Drug Study 3rd WK

Drug Study
Generic Name Classifcation Indication Dosage Nursing Responsibilities

Acetaminophe
n
Non-Opioid Analgesic/
Antipyretic
Mild to moderate
pain.
Fever control.
100 mg/mL, 160 mg/5 mL
O!"# ON$#" %#A& '!A"(ON
%O 0.5)1 *r 1)+ *r +), *r-
(. //in +0 min +0 min 0)6 *r
1al2-li2e3 Neonates3 4)5 *r. Ad5lts3 1)+ *r.
PO (Adults and Children >12 yr): +45)650
mg 6 0)6 *r or 1 g +)0 times daily or 1+00
mg 6 , *r 7not to e8ceed 0 g or 4.5 g/40 *r in
patients /it* *epatic/renal impairment9.
PO (Children 112 yr): 10)15 mg/:g/dose 6
0)6 *r as needed 7not to e8ceed 5 doses/40
*r9.
PO (Infants): 10)15 mg/:g/dose 6 0)6 *r as
needed 7not to e8ceed 5 doses/40 *r9.
Monitor liver and :idney 25nction, and
;<; periodically 2or clients on long-term
t*erapy.
;an ca5se psyc*ologic dependence.
Antidote3 Acetylcysteine 7M5comyst9

Trade Name Mechanism of Action Contraindication Aderse !"ects Actual #atient Response
Tylenol Analgesia3 in*i=its
2ormation o2
prostaglandins involved
/it* pain. Analgesia also
occ5rs =y action o2
*ypot*alam5s and =loc:ing
generation o2 pain
imp5lses.
Antipyretic3 in*i=its
2ormation o2
prostaglandins in
prod5ction o2 2ever. (t acts
on t*e *ypot*alam5s to
prod5ce vasodilation.
'oes not *ave anti-
in>ammatory or
antiplatelet action.

1ypersensitivit
y
$evere *epatic
impairment/
active liver
disease.

as*
"*rom=ocytopenia
Liver "o8icity 7to8icity can occ5r 4)40
*o5rs a2ter ingestion9
N/A
Chong $ua $ospital
'on Mariano ;5i $t. corner ?. Llorente $t., ;e=5 ;ity, %*ilippines 6000
%&ce of the Critical Care Serices Tel' (
)**'+,,, loc' -./*
!ducation0 Training 1 Research
Chong $ua $ospital
)**'+,,, loc' -./*
Drug Study
Generic
Name
Classifcation Indication Dosage Nursing Responsibilities
Morphine
Sulfate
Opioid Analgesic/
Agonist
elie2 o2 moderate to severe
pain.
%reoperative and/or
postoperative medication.
%ain relie2 in M(, relie2 o2
dyspnea occ5rring
in p5lmonary edema or
ac5te le2t ventric5lar
2ail5re.
10 mg/mL, 45 mg/mL
1al2-li2e3 Ad5lts3 4)0 *r.
O!"# ON$#" %#A&
'!A"(ON
(M 10)+0 min +0)60 min 0)5 *r
$5=c5t 40 min 50)@0 min 0)5
*r
(. rapid 40 min 0)5
*r
Epidural 630 in 1 hr up t!
2" hr
(" rapid 7min9 5n:no/n 5p to
40 *r
#pid5ral 7Ad5lts93
Interittent in#e$ti!nA5mg/day 7initially9B i2
relie2 is not o=tained at 60 min, 1)4 mg
increments may =e madeB 7total dose not to
e8ceed 10 mg/day9
C!ntinu!us infusi!n%4)0 mg/40 *rB may C=y 1)
4 mg/day 75p to +0 mg/day9B
Assess clientDs pain =e2ore giving medication.
#val5ate eEectiveness o2 analgesic incl5ding
onset and d5ration o2 response to medication.
O=serve 2or signs o2 tolerance /it* prolonged
5se.
Monitor respiratory rate and dept* =e2ore giving
dr5g, and periodically t*erea2ter.
#nco5rage sig*ing, co5g*ing, and deep
=reat*ing.
Farn am=5latory clients to avoid activities t*at
re65ire alertness.
Advise client to c*ange position slo/ly.
;*ec: 2or signs o2 5rinary retention.
&eep stool record and instit5te meas5res to
prevent constipation - e.g., >5ids, 2oods *ig* in
G=er, and activity as tolerated.
