1.emergency Drugs Group9b

EMERGENCY
DRUGS
Table of Contents
Amlodipine Diazepam
Aspirin Digoxin Lidocaine HCl
Atropine Sulfate Diphenhydramine
Dobutamine Mannitol
Bricanyl Dopamine Methergine
Bupivacaine Dynastat Methylergonovine Maleate
Buscopan Metronidazole
Butorphanol Tartrate Epinephrine Midazolam
Ephedrine Morphine Sulfate
Calcium Gluconate
Capoten Famotidine Nalbuphine HCl
Catapres Felodipine Nifedipine
Cefurosime Nitroglycerine
Celecoxib Gentamycin Norvasc
Clindamycin Nubaine
Clopidogrel Heparin
Co- amoxiclav Hydroxyzine Omeprazole
Hyperstat Osmofundin
Demerol Oxytocin
Diamicron Ketorolac
Sodium Bicarbonate
Phenergan Solu- Cortef Valium
Pilocarpine HCl Somazine Ventolin
Plasil Spiriva
Potassium Chloride Zantac
Toradol
Salbutamol Tramadol HCl
Simvastatin Tranexamic Acid
BSN IV Group 9B
Marzan, Kristy M. o Epinephrine o Omeprazole o Buscopan

o Ephedrine o Plasil o Clopidogrel
o Atropine Sulfate o Phenergan o Demerol
o Butorphanol Tartrate o Potassium Chloride Ortega, Michelle A. o Digoxin
o Bupivacaine o Valium o Dynastat
o Famotidine o Ventolin o Amlodipine o Mannitol
o Methergine o Aspirin o Nubaine
o Norvasc o Bricanyl o Toradol
o Pilocarpine HCl Noriega, Mark Anthony F. o Celecoxib o Tranexamic Acid
o Heparin
o Capoten o Morphine Sulfate
o Hyperstat o Nalbuphine HCl Peralta, Marichu A.
o Ketorolac o Oxytocin
Nacion, Arriane C. o Lidocaine HCl o Tramadol HCl o Catapres
o Methylergonovine o Dobutamine
o Calcium Gluconate Maleate o Dopamine
o Diazepam o Metronidazole Patron, Arra Mariz U. o Gentamycin
o Diphenhydramine o Midazolam o Nifedipine
o Nitroglycerine o Cefurosime o Zantac
o Salbutamol o Clindamycin
o Sodium Bicarbonate o Co- amoxiclav
o Solu- Cortef o Diamicron
o Felodipine
o Hydroxyzine
Vergara, Rhenalyn V. o Osmofundin
o Simvastatin
Nursing
Drugs Action Indication Contraindication Adverse Reaction
Consideration
Amlodipine Possible slight  Hypertension  Use with  CNS: Headache,  Check BP

(Norvasc) decrease in alone or in grapefruit juice. fatigue, lethargy. before giving the
myocardial combination with medications.
Classification contractility. CO other  GI: Nausea,
Calcium channel is increased; antihypertensives. abdominal  Monitor Vital
blocker moderate discomfort, cramps Signs.
decrease in  Chronic stable
Dosage, Route, peripheral angina alone or in  CV: Peripheral  Take with
Frequency: vascular combination with edema, palpitations foods to help
10mg 1tab OD resistance. other antianginal decrease
drugs.  Dermatologic: stomach upset.
Dermatitis, rash,
 Vasospastic pruritus  Instruct the
angina alone or in patient to report
combination with  Musculoskeletal: any symptoms of
other antianginal Muscle cramps pain chest pain, SOB,
drugs. or inflammation. dizziness,
swelling of
 GU: Polyuria, extremities,
dysuria irregular pulse, or
altered vision
 Respiratory: immediately.
Nasal or chest
congestion,
sinusitis, rhinitis.
Drugs Action Indication Contraindication Adverse Reaction Nursing

Consideration
Aspirin Relieves pain  Treatment  Hypersensiti  EENT: Dizziness,  Assess pain

(Aspilets) and reduces of mild to vity to salicylates tinnitus
inflammation moderate pain. or NSAIDS  Assess for allergic
Classification: by inhibition of  GI: Nausea, reactions
Nonsteroidal peripheral  Fever  Hemophilia dyspepsia, heartburn,
anti-inflamatory prostaglandin bleeding  Assess for
drug, synthesis. It  Various  Bleeding ototoxicity
antipyretic, also inhibits inflammatory ulcers or  Hematology:
analgesic. the synthesis conditions hemorrhagic Increase bleeding  Administer to
or action of state times, anemia, patient crushed or
other  Reduction decrease iron whole
mediators of of risk of dealth  Pregnancy concentration
inflammation. in patients with  Give with food or
Its acts on previous  Others: milk
hypothalamic infarction Hypersensitivity
heat relating recurrent reactions may include,  Advise patient to
center to transient urticaria, hives, avoid alcohol
relieve fever. ischemia rashes, angioedema, ingestion.
Also attacks or and anaphylactic
decreases stroke in men shock.
platelet who have had
aggregartion transient brain
by preventing ischemia
formation of caused by
thromboxane platelet emboli.
A.
Name of the Action Indication Contraindications Adverse Effects/ Nursing

Drug Side Effects Responsibilities
Generic Action Indication Contraindication Adverse Effects Monitor VS.
Atrophine Sulfate cholinergic As an anti- Contraindicated in CNS:
receptor sites so sialagogue for patients restlessness, Report  HR
Brand response to preanesthetic hypersensitive to ataxia,
Isopto Atropine acetylcholine is medication to drug and those with disorientation, Monitor for
decreased prevent or reduce acute angle closure hallucinations, constipation,
Classification secretions of the glaucoma, delirium, coma, oliguria.
Anticholinergics respiratory tract obstructive insomnia,
uropathy, agitation, Atrophine could
To restore obstructive disease confusion. result in CNS
cardiac rate and of GI tract, paralytic CV: tachycardia, stimulation
arterial pressure elius, toxic angina, (confusion,
during magacolon, arrhythmias, excitement) or
anesthesia, when intestinal atony, flushing. drowsiness
vagal unstable CV status EENT:
in acute photophobia, Instruct to take 30
To lessen the hemorrhage, blurred vision, mins before meals
degree of asthma, or mydriasis.
atrioventricular myasthenia gravis. GI: dry moth, Eat foods high in
(A-V) heart block Also contraindicated constipation, fiber and drink
when increased in pregnant women. vomiting. plenty fluids.
vagal tone is a GU: urine
major factor in retention. Avoid OTC
the conduction Hematologic: antihistamines.
defect, as in leukocytosis
some cases due Other: Instruct client not to
to digitalis anaphylaxis drive a motor
vehicle or
To overcome Side Effects participate in
severe carotid CNS: headache, activities requiring
sinus reflex excitement. alertness.
Antidote for CV: palpitations
cardiovascular GI: thirst, Advise to use hard
collapse from the nausea. candy, ice chips,
injudicious use of etc. for dry mouth.
a cholinergic
drug.
Consideration
Terbutaline Specific beta  Terbutaline  Hypersensiti  Palpitations  Assess patient’s

(Bricanyl) 2 adrenergic is given as the vity condition before
receptor sulfate for its  Tachycardia therpy.
Classification: stimulant, bronchodilating  Thyrotoxicosi
Sympathomimet resulting to properties in s  Chest discomfort  Assess respirations
ic, direct-acting bronchopdilati reversible or pain
on and airways  Pregnancy  Assess for
relaxation of obstruction, as  Arrhythmias paradoxical
peripheral occurs in  Cardiac bronchospasm
vasculature. It asthma and in arrhytmias  CNS stimulation
also causes some patients associated with  Monitor for allergic
relaxation of with chronic tachycardia.  Tremor reactions and possible
uterine pulmonary drug induced adverse
smooth disease. It also  Dizziness reactions.
muscles and decreases
has minimal uterine  nervousness  Give oral
beta 1 activity. contractility administrations with
and may be  drowsiness meals.
used to arrest
premature  headache  Store in light
labor. resistant container.
 weakness
 Advise patient to
 nausea and avoid smoking.
vomiting
 flushing
DRUG NAME MECHANISM INDICATIONS CONTRAINDI- ADVERSE NURSING

OF ACTION CATION EFFECTS RESPONSIBILITIES
Generic Name:  With or without Contraindicated to CV: prolonged  Asses for allergic
Bupicavacaine Reversible epinephrine: caudal patients cardiovascular reaction
inhibits nerve or lumbar nerve hypersensitive to depression and  Assess BP,
Brand Name: conduction by block the drug and its arrhythmias pulse, level of
Marcaine blocking sodium  With epinephrine: component. consciousness
influx. dental infiltration or and mental status
Classification: nerve block. to check for CNS
Local anesthetic, toxicity.
analgesic, anti-  With dextrose:  Do not use if
inflammatory subarachnoid block. solution is
agents discolored or
contains
precipitate.
 Discard unused
portions of
preparation that
do not contain a
preservative.
 Don’t chew gum
 Provide safety
precautions.
DRUGS ACTION INDICATION CONTRAINDICATION ADVERSE NURSING
REACTION CONSIDERATION
Relieve indicated for Tab Myasthenia gravis Urinary retention, Drug
Generic Name: cramps or the control of & megacolon. Should allergic & skin compatibility
Buscopan spasms of abdominal not be used in patients reactions, rarely
should be
the pain (colic) who have prior dyspnea (in
Brand Name: stomach,in associated sensitivity to hyosine patients w/ monitored
Hyoscine-N- testines, with n-butyl bromide or any history of closely in
butylbromide and spasmodic component of bronchial asthma patients
bladde colic, flatulent buscopan. Amp or allergy). requiring
Classification: colic Untreated narrow- Parenteral Visual adjunctive
Antispasmodics angle glaucoma, accommodation therapy
prostate hypertrophy disturbance,
w/ urinary retention, infrequently inj
•Avoid driving &
mechanical stenosis in site pain (after IM
operating
the GIT, tachycardia, inj), rarely
megacolon, anaphylactoid machinery after
myasthenia gravis. IM reactions & parenteral
inj in patients on anaphylactic administration
anticoagulants. shock. Avoid strict heat
Name of the Action/Classificatio Indication Contraindications Adverse Effects/ Nursing

