Assignment of pharmachology

Drugs

● Name :Albra Ibrahim Alneami

● ID number :201911871

● Level :5

● Year :2021

● Under supervision : Dr. Abdul Vahed Mohammad

NO. Drug name Dose & Indications contraindications Mechanism of Side effects
generic & brand formulation action

1.Acetaminophen Generic Name: Adult Dosage Like other OTC . caloric The exact . stomach pain,
acetaminophen Forms & pain relievers, undernutrition. mechanism of . loss of appetite,
Strengths acetaminophen . acute liver action of . itching,
Brand Name: temporarily failure. acetaminophen is . rash,
Tylenol, Tylenol Tablets relieves minor . liver problems. not known. It may . headache,
Arthritis Pain, 325 mg aches and pains . severe renal reduce the
Tylenol Ext, 500 mg due to headache, impairment. production of
backache, the prostaglandins in
Caplets common cold, the brain.
325 mg minor pain of Prostaglandins
500 mg arthritis, are chemicals
650 mg toothache, that cause
premenstrual and inflammation and
Capsules menstrual swelling.
500 mg cramps, and
muscular aches,
Gelcaps/Geltabs and temporarily
500 mg reduces fever.

Caplets,
Extended
Release
650 mg
 Tablets,
Chewable
80 mg

Oral
solution/suspensi
on
160 mg/5 mL
80mg/0.8mL (oral
drops)

Liquid Oral
500mg/5mL
2.Activated Generic Name : Adult and Activated Charcoal is Activated constipation
Charcoal charcoal (CHAR pediatric charcoal is contraindicated in charcoal adsorbs black stools.
coal) dosages: commonly taken individuals with ingested toxins slowing or
by mouth to treat unprotected within the blockage of the
Brand Name : Adult poisoning: poisonings. It is airways and gastrointestinal intestinal tract,
Actidose-Aqua, also used for decreased levels tract preventing regurgitation into
Activated 1 g/kg, 25-100 g intestinal gas of consciousness the systemic the lungs,
Charcoal, orally. (flatulence), high if not intubated; absorption of that and dehydration.
Charcoal Plus cholesterol, ingestion of acids toxin. Activated
DS, EZChar, Alternatively 10 g hangovers, upset or alkalis; cases charcoal only
Insta-Char, Liqui- charcoal/1 g drug stomach, and bile in which the risk adsorbs toxins
Char, Optimum ratio flow problems or severity of that are in the
Charcoal (cholestasis) aspiration is dissolved liquid
Minimum dose = during pregnancy. increased; or phase via direct
25 g Activated isolated contact.
charcoal is ingestions of
applied to the lithium, iron,
Infants: 1 skin as part of heavy metals, or
g/kg/dose orally, bandages for ethanol
may repeat every helping heal
4-6 hours. wounds
 Children: 1-2
g/kg/dose (or 25-
50 g/dose) orally,
may repeat every
4-6 hours.

Adolescents: 5-10
times the
estimated weight
of drug/chemical
ingested (or 50-
100 g/dose)
orally, may repeat
every 4-6 hours.
3Adenosine: Adenocard, and injectable solution Paroxysmal Second- or third- Adenocard facial flushing.
Adenoscan 6mg/2mL prefilled Supraventricular degree A-V block (adenosine difficulty
syringe Tachycardia. (except in injection) slows breathing.
12mg/4mL Indicated for patients with a conduction time chest pain.
prefilled syringe conversion to functioning through the A-V heart attack.
sinus rhythm of artificial node, can lightheadedness.
paroxysmal pacemaker). interrupt the dizziness
supraventricular Sinus node reentry pathways
tachycardia disease, such as through the A-V
(PSVT), including sick sinus node, and can
that associated syndrome or restore normal
with accessory symptomatic sinus rhythm in
bypass tracts bradycardia patients with
(Wolff-Parkinson- (except in paroxysmal
White Syndrome) patients with a supraventricular
... functioning tachycardia
artificial (PSVT), including
pacemaker) PSVT associated
with Wolff-
Parkinson-White
Syndrome.
4-Albuterol Proventil HFA, powder metered- treatment and cardiovascular Albuterol acts on headache,
Ventolin HFA, dose inhaler prevention of disorders, beta-2 adrenergic dizziness,
Proair HFA bronchospasm especially receptors to relax sleep problems
90mcg (acute or severe) coronary the bronchial (insomnia),
(base)/actuation in patients with insufficiency, smooth muscle. It cough,
(equivalent to reversible cardiac also inhibits the hoarseness,
108mcg albuterol obstructive airway arrhythmias, and release of sore throat,
sulfate); ProAir disease, including hypertension; in immediate runny or stuffy
RespiClic exercise-induced patients with hypersensitivity nose,
tablet: bronchospasm convulsive mediators from nausea
2mg disorders, cells, especially
4mg hyperthyroidism, mast cells.
syrup: or diabetes
2mg/5mL mellitus
5.Amiodarone amiodarone IV: asthma or Amiodarone Amiodarone is a wheezing
Pacerone Initial dose: 1000 another lung affects the rhythm primarily a class cough
mg over the first disorder of your III antiarrhythmic. chest pain
24 hours of liver disease heartbeats. It is Like other fever
therapy, delivered a thyroid disorder used to help keep antiarrhythmic
by the following vision problems the heart beating drugs of this
infusion regimen: high or low blood normally in class,
-Loading pressure people with life- amiodarone
infusions: 150 mg threatening heart works primarily by
over the first 10 rhythm disorders blocking
minutes (15 of the ventricles potassium
mg/min), followed (the lower rectifier currents
by 360 mg over chambers of the that are
the next 6 hours heart that allow responsible for
(1 mg/min) blood to flow out the repolarization
-Maintenance of the heart). of the heart
infusion: 540 mg during phase 3 of
over the the cardiac action
remaining 18 potential.
hours (0.5
mg/min)
6-Amyl Nitrite, Amyl Nitrite Adults: 0.3 Allergies Amyl nitrite (amyl Cyanide inhibits syncope
Sodium Nitrite, poppers milliliter (1 ampul) Geriatric nitrite inhalant) is aerobic hypotension
Sodium taken by inhaling Breastfeeding indicated for the metabolism by pallor
Thiosulfate the vapor of amyl rapid relief of binding to the cold sweat
(Cyanide nitrite through the angina pectoris. binuclear heme weakness
Antidote) nose. Dose may Its effect appears center of
be repeated within 30 seconds cytochrome c
within 1 to 5 and lasts for oxidase (CcOX).
minutes if pain is approximately 3
not relieved. If to 5 minutes.
you still have
chest pain after a
total of 2 doses in
a 10-minute
period, contact
your doctor or
have someone
take you to a
hospital
emergency room
without delay.
7-Aspirin acetylsalicylic Adults: 325-650 Angina pectoris. systemic The acetyl group Skin swelling
acid mg orally/rectally Angina pectoris mastocytosis. of acetylsalicylic Bronchospasm
once every 4-6 prophylaxis. low vitamin K acid binds with a Skin problems
hours as needed Ankylosing levels. serine residue of Liver damage
Children under 12 spondylitis. a type of joint the Hearing loss
years: Cardiovascular disorder due to cyclooxygenase-1 Nausea
10-15 mg/kg risk reduction. excess uric acid (COX-1) enzyme,
orally once every Colorectal in the blood leading to
4 hours, up to 60- cancer. called gout. irreversible
80 mg/kg/day Fever. anemia. inhibition. This
Ischemic strok hemophilia. prevents the
production of
pain-causing
 prostaglandins.
8-Atropine Atropen intramuscular hypersalivation, glaucoma, pyloric Atropine inhibits dry mouth,
device: bronchial stenosis, the muscarinic blurred vision,
0.25mg/0.3mL secretions, or thyrotoxicosis, actions of sensitivity to light,
0.5mg/0.7mL bradycardia. fever, urinary acetylcholine on lack of sweating,
1mg/0.7mL tract obstruction structures dizziness,
2mg/0.7mL and ileus. innervated by nausea,
injectable postganglionic loss of balance
solution: cholinergic
0.05mg/mL nerves, and on
0.1mg/mL smooth muscles,
0.4mg/mL which respond to
0.8mg/mL endogenous
1mg/mL acetylcholine but
are not so
innervated.
9-Bumetanide Edimex Adult dosage for Edema Hypersensitivity Bumetanide is a Drought
Purinex treating ascites - to bumetanide or diuretic called
edema - Ascites any of its loop diuretics. It Low blood
pulmonary ingredients, or works by pressure
edema: Pulmonary sensitivity to increasing the
edema sulfonylureas. excretion of fluids Orthostatic
Oral: 0.5: 2 mg Anuria. Patients and salts, such as hypotension
once a day, and it hypertension with severely low potassium and
can be repeated sodium or sodium, through Itch
after 4-5 hours, electrolyte the kidneys and
until 2 doses are imbalance and urine. It is used Rash
reached. Do not patients who in the treatment
exceed 10 mg / suffer from of high blood Kidney failure
day. hepatic coma pressure, edema
until the condition and fluid Skin reactions
Intravenous or improves. Any retention, in are dangerous
intramuscular significant cases of heart
injection: 0.5: 1 increase in blood failure, where rotary
mg once a day, urea nitrogen or fluid collects in
and may be creatinine, or the the ankles and in vomiting
repeated after 2: development of the lungs, and in
3 hours, until 2 oliguria during cases of cirrhosis,
doses are treatment of where fluids
reached. Do not patients with collect in the
exceed 10 mg / progressive renal abdomen and
day. disease, is an legs.
indication for
Continuous discontinuation of
intravenous bumetanide use.
infusion: 1 mg / Pregnancy. It is
hour and up to 12 not licensed for
mg / day. use by children
under the age of
Adult dosage for 18
treating
hypertension
(non-prescribed
use):

1 mg
intravenously as
a large initial
dose (loading
dose), then orally:
0.5: 2 mg per day
in divided into two
doses every 12
hours.

Young people:
The safety and
efficacy of this
medicine have
not yet been
established in
children under 18
years of age

Young age dose

for edema
(edema):

Age younger
than 6 months:
0.01-0.05 mg / kg
once daily or
every other day,
and it was
observed that the
optimal effect of
diuresis was at a
dose of 0.04 mg /
kg, and it was
observed that
lower doses had
a higher effect.

Age greater than

or equal to 6
months: 0.015-
0.1 mg / kg once
a day or every
other day, so that
it does not
exceed 10 mg /
day.

The elderly:
 In general, the
choice of dosage
for the elderly
should be
cautious, and
usually the lowest
possible dose
should be started,
taking into
account an
increased rate of
decreased liver,
kidney, or heart
function and an
increase in the
frequency of
associated
disease or other
drug therapy.

Dosage
adjustment in
kidney disease:
No information is
available

Dose adjustment
in liver disease: In
patients with
cirrhosis and
ascites, small
doses are used to
increase the
likelihood of
developing an
imbalance of
fluids, salts and
minerals in the
body that can
lead to hepatic
coma.

