1

Hematologic & Immune System Medications

CLASSIFICATIO
N NAME

Cytoxan
Antineoplastic,
immunosuppres
sants
Folic Acid
Antianemic,
vitamin

Cyanocobalam
ine
(Vit. B12)

MECHANISM
OF ACTION

Death of rapidly
replicating malignant
cells.

Cancers, lymphomas,
myelomas, leukemias.
Prevent organ transplant
rejection.
or prevent an immune Tx for autoimmune
response and suppress
diseases
the immune system
Maintains and restores Prevention and Tx of
normal erythropoiesis.
megaloblastic anemias.
During pregnancy:
promotes normal fetal
growth. Prevent NTD.

Corrects manifestations
of pernicious anemia.
(Megaloblastic anemia,
GI lesions, and neuro
damage)

Antianemic,
vitamin
Ferrous Sulfate Prevent and Tx iron
deficiency.
Iron
supplement,
Need for hemoglobin
antianemic
formation.

Lovenox
(Enoxaprin)
Anticoagulant,
low molecular
heparin
Epogen
(Erythropoetin)
Hormone,antian
emic

INDICATIONS

Prophylactic/
Prevention of further
thrombus (clot)
formation.

Vit.B12 deficiency, to
meet demands.
Confirmed w/ Schilling
Prevent and Tx iron
deficiency anemia.

DVT,
PE- thromboemboli,
ischemic complications;
(prevents clots, especially in
immobile patients).

Maintains and may

elevate RBCs

Tx of anemia assoc. w/
renal failure or AIDS
therapy.

SIDE EFFECTS

BM suppression:
(pancytopenia),
N/V/D, hepatotoxic,
alopecia, cardiopulmo. fibrosis

NURSING
CONSIDERATIONS
AND PATIENT
EDUCATION

Rx for infection.
Rx for hemorrhage
Monitor VS
Monitor kidney fx
( fluids)
Take meds w/
meals.
Allergic Rx
Monitor folate and
Rashes
B12 levels
fever
H&H
Encourage to eat
foods in Folic
acid:
(veggies, organ
meats)
Anaphylaxis
Given IM
Diarrhea
Life-long
Itching
medication
Hypokalemia
Give w/ meals
Pain at inj. site
Encourage to eat
animal products
GI upset (constipation, Assess bowel fx;
dk stools),
dk stool (- occult
hypotension,
bld)
Seizures, stains teeth
Monitor BP and
(PO) or skin (IM),
HR; H&H
Anaphylaxis
Encourage to eat
gr. leafy veggies
and organ meats;
take w/ OJ to
absorp.
PO: Use straw; Ztrack IM
Bleeding, anemia,
Assess s/s of
thrombocytopenia,
bleeding and
dizziness, HA,
hemorrhage
constipation, N/V
Assess nuero &
pulmonary fx
Monitor CBC
Antidote:
Protamine sulfate
HTN, arthralgias,
Monitor BP, CBC
fatigue, HA,
Encourage foods
SEIZURES
in iron

Gastrointestinal System Medications

CLASSIFICATI
ON NAME

MECHANISM
OF ACTION

Lactulose

water content and

softens the stool.
pH of colon NH4

Osmotic,
laxative
Desmopressin
(DDAVP)
Hormone,
antidiuretic /
vasopressin
Neomycin
(Aminoglycosi
des)
Anti-infectives
Zantac
(Ranitidine)
Tagamet
(Cimetidine)
Antiulcer
agents,
histamine H2
antagonist

INDICATIONS

SIDE EFFECTS

NURSING
CONSIDERATIONS AND
PATIENT EDUCATION

Tx of chronic
constipation
Management of
hepatic
encephalopathy.

Belching, cramps,
distention,
flatulence, diarrhea,
hyperglucemia

Controls bleeding in
hemophilia.
Prevents nocturnal
enuresis

Controls bleeding in
hemophilia
Management of
nocturnal enuresis;

Drowsiness,
pharyngitis, dry
mouth, anaphylaxis

Maintains approp.
water content in
Diabetes Insip.
Bacterialcidal action.
Powerful antibiotics
used to treat serious
infections caused by
gram (-) bacteria

Tx of D.I.

