DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING

ACTION RESPONSIBILITIES
Generic Name: > It inhibits muscarinic > Bradysystolic cardiac > Contraindicated in CNS: headache, 1. In adults, doses less
Atropine Sulfate actions of acetylcholine arrest. patients hypersensitive restlessness, insomnia, than 0.5 mg may
at parasympathetic to drug and in patients dizziness, ataxia, increase risk of
disorientation,
Brand Name: neuro effector junction, > Organophosphorus or with hyperthermia. paradoxical
hallucination, delirium,
AtroPen blocking vagal effects muscarinic mushroom > Drug may increase risk excitement, agitation, bradycardia.
on SA and AV nodes, poisoning. of acute angle closure confusion, fever.
Dosage: enhancing conduction glaucoma, obstructive CV: bradycardia, 2. Watch for
1mg through AV node and > Initial treatment of uropathy, obstructive palpitations, tachycardia in cardiac
increasing HR. muscarinic symptoms of disease of GI tract, and tachycardia, atrial and patients because it may
Route: insecticide paralytic ileus, toxic ventricular arrhythmias. lead to ventricular
EENT: blurred vision,
- I.V (organophosphorus or megacolon, and fibrillation.
mydriasis, photophobia,
- I.M carbamate) poisoning intestinal atony. cycloplegia, increased
- SC or organophosphorus > Use cautiously in IOP. 3. Monitor fluid intake
nerve agent poisoning. patients with GI: dry mouth, and urine output. Drug
hyperthyroidism, CAD, constipation, thirst, causes urine retention
Therapeutic > Preoperatively to HTN, HF, tachycardia, nausea, vomiting. and urinary hesitancy.
Classification: diminish secretions and hiatal hernia with reflux GU: urine retention,
erectile dysfunction.
Antiarrhythmics block cardiac vagal esophagitis, prostatic
HEMATOLOGIC:
reflexes. hypertrophy, leucocytosis
myasthenia gravis, or METABOLIC:
Pharmacologic > Stress renal or hepatic hyperglycemia,
Classification: echocardiography impairment, and in hypoglycemia,
Anticholinergics- (adjunct chronotropic elderly patients. hyponatremia,
hypokalemia.
belladonna alkaloids agent) > Use cautiously in
SKIN: rash
patients with down
OTHERS: anaphylaxis
> Symptomatic syndrome because they
bradycardia. may be more sensitive
to drug.
 DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING
ACTION RESPONSIBILITIES
Generic name: > Is generally > Is intended for use > Hypersensitivity to > Hypotension 1. Be aware of the high
Amiodarone considered a class III only in patients with life drug or iodine. risk of adverse
> AV BLOCK
Hydrochloride antiarrhythmic, which threatening recurrent reactions.
> Congestive heart
inhibits adrenergic ventricular fibrillation or > Those with
Brand name: 2. Obtain baseline
stimulation, affects recurrent cardiogenic shock, failure
Nexterone pulmonary, liver and
sodium, potassium and hemodynamically second or third degree > Bradycardia thyroid function test
Dosage: calcium channels, unstable ventricular AV block, severe SA results and baseline
> Cardiogenic shock
150mg markedly prolongs tachycardia node disease resulting chest X-ray.
action potential and unresponsive to in bradycardia unless an > Impaired memory
Route: repolarization and adequate doses of artificial pacemaker is 3. Drug may cause
> Fatigue
I.V hyperthyroidism or
decreases AV other antiarrhythmics present, and in those
> Malaise hypothyroidism.
Therapeutic conduction and sinus or when alternative for whom bradycardia
node function. drugs can’t be has caused syncope. > Tremor
Classification: 4. Watch for evidence
Antiarrhythmics tolerated. > Peripheral neuropathy of pneumonitis,
> Use cautiously in exertional dyspnea,
> Ataxia
Pharmacologic patients receiving other non-productive cough
Classification: antiarrhythmics. Upon > Paresthesia and pleuritic chest pain.
Benzofuran derivatives Monitor pulmonary
starting amidorone, > Insomnia
function tests and chest
