Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing Responsibilities

Contraindications Effects
Generic Name: Cardiac arrest: Action: Indications: Adverse Effects: Monitor V/S. and check for
epinephrine 1 mg IV of 1:10,000 Stimulates beta receptors o Asthma
cardiac dysrhythmias
solution q 3-5 min; double in lung. o Bronchitis
Brand Name: dose if administering o Emphysema nervousness, tremor,
Injection, OTC nasal via ET tube Relaxes bronchial smooth o All cardiac arrest, vertigo, pain, widened Drug increases rigidity and
solution: muscle. anaphylaxis pulse pressure, tremor in patients with
Adrenalin Chloride Anaphylaxis: 0.1- 1 mg o Used for hypertension nausea Parkinson’s disease
SQ or IM of 1:1000 Increases vital capacity symptomatic
Ophthalmic solution: solution.  BP,  HR,  PR  Epinephrine therapy
bradycardia.
Epifrin, Glaucon o Relief of Side Effects: interferes with tests for
Asthma: 0.1-0.3 mg SQ or Decreases airway headache urinary catecholamine
bronchospasm
Insect sting emergencies: IM of 1:10,000 solution resistance.
occurring during  Avoid IM use of
EpiPen Auto-Injector
anesthesia parenteral suspension into
(delivers 0.3 mg IM adult Refractory bradycardia
Classification: o Exercised-induced
dose), EpiPen Jr. Auto- and hypotension: 2- buttocks. Gas gangrene
Beta2 Adrenergic Agonists bronchospasm
Injector (delivers 0.15 mg 10ug/min may occur
IM for children)
Contraindications: Massage site after IM
OTC solutions for
Contraindicate in patients injection to counteract
with angle-closure
nebulization: possible vasoconstriction.
glaucoma, shock (other
AsthmaNefrin, microNefrin,  Observe patient closely
than anaphylactic shock),
Nephron, S2
organic brain damage, for adverse reactions.
cardiac dilation, Notify doctor if adverse
arrhythmias, coronary
reaction develop
insufficiency, or cerebral
arteriosclerosis. Also  If blood pressure
contraindicated in patient increases sharply, rapid-
receiving general acting vasodilators such as
anesthesia with
nitrates or alpha blockers
halogenated hydrocarbons
or cyclopropane and in can be given to counteract
patients in labor (may delay
second stage)

1
Some products containing
sulfites and are
contraindicated in patients
with sulfite allergies except
when drug is used for
serious allergic reactions or
in other emergency
situations.

In conjunction with local

anesthesia, epinephrine is
contraindicated for use in
finger, toes, ears, nose,
and genitalia.

Use cautiously with long-

standing bronchial asthma
and emphysema, who have
developed degenerative
heart disease and in those
with hyperthyroidism, CV
disease, hypertension,
psychoneurosis, or
diabetes.

In pregnant woman, drug is

contraindicated.

In breast feeding do not

use the drug or stop breast
feeding.

2
KEREN MICHAL B. CAPITULO
BSN 401
GROUP 1

EMERGENCY DRUGS

Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing Responsibilities
Contraindications Effects
Generic Name: 1-1.5 mg/kg IVP or ETT Action: Indications: Adverse Effects: Monitor EKG, BP, pulse,
lidocane (double dose if giving via Decrease cardiac rhythm, continuously.
Decrease cardiac CNS: Confusion, tremor,
ET tube), may repeat q 5- excitability, cardiac
Brand Name: 10 min. max excitability, cardiac contraction is delayed in lethargy, somnolence, Monitor serum lidocaine
Xylocaine 3 mg/kg; If conversion contraction is delayed in the atrium and ventricle stupor, restlessness levels throughout theraphy;
successful start an infusion the atrium and ventricle anxiety, hallucinations, therapreutic range 1.5-5
of 2-4 mg/min Contraindications: mcg/ml
nervousness, seizure. CV:
Classification: Contraindicated in patients
hypersensitive to amide- hypotension, bradychardia, Monitor intake and output
Antiarrythmic and
Anesthetic type local anesthetics and new or worsened
in those with Adams –Stoke arrhythmias EENT: tinnitus, Do not mix in the same
syndrome. Wolff- syringe with amphoterin B
blurred or double vision.
Parkinsons-White or cefazolin
Syndrome, or severe Respiratory: Respiratory
degrees of SA, AV, or depression and arrest
Administer Lidocaine TIV.
intraventricular block in the Skin: soreness at injection
absence of pacemaker.
site
In case of circulatory
Other: anaphylaxis,
depression have dopamine
available
Side Effects:
sensation of cold, vomiting

3
Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing Responsibilities
Contraindications Effects
Generic Name: 0.5-1 mg/kg slow IVP over Action: Indications: Adverse Effects: Monitor serum
furosemide 1-2 min, may repeat once inhibits sodium and Edema associated with vertigo, headache, glucose, and electrolyte
Brand Name: at 2 mg/kg slow IVP over 1- chloride reabsorption at the CHF paresthesia, orthostatic D iet- K+ for all
2 mins. proximal and distal tubules hypotension, except aldactone
Apo-Furosemide and the ascending loop of Cirrhosis with ascites or thrombophlebitis, I ntake and Output,
Henlen renal dysfunction abdominal pain, daily weight
Furoside Hypokalemia, anemia, U ndesirable
Classification: For hypertension or in muscle spasm effects; Fluid and
Lasix Loop Diuretics combination with other electrolyte imbalance
antihypertensive R eview HR, BP
Lasix Speacial medications. and electrolytes
E lderly-Careful
Novosemide  ICP, nephritic syndrome, T ake with or after
hepatic cirrhosis meals and in AM
Uritol I ncrease risk of
Contraindications: orthosthatic hypotension;
move slowly
Contraindicated to patients C ancel alcohol
hypersensitive to drug or
any of its components and
in those with anuria.

Use cautiously in patient

with hepatic cirrhosis.

Patients with allergies to

sulfonamides may also be
allergic to furosemide.

In pregnant woman, use

only if benefits outweighs
the risk to the fetus.

