JUNATHAN L.

DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

DRUGS USED FOR EMERGENCY SITUATIONS

1) AMINOPHYLLINE

Brand Names: Phil Pharmawealth/Atlantic Aminophylline amp Theofil amp

Classification: Antiasthmatic & COPD Preparations
Dosage: Initial: 225-450 mg twice daily, increased if needed. IV Acute severe bronchospasm. Loading
dose: 5 mg/kg (ideal body wt). Maintenance: 0.5 mg/kg/hr. Rate should not exceed 25 mg/min.
Indication: PO Chronic bronchospasm as hydrate
Action: Increases the level of cAMP resulting in bronchodilation
Adverse Reactions: Nausea, vomiting, abdominal pain, diarrhea, headache, insomnia, dizziness, anxiety,
restlessness; tremor, palpitations. Potentially Fatal: Convulsions, cardiac arrhythmias, hypotension and
sudden death after too rapid IV injection.
Nursing Responsibilities:
• Caution patient not to chew or crush enteric- clock for adequate control of asthma attacks.
coated timed-release forms. • Avoid excessive intake of coffee, tea, cocoa, cola
• Do not give timed-release forms with food; these beverages, chocolate.
should be given on an empty stomach 1 hr before • Smoking cigarettes or other tobacco products
or 2 hr after meals. impacts the drug's effectiveness. Try not to smoke.
• Maintain adequate hydration. Notify the care provider if smoking habits change
• Monitor results of serum theophylline levels while taking this drug.
carefully, and arrange for reduced dosage if serum • Frequent blood tests may be necessary to monitor
levels exceed therapeutic range of 10–20 mcg/mL. the effect of this drug and to ensure safe and
• Ensure that diazepam is readily available to treat effective dosage; keep all appointments for blood
seizures. tests and other monitoring.
• It may be necessary to take this drug around the

2) AMIODARONE HYDROCHLORIDE

Brand Names: Anoion tab Cordarone Cordarone inj Sandoz Amiodarone HCl tab
Classification: Cardiac Drugs
Dosage: PO Initial: 200 mg 3 times/day for 1 wk, reduce to 200 mg twice daily for a further wk.
Maintenance: 200 mg/day or lowest effective dose. IV Initial: 5 mg/kg infusion via central venous catheter.
Max: 1.2 g/24 hr.
Indication: Ventricular and supraventricular arrhythmias.
Action: Blocks potassium chloride leading to prolongation of action potential duration.
Adverse Reactions: Blue-grey discoloration of skin, photosensitivity, peripheral neuropathy, paraesthesia,
myopathy, ataxia, tremor, nausea, vomiting, metallic taste, hypothyroidism, hyperthyroidism, alopecia,
sleep disturbances, corneal microdeposits, hot flushes, sweating. Heart block, bradycardia, sinus arrest,
hepatotoxicity, heart failure. Potentially Fatal: Pulmonary toxicity including pulmonary fibrosis and
interstitial pneumonitis, hepatotoxicity, thyrotoxicity. Ventricular arrhythmias, pulmonary alveolitis,
exacerbation of arrhythmias and rare serious liver injury. Generally in patients with high doses and having
preexisting abnormalities of diffusion capacity.
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

