EMERGENCY DRUGS CARDIAC DRUGS ATROPINE SULFATE Isopto Atropine Classification Anticholinergics Dosage  Bradycardia: 0.

5 mg IV every 3-5 mins, max of 0.04 mg/kg  Cardiac Arrest: 1 mg every 3-5 mins  Nerve and Organophosphate symptoms: may repeat in 2 mg increments q 3 mins titrated to relief symptoms Indication  Pre-op meds/pre-anesthetic meds  To restore cardiac rate and arterial pressure during anesthesia when vagal  To lessen the degree of A-V heart block  To overcome severe carotid sinus reflex  Antidote for cholinergic toxicity Side effects  CNS: restlessness, ataxia, disorientation, hallucinations, delirium, coma, insomnia, agitation, confusion.  CV: tachycardia, angina, arrhythmias, flushing.  EENT: photophobia, blurred vision, mydriasis.  GI: dry mouth, constipation, vomiting.  GU: urine retention.  Other: anaphylaxis Adverse effects  CNS: headache, excitement.  CV: palpitations  GI: thirst, nausea Contraindications  Hypersensitivity  With acute angle closure glaucoma, obstructive uropathy, obstructive disease of GI tract, paralytic ileus, toxic megacolon, intestinal atony, unstable CV status in acute hemorrhage, asthma, or myasthenia gravis.  Pregnant women. Nursing Management  Monitor VS.  Report é HR  Monitor for constipation, oliguria.  Instruct to take 30 mins before meals  Eat foods high in fiber and drink plenty fluids.  Can cause photophobia  Instruct client not to drive a motor vehicle or participate in activities requiring alertness.

 Advise to use hard candy, ice chips, etc. for dry mouth. NITROGLYCERINE Nitrostat Classification  Antianginal  Nitrate  Vasodilator,  Coronary Dosage  0.3-0.4 mg SL q 5 min, max 3 doses.  Every 6 hrs except for midnight (cream)  Wear 12 hrs a day for skin patch Action      Relaxes the vascular smooth system Reduces myocardial oxygen consumption Reduces left ventricular workload Reduces arterial BP Reduces venous return

Indication  Angina pectoris  CHF associated with AMI  Cardiac load reducing agent  Hypertensive Crisis Side effects  CNS: headache, throbbing, dizziness, weakness.  GI: nausea, vomiting  Skin: Rash  Adverse Reactions  CV: orthostatic hypotension, flushing, fainting.  EENT: sublingual burning.  Skin: Cutaneous vasodilation, contact dermatitis (patch) Contraindications  Contraindicated in patients hypersensitive to nitrates  With early MI. (S.L. form), severe anemia, increase ICP angle-closure glaucoma, IV nitroglycerine is contraindicated in patients with hypovolemia, hypotension, orthostatic hypotension, cardiac tamponade restrictive cardiomyopathy, constrictive pericarditis. Nursing Management  Record characteristics and precipitating factors of anginal pain.  Monitor BP and apical pulse before administration and periodically after dose.  Have client sit or lie down if taking drug for the first time.  Client must have continuing EKG monitoring for IV administration

