1) AMINOPHYLLINE Brand Names: Phil Pharmawealth/Atlantic Aminophylline amp Theofil amp Classification: Antiasthmatic & COPD Preparations Dosage

: Initial: 225-450 mg twice daily, increased if needed. IV Acute severe bronchospasm. Loading dose: 5 mg/kg (ideal body wt). Maintenance: 0.5 mg/kg/hr. Rate should not exceed 25 mg/min. Indication: PO Chronic bronchospasm as hydrate Action: Increases the level of cAMP resulting in bronchodilation Adverse Reactions: Nausea, vomiting, abdominal pain, diarrhea, headache, insomnia, dizziness, anxiety, restlessness; tremor, palpitations. Potentially Fatal: Convulsions, cardiac arrhythmias, hypotension and sudden death after too rapid IV injection. Nursing Measures: • Administer to pregnant patients only when clearly needed—neonatal tachycardia, jitteriness, and withdrawal apnea observed when mothers received xanthines up until delivery. • Caution patient not to chew or crush enteric-coated timed-release forms. • Give immediate-release, liquid dosage forms with food if GI effects occur. • Do not give timed-release forms with food; these should be given on an empty stomach 1 hr before or 2 hr after meals. • Maintain adequate hydration. • Monitor results of serum theophylline levels carefully, and arrange for reduced dosage if serum levels exceed therapeutic range of 10–20 mcg/mL. • Take serum samples to determine peak theophylline concentration drawn 15–30 min after an IV loading dose. • Monitor for clinical signs of adverse effects, particularly if serum theophylline levels are not available. • Ensure that diazepam is readily available to treat seizures. • Take this drug exactly as prescribed; if a timed-release product is prescribed, take this drug on an empty stomach, 1 hr before or 2 hr after meals. • Do not to chew or crush timed-release preparations. • Administer rectal solution or suppositories after emptying the rectum. • It may be necessary to take this drug around the clock for adequate control of asthma attacks. • Avoid excessive intake of coffee, tea, cocoa, cola beverages, chocolate.

• Smoking cigarettes or other tobacco products impacts the drug's effectiveness. Try not to smoke. Notify the care provider if smoking habits change while taking this drug. • Frequent blood tests may be necessary to monitor the effect of this drug and to ensure safe and effective dosage; keep all appointments for blood tests and other monitoring. • These side effects may occur: Nausea, loss of appetite (taking this drug with food may help if taking the immediate-release or liquid dosage forms); difficulty sleeping, depression, emotional lability (reversible). • Report nausea, vomiting, severe GI pain, restlessness, seizures, irregular heartbeat 2) AMIODARONE HYDROCHLORIDE Brand Names: Anoion tab Cordarone Cordarone inj Sandoz Amiodarone HCl tab Classification: Cardiac Drugs Dosage: PO Initial: 200 mg 3 times/day for 1 wk, reduce to 200 mg twice daily for a further wk. Maintenance: 200 mg/day or lowest effective dose. IV Initial: 5 mg/kg infusion via central venous catheter. Max: 1.2 g/24 hr. Indication: Ventricular and supraventricular arrhythmias. Action: Blocks potassium chloride leading to prolongation of action potential duration. Adverse Reactions: Blue-grey discoloration of skin, photosensitivity, peripheral neuropathy, paraesthesia, myopathy, ataxia, tremor, nausea, vomiting, metallic taste, hypothyroidism, hyperthyroidism, alopecia, sleep disturbances, corneal microdeposits, hot flushes, sweating. Heart block, bradycardia, sinus arrest, hepatotoxicity, heart failure. Potentially Fatal: Pulmonary toxicity including pulmonary fibrosis and interstitial pneumonitis, hepatotoxicity, thyrotoxicity. Ventricular arrhythmias, pulmonary alveolitis, exacerbation of arrhythmias and rare serious liver injury. Generally in patients with high doses and having preexisting abnormalities of diffusion capacity. Nursing Measures: • Monitor cardiac rhythm continuously. • Monitor for an extended period when dosage adjustments are made. • Monitor for safe and effective serum levels (0.5–2.5 mcg/mL). • Doses of digoxin, quinidine, procainamide, phenytoin, and warfarin may need to

be reduced one-third to one-half when amiodarone is started. • Give drug with meals to decrease GI problems. • Arrange for ophthalmologic exams; reevaluate at any sign of optic neuropathy. • Arrange for periodic chest x-ray to evaluate pulmonary status (every 3–6 mo). • Arrange for regular periodic blood tests for liver enzymes, thyroid hormone levels. • Drug dosage will be changed in relation to response of arrhythmias; you will need to be hospitalized during initiation of drug therapy; you will be closely monitored when dosage is changed. • Have regular medical follow-up, monitoring of cardiac rhythm, chest x-ray, eye exam, blood tests. • These side effects may occur: Changes in vision (halos, dry eyes, sensitivity to light; wear sunglasses, monitor light exposure); nausea, vomiting, loss of appetite (take with meals; eat small, frequent meals); sensitivity to the sun (use a sunscreen or protective clothing when outdoors); constipation (a laxative may be ordered); tremors, twitching, dizziness, loss of coordination (do not drive, operate dangerous machinery, or undertake tasks that require coordination until drug effects stabilize and your body adjusts to it). • Report unusual bleeding or bruising; fever, chills; intolerance to heat or cold; shortness of breath, difficulty breathing, cough; swelling of ankles or fingers; palpitations; difficulty with vision. 3) ATROPINE SULFATE Brand Names: Anespin amp Atropol amp Euro-Med Atropine Sulfate amp Isopto Atropine eye drops Phil Pharmawealth/Atlantic Atropine amp Classification: Other Cardiovascular Drugs, Muscle Relaxants, Mydriatic Drugs, Antidotes, Detoxifying Agents & Drugs Used in Substance Dependence Indication/Dosage: IV Bradycardia 500 mcg every 3-5 mins. Total: 3 mg. IV/IM Organophosphorus poisoning 2 mg every 10-30 mins until muscarinic effects disappear or atropine toxicity appears. IM/SC Premed in anesth 300-600 mcg 30-60 mins before anesth. IV/IM/SC Overdosage w/ other compd having muscarinic actions 0.6-1 mg, repeat 2 hrly. Ophth Inflammatory eye disorders As 0.5-1% soln: 1-2 drops 4 times/day. Eye refraction As 1% soln: 1 drop twice daily for 1-2 days before procedure. Action: An anti-cholinergic that inhibits acetylcholine at the parasympathetic neuroeffector junction, enhances the conduction of AV node and increases heart

confusion. raised intraocular pressure. photophobia. on prolonged use may lead to irritation.rate Adverse Reactions: Dry mouth. 4) BUMETANIDE Brand Names: Burinex amp Burinex tab Classification: Sulfonamide Diuretics . Inhalation: Dryness of mouth. eye pain. constipation. arrhythmias. hyperemia. confusion (use caution driving or performing hazardous tasks). 30 min before meals. AV dissociation. multiple ventricular ectopics. provide environmental control (temperature) to prevent hyperpyrexia. proper diet). tremors. delirium and may progress to circulatory failure and respiratory depression. blurred vision. cycloplegia. hallucinations. sensitivity to light (reversible. Increased intraocular pressure. tachycardia. difficulty breathing. constipation. wear sunglasses in bright light). • When used preoperatively or in other acute situations. avoid excessive dosage. difficulty in urination. may be transient). • Report rash. palpitations. Nursing Measures: • Ensure adequate hydration. dry mouth (suck sugarless lozenges. restlessness. the following apply to oral medication for outpatients: • Take as prescribed. hallucinations. Eye drops: Systemic toxicity especially in children. mydriasis. edema and conjunctivitis. and dangerous reactions may occur. hyperpyrexia. • These side effects may occur: Dizziness. irregular heartbeat. sensitivity to light. incorporate teaching about the drug with teaching about the procedure. headache. you will be heat intolerant. avoid tasks that require acute vision. difficulty swallowing. throat. abdominal distention. Toxic doses cause tachycardia. flushing. dysphagia. constipation (ensure adequate fluid intake. impotence (reversible). • Avoid hot environments. the ophthalmic solution is used mainly acutely and will not be self-administered by the patient. severe or persistent dry mouth. Potentially Fatal: Atrial arrhythmias. flushing and dryness of skin. loss of coordination. excitement. difficulty in urination (empty the bladder prior to taking drug). perform frequent mouth care. palpitations. • Have patient void before taking medication if urinary retention is a problem.

