Drug Study

In Partial fulfillment of the Requirements in EMERGENCY ROOM ROTATION

Submitted To: Mr. Raymund Bautista RN, MAN

Submitted By: 3AN2A Duenas, Ely Jane Faciolan, Sarah Ann Jamilla L. Fiedacan, Irish Luz V. Gabion, Leanna Mae

inhibiting gastric acid secretions. relieves tremor and rigidity  Relief of bradycardia and syncope due to hyperactive carotid sinus reflex  Relief of pylorospasm.Duenas. stupor. INDICATIONS SYSTEMIC ADMINISTRATION:  Antisialogogue for preanesthetic medication to prevent or reduce respiratory tract secretions  Treatment of parkinsonism. hypertonicity of the small intestine and hypermotility of the colon  Relaxation of the spasm of biliary and ureteral colic and bronchospasm  Relaxation of the tone of the detrusor muscle of the urinary bladder in the treatment of urinary tract disorders  Control of crying and laughing episodes in patients with brain lesions  Treatment of closed head injuries that cause acetylcholine release into CSF. relaxing the GI and GU tracts. ampule . Ely Jane DRUG NAME GENERIC NAME: ATROPINE SULFATE ACTION Competitively blocks the effects of acetylcholine at muscarinic cholinergic receptors that mediate the effects of parasympathetic post-ganglionic impulses. inhibiting the vagal influences on the heart. relaxing the pupil of the eye and preventing accommodation for near vision also blocks the effects of acetylcholine in the CNS. depressing salivary and bronchial secretions. dilating the bronchi. neurologic signs  Relaxation of uterine hypertonicity  Management of peptic ulcer  Control of rhinorrhea of acute rhinitis or hay fever BRAND NAME: PARENTERAL AND ORAL PREPARATIONS: MINIMS (CAN) OPHTHALMIC SOLUTION: ATROPISOL (CAN) AVAILABILITY: 1mg. EEG abnormalities.

treatment of symptomatic atrial flutter. use alternative agents first. may produce benefit in left ventricular ejection fraction. Serious and even fatal toxicity has been reported with this drug. ampule . prolongs repolarization and refractory period. exercise tolerance and ventricular arrhythmias in patients with CHF BRAND NAME: CORDARONE AVAILABILITY: 150mg. acts on peripheral smooth muscle to decrease peripheral resistance INDICATIONS  Only for treatment of the following documented life-threatening recurrent ventricular arrhythmias that do not respond to other antiarrhythmics or when alternative agents are not tolerated: recurrent dynamically unstable ventricular tachycardia. very closely monitor patient receiving this drug.DRUG NAME GENERIC NAME: AMIODARONE ACTION Type III antiarrhythmic: acts directly on cardiac cell membrane.  Unlabeled use: treatment of refractory sustained or paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia. increases ventricular fibrillation threshold.

rickets.DRUG NAME GENERIC NAME: CALCIUM GLUCONATE ACTION Essential element of the body. acute and chronic hypoparathyroidism. peptic esophagitis. particularly after open heart surgery  Symptomatic relief of upset stomach associated with hyperacidity. gastritis. hyperacidity associated with peptic ulcer. postmenauposal and senile osteoporosis. blood coagulation. pseudohypoparathyroidism. neutralizes or reduces gastric acidity INDICATIONS  Dietary supplement when calcium intake is inadequate  Treatment of calcium deficiency in tetany of newborn. gastric hyperacidity. helps maintain cardiac function. pending correction of increased potassium in the extracellular fluid  Improves weak or myocardial contractions when epinephrine fails in cardiac resuscitation. osteomalacia  Prevention of hypocalcemia during exchange transfusion  Combats the effects of hyperkalemia as measured by ECG. is an enzyme cofactor and affects the secretory activity of endocrine and exocrine glands. helps maintain the functional integrity of the nervous and muscular system. hiatal hernia BRAND NAME: DICARBOSIL AVAILABILITY: 10% vial .

stiff-man syndrome  Preoperative: relief of anxiety and tension and to lessen recall in patients prior to surgical procedures. athetosis. potentiates the effects of GABA. hallucinosis  Treatment of tetanus  Antiepileptic: adjunct in status epilepticus and severe recurrent convulsive seizures. may act in spinal cord and at supraspinal sites to produce skeletal muscle relaxation. anxiolytic effects occur at doses well below those necessary to cause sedation. spasticity caused by upper motoneuron disorder . ataxia. adjunct in convulsive disorder  Muscle relaxant: adjunct for relief of reflex skeletal muscle spasm due to local pathology or secondary to trauma. an inhibitory neurotransmitter. acts mainly at the limbic system and reticular formation. may be useful in symptomatic relief of acute agitation. tremor. delirium tremens. has little effect on cortical function INDICATIONS  Management of anxiety disorders or for short-term relief of symptoms of anxiety  Acute alcohol withdrawal.DRUG NAME GENERIC NAME: DIAZEPAM ACTION Exact mechanism of action not understood. cardioversion and endoscopic procedures BRAND NAME: VALIUM AVAILABILTY: 10mg ampule .

