Drug Name Dosage & Route Action Indication Adverse Effects Contraindication Nursing Responsibility

DOPAMINE Shock Naturally occurring To correct hemodynamic CV: Hypotension, Pheochromocytoma; Assessment & Drug
HYDROCHLORIDE Adult/Child: IV 2–5 neurotransmitter and imbalance in shock ectopic beats, tachyarrhythmias or Effects
(doe'pa-meen) mcg/kg/min increased immediate precursor of syndrome due to MI tachycardia, anginal pain, ventricular fibrillation.
gradually up to 20–50 norepinephrine. Major (cardiogenic shock), palpitation, Safe use during
cardiovascular effects trauma, endotoxic pregnancy (category C),  Monitor blood
Dopastat, Intropin, mcg/kg/min if necessary vasoconstriction pressure, pulse,
produced by direct action septicemia (septic shock), (indicated by lactation, or children is
Revimine  on alpha- and beta- open heart surgery, and not established. peripheral pulses, and
Renal Failure disproportionate rise in urinary output at
Adult: IV 2–5 adrenergic receptors and CHF.
diastolic pressure), cold intervals prescribed
Classifications: on specific dopaminergic
mcg/kg/min extremities; less
AUTONOMIC NERVOUS receptors in mesenteric by physician. Precise
frequent: aberrant
SYSTEM AGENT; and renal vascular beds. measurements are
conduction, bradycardia, essential for accurate
ALPHA- AND BETA- widening of QRS
ADRENERGIC titration of dosage.
complex, elevated blood  Report the
AGONIST pressure. GI: Nausea,
(SYMPATHOMIMETIC) following indicators
vomiting. CNS: promptly to physician
Headache. Skin: for use in decreasing
Necrosis, tissue sloughing or temporarily
with extravasation, suspending dose:
gangrene, piloerection. Reduced urine flow
Other: Azotemia, rate in absence of
dyspnea, dilated pupils hypotension;
(high doses). ascending
tachycardia;
dysrhythmias;
disproportionate rise
in diastolic pressure
(marked decrease in
pulse pressure); signs
of peripheral ischemia
(pallor, cyanosis,
mottling, coldness,
complaints of
tenderness, pain,
numbness, or burning
sensation).
 Monitor
therapeutic
effectiveness. In
addition to
improvement in vital
signs and urine flow,
other indices of
adequate dosage and
perfusion of vital
organs include loss of
pallor, increase in toe
 temperature,
adequacy of nail bed
capillary filling, and
reversal of confusion
or comatose state.

Drug Name Dosage & Route Action Indication Adverse Effects Contraindication Nursing Responsibility
 Bronchospasm Synthetic Pregnancy (category
ALBUTEROL Adult: PO 2–4 mg 3–4 sympathomimetic To relieve Body as a Whole: C), lactation. Use of Assessment & Drug
(al-byoo'ter-ole)) times/d, 4–8 mg amine and moderately bronchospasm Hypersensitivity oral syrup in children Effects
sustained release 2 selective beta2- associated with acute reaction. CNS: <2 y.
Accuneb, times/d Inhaled 1–2 adrenergic agonist or chronic asthma, Tremor, anxiety,
 Monitor
Novosalmol , inhalations q4–6h with comparatively bronchitis, or other nervousness,
therapeutic
Proventil, Proventil Child: PO 2–6 y, 0.1– long action. Acts more reversible obstructive restlessness,
airway diseases. Also effectiveness
HFA, Proventil 0.2 mg/kg t.i.d. (max: prominently on beta2 convulsions,
used to prevent which is
Repetabs, 4 mg/dose); 6–12 y, 2 receptors (particularly weakness, headache,
exercise-induced indicated by
Salbutamol, Ventolin, mg 3–4 times/d; smooth muscles of hallucinations. CV:
bronchospasm. significant
Ventolin Rotocaps, Inhaled 6–12 y, 1–2 bronchi, uterus, and Palpitation,
subjective
Volmax inhalations q4–6h vascular supply to hypertension,
improvemen
skeletal muscles) than hypotension,
t in
Classifications: on beta1 (heart) bradycardia, reflex
pulmonary
autonomic nervous receptors. Minimal or tachycardia. Special
function
system agent; beta- no effect on alpha- Senses: Blurred vision,
within 60–90
adrenergic agonist adrenergic receptors. dilated pupils. GI:
min after
(sympathomimetic); Inhibits histamine Nausea, vomiting.
drug
bronchodilator release by mast cells. Other: Muscle cramps,
administrati
(respiratory smooth hoarseness.
on.
muscle relaxant)
 Monitor for:
S&S of fine
tremor in
fingers,
which may
interfere
with
precision
handwork;
CNS
stimulation,
particularly
in children
2–6 y,
(hyperactivit
y,
excitement,
nervousness,
insomnia),
tachycardia,
 GI
symptoms.
Report
promptly to
physician.
 Lab tests:
Periodic
ABGs,
pulmonary
functions,
and pulse
oximetry.
 Consult
physician
about giving
last albuterol
dose several
hours before
bedtime, if
drug-
induced
insomnia is a
problem.
 Drug Name Dosage & Route Action Indication Adverse Effects Contraindication Nursing Responsibility

