DRUG STUDY OF AMINOPHYLLINE

DRUG FEATURES MECHANISM

OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Aminophylline

Brand name:
Phil
Pharmawealth/Atlantic
Aminophylline amp
TheoIil amp

Classification:
Antiasthmatic &
COPD Preparations

Dosage:
Initial: 225-450 mg
twice daily, increased
iI needed



Increases the
level oI cAMP
resulting in
bronchodilation
Chronic
bronchospasm
as hydrate

Nausea,
vomiting,
abdominal
pain, diarrhea,
headache,
insomnia,
dizziness,
anxiety,
restlessness;
tremor,
palpitations.

Potentially
Fatal.
Convulsions,
cardiac
arrhythmias,
hypotension
and sudden
death aIter too
rapid IV
injection.

Administer to pregnant
patients only when clearly
neededneonatal tachycardia,
jitteriness, and withdrawal
apnea observed when mothers
received xanthines up until
delivery.
Caution patient not to chew or
crush enteric-coated timed-
release Iorms.
Give immediate-release, liquid
dosage Iorms with Iood iI GI
eIIects occur.
Do not give timed-release
Iorms with Iood; these should
be given on an empty stomach 1
hr beIore or 2 hr aIter meals.
Maintain adequate hydration.
Monitor results oI serum
theophylline levels careIully,
and arrange Ior reduced dosage
iI serum levels exceed
therapeutic range oI 1020
mcg/mL.
Take serum samples to
determine peak theophylline
concentration drawn 1530 min
aIter an IV loading dose.
Monitor Ior clinical signs oI
adverse eIIects, particularly iI
serum theophylline levels are
not available.
Ensure that diazepam is
readily available to treat
seizures.
Take this drug exactly as
prescribed; iI a timed-release
product is prescribed, take this
drug on an empty stomach, 1 hr
beIore or 2 hr aIter meals.
Do not to chew or crush
timed-release preparations.
Administer rectal solution or
suppositories aIter emptying the
rectum.
It may be necessary to take
this drug around the clock Ior
adequate control oI asthma
attacks.
Avoid excessive intake oI
coIIee, tea, cocoa, cola
beverages, chocolate.
Smoking cigarettes or other
tobacco products impacts the
drug's eIIectiveness. Try not to
smoke. NotiIy the care provider
iI smoking habits change while
taking this drug.
Frequent blood tests may be
necessary to monitor the eIIect
oI this drug and to ensure saIe
and eIIective dosage; keep all
appointments Ior blood tests
and other monitoring.
These side eIIects may occur:
Nausea, loss oI appetite (taking
this drug with Iood may help iI




taking the immediate-release or
liquid dosage Iorms); diIIiculty
sleeping, depression, emotional
lability (reversible).
Report nausea, vomiting,
severe GI pain, restlessness,
seizures, irregular heartbeat

DRUG STUDY OF AMIODARONE HYDROCHLORIDE
DRUG FEATURES MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
AMIODARONE
HYDROCHLORIDE
Brand name:
Anoion tab
Cordarone
Cordarone inj
Sandoz Amiodarone
HCl tab

ClassiIication:
Cardiac Drugs


Dosage:
PO Initial: 200 mg 3
times/day Ior 1 wk,
reduce to 200 mg
twice daily Ior a
Iurther wk.

Form:

Route:

Frequency:

Blocks
potassium
chloride leading
to prolongation
oI action
potential
duration.
Ventricular and
supraventricular
arrhythmias.

: Blue-grey
discoloration oI
skin,
photosensitivity,
peripheral
neuropathy,
paraesthesia,
myopathy,
ataxia, tremor,
nausea,
vomiting,
metallic taste,
hypothyroidism,
hyperthyroidism,
alopecia, sleep
disturbances,
corneal
microdeposits,
hot Ilushes,
sweating. Heart
block,
bradycardia,
sinus arrest,
hepatotoxicity,
heart Iailure.

Potentially Fatal:
Pulmonary
toxicity
including
Monitor cardiac rhythm
continuously.
Monitor Ior an extended
period when dosage adjustments
are made.
Monitor Ior saIe and eIIective
serum levels (0.52.5 mcg/mL).
Doses oI digoxin, quinidine,
procainamide, phenytoin, and
warIarin may need to be
reduced one-third to one-halI
when amiodarone is started.
Give drug with meals to
decrease GI problems.
Arrange Ior ophthalmologic
exams; reevaluate at any sign oI
optic neuropathy.
Arrange Ior periodic chest x-
ray to evaluate pulmonary status
(every 36 mo).
Arrange Ior regular periodic
blood tests Ior liver enzymes,
thyroid hormone levels.
Drug dosage will be changed
in relation to response oI
arrhythmias; you will need to be
hospitalized during initiation oI
drug therapy; you will be
closely monitored when dosage
is changed.
pulmonary
Iibrosis and
interstitial
pneumonitis,
hepatotoxicity,
thyrotoxicity.
Ventricular
arrhythmias,
pulmonary
alveolitis,
exacerbation oI
arrhythmias and
rare serious liver
injury. Generally
in patients with
high doses and
having
preexisting
abnormalities oI
diIIusion
capacity.

Have regular medical Iollow-
up, monitoring oI cardiac
rhythm, chest x-ray, eye exam,
blood tests.
These side eIIects may occur:
Changes in vision (halos, dry
eyes, sensitivity to light; wear
sunglasses, monitor light
exposure); nausea, vomiting,
loss oI appetite (take with
meals; eat small, Irequent
meals); sensitivity to the sun
(use a sunscreen or protective
clothing when outdoors);
constipation (a laxative may be
ordered); tremors, twitching,
dizziness, loss oI coordination
(do not drive, operate dangerous
machinery, or undertake tasks
that require coordination until
drug eIIects stabilize and your
body adjusts to it).
Report unusual bleeding or
bruising; Iever, chills;
intolerance to heat or cold;
shortness oI breath, diIIiculty
breathing, cough; swelling oI
ankles or Iingers; palpitations;
diIIiculty with vision.





DRUG STUDY OF ATROPINE SULFATE

DRUG FEATURES MECHANISM
OF ACTION
INDICATION
S
CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Atropine SulIate

Brand name:
Anespin amp Atropol
amp Euro-Med
Atropine SulIate amp
Isopto Atropine eye
drops Phil
Pharmawealth/Atlantic
Atropine amp

Classification:
Cardiovascular Drugs,
Muscle Relaxants,
Mydriatic Drugs,
Antidotes, DetoxiIying
Agents & Drugs Used
in Substance
Dependence

Dosage:
IV Bradycardia 500
mcg every 3-5 mins.
Total: 3 mg. IV/IM
Organophosphorus
poisoning 2 mg every
10-30 mins until
muscarinic eIIects
An anti-
cholinergic that
inhibits
acetylcholine at
the
parasympathetic
neuroeIIector
junction,
enhances the
conduction oI
AV node and
increases heart
rate
Bradycardia
Organophospho
rus poisoning
Dry mouth,
dysphagia,
constipation,
Ilushing and
dryness oI skin,
tachycardia,
palpitations,
arrhythmias,
mydriasis,
photophobia,
cycloplegia,
raised
intraocular
pressure.

Toxic doses
cause
tachycardia,
hyperpyrexia,
restlessness,
conIusion,
excitement,
hallucinations,
delirium and
may progress to
circulatory
Iailure and
respiratory
depression. Eye
Ensure adequate hydration;
provide environmental control
(temperature) to prevent
hyperpyrexia.
Have patient void beIore
taking medication iI urinary
retention is a problem.
When used preoperatively or
in other acute situations,
incorporate teaching about the
drug with teaching about the
procedure; the ophthalmic
solution is used mainly acutely
and will not be selI-
administered by the patient;
the Iollowing apply to oral
medication Ior outpatients:
Take as prescribed, 30 min
beIore meals; avoid excessive
dosage.
Avoid hot environments; you
will be heat intolerant, and
dangerous reactions may
occur.
These side eIIects may
occur: Dizziness, conIusion
(use caution driving or
perIorming hazardous tasks);
constipation (ensure adequate
disappear or atropine
toxicity appears.

Form:

Route:

Frequency:

drops:

Systemic
toxicity
especially in
children, on
prolonged use
may lead to
irritation,
hyperemia,
edema and
conjunctivitis.
Increased
intraocular
pressure.

Inhalation:
Dryness oI
mouth, throat.

Potentially
Fatal.
Atrial
arrhythmias,
AV
dissociation,
multiple
ventricular
ectopics.

Iluid intake, proper diet); dry
mouth (suck sugarless
lozenges; perIorm Irequent
mouth care; may be transient);
blurred vision, sensitivity to
light (reversible; avoid tasks
that require acute vision; wear
sunglasses in bright light);
impotence (reversible);
diIIiculty in urination (empty
the bladder prior to taking
drug).
Report rash; Ilushing; eye
pain; diIIiculty breathing;
tremors, loss oI coordination;
irregular heartbeat,
palpitations; headache;
abdominal distention;
hallucinations; severe or
persistent dry mouth; diIIiculty
swallowing; diIIiculty in
urination; constipation;
sensitivity to light.






DRUG STUDY OF BUMETANIDE

DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Bumetanide

Brand name:
Burinex amp
Burinex tab

Classification:
SulIonamide
Diuretics

Dosage:


Form:

Route:

Frequency:

Inhibits Sodium
and Chloride
reabsorption at
the ascending
loop oI Henle

Contraindicated
with patiens who
are sensitive to
the drug
Muscle cramps,
dizziness,
hypotension,
headache,
nausea, impaired
hearing, pruritus,
ECG changes,
musculoskeletal
pain, rash, chest
discomIort, renal
Iailure,
premature
ejaculation,
thrombocytopeni
a, hypokalemia,
hypomagnesaem
ia,
hyponatremia,
hyperuricemia,
hyperglycemia,
hypocalcaemia.

