Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Nursing

Contraindications Side Effects Responsibilities

Generic Name: Cardiac arrest: Action: Indications: Adverse Effects: Monitor V/S. and check
epinephrine 1 mg IV of 1:10,000 Stimulates beta receptors o Asthma
for cardiac
solution q 3-5 min; in lung. o Bronchitis
Brand Name: double dose if o Emphysema nervousness, tremor, dysrhythmias
Injection, OTC nasal administering Relaxes bronchial smooth o All cardiac arrest, vertigo, pain, widened
solution: via ET tube muscle. anaphylaxis pulse pressure, Drug increases rigidity
Adrenalin Chloride o Used for hypertension nausea and tremor in patients
Anaphylaxis: 0.1- 1 Increases vital capacity symptomatic
Ophthalmic solution: mg SQ or IM of  BP,  HR,  PR with Parkinson’s
bradycardia.
Epifrin, Glaucon 1:1000 solution. o Relief of Side Effects: disease
Decreases airway headache  Epinephrine therapy
bronchospasm
Insect sting Asthma: 0.1-0.3 mg resistance. occurring during interferes with tests for
emergencies: SQ or IM of 1:10,000 anesthesia
EpiPen Auto-Injector solution urinary catecholamine
Classification: o Exercised-induced
(delivers 0.3 mg IM  Avoid IM use of
Beta2 Adrenergic bronchospasm
adult dose), EpiPen Jr. Refractory parenteral suspension
Auto-Injector (delivers bradycardia and Agonists Contraindications: into buttocks. Gas
0.15 mg IM for hypotension: 2-
Contraindicate in patients gangrene may occur
children) 10ug/min
with angle-closure
OTC solutions for Massage site after IM
glaucoma, shock (other than
anaphylactic shock), injection to counteract
nebulization:
organic brain damage, possible
AsthmaNefrin,
cardiac dilation, vasoconstriction.
microNefrin, Nephron,
arrhythmias, coronary
S2  Observe patient
insufficiency, or cerebral
arteriosclerosis. Also closely for adverse
contraindicated in patient reactions. Notify doctor
receiving general anesthesia if adverse reaction
with halogenated develop
hydrocarbons or
cyclopropane and in  If blood pressure
patients in labor (may delay increases sharply, rapid-
second stage) acting vasodilators such
as nitrates or alpha

1
 Some products containing blockers can be given to
sulfites and are
counteract
contraindicated in patients
with sulfite allergies except
when drug is used for
serious allergic reactions or
in other emergency
situations.

In conjunction with local

anesthesia, epinephrine is
contraindicated for use in
finger, toes, ears, nose, and
genitalia.

Use cautiously with long-

standing bronchial asthma
and emphysema, who have
developed degenerative
heart disease and in those
with hyperthyroidism, CV
disease, hypertension,
psychoneurosis, or diabetes.

In pregnant woman, drug is

contraindicated.

In breast feeding do not use

the drug or stop breast
feeding.

Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing
Contraindications Effects Responsibilities
Generic Name: 1-1.5 mg/kg IVP or Action: Indications: Adverse Effects: Monitor EKG, BP,
lidocane ETT (double dose if Decrease cardiac pulse, rhythm,
Decrease cardiac CNS: Confusion,
giving via ET tube), excitability, cardiac continuously.

2
Brand Name: may repeat q 5-10 min. excitability, cardiac contraction is delayed in tremor, lethargy,
Xylocaine max the atrium and ventricle Monitor serum
contraction is delayed in somnolence, stupor,
3 mg/kg; If conversion lidocaine levels
successful start an the atrium and ventricle Contraindications: restlessness anxiety, throughout theraphy;
infusion of 2-4 mg/min Contraindicated in hallucinations, therapreutic range 1.5-5
Classification: patients hypersensitive to mcg/ml
nervousness, seizure.
Antiarrythmic and amide-type local
Anesthetic CV: hypotension,
anesthetics and in those Monitor intake and
with Adams –Stoke bradychardia, new or output
syndrome. Wolff- worsened arrhythmias
Parkinsons-White EENT: tinnitus, blurred Do not mix in the same
Syndrome, or severe syringe with amphoterin
or double vision.
degrees of SA, AV, or B or cefazolin
intraventricular block in Respiratory:
the absence of Respiratory depression
Administer Lidocaine
pacemaker. and arrest
TIV.
Skin: soreness at
injection site
In case of circulatory
Other: anaphylaxis,
depression have
dopamine available
Side Effects:
sensation of cold,
vomiting

Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing
Contraindications Effects Responsibilities
Generic Name: 0.5-1 mg/kg slow IVP Action: Indications: Adverse Effects: Monitor serum
furosemide over 1-2 min, may inhibits sodium and Edema associated with vertigo, headache, glucose, and electrolyte
Brand Name: repeat once at 2 mg/kg chloride reabsorption at CHF paresthesia, orthostatic D iet- K+
slow IVP over 1-2 the proximal and distal hypotension, for all except aldactone
Apo-Furosemide mins. tubules and the ascending Cirrhosis with ascites or thrombophlebitis, I ntake and
loop of Henlen renal dysfunction abdominal pain, Output, daily weight
Furoside Hypokalemia, anemia,

3
 Classification: For hypertension or in muscle spasm U ndesirable
Lasix Loop Diuretics combination with other effects; Fluid and
antihypertensive electrolyte imbalance
Lasix Speacial medications. R eview HR,
BP and electrolytes
Novosemide  ICP, nephritic E lderly-
syndrome, hepatic Careful
Uritol cirrhosis T ake with or
after meals and in AM
Contraindications: I ncrease risk
of orthosthatic
Contraindicated to hypotension; move
patients hypersensitive to slowly
drug or any of its C ancel
components and in those alcohol
with anuria.

Use cautiously in patient

with hepatic cirrhosis.

Patients with allergies to

sulfonamides may also
be allergic to furosemide.

In pregnant woman, use

only if benefits
outweighs the risk to the
fetus.

In breast feeding woman,

do not use drug.

Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing
Contraindications Effects Responsibilities
Generic Name: Adults: For rapid Action: Indications: Adverse Effects: Monitor K+, Mg++,

4
digoxin digitalization, give 0.4 Inhibits the sodium- V-fib, V-flutter, CHF, CNS: hallucinations, ECG, liver/renal
to 0.6 mg I.V. initially, potassium ATP phase. pulmonary edema, atrial paresthesia, stupor, function tests, drug level
Brand Name: followed by 0.1 to 0.3 fibrillation and or flutter, vertigo. (therapeutic level 0.5-
Lanoxin, Digoxin, mg I.V. every 4 hours, Classification: and paroxysmal atrial CV: Arrythmias, heart 2.0 mg/ml, toxicity is
Lanoxicap as needed and tolerated, Cardiac Glycosides contractions failure, hypotension. >2.0 mg/ml).
for 24 hours. EENT: blurred vision,
Contraindications: diplopia, light flashes, Before each dose assess
Children: digitalizing Contraindicated in photophobia, yellow- apical pulse for full
dose is based on child’s patients hypersensitive to green halos around minute, record and
age and is given in the drug or any of its visual images. report changes in rate or
three or more divided components and in those GI: anorexia, diarrhea, rhythm.
doses over the first 24 with digitalis-induced nausea, vomiting.
hours. First dose is toxicity, ventricular Withhold drug and
50% of total dose; fibrillation, or ventricular Side Effects: contact provider if pulse
subsequent dose are tachycardia unless caused CNS: agitation, is < 60/min. or >100
given q 4 to 8 hours as by heart failure. dizziness, fatigue, (adults) or < 110/minute
needed and tolerated. generalized weakness, (children)
Use cautiously in patients headache, malaise.
Children age 10 years with acute MI, in GI: Nausea Weigh daily
and older: For rapid complete Av block, sinus Monitor I&O and signs
digitalization, give 8 to bradycardia, PVCs,, of CHF
12 mcg/kg I.V. over 24 chronic constrictive
hours, divided as pericarditis, hyperthropic
above, Maintenance cardiomyopathy, renal
dose is 25% to 35% of insufficiency, severe
total digitalizing dose, pulmonary disease, or
given daily as a single hypothyroidism.
dose.