muscle weakness or cramps. repeat 20 mins. hypokalemia. hydration. IV Pulmonary edema 1-2 mg. dizziness. dizziness. renal failure. sensitivity to sunlight (use sunglasses. • Avoid IV use if oral use is possible. • Take the drug early in day so increased urination will not disturb sleep. • These side effects may occur: Increased volume and frequency of urination.5-1 mg/day. • Provide diet rich in potassium or supplemental potassium. • Give single dose early in day so increased urination will not disturb sleep. • Report weight change of more than 3 lb in 1 day. use frequent mouth care). hypomagnesaemia. rash. dizziness.5-1 mg. then adjust according to response. sunscreen. impaired hearing. at the same time. such as driving. nausea. wear protective clothing). Max: 10 mg/day. hyperglycemia. chest discomfort. later if needed. hyponatremia. trembling. 5) CALCIUM GLUCONATE . hypotension. ECG changes. • Mark calendars or use reminders if intermittent therapy is best for treating edema. • Arrange to monitor serum electrolytes. thrombocytopenia. pruritus. loss of body potassium (a potassium-rich diet. hypocalcaemia. numbness. hyperuricemia. 2nd dose 6-8 hr later if needed. • Weigh yourself on a regular basis. Refractory edema Initial: 5 mg/day. hazardous activities. premature ejaculation. swelling in ankles or fingers. • Record alternate day or intermittent therapy on a calendar or dated envelopes. IV/IM Emergency edema 0. may increase dose depending on response. drowsiness (avoid rapid position changes. fatigue. and alcohol consumption).Indication/Dosage: PO edema 1 mg once daily. record the weight on your calendar. Nursing Measures: • Give with food or milk to prevent GI upset. Action: inhibits Sodium and Chloride reabsorption at the ascending loop of Henle Adverse Reactions: Muscle cramps. Max: 5 mg/day. unusual bleeding or bruising. take with food or meals to prevent GI upset. and in the same clothing. liver function during long-term therapy. musculoskeletal pain. HTN 0. headache. increased thirst (suck sugarless lozenges. feeling faint on arising. or supplement will be needed). nausea.

25 mmol via slow inj . reduces Sodium and water retention. Hypercalcaemia characterised by anorexia. route is available bec. vomiting. Action: inhibits ACE.M. soft-tissue calcification. Maintenance: 25-50 mg twice daily.25 mg/day. lowers blood pressure . renal calculi. crash carts may contain both calcium gluconate and calcium chloride. mental disturbances.25-12.5 mg twice daily. hot flushes and peripheral vasodilation. • Give I. abdominal pain. Use I. constipation. skin sloughing or necrosis after IM/SC inj. 6) CAPTOPRIL Brand Names: Ace-Bloc tab Capomed tab Capotec tab Capoten tab Captor tab Captril tab Cardiovaz tab Conamid tab Hartylox tab Normil tab Phil Pharmawealth/Panion & BF Captopril tab Prelat tab Primace tab Retensin tab SpecAce tab Tensoril tab Unihype tab Vasostad tab Classification: ACE Inhibitors Indication/Dosage: PO HTN Initial: 12. Hypercalcemia may result after large doses in chronic renal failure. polyuria. Action: replaces Calcium and maintains Calcium level Adverse Reactions: GI irritation. Antidote in severe hypermagnesaemia.5 mg 2-3 times/day. route only in emergencies when no I. Potentially Fatal: Cardiac arrhythmias and coma.M. nephrocalcinosis. nausea. then 58-77 mL of 10% soln diluted and administered as a continuous IV infusion. Max: 50 mg 3 times/day. Max: 50 mg 3 times/day. polydipsia. • Tell patient to take oral calcium with a full glass of water. Initial: 6. • Monitor calcium levels frequently. Severe hyperkalaemia 10 mL of 10% soln. injection in gluteal region in adults and in lateral thigh in infants.Brand Names: Phil Pharmawealth/Harson Calcium Gluconate amp Classification: Electrolytes Indication/Dosage: PO Hypocalcaemia 10-50 mmol/day. • Tell patient to take oral calcium 1 to 11/2 hours after meals if GI upset occurs. Nursing Measures: • Make sure prescriber specifies form of calcium to be given. Post MI Start 3 days after MI. chalky taste. may increase after several wk to 150 mg/day in divided doses if needed and tolerated. repeat every 10 mins if needed. of irritation of tissue by calcium salts. muscle weakness. IV Hypocalcaemic tetany 2. Report abnormalities.V. HTN in diabetic nephropathy 75-100 mg/day in divided doses. Heart failure Initial: 6.

Proteinuria. taste disturbance. swelling of the hands. • Take drug 1 hr before or 2 hr after meals. change in taste perception (limited effects. excessive hypotension may occur. cold. feet. allergy medications that may contain ingredients that will interact with ACE inhibitors. • Report mouth sores. dizziness. rash. eyes. 7) CLONIDINE Brand Names: Catapin amp Catapres amp Catapres tab Classification: Other Antihypertensives Indication/Dosage: PO HTN Initial: 50-100 mcg 3 times/day. • Alert surgeon and mark patient's chart with notice that captopril is being taken. chest pain. • Reduce dosage in patients with impaired renal function. . and limit your activities to those that do not require alertness and precision). diarrhea). skin rashes. Do not stop without consulting your health care provider. pruritus. Consult your health care provider. • These side effects may occur: GI upset.Adverse Reactions: Hypotension. Nursing Measures: • Administer 1 hr before or 2 hr after meals. hyperkalaemia. loss of appetite. chest pains. swelling of the face. Hyperkalaemia. • Avoid over-the-counter medications. Anaphylactic reactions. consult your health care provider. difficulty breathing. usually occurs within 3 mth of starting therapy especially in patients with renal dysfunction or collagen diseases. Max: 2. Potentially Fatal: Neutropenia. • Monitor patient closely for fall in BP secondary to reduction in fluid volume (excessive perspiration and dehydration. dehydration). chills. irregular heartbeat. do not take with food. the angiotensin II formation subsequent to compensatory renin release during surgery will be blocked. vomiting. mouth sores (perform frequent mouth care). will pass). nonproductive cough.400 mcg/day. light-headedness (usually passes after the first few days. fever. headache. if light-headedness or dizziness occurs. vomiting. hypotension may be reversed with volume expansion. sore throat. sweating. especially cough. lips. angioedema. change position slowly. palpitations. fast heart rate. • Be careful of drop in blood pressure (occurs most often with diarrhea. tongue. tachycardia.

Do not discontinue abruptly. Do not miss doses. mouth sores (perform frequent mouth care). dry. swelling of the face. urinary retention. dizziness. arrhythmias. light-headedness (usually passes after the first few days. Reduced GI motility at times may cause paralytic ileus. • These side effects may occur: GI upset. overdose or on digitalis). up to 75 mg twice daily. especially cough. impotence. • Avoid over-the-counter medications. IV Hypertensive crisis 150-300 mcg via slow inj. lips. Migraine prophylaxis 50 mcg twice daily. loss of appetite. chest pains. insomnia. urticaria. Do not stop without consulting your health care provider. Epidural Severe cancer pain Initial: 30 mcg/hr as continuous infusion in combination w/ an opioid. itching. dehydration). consult your health care provider. • Take this drug exactly as prescribed. change position slowly. vivid dreams. • Be careful of drop in blood pressure (occurs most often with diarrhea. GI upset. lowers peripheral vascular resistance. headache. • Report mouth sores. Clonidine withdrawal syndrome could be life threatening. difficulty breathing. convulsion. blood pressure. change in taste perception (limited effects. . allergy medications that may contain ingredients that will interact with ACE inhibitors. vomiting. nausea. weakness. fever. Consult your health care provider.Menopausal flushing. and limit your activities to those that do not require alertness and precision). drowsiness. agitation. Action: stimulates alpha 2 receptors and inhibits central vasomotor centers. swelling of the hands. will pass). If you travel. orthostatic hypotension. and heart rate Adverse Reactions: Dry mouth. Potentially Fatal: Transient hypertension or profound hypotension. rash. chills. if light-headedness or dizziness occurs. feet. do not take with food. cold. Transdermal HTN As patch releasing 100-300 mcg clonidine base/day at constant rate: Apply once wkly. life-threatening adverse effects may occur. respiratory depression. coma and disturbances in conduction (in individuals with preexisting diseases of SA/AV nodes. tongue. constipation. sore throat. take an adequate supply of drug. fast heart rate. irregular heartbeat. eyes. Bradycardia. myalgia. fluid or electrolyte imbalance. Nursing Measures: • Take drug 1 hr before or 2 hr after meals. pruritus. sedation. burning sensation in the eye. Max: 750 mcg over 24 hr. sweating. paralytic ileus. Do not discontinue the drug unless so instructed. dizziness.