Give with Iood or milk to
prevent GI upset.
Mark calendars or use
reminders iI intermittent
therapy is best Ior treating
edema.
Give single dose early in day
so increased urination will not
disturb sleep.
Avoid IV use iI oral use is
possible.
Arrange to monitor serum
electrolytes, hydration, liver
Iunction during long-term
therapy.
Provide diet rich in potassium
or supplemental potassium.
Record alternate day or
intermittent therapy on a
calendar or dated envelopes.
Take the drug early in day so
increased urination will not
disturb sleep; take with Iood or
meals to prevent GI upset.
Weigh yourselI on a regular
basis, at the same time, and in
the same clothing; record the
weight on your calendar.
These side eIIects may occur:
Increased volume and
Irequency oI urination;
dizziness, Ieeling Iaint on
arising, drowsiness (avoid rapid
position changes; hazardous
activities, such as driving; and
alcohol consumption);
sensitivity to sunlight (use
sunglasses, sunscreen, wear
protective clothing); increased
thirst (suck sugarless lozenges;
use Irequent mouth care); loss
oI body potassium (a
potassium-rich diet, or
supplement will be needed).
Report weight change oI more
than 3 lb in 1 day; swelling in
ankles or Iingers; unusual
bleeding or bruising; nausea,
dizziness, trembling, numbness,
Iatigue; muscle weakness or
cramps.





DRUG STUDY OF CALCIUM GLUCONATE
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Calcium gluconate

Brand name:


Classification:
Electrolytes


Dosage:
Electrolytes: PO
10-50 mmol/day.

Form:
Liquid

Route:
Per Orem

Frequency:

replaces
Calcium and
maintains
Calcium level

Hypocalcaemia
Antidote in severe
hypermagnesaemi
a; Severe
hyperkalaemia
Contraindicated
with patients who
has
hypersensitivity
in the drug
GI irritation;
soIt-tissue
calciIication,
skin sloughing or
necrosis aIter
IM/SC inj.
Hypercalcaemia
characterised by
anorexia, nausea,
vomiting,
constipation,
abdominal pain,
muscle
weakness,
mental
disturbances,
polydipsia,
polyuria,
nephrocalcinosis,
renal calculi;
chalky taste, hot
Ilushes and
peripheral
vasodilation.

Potentially
Fatal.
Cardiac
arrhythmias and
coma.

Make sure prescriber
speciIies Iorm oI calcium to be
given; crash carts may contain
both calcium gluconate and
calcium chloride.
Tell patient to take oral
calcium 1 to 11/2 hours aIter
meals iI GI upset occurs.
Give I.M. injection in gluteal
region in adults and in lateral
thigh in inIants. Use I.M. route
only in emergencies when no
I.V. route is available bec. oI
irritation oI tissue by calcium
salts.
Tell patient to take oral
calcium with a Iull glass oI
water.
Monitor calcium levels
Irequently. Hypercalcemia
may result aIter large doses in
chronic renal Iailure. Report
abnormalities.
DRUG STUDY OF CAPTOPRIL
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Captopril

Brand name:
Ace-Bloc

Classification:
ACE Inhibitors


Dosage:
12.5 mg

Form:tablet

Route:
PO

Frequency:
BID
ACE, reduces
Sodium and
water retention,
lowers blood
pressure


Hypertension
Heart Iailure
Contraindicated
to patients who
is hypersensitive
to the drug
Adverse
Reactions:
Hypotension,
tachycardia,
chest pain,
palpitations,
pruritus,
hyperkalaemia.
Proteinuria;
angioedema,
skin rashes; taste
disturbance,
nonproductive
cough, headache.

Potentially
Fatal.
Neutropenia,
usually occurs
within 3 mth oI
starting therapy
especially in
patients with
renal dysIunction
or collagen
diseases.
Hyperkalaemia.
Anaphylactic
reactions.


Administer 1 hr beIore or 2 hr
aIter meals.
Alert surgeon and mark
patient's chart with notice that
captopril is being taken; the
angiotensin II Iormation
subsequent to compensatory
renin release during surgery
will be blocked; hypotension
may be reversed with volume
expansion.
Monitor patient closely Ior Iall
in BP secondary to reduction in
Iluid volume (excessive
perspiration and dehydration,
vomiting, diarrhea); excessive
hypotension may occur.
Reduce dosage in patients
with impaired renal Iunction.
Take drug 1 hr beIore or 2 hr
aIter meals; do not take with
Iood. Do not stop without
consulting your health care
provider.
Be careIul oI drop in blood
pressure (occurs most oIten
with diarrhea, sweating,
vomiting, dehydration); iI light-
headedness or dizziness occurs,
consult your health care
provider.
Avoid over-the-counter
medications, especially cough,
cold, allergy medications that
may contain ingredients that
will interact with ACE
inhibitors. Consult your health
care provider.
These side eIIects may occur:
GI upset, loss oI appetite,
change in taste perception
(limited eIIects, will pass);
mouth sores (perIorm Irequent
mouth care); rash; Iast heart
rate; dizziness, light-headedness
(usually passes aIter the Iirst
Iew days; change position
slowly, and limit your activities
to those that do not require
alertness and precision).
Report mouth sores; sore
throat, Iever, chills; swelling oI
the hands, Ieet; irregular
heartbeat, chest pains; swelling
oI the Iace, eyes, lips, tongue,
diIIiculty breathing.




DRUG STUDY OF CLONIDINE
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Clonidine

Brand name:
Catapres

Classification:
Other
Antihypertensives

Dosage: 50-100
mcg


Form:Tablet

Route:PO

Frequency: TID

Stimulates
alpha 2
receptors and
inhibits central
vasomotor
centers, lowers
peripheral
vascular
resistance,
blood pressure,
and heart rate


Hypertension
Menopausal
Ilushing;
Migraine
prophylaxis
Contraindicated
with patient who
is hypersensitive
to the drug.
Dry mouth,
drowsiness,
dizziness,
headache,
constipation,
impotence, vivid
dreams, urinary
retention; dry,
itching, burning
sensation in the
eye; Iluid or
electrolyte
imbalance, GI
upset, paralytic
ileus, orthostatic
hypotension,
weakness,
sedation,
pruritus,
myalgia,
urticaria, nausea,
insomnia,
arrhythmias,
agitation.
Reduced GI
motility at times
may cause
paralytic ileus.



Take drug 1 hr beIore or 2 hr
aIter meals; do not take with
Iood. Do not stop without
consulting your health care
provider.
Be careIul oI drop in blood
pressure (occurs most oIten
with diarrhea, sweating,
vomiting, dehydration); iI light-
headedness or dizziness occurs,
consult your health care
provider.
Avoid over-the-counter
medications, especially cough,
cold, allergy medications that
may contain ingredients that
will interact with ACE
inhibitors. Consult your health
care provider.
These side eIIects may occur:
GI upset, loss oI appetite,
change in taste perception
(limited eIIects, will pass);
mouth sores (perIorm Irequent
mouth care); rash; Iast heart
rate; dizziness, light-headedness
(usually passes aIter the Iirst
Iew days; change position
slowly, and limit your activities
to those that do not require
alertness and precision).
Potentially
Fatal.
Transient
hypertension or
proIound
hypotension,
respiratory
depression,
convulsion.
Clonidine
withdrawal
syndrome could
be liIe
threatening.
Bradycardia,
coma and
disturbances in
conduction (in
individuals with
preexisting
diseases oI
SA/AV nodes,
overdose or on
digitalis).

Report mouth sores; sore
throat, Iever, chills; swelling oI
the hands, Ieet; irregular
heartbeat, chest pains; swelling
oI the Iace, eyes, lips, tongue,
diIIiculty breathing.
Take this drug exactly as
prescribed. Do not miss doses.
Do not discontinue the drug
unless so instructed. Do not
discontinue abruptly; liIe-
threatening adverse eIIects may
occur. II you travel, take an
adequate supply oI drug.
Use the transdermal system as
prescribed; reIer to directions in
package insert, or contact your
health care provider with
questions. Be sure to remove
old systems beIore applying
new ones.
Attempt liIestyle changes that
will reduce your BP: stop
smoking and using alcohol; lose
weight; restrict intake oI
sodium (salt); exercise
regularly.
Use caution with alcohol.
Your sensitivity may increase
while using this drug.
These side eIIects may occur:
Drowsiness, dizziness, light-
headedness, headache,
weakness (oIten transient;
observe caution driving or
perIorming other tasks that
require alertness or physical
dexterity); dry mouth (suck on
sugarless lozenges or ice chips);
GI upset (eat small, Irequent
meals); dreams, nightmares
(reversible); dizziness, light-
headedness when you change
position (get up slowly; use
caution climbing stairs);
impotence, other sexual
dysIunction, decreased libido
(discuss with care providers);
breast enlargement, sore
breasts; palpitations.
Report urinary retention,
changes in vision, blanching oI
Iingers, rash.