attempt to gradually > Sleep disturbances X-ray.
discontinue prior
> Headache
antiarrhythmics. 5. Watch carefully for
> Dizziness pulmonary toxicity.
> Nausea
> Vomiting
 DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING
ACTION RESPONSIBILITIES
Generic name: > Naturally occurring > To convert > Contraindicated in CNS: headache, 1. Monitor BP closely.
Adenosine nucleosides that acts on paroxysmal patients hypersensitive dizziness, light- Discontinue drug in
the AV node to slow supraventricular (PSVT) to drug. headeness, numbness, patients who develop
Brand name: to sinus rhythm. > Contraindicated in tingling arms, persistent or
conduction and inhibit
Adenocard those with second or nervousness. symptomatic
re-entry pathways. Drug > Stress-testing third-degree heart block hypotension.
Dosage: is also useful in treating diagnostic aid. or sinus node disease CV: chest pressure,
3 mg/ml PSVTs, including those (sick sinus syndrome facial flushing, 2. Monitor patient for
with accessory bypass and symptomatic hypotension, seizures during therapy.
Route: tracts (Wolf-Parkinson- bradycardia), except arrhythmias, first or
I.V White syndrome.) those with a second-degree AV 3. Don’t confuse
pacemaker. block. adenosine with
> Use cautiously in adenosine phosphate.
Therapeutic patients with EENT: throat, neck, or
Classification: obstructive lung disease jaw discomfort. 4. New arrhythmias,
Antiarrhythmics not associated with including heart block
bronchoconstriction or GI: nausea. and transient asystole,
bronchospasm may develop, monitor
Pharmacologic (Asthma). RESPIRATORY: dyspnea. cardiac rhythm and
Classification: > Drug may increase risk treat as indicated.
Nucleosides of seizure.
> Avoid use in patients 5. By decreasing
With signs and conduction through the
symptoms of acute MI. AV node, drug may
Drug may increase risk produce first-second, or
of serious CV reaction. third heart block.
> Use cautiously in Patients may develop
patients with high level heart block
autonomic dysfunction, after a single dose
stenotic carotid artery shouldn’t receive
disease with additional doses.
cerebrovascular
insufficiency.
 DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING
ACTION RESPONSIBILITIES
Generic name: > A calcium channel > To manage Prinzmetal > Contraindicated in CNS: headache, 1. Patients controlled
Diltiazem blocker that inhibits or variant angina or patients hypersensitive dizziness, asthenia, on drug alone or with
calcium ion influx across chronic stable angina to drug and in those somnolence. other drugs may be
Brand name: cardiac and smooth pectoris. with sick sinus switched to Cardizem
Cardizem LA muscle cells, dereasing syndrome or second- or CV: edema, LA tablets once a day at
myocardial contractility > HTN, alone or as third- degree AV block arrhythmias, AV block, the nearest equivalent
Dosage: and oxygen demand. combination therapy. in the absence of an bradycardia, HF, total daily dose.
60mg Drug also dilates artificial pacemaker, flushing, hypotension,
coronary arteries and > Atrial fibrillation or hypotension, acute MI, conduction 2. Monitor BP and HR
Route: arterioles. flutter; paroxysmal and pulmonary abnormalities, when starting therapy
Oral supraventricular congestion. abnormal ECG. and during dosage
tachycardia. > Additional adjustments.
contraindications for I.V GI: nausea,
Therapeutic form include patients constipation, abdominal 3. Maximal
Classification: who have atrial discomfort. antihypertensive effect
Antihypertensives fibrillation or flutter may not be seen for 14
with an accessory HEPATIC: acute hepatic days.
bypass tract, as in injury.
Pharmacologic Wolff-Parkinson-White 4. If systolic BP is below
Classification: syndrome or short PR SKIN: rash 90 mm Hg or HR is
Calcium channel interval syndrome, below 60 beats/minute,
blockers cardiogenic shock, and withhold dose and