dizziness. breast enlargement. depresses the CNS & suppresses the spread of seizure activity Adverse Reaction: drowsiness. weakness (often transient. headache. agitation & tension due to psychoneurotic states & transient situational disturbances Action: a benzodiazepine that probably potentiates the effects of GABA. • Report urinary retention. headache. transient amnesia.• Use the transdermal system as prescribed. refer to directions in package insert. other sexual dysfunction. • Reduce dose of narcotic analgesics with IV diazepam. Be sure to remove old systems before applying new ones. fatigue. ataxia. • Do not use small veins (dorsum of hand or wrist) for IV injection. restrict intake of sodium (salt). do not permit ambulatory patients to operate a vehicle following an injection. sore breasts. dry mouth (suck on sugarless lozenges or ice chips). insomnia. • Change from IV therapy to oral therapy as soon as possible. dizziness. tremor. lose weight. respiration during IV administration. seizures may recur after . slurred speech. blanching of fingers. Your sensitivity may increase while using this drug. • Monitor EEG in patients treated for status epilepticus. or contact your health care provider with questions. • Carefully monitor P. rash.dysarthria. nightmares (reversible). BP. dose should be reduced by at least one-third or eliminated. observe caution driving or performing other tasks that require alertness or physical dexterity). frequent meals). light-headedness when you change position (get up slowly. may produce arteriospasm. • Maintain patients receiving parenteral benzodiazepines in bed for 3 hr. gangrene. changes in vision. palpitations. GI upset (eat small. hallucination Nursing Measures: • Do not administer intra-arterially. • These side effects may occur: Drowsiness. impotence. light-headedness. • Attempt lifestyle changes that will reduce your BP: stop smoking and using alcohol. • Use caution with alcohol. paradoxical anxiety. dreams. exercise regularly. decreased libido (discuss with care providers). use caution climbing stairs). 8) DIAZEPAM Brand name: Valium Classification: Anxiolytics Dosage: 10mg/2ml Indication: relief of anxiety.

• Follow diluting instructions carefully. cardiac monitor on standby in case toxicity develops. 9) DIGOXIN Brand name: Digitek. Lanoxicaps. promoting movement of calcium from extracellular to intra-cytoplasm and strengthening myocardial contraction. atropine. Note any change from baseline rhythm or rate. management of chronic cardiac failure where systolic dysfunction or ventricular dilatation is dominant. dizziness. lidocaine.initial control. Novo-Digoxin (CAN) Classification: Inotropics Dosage: 5mg/2ml Indication: Cardiac failure accompanied by atrial fibrillation. and use diluted solution promptly. • Monitor for therapeutic drug levels: 0. facial pain. particularly chronic atrial flutter & fibrillation. especially in epileptic patients. headache. hold dose if pulse < 60 in adult or < 90 in infant. also acts on CNS to enhance vagal tone Adverse Reaction: nausea. this will delay absorption. 10) DIPENHYDRAMINE . • Monitor liver and kidney function. disorientation. drowsiness. retake pulse in 1 hr. hold drug and notify prescriber. • Discuss risk of fetal abnormalities with patients desiring to become pregnant. bad dreams. have K+ salts. which may be very painful. • Check dosage and preparation carefully. phenytoin. If adult pulse remains < 60 or infant < 90. • Arrange for epileptic patients to wear medical alert ID indicating that they are epileptics taking this medication. • Have emergency equipment ready. mental confusion. weakness. CBC during long-term therapy. • Avoid giving with meals.5–2 ng/mL. • Taper dosage gradually after long-term therapy. convulsions Nursing Measures: • Monitor apical pulse for 1 min before administering. Lanoxin. • Avoid IM injections. vomiting. management of certain supraventricular arrhythmias. Action: inhibits sodium-potassium activated adenosine triphosphate. presumably because of short duration of drug effect. anorexia. fatigue.

motion sickness. drug provides local anesthesia and suppresses cough reflex Adverse Reaction: CV and CNS effects. EpiPen Jr. • Assess movement disorder before and after administration. and sugarless gum or candy may minimize this effect. good oral hygiene. other anticholinergic side effects and fall risk. urticaria. can cause hallucinations. Auto-Injector (delivers 0. OTC nasal solution: Adrenalin Chloride Ophthalmic solution: Epifrin. 11) EPINEPHRINE Brand name: Epinephrine Bitartrate Aerosols: Primatene Mist Epinephrine Borate Ophthalmic solution: Epinal Epinephrine Hydrochloride Injection. atopic eczema.Brand name: Benadryl Classification: antihistamine Dosage: 50mg/ml Indication: Hay fever. serum & penicillin reaction. microNefrin. Nephron. overdosage. other allergic dermatoses. Institute measures to prevent falls. pruritus. GI disturbances. contact dermatitis. Nursing Measures: • Monitor carefully. including products used topically. Caution parents or caregivers about proper dose calculation.3 mg IM adult dose). blood disorders. • It can cause excitation in children. Beta1and beta2- . seizures or death Inform patient that this drug may cause dry mouth. Frequent oral rinses. Glaucon Insect sting emergencies: EpiPen Auto-Injector (delivers 0. S2 Classification: Sympathomimetic. • Caution patient not to use oral OTC diphenhydramine products with any other product containing diphenhydramine. Alpha-adrenergic agonist. angioneurotic edema. assess for confusion. Notify dentist if dry mouth persists for more than 2 weeks. parkinsonism.15 mg IM for children) OTC solutions for nebulization: AsthmaNefrin. food sensitivity. delirium. drug sensitization. vasomotor rhinitis. antimuscarinic effects and allergic reactions. Action: prevents histamine mediated responses. especially in infants and children.

Effects on beta receptors include positive chronotropic and inotropic effects on the heart (beta1 receptors). Cardiac stimulant. "epinephrine-fastness" (a form of drug tolerance) can occur with prolonged use. bronchodilation. • Have an alpha-adrenergic blocker or facilities for intermittent positive pressure breathing readily available in case pulmonary edema occurs. • Use minimal doses for minimal periods of time. do not use for longer than 3–5 . administer at peak effect of previous dose. do not use pink or brown solutions. vasodilation. Mydriatic. • Use extreme caution when calculating and preparing doses. a cardioselective beta-blocker. • Keep a beta-adrenergic blocker (propranolol. • Protect drug solutions from light. extreme heat. 3–5 min. vertigo. decreased production of aqueous humor. Adverse Reaction: drowsiness. • Do not exceed recommended dosage of inhalation products. • Rotate SC injection sites to prevent necrosis. administer pressurized inhalation drug forms during second half of inspiration. Doublecheck pediatric dosage. Bronchodilator. and uterine relaxation (beta2 receptors). Effects on alpha receptors include vasoconstriction. Antiglaucoma drug Dosage: 1mg/ml Indication: Acute asthmatic attacks. Drug solutions should be clear and colorless (does not apply to suspension for injection). • Shake the suspension for injection well before withdrawing the dose. the effects of which are mediated by alpha or beta receptors in target organs. Vasopressor. • Keep a rapidly acting alpha-adrenergic blocker (phentolamine) or a vasodilator (a nitrate) readily available in case of excessive hypertensive reaction. nervousness. because the airways are open wider and the aerosol distribution is more extensive. Antasthmatic drug. such as atenolol. If a second inhalation is needed. contraction of dilator muscles of iris.adrenergic agonist. small errors in dosage can cause serious adverse effects. weakness. Advanced cardiac life support Action: Naturally occurring neurotransmitter. dizziness. epinephrine is a very potent drug. and freezing. • Use topical nasal solutions only for acute states. pain Nursing Measures: • Monitor heart rate. Nasal decongestant. cerebral hemorrhage. headache. tremors. should be used in patients with respiratory distress) readily available in case cardiac arrhythmias occur. monitor injection sites frequently.

Hold dropper above eye. • To give eye drops: Lie down or tilt head backward. anxiety. weakness. restlessness. change in taste (eat frequent small meals). fatigue. 12) FUROSEMIDE Brand name: Apo-Furosemide (CAN). polyguria Nursing Measures: • Monitor BP after administration • Administer with food or milk to prevent GI upset. • These side effects may occur: Dizziness. Do not touch dropper to eye. paresthesia. Nasal solution may cause burning or stinging when first used (transient). decrease in visual acuity (ophthalmic). wait at least 5 min before using other eye drops. Rebound nasal congestion can occur after vasoconstriction subsides. emotional changes. oliguria. headache. . headache or brow ache (only during the first few days). apprehension (use caution if driving or performing tasks that require alertness). Ophthalmic solution may cause slight stinging when first used (transient).days. • Report chest pain. and consult your health care provider or pharmacist if you have any questions. • Reduce dosage if given with other antihypertensives. and look up. fast heart rate. Read the instructions that come with respiratory inhalant products. productive cough. hypertension Action: inhibits Sodium and Chloride reabsorption at the proximal and distal tubules and the ascending loop of Henle Adverse Reaction: vertigo. vomiting. dizziness. nausea. keep eye open. and do not exceed recommended dosage. Myrosemide (CAN) Classification: loop diuretics Dosage: 20mg/2ml Indication: edema. drop medicine inside lower lid while looking up. drowsiness. Lasix. readjust dosage gradually as BP responds. or any surface. failure to respond to usual dosage (respiratory inhalant). nocturia. Furoside (CAN). tremor or irregular heart beat (respiratory inhalant. insomnia. • Do not exceed recommended dosage. difficulty breathing. fingers. fever. weakness. adverse effects or loss of effectiveness may result. nasal solution). and do not blink for at least 30 sec. dizziness. Release lower lid. Apply gentle pressure with fingers to inside corner of the eye for about 1 min.