Drug n Side Effects Responsibilities
Generic Class: Opioid agonist- Indication Contraindication  When giving by
butorphanol antagonist analgesic Cardiovascular IM route, use deep,
Brand Management of Hypersensitivity to slow injection.
Butorphanol pain when use of this medication or Palpitations  If accidental
Tartrate an opioid the preservative skin contact
analgesic is benzethonium Dermatologic occurs, wash
appropriate chloride. exposed area with
(parenteral/nasal) Pruritus, cool water.
; preoperative or sweating/clammines  Do not
preanesthetic s administer if
medication, as a solution is
supplement to EENT discolored, cloudy,
balanced or contains
anesthesia, and Nasal congestion particulate matter.
for relief of pain (nasal spray; 13%);
during labor blurred vision, ear  Nasal
(parenteral). pain, pharyngitis,  Pump reservoir
rhinitis, tinnitus, must be primed
unpleasant taste (at prior to initial use;
least 1%). pump sprayer
firmly and quickly
GI until a fine spray
appears (up to 7 to
Nausea, vomiting 8 strokes).
anorexia,
constipation, dry  Pump reservoir
mouth, stomach pain must be reprimed
(1 or 2 strokes) if
not used for 48 h
or longer).
Generic name Action Indication Contraindication Adverse Reaction Nursing
Consideration
 Calcium  Replaces  Hypocalcemic  Contraindicated in  CNS: tingling  Use all calcium
gluconate calcium and emergency cancer patients sensations, sense products with
Brand name maintains  Hypocalcemic with bone of oppression or extreme caution in
 Harson calcium level. tetany metastases and heart waves with digitalized patients
 Adjunctive in those with I.V. use, syncope and patients with
Classification treatment of ventricular with rapid I.V. sarcoidosis and
 Electrolyte management fibrillation,hyperca use. renal or cardiac
intoxication lcemia,hypophosp  CV: bradycardia, disease. Use
 During hatemia,or renal arrhythmia calcium chloride
exchange calculi.  GI: constipation cautiously in
transfusions  GU: renal calculi patients with cor
 Hyperphosphate  Metabolic: pulmonale,
mia hypercalemia respiratory acidosis
 Dietary  Skin: necrosis, or respiratory
supplement cellulitis failure.
 Hyperkalemia  Signs and
with secondary symptoms of
cardiac toxicity severe
hypercalcemia may
include stupor,
confusion, delirium
and coma. Signs
and symptoms of
mild hypercalcemia
may include
anorexia, nausea,
and vomiting.
Drug Action Indication Contraindication Adverse Nursing Consideration
Reaction
Generic Captopril competes o Hypertension o History of ACEI- o light-headed Take each dose with a
Name: with angiotensin I for o congestive heart associated or o urinating more full glass of water.
Captopril binding at the failure other or less than
angiotensin- o renal syndromes angioedema. usual Capoten is usually
Brand Name: converting enzyme, such as diabetic o Pregnancy o fever taken 1 hour before
Capoten blocking the nephropathy and o chills meals.
conversion of scleroderma. o pale skin
Classification angiotensin I to o fast, pounding, If you need to have any
: angiotensin II. As type of surgery, tell the
or uneven
ACE angiotensin II is a surgeon ahead of time
heartbeats
inhibitors vasoconstrictor and that you are taking
o chest pain
a negative feedback Capoten.
o rapid weight
mediator for renin
activity, lower gain To be sure this
angiotensin II levels o cough medication is helping
results in a decrease o loss of appetite your condition, your
in blood pressure, o nausea blood pressure will need
an increase in renin o diarrhea to be checked on a
activity, and constipation regular basis.
stimulation of o drowsiness
baroreceptor reflex o dizziness Take Capoten exactly
mechanisms. o dry mouth as it was prescribed for
Kininase II, an you. Do not take the
enzyme which medication in larger
degrades the amounts, or take it for
vasodilator longer than
bradykinin recommended by your
doctor.
DRUG ACTION INDICATION CONTRAINDICA ADVERSE NURSING
TION REACTION CONSIDERATIONS
Generic  Stimul  Management  Hypersensi  HTN, severe  Do not
Name: ates of all grades tivity to rebound, discontinue
Clonidine central of clonidine. hypotension, abruptly;
alpha- hypertension Sick sinus severe discontinue
Brand Names: adrene with the syndrome. bradycardia, therapy by
Catapres rgic exception of AV block, reducing the
recept HPN due to depression, dosage
Classification: ors to phaechromoc dry mouth, gradually over 2–4
Cardiovascular inhibit ytoma. drowsiness , days to avoid
Drugs sympat Prophylactic dizziness, rebound
hetic treatment of constipation, hypertension,
cardio migraine or sedation, tachycardia,
acceler recurrent fever flushing,
ator vascular (epidural nausea, vomiting,
and treatment of use), cardiac
vasoco migraine. For weakness, arrhythmias
nstricto relief of nausea/vomi (hypertensive
r cancer pain, ting, fatigue, encephalopathy
center. in nervousness and death
combination , agitation have occurred
with opiates after abrupt
for epidural cessation of
use. clonidine).
 Do not
discontinue prior to
surgery; monitor
BP carefully during
surgery; have
 other BP-
controlling drugs
readily available.
 Reevaluate
therapy if clonidine
tolerance occurs;
giving concomitant
diuretic
 increases the
antihypertensive
efficacy of
clonidine.
 Monitor BP
carefully when
discontinuing
clonidine;
hypertension
usually returns
within 48 hr.
Drugs Mechanism Indication Contraindicati Adverse Nursing
of Action on Reaction Considerations
.
Cefuroxime Broad- It is effective for the Hypersensitivity  GI:  Determine history
spectrum treatment of to Diarrhea, of hypersensitivity
Classification: cephalosporin penicillinase- cephalosporins nausea, reactions to
Anti-infective; antibiotic producing Neisseria and related antibiotic- cephalosporins,
antibiotic resistant to gonorrhoea antibiotics; associated penicillins, and
beta- (PPNG). Effectively pregnancy colitis. history of allergies,
lactamase. It treats bone and joint (category B),  Skin: particularly to
has been infections, lactation Rash, drugs, before
proposed for bronchitis, pruritus, therapy is initiated.
infections meningitis, urticaria.  Inspect IM and IV
with gram- gonorrhea, otitis  Urogenital injection sites
negative and media, : Increased frequently for
gram-positive pharyngitis/tonsillitis serum signs of phlebitis.
organisms, , sinusitis, lower creatinine  Report onset of
gonorrhea, respiratory tract and BUN, loose stools or
and infections, skin and decreased diarrhea. Although
haemophilus. soft tissue creatinine pseudomembrano
infections, urinary clearance. us colitis.
tract infections, and  Monitor I&O rates
is used for surgical and pattern:
prophylaxis, Especially
reducing or important in
eliminating infection. severely ill patients
receiving high
doses. Report any
significant
changes.
Consideration
Celecoxib Inhibits  Relief of signs  Use in severe  GI: Dyspepsia,  Assess for
(Celebrex) prostaglandin and symptoms of hepatic diarrhea, renal and liver
synthesis, rheumatoid impairement, in abdominal pain. dysfunction.
Classification: primarily by arthritis and those who have
Nonsteroidal anti- inhibiting cyclo- osteoarthritis in shown an allergic  Respiratory:  Do not
inflammatory oxygenase-2; it adults. reaction to URI, sinusitis, consume
drug, COX-2 does not inhibit sulfonamides, or pharyngitis, rhinitis, alcoholic
inhibitor the  Acute pain those who have bronchitis beverages while
cyclooxygenase- and primary experienced on this drug.
1 isoenzyme. dysmenorrhea in asthma, urticaria,  Infections:
Does not affect adults. or allergic type Bacterial, fungal, or  May take with
platelet reactions after viral infection. food to decrease
aggregation;  Reduce the taking aspirin or GI upset.
renal effects number of other NSAIDS.  Dermatologic:
similar to other adenomatous Rash, ecchymosis,  Report weight
NSAIDS. colorectal polyps alopecia, dermatitis, gain, swelling of
in familial nail disorder. ankles, chest pain
adenolatous or SOB.
polyposis.
Nursing
Consideration
Clindamycin A semisynthetic  Serious  Hypersensitivity  GI: diarrhea,  Reduce

(Cleocin) antibiotic that respiratory to either abdominal pain dosage in severe
suppresses infection clindamycin or renal
Classification: protein synthesis lincomycin. Use in  Hematologic: impairement.
Antibiotic, by  Serious skin treating viral and Leukopenia,
lincosamide microorganisms and soft tissue minor bacterial neutropenia.  Auscultate
by binding to infections. infections or in lungs; assess
ribosomes and clients with a  Hepatic: extent of
preventing history of regional Jaundice respiratory tract
peptide bond enteritis, non infections
formation. I both bacterial infections.  GU: Renal
bacteriostatic Dysfunction,  Monitor renal
and bactericidal. vaginitis. function.
 Miscellaneous:  Take oral

Super infection. medication with a
full glass of water
to prevent
esophageal
ulceration. May
be taken with or
without food.
Generic Name: Clopidogrel Prophylaxis Hypersensitivity. Dyspepsia, 1.Provide small,
Clopidogrel inhibits of Active pathological abdominal frequent meals if
adenosine thromboemb bleeding. admin pain, nausea, GI upset occurs
Brand Name: diphosphate olic events within 7 days after MI vomiting, (not as common as
Plavix (ADP) from daily. Acute and ischaemic stroke, flatulence, with aspirin).
binding to its coronary coagulation constipation,
Classification: receptor sites syndrome Fo disorders. Lactation. gastritis, 2.Provide comfort
Anticoagulants, on the platelets r ST-elevation gastric and measures and
Anti-platelets & and subsequent myocardial duodenal arrange for
Antifibrinolytics, activation of infarction: W/ ulcers. GI analgesics if
glycoprotein GP aspirin: upset, headache occurs.
IIb/IIIa complex For unstable diarrhoea,
thus preventing angina, non- paraesthesia, 3.Take daily as
fibrinogen ST-elevation vertigo, prescribed. May be
binding, platelet myocardial headache, taken with meals.
adhesion and infarction: dizziness,
aggregation. Initial: pruritus and 4.These side
rashes. effects may occur:
Potentially Dizziness, light-
Fatal: Bleedin headedness
g disorders
including GI 5.Report skin rash,
and chest pain, fainting,
intracranial severe headache,
haemorrhage. abnormal bleeding
Blood
dyscrasias.
Drug Mechanism of Indication Contraindicatio Side effect Nursing Consideration
Action n
Generic Name: -Prevents Treatment of -hypersensitivity -Dizziness, fatigue,- Obtain pt. history of
CoAmoxiclav bacterial cell infections of to penicillin, insomnia, reversibleallergy.
Brand Name: wall synthesis respiratory cephalosporins or hyperacidity,urticaria,
-Assess pt. for previous
Amoxicillin during tract, skin and emipenem. skin rashes, itchy sensitivity reaction to
replication skin structures, eyes, glossitis, drypenicillin or other
Classification: otitis media, -Not used to treat mouth, abnormal cephalosporins.
Anti-infectives -Bactericidal meningitis, severe taste sensation, -Monitor for bleding
septicemia, pneumonia anorexia, nausea -Instruct pt. to take
Dosage: sinusitis, empyema, and vomiting, entire quantity of drug
Adult: Oral bacterial bacteremia, abdominal pain , exactly as prescribed
administration endocarditis pericarditis, diarrhea, rectal even after feeling better
250 to 500 mg prophylaxis. meningitis and bleeding, vaginitis,and not to double dose.
every 8 hours. purulent or septic anemia. -Advise pt. to watch and
Children: Oral arthritis during report signs of infection
administration 20 acute stage. -reduced hemoglobin like vaginal itching,
to 40mg/kg/day and hematocrit. loose foul smelling stool
in divided doses or furry tongue.
given in every 8 -prolonged bleeding -Teach pt to report sore
hours. and prothrombin throat, joint pain and
time, increased or bloody diarrhea which
decreased may indicate blood
lymphocyte count. dyscrasias and
pseudomembranous
colitis respectively.
Generic Name: DEMEROL Relief of respiratory depression Resp depression, 1. Administer to
Meperidine contains moderate to lightheadedness, circulatory lactating women 4–6
meperidine, a severe pain, dizziness, sedation, depression, resp hr before the next
Brand Name: mu-agonist pre-op nausea, vomiting, and arrest, shock, feeding to minimize
Demerol opioid with an medication, sweating cardiac arrest. GI the amount
hydrochloride abuse liability support of disturbance. in milk.
similar to anesth & obstet Nervous Lightheadedness,
Classification: morphine and analgesia. System: Euphoria, dizziness, 2.Provide narcotic
is a Schedule II dysphoria, weakness, sedation, nausea, antagonist, facilities
Anaesthetics- controlled headache, agitation, vomiting, for assisted or
Local and substance. tremor, uncoordinated sweating. controlled
General Meperidine, like muscle movements (e.g. Euphoria, respiration on
morphine and muscle twitches, dysphoria, standby
other opioids myoclonus), severe weakness, during parenteral
used in convulsions, transient headache, administration.
analgesia, can hallucinations and tremor, agitation,
be abused and disorientation, visual uncoordinated 3. Use caution when
is subject to disturbances. muscle injecting SC into
criminal movements, chilled areas of the
diversion Gastrointestinal: Dry severe body or in patients
convulsions, with
mouth, constipation,
hypotension or in
biliary tract spasm. transient
shock; impaired
hallucinations &
perfusion may delay
Cardiovascular: Flushin disorientation,
absorption; with
g of the face, visual
repeated doses,
tachycardia, disturbance.
an excessive amount
bradycardia, palpitation, Flushing,
may be absorbed
hypotension (see tachycardia,
when circulation is
WARNINGS), syncope. bradycardia, restored.
palpitation,
hypotension, 4. Reduce dosage of
Genitourinary: Urinary syncope, meperidine by 25%–
retention. phlebitis. Urinary 50% in patients
retention. Allergic receiving
Allergic: Pruritus, reactions. Pain at phenothiazines or
urticaria, other skin inj site, local other tranquilizers
rashes, wheal and flare tissue irritation.
over the vein with 5.Give each dose of
intravenous injection. the oral syrup in half
Hypersensitivity glass of water. If
reactions including taken undiluted, it
anaphylaxis. may exert a
slight local
anesthetic effect on
mucous membranes.
· Reassure patient
about addiction
liability; most
patients who receive
opiates for medical
reasons do not
develop dependence
syndromes.
Name of Mechanism Adverse