peripheral circulatory collapse. antihistamines. Cardioverter/ defibrillator must not be discharged through paddle electrode overlying  Nitro-Bid ointment or the Transderm-Nitro Patch. coma. orthostatic hypotension. Rescudose. tachycardia.  Other: sweating. suppression of cough reflex  CV: Facial flushing. Kadian: 20–100 mg PO daily–24-hr release system. Assist with ambulating if dizzy. Respiratory: laryngospasm. M-Eslon (CAN). Roxanol.  Keep opioid antagonist and facilities for assisted or controlled respiration readily available during IV administration. Controlled-release: 30 mg q 8–12 hr PO or as directed by physician. MS Contin. over-the-counter drugs. advise to seek medical assistance immediately. lethargy. syncope  Dermatologic: Pruritus. anorexia. tremor. dizziness. dysphoria.physical tolerance and dependence. constipation. euphoria. . Duramorph. respiratory arrest. or as directed by physician. headache. impaired mental and physical performance. euphoria. delirium. MS Contin: 200 mg PO q 12 hr. chest wall rigidity. Continuous IV infusion: 0.  Instruct to take at first sign of anginal pain. urinary retention or hesitancy. drowsiness. insomnia.1–1 mg/mL in 5% dextrose in water by controlled infusion device. antidiuretic effect. of 3 doses. circulatory depression. miosis. urticaria. Avoid alcohol. Roxanol T Rectal suppositories:  RMS Injection:  Astramorph PF. reduced libido or potency  Respiratory:Respiratory depression. increased colonic motility in patients with chronic ulcerative colitis  GU: Ureteral spasm. biliary tract spasm.  If the client doesn’t experience relief. oliguria. disorientation. vomiting. tranquilizers. sedatives.  Dilute and administer slowly  Tell patient to lie down during IV administration. hallucinations. apnea.  SC and IM:10 mg (5–20 mg)/70 kg q 4 hr or as directed by physician. sedation Indication  Relief of moderate to severe acute and chronic pain  Preoperative medication  Analgesic adjunct during anesthesia  Component of most preparations that are referred to as Brompton's cocktail or mixture  Intraspinal use with microinfusion devices for the relief of intractable pain  Unlabeled use: Dyspnea associated with acute left ventricular failure and pulmonary edema Side Effects  GI: dry mouth. fear. spasm of vesical sphincters. seizures.  Rectal:10–30 mg q 4 hr or as directed by physician.5–15 mg/70 kg of body weight in 4–5 mL water for injection administered over 4–5 min. anxiety. visual disturbances. bradycardia. hypertension. bronchospasm. Epimorph (CAN) Preservative-free concentrate for microinfusion devices for intraspinal use:  Infumorph Classification  Opioid Agonist Analgesic Dosage  Oral: 10–30 mg q 4 hr PO. psychological dependence Adverse Effects  CNS: Light-headedness. sedation. edema  GI: Nausea. mood changes. Action  Acts as agonist at specific opioid receptors in the CNS to produce analgesia. weakness.  IV:2. palpitations. hypotension. shock. arrhythmia.  May be repeated q 5 minutes to max. agitation.  Keep in a dark colored container MORPHINE SULFATE Immediate-release tablets:  MSIR Timed-release:  Kadian.  Use caution when injecting SC or IM into chilled areas or in patients with hypotension or in shock  Reassure patients that they are unlikely to become addicted  Teaching points  Take this drug exactly as prescribed. Oramorph SR Oral solution:  MSIR.  Skin: Tissue irritation and induration (SC injection). cardiac arrest Contraindications  Hypersensitivity to opioid  Diarrhea caused by poisoning until toxins are eliminate During labor or delivery of a premature infant  After biliary tract surgery or following surgical anastomosis  Pregnancy  Labor Nursing Management Interventions  Caution patient not to chew or crush controlledrelease preparations.