EPINEPHRINE Anaphylaxis Naturally occurring Temporary relief of Special Senses: Nasal Hypersensitivity to Assessment & Drug
(ep-i-ne'frin) Adult: SC 0.1–0.5 mL of catecholamine obtained bronchospasm, acute burning or stinging, sympathomimetic Effects
1:1000 q10–15min from animal adrenal asthmatic attack, mucosal dryness of nasal mucosa, amines; narrow-angle
Bronkaid Mist, Epi-E- prn IV 0.1–0.25 mL of glands; also prepared congestion, sneezing, rebound glaucoma; hemorrhagic,
1:1000 q10–15min synthetically. Acts hypersensitivity and congestion. Transient traumatic, or cardiogenic  Monitor BP, pulse,
Zpen, Epinephrine
Child: SC 0.01 mL/kg of, directly on both alpha anaphylactic reactions, stinging or burning of shock; cardiac dilatation, respirations, and
Pediatric, EpiPen Auto-
Injector, Primatene 1:1000 q10–15min and beta receptors; the syncope due to heart eyes, lacrimation, cerebral arteriosclerosis, urinary output and
Mist Suspension prn IV 0.01 mL/kg of most potent activator of block or carotid sinus browache, headache, coronary insufficiency, observe patient
1:1000 q10–15min alpha receptors. hypersensitivity, and to rebound conjunctival arrhythmias, organic closely following IV
Classifications: Neonate: IV Strengthens myocardial restore cardiac rhythm in hyperemia, allergy, iritis; heart or brain disease; administration.
AUTONOMIC NERVOUS Intratracheal 0.01–0.03 contraction; increases cardiac arrest. with prolonged use: during second stage of Epinephrine may
SYSTEM AGENT; mg/kg (0.1–0.3 mL/kg of systolic but may decrease Ophthalmic preparation melanin-like deposits on labor; for local anesthesia widen pulse pressure.
diastolic blood pressure; is used in management of of fingers, toes, ears, If disturbances in
ALPHA- AND BETA- 1:10,000) q3–5min prn lids, conjunctiva, and
increases cardiac rate and simple (open-angle) nose, genitalia. Safety cardiac rhythm occur,
ADRENERGIC cornea; corneal edema;
cardiac output. glaucoma, generally as an during pregnancy withhold epinephrine
AGONIST; Cardiac Arrest loss of lashes
adjunct to topical miotics (category C) or lactation and notify physician
BRONCHODILATOR Adult: IV 0.1–1 mg (1–10 (reversible);
and oral carbonic is not established. immediately.
mL of 1:10,000) q5min as maculopathy with central
anhydrase inhibitors; also  Keep physician
needed Intracardiac scotoma in aphakic
used as ophthalmic
0.1–1 mg patients (reversible). informed of any
decongestant. Relaxes
Child: IV 0.01 mg/kg (0.1 Body as a Whole: changes in intake-
myometrium and inhibits
mL/kg of 1:10,000) uterine contractions; Nervousness, output ratio.
q5min as prolongs action and restlessness,  Use cardiac
needed Intracardiac delays systemic sleeplessness, fear, monitor with patients
0.05–0.1 mg/kg absorption of local and anxiety, tremors, severe receiving epinephrine
intraspinal anesthetics. headache, IV. Have full crash
Asthma Used topically to control cerebrovascular accident, cart immediately
Adult: SC 0.1–0.5 mL of superficial bleeding. weakness, dizziness, available.
1:1000 q20min– syncope, pallor,  Check BP
4h Inhalation 1 sweating, dyspnea. repeatedly when
inhalation q4h prn Digestive: Nausea, epinephrine is
Child: SC 0.01 mL/kg of vomiting. administered IV
1:1000 q20min– Cardiovascular: during first 5 min,
4h Inhalation 1 Precordial pain, then q3–5min until
inhalation q4h prn palpitations, stabilized.
hypertension, MI,  Advise patient to
tachyarrhythmias report to physician if
including ventricular symptoms are not
fibrillation. relieved in 20 min or
Respiratory: Bronchial if they become worse
and pulmonary edema. following inhalation.
Urogenital: Urinary  Advise patient to
retention. Skin: Tissue report bronchial
necrosis with repeated irritation,
injections. Metabolic: nervousness, or
Metabolic acidoses, sleeplessness. Dosage
elevated serum lactic should be reduced.
acid, transient elevations  Monitor blood
of blood glucose. glucose & HbA1c for
Nervous System: loss of glycemic
Altered state of control if diabetic.
perception and thought,
psychosis.
 Drug Name Dosage & Route Action Indication Adverse Effects Contraindication Nursing Responsibility