Classification Indication Contraindication Nursing Responsibilities
Drug of Action Reaction
Gliclazide Anti Diabetic Drug Stimulates Non- Type I diabetes; Hypoglycemia, Asses for
(Diamicron) insulin insulin diabetes GI hypoglycemic/hyperglycemic
Pharmacokinetics release from dependent complicated with disturbances, reactions.
Dosage: Absorption: pancreatic diabetes ketosis and dermatological
80 mg 1 tab Effectively absorbed beta cells. mellitus acidosis; reactions, Monitor CBC, glycosylated
OD in the GIT (NIDDM). pregnancy, biochemical hemoglobin during
Distribution: highly diabetics under- abnormalities, treatment.
bound to plasma going surgery, headache.
proteins (94%) hypersensitivity to Monitor liver and renal
Metabolism: liver sulfonylureas. function test periodically.
Excretion: Urine,
feces (10-20%) Assess for hypersensitivity of
Half life: 10.4 hrs the patient to medications.
Pharmacodynamics
Onset: unknown
Peak: 4-6 hrs
Duration: unknown

Consideration
 Diazepa  A  Anxiety  Diastat rectal  CNS: drowsiness,  Use Diastat
m benzodiaz  Acute gel is dysarthria, rectal gel to
Brand name epine that alcohol contraindicate slurred speech. treat no more
 Diazepa probably withdrawal d in patients  CV: CV collapse, than five
m potentiates  Before with acute bradycardia. episodes per
Classificati the effects endoscopic angle- closure  EENT: diplopia, month and no
on of GABA, procedures glaucoma. blurred vision, more than one
 Benzodia depresses  Muscle  Use cautiously nystagmus. episode every 5
zepine the CNS, spasm in patients  GI: nausea, days because
and  Preoperative with liver or constipation. tolerance may
suppresse sedation renal  GU: incontinence, develop.
s the  Cardioversio impairment, urine retention.  Monitor elderly
spread of n depression or  Hematologic: patients for
seizure chronic open neutropenia dizziness,
activity. angle- ataxia, mental
glaucoma. status changes.
Use cautiously Patients are at
in elderly and an increased
debilitated risk for falls.
patients.
DRUGS ACTION INDICATION CONTRAINDI ADVERSE NURSING

CATION REACTION CONSIDERATIONS
Generic Digoxin is a Oral Digitalis Extra beats, 1. Measure liquid
Name: cardiac glycoside Heart failure he use toxicity, anorexia, nausea precisely, using a
Digoxin which has positive of digoxin in heart ventricular and vomiting. calibrated dropper or
inotropic activity problems tachycardia/fib syringe.
Brand Name: characterized by during sinus rillation, Diarrhea in elderly, obtain written
Lanoxin an increase in the rhythm was once obstructive confusion, parameters.
force of standard, but is now cardiomyopat dizziness,
Classification: myocardial controversial. hy. drowsiness, 2. obtain written
Cardiac Drugs contraction. Arrhythmias restlessness, parameters indicating
Digoxin is no longer due to nervousness, the pulse rate, both
Digoxin also the first choice accessory agitation and high and low, at
exerts direct for congestive heart pathways amnesia, visual which cardiac
action on vascular failure, but can still (e.g. Wolff- disturbances, glycosides are to be
smooth muscle be useful in patients Parkinson- gynecomastia, local held
and indirect who remain White irritation (IM/SC inj),
effects mediated symptomatic despite syndrome). rapid 3. protection from
primarily by the proper diuretic. IV admin may lead light
autonomic to vasoconstriction
nervous system and transient 4. give IV injections
and an increase in hypertension. over 5 min (or longer)
vagal activity. either undiluted or
Potentially Fatal: diluted fourfold or
Cardiac arrhythmias greater with sterile
in combination with water for injection,
heart block. 0.9% NaCl. RL
injection or D5W

Consideration
 Diphenhy Competes  Rhinitis,  Avoid use in  CNS: seizures,  Stop drug 4
dramine with histamine allergy patients taking drowsiness, days before
hydrochlo for H1- symptoms, MAO sedation diagnostic
ride receptor sites. motion inhibitors.  CV: testing.
Brand name Prevents, but sickness,  Use with palpitations,hypote  Dizziness,
 Benadryl doesn’t Parkinson caution in nsion, tachycardia excessive
reverse, disease patients with  EENT: diplopia, sedation,syncop
Classification histamine-  Sedation prostatic blurred vision, e, toxicity,
 Ethanola mediated  Nighttime hyperplasia, nasal congestion, paradoxical
mine responses, sleep aid asthma, tinnitus. stimulation, and
derivative particularly  Nonproducti COPD,  GI: dry mouth, hypotension are
those of the ve cough increased nausea, epigastric more likely to
bronchial (syrup only) intraocular distress. occur in the
tubes, GI tract, pressure,  GU: dysuria, urine elderly.
uterus, and hyperthyroidis retention, urine
blood vessels. m, CV frequency.
disease, and  Hematologic:
hypertension. thrombocytopenia,
agranulocytosis.
 Respiratory:
thickening of
bronchial
secretions.
 Skin: urticaria
 Other:
anaphylactic
shock.
DRUG ACTION INDICATION CONTRAINDICATION ADVERSE NURSING

REACTION CONSIDERATIONS
Generic Name: Direct-acting Treatment of Patients with known Tachycardia,  Observe IV
Dobutamine inotropic agent cardiac hypersensitivity to the increase in site closely and
whose primary decompensation drug or with idiopathic premature avoid
Brand Names: activity results due to depressed hypertropic subaortic ventricular extravasation.
Dobuject from stimulation contractility stenosis (IHSS). The beats, transient Dobutamine can
Dobutrex of the b- resulting from injectable formulation bigeminy, cause
receptors of the organic heart contains sodium angina, inflammatory
Classification: heart while disease or bisulfite as a elevation in response and
Sympathomimetic producing less following cardiac preservative which blood pressure. tissue
( Cardiovascular marked surgical has been documented ischaemia.
Drugs) chronotropic, procedures in to cause allergic-type  Monitor for
hypertensive, which parenteral reactions in some adverse
arrhythmogenic therapy is human patients.. reactions
or vasodilatory necessary for  Continuous
effects. inotropic support. blood pressure
Dobutamine, Myocardial monitoring
unlike perfusion  Continuous
dopamine, does imaging. cardiorespiratory
not cause the monitoring
release of  Document
endogenous vital signs hourly
norepinephrine. and PRN
No specific  Monitor fluid
effect on the balance
renal
vasculature was
observed.

Generic Immediate Correction of Should not be used in Ectopic beats;  Explain to
Name: precursor of hemodynamic patients with tachycardia; patient/family the
Dopamine epinephrine in the imbalances phaechromocytoma or angina pain; reasons for
body, exogenous present in hyperthyroidism, nor in palpitation; medication,
Brand administration the shock synd the presence of vasoconstriction; expected results,
Names: produces direct rome due to uncorrected ventricular reason for all
Dopamine effect of beta-1 myocardial tachyarrhythmias or arrhythmias (at monitoring and
HCl receptors and infarctions, trau ventricular fibrillation. high doses); procedures done.
variable ma, hypertension.  Advise patient
Classificatio stimulation of endotoxicseptic Headache; to be aware and to
n: alpha receptors, emia, open anxiety. Dilated report all identified
Cardiovascul will cause release heart surgery, pupils. Nausea; adverse reactions.
ar Drugs of norepinephrine renal failure, vomiting.  Emphasize the
from storage site. and chronic car Decreased urine importance of
These actions diacdecompen output. Dyspnea. reporting discomfort
result in increased sation as in Gangrene of at IV site.
myocardial congestive extremities.
contraction and failure.
cardiac output,
systemic
vasoconstriction
as well as
increase renal
blood flow and
sodium excretion.

Generic Name: The mechanism Management of Hypersensitivity to Clinical Trials: 1. Do not take
Parecoxib of action of acute pain. It parecoxib or to any The following alcohol or aspirin
valdecoxib is by may be used other ingredient of adverse events together with
Brand Name: inhibition of preoperatively to Dynastat. Patients were reported at NSAIDs. If GI
Dynastat cyclooxygenase- prevent or who have an incidence upset occurs, take
2 (COX-2)- reduce demonstrated allergic- rate of ≥0.5% with food, milk or
Classification: mediated postoperative type reactions to and greater than antacids
Non-Steroidal prostaglandin pain and can sulfonamides, or equal to 2. NSAIDs may
Anti-inflammatory synthesis. reduce opioid acetylsalicylic acid placebo in have an additive
Drugs (NSAIDs) Cyclooxygenase requirements (aspirin) or patients who analgesic effect
is responsible for when they are nonsteroidal anti- received when
generation of used inflammatory drugs parecoxib in 13 administering with
prostaglandins. concomitantly. (NSAIDS) including controlled narcotic
Two isoforms, other cyclooxygenase- general and oral analgesics, thus
COX-1 and COX- 2 (COX-2) specific surgery trials: permitting lower
2, have been inhibitors; asthma and Events narcotic dosages
identified. COX-2 urticaria. Occurring ≥1% 3. clients who do
is the isoform of and <10%: not respond to one
the enzyme that Autonomic NSAID may
has been shown Nervous respond to another
to be induced by System: 4. note allergic
pro-inflammatory Hypotension. responses to
stimuli and has Body as a aspirin or anti-
been postulated Whole: Back inflammatory
to be primarily pain. Central agents.
responsible for and Peripheral 5. monitor CBC,
the synthesis of Nervous liver and renal
prostanoid System: function studies,
mediators of pain, Dizziness. GI causes platelet
inflammation and System: Alveolar inhibition which is
fever. osteitis (dry reversible in 24-48
socket), hours.
constipation and
flatulence.
Platelet,
Bleeding and
Clotting:
Ecchymosis.
Psychiatric:
Agitation and
insomnia. Skin
and
Appendages:
Generic name Action Indication Contraindication Adverse Reaction Nursing Management

 Epinephri Relaxes  Bronchospas  Contraindicate  CNS:  In patient with
ne bronchial m, d for use in drowsiness, Parkinson
Brand name smooth hypersensitivity fingers, toes headache,ner disease, drug
 Adrenalin muscle by reactions, ears, nose, or vousness increases
e stimulating anaphlaxis genitalia when  CV: rigidity and
Classificatio beta2  Hemostasis used with local palpitations,ve tremor.
n receptors and  Acute anesthetig. ntricular  Drug interferes
 Adrenergi alpha and asthma attacks  Use cautiously fibrillation with tests for
c beta receptors  To prolong in patients with  GI: nausea urinary
in the aneasthetic long- standing and vomiting catecholamines.
sympathetic effect bronchial astma  Respiratory:
nervous  To restore ay emphysema dyspnea
system. cardiac rhythm who have
in cardiac developed
arrest degenerative
heart disease.

