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Drug Study MICU
Drug Study MICU
Name
calcium gluconate
Magnesium sulfate
Mechanism of Action
Indications
Contraindications
Adverse Reactions
Prevention and
treatment of
hypocalcemia,
hypermagnesemia,
hypoparathyroidism,
cardiac toxicity caused
by hyperkalemia, ;lead
colic,
hyperphosphatemia,
calcium antagonist
toxicity
-hypercalcemia
-digitalis toxicity
-ventricular fibrillation
-renal calculi
-hypotension
-bradycardia
-dysrhythmias
-nausea
-constipation
-lethargy
-headache
-polyuria
Increases osmotic
pressure, draws fluid
into colon, neutralizes
HCL.
-constipation
-anticonvulsant
-electrolyte
-bowel prep
-hypersensitivity
-abdominal pain
-nausea/vomiting
-obstruction
-acute surgical abdomen
-rectal bleeding
-nausea
-vomiting
-anorexia
-cramps
-muscle weakness
-sweating
-electrolyte, fluid
imbalances
Nursing
Responsibilities
-monitor ECG, calcium
levels
-assess cardiac status,
rhythm, CVP
-provide seizure
precautions: padded
side rails; place airwasy
suction equipment
-patient should remain
recumbent 30mins. After
I dose.
-adise patient to add
food high in vitamin D
-assess I and O; check
for decrease in urinary
output.
-assess cramping, rectal
bleeding, nausea and
vomiting
-assess visual changes,
edema
-administer with food or
milk to decrease gastric
symptoms
-inform patient to avoid
alcohol intoxication
Atropine sulfate
Mechanism of Action
Indications
Contraindications
-prevention treatment of
hypokalemia
-cardiac depression
-nausea
-vomiting
-cramps
-diarrhea
Blocks acetylcholine at
parasympatheticneurro
affector sites; increases
cardiac output, HR by
blocking agal stimulation in
heart; dries secretions,
decrease sweating ,
mydriasis, increase HR at
moderate dose; motility of
GI, GU system
-bradycardia
-bradydysrhythmia
-insecticide poisoning
-decreasing secretions
before surgery
-antispasmodic with GU
and biliary surgery
-bronchodilator
-cyclopegia
-mydriasis
-hypersensitiivty to
belladonna alkaloids
-
-nausea
-vomiting
-anorexia
-cramps
-muscle weakness
-sweating
-electrolyte, fluid
imbalances
Mechanism of Action
Indications
Contraindications
Adverse Reactions
Adverse Reactions
Nursing
Responsibilities
-assess ECG
-monitor I and O ratio,
potassium level, cardiac
status
-dilute in LARGE
VOLUME OF IV
SOLUTION, NEVER
GIVE BOLUS.
-tell patient to take cap
with full glass of liquid
(120ml)
Name
Responsibilities
Lidocaine (xyloccine)
Increases electrical
stimulation threshold of
Ventricle and his-purkinje
System w/c stabilizes
cardiac
Membrane and decrease
automaticity; locally
produces
Anesthesia by preventing
initiation and conduction of
impulse
-Ventricular tachycadics
-ventricular dysrhythmia
during cardiac sx
-Mi
-digitalis toxicity
-cardiac catheter
-anesthesia locally
-hypersensitivity to
amides
-severe heart block
-supraventricular
dysrhythmias
-adams-stroke
syndrome
-wolff-parkinson-white
syndrome
-headache
-dizziness
-drowsiness
-hypertension
-bradycardia
-assess for
oxygenation/perfusion
deficit, respiratory
status,
Urinary retention
-monitor I and O ration
liver function studies,
ECG, blood levels
-give iv bolus undiluted
(1%, 2% only); give
long or less over 1min
of using an iv line
Morphine sulfate
-severe pain
-often given after or
during MI
-hypersensitivity
-addiction (opioid)
-hemorrhage
-bronchial asthma
-increased ICP
-drowsiness
-dizziness
-confusion
-sedation\
-constipation
patient safety
Mechanism of Action
B1 and B2 agonist causing
increased levels of cyclic
AMP producing
bronchodilation, cardiac and
CNS stimulation; large
doses can cause
vasoconstriction via alpha
receptors; small dose can
cause vasodilation via b2
vascular receptors
Indications
-acute asthma attack
-hemostasis
-bronchospasm
-anaphylaxis
-allergic reactions
-cardiac arrest
-adjunct in anesthesia
