Amiodarone Hydrochloride Brand Names: Anoion tab Classification: Cardiac Drugs Dosage: PO Initial: 200 mg 3 times/day for 1 wk,

reduce to 200 mg twice daily for a further wk Action: Blocks potassium chloride leading to prolongation of action potential duration. sweating. Indication: Ventricular and supraventricular arrhythmias. Contraindications: sinus node dysfunction, lactation Side effects: Blue-grey discoloration of skin, photosensitivity, paresthesia, tremor, nausea, vomiting, metallic taste, Changes in vision Nursing Measures: Monitor cardiac rhythm continuously. Give drug with meals to decrease GI problems. Teach patients not to drive, operate dangerous machinery, or undertake tasks that require coordination. Report unusual bleeding or bruising. Lidocane

Contraindications: Severe degrees of SA, AV, or

intraventricular block in the absence of pacemaker.

Nursing Responsibility: Monitor urinary pH, calcium, electrolytes and phosphate levels. Record amount and consistency of stools.

Side Effects: sensation of cold, vomiting Adverse Effects: Confusion, tremor, lethargy,
somnolence, stupor, restlessness anxiety, Respiratory depression and arrest, hypotension, bradycardia Nursing Responsibility: Monitor EKG, BP, pulse, rhythm, continuously. Monitor serum lidocaine levels throughout therapy; therapreutic range 1.5-5 mcg/ml Monitor intake and output Avoid activities requiring mental alertness. Sodium Bicarbonate Clients on low-sodium diets should evaluate sodium contents of antacids. Nitroglycerin Brand Name: Nitrostat Classification: Antianginal, Nitrate, Vasodilator, Coronary Dosage: 0.3-0.4 mg SL q 5 min, max 3 doses. Action: Relaxes the vascular smooth system Indication: Angina pectoris, CHF associated with AMI, Cardiac load reducing agent Contraindication: Hypersensitive to nitrates and in those with early MI, severe anemia, increased ICP angle-closure glaucoma, hypovolemia, hypotension, orthostatic hypotension Adverse Effects: orthostatic hypotension, flushing, fainting. Side Effects: headache, throbbing, dizziness, weakness, nausea, vomiting, rashes. Nursing Responsibility:

Brand Name: Arm and Hammer Pure Baking Soda,

Citrocarbonate

Classification: Alkalizing Agent, Buffer, Antacid,

electrolyte Dosage: 1 mEq/kg IVP, may repeat 0.5 mEq/kg 10 min.

Action: Neutralizes gastric acid; Decrease pepsin

activity

Brand Name: Xylocaine Classification: Antiarrythmic and Anesthetic

Dosage: 1-1.5 mg/kg IVP or ETT (double dose if giving via ET tube), may repeat q 5-10 min. max

Indications: Hyperacidity, Hyperkalemia, Shock

associated with severe diarrhea Contraindications: Metabolic or respiratory alkalosis. Oral sodium bicarbonate is contraindicated for acute ingestion of strong mineral acids. Monitor BP and apical pulse before administration and periodically after dose. Have client sit or lie down if taking drug for the first time. Client must have continuing EKG monitoring for IV administration Instruct to take at first sign of anginal pain.

Action: Decrease cardiac excitability, cardiac

contraction is delayed in the atrium and ventricle

Indications: Decrease cardiac excitability, cardiac

contraction is delayed in the atrium and ventricle

Side Effects: Gastric distention, metabolic

alkalosis, hypernatremia, hypokalemia, pain and irritation at injection site.