chest pain. loss of appetite. hypotension and palpitations  GU: dysuria. Oramorph SR) whole. constipation. dizziness and headache  EENT: blurred vision. Verelan. Dilacor. impaired visual acuity  Report severe nausea. anorexia. Covera HS Classification  Anti-anginal  Anti-arrhythmics  Anti-hypertensive  Vascular headache suppressants Dosage  PO 80-120 mg 3x daily. nocturia and polyuria  GI: abnormal liver function. CHF. VERAPAMIL Calan. do not cut. 3-4x daily or 60-120 mg twice daily as SR capsules  IV: 0. CHF. dizziness. rash. and do not let anyone else take your prescription. during titration and therapy  Monitor I&O and weight  Assess for CHF  Routine serum digoxin monitoring LIDOCAINE Xylocaine Classification  CV drugs: Anti-arrhythmics  Anesthetic Dosage . constipation.  These side effects may occur: Nausea. Novo-Diltiazem. anxiety. shortness of breath or difficulty breathing. chest pain. diarrhea. drowsiness. Tiamate and Tiazac Classification  Anti-anginals  Antiarrhythmics  Antihypertensive  Ca channel blocker Dosage  PO: 30-120 mg. anxiety. nausea and vomiting Contraindications  Hypersensitivity  Sick sinus syndrome  2nd or 3rd degree AV block  CHF  Cardiogenic shock  Concurrent IV beta-blocker Nursing Management  Monitor BP and pulse before therapy. crush. constipation. epistaxis and tinnitus  CV: arrhythmia. diarrhea. constipation. Isoptin. confusion. nocturia and polyuria  GI: abnormal liver function. epistaxis and tinnitus  CV: arrhythmia. sedation.  Do not take leftover medication for other disorders. anorexia. vomiting. serum potassium and weight. I&O. bradycardia. hypotension and palpitations  GU: dysuria. or chew them.25 mg/kg Action  Inhibits calcium transport into myocardial smooth muscle cells  Systemic and coronary vasodilation Indication  Hypertension  Angina Pectoris  Supraventricular Arrhythmia  Atrial flutter/fibrillation Side Effects and Adverse and Reactions  CNS:abnormal dreams.  Assess for CHF DILTIAZEM Cardizem. increases as needed Action  Inhibits calcium transport into myocardial smooth muscle cells  Decreases SA and AV conduction and prolongs AV node refractory period in conduction tissue Indication  Hypertension  Angina Pectoris  Supraventricular Arrhythmia  Atrial flutter/fibrillation Side Effects and Adverse Reactions  CNS:abnormal dreams. bradycardia. Swallow controlled-release preparation (MS Contin. dizziness and headache  EENT: blurred vision. during titration and therapy  Monitor ECG. confusion. nausea and vomiting Contraindications  Hypersensitivity  Sick sinus syndrome  2nd or 3rd degree AV block  CHF  Cardiogenic shock  Concurrent IV beta-blocker Nursing Management  Monitor BP and pulse before therapy.

K. constipation. death. nervousness. toxicosis. non-specific hepatic disorders. fetal intoxication. heart block. flushing. visual impairment. I&O.7-1. vomiting. decreased libido. bradycardia. insomnia. BP  Assess vision PROCAINAMIDE Pronestyl. abnormal salivation. pulmonary inflammation. coagulation abnormalities. resulting to decrease depolarization. sleep disturbances. sinus arrest. ataxia. automaticity and excitability in ventricles during diastolic phase Indication  Anesthesia  Arrhythmias  Control of Status epilepticus refractory to other treatments Side Effects and Adverse Reactions  GI disturbances. abdominal pain. SA node dysfunction. edema. headache. hypo and hyperthyroidism Contraindications  Severe sinus node dysfunction  2nd or 3rd degree AV block  Hypersensitivity Nursing Management  Assess cardiovascular status before therapy  Assess pulmonary. vomiting. anorexia. This results in slowed conduction and ultimately the decreased rate of rise of the action potential may result on the widening of QRS on ECG Indication  Supraventricular and ventricular arrhythmias. prolonging myocardial cell action potential and refractory period  Non competitive alpha and beta adrenergic blockage Indication  Life threatening recurrent arrhythmias  Ventricular fibrillation  Ventricular tachycardia Side Effects and Adverse Reactions  Exacerbation of arrhythmias.4 mg/kg body weight. euphoria. muscle twitching. bradycardia. hypotension. corneal microdeposits. fatigue. abnormal involuntary movements. blindness. photophobia. dizziness. symptomatic atrial flutter: POà 600-800 mg/day for 1 month  Arrhythmias with CHF: 200 mg/day  Ventricular dysrrhythmias: 150 mg over the 1st 10 mins then slow 360 mg over the next 6 hrs Action  Blocks Na channels. malaise. dizziness. nausea. light headedness. respiratory arrest and CV collapse Contraindications  Hypersensitivity  Heart block  Hypovolemia  Adams stroke syndromes  Infection at site of injection Nursing Management  Assess pt before and after therapy  Pts infusion must be on cardiac monitor  Monitor ECG. withhold the drug  Monitor BP. paresthesia. Procanbid Classification Antiarrhythmics Dosage  Arrhythmias: 50 mg/kg/day in divided doses 3-6 hourly Action  Blocks open Na channels and prolongs the cardiac action potential. check for rebound HPN after 1-2 hrs  Assess respiratory status. apprehension. abnormal taste. . sensation of heat. restlessness. convulsion. tinnitus. dyspnea. Arrhythmia: IV: 0. hepatic and thyroid function before and during therapy  Monitor fluid and electrolytes. blurred vision. if QT or QRS increases by 50% or more. Na and Cl  Monitor ECG. No more than 200 mg within 1 hour period IM: 4-5 mg/kg body weight Action  Increases electrical stimulation of ventricle and His-purkinje system by direct action on tissues. drowsiness. numbness of tongue. oxygenation and pulse deficits  Assess renal and liver function  Monitor CNS symptoms  Monitor blood levels AMIODARONE Cordarone Classification Anti-arrhythmics Dosage  Recurrent ventricular arrhythmias:  POà800-1600 mg/day for 1-2 wks  PSVT. Procan-SR.