Dose setting:

The oral dose is

titrated every 4
hours

The dose given

by intravenous or
intramuscular
injection is titrated
every 2: 3 hours

Patients with
edema often
benefit from
taking the
medication every
2 days or every 3
to 4 days.

The dose is
carefully adjusted
for patients with
liver disease and
kidney failure

The maximum
recommended
 dose is 10 mg /
day orally or 12
mg / hour by
intravenous drip.
10 Butorphanol For intravenous This medicine is It is The drug affects Anorexia
Generic name is administration, used to relieve contraindicated in certain centers in
stadol the dose used is pain (analgesic). patients with the central Say e
0.5-2 mg every pulmonary failure nervous system
three to four or in patients who to relieve pain, as Blurred vision
hours have difficulty it binds to opioid
Intramuscular breathing receptors in the Bronchitis
injections are This treatment brain to block the
given as 1-4 mg should be used transmission of confusion
every three to by patients pain signals.
four hours suffering from the Constipation
The hardest following
possible dose is diseases with Cough
0.06 mg / kg, or 4 great caution:
mg / 70 kg). arrhythmias, Dry mouth
cardiovascular
disease, and shortness of
coronary breath
insufficiency.
Ear pain
11.Calcium Brand name : The usual adult chloride (calcium In cardiac Calcium chloride hives,
chloride Calcium chloride dose of this chloride) is resuscitation, the in water difficulty
injection 10% preparation varies indicated in the use of calcium dissociates to breathing,
from 5 to 10 mLat immediate chloride (calcium provide calcium swelling of your
Generic name : intervals of 1 to 3 treatment of chloride) is (Ca2+) and face, lips, tongue,
Calcium chloride days. hypocalcemic contraindicated in chloride (Cl-) or throat,
In cardiac tetany. Other the presence of ions. They are dizziness,
resuscitation, the therapy, such as ventricular normal fainting,
usual dose is 2 to parathyroid fibrillation . constituents of mood changes,
4 mL injected into hormone or the body fluids changes in the
the ventricular vitamin D, may be and are amount of urine,
 cavity. Care indicated dependent on abnormal
should be taken according to the various heartbeat,
to avoid injection etiology, of the physiological
into the cardiac tetany. It is also mechanisms for
muscle . important to maintenance of
Parenteral drug institute oral balance between
products should calcium therapy intake and output.
be inspected as soon as For hyperkalemia,
visually for practicable. the influx of
particulate matter calcium helps
and discoloration, restore the
whenever Calcium salts normal gradient
solution and have been used between
container permit. as adjunctive threshold
therapy in a potential and
number of resting
conditions, membrane
including : potential.

Black Widow
Spider bites

Sensitivity
reactions
12.Compazine Brand name : Dosage Compazine is a Do not use in It mainly works by Drowsiness,
Compazine prescription comatose states depressing the dizziness,
Adults medicine used to or in the presence chemoreceptor amenorrhea ,
Generic name : Dosage should treat the of large amounts trigger zone and hypotension,blurr
pro be increased symptoms of of central nervous blocking D2 ed vision, skin
chlorpromazine more gradually in psychosis and system dopamine reactions
debilitated or severe nausea or depressants receptors in the
emaciated vomiting. (alcohol, brain. It was Motor
patients. Compazine may barbiturates, shown to also Restlessness
be used alone or narcotics, etc.). block
Elderly Patients with other histaminergic, Dystonia
In general, medications. Do not use in cholinergic and
dosages in the pediatric surgery. noradrenergic
lower range are receptors.
sufficient for most Do not use in
elderly patients. children under 2
Since they years of age or
appear to be under 20 lbs. Do
more susceptible not use in
to hypotension children for
and conditions for
neuromuscular which dosage has
reactions, such not been
patients should established.
be observed
closely. Dosage
should be tailored
to the individual,
response
carefully
monitored and
dosage adjusted
accordingly.
Dosage should
be increased
more gradually in
elderly patients.

Rectal Dos age:

25 mg twice daily

Each suppository
contains
Prochlorperazine
 25mg and the
following inactive
ingredients:
glycerin, glyceryl
monopalmitate,
glyceryl
monostearate,
hydrogenated
coconut oil fatty
acids,
hydrogenated
palm kernel oil
fatty acids

13- Decadron is the Dexamethasone Dexamethasone active, untreated Glucocorticoids upset stomach.
Dexamethasone trade name for sodium is used to treat tuberculosis. both natural and stomach irritation.
dexamethasone. phosphate conditions such inactive synthetic, are vomiting.
Dexasone and injection, 4 mg as arthritis, tuberculosis. adrenocortical headache.
diodex or per mL blood/hormone herpes simplex steroids that are dizziness.
hexadrol are First Day: 1 or 2 disorders, allergic infection of the readily absorbed insomnia.
other names for mL, reactions, skin eye. from the restlessness.
dexamethasone. intramuscularly diseases, eye a herpes simplex gastrointestinal depression
Dexamethasone problems, infection. tract.
tablets, 0.75 mg breathing an infection due Glucocorticoids
Second Day: 4 problems, bowel to a fungus. cause varied
tablets in two disorders, cancer, intestinal infection metabolic effects,
divided doses and immune caused by the they modify the
Third Day: 4 system disorders. roundworm body immune
tablets in two It is also used as Strongyloides. responses to
divided doses a test for an a condition with diverse stimuli.
Fourth Day: 2 adrenal gland low thyroid Naturally
tablets in two disorder hormone levels. occurring
divided doses (Cushing's diabetes. glucocorticoids
Fifth Day: 1 tablet syndrome). (hydrocortisone
Sixth Day: 1 and cortisone)
 tablet have sodium-
retaining
properties and
are used as
replacement
therapy in
adrenocortical
deficiency states.
Their synthetic
analogs, including
dexamethasone,
are primarily used
for their anti-
inflammatory
effects. At
equipotent anti-
inflammatory
doses,
dexamethasone
almost completely
lacks the sodium-
retaining property
of hydrocortisone.
14-Dextrose Brand Name: N/A intravenous Hypoglycemia in Solutions This medication is Possibility of
Generic Name: solution premature infants containing an intravenous intracellular lactic
Dextrose 2.5%5%10%20% • Insulin induced dextrose may be (IV) solution used acid production in
(Antidote) 30%50%70% hypoglycemia • contraindicated in to supply fluids setting of
Drug Class: oral liquid Nutritional patients with and calories to ischemic brain
Hypoglycemia 55% support known allergy to the body. It is cells and high
Antidotes Hypoglycemia corn or corn also used as a blood sugar
IV: 10-25 g (ie, products. diluent for other (hyperglycemia)
20-50 mL 50% IV medications. Low blood
solution or 40-100 potassium
mL of 25%) (hypokalemia)
PO: 4-20 g as a Fluid retention
 single dose; may (edema)
repeat after 15 High or low blood
min if self- volume
montoring of (hyper/hypovolem
blood glucose ia)
shows continued Dehydration.
hypoglycemia Fever.
Mental confusion.
15 Diazepam ( * ORAL: 2 to 10 for the contraindicated in is by increasing * drowsiness.
Valium ) mg orally 2 to 4 management of patients with a the effect of the * dizziness.
times a day anxiety disorders known neurotransmitter * tiredness.
or for the hypersensitivity to gamma- * muscle
* PARENTERAL: shortterm relief of diazepam and, aminobutyric acid weakness.
2 to 5 mg IM or IV the symptoms of because of lack (GABA) * headache.
anxiety of sufficient
clinical
experience, in
pediatric patients
under 6 months
of age
16 Diltiazem Patients with diltiazem inhibits * dizziness,
(Cardizem) hypotension the inflow of * lightheadedness
* 30 mg PO q6hr; for the treatment calcium ions into * weakness
increased every 1 of hypertension, * Patients with the cardiac * tired feeling
or 2 days to lower blood acute myocardial smooth muscle * nausea
pressure infarction and during
* 120-180 mg/day pulmonary depolarization.
PO; titrate over 7-
14 days

17 Diphenhydramine 12.5mg/5mL Diphenhydramine 1-overactive Diphenhydramine 1-dry mouth,

(Benadryl Allergy is an thyroid gland. acts as an nose, and throat.
Childrens, antihistamine 2-increased inverse agonist at 2-drowsiness.
PediaCare used to relieve pressure in the the H1 receptor, 3-dizziness.
 Children’s symptoms of eye. thereby reversing 4-nausea.
Allergy, Allergy allergy, hay fever, 3-closed angle effects of 5-vomiting.
Relief Childrens) and the common glaucoma. histamine on 6-loss of appetite.
50mg/30mL cold. These 4-high blood capillaries, 7-constipation.
(ZzzQuil) symptoms include pressure. reducing allergic 8-increased chest
rash, itching, 5-stenosing reaction congestion.
watery eyes, itchy peptic ulcer. symptoms. Lastly,
eyes/nose/throat, 6-blockage of the diphenhydramine
cough, runny urinary bladder. acts as an
nose, and 7-enlarged intracellular
sneezing. It is prostate. sodium channel
also used to 8-an inability to blocker, resulting
prevent and treat completely empty in local anesthetic
nausea, vomiting the bladder properties.
and dizziness
caused by motion
sickness.
18 Dobutamine infusion solution, Dobutamine is 1-low amount of Dobutamine is a 1-increased heart
in D5W indicated for potassium in the synthetic rate and 2-
-100mg/100mL patients who blood. catecholamine increased blood
-200mg/100mL require positive 2-high blood that acts on pressure,
-400mg/100mL inotropic support pressure. alpha-1, beta-1 3-ventricular
in the treatment 3-a heart attack. and beta-2 ectopic activity,
of cardiac 4-narrowing of adrenergic 4-nervousness,
decompensation the aortic heart receptors. In the 5-headache,
due to depressed valve. heart, the 6-nausea,
contractility 5-hypertrophic 6- stimulation of 7-vomiting,
resulting either cardiomyopathy. these receptors 7-palpitations,
from organic 7-atrial fibrillation. produces a 9-low platelet
heart disease or 8-ventricular relatively strong, counts
from cardiac premature beats. additive inotropic (thrombocytopeni
surgical 9-abnormal EKG effect and a a)
procedures, with QT changes relatively weak
especially when a from birth. chronotropic
low cardiac effect.
 output is
associated with
raised pulmonary
capillary
19 dopamine Dopamine HCl is Dopamine HCl At low doses it tachycardia,
Brand Name: for adult infusion indicated for the should not be acts through the anginal pain,
Intropin solution, in D5W correction of used in patients sympathetic dyspnea, nausea,
hemodynamic with nervous system vomiting,
Generic Name: • 80mg/100mL imbalances pheochromocyto to increase heart headache,
dopamine present in the ma. muscle anxiety,
• 160mg/100mL shock syndrome contraction force azotemia.
due to myocardial Dopamine HCl and heart rate,
• 320mg/100mL infarction, trauma, should not be thereby
endotoxic administered to increasing
septicemia, open- patients with cardiac output
for children heart surgery, uncorrected and blood
infusion solution, renal failure, and tachyarrhythmias pressure. Higher
in D5W chronic cardiac or ventricular doses also cause
decompensation fibrillation. vasoconstriction
• 80mg/100mL as in congestive that further
failure. increases blood
• 160mg/100mL pressure.

