DAYRIT, Marion Liana M.

BSN IV B2

DRUGS: 1. CITICOLINE (Zynapse, Cholinen) Drug class: neurotonics, nootropics, psychostimulant MOA: intermediate in the generation of phosphatidylcholine from choline. Seems to increase a brain chemical called phosphatidylcholine which is important for brain function might also decrease brain tissue damage when brain is injured. It enhances the action of the brain stem ciliary body especially the ascending ciliary body activating system, which is closely related to consciousness, but does not exert effort on the extrapyramidal system. It increases blood flow and oxygen consumption of the brain and improves cerebral circulation and metabolism. Indication: head injury, cerebral vascular disease, cerebral surgery S/E: body temp elevation, restlessness, headache, nausea and vomiting, diarrhea low or high BP, tachycardia, insomnia, blurred vision, chest pains. NSG resp.: may be taken with or without food 2. DOBUTAMINE ( Dobuzef) Drug class: beta 1 selective adrenergic agonist, sympathomimetic MOA: Positive inotropic effects are mediated by beta1- adrenergic receptors in the heart; increases the force of Myocardial contraction with relatively minor effects on blood vessels. Indication: for inotropic support in the short term treatment of adults with cardiac decompensation due to Depressed contractility. 3. TRANEXAMIC ACID ( Hemostan) Drug class: Anti-fibrinolytic, antihemorrhagic Indication: used for prompt and effective control of hemorrhage in various and clinical areas: - surgical operations - treating heavy menstrual bleeding - hemorrhage ff. dental and/or oral surgery in patients with hemophilia - obstetric and gyne: abortion, post partum hemorrhage MOA: It is a synthetic derivative of the amino acids lysine. It exerts its antifibrinolytic effect through the reversible bloackade of lysine-binding sites on plasminogen molecules. Antifibrinoytic drug inhibits endometrial plasminogen activator and thus prevents fibrinolysis and the breakdown of clots. The plasminogen-plasmin enzyme system is known to cause coagulation defects through lytic activity on fibrinogen and other clotting factors. By inhibiting the action of plasmin(fibrinolysin) the antifibolytic agents reduce excessive breakdown of fibrin and effect physiological hemostasis. S/E: rash, hives, itching, dyspnea, tightness in chest, swelling of the mouth, face, lips, or tongue. Nsg resp ; report unusual change in bleeding 4. CORDARONE ( Amiodarone) Drug class: Adrenergic blocker, anti arrhythmic MOA: type 3 antiarrhythmic: acts directly on cardiac cell membrane; prolongs repolarization and refractory Period; increases ventricular fibrillation threshold; acts on peripheral smooth muscle to decrease Peripheral resistance. Indication: life threatening recurrent ventricular arrhythmias that do not respond to other antiarrhythmics. 5. DOPAMINE HCl (Myocard) Drug class: alpha-adrenergic agonist, beta1-selective adrenergic agonist, dopaminergic drug,sympathomimetic MOA: drug acts directly and by the release of norepinephrine from sympathetic nerve terminals; dopaminergic receptors mediate dilation of vessels in the renal and splanchic beds, which maintains renal perfusion and