DRUG STUDY OF DIAZEPAM

DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Diazepam

Brand name:
Valium

Classification:
Anxiolytics

Dosage:
10mg/2ml

Form:

Route:

Frequency:

A benzo
diazepine that
probably
potentiates the
eIIects oI
GABA,
depresses the
CNS &
suppresses the
spread oI
seizure activity
RelieI oI
anxiety,
agitation &
tension due to
psychoneurotic
states &
transient
situational
disturbances
Drowsiness,
dysarthria, slurred
speech, tremor,
transient amnesia,
Iatigue, ataxia,
headache,
insomnia,
paradoxical
anxiety,
hallucination


Do not administer intra-
arterially; may produce
arteriospasm, gangrene.
Change Irom IV therapy to
oral therapy as soon as
possible.
Do not use small veins
(dorsum oI hand or wrist) Ior
IV injection.
Reduce dose oI narcotic
analgesics with IV diazepam;
dose should be reduced by at
least one-third or eliminated.
CareIully monitor P, BP,
respiration during IV
administration.
Maintain patients receiving
parenteral benzodiazepines in
bed Ior 3 hr; do not permit
ambulatory patients to operate
a vehicle Iollowing an
injection.
Monitor EEG in patients
treated Ior status epilepticus;
seizures may recur aIter initial
control, presumably because oI
short duration oI drug eIIect.
Monitor liver and kidney
Iunction, CBC during long-
term therapy.
Taper dosage gradually aIter
long-term therapy, especially
in epileptic patients.
Arrange Ior epileptic patients
to wear medical alert ID
indicating that they are
epileptics taking this
medication.
Discuss risk oI Ietal
abnormalities with patients
desiring to become pregnant.




DRUG STUDY OF DIPENHYDRAMINE

DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Dipenhydramine

Brand name:
Benadryl



Classification:
Antihistamine

Dosage: 50mg/ml


Form:

Route:

Frequency:

Prevents
histamine
mediated
responses, drug
provides local
anesthesia and
suppresses
cough reIlex

Hay Iever,
urticaria,
vasomotor
rhinitis,
angioneurotic
edema, drug
sensitization,
serum &
penicillin
reaction, contact
dermatitis, atopic
eczema, other
allergic
dermatoses,
pruritus, Iood
sensitivity,
parkinsonism,
motion sickness.

CV and CNS
eIIects, blood
disorders, GI
disturbances,
anti-muscarinic
eIIects and
allergic
reactions.
Monitor careIully, assess Ior
conIusion, delirium, other
anticholinergic side eIIects and
Iall risk. Institute measures to
prevent Ialls.
Assess movement disorder
beIore and aIter administration.
Caution patient not to use oral
OTC diphenhydramine products
with any other product containing
diphenhydramine, including
products used topically.
It can cause excitation in
children. Caution parents or
caregivers about proper dose
calculation; overdosage,
especially in inIants and children,
can cause hallucinations, seizures
or death InIorm patient that this
drug may cause dry mouth.
Frequent oral rinses, good oral
hygiene, and sugarless gum or
candy may minimize this eIIect.
NotiIy dentist iI dry mouth
persists Ior more than 2 weeks.

DRUG STUDY OF EPINEPHRINE

DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Epinephrine

Brand name:
Epinephrine
Bitartrate

Classification:
Sympathomimetic,


Dosage:
1mg/ml


Form:

Route:

Frequency:

Naturally
occurring
neurotransmitter,
the eIIects oI
which are
mediated by
alpha or beta
receptors in
target organs.
EIIects on alpha
receptors include
vasoconstriction,
contraction oI
dilator muscles
oI iris. EIIects
on beta receptors
include positive
chronotropic and
inotropic eIIects
on the heart
(beta1
receptors);
bronchodilation,
vasodilation, and
uterine
relaxation (beta2
receptors);
decreased
production oI
aqueous humor.
Acute asthmatic
attacks,
Advanced
cardiac liIe
support
drowsiness,
headache,
nervousness,
tremors,
cerebral
hemorrhage,
dizziness,
weakness,
vertigo, pain
Monitor heart rate.
Use extreme caution when
calculating and preparing doses;
epinephrine is a very potent drug;
small errors in dosage can cause
serious adverse eIIects. Double-
check pediatric dosage.
Use minimal doses Ior minimal
periods oI time; "epinephrine-
Iastness" (a Iorm oI drug tolerance)
can occur with prolonged use.
Protect drug solutions Irom light,
extreme heat, and Ireezing; do not
use pink or brown solutions. Drug
solutions should be clear and
colorless (does not apply to
suspension Ior injection).
Shake the suspension Ior injection
well beIore withdrawing the dose.
Rotate SC injection sites to
prevent necrosis; monitor injection
sites Irequently.
Keep a rapidly acting alpha-
adrenergic blocker (phentolamine)
or a vasodilator (a nitrate) readily
available in case oI excessive
hypertensive reaction.
Have an alpha-adrenergic blocker
or Iacilities Ior intermittent positive
pressure breathing readily available
in case pulmonary edema occurs.
Keep a beta-adrenergic blocker
(propranolol; a cardioselective beta-
blocker, such as atenolol, should be
used in patients with respiratory
distress) readily available in case
cardiac arrhythmias occur.
Do not exceed recommended
dosage oI inhalation products;
administer pressurized inhalation
drug Iorms during second halI oI
inspiration, because the airways are
open wider and the aerosol
distribution is more extensive. II a
second inhalation is needed,
administer at peak eIIect oI
previous dose, 35 min.
Use topical nasal solutions only
Ior acute states; do not use Ior
longer than 35 days, and do not
exceed recommended dosage.
Rebound nasal congestion can
occur aIter vasoconstriction
subsides.
Do not exceed recommended
dosage; adverse eIIects or loss oI
eIIectiveness may result. Read the
instructions that come with
respiratory inhalant products, and
consult your health care provider or
pharmacist iI you have any
questions.
To give eye drops: Lie down or
tilt head backward, and look up.
Hold dropper above eye; drop
medicine inside lower lid while
looking up. Do not touch dropper to
eye, Iingers, or any surIace. Release
lower lid; keep eye open, and do
not blink Ior at least 30 sec. Apply
gentle pressure with Iingers to
inside corner oI the eye Ior about 1
min; wait at least 5 min beIore
using other eye drops.
These side eIIects may occur:
Dizziness, drowsiness, Iatigue,
apprehension (use caution iI driving
or perIorming tasks that require
alertness); anxiety, emotional
changes; nausea, vomiting, change
in taste (eat Irequent small meals);
Iast heart rate. Nasal solution may
cause burning or stinging when Iirst
used (transient). Ophthalmic
solution may cause slight stinging
when Iirst used (transient);
headache or brow ache (only during
the Iirst Iew days).
Report chest pain, dizziness,
insomnia, weakness, tremor or
irregular heart beat (respiratory
inhalant, nasal solution), diIIiculty
breathing, productive cough, Iailure
to respond to usual dosage
(respiratory inhalant), decrease in
visual acuity (ophthalmic).





DRUG STUDY OF FUROSEMIDE
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Furosemide

Brand name:
Apo-Furosemide
(CAN),

Classification:
Loop diuretics


Dosage:
20mg/2ml

Form:

Route:

Frequency:

Inhibits
Sodium and
Chloride
reabsorption at
the proximal
and distal
tubules and the
ascending loop
oI Henle

Edema,
hypertension
Vertigo,
headache,
dizziness,
paresthesia,
weakness,
restlessness,
Iever, nocturia,
oliguria,
polyguria.

Nursing Measures:
Monitor BP aIter administration
Administer with Iood or milk to
prevent GI upset.
Reduce dosage iI given with
other antihypertensives; readjust
dosage gradually as BP responds.
Give early in the day so that
increased urination will not
disturb sleep.
Avoid IV use iI oral use is at all
possible.
Do not mix parenteral solution
with highly acidic solutions with
pH below 3.5.
Do not expose to light, may
discolor tablets or solution; do not
use discolored drug or solutions.
Discard diluted solution aIter 24
hr.
ReIrigerate oral solution.
Measure and record weight to
monitor Iluid changes.
Arrange to monitor serum
electrolytes, hydration, liver
Iunction.
Arrange Ior potassium-rich diet
or supplemental potassium as
needed

DRUG STUDY OF HYDRALAZINE HYDROCHLORIDE
DRUG FEATURES MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Hydralazine
hydrochloride

Brand name: Supres

Classification:
antihypertension

Dosage: 20mg/ml


Form:

Route:

Frequency:

a direct acting
peripheral
vasodilator that
relaxes
arteriolar
smooth muscles



For hypertensive
patient
Tachycardia,
palpitation,
angina
pectoris,
severe
headache,
dizziness,
weight gain,
GI
disturbances,
pruritus,
rashes, nausea
and vomiting

Give oral drug with Iood to
increase bioavailability(drug
should be given in a consistent
relationship ti ingestion oI Iood
Ior consistent response to
therapy).
Drug may cause a syndrome
resembling systemic lupus
erythematosus (SLE). Arrange Ior
CBC, LE cell preparations, and
ANA titers beIore and
periodically during prolonged
therapy, even in the
asymptomatic patient.
Discontinue iI blood dyscrasias
occur. Reevaluate therapy iI ANA
or LE tests are positive.
Arrange Ior pyridoxine iI patient
develops symptoms oI peripheral
neuritis.
Monitor patient Ior orthostatic
hypotension which is most
marked in the morning and in hot
weather, and with alcohol or
exercise.


