Sl Name of Drug Dose Action Indication Contraindicatio Side effect Nurses

N n responsibility
o

1. VERAPAMIL (Calan, 2.5-5.0 mg slow Inhibits calcium ion PSVT (with narrow A-fib with Wolff- Hypotension, Monitor ECG
Isoptin) (Calcium IVP over 2 min; influx across cell QRS and adequate Parkinson-White exacerbation of Monitor vital
Channel Blocker, may give second membrane during BP) refractory to syndrome, wide- CHF with left signs
Antiarrhythmic, dose, ifneeded, of cardiac depolarization; adenosine, rapid complex ventricular
Antihypertensive) 5-10 mg IVP in 15- produces relaxation of ventricular rates in tachycardia of dysfunction,
30 min, max. dose coronary vascular A-fib, A-flutter, or uncertain origin, bradycardia, AV
20 mg. An smooth muscle; dilates MAT. 2nd-or 3rd-degree block.
alternative second coronary arteries; AV block (unless
dose is 5 mg IVP decrease SA/AV node a functioning
every 15 min, max. conduction; dilates artificial
dose30 mg peripheral arteries pacemaker is in
place), sick sinus
syndrome,
hypotension,
severe
CHF,cardiogenic
shock.
Sl Name of Drug Dose Action Indication Contraindication Side effect Nurses
No responsibility

2. ACE INHIBITORS Usually not started It selectively suppresses MI, hypertension Lactation, Tachycardia, Monitor heart rate,
Captopril, enalapril, inemergency rein- angiotensin- (HTN), congestive pregnancy, dizziness, blood pressure
lisinopril department, but aldosterone system; heart failure(CHF), angioedema, headache, fatigue,
within 24hr after inhibits ACE; prevents heart failure hypersensitivity hypotension,
fibrinolytic therapy conversion of without to ACE hyperkalemia.
has been completed angiotensin I to II; hypotension, ST inhibitors, serum
and blood pressure results in dilation of segmentelevation, potassium
(BP) has stabilized. arterial venous vessels left ventricular 5mEq/L.
dysfunction after
MI.
Sl Name of Drug Dose Action Indication Contraindication Side effect Nurses
No responsibility

3. ADENOSINE 6 mg rapid Slows conduction Narrow-complex Hypersensitivity, Vasodilation,hypotension Monitoring ECG

intravenous push through AV node, can tachycardias and sick sinus , visual impairment, changes
(IVP) over 1-3 interrupt re entry PSVT. syndrome, 2nd-or hepatotoxicity, Monitoring vital
sec followed by a pathmays through Av 3rd-degree AV pulmonary toxicity. CHF; signs.Assess
20- mL bolus of node, and can restore block (unless a may prolong QTinterval, visual changes
normal saline. normal sinus rhythm functional producing torsade de
Give 12 mg by in patients with artificial pointes
IVP in 1-2min if paroxysmal pacemaker is
needed. A third supraventricular present), drug-or
dose of 12 mg tachycardia poison-induced
IVP may be given tachycardia.
in 1-2min, max.
30 mg.
Sl Name of Drug Dose Action Indication Contraindication Side effect Nurses
No responsibility

4. AMIODARONE Cardiac arrest 300 Prolong duration of Wide- and narrow- Bradycardia, Vasodilation, Maintain intake
(Cordarone, mg (diluted in 20- action potential and complex tachy hypersensitivity, hypotension, and output chart
Pacerone) 30 mL D5W) IVP: effective refractory cardia, polymorphic cardiogenic visual LFT test done
(Antiarrhythmic) consider additional period, noncompetitive á VT, shock shock, 2nd-or impairment, Monitoring ECG
150 mg IVP in 3-5 and å andrenergic refractory VF or 3rd-degree AV hepatotoxicity, Monitoring
min. Wide-and inhibition pulseless VT, SVT, block. pulmonary electrolytes Chest
narrow-complex PSVT toxicity, CHF; x ray, thyroid test
tachycardia (stable) may prolong
150 mg IVP over QTinterval,
first 10 min (15mg/ producing torsade
min)-may repeat de pointes.
infusion of 150 mg
IVP every 10 min
as needed; slow
infusion of 360 mg
IV over next 6 hr
(1 mg/min);
maintenance
infusion of 540 mg
over next 18 hr (0.5
mg/min).Max.
cumulative dose:
2.2 g IV in 24 hr.
Sl Name of Drug Dose Action Indication Contraindication Side effect Nurses
No responsibility