Na and Cl  Monitor ECG. Glaucon Insect sting emergencies:  EpiPen Auto-Injector (delivers 0.1.1 mg SQ or IM of 1:1000 solution. Relaxes bronchial smooth muscle. tremor. myocardial depression. rapid-acting vasodilators such as nitrates or alpha blockers can be given to counteract VASOPRESSIN Pitressin Classification Pituitary Hormones ADH Dosage . widened pulse pressure. I&O. coronary insufficiency. and genitalia. ears. S2 Classification Beta2 Adrenergic Agonists Dosage  Cardiac arrest: 1 mg IV of 1:10. Gas gangrene may occur  Massage site after IM injection to counteract possible vasoconstriction.  Observe patient closely for adverse reactions. Notify doctor if adverse reaction develop  If blood pressure increases sharply. organic brain damage. OTC nasal solution:  Adrenalin Chloride Ophthalmic solution:  Epifrin. drug is contraindicated. hepatic and thyroid function before and during therapy  Monitor fluid and electrolytes. and check for cardiac dysrrhythmias  Drug increases rigidity and tremor in patients with Parkinson’s disease  Epinephrine therapy interferes with tests for urinary catecholamine  Avoid IM use of parenteral suspension into buttocks. skin irritation. epinephrine is contraindicated for use in finger. Treatment of Wolf-Parkinson-White Syndrome Side Effects and Adverse Reactions  Severe hypotension.1-0. toes. pain. microNefrin.  Drug induced SLE syndrome. angioedema.  In breast feeding do not use the drug or stop breast feeding. agrunulocytosis. Increases vital capacity Increases BP. ventricular fibrillation and asystole. nose. Nursing Management  Monitor V/S. arrhythmias. K. hepatomegaly. GI and CNS effects Contraindications  Heart block  Heart failure  Hypotension  Myesthenia gravis  Digoxin toxicity  Lactation Nursing Management  Assess cardiovascular status before therapy  Assess pulmonary. heart failure. Nephron.  Asthma: 0. é HR. vertigo. psychosis.3 mg SQ or IM of 1:10.15 mg IM for children) OTC solutions for  Nebulization:  AsthmaNefrin.  Relief of bronchospasm occurring during anesthesia  Exercised-induced bronchospasm Side Effects/Adverse Reactions Side Effects:  nervousness. shock (other than anaphylactic shock). Indication  Asthma  Bronchitis  Emphysema  All cardiac arrest. BP  Assess vision EPINEPHRINE Injection. é PR Decreases airway resistance. Also contraindicated in patient receiving general anesthesia with halogenated hydrocarbons or cyclopropane and in patients in labor (may delay second stage)  In conjunction with local anesthesia. or cerebral arteriosclerosis. hypergammaglobulinemia. anaphylaxis  Used for symptomatic bradycardia.000 solution  Refractory bradycardia and hypotension: 210ug/min Action      Stimulates beta receptors in lung.  In pregnant woman. cardiac dilation.000 solution q 3-5 min. blood disorders.3 mg IM adult dose). double dose if administering via ET tube  Anaphylaxis: 0. Auto-Injector (delivers 0. fever. EpiPen Jr. hypertension nausea  Adverse Effects:  headache Contraindications  With angle-closure glaucoma.

