Tatoy Emergency Drugs

ST.
PAUL UNIVERSITY DUMAGUETE

COLLEGE OF NURSING
DUMAGUETE CITY
1 Semester, 2022-2023
st
IN PARTIAL FULFILLMENT OF THE RESEARCH REQUIREMENT FOR
NCM 118
Emergency Activity No. 2
SUBMITTED TO:
Ms. Maria Lourdes Agustin, RN, MAN
SUBMITTED BY:
Tatoy, Christian Dene O.
BSN 4B
October 16, 2022

ST. PAUL UNIVERSITY DUMAGUETE
COLLEGE OF NURSING
DUMAGUETE CITY
1 Semester, 2022-2023
st
EMERGENCY DRUGS
1.Adenosine 16. Norepinephrine (Levophed)

2.Aminophylline 17.Magnesium SO4
3.Apresoline 18.Midazolam (Dormicum)
4.Atropine Sulfate 19.Morphine SO4
5.Bricanyl (Terbutaline SO4) 20.Nicardipine (Cardepine)
6.Calcium Gluconate 21.Phenobarbital (Luminal)
7.Cordarone/Amiodarone 22.Phenytoin
8.Dexamethasone 23.Solucortef
9.Diazepam 24.Tranexamic Acid
10.Diphenhydramine 25.Nimodipine
11.Dobuject (Dobutamine) 26.Verapamil (Isoptin)
12.Epinephrine 27.Tetanus Immune Globulin, human
13.Furosemide 28.Nexium
14.Isosorbide Dinitrate (Isoket) 29.Omeprazole
15.Lanoxin
Name of Classification/ Mode of action Side Nursing

the Drug Route of effects/Adverse considerations/responsibilitie
administration effects s
Cardiovascular Slows CNS: Headache, Assessment & Drug Effects
Adenosine Agent, conduction lightheadedness,
Antiarrhythmic through the dizziness, tingling Monitor for S&S of
atrioventricular in arms (from IV bronchospasm in asthma
Route of (AV) and infusion), patients. Notify physician
Administration: sinoatrial (SA) apprehension, immediately.
Intravenous nodes. Can blurred vision,
interrupt the burning sensation Use a hemodynamic
reentry (from IV monitoring system during
pathways infusion). CV: administration; monitor BP and
through the AV Transient facial heart rate and rhythm
node. flushing, continuously for several
Depresses left sweating, minutes after administration.
ventricular palpitations, chest
function, but pain, atrial Note: Adverse effects are
effect is fibrillation or generally self-limiting due to
transient due to flutter. short half-life (10 s).
short half-life. Respiratory:
Shortness of Note: At the time of conversion
breath, transient to normal sinus rhythm, PVCs,
dyspnea, chest PACs, sinus bradycardia, and
pressure. GI: sinus tachycardia, as well as
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Nausea, metallic various degrees of AV block,

taste, tightness in are seen on the ECG. These
throat. Other: usually last only a few seconds
Irritability in and resolve without
children. intervention.
Patient & Family Education
Note: Flushing may occur

along with a feeling of warmth
as drug is injected.
Name of the Classification/ Mode of Side Nursing

Drug Route of action effects/Adverse considerations/responsibiliti
administratio effects es
n
Aminophylline CNS:
bronchodilator is a salt of Nervousness, Assessment & Drug Effects
Aminophyllin (respiratory theophylline restlessness,
e smooth muscle with effects depression, Monitor for S&S of toxicity
relaxant); similar to those insomnia, (generally related to
xanthine of other irritability, theophylline serum levels over
xanthene’s headache, 20 mg/mL). Observe patients
Route of (e.g., caffeine dizziness, receiving parenteral drug
Administration and muscle closely for signs of
: intravenous theobromine). hyperactivity, hypotension, arrhythmias, and
infusion Action is convulsions. convulsions until serum
dependent on CV: Cardiac theophylline stabilizes within
theophylline arrhythmias, the therapeutic range.
content tachycardia
(approximately (with rapid IV), Note: High incidence of
80%) and is hyperventilation, toxicity is associated with
measured as chest pain, rectal suppository use due to
theophylline in severe erratic rate of absorption.
the serum. hypotension,
cardiac arrest. Monitor & record vital signs
GI: Nausea, and I&O. A sudden, sharp,
vomiting, unexplained rise in heart rate
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anorexia, may indicate toxicity.

hematemesis,
diarrhea, Lab tests: Monitor serum
epigastric pain. theophylline levels.
Note: Older adults, acutely ill,

and patients with severe
respiratory problems, liver
dysfunction, or pulmonary
edema are at greater risk of
toxicity due to reduced drug
clearance.
Note: Children appear more

susceptible to CNS
stimulating effects of
xanthines (nervousness,
restlessness, insomnia,
hyperactive reflexes,
twitching, convulsions).
Dosage reduction may be
indicated.
Note: Use of tobacco tends to

increase elimination of this
drug (shortens half-life),
necessitating higher dosage or
shorter intervals than in
nonsmokers.
Report excessive nervousness

or insomnia. Dosage reduction
may be indicated.
Note: Dizziness is a relatively

common side effect,
particularly in older adults;
take necessary safety
precautions.
Do not take OTC remedies for

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treatment of asthma or cough

unless approved by physician.
Do not breast feed while

taking this drug without
consulting physician.
Name of Classification/ Mode of Side Nursing

the Drug Route of action effects/Adverse considerations/responsibilitie
Apresoline cardiovascular Reduces BP Body as a Whole: Nursing Implications

agent; nonnitrate mainly by Hypersensitivity Assessment & Drug Effects
vasodilator; direct effect (rash, urticaria,
antihypertensive on vascular pruritus, fever,
smooth chills, arthralgia, Lab tests: Determine
Route of muscles of eosinophilia, antinuclear antibody titer
Administration: arterial- cholangitis, before initiation of therapy and
Oral/ resistance hepatitis, periodically during prolonged
Intramuscular vessels, obstructive therapy.
resulting in jaundice). CNS:
vasodilation. Headache, Make baseline and periodic
Has little dizziness, tremors. determinations of BUN,
effect on CV: Palpitation, creatinine clearance, uric acid,
venous- angina, serum potassium, blood
capacitance tachycardia, glucose, and ECG.
vessels. flushing,
Hypotensive paradoxical pressor Monitor for S&S of SLE,
effect may be response. especially with prolonged
limited by Overdose: therapy.
sympathetic arrhythmia, shock.
reflexes, Special Senses: Monitor BP and HR closely.
which Lacrimation, Check every 5 min until it is
increase heart conjunctivitis. GI: stabilized at desired level, then
rate, stroke Anorexia, nausea, every 15 min thereafter
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volume, and vomiting, diarrhea, throughout hypertensive crisis.

cardiac constipation,
output. abdominal pain, Monitor I&O when drug is
paralytic ileus. given parenterally and in those
Urogenital: with renal dysfunction.
Difficulty in
urination, Patient & Family Education
glomerulonephritis.
Hematologic:
Decreased
hematocrit and Monitor weight, check for
hemoglobin, edema, and report weight gain
anemia, to physician.
agranulocytosis
(rare). Other: Nasal Note: Some patients
congestion, muscle experience headache and
cramps, SLE-like palpitations within 2–4 h after
syndrome, fixed first PO dose; symptoms
drug eruption, usually subside spontaneously.
edema.
Make position changes slowly
and avoid standing still, hot
baths/showers, strenuous
exercise, and excessive alcohol
intake.
Do not drive or engage in other

potentially hazardous activities
until response to drug is
known.
Do not breast feed while taking

this drug without consulting
physician.

the Drug Route of action effects/Adverse considerations/responsibilities
administration effects
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Atropine Autonomic Acts by CNS: Headache, Assessment & Drug Effects

Sulfate Nervous System selectively ataxia, dizziness,
Agent; blocking all excitement,
Anticholinergic muscarinic irritability, Monitor vital signs. HR is a
(Para- responses to convulsions, sensitive indicator of patient's
sympatholytic); acetylcholine drowsiness, response to atropine. Be alert to
Antimuscarinic (ACh), fatigue, changes in quality, rate, and
whether weakness; mental rhythm of HR and respiration
excitatory or depression, and to changes in BP and
inhibitory. confusion, temperature.
Selective disorientation,
depression of hallucinations. Initial paradoxical bradycardia
CNS relieves CV: following IV atropine usually
rigidity and Hypertension or lasts only 1–2 min; it most likely
tremor of hypotension, occurs when IV is administered
Parkinson's ventricular slowly (more than 1 min) or
syndrome. tachycardia, when small doses (less than 0.5
Antisecretory palpitation, mg) are used. Postural
action paradoxical hypotension occurs when patient
(vagolytic bradycardia, AV ambulates too soon after
effect) dissociation, parenteral administration.
suppresses atrial or
sweating, ventricular Note: Frequent and continued
lacrimation, fibrillation. GI: use of eye preparations, as well
salivation, and Dry mouth with as overdosage, can have systemic
secretions thirst, dysphagia, effects. Some atropine deaths
from nose, loss of taste; have resulted from systemic
mouth, nausea, vomiting, absorption following ocular
pharynx, and constipation, administration in infants and
bronchi. delayed gastric children.
Blocks vagal emptying, antral
impulses to stasis, paralytic Monitor I&O, especially in older
heart with ileus. Urogenital: adults and patients who have had
resulting Urinary hesitancy surgery (drug may contribute to
decrease in and retention, urinary retention). Palpate lower
AV conduction dysuria, abdomen for distention. Have
time, increase impotence. Skin: patient void before giving
in heart rate Flushed, dry atropine.
and cardiac skin; anhidrosis,
output, and rash, urticaria, Monitor CNS status. Older adults
shortened PR contact and debilitated patients
interval. dermatitis, sometimes manifest drowsiness
allergic or CNS stimulation (excitement,
conjunctivitis, agitation, confusion) with usual
fixed-drug doses of drug or other belladonna
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eruption. Special alkaloids. In addition to dosage

Senses: adjustment, side rails and
Mydriasis, supervision of ambulation may
blurred vision, be indicated.
photophobia,
increased Monitor infants, small children,
intraocular and older adults for "atropine
pressure, fever" (hyperpyrexia due to
cycloplegia, eye suppression of perspiration and
dryness, local heat loss), which increases the
redness. risk of heatstroke.
Note: Intraocular tension and

depth of anterior chamber should
be determined before and during
therapy with ophthalmic
preparations to avoid glaucoma
attacks (ophthalmic solutions and
ointments are available in
various strengths).
Patients receiving atropine via

inhalation sometimes manifest
mild CNS stimulation with doses
in excess of 5 mg and mental
depression and other mental
disturbances with larger doses.
Follow measures to relieve dry

mouth: adequate hydration;
small, frequent mouth rinses with
tepid water; meticulous mouth
and dental hygiene; gum
chewing or sucking sugarless
sourballs.
Note: Drug causes drowsiness,

sensitivity to light, blurring of
near vision, and temporarily
impairs ability to judge distance.
Avoid driving and other
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activities requiring visual acuity

and mental alertness.
Discontinue ophthalmic
preparations and notify physician
if eye pain, conjunctivitis,
palpitation, rapid pulse, or
dizziness occurs.

physician.

