Professional Documents
Culture Documents
Emergency Drugs
Emergency Drugs
1) AMINOPHYLLINE
Nursing Measures:
• It may be necessary to take this drug around the clock for adequate control
of asthma attacks.
• Frequent blood tests may be necessary to monitor the effect of this drug and
to ensure safe and effective dosage; keep all appointments for blood tests
and other monitoring.
• These side effects may occur: Nausea, loss of appetite (taking this drug with
food may help if taking the immediate-release or liquid dosage forms);
difficulty sleeping, depression, emotional lability (reversible).
2) AMIODARONE HYDROCHLORIDE
Brand Names: Anoion tab Cordarone Cordarone inj Sandoz Amiodarone HCl tab
Dosage: PO Initial: 200 mg 3 times/day for 1 wk, reduce to 200 mg twice daily for a
further wk. Maintenance: 200 mg/day or lowest effective dose. IV Initial: 5 mg/kg
infusion via central venous catheter. Max: 1.2 g/24 hr.
Nursing Measures:
• Arrange for periodic chest x-ray to evaluate pulmonary status (every 3–6
mo).
• Arrange for regular periodic blood tests for liver enzymes, thyroid hormone
levels.
• These side effects may occur: Changes in vision (halos, dry eyes, sensitivity
to light; wear sunglasses, monitor light exposure); nausea, vomiting, loss of
appetite (take with meals; eat small, frequent meals); sensitivity to the sun
(use a sunscreen or protective clothing when outdoors); constipation (a
laxative may be ordered); tremors, twitching, dizziness, loss of coordination
(do not drive, operate dangerous machinery, or undertake tasks that require
coordination until drug effects stabilize and your body adjusts to it).
3) ATROPINE SULFATE
Brand Names: Anespin amp Atropol amp Euro-Med Atropine Sulfate amp Isopto
Atropine eye drops Phil Pharmawealth/Atlantic Atropine amp
Indication/Dosage: IV Bradycardia 500 mcg every 3-5 mins. Total: 3 mg. IV/IM
Organophosphorus poisoning 2 mg every 10-30 mins until muscarinic effects
disappear or atropine toxicity appears. IM/SC Premed in anesth 300-600 mcg 30-60
mins before anesth. IV/IM/SC Overdosage w/ other compd having muscarinic actions
0.6-1 mg, repeat 2 hrly. Ophth Inflammatory eye disorders As 0.5-1% soln: 1-2 drops
4 times/day. Eye refraction As 1% soln: 1 drop twice daily for 1-2 days before
procedure.
Nursing Measures:
• Avoid hot environments; you will be heat intolerant, and dangerous reactions
may occur.
• These side effects may occur: Dizziness, confusion (use caution driving or
performing hazardous tasks); constipation (ensure adequate fluid intake,
proper diet); dry mouth (suck sugarless lozenges; perform frequent mouth
care; may be transient); blurred vision, sensitivity to light (reversible; avoid
tasks that require acute vision; wear sunglasses in bright light); impotence
(reversible); difficulty in urination (empty the bladder prior to taking drug).
4) BUMETANIDE
Action: inhibits Sodium and Chloride reabsorption at the ascending loop of Henle
Nursing Measures:
• Give single dose early in day so increased urination will not disturb sleep.
• Weigh yourself on a regular basis, at the same time, and in the same
clothing; record the weight on your calendar.
• These side effects may occur: Increased volume and frequency of urination;
dizziness, feeling faint on arising, drowsiness (avoid rapid position changes;
hazardous activities, such as driving; and alcohol consumption); sensitivity to
sunlight (use sunglasses, sunscreen, wear protective clothing); increased
thirst (suck sugarless lozenges; use frequent mouth care); loss of body
potassium (a potassium-rich diet, or supplement will be needed).
5) CALCIUM GLUCONATE
Classification: Electrolytes
Nursing Measures:
• Make sure prescriber specifies form of calcium to be given; crash carts may
contain both calcium gluconate and calcium chloride.
• Tell patient to take oral calcium 1 to 11/2 hours after meals if GI upset occurs.
