Generic Brand Name Classification Mechanism of Indication Adverse Reaction Nursing Consideration

Name Action
Epinephrine alpha and beta – Relaxes bronchial  Bronchospasm CNS: drowsiness, - monitor BP, pulse,
adrenergic agonist smooth muscle by  hypersensitivity headache, respiration, and urinary
stimulating beta2 reactions nervousness, treamor, output and observe patient
receptors and  anaphylaxis cerebral hemorrhage, closely following IV
alpha and beta  hemostatis stroke, vertigo, pain, administration. Epinephrine
receptors in the  acute asthma disorientation, may widen pulse pressure. If
sympathetic attacks agitation, fear, disturbances in cardiac
nervous system.  to prolong dizziness, weakness rhythm occur, withhold
anesthetic effect epinephrine and notify
 to control cardiac CV: palpitation, physician immediately.
rhythm in cardiac ventricular fibrillation, - Keep physician informed of
arrest shock, widened pulse any changes in intake output
pressure, hypertention, ratio.
tachycardia, angina - Use cardiac monitor with
pain, altered ECG patients receiving
(including a decreased epinephrine IV. Have full
T wave amplitude) crash cart immediately
available
Respiratory: dyspnea - check BP repeatedly when
epinephrine is administered
Skin: urticaria, IV during first 5 mins, then
hemorrhage at q3-5 mins until stabilized.
injection site, pallor - Advise patient to report
Other: tissue necrosis physician if symptoms are
not relieved in 20 min or if
may become worst following
inhalation.
- Advise patient to report
bronchial irritation,
nervousness, or
sleeplessness. Dosage should
be reduced.
Generic Brand Name Classification Mechanism of Indication Adverse Reaction Nursing Consideration
Name Anticholinergic or Action Temporary blockade CNS: Headache, - Monitor apical pulse prior to
Atropine antiparasympathetic it is termed an of severe or life ataxia, dizziness, administration.
Sulfate (parasympatholytic) antimuscarinic threatening excitement, irritability, - Cardiac monitor should be used on
drug. agent since it muscarinic effects, convulsions, patients receiving atropine IV
antagonizes the e.g., as an drowsiness, fatigue, boluses.
muscarine- antisialagogue, an weakness; mental - Doses of 0.5 mg or less may result in
like actions of antivagal agent, an depression, confusion, paradoxical slowing of heart rate.
acetylcholine and antidote for disorientation, - Eye preparations generally used only
other choline organophosphorus hallucinations, for procedures and have only
esters. or muscarinic localized effects on optic muscles.
mushroom CV: Hypertension or Chronic use of eye preparations may
poisoning, and to hypotension, result in systemic anticholinergic
treat brady systolic ventricular symptoms which may be hazardous
cardiac arrest. tachycardia, in infants and children.
palpitation, - Atropine can be administered via
paradoxical endotracheal tube in dose of 2-3 mg
bradycardia, AV diluted in 10 ml H2O, but
dissociation, artrial or intraosseous route is preferred over
ventricular, endotracheal tube if IV access cannot
fibrillation. be achieved.
- Older adults and debilitated patients
GI: Dry mouth with may be more vulnerable to CNS
thirst, dyspaghia, loss disturbances from atropine.
of taste; nausea, - Monitor temperature in infants and
vomiting, children for "atropine fever".
constipation, delayed - Measures to relieve dry mouth:
gastric emptying, adequate fluid hydration, oral
antral statis, paralytic hygiene (don't use alcohol based
ileus. mouthwashes), ice chips, sugarless
Urogenital: urinary gum, or hard candies to suck on.
hesitancy and - Avoid driving or operating heavy
retention, dysuria, machinery while under the influence
impotence. of atropine.
- Reduce lighting to decrease
Skin: Flushed, dry skin; photophobia.
anhidrosis, rash, - Monitor GI motility (BMs and flatus)
urtacaria, contract and urine output while patient is
dermatitis, allergic receiving atropine.
conjunctivitis, fixed- - Atropine is a common pre-operative
drug eruption. agent, and can be given IM, SC, PO,
or IV.
