Generic Name / Brand

Name
calcium gluconate

Magnesium sulfate

Mechanism of Action

Indications

Contraindications

Adverse Reactions

Cation needed for

maintenance of nervous,
muscular, skeletal
systems, enzyme
reactions, normal
cardiac contractility,
coagulation of blood;
affects secretory activity
of endocrine, exocrine
glands.

Prevention and
treatment of
hypocalcemia,
hypermagnesemia,
hypoparathyroidism,
cardiac toxicity caused
by hyperkalemia, ;lead
colic,
hyperphosphatemia,
calcium antagonist
toxicity

-hypercalcemia
-digitalis toxicity
-ventricular fibrillation
-renal calculi

-hypotension
-bradycardia
-dysrhythmias
-nausea
-constipation
-lethargy
-headache
-polyuria

Increases osmotic
pressure, draws fluid
into colon, neutralizes
HCL.

-constipation
-anticonvulsant
-electrolyte
-bowel prep

-hypersensitivity
-abdominal pain
-nausea/vomiting
-obstruction
-acute surgical abdomen
-rectal bleeding

-nausea
-vomiting
-anorexia
-cramps
-muscle weakness
-sweating
-electrolyte, fluid
imbalances

Nursing
Responsibilities
-monitor ECG, calcium
levels
-assess cardiac status,
rhythm, CVP
-provide seizure
precautions: padded
side rails; place airwasy
suction equipment
-patient should remain
recumbent 30mins. After
I dose.
-adise patient to add
food high in vitamin D
-assess I and O; check
for decrease in urinary
output.
-assess cramping, rectal
bleeding, nausea and
vomiting
-assess visual changes,
edema
-administer with food or
milk to decrease gastric
symptoms
-inform patient to avoid
alcohol intoxication

Generic Name / Brand

Name
Potassium chloride

Atropine sulfate

Generic Name / Brand

Mechanism of Action

Indications

Contraindications

Needed for adequate

transmission of nerve
impulses and cardiac
contraction, renal function,
intracellular ion
maintenance

-prevention treatment of
hypokalemia

-renal disease (severe)

-severe hemolytic
disease
-Addisons disease
-hyperkalemia
-acute dehydration
-extensive tissue
breakdown.

-cardiac depression
-nausea
-vomiting
-cramps
-diarrhea

Blocks acetylcholine at
parasympatheticneurro
affector sites; increases
cardiac output, HR by
blocking agal stimulation in
heart; dries secretions,
decrease sweating ,
mydriasis, increase HR at
moderate dose; motility of
GI, GU system

-bradycardia
-bradydysrhythmia
-insecticide poisoning
-decreasing secretions
before surgery
-antispasmodic with GU
and biliary surgery
-bronchodilator
-cyclopegia
-mydriasis

-hypersensitiivty to
belladonna alkaloids
-

-nausea
-vomiting
-anorexia
-cramps
-muscle weakness
-sweating
-electrolyte, fluid
imbalances

Mechanism of Action

Indications

Contraindications

Adverse Reactions

Adverse Reactions

Nursing
Responsibilities
-assess ECG
-monitor I and O ratio,
potassium level, cardiac
status
-dilute in LARGE
VOLUME OF IV
SOLUTION, NEVER
GIVE BOLUS.
-tell patient to take cap
with full glass of liquid
(120ml)

-assess I and O; check

for decrease in urinary
output.
-assess cramping,
rectal bleeding, nausea
and vomiting
-assess visual changes,
edema
-administer with food or
milk to decrease gastric
symptoms
-inform patient to avoid
alcohol intoxication
Nursing

Name

Responsibilities

Lidocaine (xyloccine)

Increases electrical
stimulation threshold of
Ventricle and his-purkinje
System w/c stabilizes
cardiac
Membrane and decrease
automaticity; locally
produces
Anesthesia by preventing
initiation and conduction of
impulse

-Ventricular tachycadics
-ventricular dysrhythmia
during cardiac sx
-Mi
-digitalis toxicity
-cardiac catheter
-anesthesia locally