-shock
Contraindications
-hypersensitivity to
symphatomimetics
-narrow-angle
glaucoma
-organic brain and heart
disease syndrome
-local anesthesia of
certain area
-labor
-cardiac dilation
-coronary insufficiency
-cerebral
arteriosclerosis
Adverse Reactions
-tremors
-anxiety
-palpitations
-tachycardia
-dysrhythmias
-anorexia
-dyspnea
Nursing
Responsibilities
-monitor respiratory
function, ECG to
prevent cerebral
hemorrhage
-monitor for evidence of
allergic reactions,
paradoxical
bronchospasm
-instruct patient to use
this medication before
other medications and
allow at least 5 mins
between each, to
prevent overstimulation
Sodium bicarbonate
-acidosis
-cardiac arrest
-alkalinization
-gastric acid
neutralization/antacid
-hypertension
-peptic ulcer
-renal disease
-hypocalcemia
Mechanism of Action
Indications
Contraindications
-hypersensitivity
-psychiatric condition
-bradycardia
-stoke-adams syndrome
-hepatic failure
-acute intermittent
porphyria
-twitching
-hypereflexia
-belching
-distention
-alkalosis
Adverse Reactions
-headache
-hypotension
-gingival hyperplasia
-nystagmus
-diplopia
-urine discoloration
-hypocalcemia
-assess respiratory
function and pulse rate,
depth, lung sounds
-assess for CO2 in GI
tract
-monitor fluid balance,
electrolytes, blood PH,
urine output
-advise patient to notify
MD if indigestion is
accompanied with chest
pain, dyspnea, diarrhea
Nursing
Responsibilities
-assess mental status,
seizure activity, renal
studies and blood
studies
-monitor hepatic
stuches and WOF
toxicity
-give with meals to
decrease GI upset
-do not take antacid
together with phenytoin
-instruct patient in
proper oral hygiene
Diazepam (Valium)
-anxiety
-acute alcohol
withdrawal
-adjunct in seizure
disorders
-pre op skeletal muscle
relaxation
-hypersensitivity to
benzodiazepines
-narrow angle glaucoma
-psychosis
-respiratory depression
-coma
Mechanism of Action
Indications
Contraindications
-dizziness
-drowsiness
-orthostatic
hypotension
-blurred vision
Adverse Reactions
-assess degree of
anxiety
-monitor BP with patient
lying, standing
-give with food/milk
-use sugarless gum,
hard candy frequent
sips of water for dry
mouth
-advise patient that drug
is not to be used for
everyday stress
-inform patient to avoid
driving and to rise
abruptly
Nursing
Responsibilities
Midazolam (dormicum)
Depresses subcortical
levels in CNS; may act on
limbic system, reticular
formation, may potentiate
GABA by binding to specific
benzodiazepine receptor
-pre op sedation
-general anesthesia
induction
-sedation for diagnostic
test
-intubation
-hypersensitivity to
benzodiazepines
-shock
-coma
-alcohol intoxication
-acute narrow angle
glaucoma
-nausea
-vomiting
-coughing
-dyspnea
-loss of balance
Naloxone (Narcan)
-narcotic overdose
-post op narcotic
depression
-respiratory depression
due to non-opioid drugs
-tachycardia
-increase BP
-seizures
-cardiac arrest
-pulmonary edema
Mechanism of Action
Indications
Contraindications
Adverse Reactions
Nursing
Responsibilities
Promethazine
(Phenergan)
-motion sickness
-rhinitis
-allergy response
-sedation
-nausea
-pre op and post op
sedation
-
-hypersensitivity to h1
receptor antagonist
-sulfite allergy
-child <2yr
-acute asthma attack
-dizziness
-drowsiness
-constipation
-urinary retention
-assess respiratory
status, I and O
-give 1hr before and
2hrs after meals to
decrease GI upset
-caution patient not to
exceed recommended
dose; dysrhythmia may
occur
Hydrocortisone (solucortef)
-allergic and
inflammatory
ophthalmic processes
-GI disease ulceratic
colitis
-multiple sclerosis
-treatment of synovitis
of osteoarthritis
-treatment of keloids
-relief of discomfort
associated with
hemorrhoids perineal
itching or irritation
-systemic fungal
infection
-acute
glumeruloneprhitis
-amoebiasis
-AIDS-TB
-nonasthmatic bronchial
dse.
