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Drug General Mechanism of Contraindications Indications Side effect Nursing

Action action responsibilities

Generic name: Thrombolytic Acts with Any condition Arterial Minor bleeding at 1.NaCl injectioin or
Streptokinase enzyme plasminogen to presenting a risk of thrombosis and invaded or disturbed D5W is the preffered
produce a new hemorrhage, such embolism, acute sites, major diluent for IV use.
activator complex as recent surgery or evolving bleeding, fever, 2. For AV cannulae,
Brand Name: which enhances biopsies, delivery tansmural MI. shivering in acute dilute 250,000 units
Streptase the conversion of within 10 days, pulmonary MI. with 2 ml of NaCl
of plasminogen to ulcerative disease. embolism, CV: superficial injection or D5W.
Route of plasmin. Plasmin Arterial emboli clearing of bleeding, minor 3. reconstitute gently,
Administration: then beaks down originating from occluded bleeding at invaded a directed without
IV fibrinogen, fibrin left of the heart. arteriovenous or disturbed sites. shaking the vial.
clots, and other Also hepatic or and IV Severe and internal 4. use within 24 hour
Dosage: plasma protein renal insufficiency, cannulae, bleeding involving of reconstitution
250,000 IU/ 30 promoting the tuberculosis, recent GI, GU, 5. use an electronic
min dissolution of he cerebral embolism, retroperitoneal or infusion device to
insoluble fibrin thrombosis, intracerebral sites. administer
trapped in hemorrhage, SBE, Allergic: Nausea, streptokinase and do
intravascular rheumatic valvular headache, breathing not add any other
emboli and disease, difficulties, fever, medications to the
thrombi. Also, thrombocytopenia. shivering, line. Note any redness
inhibitors of Streptokinase bronchospasm, and or pain at the site
streptokinase such resistance in excess angioneurotic 6. Do not add any
as alpha-2- of q million IU. Use edema, urticaria, medication to
macroglobulin are to restore patency itching, flushing, streptokinase.
rapidly inactivated to IV catheters. musculoskeletal 7. Identify other
by streptokinase, pain, vasculitis, drugs taking such as
interstitial nephritis, aspirin or NSAIDs
respiratory that could increase
depression, back bleeding times.
Drug General Mechanism of Contraindications Indications Side effect Nursing
Action action responsibilities
Generic name: Inceases the force Ventricular CHF, including Tachycardia, 1.note any drugs
Digoxin Cardiac and velocity of fibrillation or that due to headache, dizziness, prescribed that
Glycoside myocardial tachycardia(unless venous mental disturbances, would adversely
Brand Name: contraction by congestive failure congestion, diarrhea, anorexia, interact with digoxin
Digitek, digoxin increasing the supervenes after edema, blurred or yellow and monitor
injection, refractory period protracted episode dyspnea, vision, hypokalemia 2. Assess for hyper
Lanoxicaps, of the AV node and not due to digitalis), orthopnea, and CV: changes in the or hypothyroidism
Lanoxin increasing total in presence of cardiac heart rate, rhythm 3. monitor vital signs
peripheral digoxin toxicity, arrhythmia. and irritability of the 4. monitor weighs
Route of resistance. This hypersensitivity to May be drug of heart and the and input and output
Administration: effect is due to cardiac glycosides, choice for CHF mechanism of the 6. if taking non-K-
Drug General Mechanism of Contraindica Indications Side effect Nursing
Action action tions responsibilities

