NAME OF DRUG

Generic Name:
Dopamine
Hydrochloride
Brand Name:
Intropin
Classification:
Sympathomimetic
Direct and Indirect
Acting

DOSAGE,
MECHANISM OF
FREQUENCY,
ACTION
ROUTE
500mL x 15gtts/min, Dopamine is the
IVTT
immediate precursor of
epinephrine in the body.
Exogenously
administered, it
produces direct
simulation of beta-1
receptor and variable
(dose dependent)
stimulation of alpha
receptor (peripheral
vasoconstriction). Will
cause a relase of
norepinephrine from its
storage sites. The action
results in increased
myocardial contraction.
CO, and SV, as well as
increased renal blood
flow and sodium
excretion. Exerts little
effect on DBP (diastolic
blood pressure) and
induces fewer
arrhythmias that are
seen with isoprotenol.
Does not cross the blood
brain barrier.
Metabolized in the liver,
and excreted in the
urine.

INDICATION

Cardiogenic
shock due to
chronic cardiac
decompensation

CONTRAINDICATION

Pheochromocytoma
Uncorrected
tachycardia
Ventricular
Fibrillation
Arrhythmias
Tachydysrhythmias

ADVERSE
REACTION

NURSING
RESPONSIBILITIES

CV: Ectopic heartbeats, Administration/Storage

tachycardia, angina
pain, palpitations,
1. Muste be diluted
hypotension,
before using.
2. Dilute prior to
hypertension.
administration,
Infrequently: abberant
solution stable for 24
conduction, bradycardia,
hours at room
widened QRS complex.
temperature, protect
from lights
CNS: Head Ache
3. When discontinuing,
gradually decrease
GI: Nausea and
dose as ordered;
Vomiting
sudden cessation may
cause marked
Integumentary Necrosis
hypotension
Respiratory: Dyspnea
Intervention:
Others: Mydriasis,
1. Monitor Vital Signs, I
infrequently:
and O and ECG; titrate
Piloerection, azotemia,
infusion to maintain
polyuria. High doses
SBP as ordered.
may cause mydriasis
2.
Assess for oxygenation
and ventricular
or perfusion; decreased
arrhythmia.
BP, chest pain,
Extravasation may result
dizziness, loss of
in necrosis and
consciousness
sloughing of
3. Check for
surrounding tissue
extravasation

NAME OF DRUG

Generic Name:
Pantoprazole
sodium
Brand Name:
Pantoloc
Classification:
Proton Pump
Inhibitor

DOSAGE,
FREQUENCY,
ROUTE
40mg IVTT OD

MECHANISM OF
ACTION
Pantoprazole is a proton
pump inhibitor. It
accumulates in the
acidic compartment of
parietal cells and is
converted to the active
form, a sulfanilamide,
which binds to
hydrogen-potassiumATP-ase at the secretory
surface of gastric
parietal cells. Inhibition
of hydrogen-potassiumATP-ase blocks the final
step of gastric acid
production, leading to
inhibition of both basal
and stimulated acid
secretion. The duration
of inhibition of acid
secretion does not
correlate with the much
shorter elimination halflife of pantoprazole.

INDICATION

Short term
treatment (Up to
8 weeks) of
erosive
esophagitis
associated with
GERD

CONTRAINDICATION

Hypersensitivity to any
component of the
formulation

ADVERSE
REACTION

NURSING
RESPONSIBILITIES

GI: Diarrhea, flatulence,

abdominal pain,
eructation, constipation,
dyspnea, gastroenteritis,
GI disorder, N&V,
rectal disorder

Administration/Storage
1. Give IVTT
mixtures over 15
min rate at 3mg or
less per minute
through a dedicated
line using the inline
filter provided.
2. Flush the IV line
before and after IV
pantoprazole with
either D5W
injection, 0.9 NaCl
injection, Plain
Lactated Ringers
injection. Do not
give IV
pantoprazole
simultaneously
through the same
line with other IV
solutions.

