. continuous IV infusion. taste, hot flushes - IV rate should not
The normal serum and peripheral exceed 0.5-2 ml/min
calcium Antidote in severe vasodilation.
concentration is 9- hypermagnesaemia - give by intermittent
10.4 mg/dl. Calcium Adult: 10 ml of 10% IV infusion at a rate
gluconate is used to calcium gluconate not exceeding 200
prevent or treat solution over 2 minutes, mg/min
negative calcium repeated every 10
balance. It also minutes if needed. - monitor any
helps facilitate adverse effect
nerve and muscle
performance as well
as normal cardiac
function.

AMLODIPINE BESYLATE
Norvasc

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION

PHARMACOLOGIC CHRONIC STABLE -Contraindicated in CNS: headache, -Assess pt’s BP or

CLASS: ANGINA; patients fatigue, somnolence angina before
dihydropyridine VASOSPASTIC hypersensitive to CV: edema, therapy and
calcium channel ANGINA drug. dizziness, flushing, regularly thereafter.
blocker (Prinzmetal’s -Use cautiously in palpitations -Monitor pt carefully
THERAPEUTIC angina) patients receiving GI: nausea, for pain. In some pt’s
CLASS: antianginal, Adults: initially, other peripheral abdominal pain, especially those with
antihypertensive 10mg PO vasodilators dyspepsia severe obstructive
(especially those coronary artery
Action: HYPERTENSION. with severe aortic disease, increased
*inhibits calcium ion Adults: initially, 5mg stenosis) and in frequency, duration,
influx across cardiac PO daily. those with heart or severity of angina
and smooth-muscle failure. or even acute MI has
cells, thus -In patients with developed after start
decreasing severe hepatic calcium channel
myocardial disease, use blocker therapy or at
contractility and cautiously and in time dosage
oxygen demand. reduced dosage increase.
Also dilates coronary because drug is -Advise pt to
arteries and metabolized by liver. continue taking drug
arterioles. even when feeling
*reduces BP and better
prevents angina

DIPHENHYDRAMINE HCL
Allerin, Benadryl

CLASSIFICATION AND INDICATION CONTRAINDICATIO SIDE EFFECT/ NURSING

MECHANISM OF ACTION AND DOSAGE N ADVERSE EFFECT RESPONSIBILITY

Classification: RHINITIS. Contraindicated to sedation, tiredness, -Stop drug 4 days

antihistamine, antiemetic, Adults and patients sleepiness, bebefore diadnostic skin
antivertigo agent, antitussive, children: 25-50 hypersensitive to dizziness, disturbed testing
sedative hypnotic, mg PO TID or drug: newborn, coordination, drying
antidyskinetic QID maximum premature neonates, and thickening of -Warn pt. not to take this
of 300mg PO breastfeeding oral and other drug with any other
Action: daily woman respiratory products that contain
*Histamine is released by the secretions, and dephenhydramine
body during several types of stomach distress
allergic reactions and--to a - May be taken with or
lesser extent--during some without food
viral infections, such as the
common cold. When -Intruct pt. to take
histamine binds to its 30mins before travel to
receptors on cells, it prevent motion sickness
stimulates changes within the
cells that lead to sneezing,
itching, and increased mucus
production. Antihistamines
compete with histamine for
cell receptors

OXYTOCIN
Pitocin
CLASSIFICATION INDICATION AND CONTRAINDICATION SIDE EFFECT/ NURSING
AND MECHANISM DOSAGE ADVERSE EFFECT RESPONSIBILITY
OF ACTION

Classification: Induction or Hypertonic uterine Maternal - Assess patient’s

Oxytoxics stimulation of labor in contraction, mechanical CNS: hemorrhage, condition before
hypotonic uterine obstruction to delivery, hypertension, starting the therapy.
Action: inertia. Prevention & fetal distress. Significant seizures.
Drugs Acting on the treatment of cephalopelvic CV: hypertension, - Monitor and record
uterus postpartum uterine disproportion, fetal increased heart rate uterine contractions,
Causes potent and atony & hemorrhage. malpresentation, GI: nausea and heart rate, blood
selective Early stages of placenta previa, vomiting pressure.
stimulation of pregnancy as an placental abruption, GU:: titanic uterine
uterine and adjunctive therapy cord presentation or contraction, - be alert for
mammary gland for the management prolapse, overdistension abruption placenta, adverse reactions
smooth muscle. of incomplete, or impaired resistance of impaired uterine and drug
Induces labor and inevitable or missed the uterus to rupture as blood flow interactions.
milk ejection and abortion. in multiple pregnancy, - Instruct patient to
reduces postpartum polyhydramnios, grand Fetal report unusual
bleeding. Initially 1 amp multiparity & in uterine CV: bradycardia, feelings.
(10units) IV in scar. Do not use for tachycardia
1000ml of D5W, prolonged period in Respi: anoxia - Instruct patient to
dextrose 5% in NSS patients w/ oxytocin- remain lying down
at 1 – 2 milliunits resistant uterine inertia, during
severe pre-eclamptic administration.
toxemia or severe CV
disorder.

AMINOPHYLLIN
(Theophylline ethylenediamine)
Truphylline

CLASSIFICATION INDICATION AND CONTRAINDICATI SIDE EFFECT/ ADVERSE NURSING

AND MECHANISM DOSAGE ON EFFECT RESPONSIBILITY
OF ACTION

Classification: Chronic Contraindicated in CNS: nervousness, - Administer to pregnant

Bronchodilator bronchospasm patients restlessness, headache, patients only when clearly
Xanthine Adult: As hydrate: hypersensitive to insomia, seizures, muscle needed—neonatal
Initially, 225-450 xanthine twitching tachycardia, jitteriness,
Action: mg bid, increased compounds CV: palpitation, sinus and withdrawal apnea
Relaxes bronchial if necessary. (caffeine, tachycardia, observed when mothers
smooth muscle, Child: >3 yr: As theobromine) and extrasystoles, flushing received xanthines up
causing modified-release ethylediamine and marked hypotension until delivery.
bronchodilation and hydrate: 12 mg/kg in those with active arrhythmias - Caution patient not to
increasing vital daily increased to peptic ulcer GI: nausea, vomiting, chew or crush enteric-
capacity, which has 24 mg/kg daily in 2 disease and seizure diarrhea, epigastric pain, coated timed-release
been impaired by divided doses after disorder (unless hematemesis, irritation forms.
bronchospasm and 1 wk. they receive with rectal suppositories - Do not give timed-
air trapping; in higher adequate Metabolic: release forms with food;
concentrations, it anticonvulsant Hyperglycemia these should be given on
also inhibits the therapy). Rectal Respiratory: tachypnea, an empty stomach 1 hr
release of slow- suppositories are respiratory arrest before or 2 hr after meals.
reacting substance of contraindicated in Skin: urticaria - Maintain adequate
anaphylaxis (SRS-A) patients who have Others: fever, hydration.
and histamine. an irritation or hypersensitivity - Monitor for clinical signs
infection of the reactions. of adverse effects
rectum or lower - Take this drug exactly as
colon. prescribed

STREPTOKINASE

CLASSIFICATION INDICATION AND CONTRAINDICA SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE TION ADVERSE EFFECT RESPONSIBILITY
OF ACTION

