Romero, Pamela A.

4/21/2022

BSN 4 – 2 (GROUP 3)

NAME:

LEVOPHED

PURPOSE:

It is used to treat life-threatening low blood pressure (hypotension) that can occur with certain
medical conditions or surgical procedures. Norepinephrine is often used during CPR (cardio-
pulmonary resuscitation).

SPECIAL CONSIDERATION:

- Infuse LEVOPHED into a large vein

- Avoid infusions into the veins of the leg in the elderly or in patients with occlusive
vascular disease of the legs
- Monitor blood pressure and apical pulse continuously
- Assess patient frequently for headache, chest pain, or other signs of toxicity
- Do not mix other medications in IV line with norepinephrine drip
Extravasation of norepinephrine may cause tissue necrosis to skin. Therefore, monitor IV
site every hour.
NAME:

DOPAMINE

PURPOSE:

It is a prescription medicine used to treat the symptoms of low blood pressure, low cardiac
output and improves blood flow to the kidneys. Dopamine may be used alone or with other
medications. Dopamine belongs to a class of drugs called Inotropic Agents.

SPECIAL CONSIDERATION:

- Infuse through a large, stable vein to avoid the possibility of extravasation injury.
- Dosage range is determined by type of desired clinical effect. Start at the lower end of the
desired range and titrate according to clinical response.
- Monitor patient for signs of compromised circulation.
- Do NOT mix with any other drug, blood, or blood products. Do NOT flush line.
- Change fluid and tubing every 48 hours or earlier if solution is discoloured
- Monitor for adverse reactions.
- Observe closely for IV filtration; discontinue immediately and notify doctor/NS-ANP.
Avoid extravasation of drug as may cause necrosis and tissue sloughing.
- Continuous blood pressure monitoring. If a disproportionate rise in diastolic pressure
(decreased pulse pressure) notify doctor/NS-ANP immediately.
- Continuous cardiorespiratory monitoring.
- Document vital signs hourly and PRN.
- Monitor urinary output.
NAME:

DOBUTAMINE

PURPOSE:

Stimulates heart muscle and improves blood flow by helping the heart pump better.
Dobutamine is used short-term to treat cardiac decompensation due to weakened heart
muscle. Dobutamine is usually given after other heart medicines have been tried without
success

SPECIAL CONSIDERATION:

- Pregnancy safety: Not well established.

- May be administered through a Y-site with concurrent dopamine, lidocaine,
nitroprusside, and potassium chloride infusions.
- Blood pressure should be closely monitored.
- Increases in heart rate of more than 10% may induce or exacerbate myocardial ischemia.
- Lidocaine should be readily available
NAME:

DIAZEPAM

PURPOSE:

Diazepam is used to relieve anxiety and to control agitation caused by alcohol withdrawal.
Diazepam belongs to a class of drugs called benzodiazepines. A class of drugs refers to
medications that work similarly. They have a similar chemical structure and are often used to
treat similar conditions.

SPECIAL CONSIDERATION:

- Don’t discontinue drug suddenly; decrease dosage slowly over 8 to 12 weeks after long-
term therapy.
- To enhance taste, oral solution can be mixed with liquids or semisolid foods, such as
applesauce or pudding, immediately before administration.
- Extended-release capsule should be swallowed whole; don’t let patient crush or chew it.
- Shake oral suspension well before administering.
- Parenteral forms of diazepam may be diluted in normal saline solution; a slight
precipitate may form, but the solution can still be used.
- Diazepam interacts with plastic. Don’t store it in plastic syringes or use plastic
administration sets because doing so decreases drug availability.
- Patient should remain in bed under observation for at least 3 hours after parenteral
administration of diazepam to prevent potential hazards; keep resuscitation equipment
nearby.
- Lower doses are effective in patients with renal or hepatic dysfunction.
- Anticipate possible transient increase in frequency or severity of seizures when diazepam
is used as adjunctive treatment of convulsive disorders. Impose seizure precautions.
- Don’t mix diazepam with other drugs in a syringe or infusion container.
NAME:

PROPOFOL

PURPOSE:

Propofol is given intravenously to induce anesthesia in surgical patients and to provide sedation
for patients in the Intensive Care Unit. It's the most common induction agent of anesthesia in
current use

SPECIAL CONSIDERATION:

- Syringe or volumetric pumps are recommended to provide controlled infusion rates.

- When infusing DIPRIVAN to patients undergoing magnetic resonance imaging, metered
control devices may be utilized if mechanical pumps are impractical.
- Changes in vital signs indicating a stress response to surgical stimulation or the
emergence from anesthesia may be controlled by the administration of 25 mg (2.5 mL) to
50 mg (5 mL) incremental boluses and/or by increasing the infusion rate of DIPRIVAN.
- Infusion rates should always be titrated downward in the absence of clinical signs of light
anesthesia until a mild response to surgical stimulation is obtained in order to avoid
administration of DIPRIVAN at rates higher than are clinically necessary. Generally,
rates of 50 mcg/kg/min to 100 mcg/kg/min in adults should be achieved during
maintenance in order to optimize recovery times.
- Infusion rates should always be titrated downward in the absence of clinical signs of light
anesthesia until a mild response to surgical stimulation is obtained in order to avoid
administration of DIPRIVAN at rates higher than are clinically necessary. Generally,
rates of 50 mcg/kg/min to 100 mcg/kg/min in adults should be achieved during
maintenance in order to optimize recovery times.
NAME:

FENTANYL

PURPOSE:

This medication is used to help relieve severe ongoing pain (such as due to cancer). Fentanyl
belongs to a class of drugs known as opioid analgesics. It works in the brain to change how your
body feels and responds to pain.

SPECIAL CONSIDERATION:

- Faster onset of action but shorter duration of action than morphine.

- Additive effects with other narcotics and/or other central nervous system depressants.
- With prolonged use the minimum effective dose may increase as tolerance develops.
- After continuous use, discontinue fentanyl over a few days because physical dependence
develops.
- Management of fentanyl overdose and/or toxicity: discontinue fentanyl, supportive
therapy (ventilation, etc.), naloxone (0.01-0.1 mg/kg/dose IV)
NAME:

NUBAIN

PURPOSE:

It is indicated for the management of pain severe enough to require an opioid analgesic and for
which alternative treatments are inadequate. NUBAIN can also be used as a supplement to
balanced anesthesia, for preoperative and postoperative analgesia, and for obstetrical analgesia
during labor and delivery.

SPECIAL CONSIDERATION:

- NUBAIN should be administered as a supplement to general anesthesia only by persons

specifically trained in the use of intravenous anesthetics and management of the
respiratory effects of potent opioids.
- Naloxone, resuscitative and intubation equipment and oxygen should be readily available
- Initiate the dosing regimen for each patient individually, taking into account the patient's
severity of pain, patient response, prior analgesic treatment experience, and risk factors
for addiction, abuse, and misuse
- Monitor patients closely for respiratory depression, especially within the first 24 to 72
hours of initiating therapy
- Parenteral drug products should be inspected visually for particulate matter and
discoloration prior to administration whenever solution and container permit
- If the level of pain increases after dosage stabilization, attempt to identify the source of
increased pain before increasing the nalbuphine hydrochloride dosage