ER-DRUGS

Monitor VS. dextrose in water by controlled hypotension, cardiac tamponade Report HR Contraindications infusion device. restrictive cardiomyopathy, Monitor for constipation, oliguria. Hypersensitivity to opioid constrictive pericarditis. ATROPINE SULFATE Instruct to take 30 mins before Diarrhea caused by poisoning until Rectal:10±30 mg q 4 hr or as Nursing Management Isopto Atropine meals toxins are eliminated directed by physician. Record characteristics and precipitating Eat foods high in fiber and drink During labor or delivery of a premature factors of anginal pain. Classification plenty fluids. infant Action Monitor BP and apical pulse before Anticholinergics Can cause photophobia After biliary tract surgery or following Acts as agonist at specific opioid administration and periodically after Instruct client not to drive a motor surgical anastomosis receptors in the CNS to produce dose. Dosage vehicle or participate in activities Pregnancy analgesia, euphoria, sedation Bradycardia: 0.5 mg IV every 3-5 requiring alertness. Labor Have client sit or lie down if taking drug Indication mins, max of 0.04 mg/kg Advise to use hard candy, ice chips, Relief of moderate to severe acute and for the first time. Cardiac Arrest: 1 mg every 3-5 mins etc. for dry mouth. chronic pain Nursing Management Client must have continuing EKG Nerve and Organophosphate Preoperative medication Interventions monitoring for IV administration symptoms: may repeat in 2 mg Analgesic adjunct during anesthesia Caution patient not to chew or crush Cardioverter/ defibrillator must not be NITROGLYCERINE increments q 3 mins titrated to relief Component of most preparations that controlled-release preparations. discharged through paddle electrode Nitrostat symptoms are referred to as Brompton's cocktail Dilute and administer slowly overlying or mixture Tell patient to lie down during IV Nitro-Bid ointment or the TransdermClassification Indication Intraspinal use with microinfusion administration. Nitro Patch. Assist with ambulating if Antianginal Pre-op meds/pre-anesthetic meds devices for the relief of intractable pain Keep opioid antagonist and facilities dizzy. Nitrate To restore cardiac rate and arterial Unlabeled use: Dyspnea associated for assisted or controlled respiration Instruct to take at first sign of anginal Vasodilator,/Coronary pressure during anesthesia when with acute left ventricular failure and readily available during IV pain. Dosage vagal pulmonary edema administration. May be repeated q 5 minutes to max. of 0.3-0.4 mg SL q 5 min, max 3 To lessen the degree of A-V heart Side Effects Use caution when injecting SC or IM 3 doses. doses. block GI: dry mouth, constipation. into chilled areas or in patients with If the client doesn¶t experience relief, Every 6 hrs except for midnight To overcome severe carotid sinus Skin: Tissue irritation and induration hypotension or in shock advise to seek medical assistance (cream) reflex (SC injection). Reassure patients that they are immediately. Wear 12 hrs a day for skin patch Antidote for cholinergic toxicity Other: sweating,physical tolerance unlikely to become addicted Keep in a dark colored container Action and dependence, psychological Teaching points Relaxes the vascular smooth Side effects dependence Take this drug exactly as prescribed. MORPHINE SULFATE system y CNS: restlessness, ataxia, Avoid alcohol, antihistamines, Immediate-release tablets: disorientation, hallucinations, delirium, Adverse Effects