14) HYDROCORTISONE SODIUM SUCCINATE Brand name: A-hydroCort. GI disturbances. even in the asymptomatic patient. • Discard diluted solution after 24 hr. do not use discolored drug or solutions. • Do not mix parenteral solution with highly acidic solutions with pH below 3. and ANA titers before and periodically during prolonged therapy. • Refrigerate oral solution. weight gain. nausea and vomiting Nursing Measures: • Give oral drug with food to increase bioavailability(drug should be given in a consistent relationship ti ingestion of food for consistent response to therapy). 250 mg/ 2 mL . liver function.5. pruritus. LE cell preparations.• Give early in the day so that increased urination will not disturb sleep. • Do not expose to light. angina pectoris. severe headache. palpitation. may discolor tablets or solution. • Arrange for pyridoxine if patient develops symptoms of peripheral neuritis. • Arrange for potassium-rich diet or supplemental potassium as needed. • Monitor patient for orthostatic hypotension which is most marked in the morning and in hot weather. • Measure and record weight to monitor fluid changes. Discontinue if blood dyscrasias occur. Arrange for CBC. 13) HYDRALAZINE HYDROCHLORIDE Brand name: Supres Classification: antihypertension Dosage: 20mg/ml Indication: For hypertensive patient Action: a direct acting peripheral vasodilator that relaxes arteriolar smooth muscles Adverse Reaction: tachycardia. Reevaluate therapy if ANA or LE tests are positive. hydration. • Arrange to monitor serum electrolytes. • Drug may cause a syndrome resembling systemic lupus erythematosus (SLE). dizziness. • Avoid IV use if oral use is at all possible. and with alcohol or exercise. rashes. Solu-Cortef Classification: corticosteroid hormones Stock Dose:100 mg/ 2 mL.

• Arrange for increased dosage when patient is subject to unusual stress. impaired wound healing. menstrual irregularities. osteoporosis. decreased carbohydrate tolerance. resp & neoplastic diseases. Nursing Measures: • Give daily before 9 AM to mimic normal peak diurnal corticosteroid levels and minimize HPA suppression. • Do not give live virus vaccines with immunosuppressive doses of hydrocortisone. mainly by stabilizing leukocyte lysosomal membranes. Cushingoid state. ophth. thin fragile skin. and carbohydrate metabolism Adverse Reactions: fluid and electrolyte disturbances. gasping syndrome. • Do not give IM injections if patient has thrombocytopenic purpura. 15) ISOSORBIDE-5. increased intraocular and intracranial pressure. peptic ulceration w/ possible perforation. control of severe incapacitating allergic conditions. aseptic necrosis. GI. • Provide antacids between meals to help avoid peptic ulcer. Oral: 30 mg. 60 mg Indication: prophylactic treatment of angina pectoris Action: Thought to reduce cardiac oxygen demand by decreasing preload and . psychic derangements. rheumatic & collagen disorders. exophthalmos. growth retardation. shock secondary to adrenocortical insufficiency or shock unresponsive to conventional therapy when adrenocortical insufficiency may be present Action: Decreases inflammation. • Use minimal doses for minimal duration to minimize adverse effects. steroid myopathy. protein catabolism. • Taper doses when discontinuing high-dose or long-term therapy. suppresses immune response. hematologic.Indication: endocrine. seizures. cataracts.anginal drug Stock Dose: SL: 5 mg/mL . • Rotate sites of IM repository injections to avoid local atrophy. masking of infections.MONONITRATE Brand name: Imdur Classification: anti. • Space multiple doses evenly throughout the day. TB meningitis w/ subarachnoid block or impending block when used concurrently with appropriate anti-TB chemotherapy. edematous states. fat. stimulates bone marrow and influences protein. dermatologic. • Use alternate-day maintenance therapy with short-acting corticosteroids whenever possible. muscle weakness.

encephalophathy & convulsions. and precipitating factors of anginal pain. 17) MAGNESIUM SULFATE Brand name: Elin Magnesium Sulfate Classification: anticonvulsant Dosage: 250 mg/10 mL Indication: treatment of hypomagnesemia accompanied by signs of tetany. • Assess location. prevention & control of convulsions in . This results in a slight drop in aortic and systemic blood pressure relieving the myocardium from a part of its afterload. control of HTN. Its systemic cardiovascular effects are mainly due to a decrease in venous return (pooling of blood in the peripheral venous system). intensity. ventricular end-diastolic pressure and volume are diminished. • Assess location. 16) ISOSORBIDE DINITRATE Brand name: Isoket IV Classification: anti – anginal drug Stock: IV amp 10 mg/ 10 mL Dose: 10 mg/10mL Indication: unresponsive left ventricular failure secondary to acute MI. These nitrate-induced changes account for both the antianginal effects of isosorbide dinitrate and for its beneficial effects in the treatment of congestive heart failure. tachycardia Nursing Measures: • Monitor BP and heart rate.afterload. Drug also may increase blood flow through the collateral coronary vessels Adverse Reactions: headache. Consequently. Side effects/ adverse reactions: severe cerebral flow deficiency and decreased coronary perfusion may develop. The arterial vessels are dilated as well. severe or unstable angina pectoris Action: Isosorbide dinitrate is a smooth muscle relaxant. thus reducing cardiac work and implicitly myocardial oxygen requirements. intensity. though to a lesser degree. duration. It is particularly effective on vascular and bronchial smooth muscle. hypotension w/ dizziness and nausea. Nursing Measures: • Monitor BP and heart rate. duration. and precipitating factors of anginal pain. nitrate headache and nausea.

hypotension. phlebitis. resp arrest. headache. allergic reactions. paralysis Nursing Measures: • Monitor the following: I. 18) MEPERIDINE HYDROCHLORIDE Brand name: Demerol Classification: antivertigo drug Dosage: 100 mg/ 2mL Indication: relief of moderate to severe pain. fetal heart rate. dizziness. light headedness. visual disturbance. bradycardia. urinary retention. flushing. resp. bowel movements. sweating. sedation. decreased deep tendon reflexes. altering perception of and emotional response to pain Adverse Reactions: resp. level of consciousness. vomiting. Codeine may impair ability to perform tasks requiring mental alertness and .V. sedation & confusion. magnesium levels. magnesium. oxygen saturation. Lie down immediately if light-headedness or dizziness occurs. circulatory depression. calcium. agitation.: Rapid administration: ECG monitoring. uncoordinated muscle movements. pre-op medication. nausea. hypotension. shock. cardiac arrest. but its anticonvulsant mechanism is unknown Adverse Reactions: flushing. and potassium levels. Oral: Renal function. tremor. vital signs. sweating. transient hallucinations & disorientation. prevention of hypomagnesemia in patients receiving TPN Action: may decrease acetylcholine released by nerve impulses. dysphoria. depression. GI disturbance. weakness. palpitation. muscular weakness. Nausea appears to worsen with ambulation. deep tendon reflexes. • Lie down when feeling nauseated and to notify physician if this symptom persists. • Avoid driving and other potentially hazardous activities until reaction to drug is known. Obstetrics: Patient status including vital signs. syncope. renal function during administration. euphoria. severe convulsions. pain at injection site and local tissue irritation. tachycardia.patients w/ preeclampsia or eclampsia. deep tendon reflexes. Nursing Measures: • Make position changes slowly and in stages particularly from recumbent to upright posture. maternal uterine activity. support of anesth & obstet analgesia Action: binds with opiate receptors in the CNS.

arrange for alteration in insulin dose or timing if diabetic control is compromised by alterations in timing of food absorption. • Do not take alcohol or other CNS depressants unless approved by physician. • Monitor diabetic patients. insomnia. Maxeran (CAN). infectious & drug induced diseases. metabolic diseases.therefore to. Humidification of ambient air may provide some relief. anxiety. Nursing Measures: • Monitor BP carefully during IV administration. fatigue & lassitude. Nu-Metoclopramide (CAN). Reglan Classification: antiemetic & anti-spasmodic Dosage: 10 mg/ 2mL Indication: disturbances of GI motility. drowsiness. and consult physician if they occur. Maxolon. and blocks dopamine receptors at the chemoreceptor trigger zone Adverse Reactions: extrapyramidal reactions. less frequently. • Hyperactive cough may be lessened by avoiding irritants such as smoking. gynecomastia. • Keep diphenhydramine injection readily available in case extrapyramidal reactions occur (50 mg IM). • Have phentolamine readily available in case of hypertensive crisis (most likely to occur with undiagnosed pheochromocytoma). dust. nausea & vomiting of central & peripheral origin associated w/ surgery. dizziness. 19) METOCLOPRAMIDE Brand name: Apo-Metoclop (CAN). • Do not breast feed while taking this drug. 20) MIDAZOLAM HYDROCHLORIDE Brand name: Dormicum Classification: hypnotics & sedatives Dosage: 5mg/5mL . Octamide PFS. • Monitor for extrapyramidal reactions. facilitate small bowel intubation & radiological procedures of GIT Action: stimulates motility of upper GI tract. nausea. fumes and other air pollutants. increases lower esophageal sphincter tone. galactorrhea. headache. bowel disturbances.