 Ephedrin  It  Diabetic  Hypersensitivit  Anxiety 1.Report any
e increases neurophatic y,  Tachycardia disturbing or
Brand name cardiac edema.  Hypertention  Dry mouth unusual side effects
Harson output,  Reversal of  Lactation  Insomnia to your doctor.
induces spinal or  tremor
Classificati peripheral epidural 2. Look for e side
on vasoconstri anesthesia- effects of the
 Vasocon ction, induced drug;like headache,
strictors bronchodil hypotension. dizziness, anxiety,
ation, restlessness,
reduces insomnia and
intestinal stomach upset.
tone and 3. the side effects
motility, are severe enough
and to make
relaxes the discontinuing the
bladder drug necessary, but
while they are usually
contracting only a nuisance.
the
spinchter 4. It is indicated for
muscle. short term use only.
GENERIC
SIDE EFFECTS/
NAME MECHANISM INDICATIO CONTRA- NURSING IMPLICATIONS/
ADVERSE
(BRAND OF ACTION N INDICATION RESPOSIBLITIES
EFFECTS
NAME)
famotidine Competitively Intractable Contraindicate CNS: dizziness,  Assess creatinine clearance

(Pepcid) blocks the ulcerations d in patient headache, confusion, before treatment.
action of or hyper with sensitivity depression.  Assess patient GI disorder before
Classification histamine at secretory to drug or any GI: constipation, starting therapy and reassess
H2-receptor the H2 conditions. of its diarrhea. regularly.
antagonist, receptors of components. SKIN: rash, acne,  Be alert for adverse reactions.
antiscretory the parietal pruritus, dry skin,  Give daily doses or last dose of
cells of the flushing. the day at bedtime.
stomach;  Take drug with food tell patient/SO
inhibits basal taking 20mg BID to take one dose
gastric acid HS.
secretion and  Avoid over the counter drugs to
chemically treat heartburns.
induced
gastric acid
secretions.
Name of Mechanism Contraindicatio Adverse Nursing
Classification Indication
Drug of Action n Reaction Responsibilities
Felodipine Antihypertensive - Inhibit calcium Treatment of Hypotension Peripheral Assess fluid volume
Calcium Channel ion influx hypertension. with systolic BP Edema, status: input output ratio
Dosage: Blocker across cell <90mmHg Hypotension and record weight, skin
50 mg 1 tab membrane, Used to treat or Precautions: syncope turgor, adequacy of
OD Pharmacokinetics resulting in prevent Lactation, CHF, atrioventricul pulses, moist mucous
Absorption: well inhibition of cerebral hepatic ar block membranes, bilateral lung
absorbed excitation/ vasospasm impairment MI sound, peripheral pitting
Distribution: contraction. following a SA Arrhythmias edema, dehydrations
unknown hemorrhage, Angina symptoms of decreasing
Metabolism: liver Relaxes the which usually Tachycardia output thirst, hypotension,
Excretion: kidneys smooth occurs 4-14 Headache dry mouth.
Half life: 11-16 hrs. muscles of the days after a Dizziness.
vessel wall stroke, inhibits Monitor cardiac status:
Pharmacodynami and reducing blood flow to the BP, pulse, respiration,
cs incidence and area, and ECG periodically.
Onset: 2-3 hrs. severity of the worsens
Peak: 2 ½ -5 hrs. spasm. ischemia. Assess for anginal pain
Duration: less than duration, intensity,
24 hrs. Neurologic ameliorating, aggravating
function is factors.
improved and
further
deterioration
from ischemia
is prevented.

Generic A wide spectrum Used to treat Patients that have Gentamicin can  Give by IM
Name: antibiotic infections reported allergic have effects on route if at all
Gentamicin provides highly caused by reactions to previous the CNS, possible; give by
effective topical aerobic gram- gentamicin exposure, specifically the deep IM injection.
Brand treatment in negative or other eigth cranial
Names: primary and bacteria. aminoglycoside use. nerve which can  Culture
Garamycin secondary Gentamicin in This is due to the lead to infected area
bacterial combination with patient cross-sensitivity irreversible before therapy.
Classificati infections of the penicillin has to these drugs. hearing loss,
on: skin. This synergetic especially in  Use 2 mg/mL
Antibiotic product may antibacterial patients with intrathecal
Topical clear infections effects against renal impairment preparation
agent that have not gram positive or in patients on without
responded to cocci. high doses for preservatives, for
other topical Gentamicin has prolonged intrathecal use.
antibiotic agents. a narrow duration of
In impetigo therapeutic therapy.  Avoid long-
contagiosa and range and may Additionally, the term therapies
other primary cause side CNS effects can because of
skin infections, effects of ear present as increased risk of
treatment with a loss and dizziness, toxicities.
small nephrotoxic. It is vertigo, ataxia, Reduction in
amount of GENT mostly useful in tinnitus, and  dose may be
AMICIN OINTM life roaring in the clinically indicated.
ENT AND threateninginfecti ears. There have
CREAM three to ons, which also been  Patients with
four times daily makes it reports of edema or ascites
usually clears compulsory for peripheral may have lower
the lesions the use of neuropathy and peak
promptly. In gentamicin. encephalopathy. concentrations
Effective levels Another serious due to
secondary skin of gentamicin side effect of  expanded
infections, the can be achieved gentamicin is extracellular fluid
product without nephrotoxicity, volume.
facilitates the overdosage. which is also
treatment of the associated with  Cleanse area
underlying high drug doses, before application
dermatosis by prolonged of dermatologic
controlling the therapy, or preparations.
infection. concurrent use
Bacteria of other  Ensure
susceptible to nephrotoxic adequate
the action of GE agents. Patients hydration of
NTAMICIN inclu may experience patient before and
de sensitive GI effects, other during therapy.
strains of strepto CNS effects such
cocci (group A as lethargy and  Monitor renal
beta-hemolytic, confusion, function tests,
alpha- rashes, transient CBCs, serum drug
hemolytic), Stap enlargement of levels during long-
hylococcus the liver or term therapy.
aureus (coagula spleen, and  Consult with
se positive, hypertension or prescriber to
coagulase hypotension. adjust dosage
negative, and
some
penicillinase-
producing
strains), and the
gram-negative
bacteria
Drugs Action Indication Contraindicatio Adverse Reaction Nursing
n Consideration
Heparin Accelerates  Prophylaxis  Hypersensit  Hemorrhage  Assess patients

(Heparin Leo) formation of and treatment of ivity to Heparin condition before
antithrombin tromboembolitic  Allergic and therapy.
Classification: lllthrombin disorder.  Actual or anaphylactic reactions
Anticoagulant complex and potential  Monitor allergic
deactivates  Prevention of hemorrhagic  Delayed onset and adverse reaction
thrombinto thromboembolic states thrombocytopenia,
preent complications skin necrosis at the  Monitor platelet
conversion of  Pregnancy injection site count regularly.
fibrinogen to
fibrin.  Threatened  Alopecia,  Instruct patient and
abortion, diarrhea, family to watch for
subacute osteoporosis. and report signs of
bacterial bleeding.
ebdocarditis,se
vere  Caution patient to
hypertension,g use soft bristle
astric or toothbrush to avoid
duodenal bleeding gums.
ulcers,
advanced renal  Instruct patient to
or hepatic carry emergency ID
disease during with information about
or immediately drug being taken and
after spinal or condition being
major surgery. treated.
Nursing
Consideration
Hydroxyzine Manifest  Symptomatic  Hypersensitivity  Low incidence  Inject in IM

(Vistaril) anticholinergic, relief of anxiety to hydroxyzine or at recommended only.
antiemetic, and tension cetirizine. dosages.
Classification: antispasmotic, associated with Pregnancy or Drowsiness, dry  Shake
Antianxiety, local anesthetic, psychoneurosis lactation. Treatment mouth, involuntary suspension
nonbenzodiazepin antihistaminic, or as an adjunct of morning sickness motor activity, vigorously until it
e and skeletal in organic during pregnancy ECG is completely
relaxant effects. disease in which or as sole agent for abnormalities, resuspended.
Has mild anxiety is treatment of dizziness,
antiarrythmic manifested. psychoses or urticaria, skin  Document
activity and mild depression. Use in reactions, indication for
analgesic  Prior to dental porphyria. hypersensitivity. therapy.
effects. High procedures.
sedative and  Note any
anti emetic  Acute associated
effects and emotional contributing
moderate problems. factors.
anticholenergic
effect.  Alcoholism.  Wait and
evaluate
 Allergic sedative effects
conditions with of drug before
strong emotional performing task
overlay. and require
mental illness.
Drug Action Indication Contraindication Adverse Reaction Nursing
Consideration
Generic Potassium channel o Hypertensive o compensatory o Nausea Caution must be
Name: activator, which Emergency hypertension, o Vomiting observed when
Diazoxide causes local o Hypoglycemia such as that o Anorexia reducing severely
relaxation in o Insulinoma associated with o Abdominal elevated blood
Brand Name: smooth muscle by aortic coarctation discomfort pressure.
Hyperstat increasing or arteriovenous o Dry Mouth
membrane shunt o Costipation Do not used for routine
Classification permeability to o hypersensitive to treatment of chronic
o Diarrhea
: potassium ions. diazoxide, other hypertension.
o Cerebral
Anti- This switches off thiazides, or other
hypertensive voltage-gated ischemia Blood glucose
sulfonamide-
calcium ion o Unconsciousnes determinations are
derived drugs.
channels which s recommended at
inhibits the o Convulsions periodic intervals after
generation of an o Paralysis parenteral
action potential. o Confusion administration to
o Sodium and monitor hyperglycemia.
water retention
after repeated Care must be taken to
injections avoid extravasation
during intravenous
administration since
cellulitis and pain (but
not necrosis) may
result.
Reaction
Generic Responsible for o Short term o Renal impairment o Edema Remember, keep this
Name: ketorolac's anti- management of o Labor and delivery o Rash and all other medicines
Ketorolac inflammatory, pain(up to 5 days) o Lactation o Heartburn out of the reach of
antipyretic and o Mild to moderate o Aspirin allergy o GI irritation or children, never share
Brand Name: analgesic effects is pain. o Recent GI hemorrhage your medicines with
Toradol the inhibition of o Opthalmic: relief of bleeding or o urinating less others, and use this
prostaglandin ocular itching due perforation than usual or medication only for the
Classification synthesis by to seasonal o Allergies not at all indication prescribed.
: competitive blocking conjunctivitis and o nausea
Anti- of the enzyme relief of post Take this medicine by
o sore throat
Pyretic, cyclooxygenase operative mouth with a full glass
NSAIDs (COX). Like most inflammation after of water.
NSAIDs, ketorolac is cataract.
a non-selective COX Do not take your
inhibitor. medicine more often
than directed.
Reaction
Generic Lidocaine HCl o Acute management o Hypersensitivity to o Edema Use IM route for
Name: stabilizes the of ventricular amide local o Erythema emergency situations
Lidocane neuronal membrane arrhythmias anesthetics o Petechiae (eg, no IV access, no
Hydrochloride by inhibiting the o topical anesthesia o Stokes-Adams o Confusion ECG monitoring) only.
ionic fluxes required in local skin syndrome o Convulsion
Brand Name: for the initiation and disorders o Wolff-Parkinson- o Drowsiness Do not use around the
Xylocaine conduction of o local anesthesia of White syndrome eyes, on body orifices,
o Diziness
impulses, thereby accessible mucous o Severe degrees of or on mucous
o Respiratory
Classification: effecting local membranes sinoatrial, AV, or membranes.
Antiarrhythmic anesthetic action. Arrest
o topical anesthesia intraventricular
agent; prior to block in absence For Im injection, deltoid
Local venipuncture or of pacemaker. muscle is preferred IM
anesthetic peripheral IV site. Switch to IV route
cannulation as soon as possible.
Use only lidocaine

specifically labeled for
IV use (without
preservatives or
epinephrine). Do not
administer with other
agents.
Advise patient that drug

may cause dizziness or
drowsiness and to avoid
getting out of bed or
walking without
assistance.