1ave narcotic antagonist 7nalo8oneHNarcanI9
availa=le 2or reversal o2 eEects i2 necessary.
Trade
N
a
m
e
Mechanism of
Action
Contraindication Aderse !"ects Actual #atient Response
M%S (n*i=its t*e
action o2
*istamine at
t*e 14-
receptor site
located
primarily in
gastric
parietal cells,
res5lting
in in*i=ition
o2 gastric
acid
secretion.
1ypersensitivity sedation
con25sion
e5p*oria
impaired coordination
diJJiness
urinary retenti!n
$!nstipati!n
*yperglycemia
respirat!ry depressi!n
*ypotension
tac*ycardia, =radycardia
na5sea K vomiting
allergic reactions
pupil $!nstri$ti!n
N/A
Drug Study
Generic
Name
Nalo2one
$ydrochlo
ride
Opioid Anatagonist %ostoperative
respiratory depression
ca5sed =y narcotics.
"*erapy in s5spected or
conGrmed narcotic
overdose.
0.0 mg/mL, 1 mg/mL
1al2-li2e3 60)@0 min 75p to + *r in
neonates9.
O!"# ON$#" %#A&
'!A"(ON
(. 1)4 min 5n:no/n
05 min
(M, $5=c5t 4)5 min 5n:no/n
L05 min
I& (Adults): 0.04)0.4 mg 6 4)+ min
5ntil response o=tainedB repeat 6 1)4
*r i2 needed.
I& (Children): 0.01 mg/:gB may repeat
6 4)+ min
5ntil response o=tained. Additional
doses may =e given 6 1)4 *r i2
needed.
#mergency res5scitative e65ipment needs to =e
availa=le.
Monitor .$, especially respirations.
Monitor s5rgical clients 2or =leeding.
Fit*dra/al symptoms /ill =e seen in client addicted to
narcotics 7vomiting, restlessness, a=dominal cramps,
increased <%, and temperat5re9.
%atients /*o *ave =een receiving opioids 2or L1 /: are
e8tremely sensitive to t*e eEects o2 nalo8one. 'il5te
and administer care25lly.
Administer 5ndil5ted 2or s5spected opioid overdose. For
!pi!id'indu$ed respirat!ry depressi!n, dil5te /it* sterile
/ater 2or inMection. For c*ildren or ad5lts /eig*ing L00
:g, dil5te 0.1 mg o2 nalo8one in
10 mL o2 sterile /ater or 0.@N Na;l 2or inMection.
Administer over +0 seconds 2or patients /it* a
s5spected opioid overdose. For patients /*o develop
opioid-ind5ced respiratory depression, administer dil5te
sol5tion o2 0.0 mg/10 mL at a rate o2 0.5 mL 70.04 mg9
direct (. every 4 min.
Assess patient 2or level o2 pain a2ter administration
Chong $ua $ospital
)**'+,,, loc' -./*
/*en 5sed to treat postoperative respiratory depression.
Nalo8one decreases respiratory depression =5t also
reverses analgesia.
Trade
N
a
m
e
Mechanism of
Action
Narcan Occ5pies opiate
receptor sites and
prevents or
reverses eEects o2
agonists.
1ypersensitivity *ypertension
tremors
reversal o2 analgesia
*yperventilation
increases %""
(n too-65ic: reversal3 na5sea,
vomiting, s/eating, tac*ycardia.
N/A
Drug Study
Generic
Name
Chong $ua $ospital
%&ce of the Critical Care Serices Tel' ( )**'+,,, loc' -./*
#henobarbita
l Sodium
<ar=it5rate/
$edative/1ypnotic/
Anti-conv5lsant
%re-operative
$edation
1ypnosis
$eiJ5re disorders
"a=lets3 15 mg, +0 mg, 60 mg, 100 mg
(nMection3 65 mg/mL, 1+0 mg/mL

1al2-li2e3 Neonates3 1.,),.+ days
(n2ants3 0.,)5.5 days
;*ildren3 1.5)+ days
Ad5lts3 4)6 days
O!"# ON$#" %#A&
'!A"(ON
%O +0)60 min 5n:no/n
L6 *r
(M, s5=c5t 10)+0 min 5n:no/n 0)
6 *r
(. 5 min +0 min
0)6 *r
%reoperative sedationA1)+ mg/:g %O/(M/(. 1)1.5 1o5rs
=e2ore t*e proced5re.
