Name of the Drug Generic Name: epinephrine Brand Name: Injection, OTC nasal solution: Adrenalin Chloride Ophthalmic

solution: Epifrin, Glaucon Insect sting emergencies: EpiPen Auto-Injector (delivers 0.3 mg IM adult dose), EpiPen Jr. AutoInjector (delivers 0.15 mg IM for children) OTC solutions for nebulization: AsthmaNefrin, microNefrin, Nephron, S2

Dosage/Route Cardiac arrest: 1 mg IV of 1:10,000 solution q 3-5 min; double dose if administering via ET tube Anaphylaxis: 0.1- 1 mg SQ or IM of 1:1000 solution. Asthma: 0.1-0.3 mg SQ or IM of 1:10,000 solution Refractory bradycardia and hypotension: 2-10ug/min

Action/Classification Action: Stimulates beta receptors in lung. Relaxes bronchial smooth muscle. Increases vital capacity  BP,  HR,  PR Decreases airway resistance. Classification: Beta2 Adrenergic Agonists

Indication/ Contraindications Indications: o Asthma o Bronchitis o Emphysema o All cardiac arrest, anaphylaxis o Used for symptomatic bradycardia. o Relief of bronchospasm occurring during anesthesia o Exercised-induced bronchospasm Contraindications: Contraindicate in patients with angle-closure glaucoma, shock (other than anaphylactic shock), organic brain damage, cardiac dilation, arrhythmias, coronary insufficiency, or cerebral arteriosclerosis. Also contraindicated in patient receiving general anesthesia with halogenated hydrocarbons or cyclopropane and in patients in labor (may delay second stage) Some products containing sulfites and are contraindicated in patients

Adverse Effects/ Side Effects Adverse Effects: nervousness, tremor, vertigo, pain, widened pulse pressure, hypertension nausea Side Effects: headache

Nursing Responsibilities Monitor V/S. and check for cardiac dysrhythmias Drug increases rigidity and tremor in patients with Parkinson’s disease  Epinephrine therapy interferes with tests for urinary catecholamine  Avoid IM use of parenteral suspension into buttocks. Gas gangrene may occur Massage site after IM injection to counteract possible vasoconstriction.  Observe patient closely for adverse reactions. Notify doctor if adverse reaction develop  If blood pressure increases sharply, rapid-acting vasodilators such as nitrates or alpha blockers can be given to counteract


In breast feeding do not use the drug or stop breast feeding. CV disease. In conjunction with local anesthesia. psychoneurosis. drug is contraindicated. In pregnant woman. 2 . hypertension. or diabetes. nose. who have developed degenerative heart disease and in those with hyperthyroidism. and genitalia. ears. toes. epinephrine is contraindicated for use in finger. Use cautiously with longstanding bronchial asthma and emphysema.with sulfite allergies except when drug is used for serious allergic reactions or in other emergency situations.

5 mg/kg IVP or ETT (double dose if giving via ET tube). tremor. may repeat q 5-10 min. If conversion successful start an infusion of 2-4 mg/min Action/Classification Action: Decrease cardiac excitability. therapreutic range 1. AV. continuously. bradychardia. pulse.5-5 mcg/ml Monitor intake and output Do not mix in the same syringe with amphoterin B or cefazolin Administer Lidocaine TIV. cardiac contraction is delayed in the atrium and ventricle Contraindications: Contraindicated in patients hypersensitive to amide-type local anesthetics and in those with Adams –Stoke syndrome. Side Effects: sensation of cold.Name of the Drug Generic Name: lidocane Brand Name: Xylocaine Dosage/Route 1-1. or severe degrees of SA. Wolff-ParkinsonsWhite Syndrome. somnolence. blurred or double vision. Adverse Effects/ Side Effects Adverse Effects: CNS: Confusion. nervousness. cardiac contraction is delayed in the atrium and ventricle Classification: Antiarrythmic and Anesthetic Indication/ Contraindications Indications: Decrease cardiac excitability. In case of circulatory depression have dopamine available 3 . hallucinations. max 3 mg/kg. CV: hypotension. lethargy. Monitor serum lidocaine levels throughout theraphy. rhythm. new or worsened arrhythmias EENT: tinnitus. or intraventricular block in the absence of pacemaker. restlessness anxiety. stupor. BP. vomiting Nursing Responsibilities Monitor EKG. seizure. Respiratory: Respiratory depression and arrest Skin: soreness at injection site Other: anaphylaxis.

