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Classification: Alpha- and betaadrenergic agonist, cardiac stimulant, vasopressor

MECHANISM OF ACTION Stimulates beta1 and alpha1 receptors in sympathetic nervous system, causing vasoconstriction, increased blood pressure, enhanced contractility, and decreased heart rate

INDICATION hypotension

CONTRAINDICATION Concurrent cyclopropane or halothane anesthesia Hypotension caused by blood volume deficit (except in emergencies until blood volume replacement is completed), profound hypoxia or hypercarbia Mesenteric or peripheral vascular thrombosis

ADVERSE EFFECT CNS: headache, anxiety CV: bradycardia, severe hypertension, arrhythmias Respiratory: respiratory difficulty Skin: irritation with extravasation, necrosis Other: ischemic injury

NURSING RESPONSIBILITIES Mix with dextrose 5% in water or dextrose 5% in normal saline solution. Inspect solution to make sure it's clear and colorless. Don't infuse if it's brown or pink. Administer through infusion pump. Titrate infusion rate to achieve and maintain low-normal systolic blood pressure (80 to 100 mm Hg). Continue infusion until adequate blood pressure and tissue perfusion persist without drug therapy. Gradually titrate dosage downward. To avoid extravasation, administer only into large vein (antecubital) or through central line. Don't use femoral vein in patients who are elderly or have occlusive vascular disorders.

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MECHANISM OF ACTION Atropine is an anticholinergic agent which competitively blocks the muscarinic receptors in peripheral tissues such as the heart, intestines, bronchial muscles, iris and secretory glands. Some central stimulation may occur. Atropine abolishes bradycardia and reduces heart block due to vagal activity. Smooth muscles in the bronchi and gut are relaxed while glandular secretions are reduced. It also has mydriatic and cycloplegic effect. Absorption: Readily absorbed from the GI tract; also absorbed from mucous membranes, eye, and through intact skin. Distribution: Distribut es throughout the body

INDICATION

CONTRAINDICATION Glaucoma, chronic respiratory disease, sick sinus syndrome, thyrotoxicosis, cardiac failure, pyloric stenosis, prostatic hypertrophy

ADVERSE EFFECT . Dry mouth, dysphagia, constipation, flushing and dryness of skin, tachycardia, palpitations, arrhythmias, mydriasis, photophobia, cycloplegia, raised intraocular pressure. Toxic doses cause tachycardia, hyperpyrexia, restlessness, confusion, excitement, hallucinations, delirium and may progress to circulatory failure and resp depression. Eye drops: Systemic toxicity esp in children, on prolonged use may lead to irritation, hyperaemia, oedema and conjunctivitis. Increased intraocular pressure. Inhalation: Dryness of mouth, throat. Potentially Fatal: Atrial arrhythmias, AV dissociation, multiple ventricular ectopics.

NURSING RESPONSIBILITIES Monitor vitalsigns. HR is asensitiveindicator of patient'sresponse toatropine. Bealert tochanges inquality, rate,and rhythm of HR andrespiration andto changes inBP and temperature. Initial paradoxical bradycar diafollowing IVatropineusually lastsonly 12 min;it most likelyoccurs whenIV isadministeredslowly (morethan 1 min) or when smalldoses (lessthan 0.5 mg)are used.Posturalhypotensiono ccurs when patientambulates toosoon after parenteraladministrati on

and crosses the bloodbrain barrier and placenta. Metabolism: Incomple te metabolism in the liver. Excretion: Excreted in urine as unchanged drug and metabolites. Half-life reported to be 4 hr.