Action: inhibits sodium and chloride reabsorption

Morphine Sulfate Brand: Duramorph Classification: Opioid agonist analgesic Dosage: 2.515 mg/70 kg of body weight in 45 mL water for injection administered over 45 min, or as directed by physician. Action: Principal opium alkaloid; acts as agonist at specific opioid receptors in the CNS to produce analgesia Indication: Relief of moderate to severe acute and chronic pain Contraindication: hypersensitivity to opioids Adverse Effect: Light-headedness, dizziness, sedation, nausea, vomiting, respiratory depression Side Effects: dry mouth, constipation, sweating, physical tolerance Nursing Interventions Tell patient to lie down during IV administration. Take this drug exactly as prescribed. Avoid alcohol, antihistamines, sedatives, tranquilizers, over-the-counter drugs. Dilute and administer slowly IV to minimize likelihood of adverse effects. Furosemide at the proximal and distal tubules and the ascending loop of Henle

Adverse Effects: anginal pain, arrythmias,

bradycardia, palpitations, tachycardia, vasoconstriction, vomiting, dyspnea Side Effects: headache, nausea Nursing Interventions: Frequently monitor ECG, BP, cardiac output, CVP and urine output Tamper dosage slowly to evaluate stability of blood pressure. Acidosis decrease effectiveness of dopamine. Captopril

Indications: Edema, ascites or renal dysfunction,

hypertension or in combination with other antihypertensive medications.

Contraindication: hypersensitive to drug or any of

its components and in those with anuria Side Effects: tinnitus, jaundice, hypotension electrolyte imbalance, dizziness Nursing Interventions: Monitor serum glucose, and electrolyte, intake and output, daily weight, HR, and BP. Take with or after meals and in AM Ask patient to move slowly to prevent orthostatic hypotension. Avoid alcohol Dopamine Hydrochloride

Brand Names: Ace-Bloc tab Classification: ACE Inhibitors Dosage: 12.5 mg twice daily. Action: inhibits ACE, reduces Sodium and water retention, lowers blood pressure Adverse Reactions: Hypotension, tachycardia, chest pain, palpitations, pruritus, hyperkalaemia. Contraindications: bilateral renal artery stenosis, pregnancy Side Effects: rash, gastric irritation, headache Nursing Interventions: Administer 1 hr before or 2 hr after meals. Monitor patient closely for fall in BP secondary to reduction in fluid volume, excessive hypotension may occur. Advice patients not to stop without consulting your health care provider. Reduce dosage in patients with impaired renal function.

Brand Name: Revimine Classification: Inotropic, vasopressor

Dosage: Adults: initially, 1 to 5 mcg/kg/minute by I.V. infusion.

Action: Stimulates dopaminergic and alpha and

beta receptors of the sympathetic nervous system

Brand Name: Apo-Furosemide Classification: Loop Diuretics

Dosage: 0.5-1 mg/kg slow IVP over 1-2 min, may repeat once at 2 mg/kg slow IVP over 1-2 mins.

Indications: shock, hemodynamic imbalances,

improve perfusion of vital organs, to increase cardiac output, and to correct hypotension.

Contraindications: patient with uncorrected

tachyarrhythmias

Epinephrine Brand Names: Adrenalin Chloride

Classification: Beta2 Adrenergic Agonists

Dosage: Cardiac arrest: 1 mg IV of 1:10,000 solution q 3-5 min; double dose if administering via ET tube

Action: Stimulates beta receptors in lung; relaxes

bronchial smooth muscle.

Indications: Asthma, Bronchitis, Emphysema, All

cardiac arrest

blocks dopamine receptors at the chemoreceptor trigger zone Indication: disturbances of GI motility, nausea & vomiting of central & peripheral origin associated w/ surgery, metabolic diseases, infectious & drug induced diseases, facilitate small bowel intubation & radiological procedures of GIT Contraindications: gastrointestinal hemorrhage, epilepsy Side effects: extrapyramidal reactions, drowsiness, fatigue & lassitude, anxiety Nursing Interventions: Monitor BP carefully during IV administration. Monitor for extrapyramidal reactions, and consult physician if they occur. Monitor diabetic patients, arrange for alteration in insulin dose or timing if diabetic control is compromised by alterations in timing of food absorption.