-depression
-flushing
-sweating
-headache
-mood changes
-hypertension
-diarrhea
-nausea
-vomiting
-hemorrhage
-monitor patients
weight, BP. Glucose
and electrolyte levels.
-assess for systemic
absorption and irritation
-advise patient to
exercise and take vit. D
and calcium
supplements
Mechanism of Action
Indications
Contraindications
Adverse Reactions
Nursing
Responsibilities
Dexamethasone
(Decadron)
-inflammation
-allergies
-neoplasms
-cerebral edema
-septic shock
-collagen disorders
-psychosis
-hypersensitivity
-idiopathic
thrombocytopenia
-amoebiasis
nonasthmatic bronchial
dse.
-depression
-flushing
-sweating
-hypertesion
-diarrhea
-nausea
-vomiting
-abdominal distention
-increased appetite
Terbutaline (bricanyl)
-bronchospasm
-hypersensitivity to
symphatomimetics
-narrow-angle
glaucoma
-tachydysrhythmias
-tremors
-insomnia
-headache
-dizziness
-palpitations
-nuasea
-vomiting
-monitor respiratory
function
-determine that patient
has not received
theophylline therapy
before giving dose
-monitor for evidence of
allergic reactions
-assess for paradoxical
bronchospasm
-should be given with
meals
-teach patient how to
use inhaler; to avoid
getting aerosol in eyes
because blurring may
result
Amiodarone
(Cordarone)
Mechanism of Action
Indications
Contraindications
Adverse Reactions
-treatment and
prophylaxis of
hemorrhage associated
with excessive
fibrinolysis
-prophylaxis for
hereditary angioedema
-hypersensitivity
-severe renal
insufficiency
-patient with
microscopic hematuria
-nausea
-vomiting
-headache
-hypotension
-severe ventricular
tachycardia
-supraventricular
tachycardia
-ventricular fibrillation
-atrial fibrillation not
controlled by 1st line
agents
-headache
-dizziness
-hypotension
Nursing
Responsibilities
-assess patient if with
active intravascular
clotting; obtain
prothrombin time of the
patient
-perform liver function
test and blood tests
-advise patient to report
visual abnormalities to
the physician.
Clonidine (Catapres)
Mechanism of Action
Indications
Contraindications
Adverse Reactions
-bronchial asthma
-emphysema
-bradycardia
-hypersensitivity to
xanthines
-active peptic ulcer
disease
-dizziness
-palpitations
-sinus tachycardia
-nausea
-vomiting
Inhibits sympathetic
ve\asomotor center in CNS
which reduce impulses in
sympathetic nervous
system; BP; pulse rate, CO
decreased; prevents pain
signal transmission in CNS
by alpha adrenergic
receptor stimulation of the
spinal cord
-mild to moderate
hypertension
-hypersensitivity
-bleeding disorders
-anticoagulants
-drowsiness
-sedation
-headache
-fatigue
-orthostatic
hypertension
-nocturia
-palpitations
-nausea
-vomitng
-dry mouth
-malaise
Nursing
Responsibilities
-monitor theophylline
blood levels, I and O,
respiratory rate
-instruct patient to avoid
hazardous activities
-teach patient if GI
upset occurs, take drug
with 8oz of water
-advise patient to
increase fluid intake
-monitor BP/pulse
-check for edema in feet
and legs daily
-monitor I and O
-instruct patient not to
discontinue drug
abruptly
-caution patient to
change position slowly
Verapamil (Isoptin)
Mechanism of Action
Indications
Contraindications
Adverse Reactions
-rapid digitalization in
acute and chronic CHF
-atrial fibrillation
-atrial flutter
-atrial bradycardia
-atrial tachycardia
-cardionegic shock
-paroxysmal atrial
tachycardia
-hypersensitivity to
digitalis