DRUG STUDY OF HYDROCORTISONE SODIUM SUCCINATE
DRUG FEATURES MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Hydrocortisone
sodium succinate

Brand name:
A-hydroCort, Solu-
CorteI

Classification:
corticosteroid
hormones

Dosage: 100 mg/ 2
mL, 250 mg/ 2 mL

Form:

Route:

Frequency:

Decreases
inIlammation,
mainly by
stabilizing
leukocyte
lysosomal
membranes,
suppresses
immune
response,
stimulates bone
marrow and
inIluences
protein, Iat, and
carbohydrate
metabolism
Endocrine,
hematologic,
rheumatic &
collagen
disorders,
dermatologic,
ophth, GI, resp
& neoplastic
diseases,
edematous
states, control oI
severe
incapacitating
allergic
conditions, TB
meningitis w/
subarachnoid
block or
impending block
when used
concurrently
with appropriate
anti-TB
chemotherapy,
shock secondary
to adrenocortical
insuIIiciency or
shock
unresponsive to
Fluid and
electrolyte
disturbances,
decreased
carbohydrate
tolerance,
impaired
wound
healing, thin
Iragile skin,
muscle
weakness,
steroid
myopathy,
osteoporosis,
aseptic
necrosis,
peptic
ulceration w/
possible
perIoration,
cataracts,
increased
intraocular
and
intracranial
pressure,
growth
retardation,
Give daily beIore 9 AM to
mimic normal peak diurnal
corticosteroid levels and
minimize HPA suppression.
Space multiple doses evenly
throughout the day.
Do not give IM injections iI
patient has thrombocytopenic
purpura.
Rotate sites oI IM repository
injections to avoid local
atrophy.
Use minimal doses Ior
minimal duration to minimize
adverse eIIects.
Taper doses when
discontinuing high-dose or
long-term therapy.
Arrange Ior increased dosage
when patient is subject to
unusual stress.
Use alternate-day
maintenance therapy with
short-acting corticosteroids
whenever possible.
Do not give live virus
vaccines with
immunosuppressive doses oI
hydrocortisone.
conventional
therapy when
adrenocortical
insuIIiciency
may be present

Cushingoid
state, protein
catabolism,
psychic
derangements,
exophthalmos,
masking oI
inIections,
gasping
syndrome,
seizures,
menstrual
irregularities.

Provide antacids between
meals to help avoid peptic
ulcer.







DRUG STUDY OF ISOSORBIDE-5- MONONITRATE
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Isosorbide-5-
mononitrate

Brand name:
Imdur

Classification:


Dosage:


Form:

Route:

Frequency:

Thought to
reduce cardiac
oxygen demand
by decreasing
preload and
aIterload. Drug
also may
increase blood
Ilow through
the collateral
coronary
vessels

Prophylactic
treatment oI
angina pectoris
Headache,
hypotension w/
dizziness and
nausea,
tachycardia

Monitor BP and heart rate.
Assess location, duration,
intensity, and precipitating
Iactors oI anginal pain.



DRUG STUDY OF ISOSORBIDE DINITRATE
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Isosorbide
dinitrate

Brand name:
Isoket IV

Classification:
anti anginal drug


Dosage: Stock: IV
amp 10 mg/ 10 mL
Dose: 10
mg/10mL


Form:

Route:

Frequency:

Isosorbide
dinitrate is a
smooth muscle
relaxant. It is
particularly
eIIective on
vascular and
bronchial
smooth muscle.
Its systemic
cardiovascular
eIIects are
mainly due to a
decrease in
venous return
(pooling oI
blood in the
peripheral
venous system).
Consequently,
ventricular end-
diastolic
pressure and
volume are
diminished,
thus reducing
cardiac work
and implicitly
myocardial
Unresponsive
leIt ventricular
Iailure secondary
to acute MI,
severe or
unstable angina
pectoris



Severe cerebral
Ilow deIiciency
and decreased
coronary
perIusion may
develop, nitrate
headache and
nausea.

Monitor BP and heart rate.
Assess location, duration,
intensity, and precipitating
Iactors oI anginal pain.
oxygen
requirements.
The arterial
vessels are
dilated as well,
though to a
lesser degree.
This results in a
slight drop in
aortic and
systemic blood
pressure
relieving the
myocardium
Irom a part oI
its aIterload.
These nitrate-
induced
changes account
Ior both the
antianginal
eIIects oI
isosorbide
dinitrate and Ior
its beneIicial
eIIects in the
treatment oI
congestive heart
Iailure.





DRUG STUDY OF MAGNESIUM SULFATE
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Magnesium
SulIate

Brand name
Elin Magnesium
SulIate

Classification:
anticonvulsant

Dosage:
250 mg/10 mL

Form:

Route:

Frequency:






May decrease
acetylcholine
released by
nerve impulses,
but its
anticonvulsant
mechanism is
unknown
Treatment oI
hypomagnesemia
accompanied by
signs oI tetany,
control oI HTN,
encephalophathy
& convulsions,
prevention &
control oI
convulsions in
patients w/
preeclampsia or
eclampsia,
prevention oI
hypomagnesemia
in patients
receiving TPN


Ilushing,
sweating,
hypotension,
muscular
weakness,
sedation &
conIusion;
decreased deep
tendon reIlexes;
resp. paralysis

Monitor the Iollowing: I.V.:
Rapid administration: ECG
monitoring, vital signs, deep
tendon reIlexes; magnesium,
calcium, and potassium levels;
renal Iunction during
administration. Obstetrics: Patient
status including vital signs,
oxygen saturation, deep tendon
reIlexes, level oI consciousness,
Ietal heart rate, maternal uterine
activity. Oral: Renal Iunction;
magnesium levels; bowel
movements.


DRUG STUDY OF MEPERIDINE HYDROCHLORIDE
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Meperidine
hydrochloride

Brand name:
Demerol

Classification:
Anti-vertigo drug

Dosage:
100 mg/ 2mL


Form:

Route:

Frequency:

Binds with
opiate receptors
in the CNS,
altering
perception oI
and emotional
response to pain
RelieI oI
moderate to
severe pain, pre-
op medication,
support oI anesth
& obstet
analgesia

Respiratory
depression,
circulatory
depression,
respiratory
arrest, shock,
cardiac arrest, GI
disturbance, light
headedness,
dizziness,
sedation, nausea,
vomiting,
sweating,
euphoria,
dysphoria,
weakness,
headache,
tremor, agitation,
uncoordinated
muscle
movements,
severe
convulsions,
transient
hallucinations &
disorientation,
visual
disturbance,
Ilushing,
Make position changes slowly
and in stages particularly Irom
recumbent to upright posture. Lie
down immediately iI light-
headedness or dizziness occurs.
Lie down when Ieeling
nauseated and to notiIy physician
iI this symptom persists. Nausea
appears to worsen with
ambulation.
Avoid driving and other
potentially hazardous activities
until reaction to drug is known.
Codeine may impair ability to
perIorm tasks requiring mental
alertness and thereIore to.
Do not take alcohol or other
CNS depressants unless approved
by physician.
Hyperactive cough may be
lessened by avoiding irritants
such as smoking, dust, Iumes and
other air pollutants.
HumidiIication oI ambient air
may provide some relieI.
Do not breast Ieed while taking
this drug.

tachycardia,
bradycardia,
palpitation,
hypotension,
syncope,
phlebitis, urinary
retention,
allergic
reactions, pain at
injection site and
local tissue
irritation.






DRUG STUDY OF METOCLOPRAMIDE
DRUG FEATURES MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Metoclopramide

Brand name:
Apo-Metoclop (CAN),
Maxeran (CAN),
Maxolon, Nu-
Metoclopramide
(CAN), Octamide
PFS, Reglan

Classification:
antiemetic & anti-
spasmodic

Dosage:
10 mg/ 2mL


Form:

Route:

Frequency:

Stimulates
motility oI
upper GI tract,
increases lower
esophageal
sphincter tone,
and blocks
dopamine
receptors at the
chemoreceptor
trigger zone
Disturbances oI
GI motility,
nausea &
vomiting oI
central &
peripheral origin
associated w/
surgery,
metabolic
diseases,
inIectious &
drug induced
diseases,
Iacilitate small
bowel intubation
& radiological
procedures oI
GIT

Extra
pyramidal
reactions,
drowsiness,
Iatigue &
lassitude,
anxiety, less
Irequently,
insomnia,
headache,
dizziness,
nausea,
galactorrhea,
gynecomastia,
bowel
disturbances.

Monitor BP careIully during IV
administration.
Monitor Ior extrapyramidal
reactions, and consult physician iI
they occur.
Monitor diabetic patients,
arrange Ior alteration in insulin
dose or timing iI diabetic control
is compromised by alterations in
timing oI Iood absorption.
Keep diphenhydramine injection
readily available in case
extrapyramidal reactions occur
(50 mg IM).
Have phentolamine readily
available in case oI hypertensive
crisis (most likely to occur with
undiagnosed
pheochromocytoma).


DRUG STUDY OF MIDAZOLAM HYDROCHLORIDE
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Midazolam
hydrochloride

Brand name:
Dormicum

Classification:
hypnotics &
sedatives

Dosage:
5mg/5mL


Form:

Route:

Frequency:

May potentiate
the eIIects oI
GABA, depress
the CNS, and
suppress the
spread oI
seizure activity

Disturbances oI
sleep rhythm,
insomnia esp
diIIiculty in
Ialling asleep
either initially or
aIter premature
awakening,
tab/inj: sedation
in premed beIore
surgical or
diagnostic
procedures,
induction &
maintenance oI
anesth.

Rarely
cardiorespiratory
adverse events,
nausea,
vomiting,
headache,
hiccoughs,
laryngospasm,
dyspnoea,
hallucination,
oversedation,
drowsiness,
ataxia, rash,
paradoxical
reactions,
amnesic
episodes.
Do not administer intra-
arterially, which may produce
arteriospasm or gangrene.
Do not use small veins (dorsum
oI hand or wrist) Ior IV injection.
Administer IM injections deep
into muscle.
Monitor IV injection site Ior
extravasation.
Arrange to reduce dose oI
midazolam iI patient is also being
given opioid analgesics; reduce
dosage by at least 50 and
monitor patient closely.
Monitor level oI consciousness
prior to, during, and Ior at least
26 hr aIter administration oI
midazolam.
CareIully monitor P, BP, and
respirations careIully during
administration.
Keep resuscitative Iacilities
readily available; have Ilumazenil
available as antidote iI overdose
should occur.
Keep patients in bed Ior 3 hr; do
not permit ambulatory patients to
operate a vehicle Iollowing an
injection.
Arrange to monitor liver and
kidney Iunction and CBC at
intervals during long-term
therapy.
Establish saIety precautions iI
CNS changes occur (use side
rails, accompany ambulating
patient).
Provide comIort measures and
reassurance Ior patients receiving
diazepam Ior tetanus.
Arrange to taper dosage
gradually aIter long-term therapy.
Provide patient with written
inIormation regarding recovery
and Iollow-up care. Midazolam is
a potent amnesiac and memory
may be altered.