4

Name of the Drug Dosage/Route
Generic Name: Adults: For rapid
digoxin digitalization, give 0.4 to
0.6 mg I.V. initially, followed
Brand Name: by 0.1 to 0.3 mg I.V. every
Lanoxin, Digoxin, 4 hours, as needed and
Lanoxicap tolerated, for 24 hours.
Children: digitalizing dose
is based on child’s age and
is given in three or more
divided doses over the first
24 hours. First dose is 50%
of total dose; subsequent
dose are given q 4 to 8
hours as needed and
tolerated.
Children age 10 years and
older: For rapid
digitalization, give 8 to 12
mcg/kg I.V. over 24 hours,
divided as above,
Maintenance dose is 25%
to 35% of total digitalizing
dose, given daily as a
single dose.
Children ages 5 to 10: For
rapid digitalization, give 15
In breast feeding woman,
do not use drug.
Action/Classification Indication/
Contraindications
Action: Indications:
Inhibits the sodium- V-fib, V-flutter, CHF,
potassium ATP phase. pulmonary edema, atrial
fibrillation and or flutter, and
Classification: paroxysmal atrial
Cardiac Glycosides contractions
Contraindications:
Contraindicated in patients
hypersensitive to the drug
or any of its components
and in those with digitalis-
induced toxicity, ventricular
fibrillation, or ventricular
tachycardia unless caused
by heart failure.
Use cautiously in patients
with acute MI, in complete
Av block, sinus
bradycardia, PVCs,,
chronic constrictive
pericarditis, hyperthropic
cardiomyopathy, renal
insufficiency, severe
pulmonary disease, or
hypothyroidism.
Adverse Effects/ Side
Effects
Adverse Effects:
CNS: hallucinations,
paresthesia, stupor, vertigo.
CV: Arrythmias, heart
failure, hypotension.
EENT: blurred vision,
diplopia, light flashes,
photophobia, yellow-green
halos around visual
images.
GI: anorexia, diarrhea,
nausea, vomiting.
Side Effects:
CNS: agitation, dizziness,
fatigue, generalized
weakness, headache,
malaise.
GI: Nausea
Nursing Responsibilities
Monitor K+, Mg++, ECG,
liver/renal function tests,
drug level (therapeutic level
0.5-2.0 mg/ml, toxicity is
>2.0 mg/ml).
Before each dose assess
apical pulse for full minute,
record and report changes
in rate or rhythm.
Withhold drug and contact
provider if pulse is <
60/min. or >100 (adults) or
< 110/minute (children)
Weigh daily
Monitor I&O and signs of
CHF
5
to 30 mcg/kg I.V. over 24
hours divided as above.
Maintenance dose is 25%
to 35% of total digitalizing
dose, divided and given in
two or three equal portions
daily.

Children ages 2 to 5: For

rapid digitalization: give 25
to 35 mcg/kg I.V. over 24
hours, divided as above.
Maintenance dose is 25%
to 35% of total digitalizing
dose, divided and given in
two or three equal portions
daily.

Infants ages 1 month to 2

years: For rapid
digitalization. Give 30 to 50
mcg/kg I.V. over 24 hours,
divided as above.
Maintenance dose is 25%
to 35% of the total
digitalizing dose, divided
and given in two or three
equal portions daily.

Neonates: for rapid

digitalization, give 20 to 30
mcg/kg I.V. over 24 hours,
divided as above.
Maintenance dose is 25%
to 30% of the total
digitalizing dose, divided
and given in two or three

6
 equal portions daily.

Premature Infants: For

rapid digitalization, give 15
to 25 mcg/kg I.V. over 24
hours, divided as above.
Maintenance dose is 20%
to 30% of the total
digitalizing dose, divided
and given into two or three
equal portions daily.

Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing Responsibilities
Contraindications Effects
Generic Name: 1 mEq/kg IVP, may repeat Action: Indications: Adverse Effects: Monitor urinary pH,
Sodium Bicarbonate 0.5 mEq/kg 10 min. Neutralizes gastric acid o Hyperacidity GI: Gastric distention, calcium, electrolytes and
o Peptic ulcer belching, flatulence. phosphate levels.
Brand Name: Arm and Decrease pepsin activity o Hyperkalemia Metabolic: metabolic
Hammer Pure Baking o Tricyclic alkalosis, hypernatremia, Record amount and
Soda, Citrocarbonate, Classification: Alkalizing antidepressant OD hypokalemia, consistency of stools.
Soda Mint Agent, Buffer, Antacid, o Shock associated hyperosmolarity (with
electrolyte with severe overdose). Clients on low-sodium diets
diarrhea, Other: Pain and irritation at should evaluate sodium
dehydration, injection site. contents of antacids.
uncontrolled DM
o Reflux esophagitis

Contraindications:
Contraindicated in patients
with metabolic or
respiratory alkalosis;
patients who are losing
chlorides from vomiting or
continuous GI suction;
patients taking diuretics