Nursing Responsibilities:
• Have regular medical follow-up, monitoring of hospitalized during initiation of drug therapy; you
cardiac rhythm, chest x-ray, eye exam, blood tests. will be closely monitored when dosage is changed.
• Monitor for an extended period when dosage • These side effects may occur: Changes in vision
adjustments are made. (halos, dry eyes, sensitivity to light; wear
• Monitor for safe and effective serum levels (0.5– sunglasses, monitor light exposure); nausea,
2.5 mcg/mL). vomiting, loss of appetite (take with meals; eat
• Doses of digoxin, quinidine, procainamide, small, frequent meals); sensitivity to the sun (use a
phenytoin, and warfarin may need to be reduced sunscreen or protective clothing when outdoors);
one-third to one-half when amiodarone is started. constipation (a laxative may be ordered); tremors,
• Give drug with meals to decrease GI problems. twitching, dizziness, loss of coordination (do not
• Arrange for ophthalmologic exams; reevaluate at drive, operate dangerous machinery, or undertake
any sign of optic neuropathy. tasks that require coordination until drug effects
• Arrange for periodic chest x-ray to evaluate stabilize and your body adjusts to it).
pulmonary status (every 3–6 mo). • Report unusual bleeding or bruising; fever, chills;
• Arrange for regular periodic blood tests for liver intolerance to heat or cold; shortness of breath,
enzymes, thyroid hormone levels. difficulty breathing, cough; swelling of ankles or
• Drug dosage will be changed in relation to fingers; palpitations; difficulty with vision.
response of arrhythmias; you will need to be

3) ATROPINE SULFATE

Brand Names: Anespin amp Atropol amp Euro-Med Atropine Sulfate amp Isopto Atropine eye drops Phil
Pharmawealth/Atlantic Atropine amp
Classification: Other Cardiovascular Drugs, Muscle Relaxants, Mydriatic Drugs, Antidotes, Detoxifying
Agents & Drugs Used in Substance Dependence
Indication/Dosage: IV Bradycardia 500 mcg every 3-5 mins. Total: 3 mg. IV/IM Organophosphorus
poisoning 2 mg every 10-30 mins until muscarinic effects disappear or atropine toxicity appears. IM/SC
Premed in anesth 300-600 mcg 30-60 mins before anesth. IV/IM/SC Overdosage w/ other compd having
muscarinic actions 0.6-1 mg, repeat 2 hrly. Ophth Inflammatory eye disorders As 0.5-1% soln: 1-2 drops 4
times/day. Eye refraction As 1% soln: 1 drop twice daily for 1-2 days before procedure.
Action: An anti-cholinergic that inhibits acetylcholine at the parasympathetic neuroeffector junction,
enhances the conduction of AV node and increases heart rate
Adverse Reactions: Dry mouth, dysphagia, constipation, flushing and dryness of skin, tachycardia,
palpitations, arrhythmias, mydriasis, photophobia, cycloplegia, raised intraocular pressure. Toxic doses
cause tachycardia, hyperpyrexia, restlessness, confusion, excitement, hallucinations, delirium and may
progress to circulatory failure and respiratory depression. Eye drops: Systemic toxicity especially in
children, on prolonged use may lead to irritation, hyperemia, edema and conjunctivitis. Increased
intraocular pressure. Inhalation: Dryness of mouth, throat. Potentially Fatal: Atrial arrhythmias, AV
dissociation, multiple ventricular ectopics.

Nursing Responsibilities:
• Ensure adequate hydration; provide environmental • Have patient void before taking medication if
control (temperature) to prevent hyperpyrexia. urinary retention is a problem.
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

• When used preoperatively or in other acute
situations, incorporate teaching about the drug with
teaching about the procedure; the ophthalmic
solution is used mainly acutely and will not be self-
administered by the patient; the following apply to
oral medication for outpatients:
• Take as prescribed, 30 min before meals; avoid
excessive dosage.
• Avoid hot environments; you will be heat
intolerant, and dangerous reactions may occur.
• These side effects may occur: Dizziness,
confusion (use caution driving or performing
hazardous tasks); constipation (ensure adequate
fluid intake, proper diet); dry mouth (suck sugarless
lozenges; perform frequent mouth care; may be
transient); blurred vision, sensitivity to light
(reversible; avoid tasks that require acute vision;
wear sunglasses in bright light); impotence
(reversible); difficulty in urination (empty the bladder
prior to taking drug).
• Report rash; flushing; eye pain; difficulty breathing;
tremors, loss of coordination; irregular heartbeat,
palpitations; headache; abdominal distention;
hallucinations; severe or persistent dry mouth;
difficulty swallowing; difficulty in urination;
constipation; sensitivity to light.