Assess abdominal
distention, bowel sounds,
stools
Monitor mental status,
BG, NH4
Take w/ fruit juice
Assess allergy symptoms,
lung sounds and bronchial
secretions
Maintain fluid intake
1500-2000 ml/day
Avoid EOTH

To suppress GI
bacteria NH4
preventing hepatic
coma.
Tx for skin wounds
and infections

Ototoxicity,
nephrotoxicity,
hypomagnesium,
muscle paralysis,
hypersensitivity

Short-term IV or IM
Assess for infection, I/O,
daily weight,
Hearing loss
Monitor mental status,
renal fx

Healing and preventing

ulcers. symptoms of
GER and secretions of
gastric acid.

Prevents acid
inactivation of
pancreatic enzymes.
GERD, multiple
peptic ulcers.
Prevent and Tx
heartburn, acid
indigestion, sour
stomach

Confusions, HA,
dizziness,
arrhythmias,
impotence,
gynecomastia,
thrombocytopenia

Take meds before meals

and bedtime
Dont stop taking meds
abruptly
No EOTH or other CNS
depressants
Avoid taking meds
antacids
Reduce stress and help
heal ulcers
Assess abdominal pain,
occult blood,
Monitor CBC

Neurological System Medications

CLASSIFICATION
NAME

MECHANISM
OF ACTION

INDICATIONS

SIDE EFFECTS

Riluzole
(Rilutek)

Exact mechanism of
action in ALS is
unknown.
Slows the deterioration
of motor neurons by
counteracting the
excitatory
glutaminergic
pathways.

Slows the progress

of Amyotrophic
Lateral Sclerosis.
May delay the need
for a tracheostomy,
not a cure for ALS.

Dizziness, tiredness,
upset stomach, stomach
pain, diarrhea,
muscle weakness or
aches, anorexia, HA

Provide symptomatic
relief by concent. Of
available Ach at
neuromuscular junction
muscle fx.
Improved bladderemptying in pt with
urinary retention.

Improvement in
muscle strength in
MG.
Prevention and Tx
of post-op bladder
distention and
urinary retention or
ileus.

SEIZURES, dizziness ,
bronchospasm, n/v/d,
XS secretions,
bradycardia, abdominal
cramps, hypotension

Stops breakdown of
Ach Ach
availability.
Tensilon is given IV
2mg -10mg. After
30sec facial`1q
weakness resolves and
ptosis in 5min.
Immediate
improvement=
positive test &
confirms dx.

Diagnostic test for

myasthenia gravis.

SEIZURES, Capillary
constriction, diplopia,
laryngospasm,
arrhythmias, twitching,
CO hypotension,
abdominal cramps,
N/V/D, urinary freq.

Glutamate
antagonist

Prostigmin
(neostigmine)
Anticholinesteras
e
Antimyasthenics,
cholinergics

Tensilon
(Edrophonium
Cl)
Anticholinesteras
e

Because brief
duration of action,
its not
recommended for
maintenance
therapy in MG.

NURSING
CONSIDERATIONS
AND PATIENT
EDUCATION

Monitor liver
function: liver
enzymes.
Monitor WBC.
Take on an empty
stomach (1 hour
before or 2 hours after
meals). Avoid drinking
or eating a lot of
caffeine. Avoid eating
charcoal-broiled
foods.
Assess VS,
neuromuscular status.
Assess for under/overdosage (cholinergic
crisis). Use Tensilon
test to distinguish.
Monitor abdomen/
bladder status, I/O,
Maintain stable
blood levels of Ach
med. Give ON TIME
& w/ food
Observe for severe
cholinergic reaction
(stop meds).
Myasthenic crisis (
meds) Observed for
bradycardia or cardiac
standstill and
cholinergic reactions if
an overdose is given.
Give Atropine 0.4 mg
to control s/e of
Tensilon (bradycardia,
sweating, cramps)

4
Baclofen
Antispasticity
agents, skeletal
muscle relaxants

Levodopa
Antiparkinson
agent, Dopamine
agonist

Inhibits reflexes at
spinal level.
muscle spasticity;
bowel and bladder fx
may also be improved.