sedatives, tranquilizers, over-theReduces myocardial oxygen MSIR coma, insomnia, agitation, confusion. CNS: Light-headedness, dizziness, counter drugs. consumption Timed-release: y CV: tachycardia, angina, arrhythmias, sedation, euphoria, dysphoria, delirium, Swallow controlled-release Reduces left ventricular workload Kadian, M-Eslon (CAN), MS Contin, flushing. insomnia, agitation, anxiety, fear, preparation (MS Contin, Oramorph Reduces arterial BP Oramorph SR y EENT: photophobia, blurred vision, hallucinations, disorientation, SR) whole; do not cut, crush, or chew Reduces venous return Oral solution: mydriasis. drowsiness, lethargy, impaired mental them. Indication MSIR, Rescudose, Roxanol, Roxanol T y GI: dry mouth, constipation, vomiting. and physical performance, coma, mood Do not take leftover medication for Angina pectoris Rectal suppositories: y GU: urine retention. changes, weakness, headache, tremor, other disorders, and do not let CHF associated with AMI RMS y Hematologic: leukocytosis seizures, miosis, visual disturbances, anyone else take your prescription. Cardiac load reducing agent Injection: y Other: anaphylaxis suppression of cough reflex These side effects may occur: Astramorph PF, Duramorph, Epimorph Hypertensive Crisis CV: Facial flushing, peripheral Nausea, loss of appetite, (CAN) Side effects Adverse effects circulatory collapse, tachycardia, constipation, dizziness, sedation, CNS: headache, throbbing, CNS: headache, excitement. bradycardia, arrhythmia, palpitations, drowsiness, impaired visual acuity Classification dizziness, weakness. CV: palpitations chest wall rigidity, hypertension, Report severe nausea, vomiting, Opioid Agonist Analgesic GI: nausea, vomiting GI: thirst, nausea hypotension, orthostatic hypotension, constipation, shortness of breath or Dosage Skin: Rash syncope difficulty breathing, rash. Oral: 10±30 mg q 4 hr PO. Adverse Reactions Contraindications Dermatologic: Pruritus, urticaria, Controlled-release: 30 mg q 8±12 CV: orthostatic hypotension, Hypersensitivity Respiratory: laryngospasm, hr PO or as directed by physician; flushing, fainting. With acute angle closure glaucoma, bronchospasm, edema VERAPAMIL EENT: sublingual burning. Kadian: 20±100 mg PO daily±24-hr obstructive uropathy, obstructive GI: Nausea, vomiting, anorexia, biliary Calan, Isoptin, Verelan, Covera HS Skin: Cutaneous vasodilation, release system; MS Contin: disease of GI tract, paralytic ileus, tract spasm; increased colonic motility 200 mg PO q 12 hr. contact dermatitis (patch) toxic megacolon, intestinal atony, in patients with chronic ulcerative colitis Classification SC and IM:10 mg (5±20 mg)/70 kg Contraindications unstable CV status in acute GU: Ureteral spasm, spasm of vesical Anti-anginal q 4 hr or as directed by physician. Contraindicated in patients hemorrhage, asthma, or myasthenia sphincters, urinary retention or Anti-arrhythmics hypersensitive to nitrates gravis. hesitancy, oliguria, antidiuretic effect, Anti-hypertensive IV:2.5±15 mg/70 kg of body weight With early MI. (S.L. form), severe Pregnant women. reduced libido or potency Vascular headache suppressants in 4±5 mL water for injection anemia, increase ICP angle-closure Respiratory:Respiratory depression, administered over 4±5 min, or as glaucoma, IV nitroglycerine is apnea, circulatory depression, Dosage directed by physician. Continuous contraindicated in patients with Nursing Management respiratory arrest, shock, cardiac arrest IV infusion: 0.1±1 mg/mL in 5% hypovolemia, hypotension, orthostatic