21) MORPHINE SULFATE Brand name: Morin Classification: Analgesics (Opioid) . • Keep resuscitative facilities readily available. nausea. and respirations carefully during administration. rash. • Monitor IV injection site for extravasation. BP. headache. oversedation. paradoxical reactions. induction & maintenance of anesth. tab/inj: sedation in premed before surgical or diagnostic procedures. during. Midazolam is a potent amnesiac and memory may be altered. • Arrange to reduce dose of midazolam if patient is also being given opioid analgesics. • Carefully monitor P. hiccoughs. reduce dosage by at least 50% and monitor patient closely. dyspnoea. insomnia esp difficulty in falling asleep either initially or after premature awakening.Indication: tab: disturbances of sleep rhythm. amnesic episodes. Nursing Measures: • Do not administer intra-arterially. vomiting. depress the CNS. • Monitor level of consciousness prior to. laryngospasm. • Keep patients in bed for 3 hr. and suppress the spread of seizure activity Adverse Reactions: rarely cardioresp adverse events. Action: may potentiate the effects of GABA. • Provide comfort measures and reassurance for patients receiving diazepam for tetanus. • Arrange to taper dosage gradually after long-term therapy. • Administer IM injections deep into muscle. have flumazenil available as antidote if overdose should occur. • Provide patient with written information regarding recovery and follow-up care. • Establish safety precautions if CNS changes occur (use side rails. accompany ambulating patient). do not permit ambulatory patients to operate a vehicle following an injection. drowsiness. which may produce arteriospasm or gangrene. • Arrange to monitor liver and kidney function and CBC at intervals during longterm therapy. hallucination. ataxia. • Do not use small veins (dorsum of hand or wrist) for IV injection. and for at least 2–6 hr after administration of midazolam.

Alleviates anxiety associated w/ severe pain. <1 mth 150 mcg/kg 4 hrly. sedation. peri-op & post-op HTN. 22) NICARDIPINE HYDROCHLORIDE Brand name: Cardepine Classification: Calcium Antagonists Dosage: IV infusion Dilute to 10-20 mg/100 mL (conc of 1. Analgesic adjunct in general anesth esp in pain associated w/ cancer. constipation & sweating. SBP <140 mmHg).01-0. 1-5 yr 2. Maintenance rate: Can be tapered down to ≤10 mg/hr. max: 10 mg/dose. Indication: Hypertensive emergencies or urgencies.5-5 mg. Nursing Measures: • Caution patient not to chew or crush controlled-release preparations. Analgesic effect Ped 100-200 mcg/kg SC 4 hrly. Hypnotic for pain-related sleeplessness. Premed.Dosage: Adult 5-20 mg IM/SC 4 hrly. or 50-100 mcg/kg slow IV. titrate dose up to 15 mg/hr until desired therapeutic response is achieved (DBP <95 mmHg. max: 15 mg/dose. nausea. an excessive amount may be absorbed when circulation is restored. Severe or chronic pain Childn 10 mg IM/SC 4 hrly. vomiting. Action: alters perception and emotional response to pain Adverse Reactions: Lightheadedness. most patients who receive opioids for medical reasons do not develop dependence syndromes. Pre-op 50-100 mcg/kg IM. Initial infusion rate: 5 mg/hr. • Use caution when injecting SC or IM into chilled areas or in patients with hypotension or in shock. impaired perfusion may delay absorption. Action: a Calcium channel blocker that inhibits Calcium ion influx across cardiac and . with repeated doses. • Reassure patients that they are unlikely to become addicted. 1-12 mth 200 mcg/kg.02%). range: 5-20 mg. • Dilute and administer slowly IV to minimize likelihood of adverse effects. • Tell patient to lie down during IV administration. hypertensive states of NPO patients. Max: 15 mg. • Keep opioid antagonist and facilities for assisted or controlled respiration readily available during IV administration. IV bolus inj 2-7 mg w/out dilution given over 1-2 min. dizziness. Indication: Relief of moderate to severe pain not responsive to non-narcotic analgesics. MI & surgery. 6-12 yr 5-10 mg.

also increases blood flow through collateral coronary vessels Adverse Reactions: Headache. Transient episodes of lightheadedness. allergic & anaphylactoid reactions. you may need to shave an area for application.4 mg/hr. crescendo angina. Change sites slightly to decrease the chance of local irritation and sensitization.smooth muscle cells. also dilates coronary arteries and arterioles Adverse Reactions: Peripheral edema. Syncope. each system has a different concentration. hypotension. • Advise patient to report immediately if experiencing chest pain 23) NTG PATCH Brand name: Deponit. tachycardia. Nursing Measures: • Patients with hepatic impairment should receive lower dose. Apply to a slightly different area each day. Shave areas that have a lot of hair. Dosing schedule: Daily patch-on period of 12-14 hr & daily patch-off period of 10-12 hr. headache. Minitran. Infrequently. Do not apply to distal extremities. Nitrek. Nitro-Dur. application site irritation. • Monitor blood pressure. Nursing Measures: • Administer transdermal systems to skin site free of hair and not subject to much movement. Depending on severity of .Allow atleast 3 days between dosage adjustment to achieve steady plasma levels. localized thrombophlebitis & hypotension. Nitrodisc. ≤10 yr 1-2 mL. Transderm-Nitro Classification: Anti-Anginal Drugs Dosage: Starting dose: 0. Rarely severe. • To use transdermal systems. palpitations. Remove transdermal system before attempting defibrillation or cardioversion. Indication: Prevention of angina pectoris due to coronary artery disease Action: a nitrate that reduces cardiac oxygen demand by decreasing left ventricular end diastolic pressure and to a lesser extent. Use care if changing brands. systemic vascular resistance. 24) PARACETAMOL Brand name: Aeknil Classification: Analgesics (Non-Opioid) & Antipyretics Dosage: Adult & childn ≥10 yr 2-3 mL.2-0. rebound HTN.

subsequent dosage should be adjusted according to therapeutic response. Headache. be aware of this when calculating total dailydose. Maintenance: 300-400 mg daily. 25) PHENYTOIN Brand name: Dilantin Classification: Anticonvulsants Dosage: Adult Initially 100 mg tid. dizziness. upper resp tract infections post-immunization reactions. temporal lobe). Fever & pain associated w/ common childhood disorders. cold. • Advise patient that drug is only for short term use and to consult the physician if giving to children for longer than 5 days or adults for longer than 10 days. • Advise patient or caregiver that many over the counter products contain acetaminophen. skin & other allergic reactions Nursing Measures: • Use liquid form for children and patients who have difficulty swallowing. slurred speech. diplopia. relieves fever Adverse Reactions: Hematological. dose may be administered by IV very slowly Indication: Pyrexia of unknown origin. ataxia. tonsillitis. <6 yr 30 mg bid. don’t exceed five doses in 24 hours. • In children. dose may be repeated 4 hrly. osteomalacia . arthritis & toothache Action: produce analgesia by blocking pain impulses by inhibiting synthesis of prostaglandin in CNS. In severe cases. Childn ≥6 yr Initially 100 mg tid. Max: 300 mg daily. Prevention of febrile convulsion. Pedia 5 mg/kg/day Initially in 2-3 equally divided doses. prevention & treatment of seizures occurring during or following neurosurgery Action: may stabilize neuronal membranes and limit seizure activity by either by increasing efflux or decreasing influx of Na ions across cell membrane in the motor cortex during generation of nerve impulses Adverse Reactions: GI disturbances. • Warn patient that high doses or unsupervised long term use can cause liver damage. Maintenance: 4-8 mg/kg/day Indication: Tonic-clonic & complex partial (psychomotor. may be increased to 30 mg tid or qid. gingival hyperplasia. sinusitis. after tonsillectomy & other conditions. hyperglycemia. hirsutism. muscle pain.case. nystagmus & mental confusion w/ headache.