Relief of tremor and

rigidity in Parkinsons
syndrome.
Converts to dopamine
in CNS, serves as
neurotransm.
( dopamine)

Tx of reversible
spasticity due to
MS or spinal cord
lesion

SEIZURES,
drowsiness, dizziness,
fatigue, confusion, HA,
edema, hypotension,
nausea, constipation,
hyperglycemia, ataxia

Assess muscle
spasticity.
Observe for adverse
effects.
Monitor BG and liver
enzymes.
Administer w/ milk or
food to gastric
irritation.
Parkinsons disease. Dyskinesia, involuntary Assess parkinsonian
movements, anxiety,
symptoms
Not useful for drug- dizziness, blurred
Assess BP and pulse
induced EPS.
vision, N/V, anorexia,
freq.
dry mouth, hemolytic
Give with meals
anemia, WBC
Monitor bowel fx
Monitor I/O
Monitor hepatic and
renal fx

Neurological System Medications

CLASSIFICATION
NAME

MECHANISM
OF ACTION

INDICATIONS

Symmetrel

Antiviral that the

release of dopamine.
Relief of parkinsonian
symptoms.
Prevent and Tx
influenza A

Symptomatic initial
and adjunct Tx of
Parkinsons disease.
Prophylaxis and Tx
of influenza A viral
infections

Confusion, ataxia,
dizziness, insomnia,
blurred vision,
hypotension, mottling.

Anti viral and

immunoregulatory
properties T-cell
proliferation.

Multiple Sclerosis

Flu-like symptoms,
seizures, HA, mental
depression, weakness,
N/V/D, conjunctivitis,
sweating,
photosensitivity,
neutropenia,
injection-site reaction
(w/ beta-1b), myalgia,
chills, fever, pain

Antiparkinson
agent, antiviral

Beta Interferons
Avonex, Rebif
(interferone beat1a)
Betaseron
(interferon beta1b)
interferons,
Anti-MS agents

incidence of relapse
(neurologic
dysfunction) and slow
physical disability.

SIDE EFFECTS

NURSING
CONSIDERATIONS
AND PATIENT
EDUCATION

Monitor blood
pressure freq. (OH)
Monitor I/O
Monitor VS and
mental status.
Do not give close to
bedtime
Assess freq. of
exacerbations of MS.
Monitor for signs of
depression.
Monitor Hgb, WBC,
platelets, and blood
chemistry and liver
function.
May give analgesic for
flu-like symptoms.
Take measures to
prevent
photosensitivity
reactions.

Genitourinary System Medications

CLASSIFICATIO
N NAME

MECHANISM
OF ACTION

INDICATIONS

SIDE EFFECTS

NURSING
CONSIDERATIONS AND
PATIENT EDUCATION

DIURETICS
Loop Diuretics
Furosemide
(Lasix)
Bumetanide
(Bumex)
Ethacrynic acid
(Edecrin)

Inhibit sodium &

chloride reabsorption
from loop of Henle and
distal renal tubule.

Edema associated
with:
CHF
Hepatic or
renal
disease

renal excretion of
H2O, Na, Cl, Mg, H, and
Ca.
Adjunct therapy
Vasodilationperiph for control of
HTN.
eral resistanceBP

Dizziness, HA, tinnitus,

hypotension, N/V/D,
constipation, dehydration,
hypokalemia,
hyperglycemia,
hyperuricemia,
neutropenia,
agranulocytosis, cramps,
Thrombocytopenia,
spasms

Monitor VS (BP & P)

and fluid status freq.
Monitor daily weight,
I/O, serum electrolyte
values.
Assess edema (amount
& location), lung
sounds, skin turgor,
mucous membranes.
Monitor potassium
levels (3.5-5.0).

Potassiumsparing
Diuretics
Spironolactone
(Aldactone)
Amiloride
(Midamor)
Triamterene
(Dyrenium)

Weak diuretic and

antihypertensive.
Blocks effects of
aldosterone in renal
tubule, causing loss of
Na and H2O and
retention of potassium.