Children ages 5 to 10:

For rapid digitalization,
give 15 to 30 mcg/kg
I.V. over 24 hours
divided as above.
Maintenance dose is
25% to 35% of total
digitalizing dose,

5
divided and given in
two or three equal
portions daily.

Children ages 2 to 5:
For rapid digitalization:
give 25 to 35 mcg/kg
I.V. over 24 hours,
divided as above.
Maintenance dose is
25% to 35% of total
digitalizing dose,
divided and given in
two or three equal
portions daily.

Infants ages 1 month to

2 years: For rapid
digitalization. Give 30
to 50 mcg/kg I.V. over
24 hours, divided as
above. Maintenance
dose is 25% to 35% of
the total digitalizing
dose, divided and given
in two or three equal
portions daily.

Neonates: for rapid

digitalization, give 20
to 30 mcg/kg I.V. over
24 hours, divided as
above. Maintenance
dose is 25% to 30% of
the total digitalizing
dose, divided and given
in two or three equal

6
 portions daily.

Premature Infants: For

rapid digitalization,
give 15 to 25 mcg/kg
I.V. over 24 hours,
divided as above.
Maintenance dose is
20% to 30% of the total
digitalizing dose,
divided and given into
two or three equal
portions daily.

Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing
Contraindications Effects Responsibilities
Generic Name: 1 mEq/kg IVP, may Action: Indications: Adverse Effects: Monitor urinary pH,
Sodium Bicarbonate repeat 0.5 mEq/kg 10 Neutralizes gastric acid o Hyperacidity GI: Gastric distention, calcium, electrolytes
min. o Peptic ulcer belching, flatulence. and phosphate levels.
Brand Name: Arm Decrease pepsin activity o Hyperkalemia Metabolic: metabolic
and Hammer Pure o Tricyclic alkalosis, Record amount and
Baking Soda, Classification: antidepressant OD hypernatremia, consistency of stools.
Citrocarbonate, Soda Alkalizing Agent, Buffer, o Shock associated hypokalemia,
Mint Antacid, electrolyte with severe hyperosmolarity (with Clients on low-sodium
diarrhea, overdose). diets should evaluate
dehydration, Other: Pain and sodium contents of
uncontrolled DM irritation at injection antacids.
o Reflux esophagitis site.

Contraindications:
Contraindicated in patients
with metabolic or respiratory
alkalosis; patients who are
losing chlorides from
vomiting or continuous GI

7
 suction; patients taking
diuretics known to produce
hypochloremia alkalosis;
and patients with
hypocalcemia in which
alkalosis may produce
tetany, hypertension,
seizures, or heart failure.
Oral sodium bicarbonate is
contraindicated in patients
with acute ingestion of
strong mineral acids.

Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing
Contraindications Effects Responsibilities
Generic Name: Adults: initially, 1 to 5 Action Indications: Adverse Effects: Blood is not a substitute
Dopamine HCl. mcg/kg/minute by I.V. Stimulates dopaminergic To treat shock and Cv: anginal pain, for blood or fluid
infusion. Adjust dose and alpha and beta correct hemodnamic arrythmias, bradycardia, volume deficit. If deficit
Brand Name: to desired receptors of the imbalances, improve conduction disturbances occurs, replace fluid
Intropin; Revimine hemodynamic or renal sympathetic nervous perfusion of vital organs, ectopic deficit first before giving
response, increase by 1 system. Action is dose- to increase cardiac breasts,hypertension, meds.
to 4 mcg/kg/minute at related; large doses can output, and to correct hypotension, palpitations,
10 to 30-minute cause mainly alpha hypotension. tachycardia, During infusion,
intervals. stimulation. vasoconstriction, frequently monitor ECG,
Contraindications: widening of QRS BP, cardiac output, CVP,
Classification: Contraindicated in complex. pulmonary artery wedge
Inotropic, vasopressor patient with uncorrected pressure, pulse rate,
tachyarrhythmias, GI: vomiting. urine output, and color
pheocromocytoma, or and temperature of the
ventricular fibrillation. GU: azotemia limbs.
- Use cautiously in Respiratory: asthma
patients with occlusive attacks, dyspnea If diastolic pressure rises
vascular disease, cold disproportionately,
injuries, diabetic Skin: decrease perfusion rate
endarteritis, and arterial necrosis,piloerection, and watch out carefully
embolism; in pregnant tissue sloughing with for further signs of

8
 woman; with a history of
sulfite sensitivity; and in
those taking MAO
inhibitor.
extravasation. vasoconstriction unless
such action is desired.
Other: anaphylaxis.
Observe for adverse
Side Effects: reaction.
CNS: headache
GI: nausea Check for urine output.
If urine flow is decrease
without hypotension,
notify physician.

After drug is stopped,

Tamper dosage slowly to
evaluate stability of
blood pressure.

Acidosis decrease
effectiveness of
dopamine.

Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing
Contraindications Effects Responsibilities
Generic Bradycardia: 0.5 -1 mg Action Indication Adverse Effects Monitor VS.
Atrophine Sulfate IV (may give via ETT at cholinergic receptor sites As an anti-sialagogue for CNS: restlessness,
double dose) q 3-5 min, so response to preanesthetic medication ataxia, disorientation, Report  HR
Brand max 0.04 mg/kg acetylcholine is decreased to prevent or reduce hallucinations,
Isopto Atropine Cardiac arrest: 1 mg q secretions of the delirium, coma, Monitor for
3-5 min, max 0.04 mg/kg Classification respiratory tract insomnia, agitation, constipation, oliguria.
Anticholinergics confusion.
Nerve gas and To restore cardiac rate CV: tachycardia,
Atrophine could result
organophosphate and arterial pressure angina, arrhythmias,
in CNS stimulation
symptoms, may repeat during anesthesia, when flushing.
(confusion, excitement)
in 2 mg increments q 3 vagal EENT: photophobia,
or drowsiness
min tiltrated to relief blurred vision,
symptoms. stimulation produced by mydriasis.
intra-abdominal surgical GI: dry moth, Instruct to take 30 mins
traction causes a sudden constipation, vomiting. before meals

9
decrease in pulse rate GU: urine retention.
and cardiac action Hematologic: Eat foods high in fiber
leukocytosis and drink plenty fluids.
To lessen the degree of Other: anaphylaxis Avo
atrioventricular (A-V) id OTC antihistamines.
heart block when Side Effects Instr
increased vagal tone is a CNS: headache, uct client not to drive a
major factor in the excitement. motor vehicle or
conduction defect, as in CV: palpitations participate in activities
some cases due to GI: thirst, nausea. requiring alertness.
digitalis Advi
se to use hard candy, ice
To overcome severe chips, etc. for dry
carotid sinus reflex mouth.
Antidote for
cardiovascular collapse
from the injudicious use
of a cholinergic drug.

Contraindication
Contraindicated in
patients hypersensitive to
drug and those with acute
angle closure glaucoma,
obstructive uropathy,
obstructive disease of GI
tract, paralytic elius,
toxic magacolon,
intestinal atony, unstable
CV status in acute
hemorrhage, asthma, or
myasthenia gravis. Also
contraindicated in
pregnant women.