CARDIAC DRUGS

PO 80-120 mg 3x daily, increases as needed Action Inhibits calcium transport into myocardial smooth muscle cells Decreases SA and AV conduction and prolongs AV node refractory period in conduction tissue Indication Hypertension Angina Pectoris Supraventricular Arrhythmia Atrial flutter/fibrillation Side Effects and Adverse Reactions CNS:abnormal dreams, anxiety, confusion, dizziness and headache EENT: blurred vision, epistaxis and tinnitus CV: arrhythmia, CHF, chest pain, bradycardia, hypotension and palpitations GU: dysuria, nocturia and polyuria GI: abnormal liver function, anorexia, constipation, diarrhea, nausea and vomiting Contraindications Hypersensitivity Sick sinus syndrome 2nd or 3rd degree AV block CHF Cardiogenic shock Concurrent IV beta-blocker Nursing Management Monitor BP and pulse before therapy, during titration and therapy Monitor ECG, I&O, serum potassium and weight. Assess for CHF

DILTIAZEM Cardizem, Dilacor, Novo-Diltiazem, Tiamate and Tiazac Classification i Anti-anginals i Antiarrhythmics i Antihypertensive i Ca channel blocker Dosage

i i Action i i

PO: 30-120 mg, 3-4x daily or 60-120 mg twice daily as SR capsules IV: 0.25 mg/kg

Inhibits calcium transport into myocardial smooth muscle cells Systemic and coronary vasodilation Hypertension Angina Pectoris Supraventricular Arrhythmia Atrial flutter/fibrillation

Action Increases electrical stimulation of ventricle and His-purkinje system by direct action on tissues, resulting to decrease depolarization, automaticity and excitability in ventricles during diastolic phase

i

i i

Indication i i i i

Indication i Anesthesia i Arrhythmias i Control of Status epilepticus refractory to other treatments

PSVT, symptomatic atrial flutter: PO 600-800 mg/day for 1 month Arrhythmias with CHF: 200 mg/day Ventricular dysrrhythmias: 150 mg over the 1st 10 mins then slow 360 mg over the next 6 hrs

PROCAINAMIDE Pronestyl, Procan-SR, Procanbid Classification Antiarrhythmics Dosage Arrhythmias: 50 mg/kg/day in divided doses 3-6 hourly Action Blocks open Na channels and prolongs the cardiac action potential. This results in slowed conduction and ultimately the decreased rate of rise of the action potential may result on the widening of QRS on ECG

EpiPen Auto-Injector (delivers 0.3 mg IM adult dose), EpiPen Jr. Auto-Injector (delivers 0.15 mg IM for children) OTC solutions for Nebulization: AsthmaNefrin, microNefrin, Nephron, S2 Classification Beta2 Adrenergic Agonists Dosage Cardiac arrest: 1 mg IV of 1:10,000 solution q 3-5 min; double dose if administering via ET tube

Action i

i Side Effects and Adverse Reactions GI disturbances, bradycardia, Side Effects and Adverse and Reactions hypotension, convulsion, numbness of Indication i CNS:abnormal dreams, anxiety, tongue, muscle twitching, restlessness, i Life threatening recurrent confusion, dizziness and headache nervousness, dizziness, tinnitus, blurred arrhythmias i EENT: blurred vision, epistaxis and vision, fetal intoxication, light i Ventricular fibrillation tinnitus headedness, drowsiness, apprehension, i Ventricular tachycardia i CV: arrhythmia, CHF, chest pain, euphoria, vomiting, sensation of heat, bradycardia, hypotension and respiratory arrest and CV collapse Side Effects and Adverse Reactions palpitations Exacerbation of arrhythmias, i GU: dysuria, nocturia and polyuria Contraindications bradycardia, SA node dysfunction, heart i GI: abnormal liver function, anorexia, i Hypersensitivity block, sinus arrest; flushing, fatigue, constipation, diarrhea, nausea and i Heart block malaise, abnormal involuntary vomiting i Hypovolemia movements, ataxia, dizziness, i Adams stroke syndromes paresthesia, decreased libido, insomnia, Contraindications i Infection at site of injection headache, sleep disturbances, visual i Hypersensitivity impairment, blindness, corneal i Sick sinus syndrome microdeposits, photophobia, abnormal Nursing Management nd or 3rd degree AV block i 2 taste, nausea, vomiting, constipation, i Assess pt before and after i CHF anorexia, abdominal pain, abnormal therapy i Cardiogenic shock salivation, coagulation abnormalities, i Pts infusion must be on cardiac i Concurrent IV beta-blocker non-specific hepatic disorders, monitor pulmonary inflammation, dyspnea, i Monitor ECG, if QT or QRS Nursing Management toxicosis, death, edema, hypo and increases by 50% or more, i Monitor BP and pulse before hyperthyroidism withhold the drug therapy, during titration and therapy i Monitor BP, check for rebound i Monitor I&O and weight Contraindications HPN after 1-2 hrs i Assess for CHF i Severe sinus node i Assess respiratory status, i Routine serum digoxin monitoring dysfunction oxygenation and pulse deficits i 2nd or 3rd degree AV block i Assess renal and liver function i Hypersensitivity i Monitor CNS symptoms LIDOCAINE i Monitor blood levels Xylocaine Nursing Management Classification i Assess cardiovascular status before AMIODARONE i CV drugs: Anti-arrhythmics therapy Cordarone i Anesthetic i Assess pulmonary, hepatic and thyroid function before and during therapy Classification Dosage i Monitor fluid and electrolytes, I&O, K, Anti-arrhythmics Arrhythmia: Na and Cl i IV: 0.7-1.4 mg/kg body weight. Dosage i Monitor ECG, BP No more than 200 mg within 1 i Assess vision Recurrent ventricular arrhythmias: hour period i PO 800-1600 mg/day for 1-2 i IM: 4-5 mg/kg body weight wks

