Emergency Drugs and Antidote

Liceo de Cagayan University
College of Nursing
NCM 118 RLE
GROUP A4
Emergency and Azote, Fretzie Gay
Beja, Christine
Antidote Drugs
Capal, Almerah
Delicana, Norlie
Hingania, Kimberly
Lonio, Jessa Kate
Madroñal, Josiah Raquie
Pepito, Alexa Gwyn
Salses, Jasmin Rose
Sumicad, April Sophia
Emergency
Drugs
● Emergency drugs are chemical compounds used in
patients during life threatening conditions so that the
symptoms can be controlled and the life of the patient can
be saved.
● for a drug to be useful in emergency, it must have a short

onset of action and be administered in such a way as to
facilitate rapid onset of action.
8.1 Local Anaesthetics
Name of Classificati Dose/Freq Mechanism Indication Contraindication Nursing Management
Drug on uency/Rout of Action
e
Lignocaine Local 50 to 100mg by The principal The indications -Contraindicated in -Tell patient to promptly
Anesthetic IV bolus at 25 mechanism of action of
include
lignocaine
the
patients with known
hypersensitivity to
report adverse reaction,
to 50mg per of lignocaine as a
minute. Bolus local anaesthetic is requirement for lignocaine or to any local such as palpitations,
dose is through blockade of
local, neuraxial, anesthetic of the amide dyspnea, confusion,
regional or type, intravenous
repeated every voltage-gated sodium anxiety, nausea and
peripheral regional anesthesia,
5 minutes until channels (VGSCs) anesthesia by severe hypotension, vomiting because toxicity
arrhythmias leading to a infiltration, hypovolemia, can occur.
subside or reversible block of block or topical paracervical block in -When Lidocaine is
adverse action potential application, or obstetrics.
reaction is propagation. the prophylaxis -Use with caution in liver administered as an
develop. or treatment of disease, epilepsy, antiarrhythmic the nurse
life-threatening impaired cardiovascular should monitor the ECG
ventricular function, and respiratory
arrhythmias. impairment.
continuously.
Blood pressure and
respiratory status should
be monitored frequently
during the drug
administration.
-When administered as an
anesthetic, the numbness
of the affected part should
be assessed.
-Dosage is changed
frequently in response to
cardiac rhythm on
monitor.
-Report difficulty
speaking, thick tongue,
numbness, tingling,
difficulty breathing, pain or
numbness at IV site,
swelling, or pain at site of
local anesthetic use.
8.2 Sedatives and Induction Agents
Name of Drug Classification Dose/Freq Mechanism of Indication Contraindication Nursing
uency/Ro Action Management
ute
Ketamine General 1 mg/kg to Ketamine's known Indicated as the Contraindicated in -Implement

Anesthetic 4.5 mg/kg, mechanism of sole anesthetic those in whom a breathing
IV, 5 to 10 action involves agent for significant elevation activities and
minutes being an diagnostic and of blood pressure
other therapeutic
antagonist for the surgical would constitute a
NMDA procedures that serious hazard, in exercises to
(N-methyl-D-aspart do not require those who have encourage
ate) receptors that skeletal muscle shown ventilation and
are found in nerve relaxation. hypersensitivity to help overcome
cells. These the drug, systemic any residual
receptors are hypertension, severe effects of the
involved in coronary or
anesthetic.
processing central myocardial disease,
nervous system cerebrovascular
input. Ketamine accident or cerebral
blocks this sensory trauma.
input.
-Tell patient to
promptly report
adverse reaction,
such as
palpitations,
dyspnea,
confusion,
anxiety, nausea
and vomiting
because toxicity
can occur.
-Advise pt to
avoid alcohol
and sleep aids
during therapy.
Name of Drug Classificatio Dose/Fre Mechanism of Indication Contraindic Nursing
n quency/R Action ation Manageme
oute nt
Thiopentone/Thio Barbiturate/ IV: 2 to 3 mL Thiopental binds to -Thiopental is used for the Thiopental -Monitor vital
pental Sedative- of a 2.5% the chloride induction of general should be signs q3–5min
Hypnotics solution ionophore site of the anaesthesia and is also used with before, during,
gamma-aminobutyric caution in
used as an adjunct to and after
acid cases of liver
(GABA)-A/chloride provide hypnosis during disease, anesthetic
ionophore receptor balanced anaesthesia with Addison's administration
complex, thereby other anaesthetic agents, disease, until recovery
enhancing the including analgesics and myxedema, and into
inhibitory actions of muscle relaxants, and also severe heart postoperative
GABA-A in the brain. used as an adjunct for disease, period, if
This leads to synaptic severe
control of convulsive necessary.
inhibition, decreased hypotension, a
neuronal excitability disorders of various severe
and induction of aetiology, including those breathing
anesthesia. caused by local disorder, or a
anaesthetics. family history
of porphyria.
-Report increases in
pulse rate or drop in
blood pressure.
Hypovolemia, cranial
trauma, or
premedication with
opioids increases
potential for apnea and
symptoms of
myocardial depression
(decreased cardiac
output and arterial
pressure).
-Shivering, excitement,
muscle twitching may
develop during recovery
period if patient is in
pain.
Name of Classificati Dose/Freq Mechanism of Action Indication Contraindi Nursing
Drug on uency/Rou cation Managemen
te t
Midazolam Benzodiazepi IV: 2.5 to 15 The mechanism of action of Midazolam injection Contraindicat -Teach pt about
ne mg midazolam indirect and is is used before ed in patients drug’s use and
related to GABA medical procedures with a known potential
accumulation and its and surgery to cause hypersensitivi adverse
affinity to the drowsiness, relieve ty to the reactions;
benzodiazepine receptors. anxiety, and prevent drug, acute advice pt to
Two separate receptors for any memory of the angle-closure immediately
GABA and benzodiazepine event. It is also glaucoma, report difficulty
couple to a common sometimes given as hypotension, breathing.
chloride channel. It part of the and shock. -Caution pt
increases the frequency of anesthesia during taking an opioid
chloride channel opening. surgery to produce a with
Occupation of both the loss of consciousness. benzodiazepine,
receptors cause membrane CNS depressant,
hyperpolarization and
neuronal inhibition.
or alcohol to seek
immediate medical
attention for
dizziness,
light-headedness,
extreme sleepiness,
slowed or difficult
breathing or
unresponsiveness.
-Warn pt to avoid
hazardous activities
that require alertness
or good coordination
until effects of drugs
are known.
8.3 Anticholinergics
Name of Drug Classification Dose/Frequ Mechanism of Indication Contraindic Nursing
ency/Route Aciton ation Management
Atropine Anticholinergic IV: 0.6mg Atropine competitively Atropine is a Contraindicate -Instruct pt to

blocks the effects of muscarinic d in patients report all adverse
acetylcholine, antagonist with reactions and to
including excess indicated for glaucoma, immediately
acetylcholine due to temporary pyloric report urine
organophosphorus blockade of stenosis, retention,
poisoning, at severe or life thyrotoxicosis, abnormal
muscarinic cholinergic threatening fever, urinary heartbeat,
receptors on smooth muscarinic tract dizziness, passing
muscle, cardiac effects. obstruction out, difficulty
muscle, secretory and ileus. breathing,
gland cells, and in weakness,
peripheral autonomic tremors, and
ganglia and the central abdominal
nervous system. edema.
8.3 Anticholinergics
Name of Drug Classification Dose/Freque Mechanism of Indication Contraindicati Nursing
ncy/Route Action on Management
Benztropine Anticholinergic PO/IM: 1-2 mg Benztropine has Benztropine is Hypersensitivity -Warn patient to
anticholinergic indicated to be to benztropine avoid activities
effects. used as an mesylate that require
Anticholinergic adjunct in the alertness until
tablets.Because
drugs block the therapy of all CNS effects of
action of forms of of its drug are known.
acetylcholine, a parkinsonism. It atropine-like side -Advise patient
neurotransmitter can also be used effects, this drug who takes a
(chemical) that for the control of is single daily dose
nerves use to extrapyramidal contraindicated to do so at
communicate disorders due to in pediatric bedtime.
with other neuroleptic -Advise patient
patients under
nerves. drugs. to report signs
three years of and symptoms of
age, and should urinary hesitancy
be used with or urine
caution in older retention.
pediatric
patients.
-Tell patient to
relieve dry mouth
with cool drinks, ice
chips, sugarless gum,
or hard candy.
-Advise patient to
limit hot weather
activities because
drug-induced lack of
sweating may cause
overheating
8.4 Opioid Analgesics
Name of Classification Dose/Freque Mechanism of Indication Contraindicat Nursing
Drug ncy/Route Action ion Management
Morphine Opioid Adults: IV-2.5 Morphine binding Morphine is Hypersensitivity -Caution patient
mg to opioid receptors used for the to morphine, taking an opioid
Analgesics blocks transmission management of respiratory with a
Pediatric: of nociceptive chronic, insufficiency or benzodiazepine,
IV-0.05 mg/kg signals, signals moderate to depression, CNS depressant, or
pain-modulating severe pain. severe CNS alcohol to seek
neurons in the Morphine is depression, immediate medical
spinal cord, and usually used in attack of attention for
inhibits primary the treatment of bronchial dizziness, light
afferent nociceptors acute asthma, heart headedness,
to the dorsal horn myocardial failure extreme
sensory projection infarction and secondary to sleepiness, slowed
cells. pulmonary chronic lung or difficult
edema disease. breathing, or
unresponsiveness.
-Explain assessment and
monitoring process to
patient and family.
Instruct them to
immediately report
difficulty breathing or
other signs or symptoms
of a potential adverse
opioid-related reaction.
-Caution ambulatory ot
about getting out of bed
or walking. Warn pt to
avoid driving and other
potentially hazardous
activities that require
mental alertness until
drug’s CNS effects are
known.
Name of Drug Classification Dose/Frequency Indication Contraindication Nursing
/Route Management
Pethidine Anticholinergic IV: 0.5 mg/kg every Indicated for the Contraindicated to -Caution patient to
5 minutes management of pt with seek immediate
acute to severe hypersensitivity to medical attention
pain. meperidine or to for dizziness,
any of other light-headedness,
ingredients of the extreme
product, sleepiness, slowed
respiratory or difficulty
depression, Acute breathing or
or severe bronchial unresponsiveness.
asthma, and
concomitant use of
monoamine
oxidase inhibitors
(MAOIs) or within
14 days of having
taken an MAOI.
-Advise pt that drug increase risk of
opioid addiction, abuse, and misuse,
which can lead to overdose and
death.
-Advise pt to avoid alcohol and
sleep aids during therapy.
-Counsel pt not to discontinue
opioids without first discussing with
prescriber the need foi gradual
tapering regimen.
-Caution ambulatory ot about
getting out of bed or walking. Warn
pt to avoid driving and other
potentially hazardous activities that
require mental alertness until drug’s
CNS effects are known.;
Name of Drug Classification Dose/Frequ Mechanism of Action Indication Contraindi Nursing
ency/Route cation Management
Fentanyl Anticholiner IV- 1-2 Fentanyl binds to opioid Manage Hypersensiti