4) BUMETANIDE

Brand Names: Burinex amp Burinex tab

Classification: Sulfonamide Diuretics
Indication/Dosage: PO edema 1 mg once daily, 2nd dose 6-8 hr later if needed. Refractory edema Initial:
5 mg/day, may increase dose depending on response. Max: 10 mg/day. HTN 0.5-1 mg/day. Max: 5
mg/day. IV Pulmonary edema 1-2 mg, repeat 20 mins. later if needed. IV/IM Emergency edema 0.5-1 mg,
then adjust according to response.
Action: inhibits Sodium and Chloride reabsorption at the ascending loop of Henle
Adverse Reactions: Muscle cramps, dizziness, hypotension, headache, nausea, impaired hearing,
pruritus, ECG changes, musculoskeletal pain, rash, chest discomfort, renal failure, premature ejaculation,
thrombocytopenia, hypokalemia, hypomagnesaemia, hyponatremia, hyperuricemia, hyperglycemia,
hypocalcaemia.
Nursing Responsibilities:
• Take the drug early in day so increased urination time, and in the same clothing; record the weight on
will not disturb sleep; take with food or meals to your calendar.
prevent GI upset. • These side effects may occur: Increased volume
• Mark calendars or use reminders if intermittent and frequency of urination; dizziness, feeling faint
therapy is best for treating edema. on arising, drowsiness (avoid rapid position
• Give single dose early in day so increased changes; hazardous activities, i.e, driving; and
urination will not disturb sleep. alcohol consumption); sensitivity to sunlight (use
• Avoid IV use if oral use is possible. sunglasses, sunscreen, wear protective clothing);
• Arrange to monitor serum electrolytes, hydration, increased thirst (suck sugarless lozenges; frequent
and liver function during long-term therapy. mouth care); loss of body potassium (a potassium-
• Provide diet rich in potassium or supplemental rich diet, or supplement will be needed).
potassium. • Report weight change of more than 3 lb in 1 day;
• Record alternate day or intermittent therapy on a swelling in ankles or fingers; unusual bleeding or
calendar or dated envelopes. bruising; nausea, dizziness, trembling, numbness,
• Weigh yourself on a regular basis, at the same fatigue; muscle weakness or cramps.
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

5) CALCIUM GLUCONATE

Brand Names: Phil Pharmawealth/Harson Calcium Gluconate amp

Classification: Electrolytes
Indication/Dosage: PO Hypocalcaemia 10-50 mmol/day. IV Hypocalcaemic tetany 2.25 mmol via slow inj ,
then 58-77 mL of 10% soln diluted and administered as a continuous IV infusion. Antidote in severe
hypermagnesaemia; Severe hyperkalaemia 10 mL of 10% soln, repeat every 10 mins if needed.
Action: replaces Calcium and maintains Calcium level
Adverse Reactions: GI irritation; soft-tissue calcification, skin sloughing or necrosis after IM/SC inj.
Hypercalcaemia characterised by anorexia, nausea, vomiting, constipation, abdominal pain, muscle
weakness, mental disturbances, polydipsia, polyuria, nephrocalcinosis, renal calculi; chalky taste, hot
flushes and peripheral vasodilation. Potentially Fatal: Cardiac arrhythmias and coma.
Nursing Responsibilities:
• Make sure prescriber specifies form of calcium to emergencies when no I.V. route is available bec. of
be given; crash carts may contain both calcium irritation of tissue by calcium salts.
gluconate and calcium chloride. • Tell patient to take oral calcium with a full glass of
• Tell patient to take oral calcium 1 to 11/2 hours water.
after meals if GI upset occurs. • Monitor calcium levels frequently. Hypercalcemia
• Give I.M. injection in gluteal region in adults and in may result after large doses in chronic renal failure.
lateral thigh in infants. Use I.M. route only in Report abnormalities.

