DRUG STUDY

Prescribed and
Brand Name Recommended Mechanism
Generic name dosage, frequency, Of Indication Contraindication Adverse Reaction Nursing Responsibilities
Classification and route of Action
administration

CNS: ataxia, • If patient has an

Amiodarone Adults. Loading: 800 Acts on cardiac cell To treat life- Bradycardia that confusion, delirium, , implantable cardiac
(Cordarone) to 1,600 mg daily in membranes, threatening, recurrent causes syncope disorientation, device, have it checked, as
divided doses for 1 to prolonging ventricular (unless dizziness, fatigue, ordered, at the
Dofetilide (Tikosyn) 3 wk. Maintenance: repolarization and the fibrillation and pacemaker present), fever, hallucinations, start of and during
600 to 800 mg daily in refractory period hemodynamically cardiogenic shock, headache, insomnia, amiodarone therapy
Ibutilide (Corvert) divided doses for and raising unstable ventricular hypersensitivity to sleep disturbances, because drug may affect
1 mo; then if cardiac ventricular tachycardia amiodarone or its tremor pacing or defibrillating
Sotalol (Betapace) rhythm is stable, fibrillation threshold. when these components, CV: Arrhythmias, thresholds.
(Betapace AF) 400 mg daily in 1 or 2 Drug relaxes vascular arrhythmias don’t hypokalemia, cardiac arrest, • Parenteral amiodarone
doses. Use lowest smooth muscles, respond to hypomagnesemia, cardiogenic shock, may be diluted in
possible dose. mainly in coronary other drugs or when SA node dysfunction, edema, heart failure, D5W or normal saline
I.V. INFUSION circulation, and patient can’t tolerate second- and hypotension, solution and given
Classification: Adults. Loading: 150 improves myocardial other drugs thirddegree vasculitis in polyvinvyl chloride
Class III mg over 10 min (15 blood flow. It relaxes AV block (unless EENT: Abnormal (PVC), polyolefin,
Antiarrhythmics mg/ min) followed by peripheral vascular pacemaker present) salivation, abnormal or glass containers.
360 mg infused over 6 smooth muscles, taste and smell, • Use an in-line filter
hrv(1 mg/min). decreasing peripheral blurred vision, during I.V. administration
Maintenance: 540 mg vascular resistance macular degeneration of amiodarone. Also use a
infused over 18 hr and myocardial ENDO: central venous catheter
(0.5 mg/min); then oxygen consumption. Hyperthyroidism, whenever possible. A
after the first 24 hr, hypothyroidism, central
720 mg infused over syndrome of venous catheter is required
24 hr (0.5 mg/ min), inappropriate ADH when infusion
continued up to 2 to 3 secretion, thyroid rate exceeds 2 mg/ml
wk, as needed. cancer because drug
Rate may be increased GI: Abdominal pain, may cause peripheral vein
in first 24 hr, if anorexia, cirrhosis, phlebitis at
needed, but initial
infusion rate constipation, higher rates. Cordarone
shouldn’t exceed 30 diarrhea, elevated I.V. must be given
mg/min. Change to liver function by volumetric infusion
oral form as soon as test results, hepatitis, pump.
possible. nausea, pancreatitis, •Monitor amiodarone I.V.
vomiting infusion closely
GU: Acute renal because loading doses at
failure, decreased higher concentrations
libido and rates may cause
SKIN: Alopecia, hepatocellular
bluish gray necrosis, acute renal
pigmentation, failure, and death.
eczema • Although maintenance
therapy usually is
needed for only up to 96
hours, infusion
of up to 0.5 mg/minute
may be continued
for 2 to 3 weeks regardless
of patient’s age,
renal function, or left
ventricular function.
 DRUG STUDY

Prescribed and
Brand Name Recommended Mechanism
Generic name dosage, frequency, Of Indication Contraindication Adverse Reaction Nursing Responsibilities
Classification and route of Action
administration