-ventricular fibrillation
-ventricular tachycardia
-carotid sinus syndrome
-2nd or 3rd degree block
-headache
-drowsiness
-hypotension
-nausea
-vomiting
-anorexia
-chronic stable
vasospastic
-unstable angina
-dysrhythmias
-hypertension
-supraventricular
tachycardia
-atrial flutter or
fibrillation
-headache
-drowsiness
-edema
-nausea
-constipation
Nursing
Responsibilities
-assess apical pulse for
1 min
-monitor cardiac status,
ECG
-advise patient to
maintain a sodiumrestricted diet as
ordered
-teach patient purpose
of drug is to regulate
the hearts functioning
Mechanism of Action
Indications
-relief of moderate to
severe pain
-for pre-operatively
analgesia
-supplemental to
balance anesthesia
-surgical anesthesia
-obstetrical anesthesia
Contraindications
-hypersensitivity
Adverse
Reactions
-sedation
-drowsiness
-sweating
-nausea
-dry mouth
-dizziness
-headache
-vomiting
Nursing Responsibilities
-assess pain characteristics
before administration
and after tx
-monitor VS after IV route
-instruct px to change position
slowly to prevent
orthostatic hypotension
and avoid getting up
without assistance
-advise Px to refrain taking
CNS depressant for at least
2 hrs after taking the drug
Phenobarbital(luminal)
Mechanism of Action
Diphenhydramine
(benadryl)
Indications
-allergy symptoms
-rhinitis
-motion sickness
-nighttime sedation
-infant colic
-non productive cough
-anaphylaxis
-nasal allergies
-dystonic reaction
-
-hypersensitivity to
barbiturates
-porphyria
-hepatic disease
-respiratory disease
-nephritis
-hypertension
-DM
Contraindications
-hypersensitivity
to H1 receptor
antagonist
-acute asthma attack
-lower respiratory tract
disease
-paradoxic
excitement
-elderly
-hang0ver
headache
-diarrhea
-rash
-local pain, swelling
Adverse Reactions
-dizziness
-drowsiness
-urinary retention
Nursing
Responsibilities
-assess respiratory
status
-provide 2L/day to
decrease secretion
thickness
-monitor I&O ratio
-instruct Px to use
sunscreen to prevent
photo sensitivity
-elevate siderails to
promote safety since
dizziness may occur
-instruct Px to request
assistance with
completion
Phytonadione
(aquamephyton)
-vit. K malabsorption
-hypoprothrombinemia
-prevention of
hemorrhagic disease of
thje new born
-hypersensitivity
-severe hepatic disease
-last few week of
pregnancy
Mechanism of Action
Indications
Contraindications
-hypersensitivity
-headache nausea
-uticaria
Adverse Reactions
-headache
-dizziness
-light headedness
-nausea
-flushing of skin
Isosorbide dinitrae
(isoket, isordil)
Mechanism of Action
Indications
Contraindications
Adverse Reactions
-shock
-to increase perfusion
-hypotension
-hypersensitivity
-ventricular fibrillation
-tachydysrythmias
-pheochromocytoma
-headache
-palpitations
-hypertension
-nausea
-vomiting
-diarrhea
Relaxation of vascular
smooth muscle, which leads
to decrease preload;
afterload thus decreasing
left ventricular end,diastolic
pressure, systemic vascular
resistance and reducing
cardiac oxygen demand
Tx and prevention of
chronic stable angina
pectoris
-hypersensitivity to
nitrates
-severe anemia
-increase ICP
-cerebral hemorrhage
-acute MI
-vascular headache
-flushing
-dizziness
-postural
hypotension
Nursing
Responsibilities
-monitor ECG, BP, and
pulse q5 min if BP
drops 30 mmHg, stop
infusion, and call
prescriber,
-check for
extravasation: change
site q48
-advise Px to report all
S/E.