-
 Generic Brand Classification Mechanism of Indication Adverse Reaction Nursing Consideration
Name Name Action
Lidocaine Cardiovascular Drug Increases Local or •GI disturbances
electricalstimulati regionalanesthetic. •Bradycardia •Monitor vitalsigns and notify thephysician
on threshold of Managementof acute •Hypotension of abnormalities.
ventricle and His- ventricular arrhyth •Convulsion •Assess patient’scondition beforetherapy
Purkinje system mias duringcardiac •Numbness of tongue and reassessregularly thereafter tomonitor
bydirect action on manipulation.Contr •Muscle twitching drug’seffectiveness.
tissues,resulting ol of •Restlessness •Monitor for possible adverse drugreactions.
to statusepilepticus •Nervousness •Assess for renaland urinary status.
decreasedepolariz refractory toother •Dizziness •Monitor CNSfunction.
ation,automaticit treatments. •Blurred vision •Monitor bloodlevels and reportabnormal
y andexcitability •Lightheadedness results
in •Drowsiness
ventriclesduring •Euphoria
diastolic phase •Vomiting

Generic Name Brand Classification Mechanism of Indication Adverse Reaction Nursing Consideration
Name Action
Naloxone Narcan Opioid Naloxone the complete or  lushing,  Observe patient closely; duration of
antagonist hydrochloride is partial reversal of  dizziness, action of some narcotics may exceed that
Opioid Overdose: essentially a pure opioid depression,  tiredness, of naloxone. Keep physician informed;
Initial' opiate antagonist. The including  weakness repeat naloxone dose may be necessary.
0.4-2mg IV;may precise mechanism of respiratory  nervousness  May precipitate opiate withdrawal if
repeat at 2-3 action of the opiate depression,  restlessness, administered to a patient who is opiate
minintervals if antagonist effects of induced by natural  irritability dependent.
desireddegree naloxone is not fully
and synthetic
 body aches  Note: Narcotic abstinence symptoms
opioids, including induced by naloxone generally start to
of counteraction understood. Naloxone  diarrhea
propoxyphene, diminish 20–40 min after administration
andimprovement is thought to act as a methadone and  stomach pain
and usually disappear within 90 min.
inrespiratory competitive antagonist  nausea
certain mixed  Monitor respirations and other vital
functionsis not at mc, κ, and σ opiate agonist-antagonist  fever
signs.
obtained receptors in the CNS; it analgesics:  chills
 Monitor surgical and obstetric patients
is thought that the nalbuphine,  goosebumps
closely for bleeding. Naloxone has been
drug has the highest pentazocine,  sneezing associated with abnormal coagulation
affinity for the μ butorphanol, and test results. Also observe for reversal of
receptor cyclazocine. analgesia, which may be manifested by
nausea, vomiting, sweating, tachycardia.
Generic Brand Classification Mechanism of Action Indication Adverse Reaction Nursing Consideration
Name Name

Calcium treatment of Calcium chloride in water
Chloride hypocalcemic dissociates to provide
tetany calcium (Ca2+) and chloride
(abnormally (Cl-) ions. They are normal
low levels constituents of the body
of calcium in fluids and are dependent
the body that on various physiological
cause muscle mechanisms for
spasm). maintenance of balance
between intake and
output. For hyperkalemia,
the influx of calcium helps
restore the normal
gradient between
threshold potential and
resting membrane
potential.
Hypocalcemia,  Erythema  Advise patient to take
Hyperkalimia,  Hypomagnesemia oral calcium 1 or 1.5
Hypermagnesemia  Hypophosphatemia hours after meals if GI
 Hypotension upset occurs.
 Hypercalcemia  Monitor calcium level of
 Nausea the patient is having mild
 Tissue necrosis at injection site renal impairment.
 Vasodilation  Advise patient to report
 Weakness for any kind of abdominal
pain, vomiting or nausea
 Renal calculi
occurs.
 Hot flashes
 Serum amylase increased
 Tingling sensations
 Rapid Administration
 Arrhythmia
 Bradycardia
 Calcium taste
 Sense of heat waves
 Ventricular fibrillation

Generic Name Brand Classification
Name
Dopamine A medication most
commonly used in the
treatment of very low
blood pressure, a slow
heart rate that is causing
symptoms, and, if
epinephrine is not
available, cardiac arrest.