Prevents
hypokalemia
caused by other
diuretics.
Used with other
diuretics to treat
edema or HTN.
Spironolactone:
Hyperaldosteronis
m. Management of
CHF.

Dizziness, HA, cramps,

N/V/D, urinary frequency,
weakness, hyperkalemia.
Spironolactone:
Clumsiness,
gynecomastia,
amenorrhea

Monitor blood glucose

(100 mg/dL)
-in loop/thiazide
diuretics.
Change position slowly
to prevent OH.
If receiving digoxin,
watch for digitalis
toxicity.
foods high in
potassium (bananas,
oranges, potatoes,
meat, fish, raisins)
Take in AM to avoid
sleep disturb.

6
Osmotic
Diuretics
Mannitol
(Osmitrol,
Resectisol)

Pulls water into blood

vessels and nephrons
from surrounding
tissues inhibits
reabsorption of
H2O and electrolyes,
along with toxins from
kidney.

Adjunct tx of :
acute oliguric
renal
failure
edema
ICP or
intraocular
pressure
excretion of
toxic substances.

Confusion, HA,
hypotension, rash, nausea,
anorexia, dry mouth,
thirst, diuresis,fluid and
electrolyte imbalances.

Report to MD: rapid

HR or syncope, weight
gain 2lbs or more.
Report adverse effects:
N/V/D
Hypokalemia (muscle
weakness & twitching,
lethargy, irregular
pulse)

Genitourinary System Medications

CLASSIFICATIO
N NAME

MECHANISM
OF ACTION

INDICATIONS

SIDE EFFECTS

NURSING
CONSIDERATIONS AND
PATIENT EDUCATION

Phosphate
Binders
Sevelamer
(Renagel)

Binds with phosphate

in the GI tract,
preventing its
absorption.

electrolyte
modifiers

Aluminum
hydroxide
(Alu-Cap)
antacids,
phosphate
binders

Prevent a continuing
rise in serum phosphate
levels by decreasing the
absorption of
phosphate from
intestinal tract
Neutralizes gastric acid
and inactivates pepsin

Reduction of the
level of
phosphorus in the
blood of patients
with end-stage
renal disease
(ESRD).

Treatment for
Hyperphosphatemi
a, hypocalcemia in
CRF.
Adjuct therapy in
treating gastric
ulcers,
hyperacidity,
indigestion.

Nausea
Vomiting
Diarrhea
Dyspepsia
Constipation
Flatulence

Constipation
Hypophosphate
mia

** Prolong use leads to

toxicity: neuro symptoms
and osteomalacia. MD
may recommend Calcium
Carbonate instead**

Assess GI side effects.

Monitor serum
phosphorus, calcium,
bicarbonate, chloride
levels
Swallow whole (Dont
crush or chew)
Take all other
medicines at least one
hour before or three
hours after.
Take with meals.
Assess gastric pain.
Monitor phosphate and
calcium levels.
Take with full glass of
water
Should be swallowed
whole 10-15 minutes
before meals.

7
Calcium Salts
Calcium
acetate
(Calphron,
PhosLo)
Calcium
carbonate
(Titralac, Calcichew)
Calcium
gluconate
(Kalcinate)
Mineral &
electrolyte
replace/
supplements

Maintain cell
membrane and
capillary permeability.
Replacement of
calcium deficiency.
Control of
hyperphosphatemia in
end-stage renal disease
without promoting
aluminum absorption.
Calcium carbonate:
Protects heart from
effects of
hyperkalemia.

Tx and prevention
of hypocalcemia.
Emergency tx of
hyperkalemia and
hypermagnesemia
and adjunct in
cardiac arrest.
Calcium acetate:
Control of
hyperphosphatemi
a in ESRD.

Cardiac Arrest
Arrhythmias
Bradycardia
Constipation
Phlebitis
Syncope
Tingling
Calculi
Hypercalciuria.

Monitor VS (BP & P)

and ECG freq.
Observe for s/s of
hypocalcemia
(paresthesia, muscle
twitching, colic)
Monitor pt on digitalis
glycosides for signs of
toxicity.
Monitor phosphate
levels and electrolytes.