In pregnant woman. abdominal pain. muscle spasm Nursing Responsibilities Monitor serum glucose. do not use drug.  ICP. use only if benefits outweighs the risk to the fetus. anemia. Action/Classification Action: inhibits sodium and chloride reabsorption at the proximal and distal tubules and the ascending loop of Henlen Classification: Loop Diuretics Indication/ Contraindications Indications: Edema associated with CHF Cirrhosis with ascites or renal dysfunction For hypertension or in combination with other antihypertensive medications. orthostatic hypotension. thrombophlebitis. Fluid and electrolyte imbalance R eview HR.K+ for all except aldactone I ntake and Output. Patients with allergies to sulfonamides may also be allergic to furosemide.5-1 mg/kg slow IVP over 12 min. Use cautiously in patient with hepatic cirrhosis. nephritic syndrome. paresthesia. hepatic cirrhosis Contraindications: Contraindicated to patients hypersensitive to drug or any of its components and in those with anuria. Adverse Effects/ Side Effects Adverse Effects: vertigo. headache. Hypokalemia. may repeat once at 2 mg/kg slow IVP over 1-2 mins. move slowly C ancel alcohol 4 .Name of the Drug Generic Name: furosemide Brand Name: Apo-Furosemide Furoside Lasix Lasix Speacial Novosemide Uritol Dosage/Route 0. daily weight U ndesirable effects. BP and electrolytes E lderly-Careful T ake with or after meals and in AM I ncrease risk of orthosthatic hypotension. and electrolyte D iet. In breast feeding woman.

give 15 to 30 mcg/kg I. record and report changes in rate or rhythm. Side Effects: CNS: agitation. GI: anorexia. Children age 10 years and older: For rapid digitalization.V. hypotension. CHF. chronic constrictive pericarditis. First dose is 50% of total dose. nausea.0 mg/ml). yellow-green halos around visual images. drug level (therapeutic level 0. Digoxin. Mg++. or >100 (adults) or < 110/minute (children) Weigh daily Monitor I&O and signs of CHF 5 . vomiting. Children ages 5 to 10: For rapid digitalization. and paroxysmal atrial contractions Contraindications: Contraindicated in patients hypersensitive to the drug or any of its components and in those with digitalis-induced toxicity.Name of the Drug Generic Name: digoxin Brand Name: Lanoxin. heart failure. diarrhea. Action/Classification Action: Inhibits the sodiumpotassium ATP phase. given daily as a single dose.3 mg I. CV: Arrythmias.0 mg/ml. EENT: blurred vision. Children: digitalizing dose is based on child’s age and is given in three or more divided doses over the first 24 hours. or ventricular tachycardia unless caused by heart failure. for 24 hours. divided and given in two or three equal portions daily. followed by 0. Classification: Cardiac Glycosides Indication/ Contraindications Indications: V-fib. sinus bradycardia. renal insufficiency.4 to 0. over 24 hours.. diplopia. Withhold drug and contact provider if pulse is < 60/min. Maintenance dose is 25% to 35% of total digitalizing dose. vertigo. fatigue.V. generalized weakness. malaise. atrial fibrillation and or flutter. ECG. paresthesia. stupor. in complete Av block. over 24 hours divided as above. Before each dose assess apical pulse for full minute. hyperthropic cardiomyopathy. subsequent dose are given q 4 to 8 hours as needed and tolerated. toxicity is >2. PVCs. every 4 hours.V. severe pulmonary disease. give 0.6 mg I. or hypothyroidism. GI: Nausea Nursing Responsibilities Monitor K+. headache.5-2. initially. Lanoxicap Dosage/Route Adults: For rapid digitalization. Use cautiously in patients with acute MI. light flashes. V-flutter. ventricular fibrillation. Adverse Effects/ Side Effects Adverse Effects: CNS: hallucinations. liver/renal function tests. give 8 to 12 mcg/kg I. divided as above.V. dizziness. photophobia.1 to 0. pulmonary edema. Maintenance dose is 25% to 35% of total digitalizing dose. as needed and tolerated.

divided as above. Maintenance dose is 25% to 35% of the total digitalizing dose. Maintenance dose is 25% to 35% of total digitalizing dose. Neonates: for rapid digitalization. Maintenance dose is 20% to 30% of the total digitalizing dose. Give 30 to 50 mcg/kg I. over 24 hours.V. divided and given in two or three equal portions daily. Maintenance dose is 25% to 30% of the total digitalizing dose. over 24 hours. give 15 to 25 mcg/kg I.V. divided as above. divided and given into two or three equal portions daily. divided and given in two or three equal portions daily. divided as above.V. Premature Infants: For rapid digitalization. over 24 hours. divided as above.V. divided and given in two or three equal portions daily. give 20 to 30 mcg/kg I. over 24 hours. 6 . Infants ages 1 month to 2 years: For rapid digitalization.Children ages 2 to 5: For rapid digitalization: give 25 to 35 mcg/kg I.