in asthma. tachyarrhythmias. Verelan. If required after 2 wk. if required. Assess oral hygiene. Hypertension 1 tab in the morning. COPD. paroxysmal supraventricular tachycardia. EEG may be monitored periodically throughout therapy. Isoptin SR 180 Coronary insufficiency 1 tab bid. tachycardia. Verelan PM Classification: Calcium Antagonists Dosage: Isoptin tab Adult 40-80 mg tid-qid. Usual daily dose: 240-480 mg. long-term treatment after MI. drug tolerance can occur with prolonged use. frequency. chronic coronary insufficiency. peripheral vasodilation. and characteristics of seizure activity. Nursing Measures: • Use minimal periods of time. Vigorous oral cleaning beginning within 10 days of initiation of phenytoin therapy may help control gingival hyperplasia. Isoptin amp 5 mg slow IV. if required. Calan SR. nervous tension. increase dose to 2 tab daily.Nursing Measures: • Assess location. up to 360 mg daily. • Do not recommended dosage. 27) VERAPAMIL HYDROCHLORIDE Brand name: Calan. angina pectoris. headache. Isoptin SR 240 Essential . Angina pectoris & rapid elimination of tachyarrhythmias 1-2 amp IV. Max: 480 mg daily. Isoptin. Decreases uterine contractility & may be used to arrest premature labor Action: relaxes bronchial smooth muscles by stimulating beta-2 receptors Adverse Reaction: Fine tremor of skeletal muscle esp hands. 26) TERBUTALINE Brand name: Bricalin Classification: Antiasthmatic & COPD Preparations Dosage: Antiasthmatic & COPD Preparations Indication: For reversible airways obstruction. duration. 5 mg after 5-10 min. palpitations. Childn >6 yr 40120 mg bid-tid. Isoptin SR 240 1 tab in the morning. Then. if required bidtid Indication: Isoptin/Isoptin SR 180 Essential hypertension. Isoptin SR. childn ≤6 yr 40 mg bid-tid. Covera-HS. continuous drip infusion of 5-10 mg/hr up to 100 mg/day. • Keep beta-adrenergic blocker readily available in case cardiac arrhythmias occur.

erythromelalgia. . • Monitor BP very carefully with concurrent doses of antihypertensives. bronchoconstriction. ocular accommodation disturbances. fatigue. ocular side effects. crush. may repeat doses until patient is stable. dizziness. and output) while drug is being titrated to therapeutic dose. nervousness. GI motility disturbances. flushing. paraesthesia. cough.5 mg/2 mL Dosage: Adult (including elderly) & adolescent >12 yr Acute attacks 1 vial. Maintenance: 1 vial tid-qid. including chronic bronchitis. Dyspnea Nursing Measures: • Monitor patient carefully (BP. nausea. hypotension. Indication: Bronchodilator for treatment of bronchospasm associated w/ COPD. dry mouth. cardiac rhythm. or chew them. emphysema and asthma Action: it works by binding to specific receptors (called muscarinic receptors) in the airway. 28) IPRATROPIUM INHALATION Brand name: Atrovent Classification: Antiasthmatic & COPD Preparations. • Monitor cardiac rhythm regularly during stabilization of dosage and periodically during long-term therapy. • Monitor patients with renal or hepatic impairment carefully for possible drug accumulation and adverse reactions. helping to relax the smooth muscle of the airway. Rarely. anticholinergics or antimuscarinics Stock: 0. it also dilates coronary arteries and arterioles Adverse Reactions: Constipation. bradycardiac arrhythmias. urinary retention. local irritation. When used to treat a runny nose. it works by decreasing the production of fluid in the glands that line the nasal passages Adverse Reaction: Headache. nausea.hypertension Action: decreases myocardial contractility and oxygen demand. headache. skin rash. • Administer sustained-release form in the morning with food to decrease GI upset. • Protect IV solution from light. increased heart rate & palpitations. CHF. vertigo. neuropathy. ankle edema. • Ensure that patient swallows SR tablets whole: do not cut. Dosage may be increased more rapidly in hospitalized patients under close supervision.

• Teach patient proper use of inhalator. cough.5 mL. in patients w/ preexisting outflow tract obstruction. Moderate bronchospasm or w/ assisted ventilation 0. Berodual F UDV Adult & childn >12 yr Acute asthma episodes 1 vial. 2 vials are needed. • Have patient void before taking medication to avoid urinary retention. Childn 6-12 yr Treatment of attacks 0. anaphylactic reactions. urticaria. nervousness. 29) FENOTEROL/IPRATROPIUM BROMIDE Brand name: Berodual Classification: Antiasthmatic & COPD Preparations Dosage: Berodual inhalation soln Adult (including elderly) & adolescent >12 yr Treatment of 1 mL for immediate symptom relief. Intermittent & long-term treatment 0. less frequently tachycardia. Store unused vials in foil pouch. • Can mix albuterol in nebulizer for up to 1 hr.angioedema. • Use nebulizer mouthpiece instead of face mask to avoid blurred vision or aggravation of narrow-angle glaucoma. paradoxical bronchoconstriction (rare). dizziness or headache.5-1 mL for each administration. up to qid. Intermittent & long-term treatment 1 vial up to qid. Nursing Measures: • Protect solution for inhalation from light.5 mL up to tid.5 mL. • Use nebulizer mouthpiece instead of face mask to avoid blurred vision or . palpitations. Indication: prevention and treatment of symptoms in chronic obstructive airway disorders with reversible bronchospasm Action: for the prevention and treatment of reversible bronchospasm associated with bronchial asthma and especially chronic bronchitis with or without emphysema Adverse Reactions: Fine tremor of skeletal muscles. Intermittent & long-term treatment 1-2 mL for each administration. control environmental temperature to prevent hyperpyrexia. Childn <6 yr (<22 kg body wt) Up to 0.5-1 mL. throat irritation or allergic reactions. Nursing Measures: • Protect solution for inhalation from light. Store unused vials in foil pouch. Dry mouth. restlessness. up to qid. Urinary retention may occur in particular. • Ensure adequate hydration. laryngospasm. Moderate bronchospasm or w/ assisted ventilation 0. in very severe cases.

30) BUDESONIDE Brand name: Symbicort Classification: Corticosteroids Dosage: 80/4. Shake well before each use. excessive secretions are present. headache. 31) ALBUTEROL AND IPRATROPIUM INHALATION Brand name: Combivent Classification: Bronchodilators Stock: 2. • Have patient void before taking medication to avoid urinary retention. • Use aerosol within 6 mo of opening. 160/4. pain. gently shake before use. nosebleed. fever.5 mcg x 60 doses. rash. wheezing Nursing Measures: • Taper systemic steroids carefully during transfer to inhalational steroids. deaths from adrenal insufficiency have occurred. 320/9 mcg x 60 doses Indication: regular treatment of asthma where use of a combination (inhaled corticosteroid and long acting beta 2 agonist) is appropriate Action: work by reducing inflammation. viral infection. nasal or sinus inflammation. ear infection or inflammation. • Ensure adequate hydration. stomach or intestinal inflammation. fungal infection in mouth. control environmental temperature to prevent hyperpyrexia. open envelopes should be discarded after 2 wk. cough. • Prime unit before use for Pulmicort Turbuhaler. throat inflammation. conjunctivitis (pinkeye).5 mL . • Teach patient proper use of inhalator.5 mcg x 60 doses. have patient rinse mouth after each use.aggravation of narrow-angle glaucoma. • Store Respules upright and protected from light. respiratory infection. vomiting. diarrhea. • Arrange for use of decongestant nose drops to facilitate penetration if edema. which helps with several conditions ranging from asthma to allergies toCrohn’s disease Adverse Reactions: Abdominal pain. • Can mix albuterol in nebulizer for up to 1 hr.