Classification: Acute myocardial - Active Internal CNS: Intracranial -Monitor vital signs,
Thrombolytic infarction bleeding. hemorrhage, including temperature,
Agents, Adult: 1.5 million -History of headache continuously for coronary
units as a single cerebrovascular CV: thrombosis and at least
Action: dose infused over 1 accident. Reperfusion every 4 hrs during therapy
Convert hr immediately after -Recent CNS arrhythmias, for other indications. Do not
plasmonogen to onset of symptoms. trauma, surgery, hypotension use lower extremities to
plasmin, which is or neoplasm. EENT: periorbital monitor blood pressure.
then able to degrade Pulmonary -Severe edema -Assess patient carefully for
fibrin present in thromboembolism uncontrolled GI: GI bleeding, bleeding. Frank bleeding
clots. Streptokinase and other hypertension. retroperitoneal and internal bleeding may
combines with arteriovenous -Arteriovenous bleeeding occur. If uncontrolled
plasmonogen to occlusions malformation. GU: GU tract bleeding occurs, stop
form activator Adult: Loading -Known bleeding bleeding medication and notify
complexes which dose: 250,000 units tendencies. RESPI: hemoptysis, physician.
then convert infused over 30 min. -Hypersensitivity; bronchospasm -Assess neurological status
plasminogen to form Maintenance: cross-sensitivity SKIN: eccymoses, throughout therapy. Altered
activator complexes 100,000 units/hr for with streptokinase urticaria, flushing sensorium or neurological
which then convert 24-72 hr depending may occur. HEMAT: bleeding changes may be indicative
plasminogen to on the condition to LOCAL: phlebitis at of bleeding intracranial
plasmin. be treated. IV site bleeding.
MS: musculoskeletal -Explain need for bed rest
pain and minimal handling during
MISC: allergic therapy to avoid injury.
reactions including
anaphylaxis, fever

THIAMINE HYDROCHLORIDE
Vitamin B1, Betamin, Beta-Sol

CLASSIFICATION INDICATION AND CONTRAINDICATI SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE ON ADVERSE EFFECT RESPONSIBILITY
OF ACTION

Classifications - RDA Contraindicated in -CNS: restlessness, - Use parenteral route

Nutritional drugs: - Beriberi patients weakness only when P.O. route is
vitamins and - Wet beriberi hypersensitive to -CV: cyanosis, CV not feasible
minerals and myocardial thiamine collapse (with - Don’t confuse thiamine
failure products. repeated I.V. with thorazine
Action: Combines - Wernickes injections) - In wernickes
with adenosine encephalopath -EENT: tightness of encephalopathy, give
triphosphate to from y throat thiamine before dextrose
coenzyme needed Dosage: Adult men: - GI: nausea, - Thiamine malabsorption
for carbohydrate 1.2 mg hemorrhage is most likely in
metabolism. Adult women: - Respiratory: alcoholism, cirrhosis and
1.1mg pulmonary Edema GI disease
Children: .9mg -Skin: feeling of
warmth, pruritus,
urticaria, diaphoresis
-Others: angioedema

IPECAC SYRUP

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION

Classification: To induce Contraindicated in CNS: depression, -Don’t give after

miscellaneous vomiting in semi comatose or drowsiness ingestion of
antagonist and poisoning unconscious patients CV: arrhythmias, petroleum products
antidote and in those with bradycardia, or volatile oils.
Dosage: severe inebriation, hypotension. Atrial -Usually induces
Action: Adults and children seizures, fibrillation vomiting within 20-
Induce vomiting by older than 12 : 15 to anaphylaxis, severe GI: diarrhea 30 mins.
acting locally on the 30 ml hypertentsion, or -Stomach is usually
gastric mucosa and Childrens 1-12: 15ml loss of gag reflex emptied completely
centrally on the P.O - If two doses
chemoreceptors Childrens ages 6 doesn’t induce
trigger zone. months to vomiting prepare for
1 year: 5-10 ml P.O gastric lavage
-cardiotoxicity
occurs in abuse of
ipecac
 LABETALOL HYDROCHLORIDE
CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING
AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION

Antihypertensives - Hypertension - Patients with CNS: dizziness, - Monitor BP

May be related to (100mg ID with or bronchial asthma, syncope frequently
reduced peripheral without diuretic) severe bradycardia CV: orthostatic - Monitor signs of
vascular resistance - - Severe - Use cautiously in hypotension, shock for drug
as a result of alpha hypertension, patients with heart ventricular masks common
and beta blockade hypertension failure, hepatic arrhythmias signs and symptoms
emergencies failure, chronic EENT: nasal of shock
(200mg diluted in bronchitis, congestion - Monitor glucose
160ml of D5W emphysema, GI: nausea, vomiting level closely for
infused at peripheral vascular GU: sexual diabetic patients
2mg/minute) disease dysfunction, urine - Tell patient that
retention stopping drug
Respiratory: abruptly can worsen
bronchospasm chest pain and
Skin: rash trigger an MI
- Warn px that
occasional harmless
scalp tingling may
occur

ISOSORBIDE DINITRATE
Isobar

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION

Anti-Anginal Drugs Long-term Marked anemia; Headache, flushing, 1. Monitor Vital signs
prophylaxis of head trauma; dizziness, 2. Should be taken
angina pectoris; as cerebral palpitations, on an empty
an adjunctive hemorrhage. Shock orthostatic stomach (Take on an
therapy in CHF. & hypotonic hypotension, empty stomach 1/2 hr
collapse. Avoid tachycardia, vertigo, before meals.).
5-30 mg qid. sildenafil, tadalafil, confusion,
vardenafil. weakness.
Precautions:
Not recommended
for childn. Monitor
hemodynamics
before & during
treatment. May
develop tolerance to
other nitrates &
nitrites.

HYDROCORTISONE
Cortin

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION
.inspect patients skin
Corticosteroid Acute adrenocortical Latent, healed & Fluid electrolyte, with petechiae;
Hormones insufficiency, active TB, herpes musculoskeletal, GI, watch for depression
bilateral simplex, chronic dermatologic, or psychotic
Decreases adrenalectomy, nephritis, acute neurological, episodes; diabetic
inflammation, severe shock, acute psychosis, Cushing's endocrine, ophth, patient may need
mainly by stabilizing hypersensitivity syndrome, peptic metabolic increased in insulin,
leukocytes reactions, ulcer & disturbances. monitor blood
lysosomial overwhelming predisposition to glucose; tell patient
membrane, infections w/ severe thrombophlebitis. not to stop drug
suppresses immune toxicity, SLE in abruptly; Elderly
respose relapse, aspiration patient may be more
pneumonitis Adult susceptible to
100-500 mg IV over osteoporosis with
a period of 1 to prolonged use;
several mins. caution patient to
Childn & infant avoid exposure to
Reduce dose but infections
should be >25 mg
daily.
 BRETYLIUM TOSYLATE

