DRUG MECHANISM OF SIDE EFFECTS INDICATION NURSING RESPONSIBILITIES

ACTION

Generic Name: Dexamethasone is a >upset stomach >Hypercalcemia associated For systemic administration, do
synthetic glucocorticoid with cancer not give drug to nursing mothers;
Dexamethasone which decreases >stomach irritation. drug is secreted in breast milk.
>Short-term management of
inflammation by inhibiting
Brand Name: >vomiting. various inflammatory and WARNING: Give daily doses before
the migration of
allergic disorders, such as 9 AM to mimic normal peak
Dexasone leukocytes and reversal of
>headache. rheumatoid arthritis, collagen corticosteroid blood levels.
increased capillary
diseases (SLE), dermatologic
permeability. It suppresses Increase dosage when the patient
Classification: >dizziness. diseases (pemphigus), status
normal immune response is subject to stress.
asthmaticus, and
Corticosteroid, >insomnia. autoimmune disorders Taper doses when discontinuing
Glucocorticoid, high-dose or long-term therapy.
>restlessness. >Hematologic disorders:
Thrombocytopenic purpura, Do not give live virus vaccines
Hormone
>depression erythroblastopenia with immunosuppressive doses of
Pregnancy
Category C corticosteroids.
>Trichinosis with neurologic
>anxiety
or myocardial involvement For respiratory inhalant, intranasal
Frequency:
>acne preparation, do not use respiratory
>Ulcerative colitis, acute
12 h apart inhalant during an acute asthmatic
exacerbations of MS, and
>increased hair growth attack or to manage status
palliation in some leukemias
asthmaticus.
Route: and lymphomas
>easy bruising
Do not use intranasal product with
IM >Cerebral edema associated
untreated local nasal infections,
>irregular or absent with brain tumor, craniotomy,
Dosage: epistaxis, nasal trauma, septal
menstrual periods or head injury
ulcers, or recent nasal surgery.
12 mg
>increased appetite and >Testing adrenocortical
WARNING: Taper systemic
weight gain hyperfunction
steroids carefully during transfer
>Unlabeled uses: Antiemetic to inhalational steroids; adrenal
Adverse Effects
for cisplatin-induced insufficiency deaths have
Growth retardation, vomiting, diagnosis of occurred.
osteoporosis, peptic ulcer, depression
For topical dermatologic
glaucoma and subcapsular
>Intra-articular or soft-tissue preparations, use caution when
 cataracts, vertebral administration: Arthritis, occlusive dressings, tight diapers
compression fractures. psoriatic plaques cover affected areas; these can
Cushing-like features, increase systemic absorption.
>Respiratory inhalant:
pancreatic dysfunction and
Control of bronchial asthma Avoid prolonged use near the
pancreatitis, GI upsets,
requiring corticosteroids in eyes, in genital and rectal areas,
increased appetite,
conjunction with other and in skin creases.
increased fragility of the
therapy
skin. Increased susceptibility
to infection. Topical >Intranasal: Relief of
application: Dermal atrophy, symptoms of seasonal or
local irritation, folliculitis, perennial rhinitis that
delayed wound healing, responds poorly to other
systemic absorption and treatments
toxicity with occlusive
dressing on application to >Dermatologic preparations:
large areas of the body and Relief of inflammatory and
broken skin. Topical pruritic manifestations of
application to eye: Corneal dermatoses that are steroid-
ulcers, glaucoma and responsive
reduced visual ability. >Ophthalmic preparations:
Inhalation: Hoarseness, Inflammation of the lid,
candidiasis of mouth and conjunctiva, cornea, and
throat. Intra-articular inj: globe
Aseptic necrosis of bone
and joint damage. Contraindication

Potentially Fatal: HPA Hypersensitivity; active

suppression; CV collapse on untreated infections;
rapid IV admin. ophthalmic use in viral,
fungal disease of the eye.