10
Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing
Contraindications Effects Responsibilities
Generic ADULTS Action Indication Adverse Effect Assessment
Morphine Sulfate Oral Principal opium alkaloid; Relief of moderate to CNS: Light- History:
One-third to one-sixth acts as agonist at specific severe acute and chronic headedness, dizziness, Hypersensitivity to
Brand as effective as opioid receptors in the pain sedation, euphoria, opioids; diarrhea caused

11
Immediate-release parenteral CNS to produce analgesia, dysphoria, delirium, by poisoning; labor or
tablets: administration because euphoria, sedation; the Preoperative medication insomnia, agitation, delivery of a premature
MSIR of first-pass receptors mediating these to sedate and allay anxiety, fear, infant; biliary tract
Timed-release: metabolism; 10–30 mg effects are thought to be apprehension, facilitate hallucinations, surgery or surgical
Kadian, M-Eslon q 4 hr PO. Controlled- the same as those induction of anesthesia, disorientation, anastomosis; head
(CAN), MS Contin, release: 30 mg q 8–12 mediating the effects of and reduce anesthetic drowsiness, lethargy, injury and increased
Oramorph SR hr PO or as directed by endogenous opioids dosage impaired mental and intracranial pressure;
Oral solution: physician; Kadian: 20– (enkephalins, endorphins). physical performance, acute asthma, COPD,
MSIR, Rescudose, 100 mg PO daily–24- Analgesic adjunct during coma, mood changes, cor pulmonale,
Roxanol, Roxanol T hr release system; MS anesthesia weakness, headache, preexisting respiratory
Rectal suppositories: Contin: 200 mg PO q Classification tremor, seizures, miosis, depression; acute
RMS 12 hr. Opioid agonist analgesic Component of most visual disturbances, abdominal conditions,
Injection: SC and IM preparations that are suppression of cough CV disease,
Astramorph PF, 10 mg (5–20 mg)/70 referred to as Brompton's reflex supraventricular
Duramorph, Epimorph kg q 4 hr or as directed cocktail or mixture, an tachycardias,
(CAN) by physician. oral alcoholic solution CV: Facial flushing, myxedema, seizure
Preservative-free IV that is used for chronic peripheral circulatory disorders, acute
concentrate for 2.5–15 mg/70 kg of severe pain, especially in collapse, tachycardia, alcoholism, delirium
microinfusion devices body weight in 4–5 mL terminal cancer patients bradycardia, arrhythmia, tremens, cerebral
for intraspinal use: water for injection palpitations, chest wall arteriosclerosis,
Infumorph administered over 4–5 Intraspinal use with rigidity, hypertension, ulcerative colitis, fever,
min, or as directed by microinfusion devices hypotension, orthostatic kyphoscoliosis,
physician. Continuous for the relief of hypotension, syncope Addison's disease,
IV infusion: 0.1– intractable pain prostatic hypertrophy,
1 mg/mL in 5% Dermatologic: Pruritus, urethral stricture, recent
dextrose in water by Unlabeled use: Dyspnea urticaria, Respiratory: GI or GU surgery, toxic
controlled infusion associated with acute left laryngospasm, psychosis, renal or
device. ventricular failure and bronchospasm, edema hepatic dysfunction;
Rectal pulmonary edema pregnancy; lactation
10–30 mg q 4 hr or as Contraindication GI: Nausea, vomiting,
directed by physician. anorexia, biliary tract Physical: T; skin color,
Epidural spasm; increased texture, lesions;
Initial injection of Contraindicated with colonic motility in orientation, reflexes,
5 mg in the lumbar hypersensitivity to patients with chronic bilateral grip strength,
region may provide opioids; diarrhea caused ulcerative colitis affect; P, auscultation,
pain relief for up to 24 by poisoning until toxins BP, orthostatic BP,
hr. If adequate pain are eliminated; during GU: Ureteral spasm, perfusion; R,