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION

Cardiac DrugS: Intravenous Hypersensitivity, Transient initial 1.keep patient

Bretylium tosilate is LIFE-THREATENING pheochromocytoma, hypertension; supine until
a quarternary VENTRICULAR severe aortic nausea, vomiting, tolerance to
ammonium ARRHYTHMIAS stenosis, severe local tissue necrosis hypotension
compound with class Adult: Initially, 5 pulmonary after IM Inj (limit vol develops
II and class III mg/kg as an hypertension. Not to and vary site), 2.Monitor patient
antiarrhythmic undiluted solution be used when there bradycardia and closely.
activities. It causes via rapid IV inj. is digitalis-induced renal impairment, 3. Monitor blood
an early release of Max Dosage: Total arrhythmias. dyspnea, chest pain, pressure, heart rate
norepinephrine at dose: 30-35 mg/kg. Precautions flushing, increase in and rhythm
the adrenergic Parenteral Pregnancy, lactation, premature contibuously.
postganglionic nerve OTHER elderly, child, renal ventricular 4. Observe for
terminals and VENTRICULAR impairment. Keep contractions, nasal increase anginal
subsequently ARRHYTHMIAS patients supine congestion, syncope. pain.
inhibits release of Adult: Dose can be (postural 5. Dosage ajust may
norepinephrine in given via IM or IV hypotension be necessary to
response to nerve admin. IM admin: common). patients with renal
stimulation. Use undiluted Continuous cardiac insufficientcy
bretylium tosilate and BP monitoring.
inj. Initially, 5-10 Rapid IV admin may
mg/kg. cause severe nausea
and vomiting, and
hypertensive crisis;
infuse diluted
solution over at least
8 minutes.

EPINEPHRINE
CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING
AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION
SYSTEMIC ADMIN:
Sympathomimetic injection: Relief from *Contraindicated CNS: Fear, anxiety, - Use minimal doses
Alpha-adrenergic respiratory distress with allergy or tenseness, for minimal periods
agonist of bronchial asthma, hypersensitivity to restlessness, of time;
Beta1- and beta2- epinephrine or "epinephrine-
other COPDs headache, light-
adrenergic agonist components of fastness" (a form of
Cardiac stimulant preparation; narrow- headedness, drug tolerance) can
Vasopressor Treatment and angle glaucoma; dizziness, occur with prolonged
Bronchodilator prophylaxis of shock other than - Protect drug
Antasthmatic cardiac arrest and anaphylactic shock; CV: Arrhythmias, solutions from light,
Nasal decongestant attacks of transitory hypovolemia; hypertension extreme heat, and
Mydriatic AV heart block with general anesthesia resulting in freezing; do not use
Therapeutic actions: with halogenated intracranial pink or brown
syncopal seizures; in
Naturally occurring hydrocarbons or hemorrhage, CV - WARNING: Keep a
acute asthmatic collapse with
neurotransmitter, cyclopropane; rapidly acting alpha-
the effects of which attacks to relieve organic brain hypotension, adrenergic blocker
are mediated by bronchospasm not damage, cerebral palpitations,
(phentolamine) or a
alpha or beta controlled by arteriosclerosis; tachycardia,
receptors in target cardiac dilation and precordial pain in vasodilator (a
inhalation or
organs. Effects on coronary patients with nitrate) readily
subcutaneous
alpha receptors insufficiency; ischemic heart available in case of
injection, Injection:
include tachyarrhythmias; disease excessive
vasoconstriction, ischemic heart GI: N/V, anorexia hypertensive
contraction of dilator disease; reaction.
muscles of iris. hypertension; renal
impairment;

PHENYTOIN SODIUM
Dilantin
CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING
AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION

Anticonvulsants Tonic-clonic & History of GI disturbances; 1.Elderly client tend

complex partial hypersensitivity to ataxia, slurred to metabolize
(psychomotor, phenytoin or other speech; diplopia, phenytoin slowly and
may not need
temporal lobe), hydantoins. nystagmus & mental
reduced dosage
prevention & confusion w/
treatment of Precautions: headache, dizziness, 2. Use clear solution
seizures occurring gingival hyperplasia, for injection
during or following Severe myocardial hirsutism,
neurosurgery.Adult insufficiency, hepatic hyperglycemia, 3. Don’t give Im
Initially 100 mg tid. impairment, osteomalacia. ulless dosage
porphyria. Avoid adjustments are
Maintenance: 300-
made.
400 mg daily. abrupt w/drawal.
Childn ≥6 yr 4. divided doses
Initially 100 mg tid, given with or after
subsequent dosage meals may decrease
should be adjusted adverse GI
according to reactionsDon’t
withdraw drug
therapeutic
suddenly because
response, <6 yr 30 seizures may
mg bid, may be worsen. Monitor
increased to 30 mg blood levels of blood
tid or qid. Pedia 5
mg/kg/day Initially in
2-3 equally divided
doses. Max: 300 mg
daily. Maintenance:
4-8 mg/kg/day.

MAGNESIUM SULFATE

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION

Pregnancy risk Convulsions Parenteral of drug Muscle weakness, 1.if used to treat
category A (treatment) - contraindicated in lack of energy, low seizure, take
Intravenous patients with heart blood pressure, n/v, appropriate seizure
Central Nervous block or nyocardial
magnesium sulfate stuffy nose, chest precaution
damage. Don’t give
system drugs is indicated for pain, pulmonary
in toxemia of
immediate control of pregnancy during 2 edema, blurry vision, 2. check blood
life-threatening hour proceeding blurred speech, magnesium level
convulsions in the delivery flushing after repeated dose.
May decrease treatment of severe
acetylcholine toxemias (pre- 3. monitor fluid
released by nerve intake and output.
eclampsia and
impulse, but its
anticonvulsant eclampsia) of
mechanism is pregnancy and in 4. Review pptential
unknown the treatment of adverse effects
acute nephritis in
children.Hypomagn
esemia
(prophylaxis and
treatment) -
Magnesium sulfate is
indicated for
replacement therapy
in magnesium
deficiency,Tetany,
uterine
(treatment) - as a
myometrial relaxant.

IM: 1-5 g; IV: 1 to 4

g magnesium sulfate
may be given
intravenously in 10%
- t20% solution

DEXTROSE
CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING
AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION

Nutritional drugs : -fluid replacement Contraindicated in CNS: confusion, *Use cautiously in

caloric and caloric patients in diabetic unconscious patients with cardiac
supplementation in coma while glucose CV: phlebitis, venous or pulmonary
A simple water patients who cant level remains sclerosis, tissue disease,
soluble sugar that maintain adequate excessively high. necrosis, hypertension, renal
minimizes the oral intake or who is Use of concentrated GU: glycosuria, insufficiency, urinary
restricted of doing solutions osmotic diuresis obstruction or
glyconeogenesis and
so contraindicated in Metabolic: hypovolemia.
promotes anabolism Dosage patients with Hyperglycemia, *Never stop
in patients whose intracranial or dehydration, hypertonic solution
oral caloric intake is Dosage depends on intraspinal hypervolemia abruptly
limited fluid caloric hemorrhage; in Respiratory: *Don’t give
dehydrated patients pulmonary edema concentrated
requirement
with delirium Others: fever solution subcutaneos
tremens; and in or IM
I.V infusion of 2.5%, patients with severe *Check vital signs
5% or 10% used to dehydration, anuria, frequently
treat hypoglycemi diabetic coma, or *Monitor glucose
glucose-galactose level
malabsorption *Monitor fluid intake
syndrome. Also and output and
contraindicated in weigh patient
patients with known carefully
allergy to corn or *Watch for signs and
corn products. symptoms of fluid
overload.
*Monitor signs for
confusion