CNS: asthenia, • Use diltiazem cautiously

Diltiazem 0.25 mg/kg IV bolus, Diltiazem inhibits IV to treat Acute MI; depression, in patients with impaired
(Cardizem) then a second bolus of calcium movement paroxysmal cardiogenic shock; dizziness, dream hepatic or renal function,
0.35 mg/kg IV if into coronary and supraventricular Lown- Ganong- disturbances, and monitor liver and
needed ; maintain vascular smooth- tachycardia Levine or Wolff- extrapyramidal renal function, as
with adults muscle cells by Parkinson-White reactions, fatigue, appropriate; drug is
Classification: continuous infusion blocking slow syndrome, second- or hallucinations, metabolized mainly in
Class IV of 5–10 mg/h for up calcium channels in third-degree AV headache, insomnia, the liver and excreted by
Antiarrhythmics to 24 h cell membranes, as block, and sick sinus syncope, tremor, the kidneys.
shown. This action syndrome, unless weakness WARNING Monitor
decreases artificial pacemaker CV: Angina, atrial patient’s blood pressure,
intracellular calcium, is in place; flutter, AV block, pulse rate, and heart rate
which: pulmonary edema; sinus tachycardia, and rhythm by
• inhibits smooth- systolic blood 12-lead ECG continuous ECG as
muscle cell pressure below 90 abnormalities, appropriate during
contractions mm Hg; ventricular ventricular therapy. Keep emergency
• decreases tachycardia (wide fibrillation, equipment and drugs
myocardial oxygen complex) EENT: Amblyopia, available.
demand by relaxing dry mouth, epistaxis, • Assess patient for signs
coronary and eye irritation, and symptoms of
vascular smooth gingival bleeding and heart failure.
muscle, reducing hyperplasia, • If patient takes digoxin,
peripheral vascular ENDO: watch for digitalis
resistance and Hyperglycemia toxicity (nausea, vomiting,
systolic and diastolic GI: Anorexia, halo vision,
blood pressures constipation, elevated serum digoxin
diarrhea, elevated level).
• slows AV liver function test • Administer sublingual
conduction time and GU: Acute renal nitroglycerin, as
prolongs failure, impotence, prescribed, during
AV nodal nocturia, polyuria, diltiazem therapy.
refractoriness sexual dysfunction • Expect to discontinue
• interrupts the HEME: Hemolytic drug if adverse skin
reentry circuit in AV anemia, leukopenia, reactions, usually
nodal reentrant prolonged bleeding transient, persist..
tachycardias. time,
MS: Arthralgia,
muscle spasms,
RESP: Cough,
dyspnea
 DRUG STUDY

Prescribed and
Brand Name Recommended Mechanism
Generic name dosage, frequency, Of Indication Contraindication Adverse Reaction Nursing Responsibilities
Classification and route of Action
administration

CNS: Apprehension, • Before use, inspect

Adenosine Adult:0.75- to 1.25- Slows conduction To convert Atrial fibrillation or dizziness, headache, adenosine for crystals.
(Cardizem) mg PO loading dose time through the AV paroxysmal flutter; light-headedness, If solution isn’t clear,
then 0.125–0.25 mg/d node and can supraventricular hypersensitivity nervousness, don’t give it.
Digoxin (Lanoxin) PO or 0.125- 0.25-mg interrupt AV node tachycardia (PSVT) to adenosine; second- CV: Atrial • Give adenosine by rapid
IV loading dose, and reentry to normal sinus or third-degree heart fibrillation, I.V. bolus over 1 to 2
then 0.125–0.25 mg/d pathways to restore rhythm block or sick sinus bradycardia, chest seconds. Slower delivery
Classification: PO normal sinus rhythm. syndrome, except in pain or pressure, can cause systemic
Other Pediatric: 10- to 50- patients with a hypotension, MI, vasodilation and reflex
Antiarrhythmics mcg/kg loading dose functioning artificial ventricular tachycardia.
PO or 8- to 50-mcg/kg pacemaker; fibrillation, • Expect prescriber to
loading dose IV, ventricular ventricular inject adenosine
based on age; then tachycardia tachycardia directly into a vein to
maintenance dose of EENT: Blurred make sure drug reaches
25%–35% of loading vision, metallic taste, systemic circulation. If
dose throat tightness given into an I.V. line,
GI: Nausea,vomiting give drug as close to
MS: Jaw, neck, and insertion site as possible
back pain and follow with rapid
RESP: saline flush.
Bronchoconstriction, WARNING Don’t give
bronchospasm, single doses of more
dyspnea, than 12 mg.
hyperventilation, •Monitor heart rate and
SKIN: Diaphoresis, rhythm, blood
facial flushing pressure, and respiratory
Other: Injection site status often during
reaction adenosine therapy.