vity to the
-Caution
gic moderate patient to
mcg/kg
receptors, especially the
mu opioid receptor, which to severe active
are coupled to pain. substance . seek
G-proteins. Activation of Known immediate
intolerance
medical
opioid receptors causes
GTP to be exchanged for to fentanyl
GDP on the G-proteins or other attention for
which in turn down morphino-m dizziness,
imetics and
light-heade
regulates adenylate
cyclase, reducing respiratory
concentrations of cAMP. depression. dness,
The exchange of GTP for extreme
sleepiness,
GDP results in
hyperpolarization of the
cell and inhibition of slowed or
nerve activity. difficulty
breathing or
unresponsiv
eness.
-Advise pt not
to stop drug
abruptly.
-Caution pt to
immediately
report signs
and symptoms
of serotonin
syndrome,
adrenal
insufficiency,
and decreased
sex hormones
to health care
provider.
8.5 Anti-emetics
Name of Classificatio Dose/Freq Mechanism of Action Indication Contraindic Nursing
Drug n uency/Rout ation Management
e
Metoclopram Anti-emeti IV: 10 mg Metoclopramide causes Metoclopr Metoclopra -Instruct pt to

ide amide is mide is take ODT’s 30
cs
antiemetic effects by
inhibiting dopamine D2 contraindicat minutes before
and serotonin 5-HT3 used to ed in food and at
receptors in the prevent patients with bedtime and
nausea pheochromo
chemoreceptor trigger
not to repeat
cytoma, with
zone (CTZ) located in the
area postrema of the and dose if
known advertently
brain.2,17 Administration of vomiting. sensitivity or
this drug leads to taken with
prokinetic effects via intolerance food.
inhibitory actions on to the drug, -Urge pt to
presynaptic and gastrointesti report
postsynaptic D2 receptors, nal bleeding, persistent or
agonism of serotonin seizures, and serious adverse
5-HT4 receptors, and depression. reactions
promptly.
antagonism of muscarinic
receptor inhibition.
-Tell pt taking ODT’s to
open blister pack with
dry hands and
immediately place
tablet on tongue, let it
melt completely and
the swallow. If tablet
breaks or crumbles,
advise pt to throw it
away and take new
tablet.
-Advise pt not to drink
alcohol during therapy.
8.5 Anti-emetics
Name of Drug Classification Dose/Freque Mechanism of Indication Contraindication Nursing
ncy/Route Action Management
Prochlorperazi Anti-emetic PO: 5 mg, Prochlorperazine Indicated History of allergy to -Advise pt to

ne for prochlorperazine or report all
s q8h
blocks the D2
dopamine treatment the phenothiazine adverse reaction
IM/IV: 12.5 receptors in the of vertigo, drug class,
and to
immediately
mg, q8h brain, which are nausea concomitant use of report signs and
and
somatodendritic
CNS depressants symptoms of
vomiting.
autoreceptors.
Inhibition of D2 leading to sedation, tardive
receptor signaling pre-existing cardiac dyskinesia and
results in the conduction NMS
blockade of abnormalities, (Neuroleptic
postsynaptic malignant
history of
dopamine syndrome).
receptors in the seizure/epilepsy, -Tell pt to avoid
mesolimbic and patients under extreme heat
system and an two years of age. because drug
increased may interfere
dopamine with the body’s
turnover. thermoregulator
y mechanisms.
-Advise pt to
avoid alcohol
while taking
drugs
because of
increased CNS
depression.
8.5 Anti-emetics
Name of Classification Dose/Fre Mechanism of Indication Contraindication Nursing
Drug quency/R Action Managemen
oute t
Prometha Anti-emeti IM/IV/P Promethazine is a Used to treat the Promethazine -Tell pt to take
symptoms of contraindications oral form with
zine cs O: 0.5
direct antagonist at the
mesolimbic dopamine Allergic include patients food or milk.
mg/kg receptors and Conditions, with -Warn pt to
alpha-adrenergic Nausea, hypersensitivity to avoid alcohol
receptors in the brain. Vomiting, Motion the drug, any drug and hazardous
Promethazine exhibits Sickness and components, or activities that
its antihistamine effects sedation. other require
as an H1-receptor phenothiazines, alertness until
blocker. children under two CNS effects of
years of age, drug are
subcutaneous or known.
intra-arterial -Warn pt about
administration, possible
comatose patients photosensitivit
and patients with y reactions.
lower respiratory Advise use of
tract symptoms. sunblock.
-Instruct pt to
report
involuntary
muscle.
8.6 Corticosteroids
Hydrocortiso Corticosteroi IV: 3 Hydrocortisone Indicated to Hypersensi -Tell patient

ne ds mg/kg,
binds to the
treat tivity to not to stop
glucocorticoid drug abruptly
q8h receptor leading inflammatio drug, or without
to downstream n, status inactive prescriber's
asthmaticus
effects such as
inhibition of tuberculosi consent.
phospholipase , acute and s, herpes
-instruct
chronic patient to take
simplex
A2, NF-kappa
oral form of
adrenal
B, other
inflammatory infection of drug with milk
insufficiency or food
the eye,
transcription
factors, and the -Warn patient
promotion of and an on long-term
anti-inflammator
infection therapy about
cushingoid
due to a
y genes.
effects
fungus.
(moon face, buffalo
hump) and the need to
notify prescriber about
sudden weight gain or
swelling.
-Teach patient signs
and symptoms of
early adrenal
insufficiency: fatigue,
muscle weakness,
joint pain, fever,
anorexia, nausea,
shortness of breath,
dizziness, and fainting.
-Warn patient about
easy bruising.
8.6 Corticosteroids
Name of Drug Classificatio Dose/Frequen Mechanism of Indication Contraindicati Nursing
n cy/Route Action on Management
Dexamethaso Corticoster IM/IV: 0.1 Glucocorticoids It relieves Contraindica -Tell patient

ne oid mg/kg, q8h
inhibit neutrophil inflammation ted in not to stop
apoptosis and
(swelling, systemic drug abruptly
heat, redness, or without
demargination;
they inhibit
and pain) and
fungal prescriber's
infections
phospholipase
A2, which is used to consent.
decreases the treat certain and patients -instruct
formation of forms of with known patient to take
arthritis; skin, hypersensiti oral form of
arachidonic acid
blood, kidney, drug with milk
derivatives; they
inhibit NF-Kappa vity to the
B and other eye, thyroid, product and or food
and intestinal -Warn patient
its
inflammatory
transcription disorders (e.g., on long-term
factors; they colitis); severe constituents therapy about
promote
allergies; and . cushingoid
asthma. effects
anti-inflammatory
genes like
interleukin-10.
(moon face, buffalo hump)
and the need to notify
prescriber about sudden
weight gain or swelling.
-Teach patient signs and
symptoms of early adrenal
insufficiency: fatigue, muscle
weakness, joint pain, fever,
anorexia, nausea, shortness
of breath, dizziness, and
fainting.
-Warn patient about easy
bruising.
-Advise pt to avoid exposure
to infections such as measles
and chickenpox.
8.6 Corticosteroids
Prednisolo Corticosteroi PO: 1 Prednisone Used to treat Prednisone is -Tell patient

ds conditions contraindicated not to stop
ne mg/kg
decreases
in patients with drug abruptly
inflammation
such as
documented or without
arthritis,
via suppression
of the migration hypersensitivit prescriber's
blood y to the drug or
of
problems, consent.
components of
-instruct
polymorphonucl
ear leukocytes immune the formulation
and patient to take
and reversing system oral form of
increased disorders, administration
of prednisone drug with milk
skin and eye
capillary
include the or food
conditions,
permeability. It
also suppresses presence of -Warn patient
the immune breathing systemic fungal on long-term
system by problems, infections. therapy about
reducing the cancer, and cushingoid
activity and the severe effects and
volume of the
allergies. need to notify
immune system. prescriber
about sudden
weight gain or
swelling.
-Tell pt to
avoid
immunization
while taking
the drug.
8.7 Anti - Epileptics
Name of Classificatio Dose/Freque Mechanism of Indication Contraindication Nursing

Drug n ncy/Route Action Management
Mechanism of
Diazepa Anti - Intravenous: manages Pregnancy (D), - Assess blood
action of
m epileptics 0.1 mg/kg; anxiety hypersensitivity pressure,
diazepam in the
Rectal: 0.5 disorders, to pulse and
central nervous
mg/kg short-term relief benzodiazepines respiration if IV
system is by
of anxiety , closed-angle administration.
potentiation of
symptoms, and
the inhibitory glaucoma, coma, - Provide
preoperative
effect of myasthenia frequent sips
anxiety relief.
γ-aminobutyric gravis, ethanol of water for dry
acid on neuronal intoxication, mouth.
transmission. hepatic disease, - Provide fluids
sleep apnea and fibre for
constipation.
Nursing
Management
- Evaluate
therapeutic
response,
mental state and
physical
dependency
after long-term
use.
Name of Classification Dose/Frequency/ Mechanism of Indication Contraindicatio Nursing
Drug Route Action n Management
Phenytoin is
Phenytoin Anti - Intravenous; Phenytoin is Pregnancy (D), - monitor
believed to
epileptics 15mg/kg indicated to hypersensitivity, serum
protect against
treat grand psychiatric phenytoin
seizures by
mal seizures, condition, levels
causing
complex bradycardia, SA - monitor for
voltage-depende
partial
nt block of and AV block, hypersensitivit
seizures, and
voltage gated Stokes-Adams y
to prevent
sodium syndrome - assess
and treat
channels. seizures
seizures
during or - assess
following hemodynamics
neurosurgery
.
8.8 Antiarrhythmics
Class I
IA.
Name of Classification Dose/Freque Mechanism of Indication Contraindication Nursing
Drug ncy/Route Action Management
Quinidine acts on
Quinidin Antiarrythmia PO: 324-658 Quinidine is Hypersensitivity, - Monitor patient
sodium channels
e s mg q8-12hr; a idiosyncratic response to
on the neuronal
IM: 600 mg medication response, therapy through
cell membrane,
then 400 mg used in the digoxin toxicity, assessment of
limiting the
q2hr; managemen blood cardiac output and
spread of seizure
t and
IV: 16mg/min activity and dyscrasias, rhythm.
treatment of
reducing seizure myasthenia - Assess for the
specific
propagation. gravis, AV block mentioned
arrhythmias.
contraindications
to this drug
8.8 Antiarrhythmics
Class II
Name of Classification Dose/Freque Mechanism of Indication Contraindicati Nursing