Drug Route of action effects/Adverse considerations/responsibilities
Autonomic Synthetic CNS:

Bricanyl Nervous System adrenergic Nervousness, Assessment & Drug Effects
(Terbutalin Agent; Beta- stimulant tremor,
e SO4) adrenergic with headache, light-
Agonist; selective headedness, Assess vital signs: Baseline pulse
Bronchodilator beta2- and drowsiness, and BP and before each dose. If
negligible fatigue, seizures. significantly altered from
Route of beta1- CV: Tachycardia, baseline level, consult physician.
Administration: agonist hypotension or Cardiovascular adverse effects
Oral/ (cardiac) hypertension, are more apt to occur when drug
Subcutaneous activity. palpitation, is given by SC route or it is used
Exerts maternal and by a patient with cardiac
preferential fetal tachycardia. arrhythmia.
effect on GI: Nausea,
beta2 vomiting. Body Most adverse effects are
receptors in as a Whole: transient, however, rapid heart
bronchial Sweating, muscle rate may persist for a relatively
smooth cramps. long time.
muscles,
inhibits Be aware that onset and degree
histamine of effect and incidence and
release from severity of adverse effects of SC
mast cells, formulation resemble those of
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and epinephrine.
increases
ciliary Aerosolized drug produces
motility. minimal cardiac stimulation or
tremors.
Be aware that muscle tremor is a

fairly common adverse effect
that appears to subside with
continued use.
Monitor for symptoms of

hypoglycemia in neonates born
of a mother who used terbutaline
during pregnancy.
Monitor patient being treated for

premature labor for CV S&S for
12 h after drug is discontinued.
Report tachycardia promptly.
Monitor I&O ratio. Fluid

restriction may be necessary.
Consult physician.

administratio effects s
n
Calcium Fluid And Calcium is an Body as a

Gluconate Electrolytic essential element Whole: Tingling
And Water for regulating the sensation. With Assessment & Drug Effects
Balance Agent; excitation rapid IV,
Replacement threshold of sensations of
Solution nerves and heat waves Assess for cutaneous burning
muscles, for (peripheral sensations and peripheral
Route of blood clotting vasodilation), vasodilation, with moderate fall
administration: mechanisms, fainting. GI: PO in BP, during direct IV
Oral cardiac function preparation: injection.
(rhythm, tonicity, Constipation,
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contractility), increased gastric Monitor ECG during IV

maintenance of acid secretion. administration to detect
renal function, for CV: (With rapid evidence of hypercalcemia:
body skeleton and infusion) decreased QT interval
teeth. Also plays hypotension, associated with inverted T
a role in bradycardia, wave.
regulating storage cardiac
and release of arrhythmias, Observe IV site closely.
neurotransmitters cardiac arrest, Extravasation may result in
and hormones; Skin: Pain and tissue irritation and necrosis.
regulating amino burning at IV
acid uptake and site, severe Monitor for hypocalcemia and
absorption of venous hypercalcemia (see Signs &
vitamin B12, thrombosis, Symptoms, Appendix F).
gastrin secretion, necrosis and
and in sloughing (with Lab tests: Determine levels of
maintaining extravasation). calcium and phosphorus (tend
structural and to vary inversely) and
functional magnesium frequently, during
integrity of cell sustained therapy. Deficiencies
membranes and in other ions, particularly
capillaries. magnesium, frequently coexist
Calcium with calcium ion depletion.
gluconate acts
like digitalis on Patient & Family Education
the heart,
increasing cardiac
muscle tone and
force of systolic Report S&S of hypercalcemia
contractions (see Appendix F) promptly to
(positive your care provider.
inotropic effect).
Milk and milk products are the
best sources of calcium (and
phosphorus). Other good
sources include dark green
vegetables, soy beans, tofu, and
canned fish with bones.
Calcium absorption can be

inhibited by zinc-rich foods:
nuts, seeds, sprouts, legumes,
soy products (tofu).
Check with physician before

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self-medicating with a calcium

supplement.

physician.
Name of the Drug Classificatio Mode of Side Nursing

n/ action effects/Adver considerations/responsibi
Route of se effects lities
administrati
on
Structurally CNS: Assessment & Drug

Cordarone/ Cardiovascul related to Peripheral Effects
Amiodarone ar Agent; thyroxine. neuropathy
Antiarrhythm Class III (muscle
ic, Class Iii antiarrhythmi weakness, Monitor BP carefully
c; also has wasting during infusion and slow
Route of antianginal numbness, the infusion if significant
Administratio and tingling), hypotension occurs;
n: Oral antiadrenergic fatigue, bradycardia should be
properties. abnormal gait, treated by slowing the
Totally dyskinesias, infusion or discontinuing if
unrelated to dizziness, necessary. Monitor heart
other paresthesia, rate and rhythm and BP
antiarrhythmi headache. CV: until drug response has
cs. Acts Bradycardia, stabilized; report promptly
directly on all hypotension symptomatic bradycardia.
cardiac (IV), sinus Sustained monitoring is
tissues. arrest, essential because drug has
Prolongs cardiogenic an unusually long half-life.
duration of shock, CHF,
action arrhythmias; Monitor for S&S of:
potential and AV block. Adverse effects,
refractory Special particularly conduction
period Senses: disturbances and
without Corneal exacerbation of
significantly microdeposits, arrhythmias, in patients
affecting blurred vision, receiving concomitant
resting optic neuritis, antiarrhythmic therapy
membrane optic (reduce dosage of previous
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potential. neuropathy, agent by 30–50% several

permanent days after amiodarone
blindness, therapy is started); drug-
corneal induced hypothyroidism or
degeneration, hyperthyroidism (see
macular Appendix F), especially
degeneration, during early treatment
photosensitivit period; pulmonary toxicity
y. GI: (progressive dyspnea,
Anorexia, fatigue, cough, pleuritic
nausea, pain, fever) throughout
vomiting, therapy.
constipation,
hepatotoxicity Lab tests: Baseline and
. Metabolic: periodic assessments
Hyperthyroidi should be made of liver,
sm or lung, thyroid, neurologic,
hypothyroidis and GI function. Drug may
m; may cause cause thyroid function test
neonatal abnormalities in the
hypo- or absence of thyroid function
hyperthyroidis impairment.
m if taken
during Monitor for elevations of
pregnancy. AST and ALT. If
Respiratory: elevations persist or if they
(Pulmonary are 2–3 times above
toxicity) normal baseline readings,
Alveolitis, reduce dosage or withdraw
pneumonitis drug promptly to prevent
(fever, dry hepatotoxicity and liver
cough, damage.
dyspnea),
interstitial Auscultate chest
pulmonary periodically or when
fibrosis, fatal patient complains of
gasping respiratory symptoms.
syndrome Check for diminished
with IV in breath sounds, rales,
children. Skin: pleuritic friction rub;
Slate-blue observe breathing pattern.
pigmentation, Drug-induced pulmonary
photosensitivit function problems must be
y, rash. Other: distinguished from CHF or
With chronic pneumonia. Keep
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use, physician informed.

angioedema.
Anticipate possible CNS
symptoms within a week
after amiodarone therapy
begins. Proximal muscle
weakness, a common side
effect, intensified by
tremors presents a great
hazard to the ambulating
patient. Assess severity of
symptoms. Supervision of
ambulation may be
indicated.
Patient & Family

Education
Check pulse daily once

stabilized, or as prescribed.
Report a pulse <60.
Take oral drug consistently

with respect to meals.
Become familiar with

potential adverse reactions
and report those that are
bothersome to the
physician.
Use dark glasses to ease

photophobia; some patients
may not be able to go
outdoors in the daytime
even with such protection.
Follow recommendation
for regular ophthalmic
exams, including
funduscopy and slit-lamp
exam.
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Wear protective clothing

and a barrier-type
sunscreen that physically
blocks penetration of skin
by ultraviolet light (e.g.,
titanium oxide or zinc
formulations) to prevent a
photosensitivity reaction
(erythema, pruritus); avoid
exposure to sun and
sunlamps.