CALCIUM CHLORIDE
CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING
AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION

PHARMACOLOGIC HYPOCALCEMIC *Contraindicated to CNS: tingling *tell patient to take

AL CLASS: mineral, EMERGENCY. cancer patients with sensation oral calcium 1-1.5
cardiotonic Adults: 7 mEq to 14 bone metastases CV: bradycardia, hours after meals if
THERAPEUTIC meq calcium I.V. and in those with milddrop in blood GI upset occurs.
CLASS: May given as 10% ventricular pressure *tell patient to take
calcium supplement calcium gluconate fibrillation, GI: constipation oral calcium with full
solution hypocalcaemia or GU:polyuria, renal glass of water.
MOA: HYPOCALCEMIC renal calculi. calculi *tell patient to report
* Replaces calcium TETANY. anorexia, N/V,
and maintain Adults; 4.5 mEq to 7 abdominal pain.
calcium level. mEq calcium I.V. *inform patient that
Children: .5 to .7 some products may
mEq/kg calcium I.V containi
TID to QID until phenyalanine or
tetany is controlled tatazine
*watch any signs ot
hypercalcemia such
us stupor,
confusioin,delirium

NITROGLYCERIN

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION
PHARMACOLOGIC PREVENTION OF *Contraindicated in CNS: headache, *Assess pt’s
CLASS: nitrate CHRONIC ANGINAL patients sometimes with condition before
THERAPEUTIC ATTACKS. hypersensitive to throbbing, dizziness, therapy and
CLASS: antianginal, nitrates and in those weakness regularly thereafter.
vasodilator ACUTE ANGINA with early MI, severe CV: orthostatic *Monitor v/s and
PECTORIS; TO anemia, increased hypotension, drug response. Be
MOA: PREVENT OR IOP, angle-closure tachycardia, particularly aware of
*reduces cardiac MINIMIZE ANGINAL glaucoma, flushing, BP. Excessive
oxygen demand by ATTACKS WHEN orthostatic palpitations, fainting hypotension may
decreasing left TAKEN IMMEDIATELY hypotension, and EENT: sublingual worsen MI..
ventricular end BEFORE STRESSFUL allergy to adhesives. burning *Tell pt to swallow
diastolic pressure EVENTS. IV nitroglycerin is GI: nausea, vomiting oral tablets whole
(preload) and, to a contraindicated in SKIN: cutaneous and not to chew
lesser extent, HPN R/T SURGERY, patients with cardiac vasodilation, contact them.
systemic vascular HEART FAILURE tamponade, dermatitis, rash *Tell pt that stopping
resistance LINKED TO MI; restrictive OTHER: drug abruptly causes
(afterload). Also ANGINA PECTORIS IN cardiomyopathy, hypersensitivity coronary vasospasm.
increases blood flow ACUTE SITUATIONS; constrictive reactions *Advise pt to avoid
through collateral TO PRODUCE pericarditis, or alcohol during drug
coronary vessels. CONTROLLED hypersensitivity to IV therapy.
*prevents or relieves HYPOTENSION form. *Tell pt to change to
acute angina, lowers DURING *Use cautiously in upright position
BP, and helps SURGERYHYPERTEN patients with slowly. Advise him to
minimize heart SIVE CRISIS. hypotension or go up and down
failure caused by MI. volume depletion. stairs carefully and
to lie down at first
sign of dizziness.

DEXAMETHASONE
CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING
AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION
--Corticosteroids -Shock: 4 to 8 mg -diabetes  Osteoporosis -Dexamethasone
intravenously -Cushing’s syndrome under long term may be given to
It is commonly used initially, repeat if -kidney dse treatment, women at risk of
to treat necessary to a total -liver dse pathologic fractures delivering
inflammation of the dose of 24 mg. -osteoporosis (e.g., hip) prematurely in order
skin, joints, lungs, -Autoimmune  Muscle atrophy, to promote
and other organs. diseases and negative protein maturation of the
Common conditions inflammations: balance (catabolism) fetus' lungs. This has
treated include longterm therapy  Elevated liver been associated with
asthma, allergies, with 0.5 to 1.5 mg enzymes, fatty liver low birth weight,
and arthritis. It is oral per day. Avoid degeneration although not with
also used for other more than 1.5 mg (usually reversible) increased rates of
conditions, like daily, because  Cushingoid neonatal death.
blood disorders and serious side effects (syndrome
diseases of the are more frequently resembling
adrenal glands encountered with hyperactive adrenal
higher doses. cortex with increase
-Adjuvant to or part in adiposity,
of chemotherapy: hypertension, bone
individual schedule demineralization,
-Diagnostic etc.)
purposes: special  Depression of the
schedule adrenal gland is
usually seen, if more
than 1.5 mg daily
are given for more
than three weeks to
a month.
 Hypertension,
fluid and sodium
retention, edema

VERAPAMIL
Isoptin, VErelan

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION
--calcium channel -hypertension -Severe left -headaches
blocker ventricular - facial flushing
-10-15 mg slow dysfunction (see -dizziness
It affects the amount IVP9over 2 min), -swelling,increased
WARNINGS)
of calcium found in repeat in 30 min urination,
your heart and -Hypotension -fatigue,nausea,
muscle cells. This (systolic pressure ecchymosis,
relaxes your blood less than 90 mm Hg) -lightheadedness,an
vessels, which can or cardiogenic shock d constipation.
reduce the amount Sick sinus syndrome
of work the heart (except in patients
has to do. This
with a functioning
medicine is used to
lower high BP artificial ventricular
pacemaker)
-Second- or third-
degree AV block
(except in patients
with a functioning
artificial ventricular
pacemaker)
 Patients with
atrial flutter or atrial
fibrillation and an
accessory bypass
tract

RETEPLASE

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION

-Acute -Active internal -BLEEDING

myocardial bleeding-History of -pericarditis
-Thrombolytic
infarction cerebrovascular -sinus bradycardia
drug
-congestive accident -dyspnea
heart failure -Recent intracranial -hypotension
-used to treat or intraspinal
heart attacks by -10 units IV bolus -Intracranial
breaking up the over 2 min; after 10 neoplasm,
clots that cause min,administer 2nd arteriovenous
them. 10 units Iv bolus -Known bleeding
over 2 min diathesis
-Severe uncontrolled
Reteplase is a
hypertension
recombinant
non-
glycosylated
form of human
tissue
plasminogen
activator, which
has been
modified to
contain 357 of
the 527 amino
acids of the
original protein.
It is produced in
the bacterium
Escherichia coli.

