Capitol University College of Nursing EMERGENCY DRUGS
DRUG ORDER MECHANISM OF AC ION INDICA IONS CON RAINDICA IONS AD!ERSE EFFEC S OF DRUGS NURSING RES"ONSI#I$I IES AND "RECAU ION
atropine sulfate Isoptone Atropine Classifi%ation& Anticholinergic Dosage& Bradydysrhymia's 0.5 1.0 mg 5 min to a max of 0.03 0.04 mg /kg Asystole 1.0 mg I or !"" #dil$te to 10 ml%. 0.1 mg /ml #ad$lt% 0.05 mg / ml #&ediatric%
'el&s to red$ce sali(a and fl$id in the res&iratory tract. )ay also $sed to treat a slo* heart+eat or insecticide or m$shroom &oisoning
"o restore cardiac rate and atrial &ress$re d$ring anesthesia
-ontraindicated in -an ca$se +l$rred &atients *ith gla$coma. (ision. dilated &yloric stenosis or &$&ils. dry mo$th. &rostatic he&ertto&hy &al&itations. $rinary exce&t in doses retention.tachy ordinaryly $sed for cardia. dro*siness to lessen the &reanesthetic and conf$sion. degree of A, heart medication +lock to o(ercome carotid sin$s reflex antidote for cholinergic toxicity
)onitor le(el of conscio$sness do not sit $& or stand $& /$ickly ad(ise &atient to stay o$t of +right light che* s$garless g$ms and s$ck hard candies to a(oid mo$th dryness $se l$+ricating dro&s is *earing contact lenses a(oid extrenme heat.
DRUG ORDER
MECHANISM OF AC ION
INDICA IONS
CON RAINDICA IONS
AD!ERSE EFFEC S OF DRUGS
NURSING RES"ONSI#I$I IES AND "RECAU ION
li'o%aine (ylo%aine Classifi%ation& - dr$gs0Antiarrhytmics Anesthetic Dosage& Arrhtymias 0 I 0 0.1 1.4 mg/kg +ody *eight. 2o more than 300 mg *ithin 1 ho$r &eriod. I)0 4 5 mg /kg +ody *eight
4ecrease Anesthesia cardiacexcita+ility. cardiaccontraction Arrhtymias is delayedin the atri$m -ontrol of stat$s and(entricle4ecre e&ile&tic$s asecardiacexcita+il retractory to ity.cardiaccontracti other treatments on isdelayed in theatri$m and(entricle
-ontraindicated in&atientshy&ersensiti( e toamide,ty&e localanesthetics and inthose *ith Adams 5toke syndrome 6olff,7arkinsons, 6hite 5yndrome. or se(ere degrees of 5A. A . or intra(entric$la r+lock in the a+senceof &acemaker
-250-onf$sion.tre mor. lethargy.somnolenc e.st$&or. restlessnessanxiety. hall$cinations.ner(o $sness.sei8$re. - 0hy&otension.+ra dychardia. ne*or *orsened arrhythmias !!2"0tinnit$s. +l$rred ordo$+le (ision. 9es&iratory09es&ira tory de&ression and arrest 5kin0 soreness atin:ection site ;ther0 ana&hylaxis
)onitor !<=. B7.&$lse. rhythm.contin$o$sly )onitor ser$m lidocaine le(els thro$gho$t thera&hy>thera&re$tic range 1.5,5 mcg/ml )onitor intake and o$t&$t 4o not mix in the same syringe *ith am&hoterin B orcefa8olin Administer?idocaine "I . In case of circ$latory de&ression ha(e do&amine a(aila+le
DRUG ORDER )Generi% na*e+ ,ran' na*e %lassifi%ationDosage+ route+ fre.uen%y/
MECHANISM OF AC ION
INDICA IONS
CON RAINDICA IONS
AD!ERSE EFFEC S OF DRUGS
NURSING RES"ONSI#I$I IES AND "RECAU ION
epinep0rine Epifrin Classifi%ation& Beta3 Adrenergic Agonists Dosage& -ardiac arrest0 1 mg I of 1010.000 sol$tion/ 3,5 min> do$+le dose administering (ia !" t$+e Ana&hylaxis00.1, 1 mg 5@or I) of 101000 sol$tion. Asthma00.1,0.3 mg 5@ orI) of 1010.000 sol$tion 9efractory +radycardia and hy&otension0 3,10$g/min
5tim$lates +eta rece&tors inl $ng.9elaxes +ronchial smooth m$scle. Increases (italc a&acity B7. '9. 79 4ecreases air*ay resistance
Asthma Bronchitis !m&hysema All cardiac arrest.ana&hylaxis Ased for sym&tomatic +radycardia 9elief of +ronchos&asmocc$r ring d$ring !xercised,ind$ced +ronchos&asm anesthesia
-ontraindicate in &atients *ith angle ,clos$re gla$coma. shock #other than ana&hylactic shock%. organic +rain damage. cardiac dilation. arrhythmias. coronary ins$fficiency. or cere+ral arteriosclerosis. Also contraindicated in &atient recei(ing general anesthesia *ith halogenated hydrocar+ons orcyclo&ro&ane and in &atients in la+or #may delay second stage% 5ome &rod$cts containing s$lfites
2er(o$sness. )onitor /5. and check tremor. (ertigo. for cardiac dysrhythmias &ain. *idened &$lse 4r$g increases rigidity &ress$re. and tremor in &atients *ith hy&ertension 7arkinson's disease na$sea !&ine&hrine thera&y interferes *ith tests for $rinary catecholamine A(oid I) $se of &arenterals$s&ension into +$ttocks. =asgangrene may occ$r
)assage site after I) in:ectio nto co$nteract &ossi+le (asoconstriction.