1ig* doses 2or long periods o2 time can
ca5se p*ysical dependence.
(. administration3 client m5st =e
monitored constantly3 ta:e ./$
2re65ently, *ave emergency
e65ipment availa=le, monitor 2or
e8travasation at in25sion site.
Fill ca5se restlessness in client in
pain.
Trade Name Mechanism of
Action
3uminal
1inders
movement o2
imp5lses 2rom
t*e t*alam5s to
t*e =rain
corte8, t*5s
creating
depression in
t*e ;N$, /*ic*
can range 2rom
mild to severe.
(n*i=its
transmission in
t*e nervo5s
system and
raises t*e
seiJ5re
t*res*old.
;onsidered a
long-acting
=ar=it5rate.
1ypersensitivity
;omatose
patients or t*ose
/it* pre-e8isting
;N$ depression.
$evere
respiratory
disease /it*
dyspnea or
o=str5ction.
!ncontrolled
severe pain.
'iJJiness, O*ang-overP
ata8ia
dro/siness,
an8iety, irrita=ility, *and tremors
vision diQc5lties
insomnia
=radycardia
lo/ =lood press5re
c*est tig*tness
/*eeJing
apnea, respiratory depression
na5sea, vomiting
constipation
*ypersensitivity reactions
N/A
Chong $ua $ospital
)**'+,,, loc' -./*
Drug Study
Generic
Name
Dia4epam Antian8iety Agents/
Anticonv5lsant/
$edative/1ypnotics
$:eletal M5scle
ela8ant/
<enJodiaJepine
An8iety disorders
M5scle rela8ant
;onv5lsive 'isorders
%reoperative
medication 7sedation9
5 mg/mL
1al2-li2e3 ;*ildren 14)16 yr3 1,)40 *r
Ad5lts3 40)50 *r
O!"# ON$#" %#A&
'!A"(ON
%O +0)60 min 1)4 *r 5p
to 40 *r
(M //in 40 min 0.5)1.5 *r
5n:no/n
(. 1)5 min 15)+0 min 15)
60 min-
(tatus Epilepti$us)(ei*ure:
I& (Adults): 5)10 mg, may repeat 6 10)
15 min to
a total o2 +0 mg, may repeat again in 4)
0 *r
I+, I& (Children -. yr): 0.05)0.+
mg/:g/dose
given over +)5 min 6 15)+0 min to a
total dose o2
10 mg, repeat 6 4)0 *r
(leletal +us$le /ela0ant:
I+, I& (Adults): 5)10 mgB may repeat in
4)0 *r
'o not mi8 /it* ot*er dr5gs in t*e same syringe.
;a5tio5s (. 5se as dr5g can precipitate in (.
sol5tions.
%arenteral administration can ca5se lo/ =lood
press5re, increased *eart rate, m5scle /ea:ness,
and respiratory
depression.
Monitor (KO.
5alium 'epresses t*e ;N$,
pro=a=ly =y
potentiating RA<A,
an in*i=itory
ne5rotransmitter.
%rod5ces s:eletal
m5scle rela8ation =y
in*i=iting spinal
polysynaptic
aEerent pat*/ays.
1as anticonv5lsant
properties d5e to
en*anced
presynaptic
in*i=ition.
1ypersensitivity
Myast*enia
gravis
$evere
p5lmonary
impairment
$evere *epatic
Angle-clos5re
gla5coma
'ry mo5t*
constipation
5rinary retention
p*otop*o=ia and =l5rred vision
*ypotension
tac*ycardia
m5scle /ea:ness
respiratory depression
N/A
Drug Study
Generic
Name
#henytoin Antiarr*yt*mic/
Anticonv5lsant/
1ydantoin
"onic-clonic and
comple8 partial
$eiJ5res
$tat5s epileptic5s
%revention o2 seiJ5res
t*at accompany
ne5ros5rgery
50 mg/mL
1al2-li2e3 44 *r 7range S)04 *r9
O!"# ON$#" %#A&
'!A"(ON
%O 4)40 *r 1.5)+ *r
6)14 *r
(. 0.5)1 *r rapid
14)40 *r
(. 7Ad5lts93 (tatus epilepti$us l!adin1
d!seA
15)40 mg/:g. ate not to e8ceed 45)
50 mg/min.