Drug ncy/Route Action on Management
Competitively
Propranol Antiarrythmia Intravenous; Propranolol can Hypersensitivit - monitor
blocks both β1
ol s 10mcg/kg q2 be used to y to this hemodynamic
and β2
mins to a ameliorate the product; parameters
adrenergic
max of 100 sympathetic cardiogenic - advise to
receptors.
mcg/kg response in shock, AV change positions
angina,
heart block; slowly to prevent
tachyarrhythmia
bronchospasti orthostatic
s, prevention of
c hypotension
acute ischemic
attacks, disease; sinus
migraine bradycardia;
prophylaxis, bronchospasm
and restless leg ; asthma
syndrome
8.8 Antiarrhythmics
Class II
Nursing
Management
- stopping
abruptly may
result in life
threatening
arrhythmias
- advise patient
to notify
physician for
difficulty
breathing
8.8 Antiarrhythmics
Class III
Name of Classificat Dose/Frequ Mechanism Indication Contraindicatio Nursing
Drug ion ency/Route of Action n Management
Works
Amiodarone Antiarryth Intravenous Most Pregnancy (D), - monitor EKG
primarily by
mias ; 5mg/kg common breastfeeding, continuously while on
blocking
over 30 indications neonates, therapy
potassium
minutes for infants, severe - assess for signs
rectifier
amiodarone sinus node and symptoms of
currents
use in the
responsible for dysfunction, ARDS
acute
the hypersensitivity - monitor liver
setting is
repolarization to this product, function test
atrial
of the heart cardiogenic - teach patient to
fibrillation
during phase 3 shock avoid drinking grape
with a rapid
of the cardiac fruit
ventricular
action
response.
potential.
8.8 Antiarrhythmics
Class IV
Name of Classificat Dose/Freque Mechanism Indication Contraindication Nursing
Drug ion ncy/Route of Action Management
inhibits the
Verapami Antiarryth Intravenous Approved Sick sinus - don’t use with
calcium ion
l mias Push: 5-10 indications for syndrome, 2nd and 3rd
(and possibly
mg (adult); verapamil include 2nd-/3rd-degree degree
sodium ion)
0.1- 0.3 angina, unstable heartblock,hypote heartblock
influx through
mg/kg (1-15 angina,hypertensi nsion,90 mmHg - don’t use with
slow
on as add-on
yrs old); channels into systolic,cardiogeni systolic BP < 90
therapy,
0.1-0.2 conductile c shock, severe - monitor heart
paroxysmal
mg/kg (0-1 and CHF, rhythm, intake
supraventricular
yrs old) contractile LownGanong-Levi and output,
tachycardia
PO: 240-480 myocardial ne syndrome, blood pressure
(PSVT)prophylaxi
mg/day cells and Wolff-Parkinson-W - assess angina
s,and
vascular hite syndrome
supraventricular
smooth
tachycardia
muscle cells
(SVT).
8.8 Antiarrhythmics
Name Classifica Dose/Frequency/Ro Mechanism Indication Contraindicati Nursing

of Drug tion ute of Action on Management
Digoxin
Digoxin Antiarryth Intravenous: 8-12 Indicated for contraindicate - Assess patient
increases the
mias mcg/kg (adult); :the d in atrial for
strength and
15-30 mcg/kg (5-10 treatment of fibrillation hypersensitivity
efficiency of
yrs old); 25-35 mild to associated - Assess patient
heart
mcg/kg (2-4 yrs old); moderate with for cardiac
contractions,
heart failure
30-50 mcg/kg and is useful Wolff-Parkins arrythmias
in adult
(infant) in the on-White including
patients.
PO: 10-15 treatment of syndrome. bradycardia
:To increase
mcg/kg(adult); heart failure - Assess signs of
myocardial
20-35 mcg/kg(5-10 and control toxicity
contraction
yrs old); 30-45 the rate and - Use caution with
in children
mcg/kg (2-4 yrs old); rhythm of the diuretic use
diagnosed
35-60 heart.
with heart
mcg/kg(infant) failure.
8.9 Anti - Hypertensive
Name of Classification Dose/Frequenc Mechanism Indication Contraindication Nursing

Drug y/Route of Action Management
Glycerol
Glyceril Anti - PO: 2.5-6.5 mg A Contraindicated in - Assess client’s
Trinitrate
Trinitrate Hypertensive q6-8hr ; vasodilator patients that have level of pain,
produces in a
IV: 5mcg/min; yd reported allergic including location,
dose related
TOPICAL: 1-2 rug used symptoms to the quality and intensity
manner,
in q8; primarily medication. - Monitor ECG,
dilation of
to provide
both arterial Known history of blood pressure, and
relief from
and venous increase ICP pulse.
anginal
beds. severe - Assess for
chest pain
anemia,and headache
right-sided - Assess for use of
myocardial sildenafil
infarction
8.9 Antihypertensive
Dose/Frequency/R
oute
TRANSLINGUAL:
0.4mg/metered
dose;
TRANSMUCOSAL:
1 mg q3-5hr during
wake hours
SUBLINGUAL:
1 tab q 5mins
(acute attack); 5-10
mins ā activites
Name of Classification Dose/Frequ Mechanism Indication Contraindi Nursing Management

Drug ency/Route of Action cation
Lowers blood
Hydralazin Anti - Intravenous; Hydralazine Hypersensi - Monitor the client’s
pressure by
e Hypertensive 10 mg q20 is primarily tivity to blood pressure and
exerting a
mins to a used to treat hydrALAZI pulse frequently during
peripheral
max of 50 hypertension NEs, mitral initial dosage adjustment
vasodilating
mg. and valvular - Inform the patient to
effect through
hypertensive
a direct rheumatic take hydralazine with
urgency
relaxation of heart meals or a snack.
/emergency.
vascular disease, - be aware that
smooth CA Hydralazine may cause
muscle. a positive direct Coomb’s
test result.
Name of Classificatio Dose/Freq Mechanism Indication Contraindi Nursing Management
Drug n uency/Ro of Action cation
ute
Nifedipine Anti - 10 mg; Blocks Primarily Hypersensit - Monitor BP and pulse

Hypertensive TID; PO voltage used as an ivity to this before, during, and
gated L-type antihyperten product or after therapy.
Calcium-chan calcium sive and as dihydropyri
nel blocker channels in anti-anginal dine; - Assess for signs of
vascular medication. CHF.
smooth Hypotensio
muscle and n - Instruct the patient
myocardial not to double dose.
cells.
Name of Classificati Dose/Freq Mechanism of Indication Contraindicati Nursing

Drug on uency/Rou Action on Management
te
Labetalol Anti - 100 mg It works by To treat Hypersensitivity - Monitor BP for

Hypertensiv BID (adult); blocking the arterial to B-blockers hypotension
e 1-3mg/kg/d action of hypertension,
ay certain natural which ranges Cardiogenic - Monitor EKG for
Beta-blocke (children), chemicals in from acute shock cardiac
r PO your body hypertensive arrhythmias
such as crises Sinus
epinephrine on (urgent/emer bradycardia - Assist with
the heart and gency). ambulation if
blood vessels. CHF dizziness occurs
8.10 Inotropic Agents
Name of Classificati Dose/Freque Mechanism Indication Contraindicati Nursing
Drug on ncy/Route of Action on Management
It causes an
Adrenalin Inotropic 1-70 Treatment of Hyperthyroidism - Monitor for chest
increase in
e Agents mcg/kg/min serious pain
cardiac output
shock Diabetes
and heart rate
Intravenous produced by mellitus - Monitor vital signs
plus
a severe and I&O
vasoconstricti
allergic
on. Severe renal
reaction or
impairment - Patient should
collapse.
ensure adequate
Used to treat fluid intake to
cardiac liquefy secretions
arrest.
Name of Classificati Dose/Frequ Mechanism Indication Contraindication Nursing

Drug on ency/Route of Action Management
Dopamin Inotropic 2-5mcg/kg/ produces Indicated for Hypersensitivity -Monitor

e Agents min (adult) positive patients who hemodynamics
inotropic have Uncorrected closely: BP, HR,
.5-2 effects on the hemodynami ventricular EKG
mcg/kg/min myocardium, c fibrillation and
(children) resulting in imbalances. tachyarrhythmias -Obtain parameters
increased for hemodynamic
Intravenous heart rate values
and cardiac
contractility. - Titrate to obtain
appropriate BP
Name of Classificatio Dose/Frequ Mechanism of Indication Contraindi Nursing Management
Drug n ency/Route Action cation
Dobutamin Inotropic 1 The ionotropic Indicated for Hypersens - Monitor for adverse
e Agents mcg/kg/min effect increases patients who itivity reactions.
contractility, require
Intravenous increased positive Idiopathic - Continuous blood
stroke volume. inotropic hypertroph pressure monitoring.
The increase in support in the ic
stroke volume treatment of subaortic - Document vital signs
leads to an cardiac stenosis hourly and PRN.
augmentation decompensat (IHSS)
of the cardiac ion due to
output of the depressed
heart. contractility
8.11 Diuretics
Name of Classificati Dose/Frequenc Mechanism of Indication Contraindica Nursing
Drug on y/Route Action tion Management
Furosemide
Furosemid Diuretics Intravenous; 40 Treat Hypersensiti - Assess fluid status
works by blocking
e mg (s̄ renal conditions vity
the absorption of
failure); 250 with volume - Monitor BP and
sodium chloride,
mg(c̅ severe overload Dehydrated pulse before and
and water from
renal failure) and edema patients during
the filtered fluid in
secondary
PO: 20-80 the kidney administration.
to
mg/day; single tubules, causing
congestive
dose; may a profound - Assess for allergy
heart failure
repeat for increase in the to sulfonamides.
exacerbatio
6-8hrs(adults); output of urine
n, liver
2 mg/kg; single (diuresis). - Assess patient for
failure, or
dose (children renal failure, skin rash frequently
>1mo) including during therapy.
nephrotic
syndrome.
8.12 Muscle Relaxants
Name of Drug Classificat Dose/Freq Mechanis Indication Contraindi Nursing
ion uency/Rou m of cation Management
te Action
Suxamenthoni Muscle Intravenous It works by The primary Hypersensiti - Prepare emergency

um Relaxants Push blocking the clinical vity equipment to
action of indication for maintain airway and
1-1.5 mg/kg acetylcholin the use of Contraindic provide mechanical
(adults) e on suxamethoni ated in ventilation if needed.
skeletal um is for a patients - Monitor patient
2mg/kg muscles. rapid onset with known temperature for
(children) and short decreased prompt detection and
duration of plasma treatment of
neuromuscul cholinestera malignant
ar block. se activity hyperthermia.
- Provide comfort
measures to help
patient tolerate drug
effects.
Name of Classification Dose/Frequen Mechanism of Indication Contraindication

Drug cy/Route Action
a nondepolarizing
Vecuronium Muscle Intravenous Is indicated as an Hypersensitivity
agent that achieves
Relaxants Push; adjunct to general
its skeletal muscle
0.1mg/kg anesthesia, to Cardiac diseases
paralysis by
facilitate is
competing with
endotracheal contraindicated
acetylcholine for
intubation and to
cholinergic receptor as these
provide skeletal
sites. Prevents ACh prolongs the
muscle relaxation
from binding, drug effect and
during surgery or
mechanical slower circulation
ventilation. time.
Name of Nursing Management

Drug
Vecuronium - Monitor ECG, heart rate,

and BP throughout
administration.
- Observe for residual

muscle weakness and
respiratory distress during
the recovery period.
- Monitor infusion site

frequently. If signs of tissue
irritation or extravasation
occur, discontinue and
restart in another vein.
8.13 Neuroleptics
Name of Drug Classification Route/ Indication Contraindication Nursing

Dose/Frequency Management
Haloperidol Antipsychotic IM: ADULTS, Treatment of CNS - Assess

ELDERLY: psychosis depression, behavior,
2.5mg repeated (including coma, appearance,
every 5 minutes schizophrenia), Parkinson’s emotional
to a maximum of Tourette’s disease, severe status, response
to 10mg disorder cardiac/hepatic to environment,
Orally: 0.5 - 2 (controls tics disease. speech pattern,
mg, BID and vocal thought content
utterances),
severe -Monitor B/P,
behavioral heart rate.
problems in
children.
Nursing Management
-Supervise suicidal-risk pt
closely during early
therapy
-Monitor for rigidity, tremor,
mask-like facial
expression, fine tongue
movement.
-Assess for therapeutic
response
8.13 Neuroleptics