Blocks Na channels, prolonging myocardial cell action potential and refractory period Non competitive alpha and beta adrenergic blockage

arteriosclerosis. Also contraindicated in patient receiving general anesthesia with halogenated hydrocarbons or cyclopropane and in patients in labor (may delay second stage) In conjunction with local anesthesia, epinephrine is contraindicated for use in finger, toes, ears, nose, and genitalia. In pregnant woman, drug is contraindicated. In breast feeding do not use the drug or stop breast feeding.

Anaphylaxis: 0.1- 1 mg SQ or IM of Nursing Management 1. Monitor V/S. and check for cardiac 1:1000 solution. dysrrhythmias Asthma: 0.1-0.3 mg SQ or IM of Indication 2. Drug increases rigidity and tremor 1:10,000 solution i Supraventricular and ventricular in patients with Parkinson¶s disease Refractory bradycardia and arrhythmias. 3. Epinephrine therapy interferes with hypotension: 2-10ug/min i Treatment of Wolf-Parkinson-White tests for urinary catecholamine Syndrome 4. Avoid IM use of parenteral Action suspension into buttocks. Gas Stimulates beta receptors in Side Effects and Adverse Reactions gangrene may occur lung. i Severe hypotension, ventricular 5. Massage site after IM injection to Relaxes bronchial smooth fibrillation and asystole. counteract possible muscle. i Drug induced SLE syndrome, blood vasoconstriction. Increases vital capacity disorders, fever, myocardial 6. Observe patient closely for adverse Increases BP, HR, PR depression, heart failure, reactions. Notify doctor if adverse Decreases airway agrunulocytosis, psychosis, reaction develop resistance. angioedema, hepatomegaly, skin 7. If blood pressure increases sharply, irritation, hypergammaglobulinemia, GI rapid-acting vasodilators such as Indication and CNS effects nitrates or alpha blockers can be Asthma Contraindications Bronchitis given to counteract i Heart block Emphysema i Heart failure All cardiac arrest, anaphylaxis i Hypotension Used for symptomatic VASOPRESSIN i Myesthenia gravis bradycardia. Pitressin i Digoxin toxicity Relief of bronchospasm i Lactation occurring during anesthesia Classification Exercised-induced Pituitary Hormones Nursing Management bronchospasm ADH i Assess cardiovascular status before therapy Dosage i Assess pulmonary, hepatic and thyroid Prevent and treat abdominal distention: function before and during therapy Side Effects/Adverse Reactions initially 5 units IM gives subsequent injections i Monitor fluid and electrolytes, I&O, K, Side Effects: q3-4 hours increasing to 10 units if needed. Na and Cl nervousness, tremor, vertigo, pain, widened pulse pressure, hypertension Action i Monitor ECG, BP nausea i Assess vision Increase permeability of renal tubular Adverse Effects: epithelium to adenosine monophosphate and headache water, the epithelium promotes reabsorption EPINEPHRINE of water and concentrated urine Contraindications Injection, OTC nasal solution: With angle-closure glaucoma, Indication Adrenalin Chloride shock (other than anaphylactic i Diabetes Insipidus Ophthalmic solution: shock), organic brain damage, Epifrin, Glaucon i Abdominal Distention cardiac dilation, arrhythmias, Insect sting emergencies: i GI bleeding coronary insufficiency, or cerebral