Mechanism of Action Indication Adverse Reaction Nursing Consideration
Sympathomimeticchemical Correction of •nausea, •Monitor vitalsigns , and
precursor hemodynamic •vomiting, ECGduring infusion,watch
tonorepinephrine. It imbalances present in •tachycardia, for dsyarrythmias andischemia
hasdiffering effects on the shock syndrome •ectopic beats, alsomonitor, PCWP,CVP, CO2,
thevascular and due to myocardial •palpitation, andurinary output
cardiacsystems, depending infarction, trauma, •anginal pain,
ondose per kilogramper endotoxic septicemia, •hypotension, •Monitor for possible
minute. Because of the open-heart surgery, •vasoconstriction, adversereaction
variability in theresponse renal failure, and •bradycardia,
todopamine, this drugmust chronic cardiac •hypertension,dyspnoea, •Assess for heartfailure: dsypnea,neck
be monitored andtitrated decompensation as in •headache, vain distention,
to effect. congestive failure. •widened QRScomplexes,
•azotaemia. •Assess for oxygenation
andperfusiondeficit
 Generic Name Brand Name Classification Mechanism of Indication Adverse Reaction Nursing Consideration
Action
Sodium Bicarbonate Rhea Sodium Antacids, Sodium bicarbonate Hyperacidity, sever Cerebral hemorrhage,  Hypertonic solutions should be
Bicarbonate Antireflux raises blood and diarrhea (where CHF (aggravated), administered by trained
agents & urinary pH there is a loss of tetany, pulmonary personnel. Avoid
Antiulcerants / dissociation to sodium edema extravasations as tissue
Electrolytes provide bicarbonate bicarbonate) irritations or cellulites may
ions, which result.
neutralizes the Urine:  Administer isotonic solutions
hydrogen ion Alkalinization, slowly; too rapid administration
concentration. It Management of may result in due to cellular
also neutralizes metabolic acidosis, acidity. Check rate of flow
gastric acid via dyspepsia frequently.
production of  If on low continuous
carbon dioxide. intermittent NG suctioning or
vomiting, assess for the
evidence of excessive chloride
loss.
 Record I & O. Observe for dry
and mucous membrane,
polydipsia, polyuria, and air
hunger; may indicate a reversal
of metabolic acidosis, asses for
the relief of dyspnea and hyper
apnea.
 Chew tablets thoroughly and
slowly and take only as
prescribed. Follow with full
glass of water. Don’t take with
milk or yogurt’ will fizz up.
 Generic Bran Classificatio Mechanis Indication Adverse Reaction Nursing
Name d n m of Consideratio
Name Action n
Isoprotereno  For mild or transient CNS: Nervousness, headache, dizziness, nausea, visual
l 10% episodes of heart blurring.
block that do not require
electric shock Cardiovascular: Tachycardia, palpitations, angina, Adams-
or pacemakertherapy. Stokes attacks, pulmonary
 For serious episodes of edema, hypertension, hypotension, ventricular arrhythmias
heart block and Adams- , tachyarrhythmias.
Stokes attacks (except
when caused In a few patients, presumably with organic disease of
by ventricular the AV node and its branches, isoproterenol hydrochloride
tachycardia or fibrillation). injection has been reported to precipitate Adams-Stokes
(See CONTRAINDICATIO seizures during normal sinus rhythm or transient heart
NS.) block.
 For use in cardiac arrest
until electric shock or
Respiratory: Dyspnea.
pacemaker therapy, the
treatments of choice, is
available. Other: Flushing of the skin, sweating, mild tremors,
(See CONTRAINDICATIO weakness, pallor.
NS.)
 For bronchospasm
occurring
during anesthesia.
 As an adjunct to fluid
and electrolyte replaceme
nt therapy and the use of
other drugs and
procedures in the
treatment
of hypovolemic and septic
shock, low cardiac
output(hypoperfusion)
states, congestive heart
failure, and cardiogenic
shock.