circulatory collapse. Action  Increase permeability of renal tubular epithelium to adenosine monophosphate and water. then continuous IV infusion 3-20 mg/min for 5-48 hours. then 0. metabolic alkalosis. PaO2.5 meq/kg IV q 10 mins depending on ABG Action  Restore buffering capacity of the body and neutralizes excessive acid Indication  Metabolic Acidosis  Cardiac Arrest Side Effects/Adverse Reactions  CNS: tetany  CV: edema  GI: gastric distention. cardiac arrest. make sure urine output is 100 ml or more in 4 hrs pd before each dose  Take appropriate seizure precautions  Keep IV Ca gluconate at bedside Na HCO3 Arm and Hammer. Baking Soda Classification Alkalinizers Dosage  Metabolic Acidosis: Usually 2-5 meq/kg IV infuse over 4-8 hr period  Cardiac Arrest: 1 meq/kg IV of 7. belching and flatulence  Metabolic: hypokalemia. Prevent and treat abdominal distention: initially 5 units IM gives subsequent injections q3-4 hours increasing to 10 units if needed. flaccid paralysis. gangrene and urticaria Contraindications  With chronic nephritis and nitrogen retention  Hypersensitivity Nursing Management  Give 1-2 glass of H20 to reduce adverse reactions and improve therapeutic response  Warm vasopressin in your hands and mixed until it is distributed evenly in the solution  Monitor urine Sp.4% sol. decreased CO. hyperosmolarity with overdose  Skin: pain @ injection site Contraindications  Metabolic and respiratory alkalosis  Pt losing Cl because of vomiting or continuous GI suction or those receiving diuretics that produces hypochloremic alkalosis Nursing Management  Obtain blood pH. hypothermia  CV: hypotension. myocardial ischemia. circumollar pallor. hypernatremia. Action  Decreased acetylcholine released Indication  Mg replacement  Arrhythmia Side Effects and Adverse Reactions  CNS: drowsiness. bradycardia. depressed cardiac function  EENT: diplopia  Respiratory: respiratory paralysis  Metabolic: hypocalcemia  Skin: diaphoresis Contraindications  Heart block and myocardial damage  Toxemia of pregnancy Nursing Management  Monitor I&O. flushing. arrhythmias. angina  GI: abdominal cramps  GU:uterine cramps  Respi: bronchoconstriction  Skin: diaphoresis. the epithelium promotes reabsorption of water and concentrated urine Indication  Diabetes Insipidus  Abdominal Distention  GI bleeding  Esophageal varices Side Effects and Adverse Reactions  CNS: tremor. depressed reflexes. headache. PaCo2 and electrolyte levels  SIVP HYPERTENSIVE CRISIS Na NITROPRUSSIDE Nittropress . Gravity and I&O to aid evaluation of drug effectiveness MAGNESIUM SO4 Classification Anti-convulsant Anti-arrhythmics Dosage  Arrhythmia: IV 1-6 grams over several minutes. vertigo  CV: vasoconstriction.5 or 8.

abdominal pain.25-0. inhibiting tubular reabsorption of water and electrolytes. I&O. BUN and CO2 levels frequently  WOF signs of hypokalemia  Monitor uric acid levels  Monitor glucose levels esp in DM pts MORPHINE SO4 (Discussed earlier) NEUROSURGICAL DRUGS MANNITOL Osmitrol Classification Diuretics Dosage  Test dose for marked oliguria or suspected inadequate renal function: 200 mg/kg or 12. increased ICP. irritation at infusion site Contraindications  Hypersensitivity  Compensatory hypotension  Inadequate cerebral circulation  Acute heart failure with reduced PVR  Congenital optic atrophy  Tobacco-induced ambylopia Nursing Management  Obtain VS before giving the drug  Place pt in supine  Giving excessive doses of 500 mcg/kg delivered faster than 2 mcg/kg/min or using max infusion rate of 10 mcg/kg/min for more than 10 mins can cause cyanide toxicity FUROSEMIDE Lasix Classification Loop Diuretics Dosage  Pulmonary edema: 40 mg IV  Edema: 20 to 80 mg PO every day in the morning  HPN: 40 mg PO bid. BP and PR  Monitor fluid. headache and fever . a second dose is given if still no response after 2nd dose stop the drug  Oliguria: 50 over 90 mins to several hrs  To induced intraocular or intracranial pressure: 1. Dosage adjusted based on response Action  Inhibits Na and Cl reabsorption at the proximal and distal tubules and in the ascending loop of Henle Indication  Acute pulmonary edema  Edema  Hypertension Side Effects/Adverse Reactions  Signs of hypotension..5% to 10% solutions up to 200 g IV  Irrigating solution during TURP: 2. pink-colored rash.5-2 gram/kg as a 15 % to 20% IV solution over 30-60 min  Diuresis in drug intoxication: 12. bradycardia. increasing water flow into extracellular fluid Indication  Test dose for marked oliguria or suspected inadequate renal function  Oliguria  To induced intraocular or intracranial pressure  Diuresis in drug intoxication  Irrigating solution during TURP Side Effects/Adverse Reactions  CN: seizures. restlessness. drug elevates plasma osmolarity. loss of consciousness. methemoglodinemia.5 gram as a 15% to 20% IV solution over 3-5 mins response is adequate if 30-50 ml of urine/hr is adequate.3 mcg/kg/minute Action  Relaxes arteriolar and venous smooth muscle Indication  Hypertensive crisis  To produce controlled hypotension during anesthesia  To reduce preload and afterload in cardiogenic shock Side Effects/Adverse Reactions  Headache. nausea. Vasodilator Dosage 0. electrolyte. hypokalemia and hyperglycemia Contraindications  Hypersensitivity  Anuria Nursing Management  Monitor wt. dizziness. muscle twitching.5-5% Action  Increases osmotic pressure of glomerular filtrate.Classification Antihypertensive.