Name of the Classificatio Mode of action Side Nursing

Drug n/ effects/Adverse considerations/responsibi
Route of effects lities
administrati
on
Dexamethason Hormones Long-acting Aerosol therapy:

e And Synthetic synthetic Nasal irritation,
Substitutes, adrenocorticoid dryness, Assessment & Drug
Adrenal with intense epistaxis, rebound Effects
Corticosteroid antiinflammatory congestion,
; (glucocorticoid) bronchial asthma,
Glucocorticoi activity and anosomia, Monitor and report S&S of
d; Steroid minimal perforation of Cushing's syndrome (see
mineralocorticoid nasal septum. Appendix F) or other
Route of activity. Systemic systemic adverse effects.
administratio Antiinflammatory Absorption—
n: Oral/ action: Prevents CNS: Euphoria, Monitor neonates born to a
Intramuscular accumulation of insomnia, mother who has been
inflammatory convulsions, receiving a corticosteroid
cells at sites of increased ICP, during pregnancy for
infection; inhibits vertigo, headache, symptoms of
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phagocytosis, psychic hypoadrenocorticism.

lysosomal enzyme disturbances. CV:
release, and CHF, Monitor for S&S of a
synthesis of hypertension, hypersensitivity reaction
selected chemical edema. (see Appendix F). The
mediators of Endocrine: acetate and sodium
inflammation; Menstrual phosphate formulations
reduces capillary irregularities, may contain bisulfites,
dilation and hyperglycemia; parabens, or both; these
permeability. cushingoid state; inactive ingredients are
Immunosuppressi growth allergenic to some
on: Not clearly suppression in individuals.
understood, but children;
may be due to hirsutism. Special Patient & Family
prevention or Senses: Posterior Education
suppression of subcapsular
delayed cataract,
hypersensitivity increased IOP,
immune reaction. glaucoma, Take drug exactly as
exophthalmos. prescribed.
GI: Peptic ulcer
with possible Report lack of response to
perforation, medication or malaise,
abdominal orthostatic hypotension,
distension, muscular weakness and
nausea, increased pain, nausea, vomiting,
appetite, anorexia, hypoglycemic
heartburn, reactions (see Appendix
dyspepsia, F), or mental depression to
pancreatitis, physician. These
bowel symptoms may signal
perforation, oral hypoadrenocorticism.
candidiasis.
Musculoskeletal: Report changes in
Muscle weakness, appearance and easy
loss of muscle bruising to physician.
mass, vertebral These symptoms may
compression signal
fracture, hyperadrenocorticism.
pathologic
fracture of long Note: Hiccups that occur
bones, tendon for several hours following
rupture. Skin: each dose may be a
Acne, impaired complication of high-dose
wound healing, oral dexamethasone.
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petechiae,
ecchymoses, Keep appointments for
diaphoresis, checkups; make sure
allergic electrolytes and BP are
dermatitis, hypo- evaluated during therapy at
or regular intervals.
hyperpigmentatio
n, SC and Add potassium-rich foods
cutaneous to diet; report signs of
atrophy, burning hypokalemia (see
and tingling in Appendix F). Concomitant
perineal area potassium-depleting
(following IV diuretic can enhance
injection). dexamethasone-induced
potassium loss.
Note: Dexamethasone dose

regimen may need to be
altered during stress (e.g.,
surgery, infections,
emotional stress, illness,
acute bronchial attacks,
trauma). Consult physician
if change in living or
working environment is
anticipated.
Discontinue drug gradually

under the guidance of the
physician.
Note: It is important to
prevent exposure to
infection, trauma, and
sudden changes in
environmental factors, as
much as possible, because
drug is an
immunosuppressor.

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the Drug Route of effects/Adverse considerations/responsibiliti
administration effects es
Diazepam Central Psychotherapeutic Body as a Assessment & Drug Effects

Nervous agent related to Whole: Throat
System Agent; chlordiazepoxide; and chest pain.
Benzodiazepine reportedly superior CNS: Monitor for adverse reactions.
Anticonvulsant; in antianxiety and Drowsiness, Most are dose related.
Anxiolytic anticonvulsant fatigue, ataxia, Physician will rely on accurate
activity, with confusion, observation and reports of
Route of somewhat shorter paradoxic rage, patient response to the drug to
Administration: duration of action. dizziness, determine lowest effective
Oral/ Like vertigo, maintenance dose.
Intramuscular chlordiazepoxide, amnesia, vivid
it appears to act at dreams, Monitor for therapeutic
both limbic and headache, effectiveness. Maximum
subcortical levels slurred speech, effect may require 1–2 wk;
of CNS. tremor; EEG patient tolerance to therapeutic
changes, tardive effects may develop after 4 wk
dyskinesia. CV: of treatment.
Hypotension,
tachycardia, Observe necessary preventive
edema, precautions for suicidal
cardiovascular tendencies that may be present
collapse. in anxiety states accompanied
Special Senses: by depression.
Blurred vision,
diplopia, Observe patient closely and
nystagmus. GI: monitor vital signs when
Xerostomia, diazepam is given
nausea, parenterally; hypotension,
constipation, muscular weakness,
hepatic tachycardia, and respiratory
dysfunction. depression may occur.
Urogenital:
Incontinence, Lab tests: Periodic CBC and
urinary liver function tests during
retention, prolonged therapy.
gynecomastia
(prolonged use), Supervise ambulation.
menstrual Adverse reactions such as
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irregularities, drowsiness and ataxia are

ovulation more likely to occur in older
failure. adults and debilitated or those
Respiratory: receiving larger doses. Dosage
Hiccups, adjustment may be necessary.
coughing,
laryngospasm. Monitor I&O ratio, including
Other: Pain, urinary and bowel elimination.
venous
thrombosis, Note: Smoking increases
phlebitis at metabolism of diazepam;
injection site. lowering clinical
effectiveness. Heavy smokers
may need a higher dose than
the nonsmoker.
Note: Psychic and physical

dependence may occur in
patients on long-term high
dosage therapy, in those with
histories of alcohol or drug
addiction, or in those who
self-medicate.
Avoid alcohol and other CNS

depressants during therapy
unless otherwise advised by
physician. Concomitant use of
these agents can cause severe
drowsiness, respiratory
depression, and apnea.
Do not drive or engage in

other potentially hazardous
activities or those requiring
mental precision until reaction
to drug is known.
Tell physician if you become

or intend to become pregnant
during therapy; drug may need
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to be discontinued.
Take drug as prescribed; do

not change dose or dose
intervals.
Check with physician before

taking any OTC drugs.


Drug Route of action effects/Advers considerations/responsibili
administration e effects ties
Diphenhydramin Antihistamine; H1-receptor CNS:

e H1-receptor antagonist and Drowsiness, Assessment & Drug
Antagonist antihistamine dizziness, Effects
with headache,
Route of significant fatigue,
administration: anticholinergi disturbed Monitor cardiovascular
Oral/Intramuscul c activity. coordination, status especially with pre-
ar High tingling, existing cardiovascular
incidence of heaviness and disease.
drowsiness, weakness of
but GI side hands, Monitor for adverse effects
effects are tremors, especially in children and
minor. Effects euphoria, the older adult.
in nervousness,
parkinsonism restlessness, Supervise ambulation and
and drug- insomnia; use side-rails as necessary.
induced confusion; Drowsiness is most
extrapyramida (especially in prominent during the first
l symptoms children): few days of therapy and
are apparently excitement, often disappears with
related to its fever. CV: continued therapy. Older
ability to Palpitation, adults are especially likely
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suppress tachycardia, to manifest dizziness,

central mild sedation, and hypotension.
cholinergic hypotension or
activity and to hypertension, Patient & Family Education
prolong action cardiovascular
of dopamine collapse.
by inhibiting Special
its reuptake Senses: Do not use alcohol and other
and storage. Tinnitus, CNS depressants because of
vertigo, dry the possible additive CNS
nose, throat, depressant effects with
nasal concurrent use.
stuffiness;
blurred vision, Do not drive or engage in
diplopia, other potentially hazardous
photosensitivit activities until the response
y, dry eyes. to drug is known.
GI: Dry
mouth, nausea, Increase fluid intake, if not
epigastric contraindicated; drug has an
distress, atropine-like drying effect
anorexia, (thickens bronchial
vomiting, secretions) that may make
constipation, expectoration difficult.
or diarrhea.
Urogenital: Do not breast feed while
Urinary taking this drug.
frequency or
retention,
dysuria. Body
as a Whole:
Hypersensitivit
y (skin rash,
urticaria,
photosensitivit
y, anaphylactic
shock).
Respiratory:
Thickened
bronchial
secretions,
wheezing,
sensation of
chest tightness.
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Drug Route of action effects/Adverse considerations/responsibilitie
Dobuject Autonomic Produces All: Generally,

(Dobutamine) Nervous System inotropic dose related. Assessment & Drug Effects
Agent; Beta- effect by CNS:
adrenergic acting on beta Headache, Correct hypovolemia by
Agonist; receptors and tremors, administration of appropriate
Catecholamine primarily on paresthesias, volume expanders prior to
myocardial mild leg initiation of therapy.
Route of alpha- cramps,
administration: adrenergic nervousness, Monitor therapeutic
Intravenous receptors. fatigue (with effectiveness. At any given
Increases overdosage). dosage level, drug takes 10–20
cardiac output CV: Increased min to produce peak effects.
and decreases heart rate and
pulmonary BP, premature Monitor ECG and BP
wedge ventricular continuously during
pressure and beats, administration.
total systemic palpitation,
vascular anginal pain. Note: Marked increases in
resistance with GI: Nausea, blood pressure (systolic
comparatively vomiting. pressure is the most likely to
little or no Other: be affected) and heart rate, or
effect on BP. Nonspecific the appearance of arrhythmias
Also increases chest pain, or other adverse cardiac
conduction shortness of effects are usually reversed
through AV breath. promptly by reduction in
node. Has dosage.
lower potential
for Observe patients with
precipitating preexisting hypertension
arrhythmias closely for exaggerated
than pressor response.
dopamine.
Note: Tolerance has been
observed with continuous or
prolonged infusions; adverse
reactions are no different than
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those seen with shorter

infusions.
Monitor I&O ratio and pattern.

Urine output and sodium
excretion generally increase
because of improved cardiac
output and renal perfusion.
Report anginal pain to

physician promptly.