• 320mg/100mL

20 .Epinephrine Anaphylaxis None Epinephrine acts anxiety

Adrenaclick Adults: 0.3 to Hypotension on both alpha and apprehensivenes
Adrenalin 0.5 mg Associated With beta-adrenergic s
Auvi-Q administered IM Septic Shock receptors. The restlessness
Epipen or mechanism of the tremor
subcutaneously rise in blood weakness
in the pressure is 3-fold: dizziness
anterolateral a direct sweating
 aspect of the myocardial palpitations
thigh, repeated stimulation that pallor
every 5 to 10 increases the nausea and
minutes as strength of vomiting
necessary. ventricular headache
Children Less contraction , an respiratory
Than 30 kg: increased heart difficulties.
0.01 mg/kg IM rate , and
or peripheral
subcutaneously vasoconstriction.
in the
anterolateral
aspect of the
thigh, up to a
maximum of 0.3
mg per injection,
repeated every
5 to 10 minutes
as necessary.

21. Etomidate Generic patients above etomidate is an patients who acts on the CNS Hyperventilation,
Name: the age of ten ultrashort- have shown to stimulate hypoventilation,
etomidate years will vary acting, non- hypersensitivity to gamma- tachycardia,
injection between 0.2 and barbiturate it aminobutyric acid bradycardia
Brand Name: 0.6 mg/kg of hypnotic receptors and.
Etomidate body weight, intravenous This agent
(Amidate) and it must be anesthetic decreases
Injection individualized in agent. cerebral oxygen
each case. Etomidate has consumption by
injected over a been approved 45% and cerebral
period of 30 to for use during blood flow by
60 seconds. induction of 34%, thereby
general decreasing ICP
anesthesia and
rapid sequence
 intubation
22. fentanyl Generic Analgesia: 1-2 indicated for the Significant Fentanyl binds to slow heart rate
Name: mcg/kg IV bolus management of respiratory opioid receptors, weak or shallow
fentanyl Severe pain: 50- pain in opioid- depression especially the mu breathing
transdermal 100 mcg/dose tolerant patients, Hypersensitivity opioid receptor, sleep apnea
Brand Name: IV/IM q1-2hr severe enough gastrointestinal which are confusion
Duragesic PRN to require daily, obstruction coupled to G- severe
around-the- bronchial asthma proteins. the G- chest pain
clock, long-term proteins which in fast or pounding
opioid treatment turn down heartbeats
and for which regulates
alternative adenylate
treatment cyclase, reducing
options are concentrations of
inadequate. cAMP. Reduced
cAMP decreases
cAMP dependant
influx of calcium
ions into the cell.
The exchange of
GTP for GDP
results in
hyperpolarization
of the cell and
inhibition of nerve
activity.
23 Flumazenil - Formulation: 1- Treatment of • Flumazenil is a Serious reaction:
Romazicon C15H14FN3O3 Benzodiazepine Hypersen benzodiazepine • Sedation
Dosage: overdose. sitivity to antagonist. It •
Usual Adult 2- Reversal of Flumazenil or competitively Neurologi
Dose for postoperative benzodiazepines inhibits the c effects
Reversal of sedation from • Signs of activity of • Seizure
Sedation benzodiazepine tricyclic benzodiazepine •
Initial dose: 0.2 anesthetics. antidepressants and non- Cardiovas
mg IV one time overdose benzodiazepine cular finding:
over 15 • substances that Arrhythmias
seconds. Benzodiaz interact with
Repeated epine use for life- benzodiazepine Common
doses: 0.2 mg threatening receptors site on reactions:
may be given diseases such as the Cardiovascular
every minute control of GABA/benzodiaz Findings
until the desired intracranial epine receptor •
level of pressure or status complex. It can Bradycard
consciousness epilepticus also reverse the ia
is achieved. binding of •
Maximum total • Mixed benzodiazepines Tachycard
dose 1 mg. overdose to ia
Resedation: 0.2 • Caution if benzodiazepine •
mg every 20 psychiatric receptors.The Hypertens
minutes as disorder- provoke onset of action is ion
needed panic attacks in about 1 to 2 • Chest
Maximum dose: patients with a minutes; 80% pain
1 mg total at any history of panic response occurs Neurologic
one time; no disorder within the first 3 Effects
more than 3 mg • minutes.The peak • Confusion
in any one hour Convulsio effect is 6 to 10 • Dizziness
Usual Adult ns may occur in minutes after • Headache
Dose for patients with a administration.Th • Impaired
Benzodiazepine chronic e duration range cognition
Overdose dependency for is from 19 •
Initial dose: 0.2 benzodiazepines minutes to 50 Opisthoto
mg IV over 30 • minutes, as it nus
seconds Convulsio depends on the
-If desired level ns or alter dose was given • Shivering
of cerebral blood and •
consciousness flow may benzodiazepine Somnolen
is not achieved precipitate in plasma ce
after waiting 30 patients with a concentrations Gastrointestinal
seconds, a head injury Effects
second dose of • Increased • Nausea
0.3 mg may be risk of seizures in • Vomiting
given over epileptic patients Immunologic
another 30 on Effects
seconds. benzodiazepine • Injection
treatment for a site reaction
Further doses of prolonged period.
0.5 mg over 30 • Caution in Ophthalmic
seconds may be patients with drug Effects
given at 1- dependency or • Defects of
minute intervals, alcoholism due to the visual field
if needed increased and diplopia
Maximum frequency of • Blurred
cumulative benzodiazepine vision
dose: 3 mg total tolerance and Otic Effects
Resedation: dependence • Hearing
Repeated doses Do not use as loss
may be given at primary treatment Psychiatric
20-minute in patients with Effects
intervals as severe lung • Anxiety
needed disease with • Panic
Maximum dose: respiratory attack
1 mg total at any depression • Psychotic
one time; no secondary to disorder
more than 3 mg benzodiazepines • Agitation
in any one hour
Pediatric Dose Dermatologic
FDA Dosage for Effects
Benzodiazepine •
reversal when Diaphores
used in is
conscious • Injection
sedation or site pain
general US Black Box
anesthesia Warning:
The initial dose Seizures:
of 0.01 mg/kg Benzodiazepine
given over 15 reversal has
seconds (up to a correlations with
maximum dose seizures.
of 0.2 mg) Seizures may
If the desired happen more
level of frequently in
consciousness patients who
is not obtained have been on
after 45 benzodiazepines
seconds, repeat for long-term
0.01 mg/kg (up sedation or in
to 0.2 mg) at 1- patients who are
minute intervals showing signs of
as needed, up severe tricyclic
to four additional antidepressant
doses. overdose. The
The maximum required dosage
total cumulative of Flumazenil
dose of 1 mg or should be
0.05 mg/kg, measured and
whichever is prepared by the
lower practitioners to
Mean total dose manage seizures.
of 0.65 mg was Flumazenil use
administered requires caution
during the in patients relying
clinical trial on a
(range: 0.08 to 1 benzodiazepine
mg) for seizure
Hepatic dosing control.
is necessary for
patients with
hepatic
insufficiency.
24 Furosemide - injectable Furosemide is Documented• Furosemide, like >10%
Lasix solution used to reduce hypersensitivity to other loop • Hyperuricemia
• 10mg/mL extra fluid in the furosemide or diuretics, acts by (40%)
oral solution body (edema) sulfonamides inhibiting the • Hypokalemia
• 10mg/mL caused by • Anuria luminal Na-K-Cl (14-60%)
• 8mg/mL conditions such cotransporter in Frequency Not
tablet as heart failure, the thick Defined
• 20mg liver disease, ascending limb of • Anaphylaxis
• 40mg and kidney the loop of Henle, • Anemia
• 80mg disease. This by binding to the • Anorexia
Edema can lessen chloride transport • Diarrhea
Edema symptoms such channel, thus • Dizziness
associated with as shortness of causing sodium, • Glucose
congestive heart breath and chloride, and intolerance
failure (CHF), swelling in your potassium loss in • Glycosuria
liver cirrhosis, arms, legs, and urine. • Headache
and renal abdomen.This The action on the • Hearing
disease, drug is also distal tubules is impairment
including used to treat independent of • Hyperuricemia
nephrotic high blood any inhibitory • Hypocalcemia
syndrome pressure. effect on carbonic • Hypokalemia
20-80 mg PO Lowering high anhydrase or •
once daily; may blood pressure aldosterone; it Hypomagnesemi
be increased by helps prevent also abolishes the a
20-40 mg q6- strokes, heart corticomedullary • Hypotension
8hr; not to attacks, and osmotic gradient • Increased
exceed 600 kidney and blocks patent ductus
mg/day problems.Furos negative, as well arteriosus during
Alternative: 20- emide is a as positive, free neonatal period
40 mg IV/IM "water pill" water clearance. • Muscle cramps
once; may be (diuretic) that Because of the • Nausea
increased by 20 causes you to large NaCl • Photosensitivity
mg q2hr; make more absorptive • Rash
individual dose urine. This helps capacity of the • Restlessness
not to exceed your body get loop of Henle, • Tinnitus
200 mg/dose rid of extra diuresis is not • Urinary
Refractory CHF water and salt. limited by frequency
may necessitate development of • Urticaria
larger doses acidosis, as it is • Vertigo
with the carbonic • Weakness
Hypertension, anhydrase
Resistant inhibitors.
20-80 mg PO Additionally,
divided q12hr furosemide is a
noncompetitive
Acute subtype-specific
Pulmonary blocker of GABA-
Edema/Hyperte A receptors.
nsive Furosemide has
Crisis/Increased been reported to
Intracranial reversibly
Pressure antagonize
0.5-1 mg/kg (or GABA-evoked
40 mg) IV over currents of
1-2 minutes; α6β2γ2 receptors
may be at μM
increased to 80 concentrations,
mg if there is no but not α1β2γ2
adequate receptors. During
response within development, the
1 hour;not to α6β2γ2 receptor
exceed 160-200 increases in
mg/dose expression in
cerebellar granule
Hyperkalemia in neurons,
Advanced corresponding to
Cardiac Life increased
Support (ACLS) sensitivity to
40-80 mg IV furosemide.
 Hypermagnese
mia in ACLS
20-40 mg IV q3-
4hr PRN
Dosing
Modifications
Acute renal
failure: 1-3
g/day may be
necessary to
attain desired
response; avoid
use in oliguric
states
Hepatic
impairment:
Monitor,
especially with
high dosages
25 Brand Name: Dose for adults Glucagon for Glucagon is glucagon temporary
Glucagen, injection, Injection is contraindicated in promotes hepatic changes in blood
Glucagon powder for indicated for use patients with conversion of pressure,
Emergency reconstitution as a diagnostic known glycogen to
Kit, (GlucaGen, aid during hypersensitivity to glucose increase in heart
GlucaGen generic) radiologic it or in patients (glycogenolysis), rate,
HypoKit examinations to with stimulates de
1mg/vial temporarily known novo glucose allergic reactions,
inhibit pheochromocyto synthesis
injectable movement of ma. (gluconeogenesis nausea,
solution (Gvoke) the ), and inhibits
gastrointestinal glucose vomiting, and
1mg/0.2mL tract. breakdown
(single-dose (glycolysis) and low blood sugar
prefilled syringe glycogen (hypoglycemia)
or HypoPen formation
 autoinjector) (glycogenesis)
—-
dose for children
injection,
powder
(GlucaGen,
generic)