5. ASPIRIN 62-325 mg PO non- It blocks pain impulse in Acute coronary Known allergy to Anorexia, Monitoring pain
enteric coated for CNS that occurs syndrome, aspirin, nausea, epigastric level LFT and RF
antiplateleteffect.Give inresponse to inhibition symptoms pregnancy. pain, anaphylaxis test done if
within minutes of of prostaglandin patiermon long
onset synthesis antipyretic term therapy
action results from Blood studies;
vasodilation of CBC, Hct, Hgb
peripheral vessels; pro-time if patient
decrease platelet on long term
aggregation therapy Checking
pupil reaction
Sl Name of Drug Dose Action Indication Contraindication Side effect Nurses
No responsibility

6. ATROPIN Cardiac arrest 1 mg IVP Blocks acetylcholine at Symptomatic sinus A-fib, A-flutter, achycardia, Monitor ECG
every 3-5 min (may parasympathetic bradycardia, glaucoma, headache, dry changes input and
givethroughendotracheal neuroeffector sites; asystole, PEA with asthma. mouth, dilated output chart
(ET) tube at 2.0-3.0 mg increase cardiac output, rate 60 bpm, pupils, VF or VT Monitoring
diluted in 10 mL heart rate by blocking cholinergic drug respirator status
normalsaline, max. vagal stimulation in toxicity and
0.03-0.04 mg/kg. heart; dries secretion mushroom
Bradycardia 0.5- 1.0 mg by blocking vagus poisoning
IVPevery 3-5 min, max. (antidote).
0.03-0.04 mg/kg
Sl Name of Drug Dose Action Indication Contraindication Side effect Nurses
No responsibility

7. BETA BLOCKERS It is based on drug It is divided into MI, unstable HR 60 bpm, Hypotension, Assessing vital
Propanolol- IV 1-3 selective and non- angina, PSVT, A systolic BP 100 dizziness, signs Monitoring
mg every 5 minutes selective blockers.Non- fib, A-flutter, HTN. mm Hg, 2nd- or bradycardia, renal values
selective blockers 3rd-degree AV headache, nausea before treatment
produce a fall in block, left and vomiting Maintaining
bloodpressure without ventricular failure intake and output
refelex tachycardia or chart Before
reductionin heartrate administering
through a mixture of check apical pulse
beta blocking effects;
elevated plasma renins
are reduced. selective
betablockers
competitivitly block
stimulation of beta
receptors in cardiac
smooth muscles these
drugs
pproducechronotropic
andinotropic effects.
Sl Name of Drug Dose Action Indication Contraindication Side effect Nurses
No responsibility

8. CALCIUM Hyperkalemia and Action needed for Hyperkalemia, Hypercalcemia, Bradycardia, Monitor heart rate,
antidote to calcium maintenance of nervous, hypocalcemia, VF, digoxin asystole, assessing
channel blocker 8- muscular skeletal, hypermagnesemia; toxicity, renal hypotension, VF, electrolytic values.
16 mg/kg (usually enzyme reactions, antidote to calcium calculi nausea and Monitor ECG for
5-10 mL) slow normal cardiac channel blockers vomiting decreased QT and
IVP, may be contractility, and beta blockers; T wave inversion
repeated as needed. coagulation of blood; given
Given effects IVP secretory prophylactically
prophylactically activity of endocrine, with calcium
prior to IV calcium exocrine glands channel blockers to
channel blockers 2- prevent hypotension
4 mg/kg (usually 2
mL) slow IVP
Sl Name of Drug Dose Action Indication Contraindication Side effect Nurses
No responsibility

9. DIGOXIN IMMUNE Dependent on Antibody fragments Symptomatic Hypercalcemia, Worsening of Monitor heart rate,
FAB serum digoxin bind to free digoxin to digoxin toxicity or VF, digoxin CHF. A-fib, assessing
levels. One 40-mg reverse digoxin toxicity acute ingestion of toxicity. Renal hypokalemia; electrolytic values
vial bindsto by not allowing digoxin unknown amount of calculi Allergy increased serum Monitor ECG for
approximately 0.6 to bind to sites of action digoxin. only. otherwise digoxin levels. decreased QT and
mg of digoxin. none known. T wave inversion
Dose lladministered Monitor
over 30 min potassium level
Monitor serum
digoxin level
Sl Name of Drug Dose Action Indication Contraindication Side effect Nurses
No responsibility