additive to local anesthetic solutions for injection to prolong their duration of action and limit systemic absorption INJECTION:  Relief from respiratory distress of bronchial asthma. acute hypersensitivity reactions. in acute asthmatic attacks to relieve bronchospasm not controlled by inhalation or SC injection. the effects of which are mediated by alpha or beta receptors in target organs. bronchodilation. serum sickness. treatment and prophylaxis of cardiac arrest and attacks of transitory AV heart block with syncopal seizures. vasodilation and uterine relaxation. emphysema and other. Effects on beta receptors includes positive chronotropic and inotropic effects on the heart. Effects on alpha receptors includes vasoconstriction . angioneurotic edema. chronic bronchitis. urticaria.DRUG NAME GENERIC NAME: EPINEPHRINE ACTION Naturally occurring neurotransmitter. decreased production of aqeous humor INDICATIONS INTRAVENOUS:  In ventricular standstill after other measures have failed to restore circulation. relaxation of uterine musculature. syncope due to carotids sinus syndrome. BRAND NAME: ADRENALINE AVAILABILITY: 1mg ampule . given by trained perssonel by intracardiac puncture and intramyocardial injection. contraction of dilator muscles of iris.

increasing excitation threshold. increases ventricular fibrillation threshold. reducing height and rate of rise of the action potential. INDICATIONS AS ANTIARRHYTHMIC:  Management of acute ventricular arrhythmias during cardiac surgery and MI. use IM when Iv administration is not possible or when ECG monitoring is not available and the danger of the ventricular arrhythmias is great AS ANESTHETIC:  Infiltration anesthesia. spinal and caudal anesthesia. central nerve blocks. retrobulbar and transtracheal injection. topical anesthetic for skin disorders and accessible mucous membrane BRAND NAME: ANTIARRHYTHMIC PREPARATIONS: XYLOCAINE HCl for cardiac arrhythmias LOCAL ANESTHETIC PREPARATIONS: DILOCAINE TOPICAL FOR MUCOUS MEMBRANE: BAYLOCAINE TOPICAL DERMATOLOGIC: XYLOCAINE AVAILABILITY: 2% 50ml vial . peripheral and sympathetic nerve blocks.DRUG NAME GENERIC NAME: LIDOCAINE ACTION Type I antiarrhythmic: decreases diastolic depolarization. Local anesthetic: blocks the generation and conduction of action potentials in sensory nerves by reducing sodium permeability. and slowing conduction velocity. decreasing automaticity of ventricular cells.

By maintaining an alkaline Indication Is used for the treatment of metabolic acidosis which may occur in severe renal disease. circulatory insufficiency due to shock or severe dehydration.DRUG NAME GENERIC NAME: MAGNESIUM SULFATE ACTION Cofactor of many enzyme system involved in neurochemical transmission and muscular excitability. and raises blood pH. Sarah Ann Jamilla L. It is also a urinary alkalizer. Also is indicated in severe diarrhea which is often accompanied by a significant . which increases plasma bicarbonate. cardiac arrest and severe primary lactic acidosis. thereby. replacement therapy(IV)  Toxemia/eclampsia/nephritis(IV. attracts/retains water in the intestinal lumen and distends the bowel to promote mass movement and relieve constipation INDICATIONS  Hypomagnesemia. increasing the excretion of free bicarbonate ions in the urine. thus effectively raising the urinary pH. buffers excess hydrogen ion concentration. Drug name Sodium bicarbonate 50 meqs/ ampule Action Is a systemic alkalizer. prevents or control convulsions by blocking neuromuscular transmission. uncontrolled diabetes.IM)  Evacuation of the colon for rectal and bowel examinations(PO)  UNLABELED USE: inhibition of premature labor BRAND NAME: EPSOM SALT GRANULES AVAILABILITY: 250mg/ml vial Faciolan . extracorporeal circulation of blood. reversing the clinical manifestations of acidosis.