ADENOSINE
Adenocard, Adenoscan

CLASSIFICATION AND INDICATION CONTRAINDICAT SIDE EFFECT/ NURSING

MECHANISM OF ACTION AND DOSAGE ION ADVERSE RESPONSIBILIT
EFFECT Y
Anti-arrthythmic Symptomatic -2nd or 3rd -headache, -Monitor heart
supraventricul degree burn light rhythm for
Converts paroxysmal ar tachycardia - headedness, arrhythmias
supraventricular tachycardia to hypersensitivity dizziness -Asses for
normal sinus rhythm resulting 6 mg rapid to drug -chest chest
by slowing conduction through IVP, then 12 -sinus node pain,palpitatio pain,dyspnea &
atrioventricular (AV)node & mg IV q1-2 disease ns, sweating
interrupting reentry pathway minx2 - Hypotension -Monitor vital
bronchoconstric -nausea, signs
tive lung pressure in
disease groin
-
hyperventilatio
n, metallic
taste

ACTIVASE
CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING
AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
 OF ACTION
.
Thrombolytic Fibrinolytic; - -fever, cerebral -Drug may be
Agents treatment of Contraindicated hemorrhage given to
acute developing in patients with -arrhythmias, menstruating
Binds to fbrin in a myocardial active internal hypotension, women.
thrombus and infarction bleeding, edema -Monitor vital signs
locally converts intracranial - GI bleeding, and neurologic
plasminogen to 15 mg IV bolus neoplasm, nausea and status carefully.
plasmin, which followed by arteriovenous vomiting Keep patient on
starts local infusion 0.75 malformation, -GU tract bleeding strict bed rest.
firinolysis. mg/kg over next aneurysm, sever - bleeding at -If uncontrollable
20 mins. ,followed uncontrolled puncture sites, bleeding occurs,
by infusion 0.5 hypertension, or cholesterol stop infusion (and
mg/kg over next history or embolization, heparin) and
60 minutes. current evidence hypersensitivity notify prescriber.
of intracranial reactions, -Anticoagulant and
hemorrhage, anaphylaxis anti platelet
suspicion of therapy is
subarachnoid commonly started
hemorrhage, or during or after
seizure at onset treatment, to
of CVA when decrease risk of
used for acute another
ischemic CVA. thrombosis.

AMIODARONE
Cordarone, Pacerone

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION
Anti-arrhythmic Persistent or -cardiogenic shock -nausea, -Monitor patient
recurrent VF or -2nd/3rd degree constipation, closely
Prolongs duration pulseless VT burn vomiting,abdo -Monitor ECG
& refractory -marked sinus pain continuously
period of action Rapid infusion bradycardia -cough, -Assess for s/sx of
potential. Slows 150-300 mg IV - hypotension lung inflammation
electrical over 10 min; breastfeeding/neo -photophobia, eye -Monitor patient’s
conduction, follow with nates discomfort,tremor, BP, pulse, heart
electrical impulse 1mg/min infusion halos rhythm.
generation from -decreased libido
sinoatrial node, -hypothyroidism
conduction -
through accessory thrombocytopenia
pathways.

BUSCOPAN
Hyoscine butylbromide

CLASSIFICATION INDICATION CONTRAINDICATION SIDE EFFECT/ NURSING

AND MECHANISM AND ADVERSE RESPONSIBILITY
OF ACTION DOSAGE EFFECT

Anticholinergic -Spastic -Contraindicated to pt. with - -raised side rails

states glaucoma,obstructive disorientation, as
Inhibits muscarinic -Delirium neuropathy and GI tract, restlessness, precautions
actions of and asthma, CPD, unstable CV headache, -advised patient
acetylcholine on preanestheti status hyperthyroidism, confusion, that eyes may
automatic effectors c sedation CAD, heart failure, hiatal impaired be more
innervated by -To prevent hernia with reflux memory sensitive to light
postganglionic nausea and esophagitis, hepatic failure - urge patient to
- palpitations,
cholinergic neurons vomiting -Use cautiously in children report urine
tachycardia,
Onset: 1 hour from motion younger than 6 year old retention
flushing
Peak: 1-3 hours sickness -reorient patient
Duration: 4-6 hours - blurred as needed
0.4 to 0.8 vision, -warn patient to
mg P.O. photophobia, avoid activities
increased IOP, that require
difficulty alertness
swallowing
 - constipation,
dry mouth
epigastric
distress
- urine
retention
- depressed
respirations
- rash,
dryness

ATROPINE
Atropen

CLASSIFICATION INDICATION AND CONTRAINDICATION SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE ADVERSE EFFECT RESPONSIBILI
OF ACTION TY

Cholinergic Antidote to Glaucoma, unstable Dryness of the *Document

Blocking drug overdosage w/ cardiac rhythm, mouth associated indications for
cholinergic prostatic w/ difficulty in therapy,
Action: substances eg, hypertrophy, reflux swallowing, onset and
Blocks organophosphate esophagitis, severe pupillary dilatation characteristic
acetylcholine insecticides & nerve coronary artery w/ loss of s of S & S
effects on gases, & poisonous disease, paralytic accommodation
postganglionic mushroom. Pre-op ileus, obstructive GI producing blurring *Check for
cholinergic medication to disorders. of vision, flushed any history of
receptors in reduce salivary & skin, tachycardia, glaucoma
smooth muscle, resp tract Precautions urinary retention, before
cardiac muscles, secretions. Severe constipation, ophthalmic
exocrine glands, bradycardia. Infants, small agitation & administration
urinary bladder, childn, elderly & restlesness,
and AV and Sa debilitated patients. hyperthermia *Obtain VS
nodes in the heart Adult 0.4-0.6 mg and ECG,
every 4-6 hr. monitor CV
status during
IV therapy

DOBUTAMINE
Dobutrex

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION
Inotropic Short term -idiopathic - -Monitor ECG &
management of hypertropic headache,nausea, blood pressure
Stimulates beta cardiac subaortic stenosis vomiting continuously
adrenergic decompensation -hypersensitivity - -Monitor fluid
receptors of resulting from to drug hypotension,angin intake & output
heart,causing a depressed a -Assess electrolyte
positive inotropic contractility - levels
effect that dyspnea,tachycar -Monitor signs of
increase Continuous IV dia hypovolemic
myocardial infusion; usual shock
contractility & dose is 2-20
stroke volume mcg/kg/min IV,
based on patient
on patient
response
 SODIUM BICARBONATE
Neut, Soda Mint

CLASSIFICATION INDICATION CONTRAINDICATION SIDE NURSING

AND MECHANISM OF AND EFFECT/ RESPONSIBILITY
ACTION DOSAGE ADVERSE
EFFECT

Acidifiers and -Metabolic -Contraindicated in -tetany -Obtain blood pH, partial

alkalinizers acidosis patient with metabolic - edema pressure of arterial
-Systemic or respiratory alkalosis - gastric oxygen and arterial
Restores the or urinary and hypocalcemia distention, carbon dioxide and
buffering capacity of alkalinizatio flatulence electrolyte level
the body and n -Contraindicated in - -Tell pt. not to take drug
neutralizes excess -Antacid patient with renal metabolic with milk by doing so
acid. Cardiac insufficiency, heart alkalosis may cause rise in
Onset: unknown arrest failure - irritation calcium in the blood
Peak: unknown at
Duration: unknown injection
site