Calcium
carbonate:
May be used as
antacid.

For
Hyperphosphatemia,
hypocalcemia; must
take with food.

Endocrine System Medications

CLASSIFICATIO
N NAME

MECHANISM
OF ACTION

Synthroid
(levothyroxine)

metabolic rate of
body tissues.
Restores normal
hormone balance.
Suppresses thyroid
cancer.

Hormones,
thyroid
preparations

INDICATIONS

Replacement/subst
itution in
diminished or
absent thyroid
function.
Thyroid cancer
(thyrotropindependent)

SIDE EFFECTS

Irritability, Insomnia,
HA, arrhythmias,
tachycardia, weight
loss, Cardiovascular
Collapse, HTN, CO

NURSING
CONSIDERATIONS AND
PATIENT EDUCATION

Assess AP & BP. For

tachyarrhythmias &
chest pain.
Monitor thyroid
function; blood & urine
glucose.
Give before breakfast
(to avoid insomnia)

8
Tapazole
(methimazole)
Propylthiouracil

(PTU)
Thioamides,
Antithyroid
agents

Bromocriptine
(Parlodel)
Dopamine
agonist/
antineoplastic

Calcium
gluconate
Mineral &
electrolyte
replace/
supplements

Mineralcorticoids
Fludrocortison
e
(Florinef)
Hormones/
corticosteroids

Prevents the formation

of thyroid hormone
within the thyroid
cells serum levels
of thyroid hormone.
Blocks the utilization of
iodine prevents
synthesis of thyroid
hormone

Direct dopamine
agonist on dopamine
receptor sites in
substantia nigra.
Inhibits GH secretion.
Antiparkinson agent.
Tx of acromegaly.

Act as activator in
transmission of nerve
impulses and
contraction of cardiac,
skeletal, and smooth
muscle.

Na reabsorption in
renal tubules and K
and H excretion Na
& H2O retention

Palliative
treatment of
hyperthyroidism.

Rash, N/V, lethargy,

drowsiness,
bradycardia,
Agranulocytosis
Methimazole:
BM suppression
PTU:
GI distress

Monitor
hyperthyroidism
response (tachycardia,
palpitations, insomnia,
fever, heat
intolerance, tremors, wt
loss)

Monitor
hypothyroidism
(intolerance to cold,
constipation, dry skin, HA,
weakness)

Assess skin for rashes

or swollen nodes.
Give before breakfast.
Seafood and iodine
may be restricted.
Monitor CBC &
differential.
Monitor for s/s of
infection or bleeding.
Tx of Parkinson;
Confusion, dizziness,
Monitor thyroid
hyperprolactinemi hypotension, N/V, HA, function, glucose
a assoc. with
visual disturbances,
tolerance, and GH
pituitary
abdominal pain, leg
levels.
adenomas, female cramps, fatigue, nasal
Assist with ambulation.
infertility assoc.
congestion
Avoid tasks that require
with
alertness, motor skills
hyperprolactinemi
until response to drug.
a.
Teach contraceptives
(other than PO)
Arrhytmias,
Assess & monitor: BP,
For
constipation, phlebitis, ECG, & renal fx
hypoparathyroidis cardiac arrest
Assess & monitor
m.
electrolytes: Mg, Ph, K
Monitor serum and
Replacement of Ca
urine Ca levels
in deficient states.
IV- push slowly, tabs
30 min-1hr after meals,
liquids before meals.
Adrenal
Frontal and occipital
Assess VS, breath
insufficiency
HA, arthralgia,
sounds, weight, tissue
(Addisons);
weakness, blood
turgor; reflexes and
replacement
volume, edema, HTN,
bilateral grip strength,
therapy in
CHF, rash, anaphylaxis, serum electrolyte.
combination with
hypokalemia
Monitor for
glucocorticoid.
hypokalemia.
Tx of salt-losing
Avoid infections; avoid
adrenogenital
fresh fruits and veggies
syndrome.
or wash very carefully

Endocrine System Medications

CLASSIFICATIO
N NAME

MECHANISM
OF ACTION

Glucocorticoid

Initiate complex
reactions responsible
for
Celestone
(betamethasone) anti-inflammatory and
immunosuppressive
effects.
Cortisone
(Cortone
Causes release of
Acetate)
epinephrine from
adrenal medulla.
Cortef
(hydrocortisone
)

Stimulate of glucose
levels for energy.