1mg/vial

injectable
solution (Gvoke)

0.5mg/0.1mL
(single-dose
prefilled syringe
or HypoPen
autoinjector)

1mg/0.2mL
(single-dose
prefilled syringe
or HypoPen
autoinjector)
26 Haloperidol Generic Dose Indications Contraindications Mechanism of Side Effects
Name : Action
Haloperidol There is HALDOL HALDOL The following
Brand Name: considerable (haloperidol) is (haloperidol) is Haloperidol is a adverse reactions
Haldol variation from indicated for the contraindicated in first-generation are discussed in
patient to patient treatment of patients with: (typical more detail in
in the amount of patients with antipsychotic) other sections of
medication schizophrenia. Severe toxic which exerts its the labeling:
required for central nervous antipsychotic
treatment. As system action by blocking , Increased
with all drugs depression or dopamine D2 Mortality In
 used to treat comatose states receptors in the Elderly Patients
schizophrenia, from any cause. brain. When 72% With Dementia-
dosage should of dopamine Related
be individualized Hypersensitivity receptors are Psychosis
according to the to this drug – blocked, this drug
needs and hypersensitivity achieves its , Cardiovascular
response of reactions have maximal effect. Effects
each patient. included
Dosage anaphylactic , Tardive
adjustments, reaction and Dyskinesia
either upward or angioedema (see
downward, WARNINGS, , Neuroleptic
should be Hypersensitivity Malignant
carried out as Reactions and Syndrome
rapidly as ADVERSE
practicable to REACTIONS). , Hypersensitivity
achieve Reactions
optimum Parkinson’s
therapeutic disease (see , Falls
control. WARNINGS,
Neurological
Adverse
Reactions In
Patients With
Parkinson’s
Disease Or
Dementia With
Lewy Bodies).
27 Hydrocortison For adult: tablet Endocrine * inactive The mechanism Gastritis,peptic
e * 5mg disorders, tuberculosis of action of ulcer,perforation
brand: Cortef * 10mg Rheumatic * herpes simplex hydrocotizone lies and pancreatitis
* 20mg disorders, infection of the in reducing the ,HTN,
powder for Collagen eye secretion of these Osteoporosis
injection diseases, * an infection due substances and Supresses
(SoluCortef) Dermatologic to a fungus limiting the immunity Delays
 * 100mg/vial diseases, * brain injury transport of wound healing
* 250mg/vial Allergic states, * a disease with multinucleated
* 500mg/vial and shrinking and leukocytes to the
* 1g/vial Gastrointestinal weaker muscles affected site, in
diseases. called myopathy addition to
PEDIATRIC: * increased reducing capillary
tablet (Cortef, pressure in the permeability.
generic) eye
* 5mg * wide-angle
* 10mg glaucoma
* 20mg
capsule,
immediate-
release oral
granules (Alkindi
Sprinkle)
* 0.5mg
* 1mg
* 2mg
* 5mg
powder for
injection
(SoluCortef)
* 100mg/vial
* 250mg/vial
* 500mg/vial
* 1g/vial

28 Ibuprofen capsule Pain and • Allergic to The main Heartburn, rash,

Barnd: Advil, * 200mg Inflammatory aspirin mechanism of kidney failure,
Motrin tablet, chewable disease. • Previous peptic action of and liver failure.
* 50mg ulcer / bleed ibuprofen is the
* 100mg • Taking another non-selective,
oral suspension NSAID reversible
* 100mg/5mL • Severe heart inhibition of the
 * 40mg/mL failure cyclooxygenase
enzymes COX-1
and COX-2
(coded for by
PTGS1 and
PTGS2,
respectively).
29 Ipratropium metered-dose management of closed angle Anticholinergic headache,
bromide inhaler asthma and glaucoma (parasympatholyti nausea,
/atrovent 17mcg/actuation chronic c) agent; inhibits dizziness,
bronchitis blockage of the vagally mediated and.
urinary bladder reflexes by difficulty
antagonizing breathing.
enlarged prostate acetylcholine
action; prevents
an inability increase in
tocompletely intracellular
empty the bladder calcium
concentration that
is caused by
interaction of
acetylcholine with
muscarinic
receptors on
bronchial smooth
muscl
30 Isoprotenrol/ injectable Adams-strokes Hypersensitivity, Strong beta-1 & tremor,
isuprel solution attacks digitalis beta-2 effects nervousness,
0.2mg/mL Cardiac arrest intoxication, resulting in shakiness,
Heart block angina pectoris, relaxation of GI, headache,
Shock preexisting bronchial, and nausea,
Bronchospasm cardiac uterine smooth vomiting,
during arrhythmias muscle; may diarrhea,
anesthesia (particularly increase heartburn,
ventricular vasodilation of lightheadedness,
 arrythmias that peripheral dizziness,
require inotropic vasculature, and difficulty sleeping
treatment & heart rate and (insomnia),
tachyarrhythmias) contractility unusual taste in
mouth,
sweating.
31 Chemically
Brand Names: Transition from IV Short-term Ketorolac is Common side
ketorolac functions
Acular, Acular or IM dosing of management of contraindicated in effects of Toradol
as a carboxylic acid
Ls, Sprix ketorolac moderately those with include:
derivative serving
tromethamine severe, acute hypersensitivity,
non-selectively to
(single- or pain requiring allergies to the headache,
block the
multiple-dose) to opioid-level medication, cross-
Generic name: prostaglandin
multiple-dose analgesia. sensitivity to other heartburn,
Ketorolac synthesis by
TORADOL NSAIDs, prior to
Tromethamine inhibition of
(ketorolac surgery, history of upset stomach,
prostaglandin G/H
tromethamine) peptic ulcer
ORAL: synthesis one and
disease, nausea,
two. Prostaglandin
gastrointestinal
functions in the
Patients age 17 to bleeding, alcohol vomiting,
body as a
64: 20 mg PO intolerance, renal
messenger for
once followed by impairment, diarrhea,
contraction/relaxati
10 mg q4-6 hours cerebrovascular
on of smooth
prn not > 40 bleeding, nasal stomach pain,
muscle and
mg/day polyps,
modulation of
angioedema, and bloating,
inflammation.
Patients age ≥ 65, asthma.
Resultant, inhibition
renally impaired, Recommendations gas,
of prostaglandin
and/or weight < exist for cautious
synthesis prevents
50 kg (110 lbs): use of ketorolac in inflammation. The constipation,
10 mg PO once those who have
primary mechanism
followed by 10 mg experienced of action dizziness,
q4-6 hours prn cardiovascular
responsible for
not > 40 mg/day disease, ketorolac's anti- drowsiness,
myocardial
inflammatory,
Note: infarction, stroke, antipyretic, and sweating,
heart failure,
analgesic effects is
Oral formulation coagulation
 should not be disorders, renal the inhibition of and ringing in the
given as an initial impairment, and prostaglandin ears.
dose hepatic impairment. synthesis by
competitive .
Use minimum blocking of the
effective dose for enzyme
the individual cyclooxygenase
patient (COX). Ketorolac is
a non-selective
Do not shorten COX inhibitor. It is
dosing interval of considered a first-
4 to 6 hours generation NSAID.

Total duration of
treatment in adult
patients: the
combined
duration of use of
IV or IM dosing of
ketorolac
tromethamine and
TORADOL
(ketorolac
tromethamine)
ORAL is not to

exceed 5 days.

TORADOL
(ketorolac
tromethamine)
ORAL 10 mg
tablets are round,
white, film-coated,
red printed
tablets. There is a
large T printed on
 both sides of the
tablet, with
TORADOL
(ketorolac
tromethamine) on
one side, and
ROCHE on the
other, available in
bottles of 100
tablets (NDC
0004-0273-01).

32 Labetalol's dual Common

Brand Hypertension Labetalol is
Hypertensive alpha and beta
Names: (off-label) contraindicated in
crisis: adrenergic Neurologic:
Normodyne , people with overt
antagonism has headache (2%),
Trandate. Hypertensive cardiac failure, different dizziness (11%).
0.4-1 mg/kg/hour erisis greater-than-first-
physiological
by continuous degree heart block, effects in short- and Gastrointestinal:
intravenous severe bradycardia,
long-term nausea (6%),
Generic infusion; cardiogenic shock, situations. In short- dyspepsia (3%).
name: severe
term, acute
labetalol. hypotension,
Max: 3 situations, labetalol Cholinergic: nasal
anyone with a
mg/kg/hour. decreases blood congestion (3%),
. history of pressure by ejaculation failure
obstructive airway
decreasing (2%) .
Hypertension: disease including systemic vascular
asthma, and those
resistance with little Respiratory:
with
mg/kg/day given effect on stroke dyspnea (2%).
hypersensitivity to
volume, heart rate
the drug.. and cardiac output. Other: fatigue (5%),
orally in two During long-term vertigo (2%),
divided doses OR use, labetalol can orthostatic
0.3-1 mg/kg reduce heart rate hypotension.
intermittently as during exercise
an intravenous while maintaining Low blood pressure
injection; cardiac output by with standing is
an increase in more severe and
 stroke volume. more common with
Max: 1.2 g/day. IV formulation (58%
Labetalol is a dual vs 1%) and is often
alpha (α1) and beta
the reason larger
(β1/β2) adrenergic doses of the oral
The formulation receptor blocker
formulation cannot
marketed consists and competes with be used.
of 5.0 mg/ml other
labetalol Catecholamines for Rare
hydrochloride, 8.1 binding to these
mg/ml sodium sites. Its action on Fever
chloride and these receptors are
sterile water for potent and Muscle cramps
injection. reversible.Labetalol
is highly selective Dry eyes
for postsynaptic
alpha1- adrenergic, Heart block
and non-selective
for beta-adrenergic Hyperkalemia
receptors. It is
about equipotent in Hepatotoxicity
blocking beta1- and
beta2- receptors. Drug eruption
The amount of similar to lichen
alpha to beta planus.
blockade depends
on whether Hypersensitivity -
labetalol is which may result in
administered orally a lethal respiratory
or intravenously distress
(IV). Orally, the
ratio of alpha to β
blockade is 1:3.
Intravenously,
alpha to β blockade
ratio is 1:7. Thus,
the labetalol can be
thought to be a
beta-blocker with
some alpha-
blocking effects. By
comparison,
labetalol is a
weaker β-blocker
than propranolol,
and has a weaker
affinity for alpha-
receptors
compared to
Phentolamine.
Labetalol
possesses intrinsic
sympathomimetic
activity.In particular,
it is a partial agonist
at beta2- receptors
located in the
vascular smooth
muscle. Labetalol
relaxes vascular
smooth muscle by
a combination of
this partial beta2-
agonism and
through alpha1-
blockade.Overall,
this vasodilatory
effect can decrease
blood pressure
Similar to local
anesthetics and
sodium channel
blocking
antiarrhythmics,
labetalol also has
membrane
stabilizing activity
 By decreasing
sodium entry,
labetalol decreases
action potential
firing and thus has
local anesthetic
activity.