12
relief is not achieved labor or delivery of a spasm of vesical adventitious sounds;
within 1 hr, premature infant (may sphincters, urinary bowel sounds, normal
incremental doses of cross immature blood– retention or hesitancy, output; urinary
1–2 mg may be given brain barrier more oliguria, antidiuretic frequency, voiding
at intervals sufficient readily); after biliary effect, reduced libido or pattern, normal output;
to assess effectiveness, tract surgery or potency ECG; EEG; thyroid,
up to 10 mg/24 hr. For following surgical liver, kidney function
continuous infusion, anastomosis; pregnancy; Respiratory: tests
initial dose of 2–4 labor (respiratory Respiratory
mg/24 hr is depression in neonate; depression, apnea, Interventions
recommended. Further may prolong labor). circulatory Caution patient not to
doses of 1–2 mg may depression, chew or crush
be given if pain relief Use cautiously with head respiratory arrest, controlled-release
is not achieved injury and increased shock, cardiac preparations.
initially. intracranial pressure; arrest
Intrathecal acute asthma, COPD, cor Dilute and administer
Dosage is usually one- pulmonale, preexisting Side Effects slowly IV to minimize
tenth that of epidural respiratory depression, GI: dry mouth, likelihood of adverse
dosage; a single hypoxia, hypercapnia constipation. effects.
injection of 0.2–1 mg (may decrease Skin: Tissue irritation
may provide respiratory drive and and induration (SC Tell patient to lie down
satisfactory pain relief increase airway injection). during IV
for up to 24 hr. Do not resistance); lactation Other: sweating,physical administration.
inject > 2 mL of the (wait 4–6 hr after tolerance and
5 mg/10 mL ampule or administration to nurse dependence, Keep opioid antagonist
> 1 mL of the the baby); acute psychological and facilities for
10 mg/10 mL ampule. abdominal conditions, dependence assisted or controlled
Use only in the lumbar CV disease, respiration readily
area. Repeated supraventricular available during IV
intrathecal injections tachycardias, myxedema, administration.
are not recommended; seizure disorders, acute
use other routes if pain alcoholism, delirium Use caution when
recurs. For epidural or tremens, cerebral injecting SC or IM into
intrathecal dosing, use arteriosclerosis, chilled areas or in
preservative-free ulcerative colitis, fever, patients with
morphine preparations kyphoscoliosis, hypotension or in
only. Addison's disease, shock; impaired

13
 prostatic hypertrophy, perfusion may delay
PEDIATRIC urethral stricture, recent absorption; with
PATIENTS GI or GU surgery, toxic repeated doses, an
Do not use in psychosis, renal or excessive amount may
premature infants. hepatic dysfunction. be absorbed when
SC or IM circulation is restored.
0.05–0.2 mg/kg (up to Reassure patients that
15 mg per dose) q 4 hr they are unlikely to
or as directed by become addicted; most
physician. patients who receive
opioids for medical
GERIATRIC reasons do not develop
PATIENTS OR dependence syndromes
IMPAIRED
ADULTS Teaching points
Use caution.
Respiratory depression Take this drug exactly
may occur in the as prescribed. Avoid
elderly, the very ill, alcohol, antihistamines,
those with respiratory sedatives, tranquilizers,
problems. Reduced over-the-counter drugs.
dosage may be
necessary. Swallow controlled-
Epidural release preparation (MS
Use extreme caution; Contin, Oramorph SR)
injection of < 5 mg in whole; do not cut,
the lumbar region may crush, or chew them.
provide adequate pain
relief for up to 24 hr. Do not take leftover
Intrathecal medication for other
Use lower dosages disorders, and do not let
than recommended for anyone else take your
adults above. prescription.

These side effects may

occur: Nausea, loss of
appetite (take with food,

14
lie quietly); constipation
(use laxative);
dizziness, sedation,
drowsiness, impaired
visual acuity (avoid
driving or performing
tasks that require
alertness and visual
acuity).

Report severe nausea,

vomiting, constipation,
shortness of breath or
difficulty breathing,
rash.

15