Medrol
(methyprednisol When combined with
mineralocorticoids
one)
some of these drugs
can be used in
Delta-Cortef
(prednisolone) replacement therapy
for adrenal
insufficiency.
Deltasone
(prednisone)
Corticosteroids

INDICATIONS

Management of adrenal
insufficiency.

SIDE EFFECTS

Depression
euphoria
HTN
Used systemically and
Peptic ulcers
locally for chronic
N/V
diseases including:
inflammatory, allergic, wound healing
Adrenal suppression
hematologic,
neoplastic, autoimmune Hyperglycemia
disorders.
Weight gain
Na & H2O retention
Immunosupressant s in CHF
prevention of organ
Immunosuppression
rejection.
Osteoporosis
Muscle wasting
Management of acute
Cushingoid
spinal cord injury
(methylprednisolone)
appearance.

NURSING
CONSIDERATIONS
AND PATIENT
EDUCATION

Administer daily in
AM.
Do not discontinue
abruptly.
Protect from
infection or invasive
procedures.
Caution in pts with
DM or peptic ulcers.
Monitor I/O, daily
weight &
electrolytes.
Signs of fluid
retention.
Give with meal.
Monitor for s/s of
adrenal insufficiency
(HA, hypotension,
wt. loss, weakness)

10

Multi-System Medications
CLASSIFICATION
NAME

Silver
sulfadiazine
(Silvadene)

MECHANISM
OF ACTION

Antibacterial and
antifungal agent.

Anti-infective/
bactericidal

Mafenide
acetate
(Sulfamylon)

Morphine
Opioid agonist,
narcotic

Versed
(midazolam)
Sedatives/
hypnotics
benzodiazepines

Bacteriostatic for
many gramnegative and grampositive organisms,

INDICATIONS

Adjunct for
prevention and
treatment of
wound sepsis in
patients with 2
and 3 burns.

Control bacterial
infection when
used under moist
dressings over
meshed
autografts on
excised burn
wounds.
Acts as agonist at
Relief of
specific opioid
moderate to
receptors in CNS to severe acute or
produce analgesia, chronic pain.
euphoria, and
Pulmonary
sedation.
edema.
Pain assoc. with
MI.
Acts at many levels Sedation,
of CNS to
anxiolysis and
produced
amnesia before
generalized CNS
procedure
depression.
Induction of
Short-term
anesthesia;
sedation;
continuous
post-op amnesia.
sedation of
intubated
patients.

SIDE EFFECTS

NURSING
CONSIDERATIONS AND
PATIENT EDUCATION

Burning feeling at
site, N/V/D, HA,
anorexia,
photosensitivity,
joint pain,
hemolytic
anemia,
hypoglycemia,
Lupus,
Liver/kidney
problems
Pain or burning
sensation, allergic
reaction, bleeding
or oozing of skin,
or metabolic
acidosis

Monitor CBC &

hepatic/renal fx.
Monitor for leucopenia for
2-3 days.
If burns are extensive or
prolonged therapy: monitor
electrolytes, UA,CBC
Cover entire wound
May cause brown-gray
discoloration.

Apply with sterile gloves/

dressing q6.
Monitor ABGs (d/c if
acidosis).
Give analgesic prior, may
cause severe burning pain
for up to 20 mins after
application.
Confusion,
Assess pain, LOC, BP,
sedation,
pulses, respirations, bowel
Respiratory
fx.
depression,
Monitor for dependence or
hypotension,HR, tolerance.
constipation, N/V, Have Narcan available for
shock, urinary
OD
retention
Respiratory
Monitor VS, respirations
depression,
and level of sedation q 3laryngospasm,
5min.
cardiac arrest,
Give Romazicon for OD.
drowsiness, HA,
Grapefruit juice
XS sedation, N/V, metabolism & effects
arrhythmias,
Monitor LOC and sedation
phlebitis

11
Digoxin
(Lanoxin)
Digitalis
glycosides

force of
myocardial
contraction.
cardiac output
and heart rate.