33 Brand Name: Children 6-11 XOPENEX Hyperthyroidism. The mechanism trouble sleeping,
Xopenex Years Old: (levalbuterol diabetic. of action of headache,
patients 6-11 HCl) Inhalation A metabolic levalbuterol is as nausea, dry
Generic years old is 0.31 Solution is condition in which an Adrenergic mouth, increased
Name: mg administered indicated for the the body cannot beta2-Agonist. coughing, or
levalbuterol three times a treatment or adequately use Levosalbutamol, runny nose may
day, prevention of the sugars called or levalbuterol, is occur.
bronchospasm ketoacidosis. a short-acting β2
Adults And in adults, Excess body adrenergic
Adolescents ≥12 adolescents, acid. receptor agonist
Years Old: is and children 6 Decreased used in the
0.63 mg years of age amount of treatment of
administered and older with potassium in the asthma and
three times a reversible blood. chronic
day, obstructive obstructive
airway disease pulmonary
formulation: disease
C13H21NO3

34 Brand Name: Percutaneous: It is a severe heart The principal Drowsiness,

Xylocaine 1-60 mL of 0.5- medication used block. mechanism of muscle twitching,
1% solution to numb tissues Adams-Stokes action of lidocaine confusion,
Generic IV regional: 10- in a specific syndrome. as a local changes in vision,
Name: 60 mL of 0.5% area. And low amount of anaesthetic is numbness,
Lidocaine solution treatment of potassium in the through blockade tingling, and
Brachial: 15-20 ventricular blood of voltage-gated vomiting. It also
mL of 1.5% tachycardia. It myasthenia sodium channels causes low blood
 Dental: 1-5 mL may also be gravis, a skeletal (VGSCs) leading pressure,
of 2% solution used to block muscle disorder to a reversible
formulation: nerves block of action
C14H22N2O

35 lorazepam oral Mechanism of ● drowsines

generic name concentrate: Ativan Ativan Action s.
is Ativan Schedule IV (lorazepam) is (lorazepam) is Lorazepam ● dizziness.
indicated for the contraindicated in binds to ● tiredness.
management of patients with benzodiazepine ● weakness.
anxiety
● 2mg/ – hypersensitivity receptors on the ● dry mouth.
disorders or for
mL the short-term to postsynaptic ● diarrhea.
relief of the benzodiazepines GABA-A ligand- ● nausea.
symptoms of or to any gated chloride ● changes in
injectable anxiety or components of channel neuron appetite.
solution: anxiety the formulation. – at several sites
Schedule IV associated with acute narrow- within the
depressive angle glaucoma. central nervous
symptoms. system (CNS). It
Anxiety or enhances the
● 2mg/
tension inhibitory effects
mL associated with
● 4mg/ of GABA, which
the stress of
mL increases the
everyday life
usually does not conductance of
require chloride ions
and the dose treatment with into the cell
depend on the an anxiolytic.
case if it
nausea.icu. The
sleep disorders effectiveness of
..etc Ativan
(lorazepam) in
long-term use,
 that is, more
than 4 months,
has not been
assessed by
systematic
clinical studies.
The physician
should
periodically
reassess the
usefulness of
the drug for the
individual
patient.

36 magnesium ● Constipati If any known The mechanism

Dosage on. hypersensitivity of action of
sulfate
generic Forms ● Hypomag reaction to magnesium
name is the nesemia magnesium sulfate is
injectable . ● heart
same solution sulfate has thought to
MgSo4
● Prevention occurred in the trigger cerebral disturba
of past, it should not vasodilation, nces,
● 40m
g/m seizures be administered. thus reducing
L
in ● breathing
If a patient is in a ischemia
● 80m
eclamps
known heart generated by difficulti
g/m ia/preecl es,
ampsia. block, magnesium cerebral
L sulfate should not vasospasm
● 50% ● Acute ● poor
nephritis be given as it can during an
infusion solution reflexes,
(pediatric exacerbate the eclamptic event.
patients) already slowed The substance ● confusion
● 1g/1
● Cardiac cardiac also acts ,
00
arrhythm conduction. Many competitively in
mL ● weaknes
ias
 ● 2g/1 secondar manufacturing blocking the s,
00 y to labels recommend entry of calcium
mL hypoma withholding into synaptic ● flushing
also gnesemi magnesium endings, (warmth
depend a. sulfate infusions thereby altering ,
the dose ● Soaking in patients with neuromuscular redness,
depend minor
preeclampsia/ecla transmission. or tingly
on the cuts or
mpsia two hours feeling),
case bruises.
before fetal
delivery due to ● sweating,
possible ● lowered
interaction with
neuromuscular blood
blocking agents pressur
given e,
intraoperatively; ● feeling
however, the
like you
medication should
not be stopped might
due to the pass
possibility of out,
precipitating ● anxiety,
seizure activity.
● cold
feeling,
● extreme
drowsin
ess,
● muscle
tightnes
 s or
contracti
on, or
● headach
e.

37 Mepeidine syrup: Schedule used to relieve Meperidine is Mechanism of lightheadedness

(Demerol) II moderate to contraindicated in action dizziness
50mg/5mL severe pain. It patients that are Meperidine is weakness
may be used actively receiving primarily a kappa- headache
tablet: before or during or have been opiate receptor extreme calm
Schedule II surgery, or to exposed during agonist and also mood changes
50mg relieve pain the past 14 days has local nausea
100mg during labor or to monoamine anesthetic vomiting
delivery. It acts oxidase inhibitors effects. stomach pain or
injectable on the central (MAOI) because Meperidine has cramps
solution: nervous system of unpredictable more affinity for constipation
Schedule II (CNS) to relieve severe, and the kappa- dry mouth
25mg/mL pain. occasionally fatal receptor than flushing
50mg/mL reactions such as morphine. Opiate sweating
75mg/mL coma, severe receptors are changes in vision
100mg/mL respiratory coupled with G-
depression, protein receptors Some side effects
hypotension, and function as can be serious.
cyanosis, and both positive and The following
acute narcotic negative symptoms are
overdose. regulators of uncommon, but if
synaptic you experience
transmission via any of them or
G-proteins that those listed in the
activate effector IMPORTANT
proteins. Binding WARNING
of the opiate section, call your
stimulates the doctor
exchange of GTP immediately:agita
for GDP on the tion,
G-protein hallucinations
complex. As the (seeing things or
effector system is hearing voices
adenylate cyclase that do not exist),
and cAMP fever, sweating,
located at the confusion, fast
inner surface of heartbeat,
the plasma shivering, severe
membrane, muscle stiffness
opioids decrease or twitching, loss
intracellular of coordination,
cAMP by nausea, vomiting,
inhibiting or diarrhea
adenylate nausea, vomiting,
cyclase. loss of appetite,
Subsequently, the weakness, or
release of dizziness
nociceptive inability to get or
neurotransmitters keep an erection
such as irregular
substance P, menstruation
GABA, dopamine, decreased sexual
acetylcholine and desire
noradrenaline is slow or difficult
inhibited. Opioids breathing
also inhibit the shaking hands
release of that you cannot
vasopressin, control
 somatostatin, seizures
insulin and changes in
glucagon. Opioids heartbeat
close N-type difficulty urinating
voltage-operated fainting
calcium channels rash
(OP2-receptor hives
agonist) and open
calcium-
dependent
inwardly rectifying
potassium
channels (OP3
and OP1 receptor
agonist). This
results in
hyperpolarization
and reduced
neuronal
excitability.
38 Methylpredni tablet 1. Endocrine Methylprednisolo Methylprednisolo shortness of
solone 2mg Disorders ne should not be ne plays an breath,
(‫؛‬Medrol) 4mg 2. Rheumatic taken orally by important role in swelling,
8mg Disorders people who have the current rapid weight gain,
16mg 3. Collagen systemic fungal treatment of bruising ,
32mg Diseases infections, with multiple sclerosis thinning skin,
4.Dermatologic the exception of (MS), particularly non-healing
injectable Diseases Depo-Medrol in the acute wounds,
suspension 5. Allergic when phase of relapse. blurred vision,
20mg/mL States administered as It acts in various tunnel vision,
40mg/mL 6.Ophthalmic an intra-articular ways to decrease eye pain,
80mg/mL Diseases injection for the inflammatory seeing halos
7.Respiratory localized joint cycle including: around lights,
powder for Diseases conditions.[] dampening the severe
injection 8.Hematologic Methylprednisolo inflammatory depression,
40mg Disorders ne is cytokine cascade, personality
125mg 9. Neoplastic contraindicated in inhibiting the changes,
500mg Diseases those with known activation of T unusual thoughts
1g For palliative hypersensitivity to cells, decreasing or behavior,
2g management of: methylprednisolo the extravasation sudden pain in an
Leukemias and ne or its of immune cells arm, leg or back,
lymphomas in components[] into the central bloody or tarry
adults Steroids should nervous system, stools,
Acute leukemia be used with facilitating the coughing up
of childhood caution in apoptosis of blood or vomit
patients with activated immune that looks like
10.Edematous ulcerative colitis, cells, and coffee grounds,
States heart disease or indirectly seizures,
To induce a hypertension, decreasing the leg cramps,
diuresis or peptic ulcer, renal cytotoxic effects constipation ,
remission of insufficiency, of nitric oxide and irregular
proteinuria in osteoporosis, tumor necrosis heartbeats,
the nephrotic myasthenia factor alpha. This fluttering in your
syndrome, gravis, glaucoma, paper reviews the chest,
without uremia, and diabetes.][] most recent increased thirst or
of the idiopathic Psychic observations on urination, and
type or that due manifestations these numbness or
to lupus may appear while mechanisms both tingling
erythematosus. taking to understand the
11.Gastrointesti methylprednisolo disease The most
nal Diseases ne, ranging from mechanism and common side
To tide the euphoria, its treatment. As effects of Medrol
patient over a insomnia, more becomes include:
critical period of personality known about swelling in your
the disease in: changes to these hands or ankles,
Ulcerative colitis depression. mechanisms, it dizziness or
Regional Caution is may become spinning
enteritis required for possible to design sensation,
12. Nervous patients with treatment changes in your
System predisposed regimes that are menstrual
Acute psychoses, as more specific periods,
exacerbations of psychotic towards both the headache,
multiple tendencies may individual and the mild muscle pain
sclerosis be exacerbated disease state. or weakness, and
13.Miscellaneou while taking stomach
s corticosteroids.] discomfort or
bloating
Solu-Medrol 40
mg dosage
contains lactose
monohydrate
produced from
cow's milk; It
should not be
taken by anyone
with known
hypersensitivity to
dairy products or
its
components.Seve
re medical events
have been
associated with
epidural
administration of
Solu-Medrol and
Depo-Medrol,
including spinal
cord infarction,
paraplegia,
quadriplegia,
cortical blindness
and stroke.
Intramuscular
injections should
 not be
administered to
those with
idiopathic
thrombocytopenic
purpura.
Formulations of
Solu-Medrol and
Depo-Medrol
containing benzyl
alcohol are
contraindicated
for use in
premature
infants.[21]
Exposure of
neural tissue to
excessive
amounts of
benzyl alcohol
has been
associated with
toxicity and in
rare events has
resulted in death.
39- Midazolam( oral syrup: used before Injectable Midazolam binds Common effects
Dormicum) 2mg/mL surgery or a midazolam is to the GABA include:
(generic) procedure. It contraindicated in receptor but does headache,
helps to cause patients with a not displace nausea,
-injectable drowsiness, known GABA; rather, it vomiting,
solution: decrease hypersensitivity to enhances the cough,
1mg/mL anxiety, and to the drug. affinity of GABA drowsiness,
(generic) decrease your Benzodiazepines for its receptor hiccups,
5mg/mL memory of the are site on the same
(generic, surgery or contraindicated in receptor complex.
 Seizalam) procedure. This patients with The
medication may acute narrow- pharmacodynami
-formulation: also be used to angle glaucoma. c consequences
C18H13ClFN3 help with Benzodiazepines of
anesthesia or to may be used in benzodiazepine
sedate people patients with agonist actions
who need a tube open-angle include
or machine to glaucoma only if antianxiety
help with they are receiving effects, sedation,
breathing. appropriate and reduction of
therapy seizure activity.