CNS, headache,
insomnia, anxiety,
dizziness, migraine
Respiratory: Bronchitis,
increased cough,
dyspnea, pharyngitis,
rhinitis, sinusitis, URTI
GU: Urinary frequency,
UTI
Body as a whole: Rash,
asthenia, flu syndrome,
infection, pain,
arthralgia
Miscellaneous:
Back/Chest/Neck Pain

Interventions
1. Administer once a
day
2. Maintain supportive
treatment as
appropriate for
underlying problem

3. Note indications for

therapy, onset and
characteristics of
symptoms. Record
abdominal
assessment, urea
breath or
endoscopic findings
if available
4. List drugs
prescribed to ensure
none require acidity
for metabolism
5. Provide additional
comfort measures
to alleviate
discomfort from GI
effects and
headache.
Client/Family Teaching
1. Report any unusual
side effects.
Worsening of Signs
and symptoms, or
lack of response
and keep F/U
appointments.

NAME OF DRUG

Generic Name:
Clindamycin
hydrochloride
Brand Name:
Cleocin
Classification:
Antibiotic

DOSAGE,
FREQUENCY,
ROUTE
600mg IVTT ANST
every 8 hours

MECHANISM OF
ACTION

INDICATION

CONTRAINDICATION

A semisynthetic
antibiotic that
suppresses protein
synthesis by
microorganism by
binding to ribosomes
(50S subunit) and
preventing peptide bond
formation. Is both
bacteriostatic and
bactericidal.

Serious
respiratory tract
infections

Hypersensitivit6y to
Clindamycin

Serious skin and

soft tissue
infections

ADVERSE
REACTION

NURSING
RESPONSIBILITIES

GI: N&V, diarrhea,

Administration/Storage
pseudomembranous
1. Do not refrigerate
colitis, abdominal pain,
the reconstituted
esophagitis, unpleasant
solution. It may
or metallic taste (after
become thickened
high IV doses), glossitis,
and difficult to
stomatitis.
pour.
2. Give parenteral
clindamycin only to
CV: Hypotension,
hospitalized
rarely, cardiopulmonary
patients
arrest after too rapid IV
3. Administer IV over
use.
a period of 20-60
Allergic: Morbilliform
minutes, depending
rash (rare), kin rashes,
on dose and desired
urticarial, erythema
therapeutic serum
multiforme,
concentration
anaphylaxis, StevenJohnson-like syndrome,
Intervention
maculopapular rash,
1. Auscultate lung;
angioneuric edema
assess extend of
Hematologic:
respiratory tract
Leukopenia,
infection
neutropenia,
2. Monitor renal
thrombocytopenia,
disease, allergies or
transient eosinophilia,

agranulocytosis,,
aplastic anemia.
Hepatic: Jaundice,
abnormal AFTs
GU: Renal dysfunctions
(azotemia, oliguria,
proteinuria, vaginitis
Miscellaneous:
Superinfections,
tinnitus, polyarthritis.
Also sore throat, fatigue,
urinary frequency, and
headache.

GI problems
3. With IV therapy,
observe for
hypotension; keep
in bed 30 min
following infusion.
Advise patient a
bitter taste may be
evident.
4. Observe closely
for:
a. Skin rash,
frequently
reported
b. Renal and/or
hepatic
impairment and
newborns for
organ dysfunction
c. GI disturbances,
such as abdominal
pain, diarrhea,
anorexia, N&V,
bloody/tarry
stools and
excessive
flatulence.

NAME OF DRUG

Generic Name:
Meloxicam
Brand Name:
Mobic
Classification:
NSAID

DOSAGE,
FREQUENCY,
ROUTE
15mg IM Q12 PRN
for Pain

MECHANISM OF
ACTION
Prolonged drug
absorption. Steady state
raeched 5 days. Over
99% plasma protein
bound. Metabolized in
the liver by P450
mediated metabolism.

INDICATION

For pain

CONTRAINDICATI
ON

ADVERSE
REACTION

NURSING
RESPONSIBILITIES

Use in those who have

exhibited asthma,
allergic type reactions
after taking aspirins or
other NSAIDS.
Use in advanced Renal
Disease

GI: abdominal Pain,

diarrhea, dyspnea,
constipation, flatulence,
N&V.
CNS: Dizziness,
headache, insomnia

Administration/ Storage
Store at 15-30C keep in a dry
place in a tight container.

