Diphenhydramine Hydrochloride (Benadryl) 50mg/1ml

Classification: Antihistamines & Antiallergics

Indications: For perennial and seasonal (hay fever) allergic rhinitis; vasomotor rhinitis,
allergic conjunctivitis due to inhalant allergens and foods; amelioration of allergic reactions
to blood or plasma, dermatographism; as therapy for anaphylactic reactions adjunctive to
epinephrine and other standard measures after the acute manifestations have been
controlled.
Mechanism of Action: Diphenhydramine HCl is an antihistamine with anticholinergic
(drying) and sedative side effects. Antihistamines appear to compete with histamine for cell
receptor sites on effector cells.
A single oral dose of diphenhydramine HCl is quickly absorbed, with maximum activity
occurring in approximately 1 hr. The duration of activity following an average dose of
Benadryl AH is from 4-6 hrs.
Nursing Responsibilities:
a) Give full prophylactic dose 30min. prior to travel if used as a prophylaxis for motion sickness
b) Take similar doses with meals and at bedtime
c) Do not use more than 2 weeks to treat insomnia
d) For IV, may give undiluted
e) Do not exceed IV rate of 25mg/minute
f) Drug causes drowsiness. Avoid activities requiring mental alertness
g) Use sun protection as it may cause photosensitivity
h) Use sugarless candy/gum to diminish dry mouth effects
i) Avoid alcohol and other CNS depressants
j) Stop therapy 72-96 hr. prior to skin testing. Report adverse effect and lack of response
 Glucagon Emergency Kit (Glucagon, Human Recombinant)

Classification: Glucose Regulation, Antihypoglycemic, Diagnostic aid adjunct

Indications: It is an emergency medicine used to treat severe hypoglycemia (low blood
sugar) in patients with diabetes who have passed out or cannot take some form of sugar by
mouth.
Glucagon is also used during x-ray tests of the stomach and bowels to improve test results
by relaxing the muscles of the stomach and bowels.
Mechanism of Action: Promotes hepatic glycogenolysis and gluconeogenesis. Stimulates
adenylate cyclase to produce increased cyclic adenosine monophosphate (cAMP), which is
involved in a series of enzymatic activities. The resultant effects are increased
concentrations of plasma glucose, a relaxant effect on smooth musculature, and a positive
chronotropic and inotropic myocardial effect. Hepatic stores of glycogen are necessary for
glucagon to elicit an antihypoglycemic effect.
Nursing Responsibilities:
a) After the end of the diagnostic procedure, give oral carbohydrates to patients who have
been fasting, if this is compatible with the diagnostic procedure.
b) Inform patients that generalized allergic reactions have been reported with Glucagon
treatment including generalized rash, and in some cases anaphylactic shock with breathing
difficulties, and hypotension. Advise patients to monitor and report any signs or symptoms
of a hypersensitivity reaction
c) Inform patients that hypoglycemia has occurred with treatment with Glucagon. Inform
patients of the symptoms of hypoglycemia and how to treat it. Advise patients to avoid
driving or operating machinery until ingesting a meal. Advise patients to inform their health
care provider if hypoglycemia occurs so that treatment may be given if necessary
d) Inform patients with diabetes mellitus that treatment with Glucagon for Injection may
increase their risk of hyperglycemia
e) Inform patients with cardiac disease that treatment with Glucagon for Injection may increase
their risk of a transient increase in blood pressure and heart rate
 Vasopressin 20 units/cc

Classification: Haemostatics / Antidiuretics

Indications: Vasopressin is used to treat diabetes insipidus, which is caused by a lack of
this naturally occurring pituitary hormone in the body. It is also used to treat or prevent
certain conditions of the stomach after surgery or during abdominal x-rays.
Mechanism of Action: It exerts direct antidiuretic action on the kidneys by increasing
tubular reabsorption of water. Vasopressin also acts by constricting the peripheral blood
vessels and causes the smooth muscle of the intestine, gall bladder and urinary bladder to
contract.
Nursing Responsibilities:
a) Check patients alertness and orientation frequently during therapy. Lethargy and confusion
associated with headache may signal onset of water intoxication, which, although insidious
in rate of development, can lead to convulsions and terminal coma.
b) Monitor urine output, specific gravity, and serum osmolality while patient is hospitalized.
c) Withhold vasopressin, restrict fluid intake, and notify physician if urine-specific gravity is
<1.015.
d) Instruct Patient to avoid concentrated fluids (e.g., undiluted syrups), since these increase
urine volume.
 Dextrose 50gm/50ml

Classification: Caloric Agents

Indication: Providing fluids containing various amounts of sugars to body when patient is
not able to drink enough liquids or when additional fluids are needed. It may also be used as
a way to give other injectable medicines.
Mechanism of Action: Dextrose is a monosaccharide that is used as a source of calories
and water for hydration. It helps to reduce loss of body protein and nitrogen. It also
promotes glycogen deposition in the liver. When used with insulin, it stimulates the uptake of
potassium by cells, especially in muscle tissue, thus lowering serum potassium levels.
Nursing Responsibilities:
a) Suspend container from eyelet support.
b) Remove plastic protector from outlet port at bottom of container.
c) Attach administration set. Refer to complete directions accompanying set
d) Clinical evaluation and periodic laboratory determinations are necessary to monitor changes
in fluid balance, electrolyte concentrations, and acid base balance during prolonged
parenteral therapy or whenever the condition of the patient warrants such evaluation.
e) Lactated Ringers and 5% Dextrose Injection, USP should be used with caution. Excess
administration may result in metabolic alkalosis.
f) Caution must be exercised in the administration of parenteral fluids, especially those
containing sodium ions to patients receiving corticosteroids or corticotrophin.
g) Solution containing acetate should be used with caution as excess administration may result
in metabolic alkalosis.
h) If an adverse reaction does occur, discontinue the infusion, evaluate the patient, institute
appropriate therapeutic countermeasures
 Amiodarone 150mg/3ml

Classification: Antiarrhythmic, Adrenergic blocker

Indication: Only for treatment of the following documented life-threatening recurrent
ventricular arrhythmias that do not respond to other anti arrhythmics or when alternative
agents are not tolerated: Recurrent ventricular fibrillation, recurrent hemodynamically
unstable ventricular tachycardia. Serious and even fatal toxicity has been reported with this
drug; use alternative agents first; very closely monitor patient receiving this drug
Mechanism of Action: Amiodarone is a class III antiarrhythmic agent which inhibits
stimulation, prolongs action potential and refractory period in myocardial tissues. It also
decreases AV conduction and sinus node function. Sinus rate is reduced by 15-20%, PR
and QT intervals are increased. Amiodarone can cause marked sinus bradycardia or sinus
arrest and heart block. In acute IV doses, amiodarone may exert a mild negative inotropic
effect
Nursing Responsibilities:
a) Reserve use for life-threatening arrhythmias; serious toxicity, including arrhythmias,
pulmonary toxicity can occur
b) Monitor cardiac rhythm continuously.
c) Monitor for an extended period when dosage adjustments are made.
d) Monitor for safe and effective serum levels (0.52.5 mcg/mL).
e) Doses of digoxin, quinidine, procainamide, phenytoin, and warfarin may need to be reduced
one-third to one-half when amiodarone is started.
f) Give drug with meals to decrease GI problems.
g) Arrange for ophthalmologic examinations; reevaluate at any sign of optic neuropathy.
h) Arrange for periodic chest X-ray to evaluate pulmonary status (every 36 mo).
i) Arrange for regular periodic blood tests for liver enzymes, thyroid hormone levels.