• Give I.M. injection in gluteal region in adults and in lateral thigh in infants.
Use I.M. route only in emergencies when no I.V. route is available bec. of
irritation of tissue by calcium salts.
• Tell patient to take oral calcium with a full glass of water.
• Monitor calcium levels frequently. Hypercalcemia may result after large doses
in chronic renal failure. Report abnormalities.
6) CAPTOPRIL
Brand Names: Ace-Bloc tab Capomed tab Capotec tab Capoten tab Captor tab
Captril tab Cardiovaz tab Conamid tab Hartylox tab Normil tab Phil
Pharmawealth/Panion & BF Captopril tab Prelat tab Primace tab Retensin tab
Spec-Ace tab Tensoril tab Unihype tab Vasostad tab
Action: inhibits ACE, reduces Sodium and water retention, lowers blood pressure
Nursing Measures:
• Alert surgeon and mark patient's chart with notice that captopril is being
taken; the angiotensin II formation subsequent to compensatory renin
release during surgery will be blocked; hypotension may be reversed with
volume expansion.
• Take drug 1 hr before or 2 hr after meals; do not take with food. Do not stop
without consulting your health care provider.
• Be careful of drop in blood pressure (occurs most often with diarrhea,
sweating, vomiting, dehydration); if light-headedness or dizziness occurs,
consult your health care provider.
• These side effects may occur: GI upset, loss of appetite, change in taste
perception (limited effects, will pass); mouth sores (perform frequent mouth
care); rash; fast heart rate; dizziness, light-headedness (usually passes after
the first few days; change position slowly, and limit your activities to those
that do not require alertness and precision).
• Report mouth sores; sore throat, fever, chills; swelling of the hands, feet;
irregular heartbeat, chest pains; swelling of the face, eyes, lips, tongue,
difficulty breathing.
7) CLONIDINE
Action: stimulates alpha 2 receptors and inhibits central vasomotor centers, lowers
peripheral vascular resistance, blood pressure, and heart rate
Nursing Measures:
• Take drug 1 hr before or 2 hr after meals; do not take with food. Do not stop
without consulting your health care provider.
• These side effects may occur: GI upset, loss of appetite, change in taste
perception (limited effects, will pass); mouth sores (perform frequent mouth
care); rash; fast heart rate; dizziness, light-headedness (usually passes after
the first few days; change position slowly, and limit your activities to those
that do not require alertness and precision).
• Report mouth sores; sore throat, fever, chills; swelling of the hands, feet;
irregular heartbeat, chest pains; swelling of the face, eyes, lips, tongue,
difficulty breathing.
• Take this drug exactly as prescribed. Do not miss doses. Do not discontinue
the drug unless so instructed. Do not discontinue abruptly; life-threatening
adverse effects may occur. If you travel, take an adequate supply of drug.
• Attempt lifestyle changes that will reduce your BP: stop smoking and using
alcohol; lose weight; restrict intake of sodium (salt); exercise regularly.
• Use caution with alcohol. Your sensitivity may increase while using this drug.
8) DIAZEPAM
Brand name: Valium
Classification: Anxiolytics
Dosage: 10mg/2ml
Indication: relief of anxiety, agitation & tension due to psychoneurotic states &
transient situational disturbances
Nursing Measures:
• Monitor EEG in patients treated for status epilepticus; seizures may recur
after initial control, presumably because of short duration of drug effect.
• Arrange for epileptic patients to wear medical alert ID indicating that they are
epileptics taking this medication.
9) DIGOXIN
Classification: Inotropics
Dosage: 5mg/2ml
Nursing Measures:
• Monitor apical pulse for 1 min before administering; hold dose if pulse < 60
in adult or < 90 in infant; retake pulse in 1 hr. If adult pulse remains < 60 or
infant < 90, hold drug and notify prescriber. Note any change from baseline
rhythm or rate.
10) DIPENHYDRAMINE
Classification: antihistamine
Dosage: 50mg/ml
Nursing Measures:
• Caution patient not to use oral OTC diphenhydramine products with any other
product containing diphenhydramine, including products used topically.