10. DIGOXIN Loading dose of It inhibits the sodium- To slow ventricular Hypersensitivity. Arrhythmias, Monitor ECG
1015 g/kg, potassium ATPase, response in A-fib or uncontrolled particularly VF changes Check
administered over 5 which makes more A-flutter, asa ventricul and AV block; visual acuity.
min. Maintenance calcium available for positive inotrope in ararthythmias, bradycardia; Monitor vital
dose determined by contractile proteins, CHF, pulmonary AV block, fatigue; blurred signs. Check
body size and renal resulting in increased edema. May be idiopathic or yellow vision; apical pulse before
function. cardiac output used asan hypertrophic headache: 1 minutes of drug
alternative drug for subaorticstenosis hypersensitivity: intake if pulse
PSVT (IHSS). hypokalemia, <60, take again in
constrictive nausea, vomiting 1 hr, if <60, call
pericarditis prescriber
Sl Name of Drug Dose Action Indication Contraindication Side effect Nurses
No responsibility

11. DILTIAZEN 15-20 mg (0.25 Inhibit calcium ion A-fib, A-flutter, Drug-or poison- Hypotension, Monitor BP,
(Calcium Channel mg/kg) IVP over 2 influx across cell PSVT refractory to inducedtachycardia, bradycardia cardiac status
Blockers) min. May repeat in membrane cardiac adenosine with widecomplex (includingAV Assess pain
15min at 20-25 depolarization; produce narrow QRS tachycardia of block),chest pain, Monitor ECG
mg(0.35 mg/kg) relaxation of coronary complex and uncertain origin, ventricular changes
IVP over 2 min. vascular smooth adequate BP. rapid A-fib and A arrhythmias Administered
Start maintenance muscle, dilates coronary flutter with Wolff before meal
drip at 5-15 mg/hr arteries, slows SA/AV Parkinson-White
and titrate to HR. node conduction times, syndrome, sick
dilates peripheral sinussyndrome,
arteries 2nd-and 3rd-degree
AV block (unless a
functionalartificial
pacemaker is
present)
Sl Name of Drug Dose Action Indication Contraindication Side effect Nurses
No responsibility

12. DOPAMIN Continuous It caused increased Symptomatic Pheochromocytoma, Tachyarhythmias, Assessing

(Intropipn) infusions(titrate to cardiac output; action bradycardia and uncorrected angina, breathing pattern
patient response): 31 and B receptors hypotension, tachycardia, hypotension, monitor vital
Lowdose1-5 causing cardiogenic shock cardiogenic shock palpitations, signs. Assess pain
g/kg/min; moderate vasoconstriction in with CHF. vasoconstriction, level, monitor
dose 5-10 g/kg/min blood vessels ;low dose dyspnea, nausea fluid statues
(cardiacdoses); causes renal and and vomiting.
high dose 10-20 mesenteric
g/kg/ min vasodilation; B1
(vasopressor stimulation produces
doses). Mix400 inotropic effects with
mg/ 250 mL in increased cardiac out
normal saline, put
lactated Ringer's
solution, or D5W
(1600 g/mL).
Sl Name of Drug Dose Action Indication Contraindicatio Side effect Nurses
No n responsibility

13. DOBUTAMIN Adult: IV It cause increased Heart failure, MI, Hypersensitivity, Headache, Monitor heart rate
INF2.510μg/kg/min contractility, increased cardiogenic shock, idiopathic dizziness. and BP
mayincrease to coronary blood flow and cardiac surgery hypertrophic palpitation,
4oµg/kg/ min if heart rate by acting on subaortic stenosis tachycardia,
needed B1 receptors in heart; hypertension
minor B and B2 effects
Sl Name of Drug Dose Action Indication Contraindication Side effect Nurses
No responsibility