7

Name of the Drug Dosage/Route
Generic Name: Adults: initially, 1 to 5
Dopamine HCl. mcg/kg/minute by I.V.
infusion. Adjust dose to
Brand Name: desired hemodynamic or
Intropin; Revimine renal response, increase by
1 to 4 mcg/kg/minute at 10
to 30-minute intervals.
known to produce
hypochloremia alkalosis;
and patients with
hypocalcemia in which
alkalosis may produce
tetany, hypertension,
seizures, or heart failure.
Oral sodium bicarbonate is
contraindicated in patients
with acute ingestion of
strong mineral acids.
Action/Classification Indication/
Contraindications
Action Indications:
Stimulates dopaminergic To treat shock and correct
and alpha and beta hemodnamic imbalances,
receptors of the improve perfusion of vital
sympathetic nervous organs, to increase cardiac
system. Action is dose- output, and to correct
related; large doses can hypotension.
cause mainly alpha
stimulation. Contraindications:
Contraindicated in patient
Classification: with uncorrected
Inotropic, vasopressor tachyarrhythmias,
pheocromocytoma, or
ventricular fibrillation.
- Use cautiously in patients
with occlusive vascular
disease, cold injuries,
diabetic endarteritis, and
arterial embolism; in
Adverse Effects/ Side
Effects
Adverse Effects:
Cv: anginal pain,
arrythmias, bradycardia,
conduction disturbances
ectopic
breasts,hypertension,
hypotension, palpitations,
tachycardia,
vasoconstriction, widening
of QRS complex.
GI: vomiting.
GU: azotemia
Respiratory: asthma
attacks, dyspnea
Skin: necrosis,piloerection,
tissue sloughing with
Nursing Responsibilities
Blood is not a substitute for
blood or fluid volume
deficit. If deficit occurs,
replace fluid deficit first
before giving meds.
During infusion, frequently
monitor ECG, BP, cardiac
output, CVP, pulmonary
artery wedge pressure,
pulse rate, urine output,
and color and temperature
of the limbs.
If diastolic pressure rises
disproportionately,
decrease perfusion rate
and watch out carefully for
further signs of
8
 pregnant woman; with a
history of sulfite sensitivity;
and in those taking MAO
inhibitor.
extravasation. vasoconstriction unless
such action is desired.
Other: anaphylaxis.
Observe for adverse
Side Effects: reaction.
CNS: headache
GI: nausea Check for urine output. If
urine flow is decrease
without hypotension, notify
physician.

After drug is stopped,

Tamper dosage slowly to
evaluate stability of blood
pressure.

Acidosis decrease
effectiveness of dopamine.

Name of the Drug Dosage/Route/Timing Action/Classification Indication/ Adverse Effects/ Side Nursing Responsibilities
Contraindications Effects
Generic 0.3-0.4 mg SL q 5 min, max Action: Indication: Adverse Effects Record characteristics and
Nitroglycerin 3 doses. Relaxes the vascular Angina pectoris CV: orthostatic precipitating factors of
Brand smooth system CHF associated with AMI hypotension, flushing, anginal pain.
Nitrostat fainting.
 Myocardial oxygen Cardiac load reducing EENT: sublingual burning. Monitor BP and apical
consumption agent Skin: Cutaneous pulse before
vasodilation, contact administration and
 left ventricular workload Hypertensive Crisis dermatitis (patch) periodically after dose.
 arterial BP Side Effects
Contraindication: CNS: headache, throbbing, Have client sit or lie down
 venous return Contraindicated in patients dizziness, weakness. if taking drug for the first
hypersensitive to nitrates GI: nausea, vomiting. time.
Classification and in those with early MI. Skin: Rash
Antianginal, Nitrate, (S.L. form), severe anemia, Client must have continuing

9

Name of the Drug Dosage/Route
Generic Bradycardia: 0.5 -1 mg IV
Atrophine Sulfate (may give via ETT at
double dose) q 3-5 min,
Brand max 0.04 mg/kg
Isopto Atropine Cardiac arrest: 1 mg q 3-5
min, max 0.04 mg/kg
Nerve gas and
organophosphate
symptoms, may repeat in
2 mg increments q 3 min
tiltrated to relief symptoms.
Vasodilator, Coronary increase ICP angle-closure
glaucoma, IV nitroglycerine
is contraindicated in
patients with hypovolemia,
hypotension, orthostatic
hypotension, cardiac
tamponade restrictive
cardiomyopathy,
constrictive pericarditis.
Action/Classification Indication/
Contraindications
Action Indication
cholinergic receptor sites As an anti-sialagogue for
so response to preanesthetic medication to
acetylcholine is decreased prevent or reduce
secretions of the
Classification respiratory tract
Anticholinergics
To restore cardiac rate and
arterial pressure during
anesthesia, when vagal
stimulation produced by
Adverse Effects/ Side
Effects
Adverse Effects
CNS: restlessness, ataxia,
disorientation,
hallucinations, delirium,
coma, insomnia, agitation,
confusion.
CV: tachycardia, angina,
arrhythmias, flushing.
EENT: photophobia, blurred
vision, mydriasis.
GI: dry moth, constipation,
vomiting.
EKG monitoring for IV
administration
Cardioverter/ defibrillator
must not be discharged
through paddle electrode
overlying
Nitro-Bid ointment or the
Transderm-Nitro Patch.
Assist with ambulating if
dizzy.
Instruct to take at first sign
of anginal pain.
May be repeated q 5
minutes to max. of 3 doses.
If the client doesn’t
experience relief, advise to
seek medical assistance
immediately.
Nursing Responsibilities
Monitor VS.
Report  HR
Monitor for constipation,
oliguria.
Atrophine could result in
CNS stimulation (confusion,
excitement) or drowsiness
10
 intra-abdominal surgical
traction causes a sudden
decrease in pulse rate and
cardiac action
To lessen the degree of
atrioventricular (A-V) heart
block when increased vagal
tone is a major factor in the
conduction defect, as in
some cases due to digitalis
To overcome severe carotid
sinus reflex
Antidote for cardiovascular
collapse from the
injudicious use of a
cholinergic drug.
GU: urine retention. Instruct to take 30 mins
Hematologic: leukocytosis before meals
Other: anaphylaxis
Eat foods high in fiber and
Side Effects drink plenty fluids.
CNS: headache, Avoid
excitement. OTC antihistamines.
CV: palpitations Instruct
GI: thirst, nausea. client not to drive a motor
vehicle or participate in
activities requiring
alertness.
Advise
to use hard candy, ice
chips, etc. for dry mouth.

Contraindication
Contraindicated in patients
hypersensitive to drug and
those with acute angle
closure glaucoma,
obstructive uropathy,
obstructive disease of GI
tract, paralytic elius, toxic
magacolon, intestinal
atony, unstable CV status
in acute hemorrhage,
asthma, or myasthenia
gravis. Also contraindicated
in pregnant women.

Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing Responsibilities
Contraindications Effects

11
Generic Adults individualized: 2.5- Action Indication Adverse Effects Monitor CVP to assess
Dobutamine 15 mcg/kg/min. Enhancing the force of Short term treatment of CV: angina, hypertension, vascular volume and
Hydrochloride myocardial contraction cardiac decompensation in hypotension, increased cardiac pumping efficiency.
Rate of administration and organic heart disease of heart rate, nonspecific
Brand duration of therapy depend  HR,  CO, and  SV cardiac surgical pressures. chest pain, phlebitis, PVCs. (Elevated CVP may
Dobutrex on the response of client as with minor effects to HR. GI: nausea and vomiting. indicate disruption on CO,
determined by HR,  elevated ventricular Contraindication Respiratory: asthma as in pump failure or
presence of activity, BP and filling pressure and helps Contraindication in patients attacks, shortness of Pulmonary edma; low CVP
urine flow AV node conduction hypersensitive to drug or breath. may indicate hypovolemia)
any of its components and Others: anaphylaxis.
Classification in those with idiopathic Monitor ECG and BP
Inotropic, Adrenergic hypertrophic subaortic Side Effects continuously during drug
stenosis. CNS: headache administration
Musculoskeletal: mild leg
crams or tingling sensation. Record I&O

Monitor glucose in diabetes

patients

Drug is administered IV to
improve cardiac function
thus increasing BP and
improving urine output.

Report any chest pain,

increase SOB, headaches
or IV site pain.

Name of the Drug Dosage/Route
Generic ADULTS
Morphine Sulfate Oral
One-third to one-sixth as
Brand effective as parenteral
Immediate-release tablets: administration because of
Action/Classification
Action
Principal opium alkaloid;
acts as agonist at specific
opioid receptors in the CNS
to produce analgesia,
Indication/ Adverse Effects/ Side
Contraindications Effects
Indication Adverse Effect
Relief of moderate to CNS: Light-headedness,
severe acute and chronic dizziness, sedation,
pain euphoria, dysphoria,
delirium, insomnia,
Nursing Responsibilities
Assessment
History: Hypersensitivity to
opioids; diarrhea caused by
poisoning; labor or delivery
of a premature infant;