40 Morphine Sulfate ( 10mg/5ml Oral Morphine Sulfate Any patient with Mechanism of More common:
Avinza) Solution Injection is one of the Action
indicated for the following Morphine is a Cramps
-2mg/ml relief of both diseases: full opioid difficulty having a
Solution for acute and agonist and is bowel movement
Injection chronic severe systemic relatively drowsiness
pain, where mastocytosis selective for the false or unusual
-formulation: continuous untreated mu-opioid sense of well-being
C17H21NO7S analgesia is decreased level receptor, relaxed and calm
required over of thyroid although it can feeling
several days hormones bind to other sleepiness or
following major decreased opioid receptors unusual
surgical function of the at higher doses. drowsiness
procedures, by adrenal gland The principal weight loss
Patient alcohol therapeutic
Controlled intoxication action of
Analgesia (PCA). drug abuse morphine is
cor pulmonale analgesia. Like
low blood all full opioid
pressure agonists, there
asthma attack is no ceiling
decreased lung effect for
function analgesia with
blockage of the morphine.
stomach or Clinically,
intestine dosage is
constipation titrated to
severe liver provide
disease adequate
biliary and analgesia and
gallbladder may be limited
problem by adverse
acute reactions,
inflammation of including
the pancreas respiratory and
severe renal CNS
impairment depression.
seizures The precise
a condition where mechanism of
the body is the analgesic
unable to action is
maintain unknown.
adequate blood However,
flow called shock specific CNS
an inability to opioid receptors
completely empty for endogenous
the bladder compounds with
weakened patient opioid-like
activity have
been identified
throughout the
brain and spinal
cord and are
thought to play
a role in the
analgesic
effects of this
 drug.
41 Naloxone (Narcan) injectable Narcan Naloxone is the mechanism flushing,
solution (naloxone) is an contraindicated in of action of dizziness,
opioid antagonist patients known to naloxone is not tiredness,
0.4mg/mL used for the be hypersensitive fully understood, weakness,
complete or to it. Use with the nervousness,
1mg/mL partial reversal of caution in patients preponderance restlessness,
opioid overdose, dependent on of evidence irritability,
IM/SC including opioids. Use with suggests that
auto-injector respiratory caution in patients naloxone Severe side effects
depression. with cardiac antagonizes the of Narcan include:
0.4mg/0.4mL (2 Narcan is also problems or those opioid effects by
auto- used for receiving competing for agitation,
injectors/packa diagnosis of cardiotoxic drugs. the same high or low blood
ge) suspected or receptor sites, pressure,
Continuous IV known acute especially the cardiac
infusion (Off- opioid overdose mu-opioid arrhythmias,
label) and also for receptor. shortness of
For use in blood pressure Recently, breath,
patients support in septic naloxone has
exposed to long shock. Narcan is been shown to
acting opioids available in bind all three
(eg, generic form. opioid receptors
methadone), (mu, kappa and
sustained gamma) but the
release strongest
products binding is to the
Calculate mu receptor.
dose/hr based
on effective
intermittent
dose used and
duration of
adequate
response seen
 Alternatively,
use two-thirds
of initial
effective
naloxone bolus
on an hourly
basis (0.25-6.25
mg/hr);
administer one-
half of initial
bolus dose 15
min after
initiating
continuous IV
infusion to
prevent drop in
naloxone levels
42 Nitroglycerin infusion solution For EMS Nitroglycerin is The principal Headache,
(Nitrostat) 25mg/250mL providers, typical contraindicated in pharmacological dizziness,
nitroglycerin patients that have action of lightheadedness,
50mg/250mL indications reported allergic nitroglycerin is nausea, and
include chest symptoms to the relaxation of flushing may occur
100mg/250mL pain or medication. vascular smooth as your body
discomfort Known history of muscle. adjusts to this
injectable associated with increased Although medication. If any
solution angina pectoris intracranial venous effects of these effects
5mg/mL or suspected pressure, severe predominate, persist or worsen,
acute myocardial anemia, right- nitroglycerin tell your doctor or
Angina infarction, as well sided myocardial produces, in a pharmacist
as pulmonary infarction, or dose-related promptly.
If intolerant of edema with hypersensitivity to manner, dilation Headache is often
or unresponsive hypertension. nitroglycerin are of both arterial a sign that this
to SL NTG all and venous medication is
5 mcg/min contraindications beds. working.
Increase by 5 to nitroglycerin
 mcg/min q3- therapy.
5min up to 20
mcg/min, THEN
Increase by 10
mcg/min
May later
increase by 20
mcg/min
Higher dosages
required for
PVC admin sets
Uninterrupted
infusion >24
hours produces
tolerance

Renal Failure

CrCl: 10-50
mL/min:
Administer q24-
72hr
CrCl: <10
mL/min:
Administer q72-
96hr
43 Nitrous Oxide Sedation and 1 - A fearful, 1- Chronic General CNS Share on Pinterest
surgical anxious, or obstructive depressant Short term side
brand names: analgesia: obstreperous pulmonary action; may act effects from nitrous
Concentration patient diseases similarly as oxide can include
Entonox s of 25% to inhalant dizziness, nausea,
or vomiting. Short
50% nitrous 2 - Certain 2 - Severe general term side effects
oxide with patients with emotional anesthetics by are not very
oxygen. For special health disturbances or stabilizing common, but they
general care needs drug-related axonal can occur. The
anesthesia, dependencies membranes to most common
concentrations 3 - A patient partially inhibit reason a person
range from whose gag reflex 3 - First trimester action may experience
40% to 70% interferes with of pregnancy potentials short term side
dental care effects is due to
via mask or leading to
inhaling the gas too
endotracheal 4 - Treatment sedation; may
4 - A patient for quickly or inhaling
tube. The with bleomycin partially act on too much.
minimum whom profound sulfate opiate receptor
alveolar local anesthesia systems to
concentration cannot be 5- cause mild
(MAC), which obtained Methylenetetrahy analgesia;
can be drofolate central
5 - A cooperative
considered as reductase sympathetic
ED50 for child is deficiency stimulating
inhalational undergoing a action
anesthesia, is lengthy dental supports blood
105%; procedure. pressure,
Therefore, systemic
giving birth in vascular
a hyperbaric resistance,
chamber is and cardiac
necessary to output; it does
use it as a not depress
complete carbon dioxide
anesthetic. drive to breath.
When taken at Nitrous oxide
70%, it increases
reduces the cerebral blood
MAC effect of flow and
other intracranial
anesthetics by pressure while
 half. decreasing
hepatic and
Dental: renal blood
Anesthesia flow; has
analgesic
and action similar
analgesia: to morphine.
concentrations
from 25% to
50% nitrous
oxide with
oxygen