-hypersensitivity to
amides
-severe heart block
-supraventricular
dysrhythmias
-adams-stroke
syndrome
-wolff-parkinson-white
syndrome

-headache
-dizziness
-drowsiness
-hypertension
-bradycardia

-assess for
oxygenation/perfusion
deficit, respiratory
status,
Urinary retention
-monitor I and O ration
liver function studies,
ECG, blood levels
-give iv bolus undiluted
(1%, 2% only); give
long or less over 1min
of using an iv line

Morphine sulfate

Depresses pain impulse

transmission at the spinal
cord level by interacting
opioid receptors, produces
CNS depression

-severe pain
-often given after or
during MI

-hypersensitivity
-addiction (opioid)
-hemorrhage
-bronchial asthma
-increased ICP

-drowsiness
-dizziness
-confusion
-sedation\
-constipation

Assess pain; location,

type, character,
intensity
-monitor I and O ratio,
CNS changes, allergic
reactions
-assess respiratory
dysfunction
-withdraw medication
slowly after long-term
use to prevent
withdrawal symptoms
-caution patient to avoid
CNS depressant24hrs
after taking this drug
-elevate side rails for

patient safety

Generic Name / Brand

Name
Epirephine levophed
(adrenaline)

Mechanism of Action
B1 and B2 agonist causing
increased levels of cyclic
AMP producing
bronchodilation, cardiac and
CNS stimulation; large
doses can cause
vasoconstriction via alpha
receptors; small dose can
cause vasodilation via b2
vascular receptors

Indications
-acute asthma attack
-hemostasis
-bronchospasm
-anaphylaxis
-allergic reactions
-cardiac arrest
-adjunct in anesthesia
-shock

Contraindications
-hypersensitivity to
symphatomimetics
-narrow-angle
glaucoma
-organic brain and heart
disease syndrome
-local anesthesia of
certain area
-labor
-cardiac dilation
-coronary insufficiency
-cerebral
arteriosclerosis

Adverse Reactions
-tremors
-anxiety
-palpitations
-tachycardia
-dysrhythmias
-anorexia
-dyspnea

Nursing
Responsibilities
-monitor respiratory
function, ECG to
prevent cerebral
hemorrhage
-monitor for evidence of
allergic reactions,
paradoxical
bronchospasm
-instruct patient to use
this medication before
other medications and
allow at least 5 mins
between each, to
prevent overstimulation

Sodium bicarbonate

Generic Name / Brand

Name
Phenytoin (Dilantin)

Orally neutralizes gastric

acid, which forms water,
NaCl, CO2, increases
plasma bicarbonate, which
buffers h1 ion concentration,
reverses acidosis

-acidosis
-cardiac arrest
-alkalinization
-gastric acid
neutralization/antacid

-hypertension
-peptic ulcer
-renal disease
-hypocalcemia

Mechanism of Action

Indications

Contraindications

Inhibits spread of seizure

activity in motor cortex by
altering ion transport;
increases AV conduction to
decrease dysrhythmias

-generalized tonicclonic seizures

-status epilepticus
-migraine
-bells palsy
-non-epileptic seizure
associated with Rayes
syndrome or head
trauma

-hypersensitivity
-psychiatric condition
-bradycardia
-stoke-adams syndrome
-hepatic failure
-acute intermittent
porphyria

-twitching
-hypereflexia
-belching
-distention
-alkalosis

Adverse Reactions
-headache
-hypotension
-gingival hyperplasia
-nystagmus
-diplopia
-urine discoloration
-hypocalcemia

-assess respiratory
function and pulse rate,
depth, lung sounds
-assess for CO2 in GI
tract
-monitor fluid balance,
electrolytes, blood PH,
urine output
-advise patient to notify
MD if indigestion is
accompanied with chest
pain, dyspnea, diarrhea

Nursing
Responsibilities
-assess mental status,
seizure activity, renal
studies and blood
studies
-monitor hepatic
stuches and WOF
toxicity
-give with meals to
decrease GI upset
-do not take antacid
together with phenytoin
-instruct patient in
proper oral hygiene

Diazepam (Valium)