i

Esophageal varices

Side Effects and Adverse Reactions i CNS: tremor, headache, vertigo i CV: vasoconstriction, Contraindications arrhythmias, cardiac arrest, i Heart block and myocardial myocardial ischemia, damage circumollar pallor, i Toxemia of pregnancy decreased CO, angina i GI: abdominal cramps Nursing Management i GU:uterine cramps i Monitor I&O. make sure i Respi: bronchoconstriction urine output is 100 ml or i Skin: diaphoresis, gangrene more in 4 hrs pd before each dose and urticaria i Take appropriate seizure Contraindications precautions i With chronic nephritis and i Keep IV Ca gluconate at nitrogen retention bedside i Hypersensitivity Nursing Management i Give 1-2 glass of H20 to reduce adverse reactions and improve therapeutic response i Warm vasopressin in your hands and mixed until it is distributed evenly in the solution i Monitor urine Sp. Gravity and I&O to aid evaluation of drug effectiveness Na HCO3 Arm and Hammer; Baking Soda Classification Alkalinizers Dosage i Metabolic Acidosis: Usually 2-5 meq/kg IV infuse over 4-8 hr period i Cardiac Arrest: 1 meq/kg IV of 7.5 or 8.4% sol, then 0.5 meq/kg IV q 10 mins depending on ABG Action Classification i Anti-convulsant i Anti-arrhythmics Dosage Arrhythmia: IV 1-6 grams over several minutes, then continuous IV infusion 3-20 mg/min for 5-48 hours. Action Decreased acetylcholine released Indication i i Restore buffering capacity of the body and neutralizes excessive acid Indication i Metabolic Acidosis i Cardiac Arrest Side Effects/Adverse Reactions i CNS: tetany i CV: edema i GI: gastric distention, belching and flatulence i Metabolic: hypokalemia, metabolic alkalosis, hypernatremia, hyperosmolarity with overdose i Skin: pain @ injection site Contraindications i Metabolic and respiratory alkalosis i Pt losing Cl because of vomiting or continuous GI suction or those

i i i i

EENT: diplopia Respiratory: respiratory paralysis Metabolic: hypocalcemia Skin: diaphoresis

receiving diuretics that produces hypochloremic alkalosis

FUROSEMIDE Lasix

MAGNESIUM SO4

Mg replacement Arrhythmia

Side Effects and Adverse Reactions i CNS: drowsiness, depressed reflexes, flaccid paralysis, hypothermia i CV: hypotension, flushing, bradycardia, circulatory collapse, depressed cardiac function

i Nursing Management Classification i Obtain blood pH, PaO2, i Loop Diuretics PaCo2 and electrolyte levels i SIVP Dosage Pulmonary edema: 40 mg IV Edema: 20 to 80 mg PO every day i in the morning HYPERTENSIVE CRISIS HPN: 40 mg PO bid. Dosage adjusted based on response i Na NITROPRUSSIDE Nittropress Action Inhibits Na and Cl reabsorption at the Action proximal and distal tubules and in the Classification Increases osmotic pressure of Antihypertensive, Vasodilator ascending loop of Henle glomerular filtrate, inhibiting tubular reabsorption of water and electrolytes; Dosage Indication drug elevates plasma osmolarity, Acute pulmonary edema 0.25-0.3 mcg/kg/minute increasing water flow into extracellular Edema fluid Action Hypertension Relaxes arteriolar and venous smooth muscle Indication Side Effects/Adverse Reactions i Test dose for marked Indication Signs of hypotension, hypokalemia and oliguria or suspected Hypertensive crisis hyperglycemia inadequate renal function To produce controlled i Oliguria Contraindications hypotension during i To induced intraocular or anesthesia Hypersensitivity intracranial pressure To reduce preload and Anuria i Diuresis in drug intoxication afterload in cardiogenic i Irrigating solution during shock TURP Nursing Management Side Effects/Adverse Reactions Side Effects/Adverse Reactions 1. Monitor wt., BP and PR CN: seizures, headache and Headache, dizziness, increased ICP, loss of 2. Monitor fluid, I&O, electrolyte, fever BUN and CO2 levels frequently consciousness, restlessness, bradycardia, i CV: edema, nausea, abdominal pain, methemoglodinemia, 3. WOF signs of hypokalemia thrombophlebitis, muscle twitching, pink-colored rash, irritation 4. Monitor uric acid levels hypotension and heart at infusion site 5. Monitor glucose levels esp in DM failure pts i EENT: blurred vision and Contraindications rhinitis Hypersensitivity i GI: thirst, dry mouth, Compensatory hypotension nausea, vomiting and Inadequate cerebral circulation NEUROSURGICAL DRUGS diarrhea Acute heart failure with reduced i GI: urine retention PVR MANNITOL i Metabolic: dehydration Congenital optic atrophy Osmitrol i Skin: local pain Tobacco-induced ambylopia i Others: chill Classification Contraindications Nursing Management i Hypersensitivity 1. Obtain VS before giving the drug Diuretics i Anuria, severe pulmonary 2. Place pt in supine Dosage congestion, frank pulmonary 3. Giving excessive doses of 500 i Test dose for marked oliguria or edema, active intracranial mcg/kg delivered faster than 2 suspected inadequate renal bleeding during craniotomy, mcg/kg/min or using max infusion function: 200 mg/kg or 12.5 gram severe dehydration, metabolic rate of 10 mcg/kg/min for more as a 15% to 20% IV solution over edema, progressive heart failure than 10 mins can cause cyanide 3-5 mins response is adequate if or pulmonary congestion after toxicity 30-50 ml of urine/hr is adequate, a drug second dose is given if still no