"a=let can =e cr5s*ed and s*o5ld =e mi8ed /it*
2ood or >5id.
;an t5rn 5rine pin:, red, or red-=ro/n.
(M ro5te not recommended.
'o not mi8 /it* ot*er dr5gs.
Monitor ;<;, liver, t*yroid, and 5rine tests.
Ringival *yperplasia seen most o2ten in c*ildren and
adolescents.
$top dr5g immediately i2 a measles li:e ras* occ5rs.
May lead to renal 2ail5re, r*a=domyolysis, or *epatic
necrosis.
Dilantin %revents
dissemination o2
electrical
disc*arges in
motor corte8 area
o2 t*e =rain.
Antiarr*yt*mic
properties is a
res5lt o2 s*ortening
t*e action
potential and
decreasing
a5tomaticity o2 t*e
*eart.
1ypersensitivity
Alco*ol intolerance
$in5s =radycardia,
sinoatrial =loc:,
4nd- or
+rd-degree *eart
=loc:
;on25sion
sl5rred speec*
slo/ p*ysical movement
=lood dyscrasias
na5sea, vomiting
constipation
1in1i2al hyperplasia
*irs5tism
ras*
acne
*ypotension
circ5latory collapse
cardiac arrest
N/A
Chong $ua $ospital
)**'+,,, loc' -./*
Drug Study
Generic
Name
#ropofol Reneral Anest*etic (nd5ction o2
general
anest*esia in
c*ildren and
ad5lts
Maintenance o2
=alanced
anest*esia /*en
5sed /it* ot*er
agents
(nitiation and
maintenance o2
monitored
anest*esia
care 7MA;9
$edation o2
int5=ated,
mec*anically
ventilated
patients in
intensive care
5nits 7(;!s9
10 mg/mL
1al2-li2e3 +)14 *r
O!"# ON$#" %#A&
'!A"(ON
(. 00 sec 5n:no/n
+)5 min
I& (Adults 3.. yr): Indu$ti!nA00 mg
6 10 sec 5ntil ind5ction ac*ieved 74)
4.5 mg/:g total9.
+aintenan$eA100)400 mcg/:g/min.
ates o2 150)400 mcg/:g/min are
5s5ally re65ired d5ring Grst 10)15
min a2ter ind5ction
Mac $ed: I& (Adults 3.. yr):
(nitiationA100)150 mcg/:g/min
in25sion or 0.5 mg/:g as slo/
inMection4 +aintenan$eA45)S5
mcg/:g/min in25sion or incremental
=ol5ses o2 10)40 mg.
Assess respiratory stat5s, p5lse, and <%
contin5o5sly
t*ro5g*o5t propo2ol t*erapy 72re65ently
ca5ses apnea lasting 60 sec9. Maintain
patent air/ay and ade65ate ventilation.
%ropo2ol s*o5ld =e 5sed only =y individ5als
e8perienced in endotrac*eal int5=ation,
and e65ipment 2or t*is proced5re s*o5ld =e
readily availa=le.
Assess level o2 sedation and level o2
conscio5sness t*ro5g*o5t and 2ollo/ing
administration.
'o not discontin5e a=r5ptly - may ca5se
rapid a/a:ening /it* an8iety, agitation,
and resistance to mec*anical ventilation.
Action
$*ort-acting
*ypnotic.
%rod5ces
amnesia.
1as no analgesic
properties.
1ypersensitivity
to propo2ol,
soy=ean oil, egg
lecit*in, or
glycerol
diJJiness
*eadac*e
A%N#A
a=dominal cramping, na5sea,
vomiting
N/A
Chong $ua $ospital
)**'+,,, loc' -./*
Drug Study
Generic
Name
6upiacaine #pid5ral Local Anest*etic Local or regional
anest*esia or
analgesia 2or
s5rgical,
o=stetric, or
diagnostic
proced5res.