Epinephrine Autonomic Naturally
Nervous occurring Special Senses: Monitor BP, pulse,
System Agent; catecholamine Nasal burning or respirations, and urinary
Alpha- And obtained from stinging, dryness output and observe patient
Beta-adrenergic animal adrenal of nasal mucosa, closely following IV
Agonist; glands; also sneezing, administration. Epinephrine
Bronchodilator prepared rebound may widen pulse pressure. If
synthetically. congestion. disturbances in cardiac rhythm
Route of Acts directly on Transient occur, withhold epinephrine
Administration: both alpha and stinging or and notify physician
Inhalation/ beta receptors; burning of eyes, immediately.
Instillation/ the most potent lacrimation, Keep physician informed of
Ophthalmic/ activator of browache, any changes in intake-output
Subcutaneous/ alpha receptors. headache, ratio.
Intravenous Strengthens rebound Use cardiac monitor with
myocardial conjunctival patients receiving epinephrine
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contraction; hyperemia, IV. Have full crash cart

increases allergy, iritis; immediately available.
systolic but with prolonged Check BP repeatedly when
may decrease use: melanin-like epinephrine is administered IV
diastolic blood deposits on lids, during first 5 min, then q3–
pressure; conjunctiva, and 5min until stabilized.
increases cornea; corneal Advise patient to report to
cardiac rate and edema; loss of physician if symptoms are not
cardiac output. lashes relieved in 20 min or if they
(reversible); become worse following
maculopathy with inhalation.
central scotoma Advise patient to report
in aphakic bronchial irritation,
patients nervousness, or sleeplessness.
(reversible). Dosage should be reduced.
Body as a Whole: Monitor blood glucose &
Nervousness, HbA1c for loss of glycemic
restlessness, control if diabetic.
sleeplessness, Patient & Family Education
fear, anxiety,
tremors, severe Be aware intranasal
headache, application may sting slightly.
cerebrovascular
accident, Administer ophthalmic drug at
weakness, bedtime or following
dizziness, prescribed miotic to minimize
syncope, pallor, mydriasis, with blurred vision
sweating, and sensitivity to light
dyspnea. (possible in some patients
Digestive: being treated for glaucoma).
Nausea,
vomiting. Transitory stinging may follow
Cardiovascular: initial ophthalmic
Precordial pain, administration and that
palpitations, headache and browache occur
hypertension, MI, frequently at first but usually
tachyarrhythmias subside with continued use.
including Notify physician if symptoms
ventricular persist.
fibrillation.
Respiratory: Discontinue epinephrine eye
Bronchial and drops and consult a physician
pulmonary if signs of hypersensitivity
edema. develop (edema of lids,
Urogenital: itching, discharge, crusting
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Urinary retention. eyelids).

Skin: Tissue
necrosis with Learn how to administer
repeated epinephrine subcutaneously.
injections. Keep medication and
Metabolic: equipment available for home
Metabolic emergency. Confer with
acidoses, elevated physician.
serum lactic acid,
transient Note: Inhalation epinephrine
elevations of reduces bronchial secretions
blood glucose. and thus may make mucous
Nervous System: plugs more difficult to
Altered state of dislodge.
perception and
thought, Report tolerance to physician;
psychosis. may occur with repeated or
prolonged use. Continued use
of epinephrine in the presence
of tolerance can be dangerous.
Take medication only as

prescribed and immediately
notify physician of onset of
systemic effects of
epinephrine.
Discard discolored or
precipitated solutions.

Name of Classification Mode of action Side Nursing

the Drug / effects/Adverse considerations/responsibiliti
Route of effects es
administratio
n
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Electrolytic Rapid-acting CV: Postural Assessment & Drug Effects

Furosemid And Water potent hypotension,
e Balance sulfonamide dizziness with Observe patients receiving
Agent; Loop "loop" diuretic excessive diuresis, parenteral drug carefully;
Diuretic and acute hypotensive closely monitor BP and vital
antihypertensive episodes, signs. Sudden death from
Route of with circulatory cardiac arrest has been
administration pharmacologic collapse. reported.
: Oral/ effects and uses Metabolic:
Intramuscular/ almost identical Hypovolemia, Monitor for S&S of
Intravenous to those of dehydration, hypokalemia (see Appendix
ethacrynic acid. hyponatremia F).
Exact mode of hypokalemia,
action not hypochloremia Monitor BP during periods of
clearly defined; metabolic diuresis and through period of
decreases renal alkalosis, dosage adjustment.
vascular hypomagnesemia,
resistance and hypocalcemia Observe older adults closely
may increase (tetany), during period of brisk
renal blood hyperglycemia, diuresis. Sudden alteration in
flow. glycosuria, fluid and electrolyte balance
elevated BUN, may precipitate significant
hyperuricemia. GI: adverse reactions. Report
Nausea, vomiting, symptoms to physician.
oral and gastric
burning, anorexia, Lab tests: Obtain frequent
diarrhea, blood count, serum and urine
constipation, electrolytes, CO2, BUN,
abdominal blood sugar, and uric acid
cramping, acute values during first few months
pancreatitis, of therapy and periodically
jaundice. thereafter.
Urogenital:
Allergic interstitial Monitor I&O ratio and
nephritis, pattern. Report decrease or
irreversible renal unusual increase in output.
failure, urinary Excessive diuresis can result
frequency. in dehydration and
Hematologic: hypovolemia, circulatory
Anemia, collapse, and hypotension.
leukopenia, Weigh patient daily under
thrombocytopenic standard conditions.
purpura; aplastic
anemia, Monitor urine and blood
agranulocytosis glucose & HbA1C closely in
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(rare). Special diabetics and patients with

Senses: Tinnitus, decompensated hepatic
vertigo, feeling of cirrhosis. Drug may cause
fullness in ears, hyperglycemia.
hearing loss (rarely
permanent), Note: Excessive dehydration
blurred vision. is most likely to occur in older
Skin: Pruritus, adults, those with chronic
urticaria, cardiac disease on prolonged
exfoliative salt restriction, or those
dermatitis, receiving sympatholytic
purpura, agents.
photosensitivity,
porphyria cutanea Patient & Family Education
tarde, necrotizing
angiitis
(vasculitis). Body
as a Whole: Consult physician regarding
Increased allowable salt and fluid
perspiration; intake.
paresthesias;
activation of SLE, Ingest potassium-rich foods
muscle spasms, daily (e.g., bananas, oranges,
weakness; peaches, dried dates) to
thrombophlebitis, reduce or prevent potassium
pain at IM depletion.
injection site.
Learn S&S of hypokalemia
(see Appendix F). Report
muscle cramps or weakness to
physician.
Make position changes slowly

because high doses of
antihypertensive drugs taken
concurrently may produce
episodes of dizziness or
imbalance.
Avoid replacing fluid losses

with large amounts of water.
Avoid prolonged exposure to

direct sun.
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taking this drug.
Name of Classification/ Mode of Side effects/Adverse Nursing

the Drug Route of action effects considerations/responsibiliti
administratio es
n
Isosorbid Cardiovascular Organic nitrate Body as a Whole:

e Agent; Nitrate with Hypersensitivity Assessment & Drug Effects
Dinitrate Vasodilator pharmacologic reaction, paradoxical
(Isoket) actions similar increase in anginal
Route of to those of pain, Monitor effectiveness of drug
administration: nitroglycerin. methemoglobinemia in relieving angina.
Oral Relaxes (overdose). CNS:
vascular Headache, dizziness, Note: Headaches tend to
smooth muscle weakness, decrease in intensity and
with resulting lightheadedness, frequency with continued
vasodilation. restlessness. CV: therapy but may require
Dilation of Palpitation, postural administration of analgesic
peripheral hypotension, and reduction in dosage.
blood vessels tachycardia. GI:
tends to cause Nausea, vomiting. Note: Chronic administration
peripheral Skin: Flushing, of large doses may produce
pooling of pallor, perspiration, tolerance and thus decrease
blood, rash, exfoliative effectiveness of nitrate
decreased dermatitis. preparations.
venous return
to heart, and Patient & Family Education
decreased left
ventricular end-
diastolic
pressure, with Make position changes
consequent slowly, particularly from
reduction in recumbent to upright posture,
myocardial and dangle feet and ankles
oxygen before walking.
consumption.
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Lie down at the first

indication of light-headedness
or faintness.
Keep a record of anginal

attacks and the number of
sublingual tablets required to
provide relief.
Do not drink alcohol because

it may increase possibility of
light-headedness and
faintness.

Name Classification/ Mode of action Side Nursing

of the Route of effects/Adverse considerations/responsibilities
Drug administration effects
Lanoxin Cardiovascular Widely used CNS: Fatigue,

Agent; Cardiac cardiac muscle Assessment & Drug Effects
Glycoside; glycoside of weakness,
Antiarrhythmic Digitalis lanata. headache, facial Take apical pulse for 1 full min,
Acts by neuralgia, mental noting rate, rhythm, and quality
Route of increasing the depression, before administering drug.
administration: force and paresthesias,
Oral velocity of hallucinations, Withold medication and notify
myocardial confusion, physician if apical pulse falls
systolic drowsiness, below ordered parameters (e.g.,
contraction agitation, <50 or 60/min in adults and <60
(positive dizziness. CV: or 70/min in children).
inotropic effect). Arrhythmias,
It also decreases hypotension, AV Be familiar with patient's
conduction block. Special baseline data (e.g., quality of
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velocity through Senses: Visual peripheral pulses, blood pressure,

the disturbances. GI: clinical symptoms, serum
atrioventricular Anorexia, electrolytes, creatinine clearance)
node. Action is nausea, vomiting, as a foundation for making
more prompt diarrhea. Other: assessments.
and less Diaphoresis,
prolonged than recurrent Lab tests: Baseline and periodic
that of digitalis malaise, serum digoxin, potassium,
and digitoxin. dysphagia. magnesium, and calcium. Draw
blood samples for determining
plasma digoxin levels at least 6 h
after daily dose and preferably
just before next scheduled daily
dose.
Monitor for S&S of drug

toxicity: In children, cardiac
arrhythmias are usually reliable
signs of early toxicity. Early
indicators in adults (anorexia,
nausea, vomiting, diarrhea,
visual disturbances) are rarely
initial signs in children.
Monitor I&O ratio during

digitalization, particularly in
patients with impaired renal
function. Also monitor for edema
daily and auscultate chest for
rales.
Monitor serum digoxin levels

closely during concurrent
antibiotic–digoxin therapy,
which can precipitate toxicity
because of altered intestinal
flora.
Observe patients closely when

being transferred from one
preparation (tablet, elixir, or
parenteral) to another; when
tablet is replaced by elixir
potential for toxicity increases
since 30% of drug is absorbed.
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Report to physician if pulse falls

below 60 or rises above 110 or if
you detect skipped beats or other
changes in rhythm, when digoxin
is prescribed for atrial
fibrillation.
Suspect toxicity and report to

physician if any of the following
occur: Anorexia, nausea,
vomiting, diarrhea, or visual
disturbances.
Weigh each day under standard

conditions. Report weight gain
>1 kg (2 lb)/d.
Take digoxin PRECISELY as

prescribed, do not skip or double
a dose or change dose intervals,
and take it at same time each
day.
Do not to take OTC medications,

especially those for coughs,
colds, allergy, GI upset, or
obesity, without prior approval
of physician.
Continue with brand originally

prescribed unless otherwise
directed by physician.