Nursing Interventions: Monitor carefully, assess for confusion, delirium, other anticholinergic side effects and fall risk. Institute measures to prevent falls. 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; Adverse Reaction: drowsiness, slurred speech, tremor, transient amnesia, fatigue, headache, hallucination Nursing Measures: Change from IV therapy to oral therapy as soon as possible. Do not use small veins (dorsum of hand or wrist) for IV injection. Reduce dose of narcotic analgesics with IV diazepam; dose should be reduced by at least one-third or eliminated. Carefully monitor P, BP, and respiration during IV administration; do not permit ambulatory patients to operate a vehicle following an injection. Monitor EEG in patients treated for statusepilepticus, seizures may recur after initial control. Monitor liver and kidney function

Contraindications: angle-closure glaucoma,

organic brain damage, shock other than anaphylactic Side Effects: tachycardia, palpitation, dizziness, vertigo, insomnia, nausea and vomiting, anorexia Nursing Interventions: Monitor V/S and check for cardiac dysrhythmias Avoid IM use of parenteral suspension into buttocks. Gas gangrene may occur Massage site after IM injection to counteract possible vasoconstriction If blood pressure increases sharply, rapid-acting vasodilators such as nitrates or alpha blockers can be given to counteract.

Dipenhydramine Brand name: Benadryl Classification: antihistamine Dosage: 50mg/ml Indication: Hay fever, urticaria, vasomotor rhinitis, angioneurotic edema, drug sensitization, serum & penicillin reaction, contact dermatitis Action: prevents histamine mediated responses, drug provides local anesthesia and suppresses cough reflex

Clonidine Hydrochloride
Brand Names: Catapres

Classification: antihypertensive
Dosage: PO 0.1 mg BID or TID

Metoclopromide Brand name: Apo-Metoclop Classification: antiemetic & anti-spasmodic Dosage: 10 mg/ 2mL Action: stimulates motility of upper GI tract, increases lower esophageal sphincter tone, and

Action: Centrally acting antiadrenergic derivative.

Stimulates alpha2-adrenergic receptors in CNS to inhibit sympathetic vasomotor centers

Contraindications: use of otc dipenhydramnine

Adverse Reaction: CV and CNS effects, blood disorders, GI disturbances, anti-muscarinic effects and allergic reactions.

Indications: Mild to moderate hypertension Contraindications: anticoagulant therapy

Side effects: Hypotensiontachycardia, bradycardia, dry mouth, constipation, drowsiness, dyspnea Nursing Interventions: Monitor I&O.Report change in I&O ratio or change in voiding pattern. Monitor BP Do not stop medication abruptly. Do not engage in activities that require mental alertness. Dobutamine Hydrochloride Brand Name: Dobutrex Classification: Inotropic, Adrenergic Dosage: Adults individualized: 2.5-15 mcg/kg/min. Action: Enhancing the force of myocardial contraction Indication: Short term treatment of cardiac decompensation in organic heart disease of cardiac surgical pressures. Contraindication: idiopathic hypertrophic subaortic stenosis Adverse Effects: angina, hypertension, hypotension, increased heart rate, nonspecific chest pain, PVCs, nausea and vomiting. Side Effects: headache, mild leg cramps or tingling sensation Nursing Interventions: Monitor CVP to assess vascular Monitor ECG and BP continuously during drug administration; Record I&O

Encourage patients to report any chest pain, headaches or IV site pain. Paracetamol Brand name: Aeknil Classification: Analgesics (Non-Opioid) & Antipyretics Dosage: Adult & childn 10 yr 2-3 mL, 10 yr 1-2 mL. Action: produce analgesia by blocking pain impulses by inhibiting synthesis of prostaglandin in CNS, relieves fever Indication: Pyrexia of unknown origin. Contraindication: hypersensitivity to the preparation and in severe liver diseases. Side effects: Hematological, skin & other allergic reactions Nursing Interventions: Use liquid form for children and patients who have difficulty swallowing. In children, dont exceed five doses in 24 hours. Advise patient that drug is only for short term use. Advise patient or caregiver that many over the counter products contain acetaminophen; be aware of this when calculating total dailydose. Warn patient that high doses or unsupervised long term use can cause liver damage.