11) EPINEPHRINE
Dosage: 1mg/ml
Nursing Measures:
• Protect drug solutions from light, extreme heat, and freezing; do not use pink
or brown solutions. Drug solutions should be clear and colorless (does not
apply to suspension for injection).
• Shake the suspension for injection well before withdrawing the dose.
• Use topical nasal solutions only for acute states; do not use for longer than
3–5 days, and do not exceed recommended dosage. Rebound nasal
congestion can occur after vasoconstriction subsides.
• To give eye drops: Lie down or tilt head backward, and look up. Hold dropper
above eye; drop medicine inside lower lid while looking up. Do not touch
dropper to eye, fingers, or any surface. Release lower lid; keep eye open, and
do not blink for at least 30 sec. Apply gentle pressure with fingers to inside
corner of the eye for about 1 min; wait at least 5 min before using other eye
drops.
12) FUROSEMIDE
Dosage: 20mg/2ml
Action: inhibits Sodium and Chloride reabsorption at the proximal and distal tubules
and the ascending loop of Henle
Nursing Measures:
• Give early in the day so that increased urination will not disturb sleep.
• Avoid IV use if oral use is at all possible.
• Do not mix parenteral solution with highly acidic solutions with pH below 3.5.
• Do not expose to light, may discolor tablets or solution; do not use discolored
drug or solutions.
Classification: antihypertension
Dosage: 20mg/ml
Action: a direct acting peripheral vasodilator that relaxes arteriolar smooth muscles
Nursing Measures:
Nursing Measures:
• Give daily before 9 AM to mimic normal peak diurnal corticosteroid levels and
minimize HPA suppression.
Nursing Measures:
Dose: 10 mg/10mL
Classification: anticonvulsant
Nursing Measures:
• Monitor the following: I.V.: Rapid administration: ECG monitoring, vital signs,
deep tendon reflexes; magnesium, calcium, and potassium levels; renal
function during administration. Obstetrics: Patient status including vital signs,
oxygen saturation, deep tendon reflexes, level of consciousness, fetal heart
rate, maternal uterine activity. Oral: Renal function; magnesium levels; bowel
movements.
Indication: relief of moderate to severe pain, pre-op medication, support of anesth &
obstet analgesia
Action: binds with opiate receptors in the CNS, altering perception of and emotional
response to pain
Adverse Reactions: resp. depression, circulatory depression, resp arrest, shock,
cardiac arrest, GI disturbance, light headedness, dizziness, sedation, nausea,
vomiting, sweating, euphoria, dysphoria, weakness, headache, tremor, agitation,
uncoordinated muscle movements, severe convulsions, transient hallucinations &
disorientation, visual disturbance, flushing, tachycardia, bradycardia, palpitation,
hypotension, syncope, phlebitis, urinary retention, allergic reactions, pain at
injection site and local tissue irritation.
Nursing Measures:
• Lie down when feeling nauseated and to notify physician if this symptom
persists. Nausea appears to worsen with ambulation.
• Avoid driving and other potentially hazardous activities until reaction to drug
is known. Codeine may impair ability to perform tasks requiring mental
alertness and therefore to.
19) METOCLOPRAMIDE
Dosage: 5mg/5mL
Action: may potentiate the effects of GABA, depress the CNS, and suppress the
spread of seizure activity
Nursing Measures:
• Keep patients in bed for 3 hr; do not permit ambulatory patients to operate a
vehicle following an injection.
• Arrange to monitor liver and kidney function and CBC at intervals during
long-term therapy.
• Establish safety precautions if CNS changes occur (use side rails, accompany
ambulating patient).
Dosage: Adult 5-20 mg IM/SC 4 hrly. Severe or chronic pain Childn 10 mg IM/SC 4
hrly, range: 5-20 mg; 6-12 yr 5-10 mg, 1-5 yr 2.5-5 mg, 1-12 mth 200 mcg/kg, <1
mth 150 mcg/kg 4 hrly. Max: 15 mg. Analgesic effect Ped 100-200 mcg/kg SC 4 hrly,
max: 15 mg/dose; or 50-100 mcg/kg slow IV. Pre-op 50-100 mcg/kg IM, max: 10
mg/dose.