Generic Name: Mannitol Oliguric phase of Pulmonary congestion Fluid and 1.Take care to
Mannitol increases renal failure, or edema; electrolyte avoid
urinary output by raised imbalance; extravasation.
Brand Name: inhibiting tubular intracranial intracranial bleeding; acidosis (with Observe
Osmitrol reabsorption of pressure, raised high doses). injection site
water and intraocular CHF; Nausea, vomiting, for signs of
Classification: electrolytes. pressure, thirst; headache, inflammation
Diuretics cerebral edema, metabolic oedema dizziness, or edema
It raises the transurethral with abnormal convulsions,
osmotic prostatic capillary fragility; chills, fever; 2.check for signs
pressure of the resection tachycardia, chest of fluid and
plasma allowing anuria due to severe pain; blurred electrolyte
water to be renal disease; vision; urticaria imbalance
drawn out of and hypotension
body tissues. severe dehydration. or hypertension; 3.measure I&O
acute renal accurately and
failure; skin record to
necrosis; achieve proper
thrombophloebitis fluid balance
4.monitor vital
signs closely.
Report
significant
changes in BP
and signs of
CHF
Generic Name Mechanism Indication Adverse Reaction Contraindicatio Nursing Responsibility

(Brand Name) of Action n
Methergine Indication: Cardiovascular: > contraindicated >Be alert for adverse reactions
(methylergonovine Methergin Prevention hypertension, in patients and drug interactions.
maleate) ↓ and treatment temporary chest hypersensitive to
Stimulates of postpartum pain, palpitation methylergonovine >This drug should be used
uterine and or any extremely carefully because of
smooth postabortion CNSHallucinations, component of the it's potent vasoconstrictor
muscles hemorrhage dizziness, seizure, formulation. action. I.V. use may induce
↓ caused by headache sudden hypertension and
producing uterine atony >ergot alkaloids cerebrovascular accidents. As a
sustained or Gastrointestinal: are last resort, give I.V. slowly over
contractions subinvolution Nausea, vomiting, contraindicated several minutes and monitor
↓ diarrhea, foul taste with potent blood pressure closely.
thereby inhibitors of
shortens the Local: CYP3A4
third stage of Thrombophlebitis (includes
labor protease
Otic: Tinnitus inhibitors, azole
antifungals, and
Renal: Hematuria some macrolide
antibiotics);
Respiratory: hypertension;
Dyspnea, nasal toxemia;
congestion pregnancy
Miscellaneous:
Diaphoresis
Drug Action Indication Contraindication Adverse Nursing
Reaction Consideration
Generic Name: o Directly o Hemorrhage, o Pregnancy o increased Frequent monitoring of
Methylergonovine stimulates the postpartum and o Labor and blood pressure vital signs, arterial
Maleate uterine muscle postabortal delivery (severe blood gases, and
to increase (prophylaxis and o Lactation headache, electrolytes.
Brand Name: force and treatment) o Hypersensitivity blurred vision)
Methergine frequency of o prevention or o o seizure Electrocardiogram
contractions. treatment of (convulsions) monitoring to assess
Classification: o Produces postpartum or o feeling light- cardiac function and
Alkaloids arterial postabortal uterine headed, perfusion.
vasoconstriction bleeding due to fainting
by stimulation of uterine atony or o pounding May include
alpha- subinvolution. heartbeat maintaining an open
adrenergic and o In cases of o chest pain or airway and breathing,
serotonin incomplete heavy feeling, maintaining proper
receptors and abortion, pain spreading fluid and electrolyte
inhibition of methylergonovine to the arm or balance, correcting
endothelial- may be used to shoulder, hypertension, and
derived hasten expulsion nausea, controlling seizures.
relaxation factor of uterine sweating,
release. contents. general ill Notify physician if
feeling infection develops,
o hallucinations since infection may
cause increased
o unpleasant
sensitivity to
taste in your
medication.
mouth
o ringing in your
ears

Reaction
Generic Metronidazole, o It is prescribed in o First trimester of o severe GI Administer with food or
Name: taken up by the treatment of a pregnancy distress milk to minimize GI
Metronidazole diffusion, is variety of o blood dyscrasias o dizziness irritation.
selectively absorbed infections, including o organic disease o neutropenia
Brand Name: by anaerobic amebiasis, o central nervous o neurologic Do not skip doses or
Flagyl bacteria and trichomoniasis, system disorders, disturbances double up on missed
sensitive protozoa. anaerobic or known o nausea doses. If a dose is
Classification: Once taken up by infections, hypersensitivity to o stomach pain missed, take as soon as
Antibiotic anaerobes, it is non- antibiotic-induced this drug prohibits remembered if not
o diarrhea
enzymatically infections, pseudo- its use. almost time for next
o headache
reduced by reacting membranous o It is dose.
with reduced o vaginal itching
colitis, and bacterial contraindicated in
ferredoxin, which is vaginosis. or discharge Inform patient that
nursing mothers. o A metallic
generated by medication may cause
pyruvate oxido- taste in the an unpleasant metallic
reductase. This mouth is taste.
reduction causes the commonly
production of toxic noted. Advise patient to
products to consult health care
anaerobic cells, and professional if no
allows for selective improvement in a few
accumulation in days or if signs and
anaerobes. symptoms of
superinfection (black
furry overgrowth on
tongue; loose or foul-
smelling stools
develop).

Reaction
Generic Actions are o Preprocedural o Pregnancy o Ataxia Assess level of sedation
Name: mediated through sedation. especially in the o Dysarthria and level of
Midazolam the inhibitory o Aids in the third trimester o Nystagmus consciousness
HCl neurotransmitter induction of o Long term use o Slurred speech throughout and for 2-6
gamma- anesthesia and as o Hypersensitivity o Somnolence hr following
Brand Name: aminobutyric acid part of balanced o Acute narrow (difficulty administration.
Midazolam (GABA), which is anesthesia. angle glaucoma staying awake)
one of the major o o Mental Monitor BP, pulse and
Classification inhibitory respiration continuously
confusion
: neurotransmitters in during IV administration.
o Hypotension
Antianxiety; the brain.
o Respiratory
Sedative or Benzodiazepines If overdose occurs,
hypnotics increase the activity arrest monitor pulse,
(Benzo- of GABA, thereby o Vasomotor respiration , and BP
diazepine) producing a calming collapse continuously.
effect, relaxing o Headache
skeletal muscles, If hypotension occurs,
and inducing sleep. treatment includes IV
Benzodiazepines act fluids, repositioning and
as agonists at the vasopressors.
benzodiazepine
receptors, which The effects of
form a component of midazolam can be
the benzodiazepine- reversed with flumazenil
GABA receptor- (Romazicon).
chloride ionophore
complex.

Consideration
Morphine Binds with  Relief of  Known  Allergic reactions.  Assess pain.

Sulfate (Hizon opoid moderate to hypersensitivity
Morphine receptors in severe acute to morphine or to  Gastrointestinal  Monitor for allergic
Sulfate the CNS and chronic one of the other disturbances reactions
causing pain. excipients,
Classification: alteration of existing intestinal  Urinary retention  Monitor for
Narcotic both  Renal obstruction and respiratory
analgesic perception of intestinal colic. pregnancy.  Depression, depression.
and emotional delirium and
response to  Cancer  Asthma, convulsion.  Monitor for input
pain through shortage of output ratio.
unknown  Myocardial breathing, brain  Nausea,xerostomi
mechanism. Infarction damage, a, emesis, anorexia,  Give with
epilepsy, dysguesia, facial antiemetic if nausea
 Pilmonary simultaneoustrea flushing. occurred.
edema to tment with
decrease antidepressants,  Administer when
pulmonary chronic alcohol pain is beginning to
congestion. abuse, return.
immediatelyafter
 Antitussive bile duct surgery,  Withdraw
anastomoses, medication slowly
 Narcotic, severe after long term use.
hypnotic, obstruction of
sedative. the gut.  Give with food or
milk.

Consideration
NAlbuphine Binds with  Relief of  Hypersensiti  Sedation  Assess patient’s

Hydrocloride opiate moderate to vity underlying condition
(Nubain) receptors in severe pain  Drowsiness before therapy.
the CNS:  Pregnancy.
Classification: ascending  For pre-  Sweating  Monitor allergic
Analgesics, pain pathways operative reactions.
Muscle in limbic analgesia,  Nausea
relaxants system, supplement to  Give only with
thalamus, balanced  Dry mouth resuscitative
midbrain, amesthesia. equipment available.
hypothalamus  Dizziness
, altering  Advice patient to
perception of  Headache refrain from taking
and emotional CNS depressants.
response to  vomiting
pain. Relieves  Teach patient to
pain. turn, cough, breathe
deeply after surgery to
prevent atelectasis.
Generic Inhibits Treatment of Hypersensitivity. Dizziness, flushing,  Monitor patient
Name: calcium ion vasospastic Cardiovascular shock. headache, carefully (BP, cardiac
Nifedipine influx across angina, Combination with hypotension, rhythm, and output)
cell chronic rifampicin. Immediate peripheral edema, while drug is being
Brand membrane stable release nifedipine tachycardia and adjusted to
Name: during angina, contraindicated in palpitations. Nausea therapeutic dose; the
Adalat cardiac hypertension unstable angina and and other gastro- dosage may be
Calcibloc depolarizatio (sustained- after recent MI, severe intestinal disturbance, increased more
n, produces release aortic stenosis, severe increase micturation rapidly in hospitalized
Classifica relaxation of tablets only). hypotension with frequency, lethargy, patients under close
tion: coronary systolic pressure eye pain, and mental supervision. Do not
Calcium vascular <90mmHg, depression have also exceed 30 mg/dose
Channel smooth decompensated heart occurred. Gingival increases.
Blocker muscle and failure. Pregnacy and hyperplasia, rashes,  Ensure that patients
peripheral lactation. fever, and do not chew or divide
vascular abnormalities in liver SR tablets.
smooth function due to  Taper dosage of
muscle, hypersensitivity beta-blockers
dilates reactions. before nifedipine ther
coronary apy.
vascular  Protect drug from
arteries, and light and moisture.
increases
myocardial
oxygen
delivery in
patients with
vasospastic
angina.