Retrieved from: dexamethasone Nursing Considerations & Management. RNpedia. (2019, February 11). https://www.rnpedia.com/nursing-notes/pharmacology-
drug-study-notes/dexamethasone/.
 DRUG MECHANISM OF SIDE EFFECTS INDICATION NURSING
ACTION RESPONSIBILITIES

Generic Dopamine produces >headache; For the correction of >Monitor hemodynamics

Name: positive chronotropic hemodynamic imbalances closely: BP, HR, EKG, CVP
>feeling anxious;
(increase HR) and present in the shock (estimate of right atrial
Dopamine (inj) inotropic (increase the >nausea, vomiting; syndrome due to pressure, has been used to
force of contraction) myocardial infarction, assess cardiac preload and
Brand Name: >chills, goose bumps.
effects on the trauma, endotoxic volume status in critically ill
Intropin myocardium, resulting in Adverse Effects septicemia, open-heart patients, assist in the diagnosis
increased heart rate and surgery, renal failure, and of right-sided heart failure, and
Classification: >Cardiovascular:
cardiac contractility. This chronic cardiac guide fluid resuscitation. It is
Inotropic Agent is accomplished directly Ventricular arrhythmia, decompensation as in determined by the interaction
by exerting an agonist atrial fibrillation (at very congestive failure between cardiac function and
Frequency: high doses), ectopic
action on beta- venous return.), and
adrenoceptors and beats, tachycardia, Contraindication Pulmonary Artery Occlusion
prn
Route: indirectly by causing anginal pain, palpitation, Pressure (PAOP or PAWP is
Pheochromocytoma;
release of cardiac conduction pressure within the pulmonary
acidosis; ventricular
IV norepinephrine from abnormalities, widened arterial system when catheter
arrhythmias; blockage or
Dosage: storage sites in QRS complex, tip 'wedged' in the tapering
closing off of blood
sympathetic nerve bradycardia, hypotension, branch of one of the pulmonary
vessels; decreased oxygen
Low dose: 1 to endings. In the brain, hypertension, arteries. in most patients this
in the tissues or blood;
5 dopamine acts as an vasoconstriction estimates LVEDP thus is an
decreased blood volume.
mcg/kg/minute agonist to the five indicator of LVEDV (preload of
>Respiratory: Dyspnea
Intermediate dopamine receptor the left ventricle) if available
dose: 5 to 15 subtypes (D1, D2, D3, >Gastrointestinal:
mcg/kg/minute D4, D5). Nausea, vomiting
>Metabolic/nutritional: >Obtain parameters for
Azotemia hemodynamic values

>Central nervous system:

Headache, anxiety >Titrate (1-2 mcg/min every 20
minutes) to obtain appropriate
 >Endocrine: Piloerection BP (more potent
vasoconstrictors may be
>Ocular: Increased
required)
intraocular pressure;
dilated pupils
>Gangrene of extremities >Irritation may occur at IV site
has occurred when high
Beta blockers may counteract
doses were administered
therapeutic effects
for prolonged periods or
in patients with occlusive
vascular disease receiving
low doses of dopamine
hydrochloride

Retrieved From: Dopamine (Intropin): Side Effects, Dosages, Treatment, Interactions, Warnings . RxList. (n.d.).
https://www.rxlist.com/consumer_dopamine_intropin/drugs-condition.htm.
 DRUG MECHANISM OF SIDE EFFECTS INDICATION NURSING
ACTION RESPONSIBILITIES