troubled breathing Nursing Measures: • Assess lung sounds. or eyelids. Some of these medicines are used to treat the symptoms of asthma. severe asthma and in routine management of chronic bronchospasm unresponsive to conventional therapy Action: used with anti-inflammatory medication to prevent asthma attacks. • Have patient void before taking medication to avoid urinary retention. emphysema. Unit dose vial Adult & childn >12 yr 1 vial every 6-8 hr. lips. flushing or redness of skin. • Ensure adequate hydration. urinary retention Nursing Measures: • Use nebulizer mouthpiece instead of face mask to avoid blurred vision or aggravation of narrow-angle glaucoma. dizziness. swelling of face. skin rash. throat irritation. Indication: management of reversible bronchospasm associated with obstructive airway diseases in patients who require more than a single bronchodilator Action: muscles in the airways and increase air flow to the lungs Adverse Reactions: Fine tremor of skeletal muscle. palpitations. severe. tightness in chest or wheezing. Childn 2-12 yr 3 drops/kg/dose (max: 2500 mcg of salbutamol) every 6-8 hr. pulse.5-5 mg. while others are used to prevent the symptoms Adverse Reactions: Dizziness. chronic bronchitis. Indication: treatment of acute. and other lung diseases. Use undiluted. control environmental temperature to prevent hyperpyrexia. or swelling in throat. feeling of choking. • Can mix albuterol in nebulizer for up to 1 hr. headache. Max 12 puffs/day. 32) SALBUTAMOL Brand name: Aero-Vent Classification: bronchodilator Stock: 1 mg/1 mL Dose: Adult & childn 2. dilute w/ sterile water or normal saline for inj. irritation.Dose: MDI Adult 2 puffs tid-qid. increased shortness of breath. Delivery of aerosol may be by face mask of ―T‖ piece. May repeat qid by hlebitis. • Teach patient proper use of inhalator. dryness of mouth. and blood pressure before administration and during . hives. For prolonged delivery time. nervousness.

preventing conversion of fibrinogen to fibrin . withhold medication and notify physician or other health care professional immediately.peak of medication. • Advise the mother to rinse the child’s mouth with water after each inhalation dose to minimize dry mouth. Note amount. If condition occurs. • Observe for paradoxical bronchospasm (wheezing). nausea. 33) TERBUTALINE SULFATE Brand name: Pulmonyl Classification: Antiasthmatic/ Brochodilator Stock: 2. drug tolerance can occur with prolonged use. 25000 iu/1 mL Indication: treatment and prophylaxis of thromboembolic disorders Action: Accelerates formation of antithrombin III-thrombin complex and deactivates thrombin. This allows for easier airflow into and out of the lungs Adverse Reactions: Headache. spacing remaining doses at regular intervals. 34) HEPARIN SODIUM Brand name: Britton Heparin Na Classification: Anticoagulants. Do not double doses or increase the dose or frequency of doses. color. • Inform the mother not to smoke near the child and to avoid respiratory irritants. • Instruct mother to take missed dose as soon as remembered. Children 2-5mg Indication: relief of bronchospasm in obstructive airway diseases Action: It works by dilating (opening) the bronchioles of the lungs by relaxing the muscles around them. • Monitor pulmonary function tests before initiating therapy and periodically throughout course to determine effectiveness of medication. tachycardia. vomiting.5 mg/ml Dose: Adult 5-10 mg. • Do not recommended dosage. and character of sputum produced. sweating & drowsiness Nursing Measures: • Use minimal periods of time. Antiplatelets & Fibrinolytics (Thrombolytics) Dosage: 5000 iu/1 mL. • Keep beta-adrenergic blocker readily available in case cardiac arrhythmias occur. palpitations.

muscular pain. Hct. Hgb. bruising. confusion. dyspnoea. somnolence. Potentially Fatal: Heparin-induced thrombocytopenia with or without thrombosis. Priapism. non-compensatory sinus tachycardias. osteoporosis. non ST segment elevation MI Action: A Class II antiarrythmic and ultra-short-acting selective beta blocker that decreases heart rate. headache. heart failure. rhinitis. all patients > 60 y. rapid pulse and other S&S of hemorrhage • Observe all needle sites daily for hematoma and signs of inflammation • Have on hand protamine sulfate. epistaxis. peripheral neuropathy. vomiting. and patients with liver disease or renal insufficiency. • Monitor vitals. tests may be done once daily • Pts vary widely in their reaction to heparin. cardiogenic shock. vomiting. fatigue. skin necrosis (SC inj).Adverse Reactions: Slight fever. diaphoresis. After dosage is established. paraesthesia. constipation. risk of hemorrhage appears greatest in women. drop in BP. bronchospasm. Potentially Fatal: Profound bradycardia. dizziness. asystole. Nursing Measures: . asthma. nausea. rigor. slight haematuria. bradycardia. report fever. fever. blurred vision. irritability. headache. alopecia. peripheral ischaemia. post-operative tachycardia or hypertension. RBC and platelet counts prior to initiation or therapy and at regular intervals throughout therapy • Monitor APTT levels closely • Draw blood for coagulation tests 30 min before each scheduled SC or intermittent IV dose and approximately q4h for pts receiving continuous IV heparin during dosage adjustments period. AV block. weakness. nausea. local irritation. specific heparin antagonist 35) ESMOLOL HYDROCHLORIDE Brand name: Brevibloc Classification: Beta blockers Dosage: 100mg/10ml Indication: supraventricular tachycardia. bleeding Nursing Measures: • Baseline blood coagulation tests. urinary retention. Hypersensitivity reactions include urticaria. intra-operative tachycardia or hypertension. chills. contractility and blood pressure Adverse Reactions: Hypotension. unstable angina. angioedema and anaphylactic shock. conjunctivitis.

shallow tidal volume. rapid respirations. 37) POTASSIUM CHLORIDE Brand name: Phil Pharmawealth/Atlantic Potassium Chloride Classification: Electrolytes Dosage: 40 meqs/20 ml Indication: for hypokalemia. turn off IV drip. hypomagnesemia & hypophosphatemia.• Monitor patient carefully (BP. Dosage may be increased more rapidly in hospitalized patients under close supervision. vein irritation. cardiac rhythm. dyspnea. • Check IV site frequently and if infiltration is noted. vomiting. Oral: Nausea. and output) while drug is being titrated to therapeutic dose. 36) D 50-50 Brand name: Phil Pharmawealth/Atlantic 50% Dextrose Classification: Intravenous & Other Sterile Solutions Dosage: 50ml/vial Indication: for hypoglycemia Action: A simple water soluble sugar that minimizes glyconeogenesis and promotes anabolism in patients whose oral caloric intake is limited Adverse Reactions: Local pain. phlebiti and abdominal . and peripheral edema) • Watch out for signs of infiltration (swelling and pain around IV site). thrombophlebitis & tissue necrosis in the event of extravasation. Infusion may result in fluid overload. • Monitor cardiac rhythm regularly during stabilization of dosage and periodically during long-term therapy. fine auscultatory crackles. acute MI Action: Replaces potassium and maintains potassium level Adverse Reactions: GI ulceration (sometimes with haemorrhage and perforation or with late formation of strictures) following the use of enteric-coated K chloride preparation. edema or water intoxication Nursing Measures: • Monitor infusion rate frequently. hyperkalaemia. turn off IV drip. Fluid & electrolyte imbalance eg hypokalemia. if signs of fluid overload. • Watch out for signs of fluid overload (distended neck veins (JVD).

Do not double dose. numbness of the tongue. return to regular doseschedule. and excitability in the ventricles during the diastolic phase by direct action on the tissues especially the Purkinje network Adverse Reactions: Restlessness. weakness.Local & General Dosage: 50 ml/vial Indication: local or regional anesthesia Action: A class IB antiarrythmic that decreases the depolarization. • Encourage compliance with recommended diet. • Emphasize correct method of administration. 38) LIDOCAINE HYDROCHLORIDE Brand name: Abbott Lidocaine Classification: Anaesthetics . if not. • Notify health care professional if nausea. and serum bicarbonate. blurred vision. methemoglobinaemia. tarry. nervousness. or tingling of extremities. tinnitus. hypotension. bradycardia. • Instruct patient to avoid salt substitutes or low-salt milk or food unless approved by health care professional. vomiting. or stomach discomfort persists. Some extended-release tablets are contained in a wax matrix that may be expelled in the stool. This occurrence is not significant. dizziness. • Explain to patient purpose of the medication and the need to take as directed. IV: Pain or phlebitis. or bloody stools. Nursing Measures: • Monitor serum potassium levels. muscle twitching. Emphasize the importance of regular follow-up exams to monitor serum levels and progress. A missed dose should be taken as soon as remembered within 2 hr. automaticity. • Dosage may require adjustment. • Patient should be advised to read all labels to prevent excess potassium intake. fetal intoxication. • Instruct patient to report dark. Nursing Measures: . diarrhea. convulsions. GI irritation or ulceration may result from chewing enteric-coated tablets or insufficient dilution of liquid or powder forms. cardiac toxicity. unusual fatigue. GI upsets. • Advise patient regarding sources of dietary potassium.especially when concurrent digoxin or diuretics are taken. renal function.cramps.