Blocks acetylcholine Infants less Peptic ulcer dry mouth, urinary 1. Do not use 3 AtroPen
Generic Name: Cholirgenic effects on than 3 months treatments, hesitancy, injections unless under
Atropine Sulfate blocking drug prostaganglionic of age, pylorospasm, headache, flushing, supervision of trained
receptors in smooth primary biliary and constipation, medical provider
Band name: muscle, cardiac glaucoma or a ureteral colic heartburn, blurred 2. note indications for
Atropen, muscle, exocrine tendency spasm and vision, stinging, therapy
Atropair, glands, urinary toward bronchial increased 3.check for glaucoma
atropine sulfate bladder, and the AV glaucoma, spasms, intraocular before ophthalmic
ophthalmic, and SA nodes of the adhesions preanesthetic to pressure, administration
heart. between the control 4. obtain VS and ECG;
Route of Ophthalmologically iris and the salivation and monitor CV status
administration: blocks acetylcholine lens, geriatric bronchial during the therapy.
Oral, parenteral, effects n the sphincter clients and secretions, 5.use the ATropen auto
ophthalmic muscle of the iris and others where restoration of injector as soon as
the accommodative undiagnosed CR during symptoms of
Dosage: muscle of the ciliary glaucoma or anesthesia, organosphosphorus or
0.3-1.2 mg q 4-6 body. This results in excessive decrease degree carbamate poisoning
hr dilation of the pupil pressure in the of AV heart appear.
and paralysis f the eye may be block, severe 6. After instillation of
muscles required to present, in bradycardia and ophthalmic ointment,
accommodate for children who syncope, compress the lacrimal
close vision have had a sac by digital pressure
previous for 1-3 min to decrease
severe systemic effects.
reaction to
Drug General Mechanism of Contraindicatio Indications Side effect Nursing
Action action ns responsibilities

Epinephrine, an Preexisting Advanced epigastric pain; CV 1. note indications

Generic Name: Antiglaucoma active principle of hypertension; cardiac life disorders; difficulty in for therapy, onset,
Epinephrine preparations the adrenal occlusive support, micturition with characteristics of
medulla, is a vascular disease; anaphylactic urinary retention; signs and
Brand Name: direct-acting angle-closure shock, ocular dyspnoea; symptoms.
epinephrine sympathomimetic. glaucoma (eye hypertension, hyperglycaemia; 2. monitor v/s
Amp, adrenin It stimulates α- and drops); open-angle sweating; 3. document disease
amp, β-adrenergic hypersensitivity; glaucoma, hypersalivation; onset, subtype,
receptors resulting cardiac asthmatic attacks weakness, tremors; other agents trialed
in relaxation of arrhythmias or coldness of and outcome.
smooth muscle of tachycardia. extremities; 4. take extra
the bronchial tree, When used in hypokalaemia. precaution on the
cardiac stimulation addition to local Gangrene, tissue patients with
and dilation of anaesthetics: necrosis and sloughing following
skeletal muscle Procedures (extravasation) when conditions: CV
vasculature. It is involving digits, used in addition to diseases;
frequently added to ears, nose, penis local anaesthetics. Eye hyperthyroidism;
local anaesthetics or scrotum. drops: Severe DM; Parkinson's
to retard diffusion smarting, blurred disease; elderly;
and limit vision, photophobia; pregnancy,
absorption, to naso-lachrymal ducts lactation.
prolong the obstruction. Oedema,
duration of effect hyperaemia and
and to lessen the inflammation of the
danger of toxicity. eyes with repeated
Drug General Mechanism of action Contraindications Indications Side effects Nursing
Action responsibilites

As a component of a Hypersensitivity to Hemorrhage or severe, shock- 1. The 10 mg/mL

Generic Name: Haemostatics liver carboxylase any of the threatened like reactions. mixed-micelle
Konakion system, it is involved in constituents of hemorrhage as a In rare cases, ampoule must not
the carboxylation of the Konakion MM/MM result of severe anaphylactoid be given to infants
Brand Name: coagulation factors II Pediatric. hypoprothrombi reactions have <1 year old
Konakion MM (prothrombin), VII, IX Pronounced allergic nemia (ie, been reported 2. Parenteral
and X, and of the diathesis. deficiency of after administration
Route of coagulation inhibitors coagulation parenteral use may be associated
administration: protein C and protein S factors II, VII, of konakion with an increased
Parenteral, oral in the post-ribosomal IX, X) due, for MM Pediatric. risk of kernicterus
phase. Anticoagulants of instance, to Local in premature
Dosage: the dicoumarol type overdosage of irritation may infants weighing
Therapy: 10 mg inhibit reduction of anticoagulants occur at the <2.5 kg.
(up to 20 mg) vitamin K1 (quinone of the injection site, 3. At the time of
form) to vitamin K1 dicoumarol type but is unlikely use, the ampoule
Oral: 2 mg hydroquinone and also or their due to the solution must be
prevent the vitamin K1 combination small clear. Improper
epoxide which arises with injection storage can cause
after the carboxylation phenylbutazone volume. turbidity or phase
reaction from being or to other separation. In this
reduced to the quinone forms of case, the ampoule
form. Phytomenadione hypovitaminosis must not be used.
is thus an antagonist of K; Prophylaxis
Marcouman and similar and treatment of
anticoagulants. It does hemorrhagic
not, however, inhibit the disease of the
action of heparin;. newborn.
Drug General Mechanism of Contraindications Indications Side Effects Nursing
Action action Responsibilities