12
MSIR first-pass metabolism; 10–
Timed-release: 30 mg q 4 hr PO.
Kadian, M-Eslon (CAN), Controlled-release: 30 mg
MS Contin, Oramorph SR q 8–12 hr PO or as directed
Oral solution: by physician; Kadian: 20–
MSIR, Rescudose, 100 mg PO daily–24-hr
Roxanol, Roxanol T release system; MS
Rectal suppositories: Contin: 200 mg PO q 12 hr.
RMS SC and IM
Injection: 10 mg (5–20 mg)/70 kg q 4
Astramorph PF, hr or as directed by
Duramorph, Epimorph physician.
(CAN) IV
Preservative-free 2.5–15 mg/70 kg of body
concentrate for weight in 4–5 mL water for
microinfusion devices for injection administered over
intraspinal use: 4–5 min, or as directed by
Infumorph physician. Continuous IV
infusion: 0.1–1 mg/mL in
5% dextrose in water by
controlled infusion device.
Rectal
10–30 mg q 4 hr or as
directed by physician.
Epidural
Initial injection of 5 mg in
the lumbar region may
provide pain relief for up to
24 hr. If adequate pain
relief is not achieved within
1 hr, incremental doses of
1–2 mg may be given at
intervals sufficient to
assess effectiveness, up to
10 mg/24 hr. For
continuous infusion, initial
dose of 2–4 mg/24 hr is
euphoria, sedation; the Preoperative medication to
receptors mediating these sedate and allay
effects are thought to be apprehension, facilitate
the same as those induction of anesthesia,
mediating the effects of and reduce anesthetic
endogenous opioids dosage
(enkephalins, endorphins).
Analgesic adjunct during
anesthesia
Classification
Opioid agonist analgesic Component of most
preparations that are
referred to as Brompton's
cocktail or mixture, an oral
alcoholic solution that is
used for chronic severe
pain, especially in terminal
cancer patients
Intraspinal use with
microinfusion devices for
the relief of intractable pain
Unlabeled use: Dyspnea
associated with acute left
ventricular failure and
pulmonary edema
Contraindication
Contraindicated with
hypersensitivity to opioids;
diarrhea caused by
poisoning until toxins are
eliminated; during labor or
delivery of a premature
infant (may cross immature
agitation, anxiety, fear,
hallucinations,
disorientation, drowsiness,
lethargy, impaired mental
and physical performance,
coma, mood changes,
weakness, headache,
tremor, seizures, miosis,
visual disturbances,
suppression of cough reflex
CV: Facial flushing,
peripheral circulatory
collapse, tachycardia,
bradycardia, arrhythmia,
palpitations, chest wall
rigidity, hypertension,
hypotension, orthostatic
hypotension, syncope
Dermatologic: Pruritus,
urticaria, Respiratory:
laryngospasm,
bronchospasm, edema
GI: Nausea, vomiting,
anorexia, biliary tract
spasm; increased colonic
motility in patients with
chronic ulcerative colitis
GU: Ureteral spasm,
spasm of vesical
sphincters, urinary
retention or hesitancy,
oliguria, antidiuretic effect,
reduced libido or potency
biliary tract surgery or
surgical anastomosis; head
injury and increased
intracranial pressure; acute
asthma, COPD, cor
pulmonale, preexisting
respiratory depression;
acute abdominal
conditions, CV disease,
supraventricular
tachycardias, myxedema,
seizure disorders, acute
alcoholism, delirium
tremens, cerebral
arteriosclerosis, ulcerative
colitis, fever,
kyphoscoliosis, Addison's
disease, prostatic
hypertrophy, urethral
stricture, recent GI or GU
surgery, toxic psychosis,
renal or hepatic
dysfunction; pregnancy;
lactation
Physical: T; skin color,
texture, lesions; orientation,
reflexes, bilateral grip
strength, affect; P,
auscultation, BP, orthostatic
BP, perfusion; R,
adventitious sounds; bowel
sounds, normal output;
urinary frequency, voiding
pattern, normal output;
ECG; EEG; thyroid, liver,
kidney function tests
13
recommended. Further
doses of 1–2 mg may be
given if pain relief is not
achieved initially.
Intrathecal
Dosage is usually one-
tenth that of epidural
dosage; a single injection
of 0.2–1 mg may provide
satisfactory pain relief for
up to 24 hr. Do not inject >
2 mL of the 5 mg/10 mL
ampule or > 1 mL of the
10 mg/10 mL ampule. Use
only in the lumbar area.
Repeated intrathecal
injections are not
recommended; use other
routes if pain recurs. For
epidural or intrathecal
dosing, use preservative-
free morphine preparations
only.
PEDIATRIC PATIENTS
Do not use in premature
infants.
SC or IM
0.05–0.2 mg/kg (up to
15 mg per dose) q 4 hr or
as directed by physician.
GERIATRIC PATIENTS OR
IMPAIRED ADULTS
Use caution. Respiratory
depression may occur in
the elderly, the very ill,
blood–brain barrier more
readily); after biliary tract
surgery or following
surgical anastomosis;
pregnancy; labor
(respiratory depression in
neonate; may prolong
labor).
Use cautiously with head
injury and increased
intracranial pressure; acute
asthma, COPD, cor
pulmonale, preexisting
respiratory depression,
hypoxia, hypercapnia (may
decrease respiratory drive
and increase airway
resistance); lactation (wait
4–6 hr after administration
to nurse the baby); acute
abdominal conditions, CV
disease, supraventricular
tachycardias, myxedema,
seizure disorders, acute
alcoholism, delirium
tremens, cerebral
arteriosclerosis, ulcerative
colitis, fever,
kyphoscoliosis, Addison's
disease, prostatic
hypertrophy, urethral
stricture, recent GI or GU
surgery, toxic psychosis,
renal or hepatic
dysfunction.
Respiratory:
Respiratory depression,
apnea, circulatory
depression, respiratory
arrest, shock, cardiac
arrest
Side Effects
GI: dry mouth, constipation.
Skin: Tissue irritation and
induration (SC injection).
Other: sweating,physical
tolerance and dependence,
psychological dependence
Interventions
Caution patient not to chew
or crush controlled-release
preparations.
Dilute and administer
slowly IV to minimize
likelihood of adverse
effects.
Tell patient to lie down
during IV administration.
Keep opioid antagonist and
facilities for assisted or
controlled respiration
readily available during IV
administration.
Use caution when injecting
SC or IM into chilled areas
or in patients with
hypotension or in shock;
impaired perfusion may
delay absorption; with
repeated doses, an
excessive amount may be
absorbed when circulation
is restored.
Reassure patients that they
are unlikely to become
addicted; most patients
who receive opioids for
medical reasons do not
develop dependence
syndromes
14
those with respiratory
problems. Reduced dosage
may be necessary.
Epidural
Use extreme caution;
injection of < 5 mg in the
lumbar region may provide
adequate pain relief for up
to 24 hr.
Intrathecal
Use lower dosages than
recommended for adults
above.
Teaching points
Take this drug exactly as
prescribed. Avoid alcohol,
antihistamines, sedatives,
tranquilizers, over-the-
counter drugs.
Swallow controlled-release
preparation (MS Contin,
Oramorph SR) whole; do
not cut, crush, or chew
them.
Do not take leftover
medication for other
disorders, and do not let
anyone else take your
prescription.
These side effects may
occur: Nausea, loss of
appetite (take with food, lie
quietly); constipation (use
laxative); dizziness,
sedation, drowsiness,
impaired visual acuity
(avoid driving or performing
tasks that require alertness
and visual acuity).
Report severe nausea,
vomiting, constipation,
shortness of breath or
difficulty breathing, rash.
15
 GENERIC NAME INDICATION ACTION CONTRAINDICATION PRECAUTION/ ADVERSE NURSING
REACTION CONSIDERATION
DIAZEPAM Symptomatic relief of Facilitates/ potentiates the Hypersensitivity. PRECAUTION: > inform pt. that drug may
anxiety, agitation, tension inhibitory activity of GABA Dependence, withdrawal Hypersensitivity: be taken with food
BRAND NAME at the limbic system and symptoms cardiorespiratory >advice pt. not to abruptly
Valium reticular formation to insufficiency, pregnancy, discontinue drug after long
reduce anxiety, promote lactation term use
DOSAGE calmness and sleep >advice pt. to avoid driving
Adult: 250-500mg every 8 ADVERSE RXN and activities that require
hours Dizziness, fatigue, blurred alertness bec, drug can
Children: 20-40mg/kg/day vision, dependence, cause drowsiness
divided dosage given every withdrawal reactions >inform pt. that smoking
8 hrs may decrease effect

16
 Drug Mechanism of Action Contraindications Indications Side Effects Nursing
responsibilities

The analgesic effect Hypersensitivity to Moderate to Dizziness, 1.do not confuse

Brand name: is only partially tramadol, in acute moderately severe pain. headache, CNS Ultram with Ultrase
Dolcet antagonized by the intoxication with stimulation, ataxia, 2. List reasons for
antagonist naloxone. alcohol, hypnotics, sedation, vertigo, therapy, location, onset,
Generic Name: Causes significantly less centrally acting itching, constipation, triggers, characteristics
Tramadol respiratory depression analgesics, opiates or nausea, seizures, of S and S. use a pin-
hydrochloride than morphine. In psychotropic drugs. paresthesia, cognitive rating scale to rate pain.
contrast to morphine, Use in cleitns with past dysfunction, 3. Assess for history
Route of tramadol does not cause r resent addictin or hallucinations, tremor, of drug addiction, allergy
administration: release of histamine. opiate dependence or amnesia, to opiates or codeine,
Oral Produces dependence in those with a prior concentration difficulty, seizures; drug may
of the mu-opioid type history of allergy to abnormal gait, increase the risk of
Classification : how ever there is little codeine or opiates. migraine, nausea, convulsions
Analgesic evidence of abuse. Use for obstetric constipation, vomiting,
Tolerance occurs but is preoperative medicatin dyspepsia, dry mouth,
Dosage: relatively mild; the of postdelivery diarrhea, anorexia
50-100mg withdrawal syndrome is analgesia In nursing
q 4-6 hrs. prn not as severe as with mothers.
other opiates