Generic Relief of Contraindicated with Causes headach Give sublingual
Relief of
Name: refractory or allergy to nitrates, severe es, suddenly preparations under
Angina
Nitroglycerin unstable anemia, early MI, head flushed skin, the tongue or in
Pectoris:
angina, control trauma, cerebral orthostatic the buccal pouch.
Reduction of
Brand of congestive hemorrhage, hypertrophic problems, or Encourage patient not
Myocardial
Names: heart failure. cardiomyopathy, reflectory to swallow. Ask
Oxygen
Nitrostat, Control of pregnancy, lactation. tachycardia in patient if the tablet
Requirement
Nitroquick, hypertension approximately 5% "fizzles" or burns.
s by
Nitrolingual, during of the treated Always check the
Extracoronar
coronary subjects. expiration date on the
y
Classification artery bypass Paradoxical bottle; store at room
Vasodilation
: graft surgery. bradycardia and temperature,
and Its
Vasodilator Management severe protected from light.
Attenuation
of hypotension with Discard unused drug
by the
hypertensive collapse are not 6 mo after bottle is
Chronic
emergency. as common. opened (conventional
Administratio
As a Hypotension can tablets); stabilized
n of
premedication, be associated to tablets (Nitrostat) are
lsosorbide
diagnostic tool a risk of cerebral less subject to loss of
Dinitrate.
and for the ischemia! potency.
treatment of · Give SR
angina in preparations with
cardiac water; warn the
catheter lab. patient not to chew
Acute the tablets or
myocardial capsules; do not
infarction crush these
preparations.
· Administer topical
ointment by applying
the ointment over a 6
× 6 inch area in a
thin, uniform layer
using the applicator.
Cover area with
plastic wrap held in
place by adhesive
tape. Rotate sites of
application to
decrease the chance
of inflammation and
sensitization; close
tube tightly when
finished.
· Administer transder
mal systems to skin
site free of hair and
not subject to much
movement. Shave
areas that have a lot
of hair. Do not apply
to distal extremities.
Change sites slightly
to decrease the
chance of local
irritation and
sensitization.
Remove transdermal
system before
attempting
defibrillation
or cardioversion.
· Administer transmu
cosal tablets by
placing them between
the lip and gum
above the incisors or
between the cheek
and gum. Encourage
patient not to swallow
and not to chew the
tablet.
· Administer
the translingual spray
directly onto the oral
mucosa; preparation
is not to be inhaled.
· WARNING: Arrang
e to withdraw drug
gradually. 4–6 wk is
the recommended
withdrawal period for
the transdermal prepa
rations.
DRUG MECHANISM INDICATION CONTRAINDICATION SIDE EFFECT NURSING
OF ACTION RESPOSIBILITIES
Generic Name: Inhibits . Indication:  Contraindicated CNS: headache, > Monitor blood
Amlodipine calcium ion  Chronic Stable in patients somnolence, pressure frequently
Besylate influx across angina. hypersensitive to fatigue. during initiation of
cardiac and  Hypertension. drug. CV: edema, therapy. Because
smooth  Use cautiously flushing drug induced
Brand Name: muscle cells, in patients GI: nausea, vasodilators has
Norvasc thus receiving other abdominal pain. gradual onset acute
decreasing peripheral GU: sexual hypotension is rare.
Classification: myocardial vasodilators, difficulties. > Don’t confuse
Anti – Anginals contractility especially those Musculoskeletal: amlodipine with
and oxygen with severe aortic muscle pain. amiloride.
demand; also stenosis, and in Respiratory: > Caution patient to
dilates those with heart dyspnea. continue taking drug
coronary failure because Skin: rash. even when feeling
arteries and drug is metabolized better.
arterioles by the liver, use > Tell patient S.L.
cautiously and nitrolycerin may be
induced dosage in taken as needed
patients with sever when angina
hepatic disease. symptoms are acute.
DRUGS ACTION INDICATION CONTRAINDICA ADVERSE NURSING
TION REACTION CONSIDERATION
a NUBAIN is NUBAIN should CNS 1. Reassess patient’s
Generic synthetic opi indicated for the not be Effects: Nervousness, level of
Name: oid agonist- relief of moderate administered to depression, pain at least 15 and 30
Nalbuphine antagonistan to severe pain. patients who are restlessness, minutes after parenteral
Hydrochloride algesic of the NUBAIN can also hypersensitive to crying, euphoria, administration
phenanthren be used as a nalbuphine floating, hostility,
Brand Name: e series. It is supplement to hydrochloride, or unusual dreams, 2. Nalbuphine acts as
Nubain chemically balanced anesth to any of the confusion, faintness, an
related to esia, other ingredients hallucinations, dyspho opioid antagonist and
Classification: both the for preoperative in NUBAIN. ria, feeling of may
Analgesics widely used andpostoperative heaviness, numbness, cause withdrawal
opioid antag analgesia, and tingling, unreality. syndrome. For patients
onist, naloxo for obstetrical who
ne, and the analgesia during Cardiovascular: Hyp have received log-term
potent opioid labor and ertension, hypotension opioids, give 25% of the
analgesic, delivery. , bradycardia, tachyca usual dose initially.
oxymorphon rdia. Watch
e. for sings of withdrawal.
Gastrointestinal: Cra
mps, dyspepsia, bitter 3. Alert: Drug causes
taste. respiratory depression,
which at 10mg is equal
Respiratory: Depress to
ion, dyspnea, asthma. respiratory depression
produced by 10 mg of
Dermatologic: Itching morphine
, burning, urticaria.
4.Monitor circulatory
Miscellaneous: Spee and
ch difficulty, urinary respiratory status,
urgency, blurred bladder
vision, flushing and and bowel function. If
warmth. respirations are shallow
or
Allergic rate is below 12
Reactions: Anaphylac breaths/minute, withhold
tic/anaphylactoid and dose and notify
other serious prescriber
hypersensitivity
reactions have been
reported following the
use of nalbuphine and
may require
immediate, supportive
medical treatment.
Drug Action Indication Contraindication Adverse Nursing
Reaction Consideration
Generic Name: Reduces gastric o Gastroesophageal o Hypersensitivity CNS: dizziness, Check for abdominal
Omeprazole acid secretion and reflux disease o frequent chest headache, pain, emesis,
increases gastric o Erosive pain asthenia diarrhea, or
Brand Name: mucus and esophagitis o unexplained constipation.
Losec bicarbonate o Short-term weight loss GI: nausea,
production, treatment of active o vomit that looks vomiting, Evaluate fluid I&O.
Classification: creating protective duodenal ulcer like blood or coffee diarrhea,
Proton pump coating on gastric o Gastric ulcers grounds constipation, Tell patient to take
inhibitor mucosa and easing o Pathologic o stomach pain abdominal pain 30 to 60 minutes
discomfort from hypersecretory before a meal,
excess gastric acid conditions Musculoskeletal: preferably in
o Frequent heartburn back pain morning.
Respiratory: Instruct patient to

cough, upper swallow capsules or
respiratory tract tablets whole and not
infection to chew or crush
them
Skin: rash
Caution patient to
avoid driving and
other hazardous
activities until he
knows how drug
affects concentration
and alertness.
Mechanism Contraindicatio Adverse Nursing

Name of Drug Classification Indication
of Action n Reactions Responsibilities
Mannitol Diuretics - Increases the Reduction of Hypersensitivity. Dizziness, Assess patient’s
(Osmofundin) Osmotic Diuretic osmotic increase Severe renal headache, condition before therapy
pressure of intracranial disease, severe convulsion, and regularly thereafter
Dosage: Pharmacokinetic glomerular pressure dehydration, rebound to monitor drug
75 cc s filtrate, which associated pulmonary increased ICP, effectiveness.
Absorption: inhibits tubular with cerebral congestion. confusion,
Complete (IV reabsorption edema; Renal seizures, and Assess fluid volume
administration) of water and promotion of dysfunction after fever. status, hypovolemia or
Metabolism: 15- electrolytes dieresis in the mannitol Edema, hypervolemia, urine
100 mins and increases prevention or administration thrombophlebiti output, skin turgor, neck
Distribution: urinary output. treatment of severe s, hypotension, veins, peripheral
crosses placenta; oliguria or pulmonary hypertension, edema, breath sounds,
may enter anuria due to edema. heart failure, peripheral pulses and
breastmilk acute renal tachycardia, mucous membranes,
Excretion: urine failure; angina like thirst and hypotension.
promoting chest pain,
Pharmacodynami urinary vascular Monitor manifestation of
cs excretion of overload. electrolyte imbalance:
Onset: ½-1 hour toxic Blurred vision, hypokalemia and
Peak: 1 hr substances. rhinitis, loss of hyponatremia.
Duration: 6-8 hrs. hearing,
decreased IOP. Assess BP before and
Nausea, during therapy with
vomiting, dry patient lying, standing,
mouth, and sitting, orthostatic
diarrhea, thirst. hypotension.
Urine retention.
Consideration
Oxytocin Acts directly  Initiation or  Preganacy  Seizures  Monitor BP and

(Syntocinon) onon improvement fluid intake and output
myofibrils, of uterine  Hypersensiti  Titanic
Classification: producing contractions to vity contractions  Assess labor
Oxytocic drugs uterine achieve early contractions
contractions: vaginal  Pregnacy-  Hypertension/hyp
stimulate milk delivery for induced otension  Assess signs of
ejection by maternal or hypertension, water intoxication
the breast fetal reasons cephalopelvic  Dysrhythmias
disproportion,  Watch for fetal
 Manageme fetal distress,  Intracranial distress, acceleration,
nt of inevitable hypertonic hemorrhage deceleration, fetal
or incomplete uterus. presentation, pelvic
abortion  Anorexia dimensions.
 Control of  Vomiting  Instruct patientto

postpartum report increased blood
bleeding or  Rush loss, abdominal
hemorrhage cramps, increased
 Asphyxia temp or foul-smelling
 Stimulation lochia.
of uterine  Premature
contraction ventricular contraction  Advise patient that
during third contractions will be
stage of labor  Jaundice similar to menstrual
cramps, gradually
 Hypoxia increasing in intensity.
Generic Mechanism of Indication Adverse Contraindication Nursing Responsibility

Name Action Reaction
(Brand
Name)
Generic Directly Pilocarpine Body as a whole: Pilocarpine  Importance of
Name: stimulates Hydrochloride body odor, Hydrochloride learning and adhering to
Pilocarpine cholinergic Tablets are hypothermia, mucous Tablets are proper administration
hydrochloride receptors, indicated for 1) membrane contraindicated in techniques to avoid
resulting in the treatment of abnormality patients with contamination of the
Classification muscarinic symptoms of uncontrolled solution or gel container.
Miotics and nicotinic dry mouth from Cardiovascular: asthma, known
effects. salivary gland bradycardia, ECG hypersensitivity to 
hypofunction abnormality, Pilocarpine, and
caused by palpitations, syncope when miosis is  Importance of
radiotherapy for undesirable, e.g., removing soft contact
cancer of the Digestive: anorexia, in acute iritis and in lenses before
head and neck; increased appetite, narrow angle administration (since
and 2) the esophagitis, (angle closure) pilocarpine may be
treatment of gastrointestinal glaucoma. absorbed by or
symptoms of disorder, tongue preservatives in
dry mouth in disorder preparations may have
patients with a deleterious effect on
Sjogren's Hematologic: the lenses)
Syndrome. leukopenia,
lymphadenopathy 
Nervous: anxiety,  Caution advised if

confusion, driving at night or
depression, abnormal performing hazardous
dreams, hyperkinesia, tasks in dim light.
hypesthesia,
nervousness, 
paresthesias.
 Importance of
informing clinicians of
existing or contemplated
concomitant therapy,
including prescription
and OTC drugs.

