DRUG STUDY DRUG NAME Generic Name: Digoxin Brand Name: Lanoxin CLASSIFICATIO N Cardiac glycoside Cardiotonic INDICATION

ON S Heart Failure Atrial Fibrillation SIDE EFFECTS Serious side effect: fast, slow, or uneven heart rate; bloody or black, tarry stools; blurred vision, yellowed vision; or confusion, hallucinations, unusual thoughts or behavior. Less serious side effects: nausea, vomiting, diarrhea, loss of appetite; feeling weak or dizzy; headache, anxiety, depression; enlarged NURSING RESPONSIBILITIES Monitor apical pulse for 1 min before administering; hold dose if pulse < 60 in adult or < 90 in infant; retake pulse in 1 hr. If adult pulse remains < 60 or infant < 90, hold drug and notify prescriber. Note any change from baseline rhythm or rate. Avoid IM injections, which may be very painful. Follow diluting instructions carefully, and use diluted solution promptly. Avoid giving with meals; this will delay absorption. Have emergency equipment ready; have K+ salts, lidocaine, phenytoin, atropine, cardiac monitor on standby in case toxicity develops. Monitor for therapeutic drug levels: 0.5\u20132 ng/Ml.

breasts in men; or Mild skin rash. Generic Name: Epinephrine Brand Name: Adrenaline Alphaadrenergic agonist Antiasthmatic Beta1 and beta2-adrenergic agonist Bronchodilator Cardiac stimulant Mydriatic Nasal decongestant Sympathomimeti c Vasopressor Asthma Bronchitis Emphysema All cardiac arrest, anaphylaxis Used for symptoma tic bradycardi a. Relief of bronchosp asmoccurring duringanesthe sia Exercisedinduced bronc hospasm sweating; nausea and vomiting; pale skin; feeling short of breath; dizziness; weakness or tremors; headache; or feeling nervous or anxious Monitor V/S. and check for cardiac dysrhythmias. Drug increases rigidity andtremor in patients with Parkinsons disease. Epinephrine therapyinterferes with tests for urinary catecholamine. Avoid IM use of parenteralsuspension into buttocks. Gas gangrene may occur. Massage site after IM injection to counteract possible vasoconstriction. Observe patient closely for adverse reactions. Notify doctor if adverse reaction develops. If blood pressure increases harply, rapid-acting vasodilators such as nitrates or alpha blockers can be given to counteract.

Generic Name: Dobutamine Hydrochloride Brand Name: Dobutrex

Beta1-selective adrenergic agonist Sympathomimeti c

For inotropic support in the short-term treatment of adults with cardiac decompensati on due to depressed contractility, resulting from either organic heart disease or from cardiac surgical procedures Investigationa l use in children with congenital heart disease undergoing diagnostic cardiac catheterizatio n, to augment CV function

Headache, nausea or vomiting restlessness muscle cramps or weakness chest pain trouble breathing dizziness palpitations rash

Arrange to digitalize patients who have atrial fibrillation with a rapid ventricular rate before giving dobutamine---dobutamine facilitates AV condunction. Monitor urine flow, cardiac output, pulmonary wedge pressure, ECG and BP closely during infusion; adjust dose and rate accordingly.

Generic Name: Furosemide Brand Name: Lasix

Loop diuretic

Oral, IV: Edema associated with heart failure, cirrhosis, renal disease IV: Acute pulmonary edema Oral: Hypertension

Dizziness,
lightheadedness, or fainting spells

Signs of
dehydration or low electrolytes, such as: Dry mouth Thirst Weakness Lethargy Drowsiness Restlessness Muscle pain or muscle cramps Low blood pressure (hypotension) Decreased urination A rapid heart rate (tachycardia) or irregular heart rhythm (arrhythmia) Nausea or vomiting

Yellowing of the
skin or the whites of the eyes (jaundice) Ringing in the

Profound dieresis with water and electrolyte depletion can occur, careful medical supervision is required. Administer with food and milk to prevent GI upset. Reduce dosages if given with other antihypertensive; readjust dosage gradually as BP responds. Give early in the day so that increased urination will not disturb sleep. Avoid IV use if oral use is at all possible. Do not mix parental solution with highly acidic solutions with pH below 3.5 Do not expose to light, which may discolored drug or solutions. Discard diluted solution after 24 hr Refrigerate oral solution. Measure and record weight to monitor fluid changes. Arrange to monitor serum electrolytes, hydration, liver and renal function. Arrange for potassium-rich diet or supplemental potassium as needed.

ears (tinnitus) or hearing problems High blood sugar (hyperglycemia)