SOPROTERENOL HCL
Isuprel

CLASSIFICATION INDICATION CONTRAINDICATION SIDE EFFECT/ NURSING

AND MECHANISM AND DOSAGE ADVERSE EFFECT RESPONSIBILITY
OF ACTION

Bronchodilators - -Used cautiously to -headache, mild -Tell pt. that drug

Bronchospas patient with tremor, isn’t a substitute
Relaxes bronchial m during tachycardia or AV weakness, for fluid and blood
smooth muscle by anesthesia block, angina pectoris, dizziness, volume deficit
stimulating beta2 -Heart block, glaucoma anxiety, -Don’t use solution
receptors. ventricular -Contraindicated when insomnia if discolored
arrhythmias used with general - palpitations, -Discontinue if
Onset: immediate -Shock anesthesia tachycardia, heart rate > 110
Peak: unknown -Post-op -Used cautiously with arrhythmias, bpm and notify
Duration: < 60 patient with elderly patients cardiac arrest physician
minutes bradycardia - nausea and -Monitor pt. for
vomiting adverse reaction
IV 0.02-0.06, -hyperglycemia -Tell patient to
then 0.01- - diaphoresis report chest pain,
0.2mcg/min or fluttering of the
chest

DOPAMINE
Intropin,Revimine

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION
Inotropic Hemodynamically - -headache, -Monitor blood
significant pheochromocytom palpitations pressure, pulse
Causes hypotension in the a -hypotension, -Monitor urinary
norepinephrine absence of - vomiting output
release, leading to hypovolemia tachyarrhythmias, -dyspnea, -Monitor color &
vasodilation of ventricular piloerection temperature
renal & Continuous IV fibrillation -mydriasis -Never stop
mesenteric infusion:dose -hypersensitivity -tachycardia infusion abruptly,
arteries,increases range:5-20 because this may
heart rate,blood mcg/kg/min;begin cause severe
flow, myocardial infusion at hypotension
contractility & mcg/kg/min;increa
stroke volume se infusion rate
according to BP &
other clinical
responses

TERBUTALINE SULFATE
Brethair, Brethine

CLASSIFICATION INDICATION AND CONTRAINDICATION SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE ADVERSE RESPONSIBILITY
OF ACTION EFFECT

Bronchodilators Bronchospasm in -Contraindicated to -nervousness, -protect med from

patients with patient hypersensitive tremor, light
Relaxes bronchial reversible to the drug dizziness, - terbutaline may
smooth muscle by obstructive headache reduce the
stimulating beta2 airway disease -Used cautiously in - palpitations, sensitivity of
receptors. 2.5-5 mg P.O. tid patient with CV tachycardia, spirometry for the
disorder, arrhythmias, Dx of bronchospasm
Onset: 30 min hyperthyroidism, flushing - make the pt.
Peak: 2-3 hours diabetes, seizure - vomiting, understand the
Duration: 4-8 disorder nausea, effects of the drug
hours heartburn - remind pt. to
-hypokalemia separate oral
-dyspnea dosages accordingly
- diaphoresis

DIAZEPAM
Valium, Vivol

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION
Anti-convulsant Seizures -Coma or CNS -dizziness, -Assist patient in
depression drowsiness, ambulation
Produces 5-10 mg IV q 10- -Narrow-angle tremor -Monitor CBC &
anxiolytic effect & 15 min prn, max glaucoma -bradycardia, kidney & liver
CNS depression by 20 mg. Administer nausea, function test
stimulating slow IVP Vomiting, diarrhea results
gamma -pruritus, -Tell patient to
aminobutyric acid diaphoresis avoid sudden drug
receptors. Relaxes -muscle rigidity, withdrawal
skeletal muscles rash
of spine by -diplopia,
inhibiting dysarthria,
polysynaptic restlessness
afferent pathways. -dystonia,
increased
salivation
-hypotension,
stupor

PROCAINAMIDE
Pronestyl, Procanbid

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION
Anti arrhythmic Recurrent -complete heart -headache, -Monitor
VF,VT,PVC’s block dizziness, electrolyte levels,
Decreases -torsades de confusion,psychos CBC, &antinuclear
myocardial 20-30 pointes is antibody titers
excitability by mg/min,max=17 -lupus - -Evaluate patient
inhibiting mg/kg or 500 mg erythematosus hypotension,brady for s/sx of
conduction -hypersensitivity cardia lupuslike
velocity,depresses to drug -nausea, vomiting, syndrome
myocardial diarrhea -Monitor vital signs
contractility -rash, urticaria,
pruritus
-bitter taste,
lupuslike
syndrome,edema
-asthenia,seizures

MORPHINE SULFATE
Roxanol, Statex

CLASSIFICATION INDICATION CONTRAINDICATION SIDE NURSING

AND MECHANISM AND EFFECT/ RESPONSIBILITY
OF ACTION DOSAGE ADVERSE
EFFECT

Opioid analgesic SEVERE -hypersensitivity to morphine -dizziness 1. *Patients

PAIN. or in any situation where euphoria, should be
MOA: opioids are contraindicated. light advised
* Unknown: binds Adults: 5 to This includes patients with headednes that
with opiate 20 mg SQ or respiratory depression (in the s, Morphine
receptors in the IM or 2.5 to absence of resuscitative nightmare Sulfate
CNS, altering 15 mg IV q 4 equipment or in unmonitored - extended-
perception of and hours PRN settings), and in patients with bradycardi release
emotional or 5-30 mg acute or severe bronchial a, cardiac tablets
response to pain PO. asthma or hypercarbia. arrest, contain
shock morphine
- nausea, and should
vomiting, be taken
anorexia only as
- urine directed.
retention *Patients should be
advised that
Morphine Sulfate
extended-release
tablets were
designed to work
properly only if
swallowed whole.

NITROUS OXIDE

CLASSIFICATI INDICATION AND DOSAGE CONTRAINDICA SIDE EFFECT/ NURSING

ON AND TION ADVERSE EFFECT RESPONSIBILI
MECHANISM TY
OF ACTION
Dissociative A lungful of nitrous oxide -Blood clotting Mild audio visual -Monitor vital
Anesthesia, results in temporary loss problems. hallucinations , loss signs.
weak of motor control and -Heart and of H20 control, long -Don’t use
anesthesia dissociative blood vessel lasting numbness wool blanket
psychological effect problems. of the extremities in area.
when sensation and -Alcohol and and other -Assess
perception becomes other sedative neurological patient’s
disconnected. Weak stimulants. problems, partial condition.
anesthetic gas depressants of CV, -Watch for
permeates the nausea and any adverse
membranes of the body. analgesia. effects.
-Help patient
establish
psychological
balance.