DRUG STUDY OF MORPHINE SULFATE
DRUG
FEATURES
MECHANIS
M OF
ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Morphine sulIate

Brand name:
Morin

Classification:
Analgesics (Opioid)

Dosage:
Adult 5-20 mg
IM/SC 4 hrly.
Severe or chronic
pain Childn 10 mg
IM/SC 4 hrly,
range: 5-20 mg; 6-
12 yr 5-10 mg, 1-5
yr 2.5-5 mg, 1-12
mth 200 mcg/kg,
1 mth 150 mcg/kg
4 hrly. Max: 15 mg.
Analgesic eIIect
Ped 100-200
mcg/kg SC 4 hrly,
max: 15 mg/dose;
or 50-100 mcg/kg
slow IV. Pre-op 50-
100 mcg/kg IM,
max: 10 mg/dose.

Alters
perception and
emotional
response to
pain

RelieI oI
moderate to
severe pain not
responsive to
non-narcotic
analgesics.
Premed.
Analgesic
adjunct in
general anesth
esp in pain
associated w/
cancer, MI &
surgery.
Alleviates
anxiety
associated w/
severe pain.
Hypnotic Ior
pain-related
sleeplessness.

Light
headedness,
dizziness,
sedation, nausea,
vomiting,
constipation &
sweating.
Caution patient not to chew or
crush controlled-release
preparations.
Dilute and administer slowly IV
to minimize likelihood oI adverse
eIIects.
Tell patient to lie down during
IV administration.
Keep opioid antagonist and
Iacilities Ior assisted or controlled
respiration readily available
during IV administration.
Use caution when injecting SC
or IM into chilled areas or in
patients with hypotension or in
shock; impaired perIusion may
delay absorption; with repeated
doses, an excessive amount may
be absorbed when circulation is
restored.
Reassure patients that they are
unlikely to become addicted;
most patients who receive opioids
Ior medical reasons do not
develop dependence syndromes.


DRUG STUDY OF NICARDIPINE HYDROCHLORIDE
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Nicardipine
hydrochloride

Brand name:
Cardepine

Classification:
Calcium
Antagonists

Dosage:
Dosage: IV
inIusion Dilute to
10-20 mg/100 mL
(conc oI 1.01-
0.02). Initial
inIusion rate: 5
mg/hr; titrate dose
up to 15 mg/hr
until desired
therapeutic
response is
achieved (DBP
95 mmHg, SBP
140 mmHg).
Form:



A Calcium
channel blocker
that inhibits
Calcium ion
inIlux across
cardiac and
smooth muscle
cells, also
dilates coronary
arteries and
arterioles
Hypertensive
emergencies or
urgencies, peri-
op & post-op
HTN,
hypertensive
states oI NPO
patients.
Peripheral
edema,
headache,
tachycardia,
palpitations,
localized
thrombophlebit
is &
hypotension.
Patients with hepatic
impairment should receive lower
dose.
Monitor blood pressure.Allow
atleast 3 days between dosage
adjustment to achieve steady
plasma levels.
Advise patient to report
immediately iI experiencing chest
pain



DRUG STUDY OF NTG PATCH
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
NTG patch

Brand name:
Deponit, Minitran,
Nitrek, Nitro-Dur,
Nitrodisc,
Transderm-Nitro

Classification:
Anti-Anginal
Drugs

Dosage:
Starting dose: 0.2-
0.4 mg/hr. Dosing
schedule: Daily
patch-on period oI
12-14 hr & daily
patch-oII period oI
10-12 hr.

Form:

Route:

Frequency:

A nitrate that
reduces cardiac
oxygen demand
by decreasing
leIt ventricular
end diastolic
pressure and to
a lesser extent,
systemic
vascular
resistance, also
increases blood
Ilow through
collateral
coronary
vessels

Prevention oI
angina pectoris
due to coronary
artery disease

Headache.
Transient
episodes oI
lightheadedness.
InIrequently,
hypotension.
Syncope,
crescendo
angina, rebound
HTN, allergic &
anaphylactoid
reactions.
Rarely severe,
application site
irritation.

Administer transdermal systems
to skin site Iree oI hair and not
subject to much movement.
Shave areas that have a lot oI
hair. Do not apply to distal
extremities. Change sites slightly
to decrease the chance oI local
irritation and sensitization.
Remove transdermal system
beIore attempting deIibrillation or
cardioversion.
To use transdermal systems, you
may need to shave an area Ior
application. Apply to a slightly
diIIerent area each day. Use care
iI changing brands; each system
has a diIIerent concentration.



DRUG STUDY OF PARACETAMOL
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Paracetamol

Brand name:
Aeknil

Classification:
Analgesics (Non-
Opioid) &
Antipyretics

Dosage:
Adult & childn
_10 yr 2-3 mL,
_10 yr 1-2 mL.
Depending on
severity oI case,
dose may be
repeated 4 hrly. In
severe cases, dose
may be
administered by IV
very slowly

Form:

Route:

Frequency:

Produce
analgesia by
blocking pain
impulses by
inhibiting
synthesis oI
prostaglandin in
CNS, relieves
Iever

Pyrexia oI
unknown origin.
Fever & pain
associated w/
common
childhood
disorders,
tonsillitis, upper
resp tract
inIections post-
immunization
reactions, aIter
tonsillectomy &
other conditions.
Prevention oI
Iebrile
convulsion.
Headache, cold,
sinusitis, muscle
pain, arthritis &
toothache
Hematological,
skin & other
allergic
reactions

Use liquid Iorm Ior children and
patients who have diIIiculty
swallowing.
In children, don`t exceed Iive
doses in 24 hours.
Advise patient that drug is only
Ior short term use and to consult the
physician iI giving to children Ior
longer than 5 days or adults Ior
longer than 10 days.
Advise patient or caregiver that
many over the counter products
contain acetaminophen; be aware oI
this when calculating total
dailydose.
Warn patient that high doses or
unsupervised long term use can
cause liver damage.


DRUG STUDY OF PHENYTOIN
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Phenytoin

Brand name:
Dilantin

Classification:
Anticonvulsants

Dosage:
Adult Initially 100
mg tid.
Maintenance: 300-
400 mg daily.
Childn _6 yr
Initially 100 mg
tid, subsequent
dosage should be
adjusted according
to therapeutic
response, 6 yr 30
mg bid, may be
increased to 30 mg
tid or qid. Pedia 5
mg/kg/day Initially
in 2-3 equally
divided doses.
Max: 300 mg
daily.


May stabilize
neuronal
membranes and
limit seizure
activity by
either by
increasing
eIIlux or
decreasing
inIlux oI Na
ions across cell
membrane in
the motor
cortex during
generation oI
nerve impulses

Tonic-clonic &
complex partial
(psychomotor,
temporal lobe),
prevention &
treatment oI
seizures
occurring during
or Iollowing
neurosurgery
GI disturbances;
ataxia, slurred
speech; diplopia,
nystagmus &
mental conIusion
w/ headache,
dizziness,
gingival
hyperplasia,
hirsutism,
hyperglycemia,
osteomalacia
Assess location, duration,
Irequency, and characteristics oI
seizure activity. EEG may be
monitored periodically
throughout therapy, Assess oral
hygiene. Vigorous oral cleaning
beginning within 10 days oI
initiation oI phenytoin therapy
may help control gingival
hyperplasia.



DRUG STUDY OF TERBUTALINE
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Terbutaline

Brand name:
Bricalin

Classification:
Antiasthmatic &
COPD

Dosage:
Antiasthmatic &
COPD
Preparations


Form:

Route:

Frequency:

Relaxes
bronchial
smooth muscles
by stimulating
beta-2 receptors
For reversible
airways
obstruction, in
asthma, COPD.
Decreases
uterine
contractility &
may be used to
arrest premature
labor

Fine tremor oI
skeletal muscle
esp hands,
palpitations,
tachycardia,
nervous tension,
headache,
peripheral
vasodilation.

Use minimal periods oI time;
drug tolerance can occur with
prolonged use.
Keep beta-adrenergic blocker
readily available in case cardiac
arrhythmias occur.
Do not recommended dosage.