Generic Name / Brand

Name

Facilitates/ potentiates the

inhibitory activity of GABA at
the limbic system and
reticular formation to reduce
anxiety

-anxiety
-acute alcohol
withdrawal
-adjunct in seizure
disorders
-pre op skeletal muscle
relaxation

-hypersensitivity to
benzodiazepines
-narrow angle glaucoma
-psychosis
-respiratory depression
-coma

Mechanism of Action

Indications

Contraindications

-dizziness
-drowsiness
-orthostatic
hypotension
-blurred vision

Adverse Reactions

-assess degree of
anxiety
-monitor BP with patient
lying, standing
-give with food/milk
-use sugarless gum,
hard candy frequent
sips of water for dry
mouth
-advise patient that drug
is not to be used for
everyday stress
-inform patient to avoid
driving and to rise
abruptly

Nursing
Responsibilities

Midazolam (dormicum)

Depresses subcortical
levels in CNS; may act on
limbic system, reticular
formation, may potentiate
GABA by binding to specific
benzodiazepine receptor

-pre op sedation
-general anesthesia
induction
-sedation for diagnostic
test
-intubation

-hypersensitivity to
benzodiazepines
-shock
-coma
-alcohol intoxication
-acute narrow angle
glaucoma

-nausea
-vomiting
-coughing
-dyspnea
-loss of balance

-monitor BP, pulse

-watch out for
respiratory depression
especially to elederly
patient
-caution patient to avoid
CNS depressants
including alcohol for
24hrs after taking this
drug

Naloxone (Narcan)

May displace opioid

analgesics from their
receptors to reduce its
effects

-narcotic overdose
-post op narcotic
depression

-respiratory depression
due to non-opioid drugs

-tachycardia
-increase BP
-seizures
-cardiac arrest
-pulmonary edema

-assess cardiac status

-monitor VS
-assess for pain, patient
respiration
-instruct patient to
report adverse reaction

Generic Name / Brand

Name

Mechanism of Action

Indications

Contraindications

Adverse Reactions

Nursing
Responsibilities

Promethazine
(Phenergan)

Acts on blood vessels, GI,

respiratory system by
competing with histamine
for h1 receptor site;
decreases allergic response
by blocking histamine; also
acts on chemo receptor
trigger zone to decrease
vomiting; increases CNS
stimulation; has
anticholinergic response

-motion sickness
-rhinitis
-allergy response
-sedation
-nausea
-pre op and post op
sedation
-

-hypersensitivity to h1
receptor antagonist
-sulfite allergy
-child <2yr
-acute asthma attack

-dizziness
-drowsiness
-constipation
-urinary retention

-assess respiratory
status, I and O
-give 1hr before and
2hrs after meals to
decrease GI upset
-caution patient not to
exceed recommended
dose; dysrhythmia may
occur

Hydrocortisone (solucortef)

Glucocorticoid with anti

inflammatory effect because
of its ability to inhibit
prostaglandin synthesis,
inhibit migration of
macrophages, leucocytes
and fibroblasts at sites of
inflammation phagocytosis
and lysomal enzyme
release. It can also cause
the reversal of increased
capillary permeability

-allergic and
inflammatory
ophthalmic processes
-GI disease ulceratic
colitis
-multiple sclerosis
-treatment of synovitis
of osteoarthritis
-treatment of keloids
-relief of discomfort
associated with
hemorrhoids perineal
itching or irritation

-systemic fungal
infection
-acute
glumeruloneprhitis
-amoebiasis
-AIDS-TB
-nonasthmatic bronchial
dse.

-depression
-flushing
-sweating
-headache
-mood changes
-hypertension
-diarrhea
-nausea
-vomiting
-hemorrhage

-monitor patients
weight, BP. Glucose
and electrolyte levels.
-assess for systemic
absorption and irritation
-advise patient to
exercise and take vit. D
and calcium
supplements

Generic Name / Brand

Name

Mechanism of Action

Indications

Contraindications

Adverse Reactions

Nursing
Responsibilities

Dexamethasone
(Decadron)

Synthetic glucocorticoid with

marked anti-inflammatory
effect because of its ability
to inhibit prostaglandin
synthesis, inhibit migration
of macrophages, leukocytes
and fibroblasts at sites of
inflammation, phagocytosis
and lysosomal enzyme
release

-inflammation
-allergies
-neoplasms
-cerebral edema
-septic shock
-collagen disorders

-psychosis
-hypersensitivity
-idiopathic
thrombocytopenia
-amoebiasis
nonasthmatic bronchial
dse.