including PSVT associated with Wolff-ParkinsonWhite Syndrome. narrow-complex supraventricular tachycardias (SVT). including barbiturates (where dissociation of the barbiturateprotein complex is desired). arrhythmias and heart failure. By increasing blood flow in normal coronary arteries with little or no increase in stenotic arteries (with little to no increase in stenotic arteries). increasing the slope of phase 4 loss of bicarbonate. the actual dissolution of uric acid stones may be accomplished. pumps in more calcium. This effect may be mediated through the drug's activation of cell-surface A1 and A2 adenosine receptors. Adenosine 6mg vial slows conduction time through the AV node and can interrupt the reentry pathways through the AV node. Adenosine also inhibits the slow inward calcium current and activation of adenylate cyclase in smooth muscle cells. Increased intracellular concentrations of calcium may promote activation of contractile proteins (e. Digoxin 250 mcg ampule For the treatment and management of congestive cardiac insufficiency. as well as an adjunct to vagal maneuvers and clinical assessment to establish a specific diagnosis of undefined. Further indicated in the treatment of certain drug intoxications. resulting in the restoration of normal sinus rhythm in patients with paroxysmal supraventricular tachycardia (PSVT). This action results in increased pH value of stomach contents. Sodium bicarbonate acts as an antacid and reacts chemically to neutralize or buffer existing quantities of stomach acid but has no direct effect on its output. stable.urine. Used as an initial treatment for the termination of paroxysmal supraventricular tachycardia (PVST). myosin). The sodium calcium exchanger (NCX)in turn tries to extrude the sodium and in so doing. thus providing relief of hyperacidity symptoms. Inhibits the Na-K-ATPase membrane pump. Also used as an adjunct to thallous chloride TI 201 myocardial perfusion scintigraphy (thallium stress test) in patients who are unable to exercise adequately. resulting in an increase in intracellular sodium. Digoxin also acts on the electrical activity of the heart.g. actin. . in poisoning by salicylates or methyl alcohol and in hemolytic reactions requiring alkalinization of the urine to diminish nephrotoxicity of blood pigments. thereby causing relaxation of vascular smooth muscle. adenosine produces a relative difference in thallous (thallium) chloride TI 201 uptake in myocardium supplied by normal verus stenotic coronary arteries.. narrow-complex SVT. and is a drug of choice for terminating stable. including that associated with accessory bypass tracts.

Documented hypoglycemia (¡Ü 4 mmol) Seizures of unknown etiology Cerebral/meningeal edema related to eclampsia For the treatment of edema associated with congestive heart failure. shortening the action potential duration. motion sickness and insect bite.Diphenhydram ine 50mg ampule Dextrose 50% 50ml vial Furosemide 20mg ampule Hydrocortison e 100mg vial depolarization. This antagonizes the effects of histamine on HAreceptors. Because the thick ascending limb is responsible for 25% of sodium reabsorption in the nephron. nausea and vomiting. may decrease losses of body protein and nitrogen. Rapidly increases blood glucose levels Transient osmotic diuretic Dextrose provides a source of calories. Diphenhydramine competes with free histamine for binding at HAreceptor sites. thus preventing the transport of sodium from the lumen of the loop of Henle into the basolateral interstitium. Dextrose is readily metabolized. the lumen becomes more hypertonic while the interstitium becomes less hypertonic. including the nephrotic syndrome. Also used to treat endocrine (hormonal) disorders (adrenal . Consequently. and decreasing the maximal diastolic potential. After binding the receptor the newly formed receptor-ligand complex translocates itself into the cell nucleus. promotes glycogen deposition and decreases or prevents ketosis if sufficient doses are provided A loop diuretic inhibits water reabsorption in the nephron by blocking the sodium-potassiumchloride cotransporter (NKCC2) in the thick ascending limb of the loop of Henle. which in turn diminishes the osmotic gradient for water reabsorption throughout the nephron. Also for the treatment of hypertension alone or in combination with other antihypertensive agents. For the relief of the inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses. Binds to the cytosolic glucocorticoid receptor. leading to a reduction of the negative symptoms brought on by histamine HA-receptor binding. cirrhosis of the liver and renal disease. where it binds to many glucocorticoid response elements For the treatment of symptoms associated with Vertigo/Meniere's disease. furosemide is a very potent diuretic. This is achieved through competitive inhibition at the chloride binding site on the cotransporter.

Additionally the immune system is suppressed by corticosteroids due to a decrease in the function of the lymphatic system. emigration. The DNA bound receptor then interacts with basic transcription factors.(GRE) in the promoter region of the target genes. tissue plasminogen activator. lupus. causing the increase in expression of specific target genes. and Crohn's disease. insufficiency. chemotaxis. the two main products in inflammation Prostaglandins and Leukotrienes are inhibited by the action of Glucocorticoids. such as arthritis. respiratory burst and the release of various inflammatory mediators (lysosomal enzymes. The cyclooxygenase (both COX-1 and COX-2) expression is also suppressed. Glucocorticoids also stimulate the lipocortin-1 escaping to the extracellular space. through inhibition arachidonic acid. and interference with antigen-antibody binding. ulcerative colitis. Addisons disease). This leads to diminished eicosanoid production. a reduction in immunoglobulin and complement concentrations. The antiinflammatory actions of corticosteroids are thought to involve lipocortins. the precipitation of lymphocytopenia. phospholipase A2 inhibitory proteins which. chemokines etc. . It is also used to treat many immune and allergic disorders. severe asthma. In other words. cytokines. potentiating the effect. control the biosynthesis of prostaglandins and leukotrienes. severe psoriasis.) from neutrophils. macrophages and mastocytes. which then binds to cell membranes preventing the phospholipase A2 from coming into contact with its substrate arachidonic acid. Specifically glucocorticoids induce lipocortin-1 (annexin-1) synthesis. phagocytosis. where it binds to the leukocyte membrane receptors and inhibits various inflammatory events: epithelial adhesion.