ventricular tachycardia, notify prescriber.
and within a few hours
of I.V beta blocker
therapy.
> Use cautiously in
elderly patients and in
those with HF,
hypertropic obstructive
cardiomyopathy, or
impaired hepatic or
renal function.
 DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING
ACTION RESPONSIBILITIES
Generic Name: > Replaces magnesium > Mild > Contraindicated in CNS: seizures, dizziness, 1. Monitor vital signs,
Magnesium Sulfate and maintains hypomagnesemia. patients with headache, fever. including central venous
magnesium level; as an myocardial damage, CV: edema, pressure and fluid
Brand Name: anticonvulsant, reduces > Symptomatic severe heart block, or coma. thrombophlebitis, intake and output
MgSO4. muscle contraction by hypomagnesemia, with hypotension, HTN, HF, hourly. Report
interfering with release magnesium level of 0.8 > Use cautiously in tachycardia, angina – increasing oliguria.
Dosage: of acetylcholine at mEq/L or less. patients with impaired like chest pain, vascular Check weight, renal
4g in 250ml D5W myoneural junction. renal function. overload. function, fluid balance,
infused slowly, followed > Magnesium EENT: blurred vision, and serum and urine
by 4-5g I.M in alternate supplementationin total rhinitis. sodium and potassium
buttocks q4h. parenteral nutrition GI: thirst, dry mouth, levels daily.
(TPN). nausea, vomiting, 2. To relieve thirst, give
Route: diarrhea. frequent mouth care or
- I.V > Seizures in GU: urine retention. fluids.
- I.M preeclampsia or METABOLIC: 3. Drug is commonly
eclampsia. dehydration, fluid and used in chemotherapy
Therapeutic electrolyte imbalance. regimens to enhance
Classification: RESPIRATORY: diuresis of renally toxic
Electrolytes pulmonary edema. drugs.
replacement SKIN: local infection, 4. Don’t give
urticarial, injection-site electrolyte-free
Pharmacologic reaction (infection, solutions with blood. If
Classification: Minerals phlebitis, venous blood is given
thrombosis) simultaneously, add at
OTHER: chills, thirst. least 20 mEq of sodium
chloride to each liter of
drug solution to avoid
pseudo agglutination.
 DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING
ACTION RESPONSIBILITIES
Generic Name: > A class IB > Ventricular > Contraindicated in CNS: confusion, tremor, 1. Monitor drug level.
Lidocaine antiarrhythmic that arrhythmias caused by patients hypersensitive stupor, restlessness, Therapeutic levels are
decreases the MI, cardiac to amide-type local light-headenss, 1.5 to 5mcg/ml
depolarization , manipulation, or cardiac anesthetics. seizures, lethargy,
Brand Name:
automaticity, and glycosides. somnolence, anxiety, 2. Monitor patients for
Xylocaine excitability in the > Contraindicated in paresthesia, muscle toxicity.
ventricles during the > Ventricular those with Adams- twitching.
Dosage: diastolic phase by direct arrhythmias; shock- stokes syndrome, and 3. Monitor patient’s
5mg/ml action on the tissues, refractory ventricular severe degrees of SA, CV: hypotension, response, especially BP
especially Purkinje fibrillation; pulseless AV, or intraventricular bradycardia, new or and electrolytes, BUN,
Route: network. ventricular tachycardia. block in the absence of worsened arrhythmias, and creatinine levels.
I.V an artificial pacemaker. cardiac arrest. Notify prescriber if
abnormalities occur.
> Use cautiously and at EENT: blurred or double
Therapeutic reduced dosages in vision, tinnitus. 4. If arrhythmias
Classification: patients with complete worsen or ECG changes
Antiarrhythmics or second-degree heart GI: vomiting occur, stop infusion and
block or sinus notify prescriber.
Pharmacologic bradycardia, in elderly RESPIRATORY:
Classification: patients, in those with respiratory depression
HF or renal or hepatic
Amide derivatives
disease, and in those SKIN: soreness at
weighing less than 50kg. injection site.