Nonsteroidal Posseses anti- Hypersenstivty to Severe, acute pain in Headache, 1. use as a part of
Generic Name: anti- inflammatoy, the drug or allergic adults, itching dizziness, a regular
Ketorolac inflammatory analgesic, and symtpms to aspirin causzed by seasonal rdrowsiness, analgesic
tromethamine antipyretic effects or other NSAIDs. allergic diarrhea, nausea, schedule rather
Active peptic ulcer conjunctivitis, , post dyspepsia, than on an as-
Brand Name: disease, recent GI operative indigestion, needed basis
Acular bleeding or inflammation epigastric pain, 2. if given p.r.n,
perforatin, history following cataract edema, transient basis, base size
Route of of peptic ulcer surgery, reduce burning stinging of repeat dose.
Administration disease, advanced ocular pain, burining upon administration, If pain returns
IM, IV, PO, renal impairment and stinging after ocular irritation, within 3-5 hr,
ophthalmic and in those at risk corneal refractive the enxt dose
for renal failure due surgery, reduction of can be
Dosage: to volume ocular pain and increased by up
60 mg for less depletion, photophobia to 50 percent
than 65 years suspected or following incisional 3. shortening the
old, IM confirmed refractive surgery, dosing intervals
cerebrovaxcula recommended
30 mg for IV bleeding, will lead to an
hemorrhagic increased
60 mg PO diathesis, or frequency and
incomplete duation of side
1gtt 4x a day hemostasis and in effects.
for ophthalmic those with high risk
route of bleeding.
Drug General Mechanism of Contraindications Indications Side Effects Nursing
Action Action responsibilities