drowsiness. swelling of the mouth. metabolic edema. Nursing Management  Assess respiratory status frequently  Respiratory rate increases within 1-2 mins IPECAC SYRUP Classification Antidote Dosage 25-30 ml followed immediately by H2O Action  Irritates the stomach lining and stimulate the vomiting center Indication  Poisoning  Overdose Side Effects  Diarrhea. active intracranial bleeding during craniotomy. DOB.  Drug can be used to measure GFR  Do not give electrolyte free solutions with blood.CVP. CV: edema. If blood id given simultaneously. tremors  CV: ventricular fibrillation. renal function fluid balance and urine K levels daily. dry mouth. vomiting and diarrhea  GI: urine retention  Metabolic: dehydration  Skin: local pain  Others: chill Contraindications  Hypersensitivity  Anuria. psychotomimetic and dysphoric effects of agonist-antagonists Indication  For suspected opioid induced respiratory depression  For postoperative opiod depression Side Effects/Adverse Reactions  CNS: seizures.4 to 2 mg IV.I&O. severe pulmonary congestion. itching. HPN with higher recommended doses. progressive heart failure or pulmonary congestion after drug Nursing Management  Monitor VS. vomiting. IM and SQ. hypotension and heart failure  EENT: blurred vision and rhinitis  GI: thirst. repeat doses q 2-3 mins PRN  For postoperative opiod depression: 0. tachycardia. nausea. gastric lavage may be considered to remove ingested substance ACTIVATED CHARCOAL Classification Antidote Dosage 30-100 g with at least 8 oz of water Action  Inhibits GI absorption of toxic substances or irritants  Hyperosmolarity . frank pulmonary edema. thrombophlebitis. stomach cramps.2 mg IV q 2-3 mins. hypotension  GI: nausea and vomiting  Respiratory: pulmonary edema  Skin: diaphoresis Contraindications  Hypersensitivity  Use cautious with cardiac irritability or opiod addiction. rash and hives Contraindications  Hypersensitivity  Given activated charcoal  Unconcious  Drowsy  Severely drunk  Having seizures  With no gag reflex Nursing Management  Don’t administer to unconscious  Pt should kept active and moving ff administration  If vomiting does not occur after 2nd dose. add at least 200 meq of NaCL to each liter POISONING NALOXONE HCL Narcan Classification Miscellaneous antagonists and antidotes Dosage  For suspected opioid induced respiratory depression: 0.01 to 0. PRN. Repeat dose within 1-2 hr. if needed. severe dehydration. Action  Reverse the effects of opiods.