44 NMB (non- The time of Non- There are both Benzylisoquinoliniu

depolarizing) onset and depolarizing contraindication nNMBs classify m, mivacurium,
as competitive atracurium,
degree of neuromuscular s and cautions
Brand name : acetylcholine cisatracurium, and
neuromuscula blockers when
(ACh) doxacurium can
r blockade (nNMBs) administering
1 - Atracurium antagonists, cause histamine
(NMB) in 80 administration nNMBs. The
which directly release when
anaesthetized serves as primary contraindication
2- Nimbex bind to the alpha administered,
patients, therapy in s include: which can cause
subunits of
3- Norcuron following facilitating bronchospasm,
nicotinic
either a single endotracheal 1 - Conditions hypotension, and
receptors on the
4 - Zemuron bolus injection intubations and that exhibit tachycardia from
of adjuvant therapy resistance: postsynaptic peripheral
membrane. vasodilation.
pancuronium in the Cerebral palsy,
Under normal
0.95 mg kg-1, perioperative burn injuries,
circumstances,
atracurium maintenance of hemiplegia (on
the transmission
0.53 mg kg-1 anesthesia and the affected side),
or vecuronium care of the peripheral nerve of impulses
from the
0.07 mg kg-1, critically ill injury, severe
or divided patient. Primarily chronic infections primary motor
doses of nNMBs of botulism or cortex to the
pancuronium (rocuronium, tetani motor endplates
0.15 mg kg-1, vecuronium, 2 - Conditions occurs via ACh
atracurium pancuronium, that exhibit release from the
0.07 mg kg-1 atracurium, hypersensitivity: presynaptic
or vecuronium cisatracurium, ALS, autoimmune terminal,
0.01 mg kg-1 mivacurium) are disorders (SLE, diffusion across
administered 3 used to facilitate polymyositis, the synaptic
min or 5 min airway dermatomyositis), membrane, and
before the management and Guillain-Barre, binding to the
second dose decrease the risk Duchenne type nicotinic
of of laryngeal muscular receptor of the
pancuronium injury during dystrophy, postsynaptic
0.08 mg kg-1, regular and myasthenia gravis membrane. The
atracurium emergent receptor binding
0.46 mg kg-1 intubations. Factors to be then activates its
or vecuronium nNMBs can cautious of when sodium (Na+)
0.06 mg kg-1, reduce administering channel domain
were hoarseness include : allowing the
determined secondary to influx of Na+
and compared intubation via 1 - Hypothermia: and depolarizing
to the same decreasing the Prolongs blockade the motor
parameters incidence of by decreasing endplate from a
measured vocal cord metabolism and resting
following injuries. elimination membrane
succinylcholin Research has potential of -100
2 - Respiratory
e found that as mV to +40 mV
acidosis:
administration adjunctive depolarized
(1 mg kg-1). therapy to Potentiates potential. The
The time to intravenous (IV) neuromuscular depolarizing
maximum or inhaled blockade and signal would
antagonizes
NMB (100%) anesthetics, reversal. reach the
following the nNMBs improve sarcoplasmic
administration mechanical membrane,
3 - Electrolyte
of ventilation which would
abnormalities:
succinylcholin outcomes in signal a release
Hypokalemia and
e was 58.1 +/- patients with of calcium ions
hypocalcemia
5.3 s, whereas poor lung (Ca2+) that
potentiate
the time to compliance who facilitates
blockade; in
maximum are critically ill muscular
preeclamptic
NMB (100%) and/or receiving contraction.
patients who are
following a treatment in the nNMBs fit into
taking magnesium
single bolus perioperative this metabolic
sulfate can
injection of setting.This process by
present with
either combination in blocking ACh
hypermagnesemia
pancuronium, the perioperative binding to the
, which also
atracurium or setting can also alpha subunits
potentiates
vecuronium facilitate access on nicotinic
blockades
was 130.6 +/- to the thoracic receptors and
22.2, 93.0 +/- and abdominal maintains the
6.4, 127.5 +/- cavities by 4 - Renal failure: polarized motor
13.0 s, depressing Decreases endplate. This
respectively. voluntary or clearance, though metabolic
These values reflex muscle prolongation of process leads to
for time to movement. blockade varies muscular
maximum paralysis, a
NMB are favorable
significantly condition for
longer than patients
the time undergoing
required for perioperative
succinylcholin procedures.
e to achieve
These agents
maximal differentiate into
blockade. The two
time to attain subcategories,
maximum classified
NMB following structurally and
divided doses clinically based
of on drug reversal
pancuronium, patterns:
atracurium or
vecuronium
● Steroidal:
separated by Rocuroni
3 min um,
decreased vecuroni
significantly to um,
77.9 +/- 4.3,
pancuron
77.5 +/- 7.6, ium
89.0 +/- 8.6 s, ● Benzyliso
respectively. quinolini
However, um:
when the two
atracuriu
doses of drug m,
were cisatracu
separated by rium,
5 min, only mivacuri
small, non-
um
significant
further
decreases Although slight
occurred in differences in
the time clinical effects
required to like the steroidal
achieve agents possess
 maximum more vagolytic
blockade. activity and
Although the benzylisoquinoli
time to nes, causing
maximum more histamine
NMB following reactions, both
divided doses subtypes have
of the same
pancuronium, mechanism of
atracurium or action.
vecuronium is However, due to
significantly the recent
longer than development of
that for sugammadex,
succinylcholin clinical reversal
e, divided algorithms now
dosing differ
significantly
decreases the
time required
to reach
maximal NMB.
45 injectable ZOFRAN is known to have Ondansetron is
Ondansetron) solution indicated for the hypersensitivity a selective 5-
(Zofran • prevention of (e.g., HT3 receptor diarrhea
2mg/mL nausea and anaphylaxis) to antagonist.
tablet vomiting ondansetron or While its headache
• associated with: any of the mechanism of
4mg • components of action has not fever
• highly the formulation. been fully
8mg emetogenic • characterized, lightheaded
• cancer receiving ondansetron is ness
24mg chemotherapy, concomitant not a dopamine-
 oral solution including apomorphine due receptor dizziness
• cisplatin greater to the risk of antagonist.
4mg/5m than or equal to profound Serotonin weakness
L 50 mg/m2 hypotension and receptors of the
oral soluble film • loss of 5-HT3 type are tiredness,
• initial and consciousness present both
4mg repeat courses peripherally on drowsiness,
• of moderately vagal nerve
8mg emetogenic terminals and constipation
orally cancer centrally in the rash
disintegrating chemotherapy chemoreceptor
tablets • trigger zone of blurred
• radiother the area vision
4mg apy in patients postrema. It is
• receiving either not certain muscle
8mg total body whether spasm.
irradiation, single ondansetron
high-dose antiemetic
fraction to the action is
abdomen, or mediated
daily fractions to centrally,
the abdomen peripherally, or
in both sites.

46 Oxytocin Injectable Treatment and • Significant lowers the • Neonatal

(Pitocin,Syntocinon) solution prophylaxis of cephalopelvic energy in the seizure
• postpartum disproportion uterine •
10 haemorrhage • myofascial Neonatal
units/mL Labour induction Unfavorabl membrane, yellowing of skin or
• Adjunct in e fetal positions increases the eyes (jaundice)
Postpart abortion or presentations, intensity and •
um e.g., transverse number of Fetal death
Hemorrhage lies, which are stimuli and • Low
• undeliverable triggers calcium Apgar score (5
10 unit without ions. minute)
 intramuscularly conversion prior •
(IM) after to delivery Slow heart
delivery of • rate
placenta Obstetric • Fast
• emergencies that heart rate
Add 10- favor surgery
40 units; not to •
exceed 40 Fetal
units; to 1000 distress where
mL of non- delivery is not
hydrating imminent
intravenous (IV) •
solution and Where
infuse at adequate uterine
necessary rate activity fails to
to control achieve
uterine atony satisfactory
Labor Induction progress
• •
0.5-1 Hyperactiv
mUnit/min IV, e or hypertonic
titrate 1-2 uterus
mUnit/min q15-
60min until
contraction
pattern reached
that is similar to
normal labor
(usually 6
mUnits/min);
may decrease
dose after
desired
frequency of
contraction
 reached and
labor has
progressed to
5-6 cm dilation
Incomplete or
Inevitable
Abortion
•
10-
20mUnit/min;
not to exceed
30 units/12
hours

47 Lyophilisate for * The doctor Uses and side effects

solution for determines the benefits The following is a
dose according Pralidoxime is list of possible
injection to the condition used for the side-effects that
Pralidoxime of each patient, treatment, may occur in
Chloride as the patient control, medicines that
receives the prevention, & contain
doses in the improvement of pralidoxime /
hospital or the following Pralidoxime in
medical service diseases, English. This is
centers, under conditions and not an exhaustive
the care of the symptoms: list. These side
medical staff. Poisoning by effects are
insecticides or as possible, but may
a result of more not always occur.
than one dose of Side effects may
drugs be rare but
* serious. Consult
Neuromuscular your doctor if you
diseases observe any of
 the following side-
If you use other effects, especially
drugs or over the if they do not go
counter products away.
at the same time, Muscle stiffness
the effects of or weakness
Pralidoxime may Nausea
change in * Change in near
English. This or distance vision
may increase the Drowsiness
risk of side Fast breathing
effects or your Difficulty focusing
medicine may a point of view
not work * Blurred or
properly. Tell double vision
your doctor Difficulty
about all the speaking
medicines, * An irregular
vitamins, and heartbeat or pulse
herbal * Pain at the
supplements you injection site
use, so that your * Dizziness
doctor can help * crush
you prevent or * Headache
manage drug Visual
interactions. disturbances
Pralidoxime may Increased heart
interact with the rate
following drugs * A case of
and products: hyperventilation
* Aminophylline Muscle
* Atropine weakness
* Morphine If you notice
* other side effects
Suxamethonium not listed above,
 * Theophylline contact your
doctor for medical
Hypersensitivity advice. You can
to Pralidoxime / also report side
Pralidoxime in effects to your
English is a local Food and
contraindication. Drug
Hypersensitivity Administration.
to Pralidoxime /
Pralidoxime in
English is a
contraindication.I
n addition,
Pralidoxime
should not be
used in English if
you have the
following
conditions:
* Poisoning by
carbamate
pesticides
* Breast feeding
* Kidney failure
* myasthenia
gravis
* Pregnancy

48 Procainamide How to take: Indications for Contraindications The mechanism What are the
Arrhythmia Tablets, use of the to the use of the of action of the common side
injection. medicine drug drug effects of this
Number of • This medicine • If the patient is This drug works medicine?
doses: is used to treat hypersensitive to by reducing the Nausea or
Tablets: every fast heart rate. procainamide or sensitivity of vomiting. It can be
4-6 hours. any other heart muscle helpful to use small
 Dosage: component of this cells to electrical frequent meals,
For adults: 1-4 medicine. impulses, which take care of oral
grams per day. • The health care slows electrical hygiene, suck dry
The start of the provider should conduction in candy or chew gum
event: be informed if the the heart to relieve this.
Within 30 - 60 patient is muscle. This • Abdominal pain.
minutes. sensitive to any helps restore a
Duration of other medicine. regular
effectiveness • The allergy that heartbeat.
3 - 6 hours. affected the
feed: patient and how it
There are no affected him must
restrictions. be reported. This
includes detection
of a rash, blisters,
itchy skin,
shortness of
breath, wheezing,
coughing,
swelling of the
face, lips, tongue,
or throat, or any
other symptoms
associated with
using the
medicine.

49 Generic Name: tablet Phenothiazine

promethazine Phenergan Phenergan derivative with Central Nervous
(Promethazine (Promethazine antidopaminergi System
Brand Name:
HCl) HCl) c effect: Blocker
Phenergan 12.5mg of mesolimbic Drowsiness is the
Suppositories, Suppositories are
USP are useful contraindicated dopamine most prominent
for: for use in receptors and CNS effect of this
pediatric patients alpha- drug. Sedation,
 25mg Perennial and less than two adrenergic somnolence,
seasonal allergic years of age. receptors in blurred vision,
rhinitis. brain dizziness;
50mg Phenergan Antihistaminic confusion,
Vasomotor (Promethazine effect: H1- disorientation, and
rhinitis. HCl) receptor blocker extrapyramidal
suppository Suppositories are symptoms such as
Allergic contraindicated in oculogyric crisis,
conjunctivitis due comatose states, torticollis, and
to inhalant and in individuals tongue protrusion;
12.5mg lassitude, tinnitus,
allergens and known to be
foods. hypersensitive or incoordination,
to have had an fatigue, euphoria,
25mg
Mild, idiosyncratic nervousness,
uncomplicated reaction to diplopia, insomnia,
50mg allergic skin promethazine or tremors, convulsive
manifestations of to other seizures,
urticaria and phenothiazines. excitation,
injectable angioedema. catatonic-like
Antihistamines states, hysteria.
solution
are Hallucinations have
Amelioration of
allergic reactions contraindicated also been reported.
to blood or for use in the
25mg/m plasma. treatment of lower Cardiovascular –
L Increased or
Dermographism. decreased blood
pressure,
50 tachycardia,
mg/mL Anaphylactic
bradycardia,
reactions, as
faintness.
adjunctive
syrup therapy to
epinephrine and Dermatologic –
other standard Dermatitis,
photosensitivity,
measures, after
 6.25mg/ the acute urticaria.
5mL manifestations
have been Hematologic –
controlled. Leukopenia,
Allergic thrombocytopenia,
Conditions Preoperative, thrombocytopenic
postoperative, or purpura,
PO/PR: 25 mg obstetric agranulocytosis.
at bedtime or sedation.
12.5 mg before Gastrointestinal –
meals and at Prevention and Dry mouth,
bedtime control of nausea nausea, vomiting,
(dosage range, and vomiting jaundice.
6.25-12.5 mg associated with
q8hr) certain types of Respiratory –
IV/IM: 25 mg; anesthesia and Asthma, nasal
may be surgery. stuffiness,
repeated in 2 respiratory
hours when depression
necessary; (potentially fatal)
switch to PO as and apnea
soon as (potentially fatal).
possible (See WARNINGS
– Respiratory
Depression).
Nausea &
Vomiting Other –
Angioneurotic
PO/PR: 12.5-25
edema. Neuroleptic
mg q4-6hr PRN
malignant
IV/IM: 12.5-25
syndrome
mg q4-6hr PRN
(potentially fatal)
has also been
Motion reported (See
WARNINGS –
Sickness Neuroleptic
Malignant
25 mg PO/PR Syndrome).
30-60 minutes
before
departure and
q8-12hr PRN;
on succeeding
travel days, 25
mg PO/PR
every morning
and every
evening