Nursing Measures:
• Caution patient not to chew or crush controlled-release preparations.
• Reassure patients that they are unlikely to become addicted; most patients
who receive opioids for medical reasons do not develop dependence
syndromes.
Action: a Calcium channel blocker that inhibits Calcium ion influx across cardiac and
smooth muscle cells, also dilates coronary arteries and arterioles
Nursing Measures:
Dosage: Starting dose: 0.2-0.4 mg/hr. Dosing schedule: Daily patch-on period of 12-
14 hr & daily patch-off period of 10-12 hr.
Action: a nitrate that reduces cardiac oxygen demand by decreasing left ventricular
end diastolic pressure and to a lesser extent, systemic vascular resistance, also
increases blood flow through collateral coronary vessels
Nursing Measures:
• Administer transdermal 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.
• To use transdermal systems, you may need to shave an area for application.
Apply to a slightly different area each day. Use care if changing brands; each
system has a different concentration.
24) PARACETAMOL
Dosage: Adult & childn ≥10 yr 2-3 mL, ≤10 yr 1-2 mL. Depending on severity of
case, dose may be repeated 4 hrly. In severe cases, dose may be administered by IV
very slowly
Indication: Pyrexia of unknown origin. Fever & pain associated w/ common childhood
disorders, tonsillitis, upper resp tract infections post-immunization reactions, after
tonsillectomy & other conditions. Prevention of febrile convulsion. Headache, cold,
sinusitis, muscle pain, arthritis & toothache Action: produce analgesia by blocking
pain impulses by inhibiting synthesis of prostaglandin in CNS, relieves fever
Nursing Measures:
• Use liquid form for children and patients who have difficulty swallowing.
• Advise patient that drug is only for short term use and to consult the
physician if giving to children for longer than 5 days or adults for longer than
10 days.
• Advise patient or caregiver that many over the counter products contain
acetaminophen; be aware of this when calculating total dailydose.
• Warn patient that high doses or unsupervised long term use can cause liver
damage.
25) PHENYTOIN
Classification: Anticonvulsants
Action: may stabilize neuronal membranes and limit seizure activity by either by
increasing efflux or decreasing influx of Na ions across cell membrane in the motor
cortex during generation of nerve impulses
Nursing Measures:
26) TERBUTALINE
Nursing Measures:
• Use minimal periods of time; drug tolerance can occur with prolonged use.
Brand name: Calan, Calan SR, Covera-HS, Isoptin, Isoptin SR, Verelan, Verelan PM
Dosage: Isoptin tab Adult 40-80 mg tid-qid. Max: 480 mg daily. Childn >6 yr 40-120
mg bid-tid, up to 360 mg daily, childn ≤6 yr 40 mg bid-tid. Isoptin SR 180 Coronary
insufficiency 1 tab bid. Usual daily dose: 40-480 mg. Hypertension 1 tab in the
morning. Isoptin SR 240 1 tab in the morning. If required after 2 wk, increase dose
to 2 tab daily. Isoptin amp 5 mg slow IV, if required, 5 mg after 5-10 min. Then, if
required, continuous drip infusion of 5-10 mg/hr up to 100 mg/day. Angina pectoris
& rapid elimination of tachyarrhythmias 1-2 amp IV, if required bid-tid
• Monitor patient carefully (BP, cardiac rhythm, and output) while drug is being
titrated to therapeutic dose. Dosage may be increased more rapidly in
hospitalized patients under close supervision.
• Ensure that patient swallows SR tablets whole: do not cut, crush, or chew
them.
• Monitor patients with renal or hepatic impairment carefully for possible drug
accumulation and adverse reactions.
Dosage: Adult (including elderly) & adolescent >12 yr Acute attacks 1 vial, may
repeat doses until patient is stable. Maintenance: 1 vial tid-qid.
Adverse Reaction: Headache, nausea, dry mouth, increased heart rate &
palpitations, ocular accommodation disturbances, GI motility disturbances, urinary
retention, ocular side effects, cough, local irritation, bronchoconstriction, skin rash,
angioedema, urticaria, laryngospasm, anaphylactic reactions.
