ATROPINE (Atro-Pen)

DOSAGE: 0.5-1 mg IV q5min, not to exceed 2-3mg CLASSIFICATION: Antiarrhythmic, Anticholinergic MOA: inhibits acetylcholine at postganglionic sites in smooth muscle, secretory glands, and CNS to produce increased heart rate INDICATIONS: Sinus bradycardia, heart block CONTRAINDICATIONS: hypersensitivity, closed angle glaucoma, tachycardia, acute hemorrhage, obstruction in GI tract ADVERSE EFFECTS: drowsiness, confusion, blurry vision, tachycardia, palpitations, arrhythmia, dry mouth, urinary hesitancy/retention, increased IOP, constipation, tachypnea, pulmonary edema NURSING: Assess vitals and ECG during use. Report changes in HR/BP. Assess bowel sounds/motility. Physostigmine as antidote. Administer over 1min, can give faster with cardiac resuscitation TEACHING: May cause drowsiness, teach methods to decrease SE of dry mouth (sugarless candy, mouth rinses)

EPINEPHRINE (Adrenalin, EpiPEn)

DOSAGE: 1mg q3-5min for cardiopulmonary resuscitation, 2-10mcg/min for bradycardia CLASSIFICATION: antiasthmatic, bronchodilator, vasopressor, adrenergic MOA: accumulation of cAMP at beta-adrenergic receptors producing bronchodilation, vasoconstriction, and maintenance of HR/BP INDICATIONS: ACLS/PALS, symptomatic bradycardia, severe hypotension, management of asthma/COPD, severe allergic reactions CONTRAINDICATIONS: hypersensitivity, arrhythmias ADVERSE EFFECTS: nervousness, restlessness, tremor, HA, angina, arrhythmia, HTN, tachycardia, NV, hyperglycemia, pulmonary edema, renal failure NURSING: Assess lung sounds, BP, RR before administration. Monitor HR/ECG/BP during IV admin and q 5min after administration. Destroyed by alkaline solutions so administer through a separate IV line. TEACHING: Teach S/S of overdose,

DOPAMINE (Intropin)
DOSAGE: 2-10 mcg/kg/min CLASSIFICATION: inotropic, vasopressor, adrenergic MOA: stimulate dopamine receptors and beta-receptors to produce cardiac stimulation (increase in HR, BP) INDICATIONS: adjunct treatment to improve BP, CO CONTRAINDICATIONS: tachyarrhythmia, hypersensitivity ADVERSE EFFECTS: HA, dyspnea, arrhythmia, hypotension, angina, ECG change, palpitations, NV, vasoconstriction NURSING: Titrate to slowest possible rate to maintain adequate HR and BP. Check BP and HR q5min. Administer through a central line is preferred r/t infiltration and necrosis. TEACHING: Explain the purpose of the medication and importance of monitoring. Advise patient to report chest pain, dyspnea, numbness, or burning of the extremities or administration site.