OTHER: anaphylaxis,
sensation of cold.
 DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING
ACTION RESPONSIBILITIES
Generic Name: > Causes contraction of > Vasodilatory shock in > Contraindicated in CNS: headache, vertigo 1. Monitor patient for
Vasopressin smooth muscle in the patients who remain patients allergic or hypersensitivity
vascular bed and hypotensive despite hypersensitive to 8 CV: hemorrhagic shock, reactions, including
fluids and arginine vasopressin or HF, atrial fibrillation, urticaria, angioedema,
Brand Name: increases systemic
catecholamines. chlorobutanol. Use in myocardial ischemia, bronchoconstriction,
Vasostrict vascular resistance and patients with impaired bradycardia, and anaphylaxis.
mean arterial BP and cardiac response may vasoconstriction,
decreases HR and worsen cardiac output. decreased cardiac 2. Monitor BP and
Dosage: cardiac output. output, distal limb hemodynamic
20units/ml > Use cautiously in ischemia. parameters Every 10 to
elderly patients. 15 minutes during
Route: HEMATOLOGIC: therapy.
I.V > Safety and thrombocytopenia
effectiveness in children 3. Monitor urine
haven’t been GI: mesenteric ischemia specific gravity and fluif
established. intake and output to aid
Therapeutic GU: acute renal evaluation of drug
Classification: insufficiency effectiveness.
Antidiuretic hormones
METABOLIC: 4. Monitor ECG and
hyponatremia fluid or electrolyte
Pharmacologic status periodically.
Classification: SKIN: cutaneous
gangrene 5. Monitor patients for
Posterior pituitary
bleeding, palpitations,
hormones or signs and symptoms
of ischemia,
 DRUG NAME MECHANISM OF INDICATION CONTRAINDICATION ADVERSE EFFECT NURSING
ACTION RESPONSIBILITIES
Generic Name: > Not clearly defined. A > Vasospastic angina; > Oral and I.V forms are CNS: anxiety, asthenia, 1. Contraindicated in
Verapamil calcium channel blocker unstable angina; classic contraindicated in seizures, depression, patients hypersensitive
that inhibits calcium ion chronic, stable angina patients hypersensitive dizziness, dysarthria, to drug or its
pectoris; chronic atrial to drug and in those fatigue, fever, components and as
Brand Name: reflux across cardiac
fibrillation. with severe left headache, insomnia, first-line therapy for
Verelan and smooth muscle ventricular dysfunction, lethargy, malaise, complex partial
cells, thus decreasing > To prevent cardiogenic shock, memory impairment, seizures.
Dosage: myocardial contractility paroxysmal second or third degree nervousness,
100mg and oxygen demand; it supraventricular AV block, or sick sinus paresthesia, sedation, 2. Drug may cause
also dilates coronary tachycardia syndrome except in vertigo, sensory loss, progressive and
Route: arteries and arterioles. presence of functioning somnolence, dystonia, permanent bilateral
Oral > Atrial flutter/atrial pacemaker, atrial flutter hypotonia, hypertonia. concentric visual field
fibrillation: or fibrillation and CV: chest pain, constriction and may
Therapeutic supraventricular accessory bypass tract peripheral edema reduce visual acuity.
arrhythmias syndrome, severe HF EENT: asthenopia,
Classification:
and severe blurred vision, diplopia, 3. Don’t use drug in
Antihypertensives > Digitalized patients hypotension. nystagmus, eye pain, patients who have or
with chronic atrial strabismus, are at high risk for other
Pharmacologic fibrillation or flutter. > I.V forms is conjunctivitis, tinnitus, types of irreversible
Classification: contraindicated in otitis media, sinusitis, vision loss unless
Calcium channel > HTN patients receiving I.V toothache benefits clearly
blockers beta blockers and in GI: abdominal outweigh risks.
those with ventricular distention, constipation,
tachycardia. diarrhea, dyspepsia, 4. Use cautiously in
nausea, stomach patients with a history
> Use cautiously in discomfort, vomiting, of abnormalities noted
elderly patients, gastroenteritis on MRI, neurotoxicity,
children, and in those GU: erectile depression, suicidal
with increased ICP or dysfunction, UTI, behaviour or ideation,
hepatic or renal disease. dysmenorrhea or anemia.
RESPIRATORY:
bronchitis, cough, URI
SKIN: rash, wound
secretion, acne
 BAGUIO CENTRAL UNIVERSITY

IN PARTIAL FULFILLMENT OF THE REQUIREMENT IN INTENSIVE NURSING PRACTICUM

DRUG STUDY

SUBMITTED TO: Ma’am OLEA ROMERO

SUBMITTED BY: MARILYN C. FANGKI

DATE OF ROTATION: MARCH 19-20-21, 2020

(EMS)