Nursing Measures:
• Protect solution for inhalation from light. Store unused vials in foil pouch.
Dosage: Berodual inhalation soln Adult (including elderly) & adolescent >12 yr
Treatment of 1 mL for immediate symptom relief. Intermittent & long-term
treatment 1-2 mL for each administration, up to qid. Moderate bronchospasm or w/
assisted ventilation 0.5 mL. Childn 6-12 yr Treatment of attacks 0.5-1 mL.
Intermittent & long-term treatment 0.5-1 mL for each administration, up to qid.
Moderate bronchospasm or w/ assisted ventilation 0.5 mL. Childn <6 yr (<22 kg
body wt) Up to 0.5 mL up to tid. Berodual F UDV Adult & childn >12 yr Acute asthma
episodes 1 vial, in very severe cases, 2 vials are needed. Intermittent & long-term
treatment 1 vial up to qid.
Nursing Measures:
• Protect solution for inhalation from light. Store unused vials in foil pouch.
30) BUDESONIDE
Classification: Corticosteroids
Dosage: 80/4.5 mcg x 60 doses; 160/4.5 mcg x 60 doses; 320/9 mcg x 60 doses
Action: work by reducing inflammation, which helps with several conditions ranging
from asthma to allergies to Crohn’s disease
Nursing Measures:
• Prime unit before use for Pulmicort Turbuhaler; have patient rinse mouth after
each use.
• Store Respules upright and protected from light; gently shake before use;
open envelopes should be discarded after 2 wk.
Classification: Bronchodilators
Stock: 2.5 mL
Dose: MDI Adult 2 puffs tid-qid. Max 12 puffs/day. Unit dose vial Adult & childn >12
yr 1 vial every 6-8 hr. Childn 2-12 yr 3 drops/kg/dose (max: 2500 mcg of
salbutamol) every 6-8 hr.
Action: muscles in the airways and increase air flow to the lungs
Nursing Measures:
32) SALBUTAMOL
Classification: bronchodilator
Stock: 1 mg/1 mL
Dose: Adult & childn 2.5-5 mg. May repeat qid by hlebitis. Delivery of aerosol may
be by face mask of ”T” piece. Use undiluted. For prolonged delivery time, dilute w/
sterile water or normal saline for inj.
Nursing Measures:
• Assess lung sounds, pulse, and blood pressure before administration and
during peak of medication. Note amount, color, and character of sputum
produced.
• Inform the mother not to smoke near the child and to avoid respiratory
irritants.
• Advise the mother to rinse the child’s mouth with water after each inhalation
dose to minimize dry mouth.
Action: It works by dilating (opening) the bronchioles of the lungs by relaxing the
muscles around them. This allows for easier airflow into and out of the lungs
Nursing Measures:
• Use minimal periods of time; drug tolerance can occur with prolonged use.
• Keep beta-adrenergic blocker readily available in case cardiac arrhythmias
occur.
Nursing Measures:
• Baseline blood coagulation tests, Hct, Hgb, RBC and platelet counts prior to
initiation or therapy and at regular intervals throughout therapy
• Monitor vitals, report fever, drop in BP, rapid pulse and other S&S of
hemorrhage
• Observe all needle sites daily for hematoma and signs of inflammation
Dosage: 100mg/10ml
Nursing Measures:
• Monitor patient carefully (BP, cardiac rhythm, and output) while drug is being
titrated to therapeutic dose. Dosage may be increased more rapidly in
hospitalized patients under close supervision.
36) D 50-50
Dosage: 50ml/vial
Action: A simple water soluble sugar that minimizes glyconeogenesis and promotes
anabolism in patients whose oral caloric intake is limited
Adverse Reactions: Local pain, vein irritation, thrombophlebitis & tissue necrosis in
the event of extravasation. Fluid & electrolyte imbalance eg hypokalemia,
hypomagnesemia & hypophosphatemia; edema or water intoxication
Nursing Measures:
• Monitor infusion rate frequently; if signs of fluid overload, turn off IV drip.