physician.
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Name of the Classification/ Mode of action Side Nursing

Drug Route of effects/Adver considerations/responsibil
administration se effects ities
Norepinephrin Autonomic Direct-acting Body as a

e (Levophed) Nervous System sympathomimeti Whole: Assessment & Drug Effects
Agent; Alpha- c amine identical Restlessness,
And Beta- to body anxiety,
adrenergic catecholamine tremors, Monitor constantly while
Agonist norepinephrine. dizziness, patient is receiving
(Sympathomimeti Acts directly and weakness, norepinephrine. Take
c) predominantly insomnia, baseline BP and pulse
on alpha- pallor, plasma before start of therapy, then
Route of adrenergic volume q2min from initiation of
administration: receptors; little depletion, drug until stabilization
intravenous action on beta edema, occurs at desired level, then
infusion via a receptors except hemorrhage, every 5 min during drug
central venous in heart (beta1 intestinal, administration.
catheter receptors). hepatic, or
Vasoconstriction renal necrosis, Adjust flow rate to maintain
and cardiac retrosternal BP at low normal (usually
stimulation; also and 80–100 mm Hg systolic) in
powerful pharyngeal normotensive patients. In
constrictor pain, profuse previously hypertensive
action on sweating. CV: patients, systolic is
resistance and Palpitation, generally maintained no
capacitance hypertension, higher than 40 mm Hg
blood vessels. reflex below preexisting systolic
bradycardia, level.
fatal
arrhythmias Observe carefully and
(large doses), record mental status (index
severe of cerebral circulation), skin
hypertension. temperature of extremities,
GI: Vomiting. and color (especially of
Metabolic: earlobes, lips, nail beds) in
Hyperglycemi addition to vital signs.
a. CNS:
Headache, Monitor I&O. Urinary
violent retention and kidney
headache, shutdown are possibilities,
cerebral especially in hypovolemic
hemorrhage, patients. Urinary output is a
convulsions. sensitive indicator of the
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Respiratory: degree of renal perfusion.

Respiratory Report decrease in urinary
difficulty. output or change in I&O
Skin: Tissue ratio.
necrosis at
injection site Be alert to patient's
(with complaints of headache,
extravasation). vomiting, palpitation,
Special arrhythmias, chest pain,
Senses: photophobia, and blurred
Blurred vision, vision as possible
photophobia. symptoms of overdosage.
Reflex bradycardia may
occur as a result of rise in
BP.
Continue to monitor vital

signs and observe patient
closely after cessation of
therapy for clinical sign of
circulatory inadequacy.

the Drug Route of action effects/Adverse considerations/responsibiliti
n
Magnesium Gastrointestina Orally: Acts as Body as a Whole: Assessment & Drug Effects
SO4 l Agent; Saline a laxative by Flushing, sweating,
Cathartic; osmotic extreme thirst, Observe constantly when
Replacement retention of sedation, confusion, given IV. Check BP and pulse
Agent; fluid, which depressed reflexes q10–15 min or more often if
Anticonvulsant distends colon, or no reflexes, indicated.
increases muscle weakness,
Route of water content flaccid paralysis, Lab tests: Monitor plasma
Administration of feces, and hypothermia. CV: magnesium levels in patients
: Oral/ causes Hypotension, receiving drug parenterally
Intramuscular mechanical depressed cardiac (normal: 1.8–3.0 mEq/L).
stimulation of function, complete Plasma levels in excess of 4
bowel activity. heart block, mEq/L are reflected in
Parenterally: circulatory depressed deep tendon
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Acts as a CNS collapse. reflexes and other symptoms

depressant and Respiratory: of magnesium intoxication
also as a Respiratory (see ADVERSE EFFECTS).
depressant of paralysis. Cardiac arrest occurs at levels
smooth, Metabolic: in excess of 25 mEq/L.
skeletal, and Hypermagnesemia, Monitor calcium and
cardiac muscle hypocalcemia, phosphorus levels also.
function. dehydration,
Anticonvulsan electrolyte Early indicators of
t properties imbalance magnesium toxicity
thought to be including (hypermagnesemia) include
produced by hypocalcemia with cathartic effect, profound
CNS repeated laxative thirst, feeling of warmth,
depression, use. sedation, confusion, depressed
principally by deep tendon reflexes, and
decreasing the muscle weakness.
amount of
acetylcholine Monitor respiratory rate
liberated from closely. Report immediately if
motor nerve rate falls below 12.
terminals, thus
producing Test patellar reflex before
peripheral each repeated parenteral dose.
neuromuscular Depression or absence of
blockade. reflexes is a useful index of
early magnesium intoxication.
Check urinary output,

especially in patients with
impaired kidney function.
Therapy is generally not
continued if urinary output is
less than 100 mL during the 4
h preceding each dose.
Observe newborns of mothers

who received parenteral
magnesium sulfate within a
few hours of delivery for
signs of toxicity, including
respiratory and neuromuscular
depression.
Observe patients receiving

drug for hypomagnesemia for
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improvement in these signs of

deficiency: Irritability,
choreiform movements,
tremors, tetany, twitching,
muscle cramps, tachycardia,
hypertension, psychotic
behavior.
Have calcium gluconate

readily available in case of
magnesium sulfate toxicity.
Drink sufficient water during

the day when drug is
administered orally to prevent
net loss of body water.
Recommended daily
allowances of magnesium are
obtained in a normal diet.
Rich sources are whole-grain
cereals, legumes, nuts, meats,
seafood, milk, most green
leafy vegetables, and bananas.


Midazolam Central Nervous Short-acting CNS: Assessment & Drug Effects

(Dormicum System Agent; parenteral Retrograde
) Benzodiazepine benzodiazepine. amnesia,
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Anxiolytic; Mechanism of headache, Inspect insertion site for

Sedative- action unclear. euphoria, redness, pain, swelling, and
hypnotic Intensifies drowsiness, other signs of extravasation
activity of excessive during IV infusion.
Route of gamma- sedation,
administration: aminobenzoic confusion. CV: Monitor for hypotension,
Intramuscular acid (GABA), a Hypotension. especially if the patient is
major inhibitory Special Senses: premedicated with a narcotic
neurotransmitter Blurred vision, agonist analgesic.
of the brain, by diplopia,
interfering with nystagmus, Monitor vital signs for entire
its reuptake and pinpoint pupils. recovery period. In obese
promoting its GI: Nausea, patient, half-life is prolonged
accumulation at vomiting. during IV infusion; therefore,
neuronal Respiratory: duration of effects is
synapses. This Coughing, prolonged (i.e., amnesia,
calms the laryngospasm postoperative recovery).
patient, relaxes (rare),
skeletal muscles, respiratory Be aware that overdose
and in high arrest. Skin: symptoms include
doses produces Hives, swelling, somnolence, confusion,
sleep. burning, pain, sedation, diminished reflexes,
induration at coma, and untoward effects on
injection site, vital signs.
tachypnea.
Body as a Patient & Family Education
Whole:
Hiccups, chills,
weakness.
until response to drug is
known. You may feel drowsy,
weak, or tired for 1–2 d after
drug has been given.
Be prepared for amnesia to

prevent an upsetting
postoperative period.
Review written instructions to

assure future understanding
and compliance. Patient
teaching during amnestic
period may not be
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remembered. Even if dose is

small and depth of amnesia is
unclear, relearn information.

the Drug Route of effects/Adverse considerations/responsibilities
Morphine Central Natural opium Body as a

SO4 Nervous alkaloid with Whole:
System (Cns) agonist activity Hypersensitivity Assessment & Drug Effects
Agent; by binding with [Pruritus, rash,
Analgesic; the same urticaria, edema, Obtain baseline respiratory rate,
Narcotic receptors as hemorrhagic depth, and rhythm and size of
(Opiate) endogenous urticaria (rare), pupils before administering the
Agonist opioid peptides. anaphylactoid drug. Respirations of 12/min or
Narcotic reaction (rare)], below and miosis are signs of
Route of agonist effects sweating, toxicity. Withhold drug and
Administration: are identified skeletal muscle report to physician.
Oral/ with 3 types of flaccidity; cold,
Intravenous receptors: clammy skin, Observe patient closely to be
Analgesia at hypothermia. certain pain relief is achieved.
supraspinal CNS: Euphoria, Record relief of pain and
level, euphoria, insomnia, duration of analgesia.
respiratory disorientation,
depression and visual Be alert to elevated pulse or
physical disturbances, respiratory rate, restlessness,
dependence; dysphoria, anorexia, or drawn facial
analgesia at paradoxic CNS expression that may indicate
spinal level, stimulation need for analgesia.
sedation and (restlessness,
miosis; and tremor, delirium, Differentiate among restlessness
dysphoric, insomnia), as a sign of pain and the need for
hallucinogenic convulsions medication, restlessness
and cardiac (infants and associated with hypoxia, and
stimulant children); restlessness caused by
effects. decreased cough morphine-induced CNS
reflex, stimulation (a paradoxic reaction
drowsiness, that is particularly common in
dizziness, deep women and older adult patients).
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sleep, coma,
continuous Monitor for respiratory
intrathecal depression; it can be severe for
infusion may as long as 24 h after epidural or
cause intrathecal administration.
granulomas
leading to Monitor carefully those at risk
paralysis. Special for severe respiratory depression
Senses: Miosis. after epidural or intrathecal
CV: injection: Older adult or
Bradycardia, debilitated patients or those with
palpitations, decreased respiratory reserve
syncope; (e.g., emphysema, severe
flushing of face, obesity, kyphoscoliosis).
neck, and upper
thorax; Continue monitoring for
orthostatic respiratory depression for at
hypotension, least 24 h after each epidural or
cardiac arrest. intrathecal dose.
GI: Constipation,
anorexia, dry Assess vital signs at regular
mouth, biliary intervals. Morphine-induced
colic, nausea, respiratory depression may
vomiting, occur even with small doses, and
elevated it increases progressively with
transaminase higher doses (generally max: 90
levels. min after SC, 30 min after IM,
Urogenital: and 7 min after IV).
Urinary retention
or urgency, Encourage changes in position,
dysuria, oliguria, deep breathing, and coughing
reduced libido or (unless contraindicated) at
potency regularly scheduled intervals.
(prolonged use). Narcotic analgesics also depress
Other: Prolonged cough and sigh reflexes and thus
labor and may induce atelectasis,
respiratory especially in postoperative
depression of patients.
newborn.
Hematologic: Be alert for nausea and
Precipitation of orthostatic hypotension (with
porphyria. light-headedness and dizziness)
Respiratory: in ambulatory patients or when a
Severe supine patient assumes the head-
respiratory up position or in patients not
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depression (as experiencing severe pain.