-depression
-flushing
-sweating
-hypertesion
-diarrhea
-nausea
-vomiting
-abdominal distention
-increased appetite

-assess infection; fever,

potassium depletion,
mental status
-monitor weight daily
-instruct patient to
report signs of adverse
reactions
-advise patient to avoid
exposure to persons
with infection

Terbutaline (bricanyl)

Relaxes bronchial snooth

muscle by direct action on
B2 adrenergic receptors
through accumulation of
cAMP at B-adrenergic
receptor sites; results are
bronchodilation, diuresis
and CNs, heart stimulation;
relaxes uterine smooth
muscle.

-bronchospasm

-hypersensitivity to
symphatomimetics
-narrow-angle
glaucoma
-tachydysrhythmias

-tremors
-insomnia
-headache
-dizziness
-palpitations
-nuasea
-vomiting

-monitor respiratory
function
-determine that patient
has not received
theophylline therapy
before giving dose
-monitor for evidence of
allergic reactions
-assess for paradoxical
bronchospasm
-should be given with
meals
-teach patient how to
use inhaler; to avoid
getting aerosol in eyes
because blurring may
result

Generic Name / Brand

Name
Tranexemic acid
(Hemostan)

Amiodarone
(Cordarone)

Mechanism of Action

Indications

Contraindications

Adverse Reactions

Inhibits breakdown of fibrin

clots. It acts primarily by
blocking the binding of
plasminogen and plamin to
fibrin; direct inhibition of
plasmin a\occurs only to a
limited degree

-treatment and
prophylaxis of
hemorrhage associated
with excessive
fibrinolysis
-prophylaxis for
hereditary angioedema

-hypersensitivity
-severe renal
insufficiency
-patient with
microscopic hematuria

-nausea
-vomiting
-headache
-hypotension

Prolongs action potential

duration and effective
refractory period, slows
sinus rate with increasing
PR and QT intervals, noncompetitive alpha and beta
adrenergic inhibition;
increase PR and QT
intervals, decrease sinus
rate and decreases PVR

-severe ventricular
tachycardia
-supraventricular
tachycardia
-ventricular fibrillation
-atrial fibrillation not
controlled by 1st line
agents

-sinus node dysfunction

-2nd or 3rd degree AV
block
-bradycardia
-neonates, infants

-headache
-dizziness
-hypotension

Nursing
Responsibilities
-assess patient if with
active intravascular
clotting; obtain
prothrombin time of the
patient
-perform liver function
test and blood tests
-advise patient to report
visual abnormalities to
the physician.

-monitor I and O ratio,

ECG
-assess for CNS
symptoms, sight and
vision
-instruct patient to
report side effects
immediately to the
prescriptor and that skin
discoloration is usually
reversible
-advise patient that dark
glasses may be needed
for photophobia
-instruct patient to use
sunscreen and
protective clothing
(photosensitivity)

Generic Name / Brand

Name
Aminophylline
(Truphylline)

Clonidine (Catapres)

Mechanism of Action

Indications

Contraindications

Adverse Reactions

Exact mechanism unknown;

relaxes smooth muscle of
respiratory system by
blocking phosphodiesterase
which increases cyclic AMP
alters intracellular calcium
ion movements

-bronchial asthma
-emphysema
-bradycardia

-hypersensitivity to
xanthines
-active peptic ulcer
disease

-dizziness
-palpitations
-sinus tachycardia
-nausea
-vomiting

Inhibits sympathetic
ve\asomotor center in CNS
which reduce impulses in
sympathetic nervous
system; BP; pulse rate, CO
decreased; prevents pain
signal transmission in CNS
by alpha adrenergic
receptor stimulation of the
spinal cord