Chlorpromazine Phenothiazine PO: ADULTS, Management of Comatose - Assess

antipsychotics. ELDERLY: psychotic states, severe behavior,
30–80 mg/day in disorders , CNS appearance,
1–4 divided severe depression. emotional
doses behavioral status, response
CHILDREN disturbances in to environment,
OLDER THAN 6 children. Relief speech pattern,
MOS: 0.5–1 of intractable thought content.
mg/kg q4–6h. hiccups, acute
IV, IM: intermittent - Monitor B/P for
ADULTS, porphyria. hypotension.
ELDERLY: - Observe signs
Initially, 25 mg; for adverse
may repeat in effects
1–4 hrs.
8.14 Anti-asthma Drugs
Aminophylline Bronchodilators. 250-500 mg or Relief of Hypersensitivity -Be alert for new

up to 5 mg/kg bronchospasm to its seizures or
via slow inj or associated with component, increased
infusion over asthma and in peptic ulcer seizure activity,
20-30 minutes. chronic disease, and especially at the
obstructive underlying onset of drug
pulmonary seizure treatment.
disease. disorders -Document the
number,
duration, and
severity of
seizures, and
report these
findings to the
physician
immediately.
Nursing Management
-Avoid I.M. injection, too painful

-Do not inject I.V. solution
faster than 25 mg/minute; oral
and I.V. should be
administered around-the-clock
rather than 4 times/day, 3
times/day
-Do not crush sustained
release drug products
-Do not crush enteric coated
drug product
-Encourage patient to drink
adequate fluids
-Monitor vital signs, I & O,
serum concentrations, and
CNS effects (insomnia,
irritability)
8.14 Anti-asthma Drugs
Salbutamol/Albu Antiasthmatic INHALED: Indicated for the Contraindicated -Assess lung

terol agent ADULTS, symptomatic in patients with sounds, PR and
OLDER relief and hypersensitivity BP before drug
CHILDREN: prevention of (allergy) to any administration
5mg bronchospasm of the active and during peak
INHALED: due to bronchial substances or of medication.
CHILDREN asthma, chronic the excipients. -Assess pulse
LESS THAN 5: bronchitis, for rhythm.
2.5mg reversible -Raise side rails
IV: 5 microgram/ obstructive up
kg (up to a max. airway disease,
Of 250
and other
microgram) over
chronic
1 to 2 mins and
bronchopulmona
repeated once
ry disorders
15mins. Later if
necessary
Nursing Management
-Raise side rails up because

client might be restless and
drowsy because of this drug.
-If patient is also using

corticosteroid inhaler, instruct
him to use the
bronchodilators first then wait
about 5 minutes before using
corticosteroids
-Advise client to have small

frequent feedings to avoid
increasing risk of vomiting
and heartburn.
8.15 Intravenous Fluids
Name of Drug Classification Content Indication Contraindication Nursing
Management
0.9 saline Isotonic 154 mmol/l of - indicated as a -Cautious use in -Document

sodium chloride source of water HTN or baseline data.
and electrolytes. preeclamptic -Observe for
-Used in blood patients, CHF signs of fluid
tranfusions, pts, renal ds, overload.
hyponatremia, cirrhosis -Monitor
and burn victims manifestations
of continued
hypovolemia.
-Elevate the
head of the bed
at 35 to 45
degrees.
-Close
monitoring for
patients with
heart failure.
8.15 Intravenous Fluids
Name of Drug Classification Content Indication Contraindication Nursing
Management
5% dextrose Glucose-Elevati 50g/l of dextrose -Treatment for -Amphotericin B -Do not

ng Agents persons need mannnitol administer
extra calories Diazepam unless solution
who cannot is clean and
tolerate fluid container is
overload undamaged
-treament of -Caution must
shock be exercised in
the
administration of
parenteral fluids
-Solution
containing
dextrose should
be used with
caution
8.16 Tetanus Prophylaxis
Name of Drug Classification Dose/route/frequ Indication Contraindication Nursing
ency Management
Tetanus Toxoid Vaccines, Non-Immune Toxoid is Contraindication -Observe the 12

Inactivated, patient with indicated for s: History of rights in giving
Bacterial tetanus prone booster injection serious allergic the medication.
wound only for persons reaction (i.e., -Monitor vital
-0.5ml/IM and 7 years of age anaphylaxis) to signs.
complete course or older against vaccine -Educate the
(with repeat tetanus (tetanus components or patient to
toxoid injections toxoid) . This encephalopathy increase fluid
at 6 weeks and vaccine is NOT not attributable intake to prevent
6months) plus indicated for to an identifiable dehydration.
Give tetanus primary cause within 7 -Educate patient
immune globulin immunization. days of that pain and
250 units IM administration of tenderness in
a vaccine with the injection site
pertussis may occur
components
Dose/route/frequency
Non-immune patient with clean

wound
-0.5ml/IM and complete course
(with repeat tetanus toxoid
injection at 6weeks and 6months)
Immune patient with tetanuns
prone wound
-if more than 5years since last
tetanus toxoid booster then give
0.5ml IM
Immune patient with clean
wound
-if more than 10years since last
tetanus toxoid booster then give
0.5ml IM
8.17 Drugs used in Cardiac Arrest
ency Management
Adrenaline alpha- and Adults:Injection: indicated to -Contraindicated -Rotate SC

beta-adrenergic 0.5-1mg increase mean in patients with injection sites
agonists arterial blood known and monitor
(sympathomimet pressure in adult hypersensitivity sites frequently
ic agents). patients with to -Use extreme
Children: hypotension symphathomime caution when
Injection: associated with tic amines, calculating and
0.01mg/kg q20 septic shock. angle closure preparing doses
mins glaucoma, and -Protect drug
nonanaphylactic solutions from
shock light, extreme
heat, and
freezing
ency Management
Sodium Alkalinizing 1mmol/kg/IV Used to treat contraindicated -Assess the

bicarbonate Agents. over 1 to 2 metabolic in patients with client’s fluid
minutes acidosis metabolic and balance
associated with respiratory throughout the
cardiac arrest alkalosis and in therapy.
patients with -Symptoms of
hypocalcemia in fluid overload
which alkalosis should be
may produce reported such as
tetan hypertension,
edema, difficulty
breathing,rales
or crackles.
Nursing Management
-Signs of acidosis should be

assessed such as disorientation,
headache, weakness, dyspnea
and hyperventilation.
-Assess for alkalosis by
monitoring the client for
confusion, irritability,
paresthesia, tetany and altered
breathing pattern.
-Hypernatremia clinical
manifestations should be
assessed and monitored which
includes: edema, weight gain,
hypertension, tachycardia, fever,
flushed skin and mental
irritability.
ency Management
Lignocaine local Usual dose: Indicated for Contraindicated -Check BP and

anaesthetics 1mg/kg IV given ventricular in patients with a cardiac monitor
and over 1 min. fibrillation and known history of prior to
antiarrhythmic ventricular hypersensitivity administration of
drugs. tachycardia. to local lidocaine.
anesthetics of -Monitor blood
the amide type pressure and
or to other cardiac monitor
components of during therapy
Xylocaine 2% with lidocaine.
Jelly. -Assess
neurological and
respiratory
status frequently
for signs of
toxicity.
ency Management
Atropine Anticholinergic, Usual dose: Treatment of Contraindicated -Monitor apical

Antispasmodic 40micrograms/k asystole and in patients with pulse prior to
Agents. g severe glaucoma,pylori administration.
bradycardia c stenosis, -Cardiac monitor
thyrotoxicosis, should be used
fever, urinary on patients
tract obstruction receiving
and ileus atropine IV
boluses.
-Doses of 0.5
mg or less may
result in
paradoxical
slowing of heart
rate.
Antidotes
● Are medicines or other remedy for
counteracting the effects of poison,
disease, etc.
Name of Drug Classification Dose/Fre Indication why Adverse Effect NSG management
quency/r drug is ordered
oute
1. acetylcyst Classification PO: Antidote for CNS: drowsiness. When

eine the CV: vasodilation. implementing
Therapeutic:
(a-se-til-s management of EENT: rhinorrhea. airway clearance
is-teen) antidotes (for potentially Resp:bronchospas techniques,
acetaminophen hepatotoxic m, attempt to
toxicity), overdosage of bronchial/tracheal intervene when
mucolytics acetaminophen irritation, chest the drug has
(should be tightness, produced
administered increased maximum
within 24 hr of secretions. mucolytic effects.
ingestion). Peak responses
typically occur
5–10 min after
inhalation
Name of Drug Classific Dose/Frequency/rou Indication why Adverse NSG
ation te drug is ordered Effect management
2. Activated Antidot Adult poisoning Non-specific black vomiting may

Charcoal es poisons except stool occur
1 g/kg, 25-100 g cyanide, iron,
orally. Alternatively lithium, caustics
10 g charcoal/1 g and alcohol.
constipa caution in
drug ratio Minimum
tion patients with
dose = 25 g
decreased
peristalsis
Name of Drug Classificati Dose/Freq Indication why drug is Adverse NSG
on uency/rou ordered Effect management
te
3.Anticholinest Prosthetic Neuromuscular blockade -Nausea -Monitor BP

erase agents (paralytics)
-Vomiting
-Diarrhea
-weight
loss
Name of Drug Classificatio Dose/F Indication why drug is Adverse Effect NSG management
n requenc ordered
y/route
4.atropine Anticholiner Atropine Sulfate dry mouth, Monitor apical

sulfate or gic, Injection is an blurred vision, pulse prior to
pralidoxime Antispasmo antimuscarinic agent sensitivity to administration.
dic used to treat
light,
bradycardia (low heart Cardiac monitor
rate), reduce salivation lack of should be used on
and bronchial secretions sweating, patients receiving
before surgery, as an dizziness, atropine IV boluses.
antidote for overdose of nausea, Doses of 0.5 mg or
cholinergic drugs or loss of balance less may result in
mushroom poisoning. paradoxical slowing
of heart rate.
Name of Drug Classification Dose/Fr Indication why drug is Adverse Effect NSG management
equency ordered
/route
5. Benzylpenicillin Amanita Intramus Benzylpenicillin is indicated Haemolytic In the presence of

phalloides cular, for most wound infections, anaemia and impaired renal
(Death cap intraveno pyogenic infections of the granulocytopenia function, large doses
mushroom) skin, soft tissue infections
us. (neutropenia), of penicillin can cause
and infections of the nose,
throat, nasal sinuses, agranulocytosis, cerebral irritation,
respiratory tract and middle leucopenia and convulsions and coma.
ear, etc. thrombocytopenia,
Skin sensitisation may
have been
occur in persons
reported in
handling the antibiotic
patients receiving
and care should be
prolonged high
taken to avoid contact
doses of
with the substance.
benzylpenicillin
sodium (eg.
Subacute bacterial
endocarditis).
Name of Drug Classification Dose/Frequency/ Indication why drug is Adverse Effect NSG management
route ordered
6. Calcium Antidotes, Intravenous -is a Tingling sensations. Assess for cutaneous

burning sensations and
Gluconate Other; cardioprotective Vasodilation peripheral vasodilation, with
Usual Dosage moderate fall in BP, during
Calcium agent in high blood direct IV injection.
Decreased blood pressure
Adults: 500 mg potassium.
Salts Bradycardia
Monitor ECG during IV
- 2 grams (5-20 administration to detect
evidence of hypercalcemia:
mL) -is the antidote for Cardiac Arrhythmias decreased QT interval
associated with inverted T
magnesium sulfate wave.
Children: Syncope and cardiac
200-500 mg
toxicity. arrest Observe IV site closely.
(2-5 mL) Local necrosis and Lab tests:

abscess formation may
Infants: not occur with IM injection Determine levels of calcium
and phosphorus magnesium
more than 200 frequently, during sustained
therapy.
mg (not more
than 2 mL)
Name of Classificatio Dose/Frequency/route Mechanism of Action Indication why Adverse Effect NSG management
Drug n drug is ordered
7.Deferox Antidotes, Acute Iron Intoxication Works in treating iron Used to treat Bluish Lab tests: Perform
baseline kidney
toxicity by binding trivalent fingernails, lips,
amine Chelating 1g (IM) initially and then
(ferric) iron (for which it has
acute iron or function tests prior to
500mg Q4hr for 2 doses or skin.
agents (maximum of 6g in 24 a strong affinity), forming aluminum drug administration.
hours) ferrioxamine, a stable toxicity (an blurred vision or Monitor injection site.
complex which is excess of
IV - only for cardiac other problems
eliminated via the kidneys.
collapse
100 mg of deferoxamine is
aluminum in with vision. Monitor I&O ratio and
pattern. Report any
capable of binding the body) in change. Observe stools
Chronic Iron Overload convulsions
SC administration: 1-2g approximately 8.5 mg of certain for blood.
trivalent (ferric) iron. (seizures)
(20-40mg/kg/day) SC over patients. Also
8-24 hours using a small Note: Periodic
portable pump capable of used in difficulty with ophthalmoscopic (slit
providing continuous certain breathing or fast lamp) examinations
mini-infusion; individualize patients with breathing. and audiometry are
infusion duration advised for patients on
IV administration: anemia who prolonged or high-dose
hearing
40-50mg/kg/day over must receive therapy for chronic iron
8-12 hours for 5-7 days/ problems.
week (maximum of < many blood overload.
60mg/kg/day and an IV transfusions. redness or

infusion rate of
flushing of the
<15mg/kg/hr)
skin.
IM administration: 0.5-1g
QD (maximum of 1g QD)
Name of Drug Classification Dose/Frequency/ro Mechanism of Indication why Adverse Effect NSG management
ute Action drug is ordered
8.Digibind Antidote IV Dosages vary

according to
DigiFab binds to Indicated fever, swollen glands, Perform skin testing
for allergy prior to
molecules of for itching, joint pain
digoxin amount of digoxin digoxin reducing
treatment
administration of
immune Fab
to be neutralized; free digoxin a light-headed feeling
immune levels, which of
Monitor for
fab Approximate Dose
results in a shift potentially heart therapeutic
of DIGIBIND
in the equilibrium life-threate problems--swelling, effectiveness:
(digoxin immune Reflected in
away from ning rapid weight gain,
fab) for Reversal improvement in
binding to the digoxin feeling; SOB
of a Single Large cardiac rhythm
Digoxin Overdose receptors, intoxication abnormalities,
thereby reducing low potassium mental orientation
. level--leg cramps,
Dose (vial) cardio-toxic and other neurologic
= effects. constipation, irregular symptoms. S&S of
Total digitalis heartbeats, fluttering reversal of digitalis
Fab-digoxin toxicity occurs in
body load / .5mg complexes in your chest, 15–60 min in adults
digitalis bound or arethen cleared increased thirst or and usually within
vial by the kidney and minutes in children.
urination, numbness or
reticuloendotheli tingling, muscle
Lab tests: Baseline
al system. weakness and periodic serum
potassium and
serum digoxin
Name of Classificatio Dose/Frequency/ro Mechanism of Action Indication why Adverse Effect NSG
Drug n ute drug is ordered management
9.Dimerc Chelating Dimercapol Combines with -used with Dimercapol -

Fever, 30% of
Monitor vital signs.
apol, Agent; Acute Lead ions of various
Encephalopathy
calcium children. Monitor I&O
edetate Antidote heavy metals to
calcium, Adult/Child: IM 4 disodium Tightness
sensation, Lab tests: Obtain
mg/kg initially, form relatively edetate in serum creatinine,
disodium chest, limbs,
calcium, and
then 3–4 mg/kg stable, nontoxic, protocols for jaw, abdomen. phosphorus before
q4h with EDTA soluble treatment of
and during each
for 2–7 d High blood course of therapy.
complexes called lead pressure
depending on
chelates, which (hypertension) Increase fluid
response poisoning (dose related) intake
can be excreted;
Edetate Calcium inhibition of Edetate
disodium enzymes by toxic Calcium
Adult/Child: IV Disodium -
1–1.5 g/m2/d
metals is thus hypocalcemia,
infused over prevented. tetany,
convulsions,
8–24 h for up to cardiac
5 d IM 1–1.5 dysrhythmias,
g/m2/d divided respiratory
q8–12 h arrest, and
renal
Name of Drug Classificatio Dose/Frequency/rou Mechanism of Action Indication why drug Adverse Effect NSG
n te is ordered management
10.Diphenh Antihist 25-50 mg PO Augmenting Used in sleepiness Monitor

cardiovascular
ydramine amine; q6-8hr; not to epinephrine anaphylaxis as status
(Benadryl) H1 exceed 300 with an H1 adjunct to dry mouth especially with
receptor antihistamine is epinephrine pre-existing
mg/day weakness
antagoni reasonable and other cardiovascular
disease.
st from a standard
measures after dizziness Supervise
symptom
10-50 mg (no acute ambulation and
control headache use side-rails as
more than 100 symptoms
standpoint, necessary.
mg) IV/IM have been
antihistamines controlled; in Do not drive or
q4-6hr; not to should only be engage in other
treatment of
exceed 400 administered parkinsonism
potentially
hazardous
mg/day for anaphylaxis and activities
after drug-induced Increase fluid
epinephrine has extrapyramidal intake, if not
been given. reaction contraindicated;
Name of Drug Classification Dose/Frequency Mechanism of Indication why Adverse Effect NSG
/route Action drug is ordered management
11.Flumaze Benzodia 0.2 mg IV -an -is useful in pain or irritation Monitor
nil zepine over 15-30 imidazobenzo reversing the respiratory

agitation or
seconds. diazepine sedation and status carefully
Antagonis respiratory
tremors
until risk of
t derivative, is a depression that flushing resedation is
Antidotes if no benzodiazepin often occur (warmth, unlikely (up to
response, e antagonist. when redness, or 120 min). Drug
tingly feeling
repeat dose It benzodiazepines under your
may not fully
of 0.5 mg IV competitively are administered reverse
skin),
to patients benzodiazepine-i
over 30 sec inhibits the
undergoing dizziness, nduced
at 1-min benzodiazepin ventilatory
anesthesia or
intervals to e binding site when patients
sweating or
insufficiency.
shivering,
max on the have taken an Monitor carefully
cumulative GABA/benzodi intentional headache,
for seizures and
dose of 3 azepine benzodiazepine blurred vision, take appropriate
mg/hr receptor overdose. or. precautions.
complex.
ringing in your
ears.
12. Fomepizole Antidote A competitive Treatment for Headache Monitor liver

15 mg/kg inhibitor of the ethylene glycol and kidney
enzyme alcohol overdose. Nausea functions.
10 mg/kg every
dehydrogenase
12 hours for 4 Dizziness Offer topicals
doses (slow IV found in the
to manage
infusion) liver. This Increased rash.
enzyme plays a Drowsiness
key role in the Advise patient
metabolism of Metallic taste to eat pleasant
ethylene glycol and skin rash tasting food to
and methanol. combat metallic
taste
13. Glucagon Hypoglycem 50-150 Glucagon binds - to manage and ● Anxiety Assess patient
mcg/kg (IM) G-coupled blurred for 3Ps.
ia Antidotes;
treat hypoglycemia ●
vision
surface receptors as an antidote to
Diagnostics, ● chills
Monitor cardiac
50 found
beta-blocker and
cold
Gastrointest
●
micrograms/kg throughout the
calcium channel
sweats activity, glucose
inal; IV loading dose, level and urine
blocker overdose.
body in varying ● coma
followed by a confusion output.
Glucose-Ele
●
concentrations;
continuous cool, pale
Evaluate
●
vating infusion of 1-15 binding to the skin
Agents mg/h glucagon ● flushed, respiratory
receptors in the dry skin functions
● fruit-like
liver, GI tract, breath
heart, pancreas, odor
fat, adrenal ● headache
glands, and ● increased
hunger
kidneys activate ● increased
adenylate thirst
cyclase, which in ● increased
turn raises cAMP urination
levels.
Indication
Side Effects /
Classificati Nursing
Name of Drug Dose/Frequen Mechanism of why drug is
Toxic Effects
on Manageme
cy/route Action ordered
nt
15. Glucose Glucose 4-20g/ PO It works by Indicated for Dehydration, Monitor

(Dextrose) elevating quickly use to treat very fever, glucose glucose
agents increasing the low blood sugar in urine levels.
amount of (hypoglycemia),
(glycosuria) and
glucose in your most often in Calibrate
blood. people with excessive flow rate as
diabetes urination. indicated.
mellitus.
Name of Drug Classification Dose/Frequ Mechanism of Specific Side Effects / Nursing
ency/route Action Indication Toxic Effects Management
(why drug is
ordered)
16. Heparin Anticoagulant Intravenous It works by It is indicated Irritation, Check for

(Hepalean) Injection: interfering with for deep venous redness, or signs of
Every 4 to 6 the body's thrombosis, mild pain at bleeding.
hours blood clotting arterial the injection
process, embolism, and site. Advise patient
preventing pulmonary to use soft
blood clots embolism. bristles.
from forming.
Assess for
petechiae.
Name of Drug Classification Dose/Frequ Mechanism Specific Side Effects / Nursing
ency/route of Action Indication Toxic Effects Management
(why drug is
ordered)
17. Water-soluble 1mg/IM It is used as Indicated for Nausea, Monitor blood

Hydroxocoba vitamin an antidote to the treatment headache, skin pressure.
lamin cyanide of pernicious rash or
poisoning. anemia and redness, red Avoid patient
(Cyanokit)
Hydroxocobal the coloring of exposure to
amin works prevention your urine direct
by helping and treatment (may last 2 to sunlight.
cells in the of vitamin
5 weeks) or
body convert B12 Monitor renal
pain, swelling,
cyanide to a deficiency. It function for
or irritation of
form that can is also ≥7 days
be removed indicated for your skin following
from the body the treatment where the therapy.
through of known or injection was
urination. suspected given.
cyanide
poisoning.
Name of Classificatio Dose/Freque Mechanism Indication Side Effects / Nursing
Drug n ncy/route of Action (why drug is Toxic Effects management
ordered)
18. Antidote 5 to 15 mg/ Protects the This Skin rash, ● Monitor