Infusion may result in fluid overload.
• Watch out for signs of fluid overload (distended neck veins (JVD), rapid
respirations, shallow tidal volume, fine auscultatory crackles, dyspnea, and
peripheral edema)
• Watch out for signs of infiltration (swelling and pain around IV site).
Classification: Electrolytes
Dosage: 40 meqs/20 ml
Nursing Measures:
Dosage: 50 ml/vial
Nursing Measures:
• Titrate dose to minimum needed for cardiac stability, when using lidocaine as
antiarrhythmic.
• Monitor fluid load carefully; more concentrated solutions can be used to treat
arrhythmias in patients on fluid restrictions.
• Be sure that such solutions are used only to produce local anesthesia. These
solutions should be injected cautiously in body areas supplied by end arteries
and used cautiously in patients with peripheral vascular disease,
hypertension, thyrotoxicosis, or diabetes.
• Monitor for safe and effective serum drug concentrations (antiarrhythmic use:
1–5 mcg/mL). Doses > 6–10 mcg/mL are usually toxic
Classification: Alkalinizers
Action: Restores buffering capacity of the body and neutralizes excess acid
Nursing Measures:
• do not take drug with milk to avoid hypercalcemia, abnormally high alkalinity
in tissues and fluids, or kidney stones.
• monitor for alkalosis by obtaining blood pH, PaO2, PCO2, and electrolyte
levels
40) DOPAMINE
Action: Stimulates dopaminergic and alpha beta receptors for the sympathetic
nervous system resulting in a positive inotropic effect and increased cardiac output.
Action is dose-related; large doses cause mainly alpha stimulation
Nursing Measures:
41) DOBUTAMINE
Classification: Adrenergics
Adverse Reaction: increased systolic BP, increased heart rate, chest pain, increased
number of premature ventricular beats, headache, tingling sensations, paresthesia.
nausea, vomiting, dyspnea, phlebitis, local inflammation after infiltration, leg
cramps
Nursing Measures:
• Monitor vital signs, ECG, cardiac output, pulmonary capillary wedge pressure,
central venous pressure and urinary output carefully throughout infusion.
Nursing Measures:
• Explain that adverse reactions related to the CNS (eg, drowsiness, confusion,
paresthesias, convulsions, respiratory arrest) can occur and are a result of
CNS toxicity.
• Advise patient that drug may cause dizziness or drowsiness and to avoid
getting out of bed or walking without assistance.
• Systemic effects can occur following topical use; use lowest possible dose to
avoid serious toxicity, shock, or heart block.
• Use with caution and in lower doses in patients with CHF, reduced cardiac
output, digitalis toxicity, and in elderly patients
43) MANNITOL
Indication: test dose for marked oliguria or suspected inadequate renal function,
oliguria, to reduce intraocular or intracranial pressure, diuresis in drug intoxication
Action: Increases osmotic pressure of glomerular filtrate; drug elevates plasma
osmolality
Adverse Reaction: Increased urination, nausea, runny nose, vomiting, severe allergic
reactions (rash, hives, itching, difficulty breathing, tightness in the chest, swelling of
the mouth, face, lips, or tongue), blurred vision, chest pain, chills or fever,
confusion, decreased alertness, difficulty urinating, extreme dizziness, extreme
thirst or dry mouth, fast or irregular heartbeat, headache, muscle cramps, pain,
redness, or swelling at the injection site, weakness
Nursing Measures:
• Monitor vital signs, including CVP, and fluid intake and output.
• Monitor weight, renal function, and serum sodium and potassium levels daily
Action: Provides some sugar for cellular metabolism and supplies body water
Adverse Reaction: Increases free water and may cause intracellular edema, fluid
overload, infiltration (swelling and pain at infusion site)
Nursing Measures:
• Monitor infusion rate frequently; if signs of fluid overload, turn off IV drip.
Infusion may result in fluid overload.
• Watch out for signs of fluid overload (distended neck veins (JVD), rapid
respirations, shallow tidal volume, fine auscultatory crackles, dyspnea, and
peripheral edema)
• Watch out for signs of infiltration (swelling and pain around IV site).