14. EPINEPHRINE Cardiac arrest 1 31 and 32-agonist Cardiac arrest: Hypersensitivity Angina, HTN, Monitor heart rate
mgIVP (10 mL of causing increased levels PEA, asystole, to adrenergic tachycardia, VT, and Bp Monitor
1:10,000 of cyclic AMP pulseless VT, amines, VF, nervousness, ECG changes
solution)every 3-5 producing VF:severe hypovolemic restlessness, Assess patient
min; follow each bronchodilation, cardiac hypotension; shock, coronary tremors, mental status
dose with 20 mL and CNS stimulation; symptomatic insufficiency weakness, Monitor vital
IV flush: higher large doses can cause bradycardia; headache, nausea signs
doses(up to 0.2 vasodilation via 32 anaphylaxis severe
mg/kg) may be vascular receptors allergic reactions,
used if 1-mg dose
fails. Give 2.0
2.5mg diluted in 10
mL normal saline if
administering by
ETtube.
Sl Name of Drug Dose Action Indication Contraindicatio Side effect Nurses
No n responsibility

15. FIBRINOLYTIC Adults Acute MI It acts by forming Within 12 hr from Active internal Hypotension, Checking bleeding
AGENT IV750000-1.5 acomplex with onset of symptoms bleeding within reperfusion, time PT, PTT
(Thrombolytic, million IU in 1 hr plasminogen that of acute MI. 21 days (except arrhythmias, values
Fibrinolytic) Intra loosely binds loosely Alteplase is the menses), heart failure, anaphylaxis
coronary:20,000IU tofibrin and it converts only fibrinolytic neurovascular headache, Assess any
started fibrin and it plasminogen to plasmin. agent approved for event within 3 increased bleeding Monitor
converts followed It has no intrinsic acute ischemic months, major bleeding time, vital signs, ECG
by 2000 4000 activity stroke and must be surgery or trauma deep or
IU/min for 30-90 started 3 hr from within 2 weeks superficial
min onset of symptoms. hemorrhage,
flushing,
urticaria,
anaphylaxis.
Sl Name of Drug Dose Action Indication Contraindication Side effect Nurses
No responsibility

16. Flurosemide Patients e'60 kg 1 It prolongs duration of SVT, including A Known Headache, nausea Assess any
( lasix) mg IVP over 10 action potential and fib and A-flutter, hypersensitivity, and vomiting. vomiting Maintain
min, may repeat effective refractory most effective history of I and O chart
same dose in 10 period, non-competitive forconversion of A ventricular Monitor
min. Patients 60 kg a and B-adrenergic fib or A-flutter of arrhythmias electrolyte
0.01 mg/kg IVP inhibition short duration. including torsade Continuous ECG
over 10 min,may de pointes monitoring
repeat same dose in
10 min.
Sl Name of Drug Dose Action Indication Contraindicatio Side effect Nurses
No n responsibility

17. IBUTILIDE IV infusion: mix 1 It acts has B1 and 32 Symptomatic Cardiac arrest, Anxiety, Monitoring BP
(Corvert) mg/250 mL in action; relaxes bronchial bradycardia, concurrent use tachycardia, heart rate,
normal saline, smooth muscles and refractory torsade with epinephrine palpitations, skin Maintain 10 chart
lactated Ringer's dilates the trachea and depoint esunres (can cause VF or flushing and check for
solution, or D5W, main bronchi by ponsive VT), poison-or urinary retention,
run at 2-10 g/min, increasing levels of tomagnesium, drug-induced frequency.
and titrate to CAMP, with relaxes bradycardia in heart shock (exception:
patient response. In smooth muscles; causes transplant patients, beta blocker
torsade de pointes increased contractility beta blocker poisoning).
titrate to increase and heart rate by acting poisoning.
heart rate until VT on B receptors in heart.
is suppressed.
Sl Name of Drug Dose Action Indication Contraindicatio Side effect Nurses
No n responsibility