$ol5tion 2or inMection 7preservative-
2ree93
0.45N, 0.5N, 0.S5N. (n com=ination
/it*3 epinep*rine 13400,000
1al2-li2e3 1.5)5 *r 7a2ter epid5ral 5se9
O!"# ON$#" %#A&
'!A"(ON
#pid5ral 10)+0 min 5n:no/n 4-,
*r
#pid5ral 7Ad5lts and ;*ildren T14
yr93 10)
40 mL o2 0.45N 7partial to moderate
=loc:9, 0.5N 7moderate to complete
=loc:9, or 0.S5N 7complete =loc:9
sol5tion. Administer in increments o2
+)5 mL allo/ing s5Qcient time to
detect to8ic signs/symptoms o2
inadvertent (. or (" administration. A
test dose o2 4)+ mL o2 0.5N /it*
epinep*rine sol5tion is
recommended prior to epid5ral
=loc:s
Monitor 2or sensation d5ring proced5re and ret5rn o2
sensation a2ter proced5re.
Assess 2or systemic to8icity 7circ5moral tingling and
n5m=ness, ringing in ears, metallic taste, diJJiness,
=l5rred vision, tremors, slo/ speec*, irrita=ility,
t/itc*ing, seiJ5res, cardiac dysr*yt*mias9 eac*
s*i2t. eport to *ealt* care pro2essional.
Monitor <%, *eart rate, and respiratory rate
contin5o5sly /*ile patient is receiving t*is
medication. Mild *ypotension is common =eca5se o2
t*e eEect o2 local anest*etic =loc: o2 nerve G=ers on
t*e sympat*etic nervo5s system, ca5sing
vasodilation. $igniGcant *ypotension and
=radycardia may occ5r, especially /*en rising 2rom
a prone position or 2ollo/ing large dose increases or
=ol5ses.
Marcaine Local anest*etics
in*i=it initiation and
cond5ction o2
sensory nerve
imp5lses =y altering
t*e in>58 o2 sodi5m
and eU58 o2
potassi5m in ne5rons,
slo/ing or stopping
pain transmission.
#pid5ral
administration
allo/s action to ta:e
place at t*e level o2
t*e spinal
1ypersensitivity circ5moral tingling and
n5m=ness
ringing in ears
metallic taste
diJJiness and =l5rred vision
tremors
slo/ speec*
irrita=ility
t/itc*ing
seiJ5res
cardiac dysr*yt*mias
na5sea, vomiting
5rinary retention
;A'(O.A$;!LA ;OLLA%$#,
arr*yt*mias, =radycardia,
N/A
Chong $ua $ospital
)**'+,,, loc' -./*
nerve roots
immediately adMacent
to t*e site o2
administration.
*ypotension,
tac*ycardia.
Drug Study
Generic
Name
$ydrala4ine Anti*ypertensive/
.asodilator
Moderate to
severe
*ypertension
40 mg/mL
1al2-li2e3 4), *r
O!"# ON$#" %#A&
'!A"(ON
(M 10)+0 min 1 *r
+), *r
(. 5)40 min 15)+0 min
4)6 *r
(M, (. 7Ad5lts93 5ypertensi!nA5)00 mg
repeated as needed. E$lapsiaA5 mg 6
15)40 minB i2 no response a2ter a total o2
40 mg, consider an alternative agent.
Monitor <% and p5lse 2re65ently d5ring initial
dose adM5stment and periodically d5ring
t*erapy.
May =e administered conc5rrently /it*
di5retics or =eta =loc:ers to permit lo/er
doses and minimiJe side eEects.
Action
Contraindicati
on
Aderse !"ects Actual #atient Response
Chong $ua $ospital
)**'+,,, loc' -./*
Apresoline 'irect-acting
perip*eral
arteriolar
vasodilator
1ypersensiti
vity
sodi5m retention, edema
tac*ycardia
dr5g-ind5ced l5p5s syndrome
diJJiness, dro/siness, *eadac*e
diarr*ea, na5sea, vomiting
N/A
Drug Study
Generic
Name
Dantrolene $:eletal M5scle
ela8ant
%O3 "reatment o2 spasticity
associated /it*3 $pinal
cord inM5ry, $tro:e,
;ere=ral palsy, M5ltiple
sclerosis.
%rop*yla8is o2 malignant
*ypert*ermia.
(.3 #mergency treatment o2
malignant *ypert*ermia.
;aps5les3 45 mg, 50 mg, 100 mg
%o/der 2or inMection3 40 mg/vial
1al2-li2e3 ,.S *r
O!"# ON$#" %#A&
'!A"(ON
%O 1 /: 5n:no/n
6)14 *r
(. rapid rapid
5n:no/n
(. 7Ad5lts and ;*ildren93 6reatent !f
ali1nant hypertheriaAat least 1
mg/:g 75p to + mg/:g9, contin5ed 5ntil
symptoms decrease or a c5m5lative
dose o2 10 mg/:g *as =een given. (2
symptoms reappear, dose may =e
repeated4 Pre2enti!n !f ali1nant
hypertheriaA4.5 mg/:g =e2ore
anest*esia.