DRUG STUDY OF VERAPAMIL HYDROCHLORIDE
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Verapamil
hydrochloride

Brand name:
Calan, Calan SR,
Covera-HS,
Isoptin, Isoptin
SR, Verelan,
Verelan PM

Classification:
Calcium
Antagonists


Dosage:
Isoptin tab Adult
40-80 mg tid-qid.
Max: 480 mg
daily. Childn ~6 yr
40-120 mg bid-tid,
up to 360 mg
daily, childn _6 yr
40 mg bid-tid.
Isoptin SR 180
Coronary
insuIIiciency 1 tab
bid. Usual daily
dose: 240-480 mg.
Hypertension 1 tab
Decreases
myocardial
contractility and
oxygen
demand, it also
dilates coronary
arteries and
arterioles
Isoptin/Isoptin
SR 180 Essential
hypertension,
chronic coronary
insuIIiciency,
angina pectoris,
paroxysmal
supraventricular
tachycardia,
tachyarrhythmias,
long-term
treatment aIter
MI. Isoptin SR
240 Essential
hypertension

Constipation,
dizziness,
nausea. Rarely,
vertigo,
headache,
hypotension,
ankle edema,
Ilushing, Iatigue,
nervousness,
erythromelalgia,
paraesthesia,
neuropathy;
bradycardiac
arrhythmias,
CHF. Dyspnea
Monitor patient careIully (BP,
cardiac rhythm, and output) while
drug is being titrated to
therapeutic dose. Dosage may be
increased more rapidly in
hospitalized patients under close
supervision.
Ensure that patient swallows SR
tablets whole: do not cut, crush,
or chew them.
Monitor BP very careIully with
concurrent doses oI
antihypertensives.
Monitor cardiac rhythm
regularly during stabilization oI
dosage and periodically during
long-term therapy.
Administer sustained-release
Iorm in the morning with Iood to
decrease GI upset.
Protect IV solution Irom light.
Monitor patients with renal or
hepatic impairment careIully Ior
possible drug accumulation and
adverse reactions.

in the morning.
Isoptin SR 240 1
tab in the morning.
II required aIter 2
wk, increase dose
to 2 tab daily.
Isoptin amp 5 mg
slow IV, iI
required, 5 mg
aIter 5-10 min.
Then, iI required,
continuous drip
inIusion oI 5-10
mg/hr up to 100
mg/day. Angina
pectoris & rapid
elimination oI
tachyarrhythmias
1-2 amp IV, iI
required bid-tid


Form:

Route:

Frequency:





DRUG STUDY OF IPRATROPIUM INHALATION
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Ipratropium
inhalation

Brand name:
Atrovent

Classification:
Antiasthmatic &
COPD
Preparations,
anticholinergics or
antimuscarinics

Dosage:
Adult (including
elderly) &
adolescent ~12 yr
Acute attacks 1
vial, may repeat
doses until patient
is stable.

Form:

Route:

Frequency:

It works by
binding to
speciIic
receptors
(called
muscarinic
receptors) in the
airway, helping
to relax the
smooth muscle
oI the airway.
When used to
treat a runny
nose, it works
by decreasing
the production
oI Iluid in the
glands that line
the nasal
passages
Bronchodilator
Ior treatment oI
bronchospasm
associated w/
COPD,
including
chronic
bronchitis,
emphysema and
asthma

Headache, nausea,
dry mouth,
increased heart
rate &
palpitations,
ocular
accommodation
disturbances, GI
motility
disturbances,
urinary retention,
ocular side eIIects,
cough, local
irritation,
bronchoconstrictio
n, skin rash,
angioedema,
urticaria,
laryngospasm,
anaphylactic
reactions.

Protect solution Ior inhalation
Irom light. Store unused vials in
Ioil pouch.
Use nebulizer mouthpiece
instead oI Iace mask to avoid
blurred vision or aggravation oI
narrow-angle glaucoma.
Can mix albuterol in nebulizer
Ior up to 1 hr.
Ensure adequate hydration,
control environmental
temperature to prevent
hyperpyrexia.
Have patient void beIore
taking medication to avoid
urinary retention.
Teach patient proper use oI
inhalator.



DRUG STUDY OF FENOTEROL/IPRATROPIUM BROMIDE
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Fenoterol/
Ipratropium
bromide

Brand name:
Berodual

Classification:
Antiasthmatic &
COPD
Preparations


Dosage:
Berodual
inhalation soln
Adult (including
elderly) &
adolescent ~12 yr
Treatment oI 1 mL
Ior immediate
symptom relieI.
Intermittent &
long-term
treatment 1-2 mL
Ior each
administration, up
to qid. Moderate
bronchospasm or
w/ assisted
For the
prevention and
treatment oI
reversible
bronchospasm
associated with
bronchial
asthma and
especially
chronic
bronchitis with
or without
emphysema
Prevention and
treatment oI
symptoms in
chronic
obstructive
airway disorders
with reversible
bronchospasm

Fine tremor oI
skeletal muscles,
nervousness,
restlessness,
palpitations; less
Irequently
tachycardia,
dizziness or
headache. Dry
mouth, throat
irritation or
allergic reactions,
cough,
paradoxical
bronchoconstricti
on (rare). Urinary
retention may
occur in
particular, in
patients w/
preexisting
outIlow tract
obstruction.

Protect solution Ior inhalation
Irom light. Store unused vials in
Ioil pouch.
Use nebulizer mouthpiece
instead oI Iace mask to avoid
blurred vision or aggravation oI
narrow-angle glaucoma.
Can mix albuterol in nebulizer
Ior up to 1 hr.
Ensure adequate hydration,
control environmental
temperature to prevent
hyperpyrexia.
Have patient void beIore
taking medication to avoid
urinary retention.
Teach patient proper use oI
inhalator.

ventilation 0.5
mL. Childn 6-12
yr Treatment oI
attacks 0.5-1 mL.
Intermittent &
long-term
treatment 0.5-1
mL Ior each
administration, up
to qid. Moderate
bronchospasm or
w/ assisted
ventilation 0.5
mL. Childn 6 yr
(22 kg body wt)
Up to 0.5 mL up
to tid. Berodual F
UDV Adult &
childn ~12 yr
Acute asthma
episodes 1 vial, in
very severe cases,
2 vials are needed.
Intermittent &
long-term
treatment 1 vial up
to qid.

Form:

Route:

Frequency:


DRUG STUDY OF BUDESONIDE
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Budesonide

Brand name:
Symbicort

Classification:
Corticosteroids


Dosage:
80/4.5 mcg x 60
doses; 160/4.5
mcg x 60 doses;
320/9 mcg x 60
doses

Form:

Route:

Frequency:

Work by
reducing
inIlammation,
which helps
with several
conditions
ranging Irom
asthma to
allergies
toCrohn`s
disease

Regular
treatment oI
asthma where
use oI a
combination
(inhaled
corticosteroid
and long acting
beta 2 agonist) is
appropriate
Abdominal pain,
conjunctivitis
(pinkeye),
cough, diarrhea,
ear inIection or
inIlammation,
Iever, Iungal
inIection in
mouth,
headache, nasal
or sinus
inIlammation,
nosebleed, pain,
rash, respiratory
inIection,
stomach or
intestinal
inIlammation,
throat
inIlammation,
viral inIection,
vomiting,
wheezing

Taper systemic steroids
careIully during transIer to
inhalational steroids; deaths Irom
adrenal insuIIiciency have
occurred.
Arrange Ior use oI decongestant
nose drops to Iacilitate
penetration iI edema, excessive
secretions are present.
Prime unit beIore use Ior
Pulmicort Turbuhaler; have
patient rinse mouth aIter each use.
Use aerosol within 6 mo oI
opening. Shake well beIore each
use.
Store Respules upright and
protected Irom light; gently shake
beIore use; open envelopes
should be discarded aIter 2 wk.




DRUG STUDY OF ALBUTEROL AND IPRATROPIUM INHALATION
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
Albuterol and
ipratropium
inhalation

Brand name:
Combivent

Classification:
Bronchodilators

Dosage:
MDI Adult 2
puIIs tid-qid. Max
12 puIIs/day. Unit
dose vial Adult &
childn ~12 yr 1
vial every 6-8 hr.
Childn 2-12 yr 3
drops/kg/dose
(max: 2500 mcg oI
salbutamol) every
6-8 hr.

Form:

Route:

Frequency:

Muscles in the
airways and
increase air
Ilow to the
lungs

Management oI
reversible
bronchospasm
associated with
obstructive
airway diseases
in patients who
require more
than a single
bronchodilator

Fine tremor oI
skeletal muscle;
palpitations;
headache,
dizziness,
nervousness;
dryness oI
mouth, throat
irritation; urinary
retention

Use nebulizer mouthpiece
instead oI Iace mask to avoid
blurred vision or aggravation oI
narrow-angle glaucoma.
Can mix albuterol in nebulizer
Ior up to 1 hr.
Ensure adequate hydration,
control environmental
temperature to prevent
hyperpyrexia.
Have patient void beIore taking
medication to avoid urinary
retention.
Teach patient proper use oI
inhalator.


DRUG STUDY OF SALBUTAMOL
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
SALBUTAMOL

Brand name:
Aero-Vent

Classification:
bronchodilator


Dosage:
Adult & childn
2.5-5 mg.

Form:

Route:

Frequency:
qid
used with anti-
inIlammatory
medication to
prevent asthma
attacks, Some
oI these
medicines are
used to treat the
symptoms oI
asthma, chronic
bronchitis,
emphysema,
and other lung
diseases, while
others are used
to prevent the
symptoms
treatment oI
acute, severe
asthma and in
routine
management oI
chronic
bronchospasm
unresponsive to
conventional
therapy

Dizziness,
severe; Ieeling oI
choking,
irritation, or
swelling in
throat; Ilushing
or redness oI
skin; hives;
increased
shortness oI
breath; skin rash;
swelling oI Iace,
lips, or eyelids;
tightness in chest
or wheezing,
troubled
breathing
Assess lung sounds, pulse, and
blood pressure beIore
administration and during peak oI
medication. Note amount, color,
and character oI sputum
produced.
Monitor pulmonary Iunction
tests beIore initiating therapy and
periodically throughout course to
determine eIIectiveness oI
medication.
Observe Ior paradoxical
bronchospasm (wheezing). II
condition occurs, withhold
medication and notiIy physician
or other health care proIessional
immediately.
Instruct mother to take missed
dose as soon as remembered,
spacing remaining doses at
regular intervals. Do not double
doses or increase the dose or
Irequency oI doses.
InIorm the mother not to smoke
near the child and to avoid
respiratory irritants.
Advise the mother to rinse the
child`s mouth with water aIter
each inhalation dose to minimize
dry mouth.