LIDOCAINE HYDROCHLORIDE
Xylocaine

CLASSIFICATION AND INDICATION CONTRAINDICATION SIDE EFFECT/ NURSING

MECHANISM OF AND DOSAGE ADVERSE RESPONSIBILIT
ACTION EFFECT Y

. Antiarrhythmics - For -Patient with Adams- - confusion, - Give IM

ventricular Strokes syndrome, anxiety, injections in
- A class IB arrhythmias Wolff-Parkinson-White hallucinations the deltoid
antiarrhythmics that caused by MI, syndrome, severe , somnolence, muscle
decreases the cardiac degrees of SA, AV or paresthesia, - Monitor
depolarization, manipulation, intraventricular block in seizure isoenzymes
automaticity and or cardiac the absence of an -hypotension, when using IM
excitability in the glycosides artificial pacemaker bradycardia, drug for
ventricles during the - Infusion - second-degree heart cardiac arrest suspected MI
diastolic phase by (premixed) block or sinus -tinnitus, - Monitor drug
direction action on the 0.2% bradycardia, blurred or level –
tissue (2mg/ml), -heart failure or renal or double vision therapeutic
0.4%(4mg/ml hepatic disease and - vomiting levels are 2.5
), weighing less than 50kg Respiratory: meq/ml
0.8%(8mg.ml respiratory - Monitor
) depression patient
- Injection for and arrest response esp.
direct IV use - soreness at ECG, BP and
1% injection site electrolytes
(10mg/ml), - Ensure safety
2% of the patient
(20mg/ml)
- Injection for
IM use:
300mg/3ml

ALBUTEROL SULFATE
Ventolin

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION

Bronchodilators - To prevent or Use cautiously in -tremor,dizziness, - Warn px about

treat px with CV headache, risk of paradoxical
- Relaxes bronchospasm in disorders - tachycardia, bronchospasm and
bronchial, uterine patients with (hypertension), palpitations, to stop drug
and vascular reversible hyperthyroidism, hypertension immediately if
smooth muscle by obstructive airway DM - dry and irritated occurs
stimulating beta2 disease (200 mcg nose nasal - Tell px to
receptors. inhaled q 4-6 hrs) congestion perform oral
- To prevent - heartburn, inhalation
exercise-induced nausea, vomiting, correctly
bronchospasm increased appetite - Tell px to remove
(200 mcg for Musculoskeletal: canister and wash
inhalation 15 muscle cramps inhaler with warm,
minutes before - cough, soapy water at
exercise) wheezing, least once a week
dyspnea,
 CAPTOPRIL
Captopren

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE EFFECT RESPONSIBILITY
OF ACTION

Classification: HYPERTENSION - Bilateral renal -Hypotension, -monitor partients

Angiotensin- Adult: Initially, 12.5 artery stenosis, tachycardia blood pressure and
converting enzyme mg bid or 6.25 mg hereditary -chest pain, pulse rate
(ACE) inhibitor bid in combination angioedema; renal palpitations
Antihypertensive with a diuretic, at impairment; -pruritus, - Advise patient to
bedtime to avoid pregnancy. hyperkalaemia. report signs and
Action: Blocks ACE precipitous fall in BP Proteinuria symptoms
from converting Maintenance: 25-50 -angioedema, skin
angiotensin I to mg bid. Max: 50 mg rashes; taste - Administer 1 hr
angiotensin II, a tid. disturbance before or 2 hr after
powerful Elderly: Initially, - nonproductive meals.
vasoconstrictor, 6.25 mg bid. cough, headache.
leading to decreased - Reduce dosage in
blood pressure, HEART FAILURE patients with
decreased Adult: Initially, impaired renal
aldosterone 6.25-12.5 mg bid-tid. function.
secretion, a small Maintenance: 25 mg
increase in serum bid-tid. Max: 50 mg
potassium levels, tid.
and sodium and fluid
loss; increased
prostaglandin
synthesis also may
be involved in the
antihypertensive
action.

RANITIDINE HYDROCHLORIDE
CLASSIFICATION INDICATION AND CONTRAINDICATION SIDE NURSING
AND MECHANISM DOSAGE EFFECT/ RESPONSIBILITY
OF ACTION ADVERSE
EFFECT

Antiulcer -Duodenal and -Contraindicated in - vertigo, -Assess patient

gastric ulcer (short- patients malaise, for abdominal
Competitively term treatment); hypersensitive to headache pain. Note
inhibits action of pathologic rug and those with - blurred presence of blood
histamine on the hypersecretory acute porphyria. vision in emesis, stool,
H2 at receptor sites conditions, such as -Use cautiously in flushing or gastric
of parietal cells, Zollinger-Ellison patients with - jaundice aspirate.
decreasing gastric syndrome. hepatic - burning -Ranitidine may
acid secretion. -Maintenance dysfunction. Adjust and itching be added to total
therapy for dosage in patients at injection parenteral
duodenal or gastric with impaired renal site, nutrition solutions
ulcers. failure. anaphylaxis,
-Gastroesophageal angioedema
reflux disease.
-Erosive esophagitis
-Heartburn

SUCCINYLCHOLINE CHLORIDE
Scoline, Sucostrine

CLASSIFICATIO INDICATION AND CONTRAINDICATION SIDE EFFECT/ NURSING

N AND DOSAGE ADVERSE RESPONSIBILIT
MECHANISM OF EFFECT Y
ACTION
 Adjunct to anesthesia
PHARMACOLOG to relax skeletal Contraindicated in - bradycardia, -Monitor
IC CLASS: muscles during short patients tachycardia, baseline
depolarizing surgical hypersensitive to HPN, electrolyte
neuromuscular procedures;endotrache drug and patients hypotension, determinations
blocker al intubation with with abnormally low arrhythmias, and v/s (check
THERAPEUTIC mechanical ventilation; pseudocholinesterase flushing, cardiac RR q 5 to
CLASS: skeletal electrically induced level, angle-closure arrest 10mins during
muscle relaxant convulsive therapy glaucoma, malignant - increased IOP infusion)
hyperthermia, or -prolonged *Monitor RR
MOA: Dosage depends on penetrating eye respiratory and pulse
*prolongs anesthetic used, injury. depression, oximetery.
depolarization individual needs and apnea, -Keep airway
of muscle end response. bronchoconstrict clear. Have
plate ion “e” respiratory
*relaxes - malignant support
skeletal muscle hyperthermia, equipment
excessive immediately
salivation, available.
allergic to -Inform patient
idiosyncratic that
hypersensitivity postoperative
reactions stiffness is
normal and
will soon
subside.

CALCIUM CHLORIDE

CLASSIFICATION INDICATION AND CONTRAINDICATION SIDE EFFECT/ NURSING

AND DOSAGE ADVERSE RESPONSIBILITY
MECHANISM OF EFFECT
ACTION

Calcium HYPOCALCEMIC -Contraindicated to - tingling -tell patient to take

supplement EMERGENCY. cancer patients with sensation oral calcium 1-1.5
Adults: 7 mEq to 14 bone metastases - hours after meals if
meq calcium I.V. -ventricular bradycardia, GI upset occurs.
* Replaces May given as 10% fibrillation milddrop in -tell patient to take
calcium and calcium gluconate -hypocalcaemia or blood oral calcium with full
maintain solution renal calculi. pressure glass of water.
calcium level. HYPOCALCEMIC - -tell patient to report
TETANY. constipation anorexia, N/V,
Adults; 4.5 mEq to 7 -polyuria, abdominal pain.
mEq calcium I.V. renal calculi -inform patient that
Children: .5 to .7 some products may
mEq/kg calcium I.V containi phenyalanine
TID to QID until or tatazine
tetany is controlled -watch any signs ot
hypercalcemia such
us stupor,
confusioin,delirium

DIGOXIN
Lanoxicaps, Lanoxin

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE NURSING RESPONSIBILITY

AND MECHANISM DOSAGE N EFFECT/
OF ACTION ADVERSE
EFFECT
Antidotes, Reversal of CNS -Hypersensitivity Nausea & -the duration of the
Detoxifying depression and to drugs. vomiting, narcotic may exceed
Agents & Drugs respiratory Use cautiously: hypotensio naloxone(the antagonist).
Used in depression -Cardiovascular n Therefore, more than one
Substance because of dse; patient -HTN dose may be necessary to
Dependence suspected opioid dependent on - cardiac counteract the effects of
overdosage opioids; pregnancy arrhythmi the narcotic.
IV (adults): 0.02- as -monitor VS @ 5 min
0.2mg q 2-3 min - intervals, then every 30
until response pulmonary mins once stabilized.
obtained; repeat edema -titrate to avoid interfering
q 1-2 hr if - Seizures. with pain control or
needed. readminister narcotic at a
IV (children): 5- lower dosage to maintain
10mcg; may pain control.
repeat q 2-3 min
until response
obtained.