low as 2–4/min)
or arrest; Monitor I&O ratio and pattern.
pulmonary Report oliguria or urinary
edema. retention. Morphine may dull
perception of bladder stimuli;
therefore, encourage the patient
to void at least q4h. Palpate
lower abdomen to detect bladder
distention.
Avoid alcohol and other CNS

depressants while receiving
morphine.
Do not use of any OTC drug

unless approved by physician.
Do not smoke or ambulate

without assistance after
receiving drug. Bedside rails are
advised.
Use caution or avoid tasks

requiring alertness (e.g., driving
a car) until response to drug is
known since morphine may
cause drowsiness, dizziness, or
blurred vision.

this drug.

the Drug Route of effects/Adverse considerations/responsibiliti
administration effects es
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Nicardipine Cardiovascular Calcium entry CNS: Dizziness

(Cardepine) Agent; Calcium blocker that or headache, Assessment & Drug Effects
Channel inhibits the fatigue, anxiety,
Blocker; transmembrane depression,
Antihypertensiv influx of parerethesias, Establish baseline data before
e Agent calcium ions insomnia, treatment is started including
into cardiac somnolence, BP, pulse, and lab values of
Route of muscle and nervousness. liver and kidney function.
administration: smooth muscle, CV: Pedal
Oral/ thus affecting edema, Monitor BP during initiation
Intravenous contractility. hypotension, and titration of dosage
More flushing, carefully. Hypotension with or
selectively palpitations, without an increase in heart
affects vascular tachycardia, rate may occur, especially in
smooth muscle increased patients who are hypertensive
than cardiac angina. GI: or who are already taking
muscle; relaxes Anorexia, antihypertensive medication.
coronary nausea,
vascular smooth vomiting, dry Avoid too rapid reduction in
muscle with mouth, either systolic or diastolic
little or no constipation, pressure during parenteral
negative dyspepsia. Skin: administration.
inotropic effect. Rash, pruritus.
Body as a Discontinue IV infusion if
Whole: hypotension or tachycardia
Arthralgia or develop.
arthritis.
Observe for large peak and
trough differences in BP.
Initially, measure BP at peak
effect (1–2 h after dosing) and
at trough effect (8 h after
dosing).
Record and report any

increase in frequency,
duration, and severity of
angina when initiating or
increasing dosage. Keep a
record of nitroglycerin use and
COLLEGE OF NURSING
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promptly report any changes

in previous anginal pattern.
Increased incidence and
severity of angina has
occurred in some patients
using nicardipine.
Do not change dosage

regimen without consulting
physician.
Be aware that abrupt

withdrawal may cause an
increased frequency and
duration of chest pain. This
drug must be gradually
tapered under medical
supervision.
Rise slowly from a recumbent

position; avoid driving or
operating potentially
dangerous equipment until
response to nicardipine is
known.
Notify physician if any of the

following occur: Irregular
heart beat, shortness of breath,
swelling of the feet,
pronounced dizziness, nausea,
or drop in BP.

taking this drug.

Drug Route of action effects/Adverse considerations/responsibiliti
n
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Long-acting Body as a Whole:

Phenobarbital Central barbiturate. Myalgia, neuralgia, Assessment & Drug Effects
(Luminal) Nervous Sedative and CNS depression,
System Agent; hypnotic coma, and death.
Anticonvulsant effects of CNS: Somnolence, Observe patients receiving
; Sedative- barbiturates nightmares, large doses closely for at
hypnotic; appear to be insomnia, least 30 min to ensure that
Barbiturate due primarily "hangover," sedation is not excessive.
to interference headache, anxiety,
Route of with impulse thinking Keep patient under constant
Administration transmission abnormalities, observation when drug is
: Oral/ of cerebral dizziness, administered IV, and record
Intramuscular cortex by nystagmus, vital signs at least every hour
inhibition of irritability, or more often if indicated.
reticular paradoxic
activating excitement and Lab tests: Obtain liver
system. CNS exacerbation of function and hematology
depression hyperkinetic tests and determinations of
may range behavior (in serum folate and vitamin D
from mild children); levels during prolonged
sedation to confusion or therapy.
coma, depression or
depending on marked excitement Monitor serum drug levels.
dosage, route (older adult or Serum concentrations >50
of debilitated mcg/mL may cause coma.
administration patients); ataxia. Therapeutic serum
, degree of CV: Bradycardia, concentrations of 15–40
nervous syncope, mcg/mL produce
system hypotension. GI: anticonvulsant activity in
excitability, Nausea, vomiting, most patients. These values
and drug constipation, are usually attained after 2 or
tolerance. diarrhea, epigastric 3 wk of therapy with a dose
Initially, pain, liver damage. of 100–200 mg/d.
barbiturates Hematologic:
suppress REM Megaloblastic Expect barbiturates to
sleep, but with anemia, produce restlessness when
chronic agranulocytosis, given to patients in pain
therapy REM thrombocytopenia. because these drugs do not
sleep returns Metabolic: have analgesic action.
to normal. Hypocalcemia,
osteomalacia, Be prepared for paradoxical
rickets. responses and report
Musculoskeletal: promptly in older adult or
Folic acid debilitated patient and
deficiency, vitamin children [i.e., irritability,
COLLEGE OF NURSING
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D deficiency. marked excitement

Respiratory: (inappropriate tearfulness and
Respiratory aggression in children),
depression. Skin: depression, and confusion].
Mild
maculopapular, Monitor for drug interactions.
morbilliform rash; Barbiturates increase the
erythema metabolism of many drugs,
multiforme, leading to decreased
Stevens-Johnson pharmacologic effects of
syndrome, those drugs. Whenever a
exfoliative barbiturate is added to an
dermatitis (rare). established regimen of
another drug, observe for
changes in effectiveness of
the first drug at least during
early phase of barbiturate
use.
Monitor for and report

chronic toxicity symptoms
(e.g., ataxia, slurred speech,
irritability, poor judgment,
slight dysarthria, nystagmus
on vertical gaze, confusion,
insomnia, somatic
complaints).
Be aware that anticonvulsant

therapy may cause
drowsiness during first few
weeks of treatment, but this
usually diminishes with
continued use.
Avoid potentially hazardous

activities requiring mental
alertness until response to
drug is known.
Do not consume alcohol in

COLLEGE OF NURSING
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any amount when taking a

barbiturate; it may severely
impair judgment and abilities.
Increase vitamin D-fortified

foods (e.g., milk products)
because drug increases
vitamin D metabolism. A
vitamin D supplement may
be prescribed.
Maintain adequate dietary

folate intake: fresh vegetables
(especially green leafy), fresh
fruits, whole grains, liver.
Long-term therapy may result
in nutritional folate (B9)
deficiency. A supplement of
folic acid may be prescribed.
Adhere to drug regimen (i.e.,

do not change intervals
between doses or increase or
decrease doses) without
contacting physician.
Do not stop taking drug

abruptly because of danger of
withdrawal symptoms (8–12
h after last dose), which can
be fatal.
Report to physician the onset

of fever, sore throat or
mouth, malaise, easy bruising
or bleeding, petechiae,
jaundice, rash when on
prolonged therapy.
Avoid pregnancy when

receiving barbiturates. Use or
add barrier device to
hormonal contraceptive when
taking prolonged therapy.
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taking this drug.

Central Hydantoin CNS: Usually dose-

Phenytoin Nervous derivative related: Nystagmus, Assessment & Drug Effects
System Agent; chemically drowsiness, ataxia,
Anticonvulsant; related to dizziness, mental
Hydantoin phenobarbital. confusion, tremors, Continuously monitor vital
Precise insomnia, headache, signs and symptoms during IV
Route of mechanism of seizures. CV: infusion and for an hour
Administration: anticonvulsant Bradycardia, afterward. Watch for
Oral/ action is not hypotension, respiratory depression.
Intravenous known, but cardiovascular Constant observation and a
drug use is collapse, ventricular cardiac monitor are necessary
accompanied fibrillation, with older adults or patients
by reduced phlebitis. Special with cardiac disease. Margin
voltage, Senses: between toxic and therapeutic
frequency, and Photophobia, IV doses is relatively small.
spread of conjunctivitis,
electrical diplopia, blurred Be aware of therapeutic serum
discharges vision. GI: Gingival concentration: 10–20 mcg/mL;
within the hyperplasia, nausea, toxic level: 30–50 mcg/mL;
motor cortex. vomiting, lethal level: 100 mcg/mL.
Class IB constipation, Steady-state therapeutic levels
antiarrhythmic epigastric pain, are not achieved for at least 7–
properties dysphagia, loss of 10 d.
similar to those taste, weight loss,
of lidocaine hepatitis, liver Lab tests: Periodic serum
and tocainide necrosis. phenytoin concentration; CBC
(also class IB Hematologic: with differential, platelet
agents). Has Thrombocytopenia, count, and Hct and Hgb; serum
class IB leukopenia, glucose, serum calcium, and
antiarrhythmic leukocytosis, serum magnesium; and liver
properties. agranulocytosis, funtion tests.
pancytopenia,
COLLEGE OF NURSING
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eosinophilia; Observe patient closely for