DRUG STUDY OF TERBUTALINE SULFATE

DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
TERBUTALINE
SULFATE

Brand name:
Pulmonyl


Classification:
Antiasthmatic/
Brochodilator

Dosage:
Adult 5-10 mg,
Children 2-5mg


Form:

Route:

Frequency:

It works by
dilating
(opening) the
bronchioles oI
the lungs by
relaxing the
muscles around
them. This
allows Ior
easier airIlow
into and out oI
the lungs
relieI oI
bronchospasm in
obstructive
airway diseases

Headache,
nausea,
vomiting,
palpitations,
tachycardia,
sweating &
drowsiness

Use minimal periods oI time;
drug tolerance can occur with
prolonged use.
Keep beta-adrenergic blocker
readily available in case cardiac
arrhythmias occur.
Do not recommended dosage.

DRUG STUDY OF HEPARIN SODIUM
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
HEPARIN
SODIUM

Brand name:
Britton Heparin
Na

Classification:
Anticoagulants,
Antiplatelets &
Fibrinolytics
(Thrombolytics)


Dosage:
5000 iu/1 mL;
25000 iu/1 mL


Form:

Route:

Frequency:

Accelerates
Iormation oI
antithrombin
III-thrombin
complex and
deactivates
thrombin,
preventing
conversion oI
Iibrinogen to
Iibrin
treatment and
prophylaxis oI
thromboembolic
disorders

Slight Iever,
headache, chills,
nausea, vomiting,
constipation,
epistaxis,
bruising, slight
haematuria, skin
necrosis (SC inj),
osteoporosis,
alopecia.
Hypersensitivity
reactions include
urticaria,
conjunctivitis,
rhinitis, asthma,
angioedema and
anaphylactic
shock. Priapism.
Potentially Fatal:
Heparin-induced
thrombocytopenia
with or without
thrombosis;
bleeding

Baseline blood coagulation
tests, Hct, Hgb, RBC and platelet
counts prior to initiation or
therapy and at regular intervals
throughout therapy
Monitor APTT levels closely
Draw blood Ior coagulation
tests 30 min beIore each
scheduled SC or intermittent IV
dose and approximately q4h Ior
pts receiving continuous IV
heparin during dosage
adjustments period. AIter dosage
is established, tests may be done
once daily
Pts vary widely in their reaction
to heparin; risk oI hemorrhage
appears greatest in women, all
patients ~ 60 y, and patients with
liver disease or renal
insuIIiciency.
Monitor vitals, report Iever,
drop in BP, rapid pulse and other
S&S oI hemorrhage
Observe all needle sites daily
Ior hematoma and signs oI
inIlammation
Have on hand protamine
sulIate, speciIic heparin
antagonist

DRUG STUDY OF ESMOLOL HYDROCHLORIDE
DRUG FEATURES MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
ESMOLOL
HYDROCHLORIDE

Brand name:
Brevibloc

Classification:
Beta blockers

Dosage:
100mg/10ml

Form:

Route:

Frequency:

A Class II
antiarrythmic
and ultra-short-
acting selective
beta blocker
that decreases
heart rate,
contractility and
blood pressure

supraventricular
tachycardia;
post-operative
tachycardia or
hypertension;
non-
compensatory
sinus
tachycardias;
intra-operative
tachycardia or
hypertension;
unstable angina,
non ST segment
elevation MI

Hypotension,
bradycardia,
heart Iailure,
local irritation,
diaphoresis,
peripheral
ischaemia,
dizziness,
somnolence,
conIusion,
Iatigue,
paraesthesia,
peripheral
neuropathy,
headache,
weakness,
irritability,
dyspnoea,
nausea,
vomiting,
blurred vision,
urinary
retention, Iever,
rigor, muscular
pain. Potentially
Fatal: ProIound
bradycardia, AV
block,
cardiogenic
shock, asystole,
bronchospasm.

Monitor patient careIully (BP,
cardiac rhythm, and output)
while drug is being titrated to
therapeutic dose. Dosage may
be increased more rapidly in
hospitalized patients under close
supervision.
Monitor cardiac rhythm
regularly during stabilization oI
dosage and periodically during
long-term therapy.





DRUG STUDY OF D 50-50
DRUG FEATURES MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
D 50-50

Brand name:
Phil
Pharmawealth/Atlantic
50 Dextrose


Classification:
Intravenous & Other
Sterile Solutions


Dosage:


Form:

Route:

Frequency:

A simple water
soluble sugar
that minimizes
glyconeogenesis
and promotes
anabolism in
patients whose
oral caloric
intake is limited

Ior
hypoglycemia
Local pain, vein
irritation,
thrombophlebitis
& tissue necrosis
in the event oI
extravasation.
Fluid & electrolyte
imbalance eg
hypokalemia,
hypomagnesemia
&
hypophosphatemia;
edema or water
intoxication

Monitor inIusion rate
Irequently; iI signs oI Iluid
overload, turn oII IV drip.
InIusion may result in Iluid
overload.
Check IV site Irequently
and iI inIiltration is noted,
turn oII IV drip.
Watch out Ior signs oI Iluid
overload (distended neck
veins (JVD), rapid
respirations, shallow tidal
volume, Iine auscultatory
crackles, dyspnea, and
peripheral edema)
Watch out Ior signs oI
inIiltration (swelling and pain
around IV site).



DRUG STUDY OF POTASSIUM CHLORIDE
DRUG FEATURES MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
POTASSIUM
CHLORIDE

Brand name:
Phil
Pharmawealth/Atlantic
Potassium Chloride


Classification:
Electrolytes


Dosage:
40 meqs/20 ml


Form:

Route:

Frequency:

Replaces
potassium and
maintains
potassium level

Ior
hypokalemia,
acute MI
GI ulceration
(sometimes with
haemorrhage
and perIoration
or with late
Iormation oI
strictures)
Iollowing the
use oI enteric-
coated K
chloride
preparation;
hyperkalaemia.
Oral: Nausea,
vomiting,
phlebiti and
abdominal
cramps. IV: Pain
or phlebitis;
cardiac toxicity.
Monitor serum potassium
levels, renal Iunction, and
serum bicarbonate.
Explain to patient purpose oI
the medication and the need to
take as directed,especially
when concurrent digoxin or
diuretics are taken. A missed
dose should be taken as soon as
remembered within 2 hr; iI not,
return to regular doseschedule.
Do not double dose.
Emphasize correct method oI
administration. GI irritation or
ulceration may result Irom
chewing enteric-coated tablets
or insuIIicient dilution oI liquid
or powder Iorms. Some
extended-release tablets are
contained in a wax matrix that
may be expelled in the stool.
This occurrence is not
signiIicant.
Instruct patient to avoid salt
substitutes or low-salt milk or
Iood unless approved by health
care proIessional.
Patient should be advised to
read all labels to prevent excess
potassium intake.
Advise patient regarding
sources oI dietary potassium.
Encourage compliance with
recommended diet.
Instruct patient to report dark,
tarry, or bloody stools;
weakness; unusual Iatigue; or
tingling oI extremities.
NotiIy health care
proIessional iI nausea,
vomiting, diarrhea, or stomach
discomIort persists.
Dosage may require
adjustment. Emphasize the
importance oI regular Iollow-
up exams to monitor serum
levels and progress.





DRUG STUDY OF LIDOCAINE HYDROCHLORIDE

DRUG FEATURES MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
LIDOCAINE
HYDROCHLORIDE
Brand name:
Abbott Lidocaine

Classification:
Anaesthetics - Local
& General

Dosage:
50 ml/vial


Form:

Route:

Frequency:

A class IB
antiarrythmic
that decreases
the
depolarization,
automaticity,
and excitability
in the ventricles
during the
diastolic phase
by direct action
on the tissues
especially the
Purkinje
network

local or regional
anesthesia

Restlessness,
nervousness,
dizziness, tinnitus,
blurred vision; GI
upsets; muscle
twitching,
convulsions;
numbness oI the
tongue; hypotension,
bradycardia;
methemoglobinaemia;
Ietal intoxication.

