c.

Drug Study
Date Ordered (mm/dd/yy) Generic Name (brand name) SIDE EFFECTS/ADVE RSE EFFECTS NURSING IMPLICATIONS/RESPOSIB LITIES

CLASSIFICA TION

DOSAGE

MECHANISM OF ACTION

INDICATION

CONTRAINDICATI ON

02/19/10

dobutamine hcl (Dobutrex)

Adrenergic s (sympatho mimetics) beta 1 selective adrenergic agonist

20ml (280mg/ 20ml) IVTT

Stimulates heart’s beta1 receptors to increase myocardial contractility and stroke volume. At therapeutic dosages, drug increases cardiac output by decreasing peripheral vascular resistance, reducing ventricular filling pressure, and facilitating AV node conduction.

To increase cardiac output caused by depressed contractility of the heart

Contraindicated to hypersensitivity to other sympatho mimetic amines, ventricular tachycardia.

CNS: headache, tremors, Paresthesias, mild leg cramps, nervousness fatigue(with over dose) CV: increase heart rate and BP premature ventricular beats palpitations angina pain GI: nausea, vomiting OTHER: nonspecific chest pain, shortness of breath.

 Give a plasma volume expander first before starting dobutamine therapy first to correct hypovolemia.  Monitor the effects of the medication by monitoring ECG and BP continuously during administration.  Observe patient with pre-existing hypertension closely for exaggerated pressor infusion.  Monitor intake and output ratio and pattern.  Report angina pain and report any unusualities to the physician.

22

c. Drug Study

DATE ORDERED (mm/dd/yy)

GENERIC NAME (BRAND NAME)

CLASSIFICA TION

DOSAGE

MECHANISM OF ACTION

INDICATION

CONTRAINDICATI ON

SIDE EFFECTS/ADVE RSE EFFECTS

NURSING IMPLICATIONS/RESPOSIB LITIES

02/19/10

famotidine (Pepcid)

H2receptor antagonist, antiscretor y

2omg IVTT q 12 hr

Competitively blocks the action of histamine at the H2 receptors of the parietal cells of the stomach; inhibits basal gastric acid secretion and chemically induced gastric acid secretions.

Intractable ulcerations or hyper secretory conditions.

Contraindicated in patient with sensitivity to drug or any of its components.

CNS: dizziness, headache, confusion, depression. GI: constipation, diarrhea. SKIN: rash, acne, pruritus, dry skin, flushing.

 Assess creatinine clearance before treatment.  Assess patient GI disorder before starting therapy and reassess regularly.  Be alert for adverse reactions.  Give daily doses or last dose of the day at bedtime.  Take drug with food tell patient/SO taking 20mg BID to take one dose HS.  Avoid over the counter drugs to treat heartburns.

23

c. Drug Study

c. Drug Study
GENERIC NAME (BRAND NAME) SIDE EFFECTS/ADVERS E EFFECTS

DATE ORDERED (mm/dd/yy)

CLASSIFICATI ON

DOSAGE

MECHANIS M OF ACTION

INDICATION

CONTRAINDICATIO N

NURSING IMPLICATIONS/RE SPOSIBLITIES

02/19/10

terbutalin e sulfate (Bricanyl)

Beta-Specific Adrenergic Agonists

5ml PO TID

Promotes contractio n by acting on beta 2adrenergic receptors.

To increase heart rate, conductivity and contractility

Contraindicated in patients hypersensitive to drug for any of its components or to sympathomimetic amines.

CNS: tremor, headache, drowsiness, dizziness, weakness. CV; tachycardia, arrhythmias, flushing, chest discomfort. EENT: tinnitus GI: vomiting, nausea, heartburn. METABOLIC: hypokalemia RESPIRATORY: paradoxical brochospasm, dyspnea SKIN: diaphoresis

 Asses patient’s condition before starting therapy and regularly there after to monitor drug’s effectiveness  Assess heart rate first before administering the drug  Monitor patient closely for toxicity especially if using with other adrenergics.

24

c. Drug Study
DATE ORDERE D (mm/dd/y y) GENERIC NAME (BRAND NAME) SIDE EFFECTS/ADVE RSE EFFECTS

CLASSIFIC ATION

DOSAGE

MECHANISM OF ACTION

INDICATION

CONTRAINDI CATION

NURSING IMPLICATIONS/RESPOSIBLITIES

02/19/10

dopamine hcL (Revimine)

Adrenergi cs (sympath omimetic s)

1amp + 200cc D5W via syringe pump

Stimulates dopaminergi c & alpha beta recptors of the sympathetic nervous system. Action is doserelated; cause mainly alpha stimulation.

To correct hemodynam ic imbalances, to improve hypotension , to increase cardiac output, to improve perfusion to vital organs

Contraindic ated to patients with pheochrom ocytana: tachy arrhythmia s or ventricular vibrillation. Use cautiously to patients with, cold injury, and arterial embolism.

CV: hypotension, ectopic beats, tachycardia, anginal pain, palpitation, vasoconstricti on (indicated by disproportiona te rise in diastolic pressure) cold extremities. GI: nausea and vomiting. CNS: headache. SKIN: necrosis, tissue sloughing with extravasation, gangrene, piloerection.

 Monitor blood pressure, pulse, peripheral pulses, and urinary output at time intervals prescribed by physicians.  Report following indicators promptly to physician for use in decreasing or temporarily suspending dose; reduce urine flow rate in absence of hypotension; ascending tachycardia; dysrythmias; disproportionate rise in diastolic pressure (mark decrease in pulse pressure); signs of peripheral schemia(pallor, cyanosis,mottling, coldness, complaints of tenderness, pain, numbness, or burning sensation).  Monitor therapeutic effects of the drug.

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