EPINEPHRINE (ADRENALINE)

Brand Name: Adrenalin, Sus-Phrine

Classification: Sympathomimetic drug, Alpha-adrenergic agonist, Beta1 and beta2-adrenergic agonist,
Cardiac stimulant, Vasopressor, Bronchodilator, Antiasthmatic drug, Nasal decongestant, Antiglaucoma drug
Indication: Treatment of shock when increased blood pressure and heart contractility are essential; to
prolong effects of regional anesthetic; primary treatment for bronchospasm, as an ophthalmic agent; to
produce local vasoconstriction that prolongs effects of local anesthetics
Mechanism of Action: Naturally occurring neurotransmitter, the effects of which are mediated by alpha or
beta receptors in target organs. Stimulates alpha and beta receptors. Effects on alpha receptors include
vasoconstriction, contraction of dilator muscles of iris. Effects on beta receptors include positive
chronotropic and inotropic effects on the heart (beta1 receptors); bronchodilation, vasodilation, and uterine
relaxation (beta2 receptors); decreased production of aqueous humor.
CONTRAINDICATION: Hypersensitivity, pheochromocytoma, tachyarrythmias or ventricular fibrillation,
hypovolemia, patients under halogenated hydrocarbon general anesthetics
Adverse Effects: Restlessness, light-headedness, psychological disturbances, CNS depression, weakness,
blurred vision, Arrhythmias, hypertension resulting in intracranial hemorrhage, cardiovascular collapse with
hypotension, precordial pain in patients with ischemic heart disease, Pallor, respiratory difficulty, sweating
Nursing Responsibilities:
Use minimal doses for minimal periods of time; "epinephrine-fastness" (a form of drug tolerance) can
occur with prolonged use.
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.

AMIODARONE
Brand Name: Cordarone
Classification: Class III Antiarrythmics, Non-selective Adrenergic Blocking Agents
Indication: Treatment of life-threatening ventricular arrhythmias
Mechanism of Action: Block potassium channels and slow the outward movement of potassium during
phase 3 of the action potential, prolonging it. Type III antiarrhythmic: Acts directly on cardiac cell membrane;
prolongs repolarization and refractory period; increases ventricular fibrillation threshold; acts on peripheral
smooth muscle to decrease peripheral resistance
Contraindications: Contraindicated with hypersensitivity to amiodarone, sinus node dysfunction, heart
block, severe bradycardia, hypokalemia, lactation
Adverse Effects: Malaise, fatigue, dizziness, tremors, ataxia, paresthesias, lack of coordination, Cardiac
arrhythmias, CHF, cardiac arrest, hypotension, Corneal microdeposits (photophobia, dry eyes, halos, blurred
vision); ophthalmic abnormalities including permanent blindness, Nausea, vomiting, anorexia, constipation,
abnormal LFTs, hepatotoxicity, Pulmonary toxicitypneumonitis, infiltrates (shortness of breath, cough, rales,
wheezes), Hypothyroidism or hyperthyroidism
Nursing Responsibilities:
Before the therapy, assess the patients vital signs and put more focus on the cardiac activity. For
patients with cardiac device implants, check its condition and if it works properly before during and
after administration.
Monitor also the pulmonary, liver and thyroid function tests as it may infer with the expected results.
Watch out for adverse drug interactions such as: peripheral neuropathy, abnormal gait, ataxia,
dizziness, headache, fatigue. Bradycardia can occur followed with hypotension and eventual sinus
arrest. Photosensitivity is an expected adverse reaction