17
 Drug Mechanism of action Contraindications Indications Side Effects Nursing
Responsibilities
. It blocks the calcium Cardiovascular shock, Treatment of Flushing, 1. dot not
Brand Name: or "slow" channels and severe aortic stenosis or in vasospastic angina, nausea, dizziness, confuse nifedipine
Calcibloc inhibits entry of calcium patients known to be chronic stable headache, with nicardipine
ions into vascular smooth hypersensitive to nifedipine. angina, tiredness, sedation, 2. do not
Generic Name: muscles particularly of Care is needed in patients hypertension. leg edema and exceed a single
Nifedipine resistance vessels and with very low blood other dose
coronary arteries. Dilates pressure (severe manifestations of 3. before
Classification: coronary and peripheral hypotension with systolic peripheral increasing dose,
Calcium channel arteries, as well as veins. pressure <90 mmHg) or vasodilation. carefully monitor
blocker Coronary arterial decompensated heart BP
vasodilation increases failure. 4. use only the
Route of coronary blood flow in the sustained release
administration: ischemic post-stenotic tablets to treat
Oral areas, while dilation of the hypertension
peripheral arteries lowers 5. concomitant
Dosage: arterial blood pressure and therapy with beta
Capsules: 10-20 mg reduces left ventricular renergic blocking
3x a day afterload. Some renal agents may be
Tablets: 30-60 mg artery dilatation may used
per day stimulate mild diuresis. 6. clients
withdrawn from
beta blockers may
manifest symptoms
of increased angina
which cannot be
prevented by
nifedipine; in fact
nifedipine may
increase the
severity of angina
situation

18
 Drug Data Mechanism of Indication Contraindicatio Side Effects Nursing Responsibilities
Action ns
Brand Name Enters target - Hepatitis CNS: Vertigo,
Solu-Cortef cells and binds to Replacement B,Vaccinia or headache, - Assess for contraindications.
cytoplasmic therapy in varicella,Antibiotic- paresthesias, - Assess body weight, skin color, V/S,
Generic receptor; initiates adrenal cortical resistant insomnia, seizures, urinalysis, serum electrolytes, X-rays,
Name many complex insufficiency infections,Immunosu psychosis, CBC.
Hydrocortisone reactions that are - Allergic ppression EENT: - Arrange for increased dosage when
responsible for its states – severe Special Cataracts, patient is subject to unusual stress.
Dosage anti-inflammatory, or incapacitating Precaution glaucoma, - Do not give live vaccines with
20-240 immunosuppressive allergic - Kidney disease increased IOP immunosuppressive doses of
mg/day in single (glucocorticoid), and conditions - Liver disease Endocrine: hydrocortisone.
dose or divided salt-retaining - - Cirrhosis Amenorrhea, - Observe the 15 rights of drug
doses (mineralocorticoid) Hematologic - irregular mens, administration.
actions.. disorders Hypothyroidism growth retardation, .- Space multiple doses evenly
Classification - Ulcerative - Ulcerative decreased throughout the day.
: colitis colitis with GI: Peptic or - Use minimal doses for minimal
Adrenal - Hypertension esophageal ulcer, duration to minimize adverse effects.
cortical steroid - Heart failure pancreatitis, -Do not give IM injections if
Corticosteroid - Hematologic: Na patient has thrombocytopenic
Glucocorticoid Thromboembolic and fluid retention, purpura.
tendencies hypocalcemia,
- Osteoporosis increased blood
- Convulsive sugar,
disorders Musculoskeletal:
- Metastatic Muscle weakness,
carcinoma steroid myopathy
and loss of muscle
mass, osteoporosis.

19
 Drug Mechanism of Contraindications Indications Side Effects Nursing
action Responsibilities
Brand Name: . • Inhibits the •Hypersensitivity, Used in 1. Use
Zantac action of histamine at Cross-sensitivity may management of various • CNS: caution in presence of
the H2 receptor site occur; some oral liquids gastro intestinal Confusion, dizziness, renal or hepatic
Generic Name: located primarily in contain alcohol and disorders such as drowsiness, impairment
Ranitidine gastric parietal cells, should be avoided in dyspepsia, hallucinations, 2. Assess
resulting in inhibition of patients with known gastroesophageal reflux headache• CV: potential interactions
Classification gastric acid secretion. intolerance. disease,peptic ulcer and Arrhythmias• GI: with other
: Zollinger-Ellison Altered taste, black pharmacological agents
Anti-ulcer • In addition, Special Precaution:: syndrome. tongue, constipation, patient maybe taking.
agents ranitidine bismuth dark stools, diarrhea, 3. Monitor
citrate has some drug-induced hepatitis, AST,ALT,serum
• Renal impair- ment
antibacterial action nausea• GU: creatinine,when used to
• Geriatric patients (more
Dosage: against H. pylori. Decreased sperm prevent stress-related
susceptible to adverse
150 – 300 mg count, impotence• GI bleeding
CNS reactions)
• Pregnancy or Lactation ENDO:
Gynecomastia•
HEMAT:
Agranulocytosis,
Aplastic Anemia,
neutropenia,
thrombocytopenia•
LOCAL:
Pain at IM site• MISC:
Hypersensitivity
reactions, vasculitis.