Check drug concentration
careIully; many
concentrations are available.
Reduce dosage with
hepatic or renal Iailure.
Continuously monitor
response when used as
antiarrhythmic or injected as
local anesthetic.
Keep liIe-support
equipment and vasopressors
readily available in case
severe adverse reaction
(CNS, CV, or respiratory)
occurs when lidocaine is
injected.
Establish saIety
precautions iI CNS changes
occur; have IV diazepam or
short-acting barbiturate
(thiopental, thiamylal)
readily available in case oI
seizures.
Monitor Ior malignant
hyperthermia (jaw muscle
spasm, rigidity); have liIe-
support equipment and IV
dantrolene on standby.
Titrate dose to minimum
needed Ior cardiac stability,
when using lidocaine as
antiarrhythmic.
Reduce dosage when
treating arrhythmias in CHF,
digitalis toxicity with AV
block, and geriatric patients.
Monitor Iluid load
careIully; more concentrated
solutions can be used to treat
arrhythmias in patients on
Iluid restrictions.
Have patients who have
received lidocaine as a spinal
anesthetic remain lying Ilat
Ior 612 hr aIterward, and
ensure that they are
adequately hydrated to
minimize risk oI headache.
Check lidocaine
preparation careIully;
epinephrine is added to
solutions oI lidocaine to
retard the absorption oI the
local anesthetic Irom the
injection site. Be sure that
such solutions are used
only to produce local
anesthesia. These solutions
should be injected cautiously
in body areas supplied by
end arteries and used
cautiously in patients with
peripheral vascular disease,
hypertension, thyrotoxicosis,
or diabetes.
Use caution to prevent
choking. Patient may have
diIIiculty swallowing
Iollowing use oI oral topical
anesthetic. Do not give Iood
or drink Ior 1 hr aIter use oI
oral anesthetic.
Treat methemoglobinemia
with 1 methylene blue, 0.1
mg/kg, IV over 10 min.
Apply lidocaine ointments
or creams to a gauze or
bandage beIore applying to
the skin.
Monitor Ior saIe and
eIIective serum drug
concentrations
(antiarrhythmic use: 15
mcg/mL). Doses ~ 610
mcg/mL are usually toxic






DRUG STUDY OF SODIUM BICARBONATE

DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
SODIUM
BICARBONATE


Brand name:
Hospira Sodium
Bicarbonate


Classification:
Alkalinizers


Dosage:
10mEq/10ml;
50mEq/50ml


Form:

Route:

Frequency:

Restores
buIIering
capacity oI the
body and
neutralizes
excess acid

metabolic
acidosis,
systemic or
urinary
alkalinization,
antacid, cardiac
arrest
Tetany, edema,
gastric
distention,
belching,
Ilatulence,
hypokalemia,
metabolic
alkalosis,
hypernatremia,
chemical
cellulitis because
oI alkalinity,
pain, irritation,
tissue necrosis,
ulceration or
sloughing at the
site oI
inIiltration

do not take drug with milk to
avoid hypercalcemia, abnormally
high alkalinity in tissues and
Iluids, or kidney stones.
do not give to patients with
metabolic or respiratory alkalosis,
and in those with hypocalcemia in
which alkalosis may produce
tetany, hypertension, seizures, or
heart Iailure.
monitor Ior alkalosis by
obtaining blood pH, PaO2, PCO2,
and electrolyte levels


DRUG STUDY OF DOPAMINE
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
DOPAMINE

Brand name:
Intropin


Classification:
Adrenergics
(Sympathomimetics)

Dosage:
40 mg/Ml;
80mg/mL; 160
mg/mL

Form:

Route:

Frequency:

Stimulates
dopaminergic
and alpha beta
receptors Ior the
sympathetic
nervous system
resulting in a
positive
inotropic eIIect
and increased
cardiac output.
Action is dose-
related; large
doses cause
mainly alpha
stimulation

shock and
hemodynamic
imbalances,
hypotension

ectopic beats,
tachycardia,
anginal pain,
palpitation,
hypotension,
vasoconstriction,
ventricular
arrhythmias,
hypertension,
headache,
anxiety, dilated
pupils, nausea,
vomiting,
decreased urine
output, dyspnea

Monitor vital signs and ECG
closely throughout therapy.
Monitor I&O regularly; note
decreases in urine output.
Monitor central venous
pressure or pulmonary wedge
pressure iI possible during
inIusion.
Note signiIicant changes in
vital signs, ECG changes,
deterioration oI peripheral
pulses, and/or cold, mottled
extremities


DRUG STUDY OF DOBUTAMINE
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
DOBUTAMINE

Brand name:
Dobatrey


Classification:
Adrenergics

Dosage:
12.5 mg/mL


Form:

Route:

Frequency:

Stimulates
heart`s beta1
receptors to
increase
myocardial
contractility and
stroke volume.
Increases
cardiac output
by decreasing
peripheral
vascular
resistance,
reducing
ventricular
Iilling pressure,
and Iacilitating
AV node
conduction

increased
cardiac output in
short term
treatment oI
cardiac
decompensation
caused by
depressed
contractility

increased
systolic BP,
increased heart
rate, chest pain,
increased
number oI
premature
ventricular beats,
headache,
tingling
sensations,
paresthesia.
nausea,
vomiting,
dyspnea,
phlebitis, local
inIlammation
aIter inIiltration,
leg cramps






Monitor vital signs, ECG,
cardiac output, pulmonary
capillary wedge pressure, central
venous pressure and urinary
output careIully throughout
inIusion.
Monitor patency and placement
oI IV catheter to reduce risk oI
extravasation and phlebitis.
Watch out Ior symptoms oI
overdosage such as excessive
hypertension, tachycardia,
nausea, vomiting, tremor,
headache, chest pain


DRUG STUDY OF LIDOCAINE PREMIXED
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
LIDOCAINE
PREMIXED

Brand name:
Xylocaine

Classification:
Antiarrhythmic
agent, Local
anesthetic

Dosage:
0.2 (2mg/ml);
0.4 (4g/ml);
0.8 (8g/ml)


Form:

Route:

Frequency:

Acts as an
anesthetic by
stabilizing the
neuronal
membrane by
inhibiting the
ionic Iluxes
required Ior the
initiation and
conduction oI
impulses,
thereby
eIIecting local
anesthetic
action. Also
acts as an
antiarrhythmic
by decreasing
the
depolarization,
automaticity,
and excitability
in the ventricles
during the
diastolic phase
by a direct
action on the
tissues,
especially the
Purkinje
network,
ventricular
arrhythmias
caused by MI,
cardiac
manipulation or
cardiac
glycosides

bradycardia,
cardiac arrest,
CV collapse,
hypotension,
apprehension,
conIusion,
dizziness,
drowsiness,
hallucinations,
headache, light-
headedness,
mood changes,
nervousness,
tremors,
conjunctival
hyperemia,
corneal epithelial
changes,
diplopia,
tinnitus, visual
disturbances,
nausea,
vomiting,
erythema,
petechiae,
edema, injection-
site reactions,
including
bruising,
burning,
contusion,
Explain that adverse reactions
related to the CNS (eg,
drowsiness, conIusion,
paresthesias, convulsions,
respiratory arrest) can occur and
are a result oI CNS toxicity.
Advise patient that drug may
cause dizziness or drowsiness and
to avoid getting out oI bed or
walking without assistance.
Advise patients that skin
reactions, including erythema,
petechiae, and edema, may occur
with intradermal injection.
Systemic eIIects can occur
Iollowing topical use; use lowest
possible dose to avoid serious
toxicity, shock, or heart block.
Do not use in patients with
congenital or idiopathic
methemoglobinemia or in inIants
younger than 12mo oI age who
are receiving methemoglobin-
inducing drugs.
Use with caution and in lower
doses in patients with CHF,
reduced cardiac output, digitalis
toxicity, and in elderly patients

without
involvement oI
the autonomic
system. Neither
contractility,
systolic arterial
blood pressure,
atrioventricular
(AV)
conduction
velocity, nor
absolute
reIractory
period is altered
by usual
therapeutic
doses
hemorrhage,
local reactions,
including
soreness at IM
injection site,
venous
thrombosis or
phlebitis,
extravasation,
burning,
stinging,
sloughing,
respiratory
depression or
arrest,
hypersensitivity
reactions





DRUG STUDY OF MANNITOL
DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
MANNITOL

Brand name:
Osmitrol


Classification:
osmotic diuretic

Dosage:
5 , 10, 15,
20, 25 in
500cc/1,000cc


Form:

Route:

Frequency:

Increases
osmotic
pressure oI
glomerular
Iiltrate; drug
elevates plasma
osmolality
test dose Ior
marked oliguria
or suspected
inadequate renal
Iunction,
oliguria, to
reduce
intraocular or
intracranial
pressure, diuresis
in drug
intoxication

Increased
urination,
nausea, runny
nose, vomiting,
severe allergic
reactions (rash,
hives, itching,
diIIiculty
breathing,
tightness in the
chest, swelling
oI the mouth,
Iace, lips, or
tongue), blurred
vision, chest
pain, chills or
Iever, conIusion,
decreased
alertness,
diIIiculty
urinating,
extreme
dizziness,
extreme thirst or
dry mouth, Iast
or irregular
heartbeat,
headache,
muscle cramps,
pain, redness, or
swelling at the
Monitor vital signs, including
CVP, and Iluid intake and output.
Monitor weight, renal Iunction,
and serum sodium and potassium
levels daily
Watch out Ior symptoms oI
overdosage such as excessive
hypertension, tachycardia,
nausea, vomiting, tremor,
headache, chest pain
To relieve thirst, give Irequent
mouth care and Iluids

injection site,
weakness





DRUG STUDY OF DEXTROSE 5 IN WATER (D5W) SOLUTION

DRUG
FEATURES
MECHANISM
OF ACTION
INDICATIONS CONTRA
INDICATIONS
ADVERSE
REACTION
SIDE
EFFECTS
NURSING
RESPONSIBILITIES
Generic name:
DEXTROSE 5
IN WATER
(D5W)
SOLUTION


Brand name:
None


Classification:
Isotonic/Hypotonic
Solution

Dosage:
250ml bottles (5g
dextrose/100ml
water)



Form:

Route:

Frequency:

Provides some
sugar Ior
cellular
metabolism and
supplies body
water
Iluid
replacement and
caloric
supplementation
in patients who
can`t maintain
adequate oral
intake or are
restricted Irom
doing so

Increases Iree
water and may
cause
intracellular
edema, Iluid
overload,
inIiltration
(swelling and
pain at inIusion
site)

Monitor inIusion rate
Irequently; iI signs oI Iluid
overload, turn oII IV drip.
InIusion may result in Iluid
overload.
Check IV site Irequently and iI
inIiltration is noted, turn oII IV
drip.
Watch out Ior signs oI Iluid
overload (distended neck veins
(JVD), rapid respirations, shallow
tidal volume, Iine auscultatory
crackles, dyspnea, and peripheral
edema)
Watch out Ior signs oI
inIiltration (swelling and pain
around IV site)