18. ISOPROTERENOL Cardiac arrest from It increase electrical VF or pulseless VT, Prophylactic use Confusion, Monitoring BP,
(Isoprel) VF or VT1.0-1.5 stimulation threshold of stable VT, wide in acute MI, seizures, heart rate, Assess
mg/kg IVP (or 2- ventricles, His purkinje complex advanced AV hypotension, any seizure
4mg/kg via ET system, which stabilizes tachycardia of block, bradycardia, episode, Monitor
tube), may repeat cardiac membrane, uncertain origin, hypotension, cardiovascular cardiac and
0.5-0.75 mg/kg IVP decrease automaticity wide-complex Wolff Parkinson- collapse, respiratory status,
every 5-10min, PSVT. White syndrome, respiratory arrest Continuous ECG
max. 3 mg/kg. hypersensitivity monitoring to
Stable VT, wide to amide-type determine
complex local anesthetics increased PR or
tachycardia of QRS segments
uncertain origin use
0.5-0.75 mg/kg and
up to 1.0-1.5 mg/
kg,may repeat 0.5
0.75 mg/kg every
5-10 min; max.
total dose3.0
mg/kg. If
conversion is
successful, start an
IV infusion of1-4
mg/min (30-50
g/kg/min) in
normal saline or
D5W.
Sl Name of Drug Dose Action Indication Contraindication Side effect Nurses
No responsibility

19. MAGNASIUMSALPHATE Cardiac arrest (in It decrease Tor sade de Hypermagnesemia, Hypotension, Assessing mental
(Electrolyte) hypomagnesemia acetylcholine in pointes, VF hypocalcemia, bradycardia, status,
or torsade motor nerve refractory to renal disease, AV cardiac arrest, Consciousness of
depointes) 1-2 g terminals, which is lidocaine, block, toxemia of respiratory patients,
(2-4 mL of a 50% responsible for an digoxin- induced pregnancy 2 hr depression, monitoring vital
solution) diluted in anti covulasn VT/VF. prior to delivery altered level of signs, serum
10 mL of D5W properties; consciousness magnesium and
IVP. Digoxin- osmotically retains (LOC),flushed sulphate
induced VT or VF fluids, which increase skin, diaphoresis
1-2 g IVP. Tor amount of water in
saded epointes faces when used as
(non-cardiac laxative; reduces SA
arrest)load with 1- node impulse
2 g mixed in 50- formation prolongs
100mL of D5W conduction time in
infused over 5-60 myocardium
min IV, then
infuse 0.5-1.0
g/hrlV (titrate to
control torsade).
Sl Name of Drug Dose Action Indication Contraindicatio Side effect Nurses
No n responsibility

20. MORPHIN 2-4 mg IVP (over Decrease pain impulse Chest pain Hypersensitivity, Respiratory Assessing mental
( Opoids Agonist 1-5 min) every 5 30 transmission at the unrelieved by heart failure due depression, status and level of
Analgesics) min spinal cord level by nitroglycerin, CHF to chronic lung hypotension, conciseness of
interacting with opioid and dyspnea disease, nausea and patient, Monitor
receptor associated with respiratory vomiting, vital signs
pulmonary edema. depression, bradycardia,
hypotension altered LOC,
seizures
Sl Name of Drug Dose Action Indication Contraindicatio Side effect Nurses
No n responsibility

21. NITROGLYCERINE Sublingual route, Decrease preload, after Angina, CHF Hypersensitivity, Hypotension with Monitor pain
(Nitrostat) 0.3-0.4 mg (1 load, which is associated with systolic BP 90 secondary level, & vital signs
tablet), repeat every responsible for acute MI, mm Hg; severe tachycardia,
5min, max. 3 decreasing left hypertensive crisis. bradycardia or syncope,
doses/15 min. ventricular end diastolic severe headache, flushed
Aerosol, spray for pressure, systemic tachycardia; skin.
0.5-1.0 sec at 5 min vascular resistances; sildenafil
intervals (provides dilates coronary arteries, (Viagra), tadalafil
0.4 mg/ dose), max. improves blood flow (Cialis),
3 sprays/15 vardenafil
min.IVP at 12.5- (Levitra) within
25.0 g 24 hr; right
ventricular
infarction.
 TRIPURA INSTITUTE OF PARAMEDICAL SCIENCE,
NURSING SECTION.
HAPANIA, AMTALI.

DRUG BOOK
MALE MEDICINE WARD
SUB:- MEDICAL SURGICAL NURSING
Date:- 03/07/2021

SUBMITTED TO, SUBMITTED BY,

Madam Gargi Maity Punam Pal

Asso. Professor(MSN) Roll No- 07

College Of Nursing, TIPS. 2nd Semester M.Sc Nursing

College Of Nursing, TIPS.