megaloblastic, neurologic adverse effects
hemolytic, or following IV administration.
aplastic anemias. Have on hand oxygen,
Metabolic: Fever, atropine, vasopressor, assisted
hyperglycemia, ventilation, seizure precaution
glycosuria, weight equipment (mouth gag,
gain, edema, nonmetal airway, suction
transient increase in apparatus).
serum thyrotropic
(TSH) level, Be aware that gingival
osteomalacia or hyperplasia appears most
rickets associated commonly in children and
with hypocalcemia adolescents and never occurs
and elevated in patients without teeth.
alkaline
phosphatase Make sure patients on
activity. Skin: prolonged therapy have
Alopecia, hirsutism adequate intake of vitamin D-
(especially in young containing foods and sufficient
female); rash: exposure to sunlight.
scarlatiniform,
maculopapular, Monitor diabetics for loss of
urticaria, glycemic control.
morbilliform;
bullous, exfoliative, Check periodically for
or purpuric decrease in serum calcium
dermatitis; Stevens- levels. Particularly susceptible:
Johnson syndrome, patients receiving other
toxic epidermal anticonvulsants concurrently,
necrolysis, as well as those who are
keratosis, neonatal inactive, have limited exposure
hemorrhage. to sun, or whose dietary intake
Urogenital: Acute is inadequate.
renal failure,
Peyronie's disease. Observe for symptoms of folic
Respiratory: Acute acid deficiency: neuropathy,
pneumonitis, mental dysfunction.
pulmonary fibrosis.
Body as a Whole: Be alert to symptoms of
Periarteritis hypomagnesemia (see
nodosum, acute Appendix F); neuromuscular
systemic lupus symptoms: tetany, positive
erythematosus, Chvostek's and Trousseau's
craniofacial signs, seizures, tremors, ataxia,
COLLEGE OF NURSING
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abnormalities (with vertigo, nystagmus, muscular

enlargement of fasciculations.
lips);
lymphadenopathy. Patient & Family Education
Be aware that drug may make

urine pink or red to red-brown.
Report symptoms of fatigue,

dry skin, deepening voice
when receiving long-term
therapy because phenytoin can
unmask a low thyroid reserve.
Do not alter prescribed drug

regimen. Stopping drug
abruptly may precipitate
seizures and status epilepticus.
Do not to request/accept
change in drug brand when
refilling prescription without
Understand the effects of

alcohol: Alcohol intake may
increase phenytoin serum
levels, leading to phenytoin
toxicity.
Discontinue drug immediately

if a measles-like skin rash or
jaundice appears and notify
physician.
Be aware that influenza

vaccine during phenytoin
treatment may increase seizure
activity. Understand that a
change in dose may be
necessary.

COLLEGE OF NURSING
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taking this drug.
Name Classification/ Mode of action Side Nursing

of the Route of effects/Adverse considerations/responsibiliti
Drug administration effects es
Solu- Skin And Short-acting Body as a Whole:

Corte Mucous synthetic steroid Hypersensitivity or Assessment & Drug Effects
f Membrane with both anaphylactoid
Agent; glucocorticoid and reactions;
Antiinflammator mineralocorticoid aggravation or Establish baseline and
y; Synthetic properties that masking of continuing data on BP,
Hormone; affect nearly all infections; malaise, weight, fluid and electrolyte
Adrenal systems of the weight gain, balance, and blood glucose.
Corticosteroids; body. obesity; urogenital
Glucocorticoid; Antiinflammatory urinary frequency Lab tests: Periodic serum
Mineralocorticoi (glucocorticoid) and urgency, electrolytes blood glucose,
d action: Stabilizes enuresis increased Hct and Hgb, platelet count,
leukocyte or decreased and WBC with differential.
Route of lysosomal motility and
Administration: membranes; number of sperm. Monitor for adverse effects.
Oral/ Rectal/ inhibits CNS: Vertigo, Older adults and patients with
Topical/ phagocytosis and headache, low serum albumin are
Intramuscular/ release of allergic nystagmus, ataxia especially susceptible to
Intravenous substances; (rare), increased adverse effects.
suppresses intracranial
fibroblast pressure with Be alert to signs of
formation and papilledema hypocalcemia (see Appendix
collagen (usually after F).
deposition; reduces discontinuation of
capillary dilation medication), mental Ophthalmoscopic
and permeability; disturbances, examinations are
and increases aggravation of recommended every 2–3 mo,
responsiveness of preexisting especially if patient is
cardiovascular psychiatric receiving ophthalmic steroid
system to conditions, therapy.
circulating insomnia, anxiety,
catecholamines. mental confusion, Monitor for persistent
Immunosuppressiv depression. CV: backache or chest pain;
e action: Modifies Syncopal episodes, compression and spontaneous
immune response thrombophlebitis, fractures of long bones and
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to various stimuli; thromboembolism vertebrae present hazards.

reduces antibody or fat embolism,
titers; and palpitation, Monitor for and report
suppresses cell- tachycardia, changes in mood and
mediated necrotizing angiitis, behavior, emotional
hypersensitivity CHF, hypertension instability, or psychomotor
reactions. edema. Endocrine: activity, especially with long-
Mineralocorticoid Suppressed linear term therapy.
action: Promotes growth in children,
sodium retention, decreased glucose Be alert to possibility of
but under certain tolerance; masked infection and delayed
circumstances hyperglycemia, healing (antiinflammatory
(e.g., sodium manifestations of and immunosuppressive
loading), enhances latent diabetes actions).
sodium excretion; mellitus;
promotes hypocorticism; Note: Dose adjustment may
potassium amenorrhea and be required if patient is
excretion; and other menstrual subjected to severe stress
increases difficulties (serious infection, surgery, or
glomerular moonfacies. GI: injury).
filtration rate Cramping,
(GFR). Metabolic bleeding. Special Note: Single doses of
action: Promotes Senses: Posterior corticosteroids or use for a
hepatic subcapsular short period (<1 wk) do not
gluconeogenesis, cataracts produce withdrawal
protein catabolism, (especially in symptoms when
redistribution of children), discontinued, even with
body fat, and glaucoma, moderately large doses.
lipolysis. exophthalmos,
increased Patient & Family Education
intraocular pressure
with optic nerve
damage,
perforation of the Expect a slight weight gain
globe, fungal with improved appetite. After
infection of the dosage is stabilized, notify
cornea, decreased physician of a sudden slow
or blurred vision. but steady weight increase [2
Metabolic: kg (5 lb)/wk].
Hypocalcemia;
sodium and fluid Avoid alcohol and caffeine;
retention; may contribute to steroid-
hypokalemia and ulcer development in long-
hypokalemic term therapy.
alkalosis decreased
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serum Do not ignore dyspepsia with

concentration of hyperacidity. Report
vitamins A and C; symptoms to physician and
hyperglycemia, do NOT self-medicate to find
hypernatremia. GI: relief.
Nausea, increased
appetite, ulcerative Do NOT use aspirin or other
esophagitis, OTC drugs unless prescribed
pancreatitis, specifically by the physician.
abdominal
distention, peptic Note: A high protein,
ulcer with calcium, and vitamin D diet
perforation and is advisable to reduce risk of
hemorrhage, corticosteroid-induced
melena. osteoporosis.
Hematologic:
Thrombocytopenia, Notify physician of slow
polycythemia, healing, any vague feeling of
ecchymoses. being sick, or return to
Musculoskeletal: pretreatment symptoms.
Osteoporosis,
compression Do not abruptly discontinue
fractures, muscle drug; doses are gradually
wasting and reduced to prevent
weakness, tendon withdrawal symptoms.
rupture, aseptic
necrosis of femoral Report exacerbation of
and humeral heads. disease during drug
Skin: Skin thinning withdrawal.
and atrophy, acne,
impaired wound Carry medical identification
healing; petechiae, at all times. It needs to
ecchymosis, easy indicate medical diagnosis,
bruising; drug therapy, and name of
suppression of skin physician.
test reaction;
hypopigmentation Apply topical preparations
or sparingly in small children.
hyperpigmentation, The hazard of systemic
hirsutism, toxicity is higher because of
acneiform the greater ratio of skin
eruptions, surface area to body weight.
subcutaneous fat
atrophy; allergic Check shelf-life date on
dermatitis, topical corticosterone during
COLLEGE OF NURSING
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urticaria, long-term use.

angioneurotic
edema, increased Do not breast feed while
sweating. With taking/using this drug without
parenteral therapy consulting physician.
at IV site–pain,
irritation, necrosis,
atrophy, sterile
abscess; Charcot-
like arthropathy
following
intraarticular use;
burning and
tingling in perineal
area (after IV
injection).

administratio effects s
n
Tranexamic
Tranexamic Antifibrinolyti acid is an Significant: Visual
Acid cs antifibrinolyti defects (e.g. Examination and Evaluation
c agent that changes in colour Be alert for bleeding gums,
Route of inhibits the vision, visual loss), nosebleeds, or other unusual
Administration breakdown of retinal venous and bleeding or bruising that might
: Intravenous/ fibrin clots. It arterial occlusions, indicate inadequate drug
Oral blocks the ligneous effects. Report signs of
lysine binding conjunctivitis; bleeding to the physician
sites of convulsions immediately.
plasminogen (particularly with
and impairs high doses of IV Monitor increased blood
the inj), severe coagulation, including venous
endogenous hypersensitivity thrombosis (lower extremity
fibrinolytic reactions (e.g. swelling, warmth, erythema,
process, thus anaphylaxis or tenderness) or arterial
preserving anaphylactoid thrombosis (extreme coldness
and stabilising reaction), venous in the hands and feet, cyanosis,
the fibrin and arterial muscle cramping). Watch for
matrix thrombosis or pulmonary embolism
structure. thromboembolism; (shortness of breath, chest
COLLEGE OF NURSING
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Additionally, cerebral oedema pain, cough, bloody sputum) or

it reduces and infarction arterial thrombosis that could
inflammation (particularly in lead to MI or stroke. Notify
associated women with physician immediately, and
with subarachnoid request objective tests
hereditary haemorrhage), (Doppler ultrasound, others) if
angioedema dizziness. thrombosis is suspected.
by inhibiting Blood and
the proteolytic lymphatic system
activity of disorders:
plasmin Anaemia. Assess blood pressure and
which Gastrointestinal compare to normal values (See
decreases the disorders: Nausea, Appendix F). Report low blood
activation of vomiting, pressure (hypotension),
complement diarrhoea, especially if patient develops
and abdominal pain. dizziness or syncope.
consumption General disorders
of C1 esterase and administration
inhibitor (C1- site conditions:
INH). Fatigue. Assess dizziness that might
Musculoskeletal affect gait, balance, and other
and connective functional activities (See
tissue disorders: Appendix C). Report balance
Musculoskeletal problems and functional
pain, back pain, limitations to the physician,
muscle cramps or and caution the patient and
spasm, arthralgia. family/caregivers to guard
Nervous system against falls and trauma.
disorders:
Headache,
migraine.
Respiratory, Patient/Client-Related
thoracic and Instruction
mediastinal
disorders: Nasal Instruct patient to report other
and sinus troublesome side effects such
symptoms. as severe or prolonged vision
Skin and abnormalities or GI problems
subcutaneous tissue (nausea, vomiting, diarrhea).
disorders: Allergic
dermatitis.