-mild to moderate
hypertension

-hypersensitivity
-bleeding disorders
-anticoagulants

-drowsiness
-sedation
-headache
-fatigue
-orthostatic
hypertension
-nocturia
-palpitations
-nausea
-vomitng
-dry mouth
-malaise

Nursing
Responsibilities
-monitor theophylline
blood levels, I and O,
respiratory rate
-instruct patient to avoid
hazardous activities
-teach patient if GI
upset occurs, take drug
with 8oz of water
-advise patient to
increase fluid intake

-monitor BP/pulse
-check for edema in feet
and legs daily
-monitor I and O
-instruct patient not to
discontinue drug
abruptly
-caution patient to
change position slowly

Generic Name / Brand

Name
Digoxin (Lanoxin)

Verapamil (Isoptin)

Mechanism of Action

Indications

Contraindications

Adverse Reactions

Inhibits sodium potassium

ATPase which makes more
calcium available for
contractile proteins,
resulting in increased
cardiac output, force of
contraction; decrease
contraction, decrease HR
and AV conduction speed

-rapid digitalization in
acute and chronic CHF
-atrial fibrillation
-atrial flutter
-atrial bradycardia
-atrial tachycardia
-cardionegic shock
-paroxysmal atrial
tachycardia

-hypersensitivity to
digitalis
-ventricular fibrillation
-ventricular tachycardia
-carotid sinus syndrome
-2nd or 3rd degree block

-headache
-drowsiness
-hypotension
-nausea
-vomiting
-anorexia

Inhibits calcium ion influx

across cell membrane
during cardiac
depolarization; produces
relaxation of coronary
vascular smooth muscle;
peripheral vascular arteries.
Increase myocardial oxygen
delivery

-chronic stable
vasospastic
-unstable angina
-dysrhythmias
-hypertension
-supraventricular
tachycardia
-atrial flutter or
fibrillation

-sick sinus syndrome

-2nd or 3rd degree heart
block
-hypotension
-cardiogenic shock
-severe CHF

-headache
-drowsiness
-edema
-nausea
-constipation

Nursing
Responsibilities
-assess apical pulse for
1 min
-monitor cardiac status,
ECG
-advise patient to
maintain a sodiumrestricted diet as
ordered
-teach patient purpose
of drug is to regulate
the hearts functioning

-assess fluid volume: I

and O ratio and record
-monitor BP and pulse,
pulmobary capillary
wedge pressure
-assess for
extravasation
-advise patient to
increase fluid intake to
counteract constipation
-advise patient to
comply with medical
regimen

Generic Name / Brand

Name
Nalbuphine(nubain)

Mechanism of Action

Indications

Binds with opiate receptors

in the CNS: ascending pain
pathways in limbic system,
thalamus, midbrain,
hypothalamus, altering
perception of end emotional
response to pain. Relieves
pain

-relief of moderate to
severe pain
-for pre-operatively
analgesia
-supplemental to
balance anesthesia
-surgical anesthesia
-obstetrical anesthesia

Contraindications
-hypersensitivity

Adverse
Reactions
-sedation
-drowsiness
-sweating
-nausea
-dry mouth
-dizziness
-headache
-vomiting

Nursing Responsibilities
-assess pain characteristics
before administration
and after tx
-monitor VS after IV route
-instruct px to change position
slowly to prevent
orthostatic hypotension
and avoid getting up
without assistance
-advise Px to refrain taking
CNS depressant for at least
2 hrs after taking the drug

Phenobarbital(luminal)

Depresses activity in brain

cells primarily in reticular
activating system in
brainstem, also selectively
depresses neurons in
posterior hypothalamus,
limbic structure; decreases
seizure and motor activity
by inhibiting CNS impulses

Generic Name / Brand

Name

Mechanism of Action

Diphenhydramine
(benadryl)

Acts on blood vessels, GI,

respiratory system by
competing with histamine
for the receptor site;
decreases allergic response
blocking histamine; causes
increase HR,vasodilatio,
secretion