Assess =o/el 25nction periodically. %ersistent
diarr*ea may /arrant discontin5ation o2 t*erapy.
Assess ne5rom5sc5lar stat5s and m5scle spasticity
=e2ore initiating and periodically d5ring t*erapy to
determine response.
Assess previo5s anest*esia *istory o2 all s5rgical
patients. Also assess 2or 2amily *istory o2 reactions
to anest*esia 7malignant *ypert*ermia or
perioperative deat*9.
Monitor #;R, vital signs, electrolytes, and 5rine
o5tp5t contin5o5sly /*en administering (. 2or
malignant *ypert*ermia.
econstit5te eac* 40 mg /it* 60 mL o2 sterile /ater
2or inMection
$*a:e 5ntil sol5tion is clear. $ol5tion m5st =e 5sed
/it*in 6 *r. Administer /it*o5t 25rt*er dil5tion.
%rotect dil5ted sol5tion 2rom direct lig*t.
Administer eac* single dose =y rapid contin5o5s (.
p5s* t*ro5g* V-t5=ing or +-/ay stopcoc:. Follo/
immediately /it* s5=se65ent doses as indicated.
Medication is very irritating to tiss5esB o=serve
Chong $ua $ospital
)**'+,,, loc' -./*
in25sion site 2re65ently to avoid e8travasation.
Action
Dantrium (nter2eres /it*
calci5m release
2rom t*e m5scle,
/*ic* ca5ses a
decrease in
m5scle
contraction.
%revents intense
cata=olic process
associated /it*
malignant
*ypert*ermia.
No contraindications
to (. 2orm in treatment
o2 *ypert*ermia
dro/siness
m5scle /ea:ness
malaise
diarr*ea
*epatoto8icity 7in e8tended 5se
at *ig* doses9
N/A
Drug Study
Generic
Name
Chong $ua $ospital
)**'+,,, loc' -./*
!pinephrine Nonselective 7Alp*a and
<eta9 Agonists/
<ronc*odilators/
.asopressor/
Adrenergic
"reatment o2
anap*yla8is and
=ronc*ospasm
;ardiac res5scitation
;ontrol or prevention
o2 lo/ =lood press5re
d5ring spinal
anest*esia,
lengt*ening eEects o2
local anest*esia
%romotion o2
mydriasis,
"reatment o2 ac5te
*ypotension
0.1 mg/mL 71310,0009, 1 mg/mL 71310009
1al2-li2e3 !n:no/n
O!"# ON$#" %#A&
'!A"(ON
$5=c5t 5)10 min 40 min W1)0 *r
(M 6)14 min 5n:no/n W1)0 *r
(. rapid 40 min 40)+0
min
(. 7Ad5lts93 (e2ere anaphyla0isA0.1)0.45
mg
6 5)15 minB may =e 2ollo/ed =y 1)0
mcg/min contin5o5s in25sionB
$ardi!pul!nary resus$itati!n
1 mg 6 +)5 minB =radycardia - 4)10
mcg/min
(. 7;*ildren93 (e2ere anaphyla0isA0.1 mg
7less
in yo5nger c*ildren9B may =e 2ollo/ed =y
0.1 mcg/
:g/min contin5o5s in25sion 7may give 5p
to 1.5
mcg/:g/min9B sypt!ati$
7rady$ardia)pulseless
arrest 0.01 mg/:g, may =e repeated 6 +)5
min *ig*er doses 75p to 0.1)0.4 mg/:g9
may =e considered.
!se great ca5tion in preparing and
calc5lating doses as t*is is a potent dr5g.
%rotect sol5tions 2rom lig*t, *eat, and
2reeJing.
1ave a 2ast-acting alp*a-adrenergic =loc:er
s5c* as p*entolamine 7egitine9 or
vasodilator s5c* as nitrite availa=le 2or
e8cessive *ypertensive reaction.
1ave an alp*a-adrenergic =loc:er availa=le
2or p5lmonary edema.
1ave a =eta-adrenergic =loc:er availa=le 2or
cardiac arr*yt*mias.