ATROPINE SULFATE Preanesthesia Acts by selectively Adjunct in symptomatic Hypersensitivity to Assessment & Drug
(a'troe-peen) Adult: IV/IM/SC 0.2–1 blocking all muscarinic treatment of GI disorders CNS: Headache, ataxia, belladonna alkaloids; Effects
mg 30–60 min before responses to (e.g., peptic ulcer, dizziness, excitement, synechiae; angle-closure
Atropair , Atropisol, surgery acetylcholine (ACh), pylorospasm, GI irritability, convulsions, glaucoma; parotitis;
Child: IV/IM/SC <5 kg, whether excitatory or hypermotility, irritable drowsiness, fatigue, obstructive uropathy,  Monitor vital signs.
Isopto Atropine
0.02 mg/kg; >5 kg, 0.01– inhibitory. Selective bowel syndrome) and weakness; mental e.g., bladder neck HR is a sensitive
0.02 mg/kg 30–60 min depression of CNS spastic disorders of depression, confusion, obstruction caused by indicator of patient's
Classifications: before surgery relieves rigidity and biliary tract. Relaxes disorientation, prostatic hypertrophy; response to atropine.
AUTONOMIC NERVOUS Arrhythmias tremor of Parkinson's upper GI tract and colon hallucinations. CV: intestinal atony, paralytic Be alert to changes in
SYSTEM AGENT; Adult: IV/IM 0.5–1 mg syndrome. Antisecretory during hypotonic Hypertension or ileus, obstructive diseases quality, rate, and
ANTICHOLINERGIC q1–2h prn (max: 2 mg) action (vagolytic effect) radiography. Ophthalmic hypotension, ventricular of GI tract, severe rhythm of HR and
(PARA- Child: IV/IM 0.01–0.03 suppresses sweating, Use: To produce tachycardia, palpitation, ulcerative colitis, toxic respiration and to
SYMPATHOLYTIC); mg/kg for 1–2 doses lacrimation, salivation, mydriasis and paradoxical bradycardia, megacolon; tachycardia changes in BP and
ANTIMUSCARINIC cycloplegia before secondary to cardiac temperature.
Organophosphate and secretions from AV dissociation, atrial or
refraction and for insufficiency or  Initial paradoxical
Antidote nose, mouth, pharynx, ventricular fibrillation.
treatment of anterior thyrotoxicosis; acute bradycardia following
Adult: IV/IM 1–2 mg and bronchi. Blocks vagal GI: Dry mouth with hemorrhage; myasthenia
uveitis and iritis. IV atropine usually
q5–60min until impulses to heart with thirst, dysphagia, loss of gravis. Safety during
Preoperative Use: To lasts only 1–2 min; it
muscarinic signs and resulting decrease in AV suppress salivation, taste; nausea, vomiting, pregnancy (category C)
symptoms subside (may conduction time, constipation, delayed most likely occurs
perspiration, and or lactation is not
need up to 50 mg) increase in heart rate gastric emptying, antral when IV is
respiratory tract established.
Child: IV/IM 0.05 and cardiac output, and secretions; to reduce stasis, paralytic ileus. administered slowly
mg/kg q10–30 min until shortened PR interval. incidence of Urogenital: Urinary (more than 1 min) or
muscarinic signs and laryngospasm, reflex hesitancy and retention, when small doses (less
symptoms subside bradycardia arrhythmia, dysuria, impotence. than 0.5 mg) are used.
COPD and hypotension during Skin: Flushed, dry skin; Postural hypotension
Adult: Inhalation general anesthesia. anhidrosis, rash, occurs when patient
0.025 mg/kg diluted with Cardiac Uses: For sinus urticaria, contact ambulates too soon
3–5 mL saline, via bradycardia or asystole dermatitis, allergic after parenteral
nebulizer 3–4 times daily during CPR or that is conjunctivitis, fixed-drug administration.
induced by drugs or toxic  Note: Frequent and
(max: 2.5 mg/d) eruption. Special
substances (e.g., continued use of eye
Child: Inhalation 0.03– Senses: Mydriasis,
pilocarpine, beta- preparations, as well
0.05 mg/kg diluted with adrenergic blockers, blurred vision,
3–5 mL saline, via photophobia, increased as overdosage, can
organophosphate have systemic effects.
nebulizer 3–4 times daily pesticides, and Amanita intraocular pressure,
Uveitis cycloplegia, eye dryness, Some atropine deaths
mushroom poisoning);
Adult/Child: local redness. have resulted from
for management of
Ophthalmic 1–2 drops systemic absorption
selected patients with
of solution or small symptomatic sinus following ocular
amount of ointment in bradycardia and administration in
eye up to t.i.d. associated hypotension infants and children.
and ventricular
irritability; for diagnosis Monitor I&O,
of sinus node dysfunction especially in older
and in evaluation of
adults and patients
coronary artery disease
 during atrial pacing who have had surgery
(drug may contribute
to urinary retention).
Palpate lower
abdomen for
distention. Have
patient void before
giving atropine.