20
 Drug Mechanism of Contraindications Indications Side Effects Nursing
action Responsibilities
Brand Name: . Relaxes -Contraindicated with -Symptomatic relief -CNS: Irritability -Administer to
Phyllocontin bronchial smooth hypersensitivity to any or prevention of (especially pregnant patients only
muscle, causing xanthine or to bronchial asthma and children); when clearly needed.
Generic Name: bronchodilation and ethylenediamine, peptic reversible restlessness, -Caution patient
Aminophylline increasing vital ulcer, active gastritis; rectal bronchospasm dizziness, not to chew or crush
capacity, which has or colonic irritation or associated with chronic severe enteric-coated timed-
Classification : been impaired by infection (use rectal bronchitis and depression release forms.
Bronchodilator bronchospasm and air preparations). emphysema -CV: -Give immediate-
trapping; in higher -Use cautiously with -Unlabeled uses: Palpitations, sinus release, liquid dosage
Route of concentrations, it also cardiac arrhythmias, acute Respiratory stimulant in tachycardia, forms with food if GI
administration: inhibits the release of myocardial injury, CHF, cor Cheyne-Stokes ventricular effects occur.
IV,Oral slow-reacting pulmonale, severe respiration; treatment of tachycardia, life -Maintain
substance of hypertension, severe apnea and bradycardia ,circulatory adequate hydration.
Dosage: anaphylaxis (SRS-A) hypoxemia, renal or hepatic in premature babies failure -Monitor for clinical
Tablets—100, and histamine. disease, hyperthyroidism, -GI: Loss of signs of adverse
200 mg; liquid— alcoholism, labor, lactation. appetite, effects
105 mg/5 mL; hematemesis, -Ensure that
injection—250 mg/10 epigastric pain, diazepam is readily
mL; suppositories— gastroesophageal available to treat
250, 500 mg reflux during sleep- seizures.
GU:
RBCs;urinary
retention in men
with prostate
enlargement

21
 Drug Mechanism of Contraindications Indications Side Effects Nursing
action Responsibilities
. Contraindicated with . Acute or long- . CNS: Headache, 1.Take drug with food or
allergy to NSAIDs, term treatment of dizziness, meals if GI upset occurs.
Brand Name: Inhibits significant renal mild to moderate somnolence, 2.Take only the
Voltaren prostaglandin impairment, pregnancy, pain, including insomnia, fatigue, prescribed dosage.
synthesis to cause lactation. dysmenorrhea tiredness, tinnitus, These side effects may
Generic Name: antipyretic and anti- Use cautiously with Rheumatoid ophthalmologic occur: Dizziness, drowsiness
Diclofenac inflammatory effects; impaired hearing, arthritis effects (avoid driving or using
sodium the exact mechanism allergies, hepatic, Osteoarthritis Dermatologic: dangerous machinery while
is unknown. cardiovascular, and GI Ankylosing Rash, using this drug).
Classificatio conditions spondylitis pruritus, sweating, 3.Report sore throat,
n: Treatment of dry mucous fever, rash, itching, weight
Anti- actinic keratosis in membranes, gain, swelling in ankles or
inflammatory conjunction with stomatitisGI: fingers, changes in vision;
sun avoidance Nausea, dyspepsia, GI black, tarry stools.
Ophthalmic: pain, diarrhea, vomiting,
Route of Postoperative constipation, flatulence
administration: inflammation from GU: Dysuria, renal
oral cataract extraction impairment
Hematologic:
Dosage: Bleeding, platelet
50 mg inhibition with higher
doses

22
PATIENT’S DRUGS
LACTULOSE Constipation, salmonellosis. Inhibits bacterial DNA Pt who require a low PRECAUTION: >Assess condition before
Treatment of hepatic gyrase thus preventing lactose diet. Lactose intolerance, therapy and reassess
BRAND NAME encephalopathy replication in susceptible Galactosemia diabetes regularly thereafter to monitor
duphalac bacteria deficiency. Intestinal drug’s effectiveness
obstruction. Adverse Rxn: >Monitor pt for any adverse
DOSAGE Abdominal discomfort GI reactions,
Infants: 5 ml associated with nausea,vomiting,diarrhea,
Children: flatulence and >Assess for adverse
1-6 y/o- 5-10ml intestinal cramps. reactions
7-14y/o- 15ml Nausea, vomiting, >for pt. with hepatic
15-45y/o- 15-30ml. diarrhea on prolonged encelopathy: regularly
use. assess mental condition
Dose given in 3 days >monitor I & O
>monitor for Inc. glucose
level in diabetic pts

Classification: ANTI-ALLERGICS_Anti-histamine

Name of Drug General Action Specific Indications Contraindications Adverse Nursing Responsibilities
Action Reaction
Antiplatelet Inhibits platelet Reduction of Contraindicated in: CNS: Depression, Assessment
Clopidogrel aggregation by atherosclerotic Hypersensitivity Dizziness, Fatigue,
agents; irreversibly events (MI, stroke, Pathologic bleeding Headache.
Assess patient for symptoms of
75 mg 1 tab PO
Platelet inhibiting the vascular death) in (peptic ulcer, stroke, peripheral vascular
OD EENT: Epistaxis.
binding of ATP to patients at risk for intracranial disease, or MI periodically during
aggregation Resp: Cough,
platelet receptors. such events hemorrhage) therapy.
inhibitors Dyspnea.
Therapeutic including recent MI, Lactation. Monitor patient for signs of
CV: Chest Pain,
Effects: acute coronary Use Cautiously in: thrombotic thrombocytic purpura
Decreased syndrome (unstable Patients at risk for Edema, Hypertension.
occurrence of angina/non-Q-wave bleeding (trauma, (thrombocytopenia,
atherosclerotic MI), stroke, or surgery, or other GI: GI Bleeding, microangiopathic hemolytic
events in patients peripheral vascular pathologic conditions) Abdominal Pain, anemia, neurologic findings, renal
at risk. disease. History of GI Diarrhea, Dyspepsia, dysfunction, fever). May rarely
bleeding/ulcer disease Gastritis.

23
 Derm: Pruritus, occur, even after short exposure
Severe hepatic Purpura, Rash. (<2 wk). Requires prompt
impairment Hemat: Bleeding, treatment.
Neutropenia,
Thrombotic
Thrombocytopenic Implementation
Purpura. Discontinue clopidogrel 5-7
Metab: days before planned surgical
Hypercholesterolemia. procedures.
PO: Administer once daily
MS: Arthralgia, Back without regard to food.
Pain.
Misc: Fever,
Hypersensitivity Patient/Family
Reactions. Teaching
Instruct patient to take
medication exactly as directed.
Take missed doses as soon as
possible unless almost time for
next dose; do not double doses.
Advise patient to notify health
care professional promptly if fever,
chills, sore throat, or unusual
bleeding or bruising occurs.
Advise patient to notify health
care professional of medication
regimen prior to treatment or
surgery.