Leucovorin OID/ PO healthy cells medication is hives, itching patients
calcium from the used to treat or wheezing. closely for
(Neovorin) effects of or prevent anaphylactoi
methotrexate serious blood d symptoms
while allowing cell disorders. such as rash
methotrexate ● Monitor
to enter and
client's
kill cancer cell
airway.
s.
Assess the
client for the
sensation of
a narrowed
airway.
Name of Classificatio Dose/Freque Mechanism Indication Side Effects / Nursing
Drug n ncy/route of Action (why drug is Toxic Effects Management
ordered)
19. Magnesium Antidysrhythmic 25-50 mg/kg This medication Used for Heart ● Educate the
sulfate (Epsom s intravenously is a mineral immediate disturbances, patient on
Salt) (IV) over 10-20 supplement control of breathing potential side
effects;
minutes used to prevent life-threatening difficulties, poor
monitor
and treat low convulsions in reflexes, patient
amounts of the treatment of weakness, movement;
magnesium in severe toxemias headache, and and assist
the blood. (pre-eclampsia drowsiness. the patient in
and eclampsia) getting out of
of pregnancy bed.
● Notify the
and in the
physician if
treatment of the baseline
acute nephritis assessment
in children. is not normal
or changes
significantly.
20. Mesna (MESNEX)
Classificat Dose/Fre Mechanism Indication Contraindica Side Effects / Nursing
ion quency/R of Action tion Toxic Effects Management/R
oute esponsibilities
Cytoprotectiv MESNEX Mesna is an Mesna is Use of Mesna is Fatigue, headache, Educate client
e agent (mesna) organosulfur indicated as a contraindicated limb pain, nausea about medications.
injection: 1 compound. It prophylactic if some have and diarrhea.
g Multidose Prepare and
works by altering agent in hypersensitivity
Vial, 100 administer
mg/mL the breakdown reducing the to the drug or medications, using
products of incidence of thiolate rights of
MESNEX cyclophosphami ifosfamide-indu compounds. medication
(mesna) de and ced administration
tablets: 400 ifosfamide found hemorrhagic
mg in the urine cystitis. Review pertinent
data prior to
making them
medication
less toxic. administration
(e.g.,
contraindications,
lab results,
allergies, potential
interactions)
21. Methylene Blue (Methylene blue injection)
Classificatio Dose/Frequ Mechanism of Indication Contraindicatio Side Effects / Nursing
n ency/Route Action n Toxic Effects Management/
Antidote Intravenously Main Indicated as an Methylene blue Dizziness, Review pertinent

very slowly mechanism of oxidation-reduc is headache, data prior to
over a period tion agent used contraindicated medication
of several
action involves increased sweating,
for the in patients who administration
minutes. inhibition of nausea,vomiting,
treatment of have developed (e.g.,
nitric oxide pediatric and hypersensitivity abdominal pain, contraindications,
synthase and adult patients reactions to it diarrhea, upset lab results,
guanylate with acquired and in severe stomach, frequent allergies, potential
cyclase. methemoglobin renal urination, or interactions)
emia. insufficiency. It stomach cramps.
can also cause
fetal harm when
administered to
a pregnant
woman
22. Nalmefene (Revex, Selincro)
Classificatio Dose/Freq Mechanism of Indication Contraindicatio Side Effects / Nursing
n uency/Rout Action n Toxic Effects Management
e
Opioid A blue Nalmefene is Indicated for Nalmefene Nausea, vomiting, Monitor

antagonist labeled used to treat a the complete or Hydrochloride tachycardia, cardiovascular
ampul narcotic partial reversal injection is hypertension, fever, status closely,
containing assessing for
dizziness and
overdose or of opioid drug contraindicated
ONE (1) mL other situation effects, in patients with changes in blood
and a in which opioid including a known headache. pressure and heart
concentratio side effects may respiratory hypersensitivity rate and
n suitable for be harmful. depression, to the product. development of
the induced by arrhythmias.
managemen either natural or
t of overdose synthetic
(1 mg/mL, opioids.
10 times as Nalmefene
concentrated Hydrochloride
, 20 times as Injection is
much drug) indicated in the
in a green management of
labeled known or
ampul suspected
opioid
overdose.
23. NALOXONE (Narcan, Evzio)
Classification Dose/Frequ Mechanism of Indication Contraindication Adverse Side Effects Nursing
ency/Route Action Management/Resp
onsibilities
Naloxone injectable Naloxone reverses NARCAN (naloxone) There are no pain, burning, or Observe patient closely;
duration of action of some
injection is in a solution the effects of opioid is indicated for the absolute redness at the
narcotics may exceed that of
class of 0.4mg/mL analgesics by complete or partial contraindications to injection site naloxone. Keep physician
medications 1mg/mL IM/SC binding to the opioid reversal of opioid the use of naloxone sweating hot informed; repeat naloxone
called opiate auto-injector receptors in the CNS, depression, in an emergency. The flashes or dose may be necessary. May
precipitate opiate withdrawal
antagonists. It 0.4mg/0.4mL and inhibiting the including only relative flushing rapid,
if administered to a patient
works by (2 typical actions of respiratory contraindication is pounding, or who is opiate dependent.
blocking the auto-injectors/ opioid analgesics, depression, induced known irregular Note: Narcotic abstinence
effects of package) including analgesia, by natural and hypersensitivity to heartbeat seeing symptoms induced by
naloxone generally start to
opiates to euphoria, sedation, synthetic opioids, naloxone. Although things or hearing
diminish 20–40 min after
relieve respiratory including naloxone is effective voices that do administration and usually
dangerous depression, miosis, propoxyphene, in reversing opioid not exist disappear within 90 min.
symptoms bradycardia, and methadone and overdose in a (hallucinations) Monitor respirations and
other vital signs. Monitor
caused by high physical dependence certain mixed hospital setting, its loss of
surgical and obstetric patients
levels of opiates agonist-antagonist use out of the consciousness closely for bleeding. Naloxone
in the blood analgesics: hospital is relatively seizures signs of has been associated with
nalbuphine, new. opiate abnormal coagulation test
results. Also observe for
pentazocine, withdrawal such
reversal of analgesia, which
butorphanol, and as body aches, may be manifested by nausea,
cyclazocine. diarrhea, fast vomiting, sweating,
heart beat, tachycardia.
fever, runny
nose, sneezing
24. Neostigmine (Prostigmin)
onsibilities
Neostigmine is a Adult: IM 0.022 Produces reversible Neostigmine is Absolute ● excessive saliva ● Check pulse before
mg/kg, may giving drug to
parasympathom cholinesterase used for the contraindications of production.
increase to 0.031 bradycardic
imetic, mg/kg if first test is inhibition or symptomatic neostigmine include ● excessive
patients. If below
specifically, a inconclusive Child: inactivation. Has treatment of a hypersensitivity to sweating.
60/min or other
reversible IM 0.025–0.04 direct stimulant myasthenia gravis neostigmine, and ● nausea.
mg/kg Treatment established
cholinesterase action on voluntary by improving peritonitis or ● vomiting. parameter, consult
of Myasthenia
inhibitor. The Gravis Adult: PO muscle fibers and muscle tone. mechanical ● diarrhea. physician. Atropine
drug inhibits 15–375 mg/d in possibly on obstruction of the ● stomach will be ordered to
acetylcholineste 3–6 divided doses autonomic ganglia intestinal or urinary cramps. restore heart rate.
IM/IV/SC 0.5–2.5
rase which is and CNS neurons. tract. ● Monitor pulse,
mg q1–3h Child: PO
responsible for 7.5–15 mg t.i.d. or respiration, and BP
the degredation q.i.d. or 0.333 during period of
of acetylcholine. mg/kg or 10 dosage adjustment
mg/m2 6 times/d in treatment of
IM/IV/SC myasthenia gravis.
AUTONOMIC 0.01–0.04 mg/kg
NERVOUS
● Report promptly
q2–4h Neonate: PO
SYSTEM AGENT; 1–4 mg q2–3h IM
and record
0.03 mg/kg q2–4h
CHOLINERGIC
accurately the
onset of
(PARASYMPATH myasthenic
OMIMETIC) symptoms and
AGENT; drug adverse
CHOLINESTERA effects in relation
SE INHIBITOR to last dose in
order to assist
25.Nitroglycerin ( Gonitro, Minitran, Mylan-nitro, Nitro-bid, Nitro-dur, Nitroject, Nitrolingual, Nitromist, Nitrostat, Rectiv, Trinipatch)

