Drug/dose/ Frequency Propranolol Hydrochlorid e

Classification/ Mechanism of action antiarrhythmic Completely blocks betaadrenergic reptors in the heart and juxtoglomerular apparatus, decreasing the influence of the sympathetic nervous system on these tissues, the excitability of the heart, cardiac workload and oxygen consumption, and the release of rennin and the lowering of bp. Acts in the CNS to reduce sympathetic outflow and vasoconstrictor tone.

Indication/ Contraindication Side effect I: hypertension, angina pectoris, subaortic stenosis, cardiac arrhythmias, prevention f reinfarction CI: allergy to betablocking agents,sinus bradycardia,second or third degree heart block,cardiogenic shock,heart failure,pregnancy , lactation Side effect: allergic reactions, dizziness,vertigo, fatigue, hallucinations, bradycardia, heart failure, eye eirritiation, dry eyes, joint pain, rhinitis, pharyngitis

Principles of care Taper drug gradually over 2 weeks with monitoring Monitor blood or urine glucose Avoid drinking alcohol

Treatment

evaluation

Take drug with meals Do not discontinue abruptly

Drug/dose/ Frequency Epinephrine

Classification/ Mechanism of action Bronchodilator Naturally occurring neurotransmitter, the effects of which are mediated by alpha or beta receptors in target organs. Effects on alpha receptors include vasoconstriction, contraction of dilator muscles of iris. Effects on beta receptors include positive chronotropic and inotropic effects of the heart

Indication/ Contraindication Side effect I: cardiac arrest, respiratory distress, mucosal congestion, uterine contractions, bronchospasm, CI: hypersensitivity to epinephrine, hypovolemia, tacchyarrythmiasm ischemic heart disease, cardiac dilation, hypersensitivity to sympathomimetic amines Side effect: fear, anxiety, tenseness, insomnia, hallucinations, weakness, blurred vision, photophobia, nausea vomiting, headache, pallor, local burning and stinging

Principles of care Protect drug solutions from light, extreme heat and freezing Shake the suspension for injection well before withdrawing the dose Do not exceed recommended dosage

Treatment

evaluation

Rotate subcutaneous injection sites to prevent necrosis Monitor injection sites frequently

Drug/dose/ Frequency Digoxin

Classification/ Mechanism of action Cardiotonic Increases intracellular calcium and allows more calcium to enter the myocardial cell during depolarization via sodiumpotassium pump mechanism; this increases force of contraction,increases renal perfusion, decreases heart rate

Indication/ Contraindication Side effect

Principles of care

Treatment

evaluation

I: heart failure, atrial Monitor apical fibrillarion pulse for 1 minute before CI: allergy to administering digitalis preparation, Follow diluting ventricular instructions tachycardia, carefully and ventricular use diluted fibrillation, heart solution block, sick sinus promptly syndrome Side effect: headache, weakness, drowsiness, arrhythmias, GI upset, anorexia

Have k salts, lidocaine,phenytoin, atropine and cardiac monitor readily available in case toxicity develops Record pulse same time each day Have a regular medical check up