Generic name: Dopamine

Brand name: Intropin

Indication: Dopamine is indicated for the correction of hemodynamic imbalances present in

the shock syndrome due to myocardial infarction, trauma, endotoxic septicemia, open-heart
surgery, renal failure, and chronic cardiac decompensation as in congestive failure.
Contraindication: Dopamine is contraindicated in patients with pheochromocytoma or
uncorrected tachyarrhythmias including ventricular fibrillation and ventricular tachycardia. 
Side effects:

 rregular heartbeats.
 Nausea.
 Vomiting.
 Anxiety.
 Headache.
 Chills.
 Goosebumps.
 Shortness of breath.

Adverse effects: CV: Hypotension, ectopic beats, tachycardia, anginal pain, palpitation,

vasoconstriction (indicated by disproportionate rise in diastolic pressure), cold extremities; less
frequent: aberrant conduction, bradycardia, widening of QRS complex, elevated blood
pressure. GI: Nausea, vomiting. CNS: Headache. Skin: Necrosis, tissue sloughing with
extravasation, gangrene, piloerection. Other: Azotemia, dyspnea, dilated pupils (high doses).

Special precautions: Patients with history of occlusive vascular disease (e.g., Buerger's or Raynaud's
disease); cold injury; diabetic endarteritis, arterial embolism.

 May cause peripheral ischemia in patients with a history of occlusive vascular

disease
 If ischemia occurs, prevent sloughing and necrosis in ischemic areas by
infiltrating areas as soon as possible with 5-10 mg of phentolamine (adrenergic blocking
agent) in 10-15 mL of saline solution
 This medication contains dopamine
 Do not take Intropin if you are allergic to dopamine or any ingredients contained
in this drug
 Keep out of reach of children
 In case of overdose, get medical help or contact a Poison Control
Center immediately
 Nursing consideration:

 Monitor blood pressure, pulse, peripheral pulses, and urinary output at intervals
prescribed by physician. Precise measurements are essential for accurate titration of
dosage.

 Report the following indicators promptly to physician for use in decreasing or

temporarily suspending dose: Reduced urine flow rate in absence of hypotension;
ascending tachycardia; dysrhythmias; disproportionate rise in diastolic pressure (marked
decrease in pulse pressure); signs of peripheral ischemia (pallor, cyanosis, mottling,
coldness, complaints of tenderness, pain, numbness, or burning sensation).
 Monitor therapeutic effectiveness. In addition to improvement in vital signs and urine
flow, other indices of adequate dosage and perfusion of vital organs include loss of
pallor, increase in toe temperature, adequacy of nail bed capillary filling, and reversal of
confusion or comatose state.

Generic name: Epinephrine

Brand Name: Adrenin/ Bronkaid Mist

Indication: used in emergencies to treat very serious allergic reactions to insect
stings/bites, foods, drugs, or other substances. 
Contraindications: There are no absolute contraindications against using epinephrine.
Some relative contraindications include hypersensitivity to sympathomimetic drugs, closed-
angle glaucoma, anesthesia with halothane.

 Side effects: pale skin, sweating;

 nausea and vomiting;
 dizziness;

Adverse effect:
anxiety, apprehensiveness, restlessness, tremor, weakness, dizziness, sweating,
palpitations, pallor, nausea and vomiting, headache, and respiratory difficulties.
Special Senses: Nasal burning or stinging, dryness of nasal mucosa, sneezing, rebound
congestion. Transient stinging or burning of eyes, lacrimation, browache, headache, rebound
conjunctival hyperemia, allergy, iritis; with prolonged use: melanin-like deposits on lids, conjunctiva, and
cornea; corneal edema; loss of lashes (reversible); maculopathy with central scotoma in aphakic patients
(reversible). Body as a Whole: Nervousness, restlessness, sleeplessness, fear, anxiety, tremors, severe
headache, cerebrovascular accident, weakness, dizziness, syncope, pallor, sweating,
dyspnea. Digestive: Nausea, vomiting. Cardiovascular: Precordial
pain, palpitations, hypertension, MI, tachyarrhythmias including ventricular
fibrillation. Respiratory: Bronchial and pulmonary edema. Urogenital: Urinary
retention. Skin: Tissue necrosis with repeated injections. Metabolic: Metabolic acidoses, elevated
serum lactic acid, transient elevations of blood glucose. Nervous System: Altered state of perception
and thought, psychosis.

Special Precautions: Do not take other medicines unless they have been discussed with your
doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and
herbal or vitamin supplements.
Do not inject this medicine into your hands or feet. There is already less blood flow to the hands
and feet, and epinephrine could make that worse and cause damage to these tissues. If you
accidentally inject epinephrine into your hands or feet, check with your doctor or go to the
hospital emergency room right away.
Do not inject this medicine into your buttocks. Epinephrine may not work as well and may cause
gas gangrene. Check with your doctor or go to the hospital emergency room right away to get
additional treatment.
Anaphylaxis is a life-threatening reaction and requires immediate medical attention. Check with
your doctor right away, or go to an emergency room as soon as possible, even if you feel better
after using this medicine.

Nursing intervention:

 Monitor BP, pulse, respirations, and urinary output and observe patient closely following
IV administration. Epinephrine may widen pulse pressure. If disturbances in cardiac
rhythm occur, withhold epinephrine and notify physician immediately.
 Keep physician informed of any changes in intake-output ratio.
 Use cardiac monitor with patients receiving epinephrine IV. Have full crash cart
immediately available.
 Check BP repeatedly when epinephrine is administered IV during first 5 min, then q3–
5min until stabilized.
 Advise patient to report to physician if symptoms are not relieved in 20 min or if they
become worse following inhalation.
 Advise patient to report bronchial irritation, nervousness, or sleeplessness. Dosage should
be reduced.
 Monitor blood glucose & HbA1c for loss of glycemic control if diabetic.

brand name: Suxemethonium

Generic: Succinylcholine

Indication: It is used in anaesthesia as a skeletal muscle relaxant to facilitate tracheal

intubation and mechanical ventilation surgical procedures. 

Contraindation: Hypersensitivity to drug or component; malignant hyperthermia, lack of

ventilatory support, ocular surgery, penetrating eye injuries, closed-angle glaucoma,
genetically determined disorders of plasma pseudocholinesterase, history of malignant
 hyperthermia, myopathies associated with elevated serum creatine kinase, acute phase
of injury following major burns (hyperkalemia may occur), multiple trauma,
extensive denervation of skeletal muscle or upper motor neuron injury

Side effects: excessive saliva,

muscle cramps, and

muscle pain

Special Precautions:

 This medication contains succinylcholine. Do not take Anectine or

suxamethonium if you are allergic to succinylcholine or any ingredients contained in this
drug.

Nursing intervention:

 Lab tests: Obtain baseline serum electrolytes. Electrolyte imbalance (particularly

potassium, calcium, magnesium) can potentiate effects of neuromuscular blocking agents.
 Be aware that transient apnea usually occurs at time of maximal drug effect (1–2 min);
spontaneous respiration should return in a few seconds or, at most, 3 or 4 min.
 Have immediately available: Facilities for emergency endotracheal intubation, artificial
respiration, and assisted or controlled respiration with oxygen.
 Monitor vital signs and keep airway clear of secretions