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MECHANISM OF ACTION

INDICATION Indications: For pain onintegumentarystructures,myalgia,neuralgia,headache,dys menorrhea,gout. Arthritis, SLE,acute rheumaticfeve

CONTRAINDICA TION Contraindication s: Hypersensitivity tosalicylates, severeanemia, history of blood coagulationdefect s, vitamin K deficiency, 1 weekbefore and aftersurgery,pregnanc y in thelast trimester

ADVERSE EFFECT GI: dyspepsia, heartburn,anorexia, nausea,epigastric discomfort,potentiation of pepticulcer Allergic: Bronchospasm,asthmalike symptoms,anaphylaxi s, skin rashes,urticaria Hematologic: prolongation of bleedingtime, thrombocytopenia,leucope nia, Other: Thirst, fever,dimness of vision

Exhibitsantipyretic, a nti-inflammatory andanalgesic effects. The isosorbid antipyreticeffect is due to anaction on e dinitrate thehypothalamus,resulti ng in heatloss Brand byvasodilation name: of peripheral Isordil bloodvessels. AntiTitradose, inflammatoryeffects aremediated by Dilatrate- adecrease inprostaglandinsynt SR, hesis. Isochron It alsodecreases plateletaggregation Classificati on:

NURSING RESPONSIBILITIE S Assess for pain:type, locationand pattern Note for asthma Monitor renal,LFTs and CBC Determinehistory of pepticulcers orbleedingtendencies. Precautions: Do not use inchildren withchicken pox orflu symptoms Lactation Mild diabetes,erosive gastritis,bleedingtend encies, liveror kidneydisease.

DRUG ORDER Generic name: mannitol Brand name:

MECHANISM OF ACTION

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NURSING RESPONSIBILITIES

Osmitrol, Resectisol
Classification:

1. In the oliguric phase of acute renal failure, Mannitol increases osmotic pressure (pressure needed to stop the absorption of something or osmosis) of the glumerular filtrate, thereby,promoting diuresis (treating the oliguric phase of renal failure) and excretes toxic materials (managem ent for toxic overdose). 2. It also elevates blood plasma osmolality thus, inhibiting the

Osmotic Diuretic

1. Acute oliguric renal failure 2. Toxic overdose 3. Edema 4. Increased intracranial pressure (ICP) 5. Intraocular pressure (IOP)

1. Susceptibility 2. Dehydration

1. Dehydration 2. Anuria 3. Intracranial bleeding 4. Headache 5. Blurred vision 6. Nausea and vomiting 7. Volume expansion 8. Chest pain 9. Pulmonary edema 10. 11. 12. Thirst Tachycardia Hypokalemia (increases the risk of digoxin toxicity) 13. Chronic renal failure

1. Observe the IV site regularly for infiltration. 2. Administration rate for oliguria should be titrated to produce a urine output. (about 3050 ml/hr in adult and 2-6 hours in children)

reabsorption of water and electrolytes (for relief of edema) and mobilizing fluids in the cerebral and ocular spaces(lowers intracranial or intraocular pressure).

DRUG ORDER Generic name: Sodium bicarbonate

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Brand name:

Bakin Soda, BellAns, Citrocarbonate, Neut, Soda Mint

Classification:

Sodium Bicarbonate acts as an alkalinizing agent by releasing bicarbonate ions. Following oral administration of this medication, it releases bicarbonate which is capable of neutralizing gastric acid.

1. Management of metabolic acidosis 2. Used to alkalinize urine and promote excretion of certain drugs in over dosage situations 3. Used as an antacid

1. Metabolic or respiratory alkalosis 2. Hypocalcemia 3. Excessive chloride loss 4. It is not recommended as an antidote following ingestion of strong mineral acids 5. Patients on sodium restricted diet 6. Renal failure 7. Severe abdominal pain

1. 2. 3. 4. 5. 6. 7. 8.

Edema Flatulence Gastric distention Metabolic alkalosis Hypernatremia Hypocalcemia Hypokalemia Sodium and water retention 9. Irritation at IV site 10. Tetany

1. Tablets must be taken with a full glass of water. 2. For clients taking the medication as a treatment for peptic ulcers it may be administered 1 and 3 hours after meals and at bedtime. 3. Hypokalemia should also be assessed by monitoring signs and symptoms such as: weakness, fatigue, U wave on ECG, arrhythmias, polyuria and polydipsia.

antiulcer agents, alkalinizing agent

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