hypotension. Promotes hepatic synthesis of active prothrombin. adjunct in cardiac surgery Phytonadione (Vitamin K) Hypoprothrombinemia caused by anticoagulant therapy . heart failure Mannitol Test dose for marked oliguria or suspected inadequate renal function. Stimulates beta1-adrenergic receptors of heart. Also protects kidneys by preventing toxins from forming and blocking tubules. and stuart Indication Treatment for Status epilepticus Verapamil hydrochloride Treatment for Angina Terbutaline sulfate Bronchospasm in reversible obstructive airway disease Dopamine hydrochloride Shock.Gabion. blood flow. These effects prolong AV node refractoriness and decrease myocardial oxygen consumption. Also reduces peripheral vascular resistance. Leanna Mae Drug Name Phenytoin Action Thought to limit seizure activity by promoting sodium efflux from neurons in motor cortex and reducing activity in brainstem centers responsible for tonic phase of tonic-clonic seizures. inhibits release of hypersensitivity mediators. inhibiting excitatory contraction. inhibiting tubular reabsorption of water and electrolytes (including sodium and potassium). These actions enhance water flow from various tissues and ultimately decrease intracranial and intraocular pressures. plasma thromboplastin component. and stroke volume. Also exerts inotropic effects on heart. which increases the heart rate. Relaxes bronchial smooth muscle by stimulating beta2-adrenergic receptors. Decreases conduction of sinoatrial and atrioventriclar (AV) nodes by inhibiting calcium influx into cardiac and vascular smooth muscle cells. myocardial contractility. leading to vasodilation of renal and mesenteric arteries. proconvertin. and promotes atrioventricular conduction. decreases ventricular filling pressure. causing a positive inotropic effect that increases myocardial contractility and stroke volume. Dobutamine Short term treatment of cardiac decompensation caused by depressed contractility( such as during refractory heart failure). especially from mast cells Causes norepinephrine release (mainly on dopaminergic receptors). Increases osmotic pressure of plasma in glomerular filtrate. hemodynamic imbalance. serum sodium level rises while potassium and blood urea levels fall.

decreases motor activity. Norepinephrine functions as a peripheral vasoconstrictor by acting on alpha-adrenergic receptors. Severe pain. Depresses pain impulse transmission at the spinal cord level by interacting with opioid receptors. reticular formation. It is also an inotropic stimulator of the heart and dilator of coronary arteries as a result of its activity at the beta-adrenergic receptors. may potentiate GABA by binding to specific benzodiazepine receptors. sedation. intubation. sedative for diagnostic endoscopic procedures. produces relaxation of coronary vascular smooth muscle and peripheral vascular smooth muscle. dilates coronary arteries. Depresses activity in brain cells primarily in reticular activating system in brainstem. often given after or during MI Chronic stable angina pectoris. Depresses subcortical levels in CNS. hypertension Isosorbide Midazolam Morphine Nicardipine Phenobarbital All forms of epilepsy. afterload. may act on limbic system. Inhibits calcium ion influx across cell membrane during cardiac depolarization.receptors in heart Decreases preload. febrile seizures in children. insomnia Noradrenaline Mainly used to treat patients in vasodilatory shock states such as septic shock and neurogenic shock and has shown a survival benefit over dopamine. and reducing cardiac O2 demand. and increases myocardial oxygen delivery in patients with vasospastic angina.factor Fiedacan. thus decreasing systematic vesicular resistance. Drug Name Dobutamine Action Causes increased contractility. able to decrease seizure activit by inhibition of impulses in CNS. Also used as a vasopressor medication for patients with critical hypotension. Preoperative sedation. increased coronary blood flow and heart rate by acting on B1. . also selectively depresses neurons in posterior hypothalamus. Irish Luz V. general anesthesia induction. refractory heart failure Chronic stable angina pectoris. prophylaxis of angina pain. status epilepticus. produces CNS depression. Indication Cardiac surgery. limbic structures.

Assessment Subjective Cues: Nursing Diagnosis Inference Planning Nursing Interventions Rationale Evaluation Objective Cues: .