Management
 Promethazine Phenotiazine  Monitor Contraindicated  CNS:  Monitor
hydrochloride derinative sickness in patients drowsiness, patient for
Brand name that  Nausea and hypersensitive sedation, neuroleptic
 Phenergan competes vomiting to drug, those coneusion. malignant
Classification with  Nighttime who have  CV: syndrome:
 Phenotiazine histamine for sedation experienced hypotension, altered
derivative H1- receptor adverse hypertension mental
sites on reactions to  EENT: dry status,autono
effector phenothiazines, mouth mic
cells. breast- feeding  Hematologic: instability,
Prevents, women, leukopenia muscle
but doesn’t children rigidity,and
reverse, younger than hyperpyrexia.
histamine- age 2, and
mediated acutel ill or
responses. dehydrated
At high children.
doses, drug
also has
local
anesthetic
effects.

Reaction
Generic o Blocks dopamine o Gastroparesis o bleeding or o tremors, or Assess patient for
Name: receptors in o GERD blockage in your restless nausea, vomiting,
Meto- chemoreceptor o Migraine stomach or muscle abdominal distention,
clopramide trigger zone of o Nausea/Vomiting intestines; movements in and bowel sounds
the CNS. o Nausea/Vomiting, your eyes, before and after
Brand Name: o Stimulates Chemotherapy o a perforation tongue, jaw, or administration.
Plasil motility of the Induced (hole) in your neck;
upper GI tract o Nausea/Vomiting, stomach or May cause drowsiness.
Classification and accelerates intestines; o mask-like
Postoperative
: gastric emptying. appearance of Advise patient to avoid
o Radiographic Exam
Antiemetic o epilepsy or other the face; concurrent use of
o Small Intestine
seizure disorder; alcohol and other CNS
Intubation depressant while taking
or o very stiff (rigid)
muscles, high this medication.
o an adrenal gland fever,
tumor confusion, fast Advise patient to notify
(pheochromocyto or uneven health care professional
ma). heartbeats, immediately if
involuntary movement
tremors,
of eyes, face or limbs
o fluid retention; occurs.
o jaundice
(yellowing of
your skin or
eyes); or
o seizure
(convulsions)
 Potassiu Replace  To prevent  Use  CNS:  Make sure

m potassium and hypokalemia cautiously paresthesia of powders are
Chloride maintains  Hypokalemia in patient limbs, flaccid completely dissolved
Brand name potassium  Severe with paralysis before giving.
 Kalium level. hypiokalemia cardiac  CV: heart  Many adverse
Dulures  Acute MI disease or block,cardiac reactions may reflect
Classificati renal arrest hyperkalemia.
on impairment  Metabolic:
 Potassiu . hyperkalemia
m salt
Generic Relaxes Relief of severe Eclampsia and severe Tremor,  Use cautiously in
Name: bronchial and bronchospasm pre-eclampsia; intra- nervousness, patients with
Salbutamol vascular associated with uterine infection, intra- headache, cardiovascular
smooth acute uterine foetal death, hyperactivity, disorders.
Brand Name: muscle by exacerbations of antepartum tachycardia,  Syrup is available
Ventolin stimulating chronic haemorrhage, placenta palpitations, for children as young
Albuterol beta2 bronchitis and praevia and cord nausea, vomiting, as age 2.
receptors. bronchial compression, bronchospasm,  Inhaler may be
Classification: asthma. threatened miscarriage, hypersensitivity used 15 minutes
Bronchodilator Treatment of cardiac disease. reactions. before exercise to
status prevent exercise-
asthmaticus. In induced
patients bronchospasm.
refractory to  Patient may use
salbutamol tablets and inhaler at
respiratory the same time. Monitor
solution for toxicity.
 Warn the patient
about the risk of
paradoxical
bronchospasm and if it
occurs, stop drug
immediately.
 Teach patient to
use the inhaler
correctly: Shake it,
clear the throat, expel
as much air as
possible from the
lungs, inhale deeply
while releasing the
drug from the inhaler,
hold breath for several
seconds.
 Use of a spacer
may improve delivery.
 Wait for 2 minutes
between puffs of
inhaler.
 If the patient is
also using a steroid
inhaler, use the
bronchodilator first,
then wait 5 minutes
before using the
steroid.
 Wash the canister
with warm water and
soap at least once a
week.
Mechanism Contraindicatio Adverse Nursing

Name of Classification Indication
of Action n Reactions Responsibilities
Drug
Simvastatin Lipid-Regulating Inhibits HMG- To reduced LDL Hypersensitivity Abdominal Assess nutrition: fat,
(Zocor) Drugs – HMG-CoA COA (3- cholesterol, to any pain protein, carbohydrates,
Reductase hyroxy-3- apolipoprotein components of Constipation nutritional analysis should
Inhibitors -Statins methyglutaryl beta this preparation. Flatulence be completed by dietitian
Dosage: coenzyme) tryglycerides. To Acute Liver Nausea before treatment is
40mg 1 tab Pharmacokinetics reductase increase HDL Disease or Acid initiated.
OD hs Absorption: 85% enzyme, cholesterol in unexplained Vomiting
Distribution:Unkno which reduces the treatment of persistent Diarrhea Instruct the patient to take
wn cholesterol hyperlipidemias, elevations of Dyspepsia drug with the evening
Metabolism:Liver synthesis, this including serum Insomnia meal because taking this
extensively enzyme is hypercholesterol transaminases Anemia enhances absorption and
Excretion: 70% needed for aemias and Rashes increases cholesterol
feces, 20% kidney cholesterol combined Headache biosynthesis.
Half-life: 3 hrs production. hyperlipidaemia.
Teach patient about
Pharmacodynami proper dietary
cs management of
Onset: unknown cholesterol and
Peak: 1-hrs triglycerides.When
Duration: unknown appropriate; recommend
weight control, exercise
and smoking.
Tell patient to notify

physician if adverse
reactions occur,
particularly muscle aches
and pain.

Generic It raises  treatment Metabolic or Metabolic  Instruct patient to
Name: blood and of respiratory alkalosis; alkalosis; mood chew antacid tab
Sodium urinary pH by metabolic hypernatraemia, changes, and drink 8 oz. of
Bicarbonate dissociation acidosis severe pulmonary tiredness, water.
to provide  as oedema; shortness of bre  Inform patient that
Brand Name: bicarbonate alkalinizing hypocalcaemia, ath, muscle renal calculi may
B. Braun 8.4 ions, which agent in hypochlorhydria. weakness, develop if antacid
% Sodium neutralises cardiopulm irregular is taken with milk.
Bicarbonate the hydrogen onary heartbeat;  Instruct the patient
ion resuscitati muscle not to use antacid
Classification concentratio on and in hypertonicity, for more than two
Electrolyte- n. It also the twitching, weeks except
alkalinizer neutralises treatment tetany; under supervision
gastric acid of certain hypernatraemia, of the physician.
via drug hyperosmolality,  Advice patient not
production of intoxicants hypocalcaemia, to take sodium
bicarbonate on
carbon hypokalaemia; routine or long
dioxide. stomach term basis.
cramps,  Advise patient to
flatulence. notify physician if
Tissue necrosis indigestion is
at inj site. accompanied by
chest pain:
dyspnea; diarrhea;
dark, tarry stools.
 Teach patient
about sodium-
restricted diet; to
avoid use of
baking soda for
indigestion.
 Caution patient to
immediately report
to physician if
symptoms such as
nausea, vomiting
and anorexia
occurs.
Generic Name: Decreases Management Serious infections, CNS: insomnia, Monitor any sign of
Hydrocortisone of
inflammation by except septic shock or nervousness anaphylactic
adrenocortical
Brand Name: suppression of tuberculosis GI: increased reaction
insufficiency,
Solu-cortef migration of meningitis, appetite
relief
polymorphonuclear inflammation hypersensitivity, viral, Derma:Hirsutism Assess
Classification:
leukocytes and of fungal or tubercular Endo: diabetes client’s urine,
Anti-
reversal of corticosteroid- skin lesion. mellitus muscle weakness
inflammatory
increased capillary responsive Resp: epistaxis and wasting, weight
agent,
permeability. dermatoses, other: cataracts,
corticosteroid,
adjunctive anthralgia
glucocorticoid
treatment of
mineralocorticoid
ulcerative
colitis.
Name of Mechanism of Contraindicatio Adverse Nursing
Classification Indication
Drug Action n Reactions Responsibilities
Citicoline CNS Stimulants/ Citicoline is a CVA in acute Hypertonia of Shock, Evaluate patient medical
(Somazine) Neurotonics derivative of and recovery the hypersensitivit history.
choline and phase. parasympathetic y,
Dosage: Pharmacokinetics cytidine involve Symptoms nervous system. hypotension, Assess patient’s
1 gm IV q 12 Absorption: almost in the and signs of insomnia, condition.
completely biosynthesis of cerebral excitement.
absorbed lecithin. It is insufficiency Monitor BP, pulse and
Distribution: claimed to (i.e., heart rate.
disperse widely increase dizziness,
throughout the blood flow headache, Assess allergic reaction
body: cross blood and oxygen poor like gastro intestinal
brain barrier consumption concentration, disturbances.
Metabolism: in the brain. memory loss,
unknown disorientation). Must not be administered
Excretion: unknown to patient with hypertonia
Half life: unknown of the parasympathetic
nervous system.
Pharmacodynami
cs
Onset: unknown
Peak: Unknown
Duration: unknown
DRUG NAME
MECHANISM INDICATION CONTRAINDICATI ADVERSE EFFECTS NURSING
OF ACTION ON CONSIDERATION

BRAND NAME: Long-acting Long-term, History of GI: Dry mouth, dyspepsia, · Docume
Spiriva antimuscarinic once daily, hypersensitivity to abdominal pain, constipation,
nt indications
GENERIC (anticholinergic maintenance atropine or its vomiting, gastroesophageal
NAME:Tiotropiu ). In the treatment of derivatives, including reflux, GI disorder, stomatitis for therapy,
m bromide airways it bronchospas ipratropium. Use for (including characteristic
CLASSIFICATI inhibits m associated initial treatment of ulcerative).CNS:Depression, of S&S, other
ON: muscarinic M3 with COPD, acute episodes of dysphonia,
receptors at the including bronchospasm paresthesia.Respiratory:URTI, agents trialed,
Anticholinergic
smooth muscle,chronic (rescue therapy). sinusitis, pharyngitis, rhinitis, and outcome.
leading to bronchitis and Use with other epistaxis, coughing, · Note
Dosage: bronchodilation emphysema. anticholinergics laryngitis. CV:Angina pectoris CXR, PFTs,
18mcg/cap OD . Since the drug (e.g., ipratropium). (including aggravated angina
is inhaled, the pectoris), atrial fibrillation, other drugs

majority is supraventricular tachycardia, prescribed
deposited in palpitation.Musculoskeletal:Art and overall
the GI tract hritis, skeletal pain, myalgia.
and, to a lesser GU: UTI, urinary physical
extent, the retention.Dermatologic:Rash
condition/
lungs (site of pruritus, urticaria. Body as a
action). The whole:Accident edema, clinical
portion infection, moniliasis, flulike presentation
metabolized is symptoms, allergic reaction, of client.
through the angioedema.Miscellaneous:her
CYP2D6 and pes zoster, leg pain, cataract, · Asses
CYP3A4 epistaxis. for any
enzyme evidence of
systems. QT
However, most
is excreted prolongation
unchanged on EKG, renal
through the dysfunction,
urine. ,
or inability to
terminal: 5-6
days. Plasma self
protein administer
binding: 72%. drug. Note