Adverse Effects/ Side Effects Adverse Effects: GI: Gastric distention. seizures. Metabolic: metabolic alkalosis. Buffer. patients who are losing chlorides from vomiting or continuous GI suction. Antacid. hypokalemia. hyperosmolarity (with overdose). and patients with hypocalcemia in which alkalosis may produce tetany. electrolytes and phosphate levels. 7 . or heart failure. electrolyte Indication/ Contraindications Indications: o Hyperacidity o Peptic ulcer o Hyperkalemia o Tricyclic antidepressant OD o Shock associated with severe diarrhea. belching. Soda Mint Dosage/Route 1 mEq/kg IVP. uncontrolled DM o Reflux esophagitis Contraindications: Contraindicated in patients with metabolic or respiratory alkalosis. hypertension.5 mEq/kg 10 min. Nursing Responsibilities Monitor urinary pH. Citrocarbonate. Record amount and consistency of stools. Action/Classification Action: Neutralizes gastric acid Decrease pepsin activity Classification: Alkalizing Agent. Other: Pain and irritation at injection site. calcium. Oral sodium bicarbonate is contraindicated in patients with acute ingestion of strong mineral acids. Clients on low-sodium diets should evaluate sodium contents of antacids. hypernatremia. dehydration. flatulence.Name of the Drug Generic Name: Sodium Bicarbonate Brand Name: Arm and Hammer Pure Baking Soda. patients taking diuretics known to produce hypochloremia alkalosis. may repeat 0.

hypertension. dyspnea Skin: necrosis. Revimine Dosage/Route Adults: initially. diabetic endarteritis. frequently monitor ECG. and in those taking MAO inhibitor. with a history of sulfite sensitivity. vasoconstriction. Tamper dosage slowly to evaluate stability of blood pressure. If deficit occurs. cold injuries. widening of QRS complex. and color and temperature of the limbs. pheocromocytoma. Action is dose-related. Other: anaphylaxis. hypotension. urine output. in pregnant woman. If urine flow is decrease without hypotension. Classification: Inotropic. to increase cardiac output. Adjust dose to desired hemodynamic or renal response. Acidosis decrease effectiveness of dopamine. arrythmias. Adverse Effects/ Side Effects Adverse Effects: Cv: anginal pain. CVP. bradycardia.Name of the Drug Generic Name: Dopamine HCl. vasopressor Indication/ Contraindications Indications: To treat shock and correct hemodnamic imbalances. cardiac output. large doses can cause mainly alpha stimulation. decrease perfusion rate and watch out carefully for further signs of vasoconstriction unless such action is desired. 8 . tissue sloughing with extravasation. If diastolic pressure rises disproportionately. pulmonary artery wedge pressure. infusion. improve perfusion of vital organs. 1 to 5 mcg/kg/minute by I. Contraindications: Contraindicated in patient with uncorrected tachyarrhythmias. During infusion.piloerection. GU: azotemia Respiratory: asthma attacks. Action/Classification Action Stimulates dopaminergic and alpha and beta receptors of the sympathetic nervous system. Side Effects: CNS: headache GI: nausea Check for urine output. increase by 1 to 4 mcg/kg/minute at 10 to 30minute intervals. replace fluid deficit first before giving meds. Observe for adverse reaction. and arterial embolism. Brand Name: Intropin. conduction disturbances ectopic breasts.V. GI: vomiting. Nursing Responsibilities Blood is not a substitute for blood or fluid volume deficit. palpitations. After drug is stopped. BP. or ventricular fibrillation. notify physician. and to correct hypotension. .Use cautiously in patients with occlusive vascular disease. pulse rate. tachycardia.