Generic Name: Epinephrine, an active Dizziness, drowsiness, For the correction of >Monitor BP, pulse,
principle of the adrenal fatigue, apprehension hemodynamic imbalances respirations, and urinary output
epinephrine medulla, is a direct- (use caution if driving or present in the shock and observe patient closely
(adrenaline) acting performing tasks that syndrome due to following IV administration.
sympathomimetic. It require alertness); myocardial infarction,
Brand Name:
stimulates α- and β- anxiety, emotional trauma, endotoxic
Adrenaclick adrenergic receptors changes; nausea, septicemia, open-heart >Epinephrine may widen pulse
resulting in relaxation of vomiting, change in taste surgery, renal failure, and pressure. If disturbances in
Classification:
smooth muscle of the (eat frequent small chronic cardiac cardiac rhythm occur, withhold
alpha- and beta- bronchial tree, cardiac meals); fast heart rate. decompensation as in epinephrine and notify
adrenergic stimulation and dilation congestive failure physician immediately.
of skeletal muscle Adverse Effects
agonists
vasculature. It is Contraindication
(sympathomimeti >CNS effects; GI
c agents) frequently added to disturbances; epigastric Preexisting hypertension; >Keep physician informed of
local anaesthetics to pain; CV disorders; occlusive vascular disease; any changes in intake-output
Frequency: retard diffusion and difficulty in micturition angle-closure glaucoma ratio.
Prn; q 5 min. limit absorption, to with urinary retention; (eye drops); Use cardiac monitor with
during prolong the duration of dyspnoea; hypersensitivity; cardiac patients receiving epinephrine
resuscitation effect and to lessen the hyperglycaemia; arrhythmias or IV. Have full crash cart
Route: danger of toxicity. sweating; tachycardia. When used in immediately available.
hypersalivation; addition to local
IV or intracardiac
weakness, tremors; anaesthetics: Procedures
injection into left
coldness of extremities; involving digits, ears, >Check BP repeatedly when
ventricular
hypokalaemia. nose, penis or scrotum. epinephrine is administered IV
chamber
>Gangrene, tissue during first 5 min, then q3–
Dosage:
necrosis and sloughing 5min until stabilized.
0.5–1 mg; During (extravasation) when
Resuscitation: 0.5 used in addition to local
mg anaesthetics. >Advise patient to report to
physician if symptoms are not
 >Eye drops: Severe relieved in 20 min or if they
smarting, blurred vision, become worse following
photophobia; naso- inhalation.
lachrymal ducts
obstruction. Oedema,
hyperaemia and >Advise patient to report
inflammation of the eyes bronchial irritation,
with repeated nervousness, or sleeplessness.
administration

>Dosage should be reduced.

Monitor blood glucose & HbA1c
for loss of glycemic control if
diabetic. R: Although
epinephrine stimulates insulin
release by activation of beta-
adrenergic receptors, its
dominant effect (mediated by
stimulation of alpha-adrenergic
receptors) is an inhibition of
insulin secretion that is
powerful enough to suppress
the secretory activity of
insulin's most potent
stimulants.

Retrieved from: epinephrine Nursing Considerations & Management. RNpedia. (2019, February 12). https://www.rnpedia.com/nursing-notes/pharmacology-
drug-study-notes/epinephrine/.
 DRUG MECHANISM OF SIDE EFFECTS INDICATION NURSING
ACTION RESPONSIBILITIES

Generic Name: Ranitidine blocks Constipation or diarrhea; >Short-term treatment of > ASSESS: Allergy to ranitidine,
histamine H2-receptors nausea, vomiting; active duodenal ulcer impaired renal or hepatic
Ranitidine in the stomach and enlargement of breasts, function, lactation, pregnancy
>Maintenance therapy for
prevents histamine- impotence or decreased
Brand Name: duodenal ulcer at reduced >ASSESS: Skin lesions;
mediated gastric acid libido; headache
dosage orientation, affect; pulse,
Zantac secretion. It does not
Adverse Effects baseline ECG; liver evaluation,
affect pepsin secretion, >Short-term treatment of
Classification: abdominal examination, normal
pentagastrin-stimulated >Headache, dizziness. active, benign gastric ulcer output; CBC, LFTs, renal
Histamine2 (H2) factor secretion or Rarely hepatitis, >Short-term treatment of function tests
antagonist serum gastrin. thrombocytopaenia, GERD
leucopaenia, >Administer oral drug with
Frequency: >Pathologic meals and at bedtime.
hypersensitivity,
BID confusion, hypersecretory conditions
>Decrease doses in renal and
Route: gynaecomastia, (eg, Zollinger-Ellison
liver failure. (R: May lead to
impotence, somnolence, syndrome) potential toxicity from
PO
vertigo, hallucinations. >Treatment of erosive decreased clearance)
Dosage: esophagitis
>Potentially >Provide concurrent antacid
150 mg Fatal: Anaphylaxis, >Treatment of heartburn, therapy to relieve pain.
hypersensitivity acid indigestion, sour
reactions. >Administer IM dose undiluted,
stomach
deep into large muscle group.
Contraindication >Arrange for regular follow-up,
Porphyria. including blood tests, to
evaluate effects.
R: it may trigger porphyric
events.
Retrieved From: ranitidine hydrochloride Nursing Considerations & Management. RNpedia. (2019, February 13). https://www.rnpedia.com/nursing-
notes/pharmacology-drug-study-notes/ranitidine-hydrochloride/.