function; alpha receptors which are activated by higher doses of dopamine, mediate vasoconstriction, which can override the vasodilating effects; beta1 receptors mediate a positive inotropic effect on the heart. Indication: correction of hemodynamic imbalances present in the shock syndrome due to MI, trauma, endotoxic Septicemia, open surgery, renal failure, and chronic cardiac decompensation in heart failure. 6. EPINEPHRINE HCl Drug class: alpha-adrenergic agonist, anti asthmatic, beta1 and beta2 adrenergic agonist,bronchodilator, cardiac stimulant, mydriatic,nasal decongestant,vasopressor MOA: Naturally occurring neurotransmitter, the effects of which are mediated by alpha or beta receptors in target organs. Effects on alpha receptors include vasoconstriction, contraction of dilator muscles of iris. Effects on beta receptors include positive chronotropic and inotropic effects on the heart (beta1 receptors); bronchodilation, vasodilation, and uterine relaxation. Indication: treatment and prophylaxis of cardiac arrest 7. ATROPINE SULFATE Drug class: anticholinergic, antidote, antimuscarinic,antiparkinsonian, MOA: competitively blocks the effects of acetylcholine at muscarinic cholinergic receptors that mediate the effects of parasympathetic postganglionic impulses, depressing salivary and bronchial secretions, dilating the bronchi, inhibiting vagal influences on the heart, relaxing the GI and GU tracts,inhibiting gastric secreations, relaxing the pupil, blocks the effects of acetylcholine in the CNS. Indication: treatment of parkinsonism, restoration of cardiac rate and arterial pressure during anesthesia, relief of bradycardia and syncope 8. FUROSEMIDE (Lasix) Drug class: loop diuretic MOA: inhibits reabsorption of sodium and chloride from the proximal and distal tubules and ascending limb of the loop of Henle, leading to a sodium-rich dieresis. Indication: oral;IV edema associated with heart failure, cirrhosis,renal disease,acute pulmonary edema, hypertension 9. MIDAZOLAM (Dormicum) Drug class: benzodiazepine (short-acting), CNS depressant MOA: exact mechanisms of action not understood; acts mainly at the limbic system and reticular formation,potentiates the effects of GABA, an inhibitory neurotransmitter; anxiolytic and amnesia effects occur at doses below those needed to cause sedation,ataxia, has little effect on cortical function Indication:sedation, anxiolysis,treatment of epileptic seizure 10. VALIUM (Diazepam) Drug class: antiepileptic, anxiolytic,benzodiazepine, skeletal muscle relaxant (centrally acting) MOA: exact mechanisms of action not understood, acts mainly at the limbic system and reticular formation, may act in spinal cord and at supraspinal sites to produce skeletal muscle relaxation; potentiates the effects of GABA, an inhibitory neurotransmitter; anxiolytic effects occur at doses well below those necessary to cause sedation; ataxia;has little effect on cortical function. 11. VERAPAMIL ( Isoptin) Drug class: antianginal,antiarrhythmic, antihypertensive,calcium-channel blocker MOA: inhibits movement of calcium ions across the membranes of cardiac and arterial muscle cells; calcium is involved in the generation of the action potential in specialized automatic and conducting cells in the heart, in arterial smooth muscle, and in excitation-contraction coupling in cardiac muscle cells; slowing of the velocity of conduction of the cardiac impulse, the depression of myocardial contractility, and dilation of coronary arteries and arterioles and peripheral arterioles;increased delivery of oxygen to myocardial cells.

Indication: angina pectoris due to coronary artery spasm, effort-associated angina, chronic stable angina, essential hypertension

12. CLONIDINE HCl (Catapres) Drug class: central acting antihypertensive, cardiovascular agent, alpha-adrenergic agonist, also have some Alpha-adrenergic antagonist, vasodilator MOA: stimulates alpha 2 adrenergic receptors in CNS to inhibit sympathetic outflow/ vasomotor centers. Central action reduces plasma concentration of norepinephrine. It decreases systolic and diastolic and HR. Also inhibit rennin release of kidneys. Indication: hypertension Nsg resp: check BP and HR

13. SODIUM BICARBONATE Drug class: Antacid Indication: symptomatic relief of upset stomach from hyperacidity Urine alkalinizer Gas pains MOA: Neutralizes the stomach acid by direct chemical reaction, increases plasma bicarbonate and buffers excess Hydrogen ion concentration. Neutralizes/ reduces gastric acidity, resulting in an increase in gastric pH, which inhibits the proteolytic activity of pepsin

IV FLUIDS: ISOTONIC: D5LRS, D5WATER, PLAIN NSS