increase ICP angle-closure glaucoma. form). dizziness. Instruct to take at first sign of anginal pain. Skin: Cutaneous vasodilation. flushing. GI: nausea.Name of the Drug Generic Nitroglycerin Brand Nitrostat Dosage/Route/Timing 0. If the client doesn’t experience relief. Nitrate. max 3 doses. Coronary Indication/ Contraindications Indication: Angina pectoris CHF associated with AMI Cardiac load reducing agent Hypertensive Crisis Contraindication: Contraindicated in patients hypersensitive to nitrates and in those with early MI. constrictive pericarditis.4 mg SL q 5 min. IV nitroglycerine is contraindicated in patients with hypovolemia. Adverse Effects/ Side Effects Adverse Effects CV: orthostatic hypotension. advise to seek medical assistance 9 . Client must have continuing EKG monitoring for IV administration Cardioverter/ defibrillator must not be discharged through paddle electrode overlying Nitro-Bid ointment or the Transderm-Nitro Patch.L. severe anemia. Monitor BP and apical pulse before administration and periodically after dose. Have client sit or lie down if taking drug for the first time. hypotension. cardiac tamponade restrictive cardiomyopathy. contact dermatitis (patch) Side Effects CNS: headache. EENT: sublingual burning. of 3 doses. vomiting. weakness. Action/Classification Action: Relaxes the vascular smooth system  Myocardial oxygen consumption  left ventricular workload  arterial BP  venous return Classification Antianginal. Vasodilator. Skin: Rash Nursing Responsibilities Record characteristics and precipitating factors of anginal pain.3-0. fainting. Assist with ambulating if dizzy. orthostatic hypotension. May be repeated q 5 minutes to max. throbbing. (S.

Atr ophine could result in CNS stimulation (confusion. disorientation.5 -1 mg IV (may give via ETT at double dose) q 3-5 min. Name of the Drug Generic Atrophine Sulfate Brand Isopto Atropine Dosage/Route Bradycardia: 0. CV: palpitations GI: thirst. Avoid OTC antihistamines. max 0. hallucinations. GI: dry moth. ice chips. vomiting. Action/Classification Action cholinergic receptor sites so response to acetylcholine is decreased Classification Anticholinergics Indication/ Contraindications Indication As an anti-sialagogue for preanesthetic medication to prevent or reduce secretions of the respiratory tract To restore cardiac rate and arterial pressure during anesthesia. Advise to use hard candy.04 mg/kg Nerve gas and organophosphate symptoms. oliguria. obstructive Adverse Effects/ Side Effects Adverse Effects CNS: restlessness. arrhythmias. delirium. EENT: photophobia. etc. blurred vision. excitement) or drowsiness Instruct to take 30 mins before meals Eat foods high in fiber and drink plenty fluids. nausea.immediately. Hematologic: leukocytosis Other: anaphylaxis Side Effects CNS: headache. coma. CV: tachycardia. for dry mouth. insomnia. Instruct client not to drive a motor vehicle or participate in activities requiring alertness. excitement. ataxia. Re port  HR M onitor for constipation. confusion. Nursing Responsibilities Monitor VS. GU: urine retention. agitation. Contraindication Contraindicated in patients hypersensitive to drug and those with acute angle closure glaucoma. max 0. as in some cases due to digitalis To overcome severe carotid sinus reflex Antidote for cardiovascular collapse from the injudicious use of a cholinergic drug.04 mg/kg Cardiac arrest: 1 mg q 3-5 min. may repeat in 2 mg increments q 3 min tiltrated to relief symptoms. flushing. when vagal stimulation produced by intraabdominal surgical traction causes a sudden decrease in pulse rate and cardiac action To lessen the degree of atrioventricular (A-V) heart block when increased vagal tone is a major factor in the conduction defect. mydriasis. constipation. 10 . angina.

intestinal atony. 11 .uropathy. toxic magacolon. Also contraindicated in pregnant women. asthma. paralytic elius. obstructive disease of GI tract. or myasthenia gravis. unstable CV status in acute hemorrhage.