response after 2nd dose stop the drug Oliguria: 50 over 90 mins to several hrs To induced intraocular or intracranial pressure: 1.5-2 gram/kg as a 15 % to 20% IV solution over 30-60 min Diuresis in drug intoxication: 12.5% to 10% solutions up to 200 g IV Irrigating solution during TURP: 2.5-5%

Nursing Management i Monitor VS,CVP,I&O, renal function fluid balance and urine K levels daily. i Drug can be used to measure GFR i Do not give electrolyte free solutions with blood. If blood id given simultaneously, add at least 200 meq of NaCL to each liter

POISONING NALOXONE HCL Narcan Classification Miscellaneous antagonists and antidotes Dosage For suspected opioid induced respiratory depression: 0.4 to 2 mg IV, IM and SQ. repeat doses q 2-3 mins PRN For postoperative opiod depression: 0.01 to 0.2 mg IV q 2-3 mins, PRN. Repeat dose within 1-2 hr, if needed. Action Reverse the effects of opiods, psychotomimetic and dysphoric effects of agonist-antagonists Indication For suspected opioid induced respiratory depression For postoperative opiod depression Side Effects/Adverse Reactions CNS: seizures, tremors CV: ventricular fibrillation, tachycardia, HPN with higher recommended doses, hypotension GI: nausea and vomiting Respiratory: pulmonary edema Skin: diaphoresis Contraindications Hypersensitivity Use cautious with cardiac irritability or opiod addiction. Nursing Management

Assess respiratory status frequently Respiratory rate increases within 1-2 mins

Poisoning Side Effects Pain, melena, diarrhea, vomiting and constipation

2.

3. 4. 5.

IPECAC SYRUP Classification Antidote Dosage 25-30 ml followed immediately by H2O Action Irritates the stomach lining and stimulate the vomiting center Contraindications Cyanide, mineral acids, organic solvents, intestinal obstruction, bleeding with fructose intolerance, broken GI tract, concomitant use of charcoal with sorbitol Nursing Management Do not mix with chocolate and together with ipecac syrup Notify doctor if caused swelling or pain in the stomach

6.