24
Name of Drug Mechanism of Action Indication Dosage, Route of Contraindication Side Effects/Adverse
administration Effects
and Frequency

Generic Recombinant human Symptomatic or 5000 iu / SC / -uncontrolled Increased blood

Name: erythropoietin (r- transfusion once a week hypertension pressure and
Erythropoietin HuEPO) is a purified requiring anaemia -known hypertensive
Brand Name: glycoprotein which associated with hypersensitivity to encephalopathy
Eprex stimulates chronic renal failure. mammalian-cell -Flu-like symptoms,
erythropoiesis. derived products bone pain and chills
-known following injections
hypersensitivity to any -Seizures
of the components of -Headache
this product -Pain in the
subcutaneous area

Drug Name Classification Mechanism of Action Indication Contraindication Side Effects

Generic Antihyperlipidemic >a fungal metabolite that >as an adjunct to diet in the >contraindicated with >CNS: headache,
name: drug inhibits the enzyme(HMG- treatment of elevated total allergy to any component dizziness, insomnia,
Rosuvastatin HMG-CoA CoA) that catalyzes the first cholesterol and LDL cholesterol of the product, active liver hypertonia, paresthesia,
calcium reductase inhibitor step in cholesterol synthesis and triglyceride levels in patients dse. or persistent elevated depression, anxiety,
pathway, resulting in a with primary serum transaminase, vertigo, neuralgia
Brand Name: decrease in serum cholesterol, hypercholesterolemia. pregnancy, lactation
TORUS serum LDLs and either >use cautiously with >CV: hypertension, angina
increase or no change in >adjunct to diet to slow impaired hepatic function, pectoris, vasodilation,

25
Dosage: serum HDLs. atherosclerosis progression in
20mg OD patients with elevated cholesterol
Date >as an adjunct to diet for the
Medication treatment of patients with
Prescribed: elevated serum triglyceride levels
>to reduce LDL-C, total
September cholesterol, and ApoB in patients
11,2014 with homozygous familiar
hypercholesterolemia as an
adjunct to other lipid-lowering
treatments or if such treatments
are available.
alcoholism, renal palpitation, peripheral
impairment, advanced age, edema
hypothyroidism
>GI: nausea, dyspepsia,
diarrhea, constipation,
gastroenteritis, vomiting,
flatulence, peridontal
abscess, gastritis, liver
failure
>RESPIRATORY:
pharyngitis, rhinitis,
sinusitis, cough, dyspnea,
pneumonia

Other: arthritis, arthralgia,

rhabdomyolysis, myopathy,
flulike symptoms
Nursing Respinsibilities
 establish baseline serum lipid levels and liver function test results before beginning therapy
 consult dietician about low cholesterol diets
 administer drugs at bedtime(highest rate of cholesterol synthesis occur between midnight and
5am)
 monitor patients for closely for signs of injury

26
 Name of Drug Mechanism of Indication Dosage, Route Contraindication Side
Action of Effects/Adverse
administration Effects
and Frequency

GENERIC NAME: Albumin (Human) It is osmotically Hypovolemia, Must be History of allergic CNS: headache; CV:
BRAND equivalent to an equal Hypoalbuminemia, administered by IV reaction to albumin, hypertension,
NAME: volume of normal human Hemolytic Disease inj. Max infusion severely anemic patients hypotension, tachycardia;
BuminateCLASSIFICATION:Pharmacologic: plasma and willincrease of the Newborn; rate: 1 mL/min. & patients w/cardiac GI: increased
blood derivativeTherapeutic: plasma volume circulating plasma Nephrotic Syndrome failure. salivation;nausea,
expander volume by an amount vomiting; DERM: rash,
approximately equal to urticaria; MS: back pain
the volumeinfused. It
provides colloidal oncotic
pressure, which serves to
mobilize fluid
fromextravascular tissues
back into the
intravascular space
NURSING RESPONSIBILITIES:
 Buminate must not be diluted with sterile water for injection.
 (R) Diluting Buminate in sterile water may cause hemolysis in recipients and possible renal failure.
 Do not mix albumin solutions with protein hydrolysates or solutions containing alcohol.
 (R) This may cause proteins to precipitate.
 Administer slowly with caution.
 (R) Rapid infusion may cause circulatory overload and interstitial dehydration in most vulnerable patients.
 Do not begin administration more than 4 hours after the container has been entered.
 (R) Since this product does not contain antimicrobial preservatives, prolonged administrationmay predispose the client to risks of infection.

27
 Name of Mechanism of Action Indication Dosage, Route Contraindication Side Effects/Adverse
Drug of Effects
administration
and Frequency

A low moleculer weight heparin istory of Heparin induced

Generic derivative that Initially at 40mg thrombocytopenia with or Hemorrhage.
Name: acceleratesformation of anti- Prevent pulmonary embolism SC withoutthrombosis. Do not Thrombocytopenia. Local
Enoxaprine thrombin III-thrombin complex and deep administer by IM route. Renal reactions (Small
Na and deactivates q8 for 10 days. or hepatic insufficiency,History localhematoma).
thrombin, preventing vein thrombosis after hip of hepatic ulcer, arterial Exceptional cases of skin
Brand conversion of fibrinogen to or kneereplacement hypertension, diabetic necrosis. Rarely
Name: fibrin. Has higher anti-factor surgery, abdominal surgery, retinophaty, shortly after neuro cutaneous or
Clexane Xa toantifactor IIa activity patients with acute illness or ophth surgery. systemicallergic reaction.
ratio. who are atincreased risk Increase liver enzymes.
because of decreased
mobility. To prevent ischemic
complicationsof unstable
angina and non-Q-wave MI
with oral aspirin theraphy.

Nursing Responsibilities:
Monitor pregnant women using the drug
Instruct patient and family to watch for signs of bleeding or abnormal bruisingand to notify prescriber immediately if any occur.Tell patient to avoid OTC drugs containing aspirin or other salicylates
unlessordered by physician.

28