 CO. Adrenergic Indication/ Contraindications Indication Short term treatment of cardiac decompensation in organic heart disease of cardiac surgical pressures.5-15 mcg/kg/min. as in pump failure or Pulmonary edma. Respiratory: asthma attacks. 12 . headaches or IV site pain. presence of activity. increase SOB. phlebitis. hypotension.Name of the Drug Generic Dobutamine Hydrochloride Brand Dobutrex Dosage/Route Adults individualized: 2. Nursing Responsibilities Monitor CVP to assess vascular volume and cardiac pumping efficiency. Rate of administration and duration of therapy depend on the response of client as determined by HR. Adverse Effects/ Side Effects Adverse Effects CV: angina. (Elevated CVP may indicate disruption on CO. nonspecific chest pain. hypertension. Contraindication Contraindication in patients hypersensitive to drug or any of its components and in those with idiopathic hypertrophic subaortic stenosis. BP and urine flow Action/Classification Action Enhancing the force of myocardial contraction  HR. GI: nausea and vomiting. Report any chest pain. shortness of breath. and  SV with minor effects to HR. Side Effects CNS: headache Musculoskeletal: mild leg crams or tingling sensation. increased heart rate. low CVP may indicate hypovolemia) Monitor ECG and BP continuously during drug administration Record I&O M onitor glucose in diabetes patients Drug is administered IV to improve cardiac function thus increasing BP and improving urine output. Others: anaphylaxis.  elevated ventricular filling pressure and helps AV node conduction Classification Inotropic. PVCs.

kyphoscoliosis. head injury and increased intracranial pressure. Continuous IV infusion: 0. insomnia. perfusion. reflexes. cerebral arteriosclerosis. biliary tract spasm. visual disturbances. delirium. dizziness. Roxanol. Rescudose. COPD. facilitate induction of anesthesia. toxic psychosis.Name of the Drug Generic Morphine Sulfate Brand Immediate-release tablets: MSIR Timed-release: Kadian. an oral alcoholic solution that is used for chronic severe pain. Controlledrelease: 30 mg q 8–12 hr PO or as directed by physician. tachycardia. Roxanol T Rectal suppositories: RMS Injection: Astramorph PF. bilateral grip strength. urticaria. BP. sedation. Rectal 10–30 mg q 4 hr or as directed by physician. acute alcoholism. suppression of cough reflex CV: Facial flushing. supraventricular tachycardias. Duramorph. adventitious 13 . orthostatic BP. syncope Dermatologic: Pruritus. lethargy. labor or delivery of a premature infant. anorexia. disorientation. especially in terminal cancer patients Intraspinal use with microinfusion devices for the relief of intractable pain Unlabeled use: Dyspnea associated with acute left ventricular failure and pulmonary edema Contraindication Adverse Effects/ Side Effects Adverse Effect CNS: Light-headedness. Oramorph SR Oral solution: MSIR. agitation.5–15 mg/70 kg of body weight in 4–5 mL water for injection administered over 4– 5 min. prostatic hypertrophy.1–1 mg/mL in 5% dextrose in water by controlled infusion device. fear. IV 2. miosis. palpitations. P. mood changes. R. preexisting respiratory depression. orientation. dysphoria. Kadian: 20–100 mg PO daily–24-hr release system. M-Eslon (CAN). arrhythmia. SC and IM 10 mg (5–20 mg)/70 kg q 4 hr or as directed by physician. or as directed by physician. anxiety. increased colonic motility in patients with chronic Nursing Responsibilities Assessment History: Hypersensitivity to opioids. lactation Physical: T. myxedema. CV disease. MS Contin: 200 mg PO q 12 hr. drowsiness. euphoria. orthostatic hypotension. endorphins). Respiratory: laryngospasm. ulcerative colitis. edema GI: Nausea. vomiting. peripheral circulatory collapse. tremor. skin color. weakness. auscultation. texture. Epidural Initial injection of 5 mg in the lumbar region may provide pain relief for up to 24 hr. delirium tremens. 10– 30 mg q 4 hr PO. seizures. MS Contin. cor pulmonale. biliary tract surgery or surgical anastomosis. coma. If Action/Classification Action Principal opium alkaloid. affect. Classification Opioid agonist analgesic Indication/ Contraindications Indication Relief of moderate to severe acute and chronic pain Preoperative medication to sedate and allay apprehension. lesions. hypotension. impaired mental and physical performance. acts as agonist at specific opioid receptors in the CNS to produce analgesia. Epimorph (CAN) Preservative-free concentrate for microinfusion devices for intraspinal use: Infumorph Dosage/Route ADULTS Oral One-third to one-sixth as effective as parenteral administration because of first-pass metabolism. recent GI or GU surgery. urethral stricture. the receptors mediating these effects are thought to be the same as those mediating the effects of endogenous opioids (enkephalins. acute abdominal conditions. euphoria. renal or hepatic dysfunction. seizure disorders. hallucinations. bradycardia. Addison's disease. sedation. hypertension. chest wall rigidity. pregnancy. and reduce anesthetic dosage Analgesic adjunct during anesthesia Component of most preparations that are referred to as Brompton's cocktail or mixture. fever. headache. bronchospasm. diarrhea caused by poisoning. acute asthma.