;+ser(e &atient closely for ad(erse reactions. 2otify doctor if ad(erse reaction de(elo&
BIf +lood &ress$re increases shar&ly. ra&id,acting (asodilators s$ch as nitrates oral&ha +lockers can +e gi(en toco$nteract
DRUG ORDER
MECHANISM OF AC ION
INDICA IONS
CON RAINDICA IONS
AD!ERSE EFFEC S OF DRUGS
NURSING RES"ONSI#I$I IES AND "RECAU ION
'igo1in $ano1in+ Digo1in Classifi%ation& Inotro&ics Dosage2Route& In:ection 500 mcg#0.5 mg% in 3 m?#350 mcg C0.35mgD &er m?%
inhi+its sodi$m, &otassi$m acti(ated adenosine tri&hos&hate. &romoting mo(ement of calci$m from extracell$lar to intra, cyto&lasm and strengthening myocardial contraction. also acts on -25 to enhance (agal tone
-ardiac fail$re accom&anied +y atrial fi+rillation> management of chronic cardiac fail$re *here systolic dysf$nction or (entric$lar dilatation is dominant> management of certain s$&ra(entric$lar arrhythmias. &artic$larly chronic atrial fl$tter E fi+rillation.
s-ontraindicated in &atients hy&ersensiti(e to the dr$g or any of its com&onents and in those *ith digitalis,ind$ced toxicity. (entric$lar fi+rillation.or (entric$lar tachycardia $nless ca$sed +y heart fail$re.Ase ca$tio$sly in &atients *ith ac$te )I. in com&lete A +lock. sin$s +radycardia
na$sea. (omiting. anorexia. headache. facial &ain. fatig$e. *eakness. di88iness. dro*siness. disorientation. mental conf$sion. +ad dreams. con($lsions
F )onitor a&ical &$lse for 1 min +efore administering> hold dose if &$lse G H0 in ad$lt or G I0 in infant> retake &$lse in 1 hr. If ad$lt &$lse remains G H0 or infant G I0. hold dr$g and notify &rescri+er. 2ote any change from +aseline rhythm or rate. F -heck dosage and &re&aration caref$lly. F A(oid I) in:ections. *hich may +e (ery &ainf$l. F Jollo* dil$ting instr$ctions caref$lly. and $se dil$ted sol$tion &rom&tly. F A(oid gi(ing *ith meals> this *ill delay a+sor&tion. F 'a(e emergency e/$i&ment ready> ha(e <K salts. lidocaine. &henytoin. atro&ine. cardiac monitor on stand+y in case toxicity de(elo&s. F )onitor for thera&e$tic dr$g le(els0 0.53 ng/m?.
DRUG ORDER %aptopril Capote% Classifi%ation& Angiotensin, con(erting en8yme #A-!% inhi+itor Antihy&ertensi(e Dosage& 7; '"2 Initial0 13.5 mg t*ice daily. 7ost )I 5tart 3 days after )I. Initial0 H.35 mg/day.
MECHANISM OF AC ION inhi+its A-!. red$ces 5odi$m and *ater retention. lo*ers +lood &ress$re
INDICA IONS B"reatment of hy&ertension alone or in com+ination *ith thia8ide,ty&e di$retics B"reatment of -'J in &atients $nres&onsi(e to con(entional thera&y> $sed *ith di$retics and digitalis B"reatment of dia+etic ne&hro&athy B"reatment of left (entric$lar dysf$nction after )I
CON RAINDICA IONS -ontraindicated *ith allergy to ca&to&ril. history of angiodema. Ase ca$tio$sly *ith im&aired renal f$nction> -'J> salt or (ol$me de&letion. lactation. ®nancy.
AD!ERSE EFFEC S OF DRUGS 'y&otension. tachycardia. chest &ain. &al&itations. &r$rit$s. hy&erkalaemia. 7rotein$ria> angioedema. skin rashes> taste dist$r+ance. non&rod$cti(e co$gh. headache. 7otentially Jatal0 2e$tro&enia. $s$ally occ$rs *ithin 3 mth of starting thera&y es&ecially in &atients *ith renal dysf$nction or collagen diseases. 'y&erkalaemia. Ana&hylactic reactions.
NURSING RES"ONSI#I$I IES AND "RECAU ION F Administer 1 hr +efore or 3 hr after meals. F Alert s$rgeon and mark &atient's chart *ith notice that ca&to&ril is +eing taken> the angiotensin II formation s$+se/$ent to com&ensatory renin release d$ring s$rgery *ill +e +locked> hy&otension may +e re(ersed *ith (ol$me ex&ansion. F )onitor &atient closely for fall in B7 secondary to red$ction in fl$id (ol$me #excessi(e &ers&iration and dehydration. (omiting. diarrhea%> excessi(e hy&otension may occ$r. F 9ed$ce dosage in &atients *ith im&aired renal f$nction. F "ake dr$g 1 hr +efore or 3 hr after meals> do not take *ith food. 4o not sto& *itho$t cons$lting yo$r health care &ro(ider.