Drug Name Dosage & Route Action Indication Adverse Effects Contraindication Nursing Responsibility

GENTAMICIN Moderate to Severe Special Senses:

SULFATE Infection Ototoxicity (vestibular History of
(jen-ta-mye'sin) Adult: IV/IM 1.5–2 mg/kg disturbances, impaired hypersensitivity to or
Broad-spectrum Parenteral use restricted Assessment & Drug
loading dose followed by aminoglycoside antibiotic to treatment of serious hearing), optic neuritis. toxic reaction with any Effects
Garamycin, Garamycin 3–5 mg/kg/d in 2–3 derived from infections of GI, CNS: neuromuscular aminoglycoside
Ophthalmic, Genoptic divided doses Intrathecal Micromonospora respiratory, and urinary blockade: skeletal muscle antibiotic. Safe use
4–8 mg preservative free purpurea. Action is tracts, CNS, bone, skin, weakness, apnea, during pregnancy  Lab tests: Perform
q.d. Topical 1–2 drops of usually bacteriocidal. and soft tissue (including respiratory paralysis (category C) or lactation C&S and renal
Classifications: function prior to first
solution in eye q4h up to burns) when other less (high doses); is not established
ANTIINFECTIVE; 2 drops q1h or small toxic antimicrobial agents arachnoiditis (intrathecal dose and periodically
AMINOGLYCOSIDE amount of ointment are ineffective or are use). CV: hypotension or during therapy;
ANTIBIOTIC b.i.d. or t.i.d. contraindicated. Has been hypertension. GI: therapy may begin
Child: IV/IM 6–7.5 used in combination with Nausea, vomiting, pending test results.
mg/kg/d in 3–4 divided other antibiotics. Also transient increase in AST, Determine creatinine
doses Intrathecal >3 mo, used topically for ALT, and serum LDH and clearance and serum
1–2 mg preservative free primary and secondary bilirubin; hepatomegaly, drug concentrations
q.d. skin infections and for splenomegaly. at frequent intervals,
superficial infections of particularly for
Neonate: IV/IM 2.5 Hematologic:
external eye and its patients with
mg/kg q12–24h Increased or decreased
adnexa. impaired renal
reticulocyte counts;
Acute Pelvic granulocytopenia, function, infants
Inflammatory thrombocytopenia (renal immaturity),
Disease (fever, bleeding older adults, patients
Adult: IV/IM 2 mg/kg tendency), receiving high doses
followed by 1.5 mg/kg thrombocytopenic or therapy beyond 10
q8h purpura, anemia. Body d, patients with fever
as a Whole: or extensive burns,
Prophylaxis of Hypersensitivity (rash, edema, obesity.
Bacterial pruritus, urticaria,  Repeat C&S if
Endocarditis exfoliative dermatitis, improvement does
Adult: IV/IM 1.5 mg/kg eosinophilia, burning not occur in 3–5 d;
30 min before sensation of skin, drug reevaluate therapy.
procedure, may repeat in fever, joint pains,  Note: Dosages are
8h laryngeal edema, generally adjusted to
Child: IV/IM < 27 kg, 2 anaphylaxis). maintain peak serum
mg/kg 30 min before Urogenital: gentamicin
procedure, may repeat in Nephrotoxicity: concentrations of 4–
8h proteinuria, tubular 10 g/mL, and trough
necrosis, cells or casts in concentrations of 1–2
urine, hematuria, rising g/mL. Peak
BUN, nonprotein concentrations above
nitrogen, serum 12 g/mL and trough
creatinine; decreased concentrations above
creatinine clearance. 2 g/mL are associated
Other: Local irritation with toxicity.
and pain following IM  Draw blood
use; thrombophlebitis, specimens for peak
abscess, superinfections, serum gentamicin
syndrome of concentration 30
hypocalcemia (tetany, min–1h after IM
weakness, hypokalemia, administration, and
hypomagnesemia). 30 min after
completion of a 30–
60 min IV infusion.
Draw blood
specimens for trough
levels just before the
next IM or IV dose.
Use nonheparinized
tubes to collect blood.