Give through freely running IV infusion into large vein to minimize pain at injection site Note history of seizure or panic disorder Assess evidence of increased ICP Note evidence of sedative and benzodiazepine dependence Instruct to avoid alcohol and nonprescription drugs for 1-24 hrs

DOBUTAMINE Dobutrex Classification Adrenergic drugs

Hypersensitivity Pheochromocytoma Insulinoma Nursing Management Monitor V/S and blood sugar level Response within 20 mins after injection Side Effects

Motion sickness Cough suppression Sedation

SHOCK DOPAMINE Intropine Classification Adrenergic drugs Dosage Initially 2-5 mcg/kg/min by IV

Dosage 0.5-1 mcg/kg/min IV infusion, titrating to optimum dosage of 2-20 mcg/kg/min 2.5 to 10 mcg/kg/min-usual effective ALBUTEROL range to increase CO Ventolin Action Stimulates heart beta receptors to increase Classification myocardial contractility and SV Bronchodilator, Adrenergic

Xerostomia Urinary retention Sedation Contraindications Acute asthmatic attack Nursing Management Risk for photosensitivity- use sunscreen

Indication Dosage To increase CO 2 inhalations reputed q 4-6 hrs via neb Treatment of cardiac decompensation Indication Action Poisoning Side Effects Activation of beta adrenergic receptors on Overdose CNS: headache airway smooth muscle Action CV: HPN, tachycardia, palpitations Side Effects Stimulates dopaminergic and alpha and beta and vasoconstriction Indication Diarrhea, drowsiness, stomach cramps, FLUMAZENIL receptors of the sympathetic nervous system GI: nausea and vomiting Asthma vomiting, itching, DOB, swelling of the Romazicon resulting in positive inotropic effect and Prevention of exercise induced mouth, rash and hives increased CO Contraindications spasms Classification Hypersensitivity Contraindications Benzodiazepine receptor antagonists Indication Use cautiously in pts with hx of HPN Side effects Hypersensitivity To treat shock and correct and AMI Palpitations Given activated charcoal hemodynamic imbalances Dosage Tachycardia Unconcious To correct hypotension 2 ml IV given over 15 seconds Nursing Management GI upset Drowsy Before starting therapy, give a Nervousness Severely drunk To improve perfusion of vital Action plasma volume expander to correct Contraindications Having seizures organs Antagonizes the effects of hypovolemia and a cardiac glycoside Hypersensitivity With no gag reflex benzodiazepines Monitor ECG, BP, pulmonary artery To increase CO wedge pressure and CO Nursing Management Nursing Management Indication Monitor electrolyte levels Monitor therapeutic effectiveness 1. Don¶t administer to unconscious Side Effects Benzodiazepine-induced depression of Don¶t confuse dobutamine to Monitor HR, BP, ABG, s/sx of 2. Pt should kept active and moving CNS: headache an anxiety the ventilatory responses to dopamine bronchospasm and CNS stimulation ff administration CV: tachy, angina, palpitations and hypercapnia and hypoxia Instruct on how to use inhaler 3. If vomiting does not occur after vasoconstriction properly 2nd dose, gastric lavage may be Side Effects GI: nausea and vomiting GLUCAGON Rinse mouth after use considered to remove ingested Nausea, vomiting, palpitations, substance Contraindications Classification sweating, flushing, dry mouth, Hypersensitivity Pancreatic Hormones tremors, insomnia, dyspnea, DIPHENHYDRAMINE HCL ACTIVATED CHARCOAL With uncorrect tachyarrhythmias hyperventilation, blurred vision, Pheochromocytoma Dosage Benadryl headache, pain at injection site Ventricular Fibrillation 0.5-1 mg SQ, IV, IM, repeat in 20 mins PRN Classification Classification Contraindications Antidote Nursing Management Action Anti-histamine Control of ICP or status Most patients received less than 20 Binds with glucagon receptor Dosage epilepticus. mcg/kg/min Dosage 30-100 g with at least 8 oz of water Signs of serious cyclic Drugs isn¶t substitute for blood or fluid Indication 25-50 mg PO, IV or IM bid-tid antidepressant overdose Hypoglycemia volume deficit Action During infusion, monitor ECG, BP, CO, Action Inhibits GI absorption of toxic Nursing Management Side Effects PR and color and temp of the limbs Blocks the effects Hi receptor sites substances or irritants 1. Must individualize dosage. Give only Nausea, vomiting, hypotension, Do not confuse dopamine to Hyperosmolarity smallest amount effective. tachycardia and hypertension dobutamine Indication Check urine output often Allergic reactions Indication Contraindications