diarrhea. blurred vision. palpitations and vasoconstriction  GI: nausea and vomiting Contraindications  Hypersensitivity  With uncorrect tachyarrhythmias  Pheochromocytoma N Ventricular Fibrillation Nursing Management  Most patients received less than 20 mcg/kg/min  Drugs isn’t substitute for blood or fluid volume deficit  During infusion.5 to 10 mcg/kg/min-usual effective range to increase CO Action Stimulates heart beta receptors to increase myocardial contractility and SV . monitor ECG. angina. broken GI tract. Give only smallest amount effective. melena. tremors. sweating.  Give through freely running IV infusion into large vein to minimize pain at injection site  Note history of seizure or panic disorder  Assess evidence of increased ICP  Note evidence of sedative and benzodiazepine dependence  Instruct to avoid alcohol and non-prescription drugs for 1-24 hrs SHOCK DOPAMINE Intropine Classification Adrenergic drugs Dosage Initially 2-5 mcg/kg/min by IV Action  Stimulates dopaminergic and alpha and beta receptors of the sympathetic nervous system resulting in positive inotropic effect and increased CO Indication  To treat shock and correct hemodynamic imbalances  To correct hypotension  To improve perfusion of vital organs  To increase CO Side Effects  CNS: headache an anxiety  CV: tachy. vomiting. titrating to optimum dosage of 2-20 mcg/kg/min  2. organic solvents. dyspnea. palpitations. pain at injection site Contraindications  Control of ICP or status epilepticus. headache. intestinal obstruction.5-1 mcg/kg/min IV infusion. concomitant use of charcoal with sorbitol Nursing Management  Do not mix with chocolate and together with ipecac syrup  Notify doctor if caused swelling or pain in the stomach FLUMAZENIL Romazicon Classification  [ Benzodiazepine receptor antagonists Dosage  2 ml IV given over 15 seconds Action  Antagonizes the effects of benzodiazepines Indication  Benzodiazepine-induced depression of the ventilatory responses to hypercapnia and hypoxia Side Effects  Nausea. hyperventilation. mineral acids. insomnia. flushing. BP. bleeding with fructose intolerance. dry mouth. PR and color and temp of the limbs  Do not confuse dopamine to dobutamine  Check urine output often DOBUTAMINE Dobutrex Classification Adrenergic drugs Dosage  0.Indication  [ Poisoning Side Effects  [ Pain. vomiting and constipation Contraindications  Cyanide.  Signs of serious cyclic antidepressant overdose Nursing Management  Must individualize dosage. CO.

vomiting. BP.use sunscreen EPINEPHRINE (Discussed earlier) .Indication  To increase CO  Treatment of cardiac decompensation Side Effects  CNS: headache  CV: HPN. IV. IV or IM bid-tid Action Blocks the effects Hi receptor sites Indication  Allergic reactions  Motion sickness  Cough suppression  Sedation Side Effects  Xerostomia  Urinary retention  Sedation Contraindications  Acute asthmatic attack Nursing Management  Risk for photosensitivity. give a plasma volume expander to correct hypovolemia and a cardiac glycoside  Monitor ECG. tachycardia.5-1 mg SQ. repeat in 20 mins PRN Action Binds with glucagon receptor Indication Hypoglycemia Side Effects  Nausea. ABG. tachycardia and hypertension Contraindications  Hypersensitivity  Pheochromocytoma  Insulinoma Nursing Management  Monitor V/S and blood sugar level  Response within 20 mins after injection ALBUTEROL Ventolin Classification Bronchodilator. s/sx of bronchospasm and CNS stimulation  Instruct on how to use inhaler properly  Rinse mouth after use DIPHENHYDRAMINE HCL Benadryl Classification Anti-histamine Dosage 25-50 mg PO. pulmonary artery wedge pressure and CO  Monitor electrolyte levels  Don’t confuse dobutamine to dopamine GLUCAGON Classification Pancreatic Hormones Dosage 0. IM. Adrenergic Dosage 2 inhalations reputed q 4-6 hrs via neb Action  Activation of beta adrenergic receptors on airway smooth muscle Indication  Asthma  Prevention of exercise induced spasms Side effects  Palpitations  Tachycardia  GI upset  Nervousness Contraindications Hypersensitivity Nursing Management  Monitor therapeutic effectiveness  Monitor HR. BP. hypotension. palpitations and vasoconstriction  GI: nausea and vomiting Contraindications  Hypersensitivity  Use cautiously in pts with hx of HPN and AMI Nursing Management  Before starting therapy.

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