-all forms of epilepsy

-status epilepticus
-febrile seizure
-sedation
-insomnia

Indications
-allergy symptoms
-rhinitis
-motion sickness
-nighttime sedation
-infant colic
-non productive cough
-anaphylaxis
-nasal allergies
-dystonic reaction
-

-hypersensitivity to
barbiturates
-porphyria
-hepatic disease
-respiratory disease
-nephritis
-hypertension
-DM

Contraindications
-hypersensitivity
to H1 receptor
antagonist
-acute asthma attack
-lower respiratory tract
disease

-paradoxic
excitement
-elderly
-hang0ver
headache
-diarrhea
-rash
-local pain, swelling

Adverse Reactions
-dizziness
-drowsiness
-urinary retention

assess mental status, respiratory

dysfunction, ,toxicity and seizure activity
-tell Px that hangover is common
-teach Px to make position changes
slowly
-elevate side rails to promote safety

Nursing
Responsibilities
-assess respiratory
status
-provide 2L/day to
decrease secretion
thickness
-monitor I&O ratio
-instruct Px to use
sunscreen to prevent
photo sensitivity
-elevate siderails to
promote safety since
dizziness may occur
-instruct Px to request
assistance with
completion

Phytonadione
(aquamephyton)

Generic Name / Brand

Name
Nifedipine (adalat)

Needed for adequate blood

clotting (factors II, VII, IX, X)

-vit. K malabsorption
-hypoprothrombinemia
-prevention of
hemorrhagic disease of
thje new born

-hypersensitivity
-severe hepatic disease
-last few week of
pregnancy

Mechanism of Action

Indications

Contraindications

Inhibits calcium ioninflux

across cell membrane
during cardiac
depolarization, produces
relaxation of coronary
vascular smooth muscle
and peripheral vascular
muscle, dilates coronary
vascular arteries, increase
myocardial oxygen delivery
in Px with vasopatic angina

-Chronic stable angina

pectoris
-vasopatic angina
-HPN

-hypersensitivity

-headache nausea
-uticaria

Adverse Reactions
-headache
-dizziness
-light headedness
-nausea
-flushing of skin

-monitor for bleeding or

bruising
-assess nutritional
status
-teach Px necessary
foods high in vit. K to be
induced in diet
-advise Px to avoid IM
inj, toothbrush, flossing;
use electric razor until
Tx is terminated.
Nursing
Responsibilities
-assess anginal pain,
fluid vol. status and
monitor K,LFT
-instruct the Px to limit
the caffeine
consumption
-advise Px to increase
fluid intake to prevent
constipation, teach Px
to check for gingival
hyperplasia and report
promptly

Generic Name / Brand

Name
dopamine

Isosorbide dinitrae
(isoket, isordil)

Mechanism of Action

Indications

Contraindications

Adverse Reactions

Assess increase CO, beta 1

and alpha receptor, causing
vasoconstriction, in blood
vessel: when low doses are
administered causes renal
mesenteric vasodilatation;
beta1 stimulation produce
inotropic effects with
increase cardiac output

-shock
-to increase perfusion
-hypotension

-hypersensitivity
-ventricular fibrillation
-tachydysrythmias
-pheochromocytoma

-headache
-palpitations
-hypertension
-nausea
-vomiting
-diarrhea

Relaxation of vascular
smooth muscle, which leads
to decrease preload;
afterload thus decreasing
left ventricular end,diastolic
pressure, systemic vascular
resistance and reducing
cardiac oxygen demand

Tx and prevention of
chronic stable angina
pectoris

-hypersensitivity to
nitrates
-severe anemia
-increase ICP
-cerebral hemorrhage
-acute MI

-vascular headache
-flushing
-dizziness
-postural
hypotension

Nursing
Responsibilities
-monitor ECG, BP, and
pulse q5 min if BP
drops 30 mmHg, stop
infusion, and call
prescriber,
-check for
extravasation: change
site q48
-advise Px to report all
S/E.

-asses for pain

-monitor for orthostatic
BP, pulse at baseline
and during Tx
-inform Px that drug
may be taken before
stressful activity
-caution Px to change
position slowly.