Respiratory:
Pharyngitis, URTI,
coughing
GU: Renal papillary
necrosis, micturation
frequency. UTI
Hematologic: Anemia
MS: Arthralgia, back
pain
Dermatologic: Pruritus,
Rash

Assessment/Intervention
Determine any GI bleed or
ulcer history, aspirin, or other
NSAID induced asthma,
urticaria, or allergic reaction
Establish safety measures if
CNS Disturbances occur
Provide further comfort
measures to reduce pain and
to reduce inflammation.
Assess for liver/renal
dysfunction; monitor CBC,
electrolytes, renal and LFTs
within 3 months of starting
therapy and then q 6 months.
Avoid dysfunction.

Body as a whole: Fluid

retention, edema, pain,
flu like symptoms,
accidents

NAME OF DRUG

Generic Name:
Paracetamol
Brand Name:
Tempra
Classification:
Nonopioid
analgesic,
antipyretic

DOSAGE,
FREQUENCY,
ROUTE
300mg IVTT
T>37.8C Q4 PRN

MECHANISM OF
ACTION
Chemical effect: may
produce analgesic effect
by blocking pain
impulses, by inhibiting
prostaglandin or pain
receptor sensitizers.
May relieve fever by
acting in hypothalamic
heat-regulating center.
Therapeutic Effect:
relieves pain and
reduces fever

INDICATION

CONTRAINDICATION

Mild pain or fever Contraindicated to

patients hypersensitive to
the drug

Client/Family teaching
Report any unusual or
persistent side effects
including dyspnea, abdominal
pain, dizziness and changes in
stool and or skin color.
Alcohol and tobacco may
aggravate GI S&S.
Report weight gain, skin rash,
swelling of ankles, chest pain,
SOB, or lack of effect.

ADVERSE
REACTION
Hematologic: Hemolytic
anemia, neutropenia,
leukopenia,
pancytopenia,
thrombocytopenia
Hepatic: Liver
damage(with toxic
doses), jaundice
Metabolic:
hypoglycemia
Skin: Rash, urticarial

NURSING
RESPONSIBILITIES
1. Check temperature
every hour.
2. Assess for pain:
type of pain,
location, intensity,
duration, and
temperature.
3. Check I&O
4. Assess allergic
reaction: rash &
urticaria; if these
occur drug may
have to be
discontinued.
5. Inform folks about
the signs and
symptoms that mat

occur and inform

them to report if
any of these signs
and symptoms
occurs.
6. Assess IV sites for
any irritation

NAME OF DRUG

Generic Name:
Ranitidine
Hydrochloride
Brand Name:
Zantac
Classification:
Histamine H-2
Receptor
Antagonist

DOSAGE,
FREQUENCY,
ROUTE
50mg IVTT Q8

MECHANISM OF
ACTION

INDICATION

CONTRAINDICA
TION

Competitively inhibits
gastric acid secretion by
blocking the effect of
histamine on histamine
H2 receptors. Both
daytime and nocturnal
basal gastric acid
secretion, as well as
food and pentagastrinstimulated gastric acid
are inhibited. Weak
inhibitor of cytochrome
p45- (drug metabolizing
enzymes); thus, drug
interactions involving
inhibition of hepatic

Short term
treatment of
active, benign
gastric ulcers.
Maintenance of
healing of gastric
ulcers.

Cirrhosis of the liver

Impaired renal or
hepatic function.

ADVERSE REACTION

GI: Constipation, N&V,

diarrhea, abdominal pain,
pancreatitis.
CNS: Headache, dizziness,
malaise, insomnia, vertigo,
confusion, anxiety, agitation,
depression, fatigue,
somnolence, hallucinations
CV Bradycardia or
tachycardia, premature
ventricular beats following
rapid IV use, vasculitis,
cardiac arrest.