The analgesic effect Hypersensitivity to Moderate to Dizziness, headache, not confuse
Generic Name: Analgesic is only partially tramadol, in acute moderately severe CNS stimulation, Ultram with Ultrase
Tramadol antagonized by the intoxication with pain. ataxia, sedation, 2. List easons for
hydrochloride antagonist alcohol, hypnotics, vertigo, itching, theapy, location,
naloxone. Causes centrally acting constipation, nausea, onset, trigges,
Brand name: significantly lesss analgesics, opiates seizures, characteristics of S
Ultram, Ultram respiratory or psychotropic paresthesia, and S. use a pin-
ER depression than drugs. Use in cognitive rating scale to rate
morphine. In cleitns with past r dysfunction, pain.
Route of contrast to resent addictin or hallucinations, 3. Assess for history
administration: morphine, tramadol opiate dependence tremor, amnesia, of drug addiction,
Oral does not cause or in those with a concentration allergy to opiates or
release of prior history of difficulty, abnormal codeine, seizures;
Dosage: histamine. Produces allergy to codeine gait, migraine, drug may increase
50-100mg q 4-6 dependence of the or opiates. Use for nausea, constipation, the risk of
hr prn mu-opioid type obstetric vomiting, dyspepsia, convulsions
how ever there is preoperative dry mouth, diarrhea, 4. Monitor VS, Iand
little evidence of medicatin of anorexia O, renal and LFTs,
abuse. Tolerance postdelivery reduce dose with
occurs but is analgesia In dysfunction and if
relatively mild; the nursing mothers. over 75 years old.
syndrome is not as
severe as with other
Drug General Mechanism of Contraindication Indication Side Effect Nursing
action Action responsibilities
High sedative, Premature & Hay fever, CV & CNS effects. 1. note reasons fo
Generic Name: antihistamine anticholinergic, newborn infants; urticaria, Blood disorders. GI therapy, signs and
Diphenhydrami and antiemetic asthma attack; vasomotor rhinitis, disturbances. symptoms of
ne HCl effects lactation. angioneurotic Antimuscarinic charactgeristics,
edema, drug effects. Allergic other agents trialed,
Brand Name: sensitization, reactions. triggers, outcome
Benadryl serum & penicillin Drowsiness, 2. do not confuse
reaction, contact constipation, diphenhydramine
Route of dermatitis, atopic diarrhea, dizziness, with desipramine
administration: eczema, other dry mouth, nose, with
Oral, IV or IM allergic throat, headache, dimenhydrinate
dermatoses, anorexia, anxiety, GI 3. take 30 minutes
Dosage: Cap pruritus, food upset, asthenia before travel
Adult & childn sensitivity, 4. use sugarless
≥12 yr 25-50 mg parkinsonism, gum, candy to
tid-qid. Syr motion sickness. diminish dry mouth
Adult & childn effects.
≥12 yr 12.5-25 5. avoid alcohol and
mg qid. Childn 6 any other CNS
yr-<12 yr 12.5 depressants unless
mg qid, 2-<6 yr prescrived
6.25 mg qid. 6. Stop therapy 72-
96 hour before skin
Drug General Mechanism of Contraindication Indication Side effect Nursing
action Action responsibilities
Relaxes vascular Use to abort Angina pectoris, Headache, vascular 1.note reasons fo
Generic Name: Anti-angina, smooth muscle by anginal attacks acute and chronic headache, therapy; include
Isosorbide coronary stimulatng CHF lightheadedness, onset, location,
dinitrate vasodlator production of hypotension. characteristics of
intracellular cyclic chest pain; pain
Brand Name: guanosine levels
Isordil monophosphate. 2.assess VS and
Dilation of post ECGT; note stress
Route of capillary vessels thallium,
administration: decreases venous catheterization, or
Sublingual, oral return to the heart IVUS findins as
due to pooling of well as CAD
Dosage: blood; thus LV history/intervention
Oral 5-30 mg end-diastolic s.
qid. Sublingual pressure is educed. 3. store at room
5-10 mg 2-3 hrly. Elaxation of temperature
Acute CHF arteriololes results protected from
Oral 10-40 mg in a decreased light. Keep bottles
qid. Sublingual systemic vascular tighly closed.
5-10 mg 2 hrly. resistance and Dipense in alight
Chronic CHF arterial pressure. resistant tight
Initially 5-10 contaainer
mg/day 2 hrly
Maintenance: 20-
40 mg qid orally.
Drug General Mechanism of Contraindicatio Indications Side Effects Nursing
Action action ns Responsibilities
. It blocks the calcium Cardiovascular All forms of Side effects are 1. dot not confuse
Generic Name: Calcium or "slow" channels and shock, severe hypertension, mild, transient and nifedipine with
Nifedipine channel inhibits entry of aortic stenosis or primary or relatively nicardipine
blocker calcium ions into in patients known secondary. infrequent. These 2. do not exceed a
Brand Name: vascular smooth to be Nifedipine is most include flushing, single dose
Calcibloc muscles particularly of hypersensitive to effective for mild to nausea, dizziness, 3. before increasing
resistance vessels and nifedipine. Care moderate degrees of headache, tiredness, dose, carefully
Route of coronary arteries. is needed in hypertension but the sedation, leg edema monitor BP
administration: dilates coronary and patients with very capsule may be and other 4. use only the
Oral peripheral arteries, as low blood bitten and swallowed manifestations of sustained release
well as veins. pressure (severe for more rapid peripheral tablets to treat
Dosage: Coronary arterial hypotension with effects as in vasodilation. hypertension
Capsules: 10-20 vasodilation increases systolic pressure hypertensive crises. 5. concomitant
mg 3x a day coronary blood flow in <90 mmHg) or Hypertension in therapy with beta
Tablets: 30-60 the ischemic post- decompensated pregnancy (at any renergic blocking
mg per day stenotic areas, while heart failure. term of pregnancy). agents may be used
dilation of the Coronary 6. clients withdrawn
peripheral arteries insufficiency with or from beta blockers
lowers arterial blood without angina. may manifest
pressure and reduces Vasospastic angina symptoms of
left ventricular (Prinzmetal's increased angina
afterload. Some renal angina). To increase which cannot be
artery dilatation may heart rate in patients prevented by
stimulate mild with sinus nifedipine; in fact
diuresis. bradycardia and nifedipine may
sick-sinus syndrome. increase the severity
of angina situation