Be sure that such solutions are used • only to produce local anesthesia. • Monitor for malignant hyperthermia (jaw muscle spasm. • Treat methemoglobinemia with 1% methylene blue. • Monitor fluid load carefully. IV over 10 min. • Keep life-support equipment and vasopressors readily available in case severe adverse reaction (CNS. or diabetes. rigidity). Do not give food or drink for 1 hr after use of oral anesthetic. • Use caution to prevent choking. or respiratory) occurs when lidocaine is injected. • Reduce dosage with hepatic or renal failure.1 mg/kg. and ensure that they are adequately hydrated to minimize risk of headache. Doses > 6–10 mcg/mL are usually toxic 39) SODIUM BICARBONATE . • Have patients who have received lidocaine as a spinal anesthetic remain lying flat for 6–12 hr afterward. CV. have lifesupport equipment and IV dantrolene on standby. digitalis toxicity with AV block. thyrotoxicosis. • Establish safety precautions if CNS changes occur. have IV diazepam or shortacting barbiturate (thiopental. These solutions should be injected cautiously in body areas supplied by end arteries and used cautiously in patients with peripheral vascular disease. • Reduce dosage when treating arrhythmias in CHF. and geriatric patients.• Check drug concentration carefully. thiamylal) readily available in case of seizures. • Apply lidocaine ointments or creams to a gauze or bandage before applying to the skin. many concentrations are available. • Continuously monitor response when used as antiarrhythmic or injected as local anesthetic. more concentrated solutions can be used to treat arrhythmias in patients on fluid restrictions. epinephrine is added to solutions of lidocaine to retard the absorption of the local anesthetic from the injection site. when using lidocaine as antiarrhythmic. • Check lidocaine preparation carefully. • Titrate dose to minimum needed for cardiac stability. hypertension. Patient may have difficulty swallowing following use of oral topical anesthetic. 0. • Monitor for safe and effective serum drug concentrations (antiarrhythmic use: 1–5 mcg/mL).

PaO2. palpitation. deterioration of peripheral . ulceration or sloughing at the site of infiltration Nursing Measures: • do not take drug with milk to avoid hypercalcemia. or kidney stones. hypotension. note decreases in urine output. tissue necrosis. hypertension. 80 mg/mL. • Monitor central venous pressure or pulmonary wedge pressure if possible during infusion. large doses cause mainly alpha stimulation Adverse Reaction: ectopic beats. cardiac arrest Action: Restores buffering capacity of the body and neutralizes excess acid Adverse Reaction: Tetany. dyspnea Nursing Measures: • Monitor vital signs and ECG closely throughout therapy. seizures. headache. abnormally high alkalinity in tissues and fluids. anxiety. hypernatremia. vomiting. ventricular arrhythmias. hypertension. metabolic alkalosis. pain. irritation. ECG changes. 160 mg/mL Indication : shock and hemodynamic imbalances. • Monitor I&O regularly. nausea. gastric distention. anginal pain. • do not give to patients with metabolic or respiratory alkalosis. vasoconstriction. decreased urine output. systemic or urinary alkalinization. or heart failure. Action is dose-related. dilated pupils. and in those with hypocalcemia in which alkalosis may produce tetany. hypokalemia. belching. PCO2. • monitor for alkalosis by obtaining blood pH. 50mEq/50ml Indication: metabolic acidosis. antacid. flatulence. and electrolyte levels 40) DOPAMINE Brand name: Intropin Classification: Adrenergics (Sympathomimetics) Dosage: 40 mg/Ml. edema. • Note significant changes in vital signs. hypotension Action: Stimulates dopaminergic and alpha beta receptors for the sympathetic nervous system resulting in a positive inotropic effect and increased cardiac output.Brand name: Hospira Sodium Bicarbonate Classification: Alkalinizers Dosage: 10mEq/10ml. tachycardia. chemical cellulitis because of alkalinity.

increased number of premature ventricular beats. vomiting. headache. 0. nausea. dyspnea. and/or cold. local inflammation after infiltration. mottled extremities 41) DOBUTAMINE Brand name: Dobatrey Classification: Adrenergics Dosage: 12. leg cramps Nursing Measures: • Monitor vital signs. • Watch out for symptoms of overdosage such as excessive hypertension. central venous pressure and urinary output carefully throughout infusion. automaticity. and facilitating AV node conduction Adverse Reaction: increased systolic BP. pulmonary capillary wedge pressure. cardiac manipulation or cardiac glycosides Action: Acts as an anesthetic by stabilizing the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses. tachycardia.8% (8g/ml) Indication: ventricular arrhythmias caused by MI. and excitability in the ventricles during the diastolic phase by a direct action on the tissues. headache. phlebitis. Also acts as an antiarrhythmic by decreasing the depolarization.4% (4g/ml). ECG. without .2% (2mg/ml). vomiting. cardiac output. 0. increased heart rate. chest pain. tingling sensations. chest pain 42) LIDOCAINE PREMIXED Brand name: Xylocaine Classification: Antiarrhythmic agent. especially the Purkinje network.pulses. • Monitor patency and placement of IV catheter to reduce risk of extravasation and phlebitis. Increases cardiac output by decreasing peripheral vascular resistance. Local anesthetic Dosage: 0. tremor. nausea. reducing ventricular filling pressure. paresthesia.5 mg/mL Indication: increased cardiac output in short term treatment of cardiac decompensation caused by depressed contractility Action: Stimulates heart’s beta1 receptors to increase myocardial contractility and stroke volume. thereby effecting local anesthetic action.

respiratory depression or arrest. petechiae. diplopia. venous thrombosis or phlebitis. digitalis toxicity. Neither contractility. use lowest possible dose to avoid serious toxicity. cardiac arrest. conjunctival hyperemia. vomiting. and edema. contusion. including soreness at IM injection site. confusion. drug elevates plasma osmolality . 10%. dizziness. tremors. hypotension. 15%. • Use with caution and in lower doses in patients with CHF. 25% in 500cc/1. diuresis in drug intoxication Action: Increases osmotic pressure of glomerular filtrate. to reduce intraocular or intracranial pressure. • Systemic effects can occur following topical use. nausea. petechiae. local reactions. may occur with intradermal injection.000cc Indication: test dose for marked oliguria or suspected inadequate renal function. drowsiness. systolic arterial blood pressure. tinnitus. apprehension. convulsions. hallucinations. CV collapse. headache. oliguria. paresthesias. including erythema. sloughing. nor absolute refractory period is altered by usual therapeutic doses Adverse Reaction: bradycardia. erythema. injection-site reactions. nervousness. visual disturbances. burning. • Advise patients that skin reactions. • Advise patient that drug may cause dizziness or drowsiness and to avoid getting out of bed or walking without assistance. 20%. stinging. extravasation. edema. hypersensitivity reactions Nursing Measures: • Explain that adverse reactions related to the CNS (eg. reduced cardiac output. including bruising. confusion. atrioventricular (AV) conduction velocity. respiratory arrest) can occur and are a result of CNS toxicity. burning. mood changes. corneal epithelial changes. • Do not use in patients with congenital or idiopathic methemoglobinemia or in infants younger than 12 mo of age who are receiving methemoglobin-inducing drugs. or heart block. drowsiness. lightheadedness. and in elderly patients 43) MANNITOL Brand name: Osmitrol Classification: osmotic diuretic Dosage: 5% . shock.involvement of the autonomic system. hemorrhage.

fluid overload. fast or irregular heartbeat. weakness Nursing Measures: • Monitor vital signs. difficulty breathing. or tongue). chills or fever. turn off IV drip. headache. infiltration (swelling and pain at infusion site) Nursing Measures: • Monitor infusion rate frequently. rapid respirations. headache. chest pain • To relieve thirst. severe allergic reactions (rash. itching. muscle cramps. blurred vision. including CVP. Infusion may result in fluid overload. tachycardia. shallow tidal volume. nausea. chest pain. tremor. give frequent mouth care and fluids 44) DEXTROSE 5% IN WATER (D5W) SOLUTION Brand name: None Classification: Isotonic/Hypotonic Solution Dosage: 250ml bottles (5g dextrose/100ml water) Indication: fluid replacement and caloric supplementation in patients who can’t maintain adequate oral intake or are restricted from doing so Action: Provides some sugar for cellular metabolism and supplies body water Adverse Reaction: Increases free water and may cause intracellular edema. decreased alertness. turn off IV drip. fine auscultatory crackles. nausea. swelling of the mouth. • Check IV site frequently and if infiltration is noted. hives. • Watch out for signs of fluid overload (distended neck veins (JVD). extreme dizziness. confusion. renal function. vomiting. and fluid intake and output. redness. difficulty urinating. extreme thirst or dry mouth. and serum sodium and potassium levels daily • Watch out for symptoms of overdosage such as excessive hypertension. dyspnea. and peripheral edema) • Watch out for signs of infiltration (swelling and pain around IV site). face. lips.Adverse Reaction: Increased urination. runny nose. or swelling at the injection site. if signs of fluid overload. Posted by Ray Mercado at 2:47 PM . pain. tightness in the chest. • Monitor weight. vomiting.

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