NURSING
RESPONSIBILITIES
Administration/Storage
1. Store vetweeb 4-25C
Assessment
1. Assess the stomach pain,
nothing characteristics
frequency of occurrence
and things that alter it.
2. Review CBC; assess for
infections, renal or liver
disease.
Client/Family Teaching
1. Avoid alcohol, aspirincontaining products, and
beverages that contain

metabolism are not

expected to occur. Food
increases bioavailability

NAME OF DRUG

Generic Name:
Albuterol sulfate
Brand name:
Salbutamol
Classification:
Bronchodilator

DOSAGE,
FREQUENCY,
ROUTE
1 neb Q6h

MECHANISM OF
ACTION
In low doses, acts
relatively selectively at
beta2-adrenergic
receptors to cause
bronchodilation; at
higher doses, beta2
selectivity is lost,. And
the drug acts at beta 2
receptors to cause
typical
sympathomimetic
cardiac effects.

Hematologic:
Thrombocytopenia,
granulocytopenia, leukopenia,
pancytopenia (sometimes
with marrow hypoplasia),
agranulocytosis, autoimmune
hemolytic or aplastic anemia.

INDICATION

Treatment of
acute attacks of
bronchospasm

caffeine; these increase

stomach acid. Avoid
things that may
aggravate symptoms,
i.e., alcohol, aspirin,
NSAIDs, caffeine, and
black pepper
2. Report any evidence of
yellow discoloration of
Hepatic: Heaptotoxicity,
the skin or eyes, or
jaundice, hepatitis, increase in
diarrhea. Maintain
ALT.
adequate hydration.
Report any confusion or
Dermatologic: Erythema
disorientation.
multiforme, rash, alopecia
3.
Report as schedule to
Allergic: Bronchospasm,
determine extent of
anaphylaxis, angioneurotic
healing and expected
edema (rare), rashes, fever,
length of therapy
eosinophilia
CONTRAINDICATION
ADVERSE
NURSING
REACTION
RESPONSIBILITIES
Contraindicated with
hypersensitivity to
albuterol
Tachyarrhythmias
Hypertension

CNS: Restlessness,
apprehension, anxiety,
fear, CNS stimulation,
kyperkinesia, insomnia,
tremor, drowsiness,
irritability, weakness,
vertigo, headache.
CV: Cardiac
arrhythmias,
tachycardia,
palpitations, PVCs
(rare), angina pain
Dermatologic:

Assessment
1. Check any history
of hypersensitivity
to albuterol;
tachycarrhythmias,
diabetes mellitus
2. Physical: Weight;
skin color,
temperature, turgor,
orientation,
reflexes, affect; P,
BP, RR,
adventitious
sounds; blood and
urine glucose,

Sweating, pallor,
flushing.
GI: N&V GERD,
unusual or bad taste
GU: Increased incidence
of leiomyomas of uterus
when given in higher
than human does in
preclinical studies
Respiratory: Respiratory
Difficulties, pulmonary
edema, coughing,
bronchospasm,
paradoxical airway
resistance with repeated
and excessive use of
inhalation preparations

serum electrolytes,
thyroid function
tests, and ECG
Interventions
1. Use minimal doses
for minimal
periods, drug
tolerance could
occur with
prolonged use.
2. Prepare solution for
inhalation by
diluting 0.5mL
0.5% solution with
2.5mL normal
saline; deliver over
5-15minutes by
nebulization
3. Do not exceed
recommended
dosage; administer
pressurized
inhalation drug
forms during
second half of
inspiration, because
the airways are
open wider and the
aerosol distribution
is more extensive
Teaching points
1. Do not exceed
recommended
dosage; adverse
effects or loss of
effectiveness may

result. Read the

instructions that
come with
respiratory inhalant.
2. These side effects
may occur;
Dizziness,
Drowsiness,
fatigue, headache;
N&V, change in
taste; rapid heart
rate, anxiety,
sweating, flushing,
insomnia
3. Report chest pain,
dizziness, insomnia,
weakness, tremors
or irregular
heartbeat, difficulty
of breathing,
productive cough,
failure to respond to
usual dosage.