NOREPINEPHRINE
Levofin amp

CLASSIFICATION INDICATION AND CONTRAINDICATIO SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE N ADVERSE RESPONSIBILI
OF ACTION EFFECT TY
ACUTE HYPOTENSIVE Monitor IV
Vasoconstrictors STATES Hypertension. Hypertension, flow rate
Adult: IV infusion of 4 Pregnancy. headache, diligently
mcg/ml in glucose 5%, Patients with peripheral
Norepinephrine is a
or sodium chloride 0.9% peripheral or ischaemia, Assess EKG,
direct-acting
and glucose 5% at a mesenteric bradycardia, BP
sympathomimetic
rate of 2-3 ml/min (8-12 vascular arrhythmias, continuously(
which stimulates β1-
mcg/min). Adjust thrombosis unless anxiety, skin be alert to
and α-adrenergic
according to BP necessary as a necrosis (with precipitous
receptors. Its α-
response. Average life-saving extravasation), BP drop
agonist effects
maintenance dose: 0.5- procedure. dyspnoea,
cause
1 ml/min (2-4 mcg/min). respiratory Never leave
vasoconstriction,
Alternatively, 40 difficulty. patient alone
thereby raising
mcg/ml at an initial rate during IV in
systolic and
of 0.16-0.33 ml/min via fusion
diastolic BP with
a central venous
reflex slowing of
catheter, using a Be alert to
heart rate.
syringe pump or drip patient
Onset: Rapid.
counter. complaint of
Duration: Short;
Child: Administer at a headache
stops within 1-2 min
rate of 2 mcg/min.
after discontinuing
Alternatively, 2
the infusion.
mcg/m2/min. Adjust rate
according to BP
response.
Elderly: Initial dose
should be at low end of
dose range.

BAXTER HUMAN TETANUS IMMUNOGLOBULIN

Tetanus Ig G

CLASSIFICATION INDICATION AND DOSAGE CONTRAINDICATION SIDE EFFECT/ NURSING

AND MECHANISM ADVERSE RESPONSIBILITY
OF ACTION EFFECT

Vaccines, prophylaxis in persons Must not be given IV - -observe history of

Antisera & w/ recent injuries eg as patient could Chills,heada allergies and
Immunologicals trauma & burns that develop shock. che, fever, reactions to
might be Should not be given -nausea, immunization.
contaminated w/ in severe vomiting, -give drug soon
Clostridium tetani; thrombocytopenia & allergic after
those who did not in hemostasis. reactions, reconstitution.
receive tetanus dizziness -don’t give immune
vaccination in the last -hypotension globulin for
10 yr or in whom the -arthralgia & prophylaxis against
immune response is moderate hepatitis A after 6
insufficient & when the low back weeks or more
 status of immunization pain. have elapsed since
is unknown or when exposure or onset
active immunization is of clinical illness.
contraindicated.

MANNITOL
Osmitrol

CLASSIFICATION INDICATION AND CONTRAINDICATION SIDE EFFECT/ NURSING

AND MECHANISM DOSAGE ADVERSE EFFECT RESPONSIBILITY
OF ACTION

Classification: Oliguric phase of *Contraindicated in CV: seizures, *Monitor vital signs,

Diuretics renal failure patients dizziness, including central
Adult: 50-100 g in a hypersensitive to headache, fever venous pressure and
24-hr period by IV
Action: Increases drug. - edema, fluid intake and
infusion of a 5-25%
osmotic pressure solution. Adjust rate of *Contraindicated in thrombophlebitis, output hourly.
of glomerular administration to patients with anuria, hypotension,
filtrate, ihibiting maintain a urine flow severe pulmonary hypertension, *Report increasing
tubular of at least 30-50 congestion, frank heart failure, oliguria. Check
reabsorption of mL/hr. pulmonary edema, tachycardia, weight, renal
water and Child: 0.25-2 g/kg. severe heart failure, angina-like chest function, fluid
electrolytes; drug severe dehydration, pain, vascular balance, and serum
Cerebral edema
elevates plasma metabolic edema, overload. and urine sodium
Adult: 0.25-2 g/kg by
osmolarity, IV infusion of a 15- progressive renal -EENT: blurred and potassium
increasing water 25% solution given disease or vision, rhinitis levels daily.
flow into over 30-60 minutes. dysfunction, or active -GI: thirst, dry,
extracellular fluid. intracranial bleeding mouth, nausea, *Don’t give
(except during vomiting, diarrhea electrolyte-free
craniotomy). mannitol solutions
with blood

PROPRANOLOL HYDROCHLORIDE
Propanolol, Inderal

CLASSIFICATION AND INDICATION AND CONTRAINDICATI SIDE EFFECT/ NURSING

MECHANISM OF DOSAGE ON ADVERSE RESPONSIBILIT
ACTION EFFECT Y

Antianginals - Angina pectoris - Patients with CNS: fatigue, - Always check

A nonselective beta ( total daily doses of bronchial lethargy px. Apical pulse
blocker that reduces 80-320mg PO when asthma, CV: before giving
cardiac oxygen given BID, TID or QID) sinus bradycardia, drug
demand by blocking - To decrease risk of bradycardia heart failure, - Give drug
catecholamine- death after MI (180- - Use intensificatio consistently
induced increases in 240mg PO OD) cautiously in n of AV block with meals.
HR, BP, force of - Supraventricular, px with GI: - Caution px to
myocardial ventricular, and atrial hepatic or abdominal continue taking
contraction. Depresses arrhythmias, renal cramping, this drug as
renin secretion and tachyarrhythmias impairment, constipation, prescribed even
prevents vasodilation caused by excessive hepatic diarrhea, he feels better
of cerebral arteries. catecholamine during disease. nausea, - Tell patient
anesthesia, vomiting not to stop drug
hyperthyroidism pr Hematologic: suddenly this
pheochromocytoma agranulocyto can worsen
(1-3mg by slow IV sis chest pain and
push) Respiratory: trigger a heart
- Hypertension (80 mg bronchospas attack
PO daily) m
- To prevent frequent Skin: rash
severe, uncontrollable
or disabling migraine
or vascular headache
(80mg PO daily)
- Essential tremor
(40mg PO BID)
- Hypertrophic
subaortic stenosis (20-
40mg PO TID or QID)
Adjunct therapy in
pheochromocytoma
(60mg PO OD)
50 Emergency Drugs
Submitted to: Gabriel Joshua S. Jumao-as, R.N., M.A.N.
Clinical Instructor