with repeated doses. Intrathecal Dosage is usually one-tenth that of epidural dosage. urinary retention or hesitancy. kyphoscoliosis. circulatory depression. incremental doses of 1–2 mg may be given at intervals sufficient to assess effectiveness. Dilute and administer slowly IV to minimize likelihood of adverse effects. renal or hepatic ulcerative colitis GU: Ureteral spasm. Tell patient to lie down during IV administration. CV disease.adequate pain relief is not achieved within 1 hr. voiding pattern. use preservative-free morphine preparations only. Further doses of 1–2 mg may be given if pain relief is not achieved initially. cerebral arteriosclerosis. normal output. labor (respiratory depression in neonate. PEDIATRIC PATIENTS Do not use in premature infants. normal output. lactation (wait 4–6 hr after administration to nurse the baby).05–0. acute abdominal conditions. pregnancy. initial dose of 2–4 mg/24 hr is recommended. Reassure patients that they are unlikely to become addicted. apnea. respiratory arrest. hypoxia. EEG. during labor or delivery of a premature infant (may cross immature blood–brain barrier more readily). most patients who receive opioids for medical reasons do 14 . prostatic hypertrophy. For continuous infusion. impaired perfusion may delay absorption. ECG. Other: sweating.physical tolerance and dependence. preexisting respiratory depression. up to 10 mg/24 hr. cardiac arrest Side Effects GI: dry mouth.2 mg/kg (up to 15 mg per dose) q 4 hr or as directed by physician. Use cautiously with head injury and increased intracranial pressure. reduced libido or potency Respiratory: Respiratory depression. oliguria. use other routes if pain recurs. an excessive amount may be absorbed when circulation is restored.2–1 mg may provide satisfactory pain relief for up to 24 hr. Use only in the lumbar area. Contraindicated with hypersensitivity to opioids. hypercapnia (may decrease respiratory drive and increase airway resistance). shock. cor pulmonale. spasm of vesical sphincters. delirium tremens. antidiuretic effect. urethral stricture. Use caution when injecting SC or IM into chilled areas or in patients with hypotension or in shock. Keep opioid antagonist and facilities for assisted or controlled respiration readily available during IV administration. supraventricular tachycardias. urinary frequency. fever. myxedema. For epidural or intrathecal dosing. diarrhea caused by poisoning until toxins are eliminated. liver. bowel sounds. acute asthma. Skin: Tissue irritation and induration (SC injection). Do not inject > 2 mL of the 5 mg/10 mL ampule or > 1 mL of the 10 mg/10 mL ampule. seizure disorders. ulcerative colitis. a single injection of 0. toxic psychosis. acute alcoholism. may prolong labor). COPD. Repeated intrathecal injections are not recommended. SC or IM 0. thyroid. psychological dependence sounds. kidney function tests Interventions Caution patient not to chew or crush controlled-release preparations. recent GI or GU surgery. Addison's disease. after biliary tract surgery or following surgical anastomosis. constipation.

dysfunction. antihistamines. vomiting. sedatives. crush. and do not let anyone else take your prescription. impaired visual acuity (avoid driving or performing tasks that require alertness and visual acuity). injection of < 5 mg in the lumbar region may provide adequate pain relief for up to 24 hr. Reduced dosage may be necessary. GERIATRIC PATIENTS OR IMPAIRED ADULTS Use caution. rash. not develop dependence syndromes Teaching points Take this drug exactly as prescribed. constipation (use laxative). constipation. tranquilizers. shortness of breath or difficulty breathing. lie quietly). Avoid alcohol. Epidural Use extreme caution. Intrathecal Use lower dosages than recommended for adults above. those with respiratory problems. Respiratory depression may occur in the elderly. the very ill. drowsiness. or chew them. 15 . dizziness. do not cut. over-the-counter drugs. Swallow controlled-release preparation (MS Contin. Do not take leftover medication for other disorders. Oramorph SR) whole. sedation. loss of appetite (take with food. These side effects may occur: Nausea. Report severe nausea.

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