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CNS: Headache.
Cardiovascular Calcium CV:
Nimodipine Agent; Calcium channel Hypotension. GI: Assessment & Drug Effects
Channel Blocker blocking Hemorrhage,
agent that is mild, transient Take apical pulse prior to
Route of relatively increase in liver administering drug and hold it if
Administration: selective function tests. pulse is below 60. Notify the
Oral for cerebral physician.
arteries
compared Establish baseline data before
with treatment is started: BP, pulse,
arteries and laboratory evaluations of
elsewhere liver and kidney function.
in the body.
This may Monitor frequently for adverse
be drug effects, including
attributed to hypotension, peripheral edema,
the drug's tachycardia, or skin rash.
high lipid
solubility Monitor frequently for dizziness
and specific or lightheadedness in older adult
binding to patients; risk of hypotension is
cerebral increased.
tissue.
Report gradual weight gain and

evidence of edema (e.g., tight
rings on fingers, ankle swelling).
Keep follow-up appointments for

monitoring of progress during
therapy.

physician.
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the Drug Route of effects/Adverse considerations/responsibilities
Cardiovascular Inhibits calcium CNS: Dizziness,

Verapamil Agent; Calcium ion influx vertigo, Assessment & Drug Effects
(Isoptin) Channel through slow headache,
Blocker; channels into fatigue, sleep Monitor therapeutic
Antiarrhythmic, cells of disturbances, effectiveness. Drug should
Miscellaneous myocardial and depression, decrease angina frequency,
arterial smooth syncope. CV: nitroglycerin consumption, and
Route of muscle. Dilates Hypotension, episodes of ST segment
Administration: coronary congestive heart deviation.
Oral/ arteries and failure,
Intravenous arterioles and bradycardia, Establish baseline data and
inhibits severe periodically monitor: BP and
coronary artery tachycardia, pulse.
spasm. peripheral
Decreases and edema, AV Lab tests: Baseline and periodic
slows SA and block. GI: liver and kidney functions.
AV node Nausea,
conduction abdominal Instruct patient to remain in
without discomfort, recumbent position for at least 1
affecting constipation, h after dose is given to diminish
normal arterial elevated liver subjective effects of transient
action potential enzymes. Body asymptomatic hypotension that
or as a Whole: may accompany infusion.
intraventricular Flushing,
conduction. pulmonary Monitor for AV block or
Associated edema, muscle excessive bradycardia when
vasodilation of fatigue, infusion is given concurrently
arterioles diaphoresis. with digitalis.
decreases total Skin: Pruritus.
peripheral Monitor I&O ratio during IV
vascular and early oral maintenance
resistance and therapy. Renal impairment
reduces arterial prolongs duration of action,
BP at rest. May increasing potential for toxicity
slightly and incidence of adverse
decrease heart effects. Advise patient to report
rate. gradual weight gain and
evidence of edema.
Monitor ECG continuously

COLLEGE OF NURSING
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during IV administration.
Essential because drug action
may be prolonged and incidence
of adverse reactions is highest
during IV administration in
older adults, patients with
impaired kidney function, and
patients of small stature.
Check BP shortly before

administration of next dose to
evaluate degree of control
during early treatment for
hypertension.
Monitor radial pulse before

each dose, notify physician of
an irregular pulse or one slower
than established guideline.
Adhere to established
guidelines for exercise program.

until response to drug is known.
Decrease intake of caffeine-

containing beverage (i.e.,
coffee, tea, chocolate).
Change positions slowly from

lying down to standing to
prevent falls because of drug-
related vertigo until tolerance to
reduced BP is established.
Notify physician of easy

bruising, petechiae, unexplained
bleeding.
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Do not use OTC drugs,

especially aspirin, unless they
are specifically prescribed by
physician.

physician.

the Drug Route of action effects/Adverse considerations/responsibilities
Biologic Sterile Body as a Assessment & Drug Effects

Tetanus Response concentrated Whole: Pain,
Immune Modifier; solution tenderness, Make sure emergency drugs and
Globulin, Immunoglobulin containing muscle stiffness appropriate emergency facilities
human globulin at IM site; local are immediately available for
Route of (primarily IgG) inflammatory treatment of anaphylaxis or
Administration: prepared from reaction, sensitization.
Intramuscular/ large pools of erythema,
Intravenous normal human urticaria, Note: Hypersensitivity reactions
plasma of angioedema, (see Appendix F) are most likely
either venous headache, in patients receiving large IM
or placental malaise, fever, doses, repeated injections, or
origin and arthralgia, rapid IV infusion.
processed by a nephrotic
special syndrome, Monitor vital signs and infusion
fractionating hypersensitivity rate closely when patient is
technique. (fever, chills, receiving IGIV.
anaphylactic
shock), infusion Note: IGIV has a mild diuretic
reactions effect in some patients due to
(nausea, presence of maltose.
flushing, chills,
headache, chest Patient & Family Education
tightness,
wheezing,
skeletal pain,
back pain, Report immediately S&S of
abdominal hypersensitivity (see Appendix
COLLEGE OF NURSING
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cramps, F).
anaphylaxis),
renal Report immediately infusion
dysfunction, symptoms of nausea, chills,
renal failure. headache, and chest tightness;
these are indications to slow rate
of infusion.
Note: Passive immunity to

measles (rubeola) lasts about 3–
4 wk after immune globulin. In
general, children 15 mo need
active immunization with
measles virus vaccine 3 mo after
IGIM.

physician.
Name Classification/ Mode of Side Nursing

of the Route of action effects/Adverse considerations/responsibilities
Drug administration effects
Nexium Gastrointestinal Isomer of CNS: Headache. Assessment & Drug Effects

Agent; Proton omeprazole. GI: Nausea,
Pump Inhibitor A weak base vomiting, Monitor for S&S of adverse CNS
that is diarrhea, effects (vertigo, agitation,
Route of converted to constipation, depression) especially in severely
Administration: the active abdominal pain, ill patients.
Oral/ form in the flatulence, dry
Intravenous highly acidic mouth. Monitor phenytoin levels with
environment concurrent use.
of the
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secretory Monitor INR/PT with concurrent

surface of the warfarin use.
gastric
parietal cells. Lab tests: Periodic liver function
Inhibits the tests, CBC, Hct & Hbg, urinalysis
enzyme for hematuria and proteinuria.
H+K+-
ATPase (the Patient & Family Education
acid pump).
Report any changes in urinary

elimination such as pain or
discomfort associated with
urination to physician.
Report severe diarrhea. Drug may

need to be discontinued.

physician.

Omeprazole Gastrointestinal An CNS: Headache,

Agent; Proton antisecretor dizziness, Assessment & Drug Effects
Pump Inhibitor y fatigue. GI:
compound Diarrhea, Lab tests: Monitor urinalysis for
Route of that is a abdominal pain, hematuria and proteinuria.
Administration: gastric acid nausea, mild Periodic liver function tests with
Oral pump transient prolonged use.
increases in liver
inhibitor.
function tests. Patient & Family Education
Suppresses
Urogenital:
gastric acid Hematuria,
secretion proteinuria. Skin:
by Rash. Report any changes in urinary
COLLEGE OF NURSING
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inhibiting elimination such as pain or

the H+, K+- discomfort associated with
ATPase urination, or blood in urine.
enzyme
system [the Report severe diarrhea; drug
acid may need to be discontinued.
(proton H+)
pump] in
this drug.
the parietal
cells.

Tatoy Emergency Drugs

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Tatoy Emergency Drugs

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ST.

PAUL UNIVERSITY DUMAGUETE

IN PARTIAL FULFILLMENT OF THE RESEARCH REQUIREMENT FOR

Emergency Activity No. 2

Ms. Maria Lourdes Agustin, RN, MAN

Tatoy, Christian Dene O.

October 16, 2022

1.Adenosine 16. Norepinephrine (Levophed)

Name of Classification/ Mode of action Side Nursing

Nausea, metallic various degrees of AV block,

Patient & Family Education

Note: Flushing may occur

Name of the Classification/ Mode of Side Nursing

anorexia, may indicate toxicity.

Note: Older adults, acutely ill,

Note: Children appear more

Patient & Family Education

Note: Use of tobacco tends to

Report excessive nervousness

Note: Dizziness is a relatively

Do not take OTC remedies for

treatment of asthma or cough

Do not breast feed while

Name of Classification/ Mode of Side Nursing

Apresoline cardiovascular Reduces BP Body as a Whole: Nursing Implications

volume, and vomiting, diarrhea, throughout hypertensive crisis.

Do not drive or engage in other

Do not breast feed while taking

Name of Classification/ Mode of Side Nursing

Atropine Autonomic Acts by CNS: Headache, Assessment & Drug Effects

eruption. Special alkaloids. In addition to dosage

Note: Intraocular tension and

Patients receiving atropine via

Patient & Family Education

Follow measures to relieve dry

Note: Drug causes drowsiness,

activities requiring visual acuity

Do not breast feed while taking

Name of the Classification/ Mode of Side Nursing

Autonomic Synthetic CNS:

Be aware that muscle tremor is a

Monitor for symptoms of

Monitor patient being treated for

Monitor I&O ratio. Fluid

Name of Classification/ Mode of action Side Nursing

Calcium Fluid And Calcium is an Body as a

contractility), increased gastric Monitor ECG during IV

Calcium absorption can be

Check with physician before

self-medicating with a calcium

Do not breast feed while taking

Name of the Drug Classificatio Mode of Side Nursing

Structurally CNS: Assessment & Drug

potential. neuropathy, agent by 30–50% several

use, physician informed.

Patient & Family

Check pulse daily once

Take oral drug consistently

Become familiar with

Use dark glasses to ease

Wear protective clothing

Do not breast feed while

Name of the Classificatio Mode of action Side Nursing