Monitor <%, p5lse, #;R, and respiratory rate
2re65ently d5ring (. administration.
;ontin5o5s #;R, *emodynamic parameters,
and 5rine o5tp5t s*o5ld =e monitored
contin5o5sly d5ring (. administration.
Adrenaline (t increases t*e 2orce o2
myocardial contraction
(ncreases systolic =lood
press5re, cardiac rate
and o5tp5t
ela8es =ronc*ial
smoot* m5scle
(n*i=its *istamine
release
%revents ins5lin release
and raises =lood s5gar
;onstricts arterioles in
:idneys, m5co5s
mem=ranes, and s:in
'ilates =lood vessels in
s:eletal m5scle
Lo/ers intraoc5lar
press5re
and decreases 2ormation
o2 a65eo5s *5mor
1ypersensitivity nervo5sness
restlessness
tremor
angina
arr*yt*mias
*ypertension
tac*ycardia
N/A
Drug Study
Generic
Name
Norepinephri
ne
.asopressor evives =lood press5re
in ac5te *ypotensive
states
7sympat*ectomy, spinal
anest*esia,
poliomyelitis,
septicemia, =lood
trans25sion, dr5g
reactions9

AdM5nct in treatment o2
cardiac arrest.
1 mg/mL in 0-mL amp5les
1al2-li2e3 !n:no/n
O!"# ON$#" %#A&
'!A"(ON
(. immediate rapid
1)4 min
(. 7Ad5lts93 0.5)1 mcg/min
initially, 2ollo/ed =y
maintenance in25sion o2 4)14
mcg/min titrated =y <%
response 7average rate 4)0
mcg/min, 5p to +0
mcg/min 2or re2ractory s*oc:
*ave =een 5sed9.
'o not mi8 dr5g in 100N saline sol5tions 7N$9 as
o8idation /ill occ5r. Mi8 in 5N de8trose sol5tion or
5N de8trose in saline
sol5tion.
Rive into large vein to prevent e8travasation.
;*ec: =lood press5re every 4 min5tes a2ter start o2
in25sion 5ntil desired =lood press5re is attainedB
t*en c*ec: =lood press5re every 5 min5tes i2
in25sion contin5ed.
Monitor (. site 2or e8travasation.
1ave p*entolamine 7egitine9 availa=le in case o2
e8travasation. 5)10 mg o2 p*entolamine 7egitine9
in 10)15 mL o2 saline s*o5ld =e inGltrated into area.
'r5g sol5tion s*o5ld =e clear and colorless.
3eophed (s an alp*a and =eta-1
receptor agonist and has
n! e8e$t !n 7eta'2
re$ept!rs4
(ts =iggest action is seen
on t*e cardiovasc5lar
system, /*ere t*e
2ollo/ing *appens3
-an increase in total
perip*eral resistance
-increased 2orce, rate, and
imp5lse cond5ction o2 t*e
*eart, /*ic* is 5s5ally
overridden =y activation
o2 =aroreceptors, t*5s
ca5sing
=radycardia.
Ot*er actions are
mydriasis and
elevated =lood gl5cose
and ins5lin
.asc5lar,
mesenteric, or
perip*eral
t*rom=osis
=radycardia
cardiac arr*yt*mias
*eadac*e
N/A
Chong $ua $ospital
)**'+,,, loc' -./*
Drug Study
Generic
Name
#henylephrin
e
Non ) $elective <eta
agonist
$ta=iliJes =lood
press5re d5ring
Anest*esia, vasc5lar
2ail5re in s*oc:
$5=d5es paro8ysmal
s5praventric5lar
tac*ycardia
For (. in25sion, c*ec: =lood press5re,
p5lse, and central veno5s press5re
every 4)5 min5tes.
(. overdose can ca5se ventric5lar
arr*yt*mias. %*entolamine 7egitine9
s*o5ld =e availa=le 2or *ypertensive
crisis seen in (. administration.
Fas* *ands a2ter *andling dr5g as
=l5rred vision and 5ne65al p5pil siJe
can res5lt i2 dr5g-contaminated Gnger
r5=s eye.