onsibilities
Nitroglycerin is tablet, SL Nitroglycerin is converted Nitroglycerin is Do not use severe or Administer IV nitroglycerin
by mitochondrial aldehyde indicated for various with extreme caution to
in a class of 0.3mg 0.4mg NITROSTAT in throbbing
dehydrogenase (mtALDH) purposes. It is patients with hypotension or
medications 0.6mg powder, to nitric oxide (NO), an patients who are headaches, hypovolemia since the IV drug
indicated to prevent
called SL (GoNitro) active substance which taking PDE-5 pounding may precipitate a severe
and treat angina or
vasodilators. It 0.4mg then activates the enzyme Inhibitors, such as heartbeats, hypotensive state. Monitor
guanylate cyclase.2 The chest pain due to patient closely for change in
works by cardiovascular avanafil, sildenafil, fluttering in your
activation of this enzyme levels of consciousness and
relaxing the is followed by the disease, as well as to tadalafil, vardenafil chest, slow for dysrhythmias. IV
blood vessels so synthesis of cyclic treat peri-operative hydrochloride. heart rate, nitroglycerin solution contains
the heart does guanosine hypertension or Concomitant use can lightheadedness a substantial amount of
3',5'-monophosphate ethanol as diluent. Ethanol
not need to induce intra-operative cause severe , blurred vision,
(cGMP), activating a intoxication can develop with
work as hard hypotension. It is also hypotension, dry mouth, chest
cascade of protein high doses of IV nitroglycerin
and therefore kinase-dependent indicated to treat syncope, or pain or pressure, (vomiting, lethargy, coma,
acute heart failure in
does not need phosphorylation events in myocardial ischemia. pain spreading breath smells of alcohol). If
smooth muscles. This patients with intoxication occurs, infusion
as much oxygen. Do not use to your jaw or
process eventually leads myocardial infarction. should be stopped promptly;
to the dephosphorylation In the ointment form, NITROSTAT in shoulder, patient recovers immediately
of the myosin light chain nitroglycerin is patients who are nausea, and with discontinuation of drug
of smooth muscles, indicated to treat pain taking the soluble sweating administration. Be aware that
causing relaxation and moisture on sublingual tissue
caused by anal guanylate cyclase
increased blood flow in is required for dissolution of
veins, arteries and cardiac fissures. The stimulators, such as sublingual tablet. However,
tissue. transdermal form is riociguat. because chest pain typically
applied directly to the Concomitant use can leads to dry mouth, a patient
skin to prevent acute may be unresponsive to
cause hypotension.
anginal attacks. sublingual nitroglycerin.
Assess for headaches.
26. PENICILLAMINE (Cuprimine, Depen)
onsibilities
Penicillamine is Wilson's Disease Thiol compound Penicillamine is a Hypersensitivity to Fever, arthralgia, Lab tests: Check WBC with
Adult: PO 250 mg lymphadenopathy, thyroiditis,
in a class of q.i.d., with 3 doses 1 h
prepared by hydrolysis chelating agent penicillamine or to differential, direct platelet
of penicillin but lacking SLE-like syndrome, counts, Hgb, and urinalysis
medications a.c. and the last dose used in the any penicillin; history thrombophlebitis, hyperpyrexia,
at least 2 h after the antibacterial activity. prior to initiation of
called heavy last meal Child: PO 20 treatment of of myasthenia gravis syndrome,
Also combines therapy and every 3 d
metal mg/kg/d in 2–4 Wilson's disease. It penicillamine-related tingling of feet, weakness. GI:
divided doses (max: 1 chemically with cystine Anorexia, nausea, vomiting, during the first month of
antagonists. It to form a soluble is also used to aplastic anemia or therapy, then every 2 wk
g/d) Cystinuria Adult: epigastric pain, diarrhea, oral
works to treat PO 250–500 mg q.i.d., disulfide complex that reduce cystine agranulocytosis; lesions, reduction or loss of thereafter. Perform liver
Wilson's disease with doses adjusted to
prevents stone excretion in patients with taste perception (particularly function tests and eye
limit urinary excretion
by binding to the of cystine to 100–200 formation and may cystinuria and to rheumatoid arthritis salt and sweet), metallic taste, examinations before start
activation of peptic ulcer,
extra copper in mg/d Child: PO 30 even dissolve existing treat patients with who have renal of therapy and at least
mg/kg/d in 4 divided pancreatitis. Urogenital:
the body and cystic stones. severe, active insufficiency or who twice yearly thereafter.
doses with doses Membranous glomerulopathy,
causing it to adjusted to limit Mechanism of action in rheumatoid arthritis are pregnant; proteinuria, hematuria. Withhold drug and contact
urinary excretion of rheumatoid arthritis physician if the patient
leave the body unresponsive to pregnancy (category Hematologic:
cystine to 100–200 not known but appears Thrombocytopenia, leukopenia, with rheumatoid arthritis
through the mg/d Rheumatoid conventional D), lactation;
to be related to agranulocytosis, thrombotic develops proteinuria .
urine. Arthritis Adult: PO
inhibition of collagen therapy. concomitant thrombocytopenic purpura,
125–250 mg/d; may
increase at 1–3 mo formation. administration with hemolytic anemia, aplastic
intervals up to 1–1.5 Cross-sensitivity drugs that can cause anemia. Metabolic: Pyridoxine
g/d Child: PO 3 deficiency. Skin: Generalized
mg/kg/d (250 mg/d) between penicillin and severe hematologic
pruritus, urticaria, mammary
times 3 mo, then 6 penicillamine can or renal reactions hyperplasia, alveolitis, skin
mg/kg/d (500 mg/d) occur. (e.g., antimalarials, friability, excessive skin
gold salts, wrinkling, early and late
occurring rashes,
immunosuppressant
pemphigus-like rash, alopecia.
s, oxyphenbutazone, Special Senses: Tinnitus, optic
phenylbutazone). neuritis, ptosis.
26. PENICILLAMINE (Cuprimine, Depen)
onsibilities
times 3 mo, then 6
mg/kg/d (500 mg/d)
in 2 divided doses
times 3 mo [max: of
10 mg/kg/d (1.5 g/d)
in 3–4 divided doses]
Lead Poisoning Child:
PO 30–40 mg/kg/d in
3–4 divided doses
(max: 1.5 g/d); initiate
at 25% target dose,
grad ually increase to
full dose over 2–3
wkWilson's Disease
Adult: PO 250 mg
q.i.d., with 3 doses 1 h
a.c. and the last dose
at least 2 h after the
last meal Child: PO 20
mg/kg/d in 2–4
divided doses (max: 1
g/d) Cystinuria Adult:
PO 250–500 mg q.i.d.,
with doses adjusted to
limit urinary excretion
of cystine to 100–200
mg/d
27. Phentolamine (Regitine)
onsibilities
alpha-Adrenergic 5 mg of Regitine produces an Regitine is indicated Contradicted for use ● Acute and 1. Assess blood pressure
Blocker Regitine (1 mg alpha-adrenergic for the prevention or in patients with: prolonged (BP) periodically and
for children), block of relatively treatment of dermal Myocardial hypotensive compare to normal
IV/ IM short duration. It also necrosis and infarction, history of episodes values. Report low BP
Before surgery: has direct, but less sloughing following myocardial infarction, ● Tachycardia (hypotension), especially
1-2 hrs marked, positive intravenous coronary ● Cardiac if patient experiences
inotropic and administration or insufficiency, angina, arrhythmias dizziness, fatigue, or
chronotropic effects extravasation of or other evidence ● Weakness other symptoms.
on cardiac muscle norepinephrine. It is suggestive of ● Dizziness
and vasodilator also for the coronary artery ● Flushing 2.Report any rhythm
effects on vascular diagnosis of disease; ● Orthostatic disturbances or
smooth muscle pheochromocytoma hypersensitivity to hypotension symptoms of increased
by the Regitine phentolamine or ● Nasal stuffiness arrhythmias.
blocking test. related compounds. ● Nausea
● Vomiting 3.To minimize
● Diarrhea orthostatic hypotension,
patient should move
slowly when assuming a
more upright position.
Phentolamine (Regitine) Cont.
Classification Dose/Freque Mechanism of Indication Contraindicatio Adverse Side Nursing
ncy/Route Action n Effects Management/Responsib
ilities
4.Instruct patient or
family/caregivers to report other
bothersome side effects such as
severe or prolonged nasal
stuffiness, skin reactions
(flushing), or GI problems.
5.Because of the risk of MI,

cerebrovascular spasm, and
abnormal BP responses, use
extreme caution during aerobic
exercise and other forms of
therapeutic exercise.
Reference: https://go.drugbank.com/drugs/DB00692
https://www.drugs.com/pro/regitine.html
https://fadavispt.mhmedical.com/content.aspx?bookid=1873&sectionid=139022310
28. Physostigmine or NaHCO3
Classification Dose/Freque Mechanism of Indication Contraindication Adverse Side Effects Nursing
ncy/Route Action Management/Res
ponsibilities
parasympathomi Adult A reversible For the treatment Contradicted for use in Common: 1.Monitor heart rate,
metic (Post-anestesia anticholinesterase of glaucoma, and patients with: ● Nausea respiratory rate
Care): which effectively in the treatment of ● Pulmonary ● Vomiting
0.5 to 1 mg, IM increases the severe disease-causing ● Increased salivation 2.Too rapid
or slow IV, at no concentration of anticholinergic bronchoconstric ● Slow heartbeat administration (I.V. rate
more than 1 acetylcholine at toxicity. tion of the Severe: not to exceed 1
mg/minute the sites of airways such as ● Increased urination mg/minute) can cause
-May repeat dose cholinergic asthma or bowel bradycardia,
at 10 to 30 transmission ● Gangrene movements hypersalivation leading
minute intervals ● Diabetes. ● Stomach cramps to respiratory
if desired ● Severe or worsening difficulties and seizures
response is not nausea or vomiting
obtained ● Increased sweating 3.Inform patient to
● Blurred vision report to any of the
● Excessive saliva in health care team if they
the mouth. experience persistent
abdominal discomfort
or any of the adverse
side effect of the drug.
Physostigmine or NaHCO3 Cont.
ilities
4. Make sure the patient

maintain adequate hydration
(2-3 L/day of fluids unless
instructed to restrict fluid
intake).
5. Inform patient to any of the

health care team if they have
signs of an allergic reaction after
receiving the medication: hives;
difficult breathing; swelling of
your face, lips, tongue, or throat.
https://www.drugs.com/mtm/physostigmine.html#side-effects
https://www.syrianclinic.com/med/en/ProfDrugs/Print/Physostigminepd.html
29. Phytomenadione (Vitamin K.)
Classification Dose/Freque Mechanism of Indication Contraindication Adverse Side Nursing
ncy/Route Action Effects Management/Res
ponsibilities
Anticoagulant Infants and Bypasses Prevention and treatment Contradicted for use ● Temporary 1.Monitor patient
reversal agents, Children: inhibition of of hypoprothrombinemia in patients with: flushing constantly. Severe
Vitamins Oral: 2.5-5 Vitamin K caused by drug-induced ● Hypersensitiv ● Taste changes reactions, including
epoxide reductase or anticoagulant-induced ity to ● Dizziness
mg/24 hours fatalities, have
enzyme vitamin K deficiency, phytonadione ● Rapid
hemorrhagic disease of or any heartbeat occurred during and
I.M., I.V.: 1-2 immediately after IV
the newborn; component ● Sweating
mg/dose as a injection.
phytonadione is more ● Shortness of
single dose effective and is preferred breath
to other vitamin K ● Bluish 2.Frequency, dose, and
Adults: preparations in the lips/skin/nails therapy duration are
Oral: 5-25 mg/24 presence of impending guided by PT/INR
hours hemorrhage; oral
clinical response.
absorption depends on
I.M., I.V.: 10 mg the presence of bile salts
3.Monitor therapeutic
effectiveness which is
indicated by shortened
PT, INR, bleeding, and
clotting times, as well
as decreased
hemorrhagic
tendencies.
Phytomenadione (Vitamin K.) Cont.
ilities
4. Be aware that patients on

large doses may develop
temporary resistance to
coumarin-type anticoagulants. If
oral anticoagulant is reinstituted,
larger than former doses may be
needed. Some patients may
require change to heparin.
5.Maintain consistency in diet

and avoid significant increases
in daily intake of vitamin K–rich
foods when drug regimen is
stabilized.
Reference: https://www.drugs.com/pro/vitamin-k1.html#s-34067-9
https://www.syrianclinic.com/med/en/ProfDrugs/Phytonadionepd.html
http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/P045.html
30. Protamine Sulfate
Classification Dose/Freque Mechanism of Indication Contraindication Adverse Side Effects Nursing
ncy/Route Action Management/Res
ponsibilities
Antiheparin Adult/Child: Protamine that is Treatment of Contradicted for use in ● CV: Abrupt drop in 1.Do not use protamine
Agents/ Antidotes IV 1 mg for every strongly basic heparin patients with: BP (with rapid IV on patient if only
100 units of combines with overdose; ● Hypersensitivity infusion), minor bleeding occurs
heparin to be acidic heparin neutralize to protamine or bradycardia. during heparin therapy
neutralized forming a stable heparin during any component ● Body as a because withdrawal of
(max: 100 mg in a complex and surgery or ● Hemorrhage not Whole:Urticaria, heparin will usually
2 h period), give neutralizes the dialysis induced by angioedema, correct minor bleeding
the first 25–50 mg anticoagulant procedures heparin overdose pulmonary edema, within a few hours.
by slow direct IV activity of both ● pregnancy anaphylaxis, dyspnea,
and the rest over drugs (category C). lassitude; transient 2. Monitor BP and
2–3 h flushing and feeling pulse q15–30min, or
of warmth. more often if indicated.
● GI: Nausea, Continue for at least
vomiting. 2–3 h after each dose,
● Hematologic: or longer as dictated by
Protamine overdose patient's condition.
or "heparin rebound"
(hyperheparinemia). 3. Be prepared to treat
patient for shock as
well as hemorrhage.
Protamine Sulfate Cont.
ilities
4. Observe patients undergoing

extracorporeal dialysis or
patients who have had cardiac
surgery carefully for bleeding
(heparin rebound).
5. Monitor effect of protamine