Preoperative
Sedation
50 mg PO/PR
on night before
procedure or
25-50 mg IV/IM
combined with
reduced doses
of analgesics
and atropinelike
drugs

Postoperativ
e Sedation
25-50 mg
IV/IM/PO/PR
combined with
reduced doses
 of analgesics
and atropinelike
drugs

Obstetric
Sedation
25-50 mg IV/IM
in early labor;
may be
increased to 25-
75 mg q2-4hr
after labor
established; not
to exceed two
doses or up to
100 mg/day
during labor

50 Generic Name: Sodium Sodium

sodium bicarbonate 5% Sodium Sodium Bicarbonate Bicarbonate Overdose of
5% injection Bicarbonate Bicarbonate (sodium (sodium sodium
Injection, USP (sodium bicarbonate 5% bicarbonate 5% bicarbonate
Brand Name: injection) Injection injection)
(sodium bicarbonate 5% (sodium
Sodium bicarbonate injection) is contraindicated Injection is bicarbonate 5%
Bicarbonate (sodium Injection may be in patients with contraindicated injection) may
bicarbonate 5% indicated in the metabolic and in patients with result in a severe
injection) 5% treatment of respiratory metabolic and degree of alkalosis
injection) is metabolic alkalosis and in respiratory which may be
supplied in the acidosis which patients with alkalosis and in accompanied by
following size. can occur in hypocalcemia in patients with hyperirritability or
severe renal which alkalosis hypocalcemia in tetany. Should
1A1833 500 disease, may produce which alkalosis alkalosis result, the
tetany. may produce
 mL NDC uncontrolled tetany. bicarbonate should
0338-0374-03 diabetes, be stopped and the
circulatory patient managed
Exposure of insufficiency due according to the
pharmaceutical to shock, anoxia degree of alkalosis
products to heat or severe present. Severe
should be dehydration, alkalosis may be
minimized. extracorporeal controlled by
Avoid excessive circulation of parenteral
heat. Protect blood and severe injections of
from freezing. It primary lactic calcium gluconate
is acidosis. Sodium or an acidifying
recommended Bicarbonate agent such as
the product be (sodium ammonium
stored at room bicarbonate 5% chloride.
temperature injection)
(25°C): brief Injection is Reactions which
exposure up to further indicated may occur because
40°C does not in the treatment of the solution or
adversely affect of certain drug the technique of
the product. intoxications, administration
including include febrile
barbiturates, in response, infection
poisoning by at the site of
salicylates or injection, venous
methyl alcohol, thrombosis or
and in hemolytic phlebitis extending
reactions from the site of
requiring injection,
alkalinization of extravasation, and
the urine to hypervolemia.
diminish
nephrotoxicity of If an adverse
blood pigments. reaction does
Sodium occur, discontinue
 Bicarbonate the infusion,
(sodium evaluate the
bicarbonate 5% patient, institute
injection) appropriate
Injection may therapeutic
also be indicated countermeasures
in severe and save the
diarrhea which is remainder of the
often fluid for
accompanied by examination if
a significant loss deemed
of bicarbonate. necessary.

51 sodium The acute The only known -Hypertension - As a result of its The most
nitroprusside/ intravenous drug interactions produce breakdown to important: -
Nipride, Nitropress mean lethal are hypotension nitric oxide excessive
doses (LD50) of pharmacodynami during surgery - (NO), sodium hypotension and
nitroprusside in c in nature, that congenital nitroprusside cyanide toxicity.
rabbits, dogs, is it is possible (Leber's) optic has potent less common: -
mice, and rats for other atrophy or with vasodilating Cardiovascular:
are 2.8, 5.0, antihypertensive tobacco effects on Bradycardia -
8.4, and 11.2 drugs to reduce amblyopia arterioles and Dermatologic:
mg/kg, the threshold for -acute congestive venules (arterial Rash. -Endocrine:
respectively. dangerous heart failure more than Hypothyroidism. -
hypotensive venous), Gastrointestinal:
effects to be whereas other Ileus. -
seen nitrates exhibit Miscellaneous :
more selectivity Flushing, venous
for veins (e.g.) streaking, irritation
at the infusion site
52 Succinylcholine / / Used in surgical -extensive The mechanism -(cardiac
Anectine, Anectine, procedures denervation of of action of arrhythmias)
suxamethonium suxamethonium where a rapid skeletal muscle or Succinylcholine - (rhabdomyolysis )
-Injection, onset and brief upper motor involves what -Cardiac arrest -
 solution duration of neuron injury appears to be a Excessive
Intramuscular ; muscle -acute phase of "persistent" salivation
Intravenous; relaxation is injury following depolarization of -Fast or slow heart
Parenteral needed (includes major burns the rate
20 mg/1mL intubation, (hyperkalemia neuromuscular -High blood
-Injection, endoscopies, may occur), junction. This potassium
solution and ECT) -multiple trauma depolarization is -High or low blood
Intramuscular ; -malignant caused by pressure -
Intravenous 100 hyperthermia Succinylcholine Increased eye
mg/1mL -lack of ventilatory mimicking the pressure
support effect of -Life threatening
-closed-angle acetylcholine elevation in body
glaucoma but without temperature
-penetrating eye being rapidly (malignant
injuries hydrolysed by hyperthermia) -
acetylcholineste Muscle twitching -
rase . This Postoperative
depolarization muscle pain -
leads to Prolonged slow
desensitization. breathing
-Rash

53 Generic Subcutaneous: Terbutaline is -Antepartum Terbutaline is a More common

name: Terbutaline 0.25mg used to treat Hemorrhage bronchodilator, 1-Shakiness in the
sulfate subcutaneously wheezing and a medication legs, arms, hands,
- brand name: into the lateral shortness of Hyperthyroidism that dilates or feet
Brethren deltoid area. breath from lung (expands) air 2-trembling or
If significant problems (e.g., Uncontrolled passages in the shaking of
improvement asthma, chronic Diabetes lungs. It the hands or Feet
does not obstructive Mellitus attaches to beta less common
occur pulmonary adrenergic -Extra heartbeat
within 15 to 30 disease, receptors on feeling faint, dizzy,
minutes, bronchitis and muscles or lightheadedn
a second dose emphysema) surrounding the ess feeling of
of 0.25mg can air passages, warmth or heat
 be administered causing the flushing or redness
Maximum muscles to relax of the skin,
dose:0.5mg and dilate the especially on the
within 4hours air passages. face and neck
Oral: 2.5 to 5 Wider air headache sweating
mg orally passages allow
three times a more air to flow
day,at in and out of
approximately .the lungs
six-hour
intervals
Maximum
dose:15mg
within 24 hours
54 Brand Name: . 50-10 used to treat or In pregnancy Thiamine side effect :such as
Vitamin B1 mg/day orally in prevent (doses exceeding combines with blue colored ;lips
Generic Name: divided doses vitamin B1 the recommende adenosine chest pain, feeling
Thiamine Beriberi Adults deficiency. d daily average) triphosphate short ;of breath
Thiamine Acute thiamine (ATP) in the black, bloody, or
injection is used deficiency liver, kidneys, tarry stools; or
Intramuscularly: to treat beriberi, reported with and leukocytes coughing up blood
5-30 g three a serious dextrose to produce or vomit that looks
times daily (if condition administratio n; thiamine like coffee .grounds
critically ill); caused by use caution when diphosphate.
then 5-30 mg prolonged lack of thiamine status Thiamine
three times vitamin .B1 .uncertain diphosphate
daily for 1 Hypersensitivity acts as a
month Duration reactions reported coenzyme in
dependent on following carbohydrate
persistence of repeated metabolism, in
symptoms parenteral doses transketolati on
reactions, and in
the utilization of
hexose in the
hexose-
 monophosphate
shunt
55 Vasopressin SECTIONS Indications Hypersensitivity; The most Abdominal or
(Hormone) Vascular disease important action stomach pain,
Dosing & Uses Pitressin is especially of vasopressin usually after eating
indicated for coronary artery is its antidiuretic a meal
ADULTPEDIAT prevention and disease; chronic action on the
RIC treatment of nephritis (until collecting ducts agitation
postoperative reasonable blood- of the kidney.
Dosage Forms abdominal nitrogen Vasopressin back pain
& Strengths distention, in concentration binds to V2
abdominal attained). receptors on the chest pain or
injection roentgenography cell surface of discomfort
solution to dispel tubular cells,
interfering gas initiating an chest tightness or
20 units/mL shadows, and in intracellular heaviness
diabetes cascade which
Abdominal insipidus. results in the coma
Distention generation of
the water confusion
5 units IM channel,
initially; aquaporin-2. constipation
repeated q3-4hr
PRN; may be convulsions
increased to 10
units cough

Diabetes decreased urine

Insipidus output

5-10 units depression

IM/SC q8-12hr
Titrate dose on diarrhea
basis of serum
sodium, serum difficulty with
osmolality, fluid swallowing
balance, and
urine output dilated neck veins

Abdominal dizziness
Roentgenograp
hy extreme fatigue

10 units fainting
(0.5mL) IM/SC
2 hours before fast or irregular
procedure, then heartbeat
10 units IM 30
minutes before headache
procedure
May give hives, itching, or
enema prior to rash
first dose of
vasopressin hostility

Dosage increased thirst

Modifications
irregular breathing
Hepatic
impairment: irritability
Lower doses
may be lethargy
required to
achieve lightheadedness,
response dizziness, or
fainting
Gastrointestinal
Hemorrhage muscle pain or
(Off-label) cramps
0.2-0.4 unit/min muscle twitching
IV initially; may
be increased to nausea or vomiting
0.8 unit/min IV
PRN no blood pressure
or pulse
Vasodilatory
Shock (Off- pain in the
label) shoulders, arms,
jaw, or neck
0.01-0.04
unit/min IV pale, cool, or
blotchy skin on the
arms or legs

puffiness or
swelling of the
eyelids or around
the eyes, face, lips,
or tongue

rapid weight gain

restlessness

slow or irregular
heartbeat

stopping of heart

stupor

sweating

swelling of the
 face, ankles,
fingers, feet, or
lower legs

troubled breathing

unconsciousness

unusual tiredness
or weakness

weak or absent
pulse in the arms
or legs
56
57
58
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