Tx of CHF, atrial
fibrillation &
atrial flutter,
tachyarrhythmias

HA, weakness,
drowsiness,
visual
disturbances, N/V
arrhythmias,
fatigue,
bradycardia, GI
upset

Monitor apical pulse for 1

min before administration.
Hold if <60 bpm.
Monitor pulse, wt., I/O and
ECG.
Adm. IV slowly >5 min,
avoid IM.
Monitor electrolytes &
digoxin levels
Therapeutic level: 0.5-2;
toxic >2
Have Digoxin immune FAB
available.

Multi-System Medications
CLASSIFICATIO
N NAME

MECHANISM
OF ACTION

INDICATIONS

SIDE EFFECTS

NURSING
CONSIDERATIONS AND
PATIENT EDUCATION

Dopamine

Sm. Doses
stimulate
dopaminergic
receptors,
producing renal
vasodilation. Lg.
doses stimulate
dopaminergic and
beta1 adrenergic
receptors,
producing cardiac
stimulation and
renal vasodilation
Blocks betaadrenergic
receptors in the
heart and kidney,
has a membranestabilization effect
and influence of
sympathetic
nervous system.
HR & BP,
suppression of
arrhythmias &
prevent MI

Cardiac output,
BP, and improves
renal blood flow.

Tachycardia,
ectopic beats,
anginal pain,
hypotension,
dyspnea, N/V, HA

Monitor BP, HR, ECG,

cardiac output, and urinary
output continuously.
Report chest pain, dyspnea,
numbness, tingling, or
burning of extremities.

Management of
HTN; angina
pectoris;
arrhythmias.
Prevention and
management of
MI.
Prevent vascular
HA.
Manage
thyrotoxicosis.

Bradycardia,
CHF, cardia
arrhythmias, heart
blocks, CVA,
pulmonary
edema, gastric
pain, flatulence,
N/V/D, exercise
tolerance,
impotence.

Monitor BP and Pulses

Pts on IV must have
continuous ECG monitor.
Hypotensive effect is
associated with cardiac
output.
Dont stop med abruptly, it
throws in 1 heart block

vasopressor/adre
nergic

Inderal
(propanalol)
Beta blockers

12

Code Drugs
CLASSIFICATION
NAME

MECHANISM
OF ACTION

Epinephrine

Reacts at alphaand betareceptor sites in

the SNS to
cause
bronchodilation
, HR, RR, BP.

Treatment of shock,
bronchospasm.
Management of
severe allergic
reactions, cardiac
arrest.

Nervousness, tremor
restlessness, angina,
arrhythmias, HTN,
tachycardia, HA, N/V
insomnia,
hyperglycemia

Neutralizes or
gastric
acidity
Antiulcer,
gastric pH.
alkalinizing
Acts as
alkalinizing
agent by
releasing
bicarbonate
ions.
Dopamine
Stimulates
dopaminergic
Adrenergic,
receptors:
sympathomimeti cardiac output,
c
inotropics, BP, and
vasopressors
improved renal
blood flow

Relief of
hyperacidity;
Management of
metabolic acidosis;
Treatment of certain
drug intoxications.

Metabolic alkalosis,
gas,
Gastric acid rebound,
hypernatremia,
hypocalcemia,
hypokalemia, Na &
H2O retention

Choice for tx of
shock.

Arrhythmias, angina,
Hypotension,
tachycardia, dyspnea,
N/V, HA,

Monitor BP, HR,

ECG, CO.
Monitor urinary
output frequently.
Palpate peripheral
pulses and assess
appearance of
extremities.

Antidote for
cholinergic OD and
mushroom
poisoning.
Pre-op to
secretions.
Restores cardiac rate
and arterial pressure.

Drowsiness, blurred
vision, tachycardia, dry
mouth, urinary
hesitancy, constipation,
decreased sweating.

Assess VS and ECG.

Monitor I/O.
Assess abdomen and
bowel sounds.
Observe for toxicity or
OD;
antidote
physostigmine.
Give 30 mins. before
meals.