in neutralizing heparin by aPTT
or ACT values.
https://www.drugs.com/monograph/protamine.html
https://www.syrianclinic.com/med/en/ProfDrugs/Print/ProtamineSulfatepd.html
http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/P092.html
31. Pyridoxine
ncy/Route Action Effects Management/Responsi
bilities
Vitamin B 6, and Adult: Reverses acute Adjunctive Contradicted for use in ● Body as a 1.Monitor neurologic status to
Analogs/Derivative PO/IM/IV pyridoxine therapy in patients with: Whole: determine therapeutic effect in
s. 2.5–10 mg/d deficiency by ethylene glycol ● hypervitamino Paresthesias, deficiency states.
times 3 wk, then promoting GABA poisoning and sis B6 (as toxic slight flushing
may reduce to synthesis. is also a levels may or feeling of
2.Record a complete dietary
2.5–5 mg/d Promotes the vitamin used to cause sensory warmth,
conversion of correct vitamin neuropathy). temporary history so poor eating habits
Child: toxic metabolite B6 deficiency ● hypersensitivit burning or can be identified and corrected
PO 5–25 mg/d glycolic acid to and to treat y to stinging pain in (a single vitamin deficiency is
times 3 wk, then glycine nausea during pyridoxine. injection site. rare; patient can be expected
1.5–2.5 mg/d pregnancy. ● CNS: to have multiple vitamin
Somnolence deficiencies).
seizures
(particularly
3.Lab tests: Periodic Hct and
following large
parenteral Hgb, and serum iron.
doses).
● Metabolic:
Low folic acid
levels.
Pyridoxine Cont.
ilities
4. Educate patient what rich

dietary sources of vitamin B6 are
such as: Yeast, wheat germ,
whole grain cereals, muscle and
glandular meats (especially
liver), legumes, green
vegetables, bananas.
5. Inform the patient to not

breastfeed while taking this drug
without consulting a physician.
Reference: http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/P100.html
https://go.drugbank.com/drugs/DB00165
32. Snake Anti-Venin
ponsibilities
Antivenom Minimal Act by Treatment of For persons Flushing, 1. Prior to

envenom binding to envenomatio with pit viper rash, administration
ation: and n caused by envenomatio itching, , take history
20-40 mL neutralizing ns of prior
bites of wheezing,
Moderate venoms threatening injections of
crotalids (pit rapid heart serum,
envenom vipers) life or limb, rate, personal or
ation: there are no
dyspnea, familial history
50-90 mL contraindicati
edema of of allergy, i.e.
Severe ons to asthma,
the face,
envenom administratio eczema or
ation: n of tongue and
drug allergy.
100-150 anti-venin. throat,
2. Closely
mL or However, cough, monitor the
more, administratio cyanosis patient for
Infused IV n to persons anaphylactic
known to be reactions,
allergic to serum
horse serum, sickness, or
requires delayed
careful hypersensitivit
judgement y.
3. Do not leave
and
the patient
considerable
unattended.
experience in 4. Monitor for
the use of systemic
antivenoms, complications.
as well as 5. Continuous
experience in patient
the assessment is
management a priority.
of severe,
immediate
allergic
reactions
33. Sodium Bicarbonate
ponsibilities
Alkalinizer, Metabolic Restores Treatment of Hypocalcemia; Headache, 1. When

acidosis: metabolic Metabolic or weakness, giving I.V.,
antacid body’s acidosis;
2-5 respiratory blurred vision, closely
mEq/kg IV
buffering treatment of alkalosis; behavioral
certain drug monitor
Alkalinizat capacity; intoxications,
Hypernatremia; changes,
arterial blood
ion of neutralizes Hypokalemia; incoordination,
including gas results
Severe muscle
urine: For excess acid barbiturates, in
pulmonary twitching, and
adults, 48 poisoning by
salicylates or edema; elevated BP, electrolyte
mEq (4 g) Seizures; bradycardia,
initially,
methyl alcohol levels.
and in hemolytic Vomiting tachypnea, 2. Stay alert
followed reactions resulting in wheezing,
by 12-24 requiring chloride loss; coughing.
for signs and
mEq (1-2 alkalinization of Diuretic use Excessive/chr symptoms of
g) every 4 the urine; also in resulting in onic use may metabolic
hours, P.O. chlorine gas hypochloremic produce alkalosis and
inhalation alkalosis metabolic electrolyte
poisoning. alkalosis.
For imbalances.
children, 3. Monitor
1-10 mEq fluid intake
(84-840 and output.
mg) per 4. Avoid rapid
kg daily, infusion,
PO which may
cause severe
alkalosis.
5. Advise
patient not to
take sodium
bicarbonate
with large
amounts of
dairy
products.
34. Sodium Thiosulphate
ponsibilities
Cyanide Adults and Serve as a Treatment Hypersensiti Hypersensiti 1. Monitor

antidote teenagers: sulfur of cyanide vity to vity patient for
12.5 g IV donor, sodium reactions, anaphylactoi
Children:
poisoning
thereby thiosulphate, severe d reactions.
412.5 mg hypotension,
per kg of increasing edema, heart 2.
the rate of disease, nausea and Continuous
body
vomiting,
weight or rhodanese hypertension assessment
disorientatio
7 g per catalyzed , kidney of vital signs,
square n, headache,
biotransfor disease, liver especially
meter of hallucination
mation of disease or s, muscle blood
body
cyanide to toxemia of cramps, pain pressure.
surface
area, IV
thiocyanate pregnancy in the joints,
ringing in
the ears
35. Thiamine (Vitamin B1)
ponsibilities
Vitamin 100 mg Combines Treatment Hypersensi Anaphylac 1. Monitor

IV, with ATP to and patient for
produce
tivity to toid
1 tablet prevention of thiamine reactions, anaphylactoi
thiamine
daily Wernicke-Ko d reactions.
diphosphate, weakness,
rsakoff 2. Instruct
which acts as
syndrome in
restlessne patient to
a coenzyme
in alcoholic or ss, eat
carbohydrate malnourishe angioede thiamine-ric
metabolism; d patients, ma, h foods (e.g.,
catalyzes and pulmonary yeast, pork,
metabolism
treatment of edema, beef, liver,
of glyoxylate
from glycolic
ethylene tightness wheat and
acid. glycol of throat other whole
poisoning
grains,
nutrient-add
ed breakfast
cereals, fresh
vegetables,
especially
peas and
dried beans)
3. Reassess
nutritional
status
throughout
therapy.
36. Vitamin C (Ascorbic Acid)
ponsibilities
Vitamin 1 to 10 g Acts as an Treatment Blood Nausea, 1. Monitor

every 6 antioxidan of disorders vomiting, patient for
hours, IV t and as a
methemog like heartburn signs and
coenzyme lobinemia thalassemi , symptoms
reduction.
in patients a, G6PD stomach of
with G6PD deficiency, cramps, hemolytic
deficiency and and anemia.
hemochro headache
matosis
Thank
you!

Emergency Drugs and Antidote

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Emergency Drugs and Antidote

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Liceo de Cagayan University

● for a drug to be useful in emergency, it must have a short

Ketamine General 1 mg/kg to Ketamine's known Indicated as the Contraindicated in -Implement

Atropine Anticholinergic IV: 0.6mg Atropine competitively Atropine is a Contraindicate -Instruct pt to

Fentanyl Anticholiner IV- 1-2 Fentanyl binds to opioid Manage Hypersensiti

Metoclopram Anti-emeti IV: 10 mg Metoclopramide causes Metoclopr Metoclopra -Instruct pt to

Prochlorperazi Anti-emetic PO: 5 mg, Prochlorperazine Indicated History of allergy to -Advise pt to

Hydrocortiso Corticosteroi IV: 3 Hydrocortisone Indicated to Hypersensi -Tell patient

Dexamethaso Corticoster IM/IV: 0.1 Glucocorticoids It relieves Contraindica -Tell patient

Prednisolo Corticosteroi PO: 1 Prednisone Used to treat Prednisone is -Tell patient

Name of Classificatio Dose/Freque Mechanism of Indication Contraindication Nursing

Name of Classification Dose/Freque Mechanism of Indication Contraindicati Nursing

Name Classifica Dose/Frequency/Ro Mechanism Indication Contraindicati Nursing

Name of Classification Dose/Frequenc Mechanism Indication Contraindication Nursing

Name of Classification Dose/Frequ Mechanism Indication Contraindi Nursing Management

Nifedipine Anti - 10 mg; Blocks Primarily Hypersensit - Monitor BP and pulse

Name of Classificati Dose/Freq Mechanism of Indication Contraindicati Nursing

Labetalol Anti - 100 mg It works by To treat Hypersensitivity - Monitor BP for

Name of Classificati Dose/Frequ Mechanism Indication Contraindication Nursing

Dopamin Inotropic 2-5mcg/kg/ produces Indicated for Hypersensitivity -Monitor

Suxamenthoni Muscle Intravenous It works by The primary Hypersensiti - Prepare emergency

Name of Classification Dose/Frequen Mechanism of Indication Contraindication

Name of Nursing Management

Vecuronium - Monitor ECG, heart rate,

- Observe for residual

- Monitor infusion site

Name of Drug Classification Route/ Indication Contraindication Nursing

Haloperidol Antipsychotic IM: ADULTS, Treatment of CNS - Assess

Name of Drug Classification Route/ Indication Contraindication Nursing

Chlorpromazine Phenothiazine PO: ADULTS, Management of Comatose - Assess

Aminophylline Bronchodilators. 250-500 mg or Relief of Hypersensitivity -Be alert for new

-Avoid I.M. injection, too painful

Salbutamol/Albu Antiasthmatic INHALED: Indicated for the Contraindicated -Assess lung

-Raise side rails up because

-If patient is also using

-Advise client to have small

0.9 saline Isotonic 154 mmol/l of - indicated as a -Cautious use in -Document

5% dextrose Glucose-Elevati 50g/l of dextrose -Treatment for -Amphotericin B -Do not

Tetanus Toxoid Vaccines, Non-Immune Toxoid is Contraindication -Observe the 12

Non-immune patient with clean

Adrenaline alpha- and Adults:Injection: indicated to -Contraindicated -Rotate SC

Sodium Alkalinizing 1mmol/kg/IV Used to treat contraindicated -Assess the

-Signs of acidosis should be

Lignocaine local Usual dose: Indicated for Contraindicated -Check BP and

Atropine Anticholinergic, Usual dose: Treatment of Contraindicated -Monitor apical

1. acetylcyst Classification PO: Antidote for CNS: drowsiness. When

2. Activated Antidot Adult poisoning Non-specific black vomiting may

3.Anticholinest Prosthetic Neuromuscular blockade -Nausea -Monitor BP

4.atropine Anticholiner Atropine Sulfate dry mouth, Monitor apical

5. Benzylpenicillin Amanita Intramus Benzylpenicillin is indicated Haemolytic In the presence of

6. Calcium Antidotes, Intravenous -is a Tingling sensations. Assess for cutaneous

(2-5 mL) Local necrosis and Lab tests:

60mg/kg/day and an IV transfusions. redness or

8.Digibind Antidote IV Dosages vary

9.Dimerc Chelating Dimercapol Combines with -used with Dimercapol -

10.Diphenh Antihist 25-50 mg PO Augmenting Used in sleepiness Monitor

11.Flumaze Benzodia 0.2 mg IV -an -is useful in pain or irritation Monitor

nil zepine over 15-30 imidazobenzo reversing the respiratory

12. Fomepizole Antidote A competitive Treatment for Headache Monitor liver

15. Glucose Glucose 4-20g/ PO It works by Indicated for Dehydration, Monitor

16. Heparin Anticoagulant Intravenous It works by It is indicated Irritation, Check for

17. Water-soluble 1mg/IM It is used as Indicated for Nausea, Monitor blood

18. Antidote 5 to 15 mg/ Protects the This Skin rash, ● Monitor