Neo7
Synephrine
%rod5ces
vasoconstriction and
increased =lood
press5re
1ypersensitivity *eadac*e, =ro/ac*e
=l5rred vision
increased sensitivity to lig*t
palpitations, tac*ycardia,
=radycardia 7overdose9
*ypertension
trem=ling, s/eating
2eeling o2 25llness in t*e *ead
sleeplessness
diJJiness, lig*t-*eadedness
tingling in e8tremities
N/A
Chong $ua $ospital
)**'+,,, loc' -./*
Chong $ua $ospital
)**'+,,, loc' -./*
Drug Study
Generic
Name
Dopamine Non ) $elective <eta
agonist
AdM5nct to standard
meas5res to
improve3 <%,
cardiac o5tp5t,
5rine o5tp5t in
treatment o2 s*oc:
5nresponsive
to >5id
replacement.
(ncrease renal
per25sion
7lo/ doses9.
400 mg/450 mL,
000 mg/450 mL
1al2-li2e3 4 min
O!"# ON$#" %#A&
'!A"(ON
(. 1)4 min 5p to 10 min
W10 min
(. 7Ad5lts93 9!painer1i$ (renal
2as!dilati!n) e8e$tsA1)5
mcg/:g/min. :eta'adrener1i$
($ardia$ stiulati!n) e8e$tsA5)15
mcg/:g/ min. Alpha' adrener1i$
(in$reased peripheral 2as$ular
resistan$e) e8e$tsAL15
mcg/:g/min- in25sion rate may =e
increased as needed.
M5st =e administered ca5tio5sly as even
small errors can prod5ce deleterio5s
eEects.
'o not mi8 /it* ot*er dr5gs.
%rotect dr5g 2rom lig*t.
(n25se into large vein. Monitor 2or
e8travasation and *ave p*entolamine
7egitine9 availa=le i2 t*is occ5rs.
;losely c*ec: =lood press5re, 5rine o5tp5t,
and cardiac o5tp5t.
(n25sion m5st =e administered via in25sion
p5mp to ens5re precise amo5nt delivered.
"itrate to response 7<%, *eart rate, 5rine
o5tp5t, perip*eral per25sion, presence o2
ectopic activity, cardiac inde89. 'ecrease
rate grad5ally /*en discontin5ing to
prevent mar:ed decreases in <%.
Intropin $mall doses 70.5)+
mcg/:g/min9
stim5late
dopaminergic
receptors,
prod5cing renal
vasodilation
Larger doses 74)10
mcg/:g/min9
stim5late
dopaminergic and
=eta1-adrenergic
receptors, prod5cing
cardiac stim5lation
and renal
vasodilation.
'oses greater t*an
10 mcg/:g/min
stim5late alp*a-
adrenergic
receptors and may
ca5se renal
vasoconstriction.
1ypersensitivity
"ac*yarr*yt*mi
as
%*eoc*romocyt
oma
tac*ycardia
palpitations
*ypotension
na5sea, vomiting
dyspnea
*eadac*e
N/A
Drug Study
Generic
Name
Dobutamin
e
(notropic/
Adrenergic
$*ort-term 7W0, *r9
management o2 *eart
2ail5re
ca5sed =y depressed
contractility 2rom
organic *eart
disease or s5rgical
proced5res.
450 mg/450 mL,
500 mg/450 mL
1al2-li2e3 4 min.
O!"# ON$#" %#A&
'!A"(ON
(. 1)4 min 10 min
=rie2 7min9
(. 7Ad5lts and ;*ildren93 4.5)15 mcg/:g/min
titrate to response 75p to 00 mcg/:g/min9
Monitor <%, *eart rate, #;R, cardiac
o5tp5t, ;.%, and 5rinary o5tp5t
contin5o5sly d5ring t*e
administration. eport signiGcant
c*anges in vital signs or
arr*yt*mias.
%alpate perip*eral p5lses and
assess appearance o2 e8tremities
ro5tinely t*ro5g*o5t do=5tamine
administration. Noti2y p*ysician i2
65ality o2 p5lse
deteriorates or i2 e8tremities
=ecome cold or mottled.
Trade
Na
me
Mechanism of
Action
Dobutre2 $tim5lates
=eta1
adrenergic
receptors
/it* relatively
minor eEect on
*eart rate or
perip*eral =lood
vessels
1ypersensitivity *ypertension,
increased *eart rate, premat5re
ventric5lar
contractions
N/A
Chong $ua $ospital
)**'+,,, loc' -./*

Drug Study 3rd WK

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Drug Study

Generic Name Classifcation Indication Dosage Nursing Responsibilities

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