Adrenergic,
sympathomimeti
c

Sodium
Bicarbonate

Atropine
Anticholinergic,
antiarrhythmic

Inhibits the
action of
acetylcholine,
blocking the
effects of
parasympathetic
NS.
HR, GI &
respiratory
secretions.

INDICATIONS

SIDE EFFECTS

NURSING
CONSIDERATIONS
AND PATIENT
EDUCATION

Assess pulmonary
function: lung sounds,
respiratory pattern;
pulse, BP.
Monitor ECG; for
arrhythmias, chest
pain.
Correct hypovolemia
prior to IV use.
May cause serum K
and glucose.
Assess GI & renal
function, serum
electrolytes.
Assess signs of
acidosis/alkalosis,
ABGs

Lidocaine
Antiarrhythmic,
anesthetic

Control of
ventricular
arrhythmias.
Local
anesthesia.

Management of
ventricular
arrhythmias.
Infiltration/
mucosal/topical
anesthetic.

Seizures, confusion,
drowsiness, Cardiac
arrest, stinging,
anaphylaxis,
hypotension, N/V,
fatigue

13
Monitor ECG and BP
and Respiratory status.
Monitor serum
electrolyte levels.
Monitor for toxicity
and OD: serum levels:
1.5-5 g/mL

Code Drugs
CLASSIFICATION
NAME

Adenosine
antiarrhythmics

MECHANISM
OF ACTION

Restores
normal sinus
rhythm.

INDICATIONS

Treatment of
supraventricular
tachycardias,
(Diagnostic agent to
assess myocardial
perfusion)

Amiodorone
antiarrythmics

Suppression of
arrhythmias.
Blocks betaadrenergic
receptors in
heart.

Life-threatening
ventricular
arrhythmias
Management of
supraventricular
tachycardia

SIDE EFFECTS

NURSING
CONSIDERATIONS AND
PATIENT EDUCATION

SOB, facial flushing,

transient arrhythmias,
HA, dizziness, chest
pain, hyperventilation,
nausea, sweating,
hypotension

Monitor HR (q1530min) & ECG, BP.

Assess Respiratory
status: breath sounds
and rate.
Change positions
slowly ( to OH)
Report adverse effects.

Dizziness, fatigue,
malaise, ARDS,
HApulmonary fibrosis,
CHF, bradycardia,
hypotension, anorexia,
constipation, N/V,
hypothyroidism, ataxia,
peripheral neuropathy,
tremors

Monitor ECG, HR and

rhythm.
Assess signs of
pulmonary toxicity
(crackles, breath
sounds, dyspnea)
Assess s/s of ARDS.
Monitor BP.
Monitor liver and
thyroid function.
Assess for
hypokalemia,
hypomagnesemia
Assist with ambulation.
May be given with
meals or divided doses

14
Nitroglycerines

Relief or
prevention of
anginal attacks.
cardiac output
BP

Antianginal,
nitrates

Dobutrex
(Dobutamine)
Adrenergics,
inotropics

Increased
cardiac output
without
significantly
increased heart
rate.

Acute & long term

prophylactic
management of
angina pectoris.
Adjunct tx of CHF
& acute MI.
Production of
controlled
hypotension.

Dizziness, HA,
hypotension,
tachycardia,
restlessness, blurred
vision, rash, flushing,
N/V, weakness.

Treatment of CHF
because
myocardial
contractility without
much change in rate
and doesnt O2
demand of heart
muscle.

HTN, HR, premature

ventricular
contractions, SOB, HA,
angina pectoris,
arrhythmias,
hypotension, N/V,
phlebitis.

HA is common s/e.

Assess anginal pain.

Monitor BP & pulse.
Monitor ECG.
PO: Administer 1 hr
before or 2 hr after
meals w/ full glass of
water.
SL: Hold tablet under
tongue until dissolved;
avoid eating or
drinking.
Change position slowly
(prevent OH)
Monitor BP, HR, ECG,
CO, urinary output.
Palpate peripheral
pulses and assess
extremities.
Monitor electrolytes,
BUN, Creat,
prothrombin time.
Check for signs of
extravasation.