BPH, narrow

angle
glaucoma, or
bladder neck
obstraction,
as drug use
may
aggravate
these
conditions

Generic - Inhibits . Short term - Hypersensitivity GI reactions, 1. Patients who
Name: prostaglandin management - Cross-sensitivity with nausea, have asthma,
Ketorolac synthesis, of pain (not to other NSAIDs may dyspepsia, aspirin-induced
producing exceed 5 days exist¨Pre- or perioperative drowsiness, allergy, and nasal
Brand Name: peripherally total for all use headache, polyps are at
Toradol mediated routes - Known alcohol sweating, increased risk for
analgesia combined) intoleranceUse cautiously edema. Anxiety, developing
Classification: - Also has in: psychotic hypersensitivity
Non Steroidal antipyretic and 1) History of GI bleeding reactions, reactions. Assess
Anti- anti- 2) Renal impair-ment interstitial for rhinitis, asthma,
inflammatory inflammatory (dosage reduction may be nephritis and urticaria.
Drugs properties. required) syndrome,
(NSAIDs) - Therapeutic 3) Cardiovascular disease nephrotic 2.Assess pain (note
effect:Decreased syndrome, type, location, and
pai bradycardia, intensity) prior to
palpitation, and 1-2 hr following
hypotension, administration.
chest pain, - Ketorolac therapy
angioedema, should always be
hematomata given initially by the
IM or IV route. Oral
therapy should be
used only as a
continuation of
parenteral therapy.
3. Caution patient to
avoid concurrent
use of alcohol,
aspirin, NSAIDs,
acetaminophen, or
other OTC
medications without
consulting health
care professional.
4.Advise patient to
consult if rash,
itching, visual
disturbances,
tinnitus, weight
gain, edema, black
stools, persistent
headche, or
influenza-like
syndromes
(chills,fever,muscles
aches, pain) occur.
Consideration
Tramadol Acentrally acting Management of  Hypersensitivity  GI: vomiting,  Observe ten

(Ultram) analgesic not moderate to to tramadol. diarrhea, rights in giving
related moderately abdominal pain, medications.
Classification: chemically to severe pain.  In acute constipation
Centrally acting opiates. Precise intoxication with  Document
Analgesic mechanism is alcohol, hypnotics,  CNS: indications for
not known. Two centrally acting Headache, therapy.
Dose, Route, complementary analgesics, opiates dizziness, vertigo,
Frequency: 40 mechanisms or psychotropic anxiety  Assess history
mg IV OD may be drugs of drug addiction,
applicable: It  CV: allergy to opiates
may bind to mu-  Use in clients vasodilation, or codeine, or
opoid receptors with past or present syncope, seizures.
and inhibit addiction or opiate orthostatic
reuptake of dependence or in hypotension,  Monitor VS,
norepinephrine those with a prior I&O, liver and
and serotonin. history of allergy to  GU: urinary renal function.
The analgesic codeine or opiates. retention,,
effect is only menstrual disorder  Advise patient
partially  Use for obstetric not to perform
antagonized by preoperative  Dermatologic: activities that
the antagonist medication or Pruritus, sweating, require mental
naloone. postdelivery rash, urticaria alertness
analgesia in
nursing mothers.  Opthalmic:
visual disturbance,
cataracts, miosis

Generic Competitively Treatment & » Intravascular clotting, GI Ophthalmological
Name: inhibits activation prophylaxis of active (risk of serious, disturbances examinations,
Tranexamic of hemorrhage even fatal, thrombus ,hypotension including tests for
Acid plasminogen there associated w/ formation) , thrombotic visual acuity, color
by reducing excessive Defective color vision, complication vision, eyeground,
Brand Name: conversion of fibrinolysis. acquired (condition , transient and visual
Cyklokapron. plasminogen to precludes assessment of disturbance fields (recommende
plasmin [Tranexamic color vision, which may of color d prior to and at
Classification: (fibrinolysin), an acid is indicated be required to determine vision. regular intervals
Haemostatics enzyme that for the toxicity) during therapy for
degrades fibrin treatment of » Hematuria of upper patients receiving the
clots, fibrinogen, severe urinary tract origin (risk medication for longer
and other plasma localized of intrarenal obstruction than several days
proteins, including bleeding secondary to clot because tranexamic
the procoagulant secondary to retention in the renal acid has caused focal
factors V and VIII hyperfibrinolysi pelvis and ureters if areas of retinal
s, including hematuria is massive; degeneration in
epistaxis, also, if hematuria is animal studies and
hyphema, or associated with a visual disturbances
hypermenorrhe disease of the renal [although retinal
a (menorrhagia) parenchyma, lesions have not been
and intravascular reported] in humans)
precipitation of fibrin may
Treatment of occur and exacerbate the
hereditary disease
angioedema » Hemorrhage,
subarachnoid

 Diazepa A  Anxiety  Diastat rectal gel  CNS:  When using oral
m benzodiazepin  Acute is drowsiness, solution, dilute
Brand name e that alcohol contraindicated slurred speech. dose just before
 Valium probably withdrawal in patienta with  CV: CV giving.
Classificati potentiates the  Muscle acute angle- collapse,  Monitor elderl
on effects of spasm closure bradycadia. patients for
 Benzodia GABA,  Preoperative glaucoma.  EENT: dizziness, ataxia,
zepine depresses the sedation  Use cautiously in diplopia,nystagmu mental status
CNS, and patients with s. changes. Patient
suppresses liver or renal  GI: nausea are at an increased
the spread of impairment,  Hematologic: risk for falls.
seizure depression, or neutropenia
activity. chronic open-
angle glaucoma.
Use cautiously
in elderly and
debilitated
patients.
Consideration
 Albuterol Relaxes  To prevent  Contraincated  CNS: tremor,  Drug may
sulfate bronchial, or treat in patients nervousness,h decrease
Brand name uterine, and bronchospas hypersensitive eadache. sensitivity of
 Ventolin vascular m in patients to drug or its  CV: spirometry used
Calssificati smooth with ingredients. tachycardia,pa for diagnosis of
on muscle by reversible  Use extended- lpitations,hype astma.
 Adrenergi stimulating obstructive release tablets rtension.  Syrup contains
c beta2 airway cautiously with  EENT: no alcohol or
receptors. disease GI narrowing. hoarseness. sugar and may
 To prevent  GI: nausea, be taken by
exercise- vomiting children as
induced young as age 2.
bronchospas
m
DRUG CLASSIFICATION/ MECHANIS CONTRAINDICATION SIDE NURSING
INDICATION M OF EFFECT RESPOSIBILITIE
ACTION S
Generic Classification: Competitively  Contraindicated in CNS: > Assess patient
Name: Anti - ulcer Drugs inhibits patients vertigo, for abdominal
Ranitidine action of hypersensitive to malaise, pain. Note
Hydrochloride histamine on drug and those headache. presence of blood
. the H2 at with acute EENT: in emesis, stool, or
receptor sites parphyria. blurred gatric aspirate.
Indication: of parietal  Use cautiously in vision. > Ranitidine may
 Duodenal and cells patients with Hepatic: be added to total
Brand Name: gatric ulcer; decreasing hepatic jaundice. parenteral nutrition
Zantac pathologic gastric acid dysfunction. Other: solution.
hypersecretory secretion. Adjust dosage in andioedema > Instruct patient
condition such as patients with , on proper use of
Zolliger – Ellison impaired renal anaphylaxis. OTC preparation,
syndrome. function. as indicated.
 Maintenance > Remind patient
therapy for to take once daily
duodenal or gatric prescription drug
ulcer. at bedtime for best
 Gatroesophageal results.
reflux disease.
 Erosive
esophagitis.
 Heartburn.

1.emergency Drugs Group9b

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1.emergency Drugs Group9b

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EMERGENCY

Marzan, Kristy M. o Epinephrine o Omeprazole o Buscopan

Amlodipine Possible slight  Hypertension  Use with  CNS: Headache,  Check BP

Drugs Action Indication Contraindication Adverse Reaction Nursing

Aspirin Relieves pain  Treatment  Hypersensiti  EENT: Dizziness,  Assess pain

Name of the Action Indication Contraindications Adverse Effects/ Nursing

Terbutaline Specific beta  Terbutaline  Hypersensiti  Palpitations  Assess patient’s

DRUG NAME MECHANISM INDICATIONS CONTRAINDI- ADVERSE NURSING

Name of the Action/Classificatio Indication Contraindications Adverse Effects/ Nursing

Clindamycin A semisynthetic  Serious  Hypersensitivity  GI: diarrhea,  Reduce

 Miscellaneous:  Take oral

Name of Mechanism Adverse

Generic name Action Indication Contraindication Adverse Reaction Nursing

DRUGS ACTION INDICATION CONTRAINDI ADVERSE NURSING

Generic name Action Indication Contraindication Adverse Reaction Nursing

DRUG ACTION INDICATION CONTRAINDICATION ADVERSE NURSING

DRUG ACTION INDICATION CONTRAINDICATION ADVERSE NURSING

DRUGS ACTION INDICATION CONTRAINDICATION ADVERSE NURSING

Generic name Action Indication Contraindication Adverse Reaction Nursing Management

Generic name Action Indication Contraindication Adverse Reaction Nursing Management

famotidine Competitively Intractable Contraindicate CNS: dizziness,  Assess creatinine clearance

DRUG ACTION INDICATION CONTRAINDICATION ADVERSE NURSING

Heparin Accelerates  Prophylaxis  Hypersensit  Hemorrhage  Assess patients

Hydroxyzine Manifest  Symptomatic  Hypersensitivity  Low incidence  Inject in IM

Use only lidocaine

Advise patient that drug

DRUGS ACTION INDICATION CONTRAINDICATION ADVERSE NURSING

Generic Name Mechanism Indication Adverse Reaction Contraindicatio Nursing Responsibility

Drug Action Indication Contraindication Adverse Nursing Consideration

Drug Action Indication Contraindication Adverse Nursing Consideration

Drugs Action Indication Contraindication Adverse Reaction Nursing

Morphine Binds with  Relief of  Known  Allergic reactions.  Assess pain.

Drugs Action Indication Contraindication Adverse Reaction Nursing

NAlbuphine Binds with  Relief of  Hypersensiti  Sedation  Assess patient’s

DRUG ACTION INDICATION CONTRAINDICATION ADVERSE NURSING

Respiratory: Instruct patient to

Mechanism Contraindicatio Adverse Nursing

Oxytocin Acts directly  Initiation or  Preganacy  Seizures  Monitor BP and

 Control of  Vomiting  Instruct patientto

Generic Mechanism of Indication Adverse Contraindication Nursing Responsibility

Nervous: anxiety,  Caution advised if

Generic name Action Indication Contraindication Adverse Reaction Nursing

Drug Action Indication Contraindication Adverse Nursing Consideration

Generic name Action Indication Contraindication Adverse Reaction Nursing Management

 Potassiu Replace  To prevent  Use  CNS:  Make sure

Mechanism Contraindicatio Adverse Nursing

Tell patient to notify

DRUG ACTION INDICATION CONTRAINDICATION ADVERSE NURSING

DRUGS ACTION INDICATION CONTRAINDICATION ADVERSE NURSING

Tramadol Acentrally acting Management of  Hypersensitivity  GI: vomiting,  Observe ten

DRUGS ACTION INDICATION CONTRAINDICATION ADVERSE NURSING

Generic name Action Indication Contraindication Adverse Reaction Nursing Management

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