6) CAPTOPRIL

Brand Names: Ace-Bloc tab Capomed tab Capotec tab Capoten tab Captor tab Captril tab Cardiovaz tab
Conamid tab Hartylox tab Normil tab Phil Pharmawealth/Panion & BF Captopril tab Prelat tab Primace tab
Retensin tab Spec-Ace tab Tensoril tab Unihype tab Vasostad tab
Classification: ACE Inhibitors
Indication/Dosage: PO HTN Initial: 12.5 mg twice daily. Maintenance: 25-50 mg twice daily. Max: 50 mg 3
times/day. Heart failure Initial: 6.25-12.5 mg 2-3 times/day. Max: 50 mg 3 times/day. Post MI Start 3 days
after MI. Initial: 6.25 mg/day, may increase after several wk to 150 mg/day in divided doses if needed and
tolerated. HTN in diabetic nephropathy 75-100 mg/day in divided doses.
Action: inhibits ACE, reduces Sodium and water retention, lowers blood pressure
Adverse Reactions: Hypotension, tachycardia, chest pain, palpitations, pruritus, hyperkalaemia.
Proteinuria; angioedema, skin rashes; taste disturbance, nonproductive cough, headache. Potentially
Fatal: Neutropenia, usually occurs within 3 mth of starting therapy especially in patients with renal
dysfunction or collagen diseases. Hyperkalaemia. Anaphylactic reactions.

Nursing Responsibilities:
• Take drug 1 hr before or 2 hr after meals; do not that captopril is being taken; the angiotensin II
take with food. Do not stop without consulting your formation subsequent to compensatory renin
health care provider. release during surgery will be blocked; hypotension
• Alert surgeon and mark patient's chart with notice may be reversed with volume expansion.
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

• Monitor patient closely for fall in BP secondary to
reduction in fluid volume (excessive perspiration
and dehydration, vomiting, diarrhea); excessive
hypotension may occur.
• Reduce dosage in patients with impaired renal
function.
• Be careful of drop in blood pressure (occurs most
often with diarrhea, sweating, vomiting,
dehydration); if light-headedness or dizziness
occurs, consult your health care provider.
• Avoid over-the-counter medications, especially
cough, cold, allergy medications that may contain
ingredients that will interact with ACE inhibitors.
Consult your health care provider.
• These side effects may occur: GI upset, loss of
appetite, change in taste perception (limited effects,
will pass); mouth sores (perform frequent mouth
care); rash; fast heart rate; dizziness, light-
headedness (usually passes after the first few days;
change position slowly, and limit your activities to
those that do not require alertness and precision).
• Report mouth sores; sore throat, fever, chills;
swelling of the hands, feet; irregular heartbeat,
chest pains; swelling of the face, eyes, lips, tongue,
difficulty breathing.

7) CLONIDINE

Brand Names: Catapin amp Catapres amp Catapres tab

Classification: Other Antihypertensives
Indication/Dosage: PO HTN Initial: 50-100 mcg 3 times/day. Max: 2,400 mcg/day. Menopausal flushing;
Migraine prophylaxis 50 mcg twice daily, up to 75 mg twice daily. IV Hypertensive crisis 150-300 mcg via
slow inj. Max: 750 mcg over 24 hr. Epidural Severe cancer pain Initial: 30 mcg/hr as continuous infusion in
combination w/ an opioid. Transdermal HTN As patch releasing 100-300 mcg clonidine base/day at
constant rate: Apply once wkly.
Action: stimulates alpha 2 receptors and inhibits central vasomotor centers, lowers peripheral vascular
resistance, blood pressure, and heart rate
Adverse Reactions: Dry mouth, drowsiness, dizziness, headache, constipation, impotence, vivid dreams,
urinary retention; dry, itching, burning sensation in the eye; fluid or electrolyte imbalance, GI upset,
paralytic ileus, orthostatic hypotension, weakness, sedation, pruritus, myalgia, urticaria, nausea, insomnia,
arrhythmias, agitation. Reduced GI motility at times may cause paralytic ileus. Potentially Fatal: Transient
hypertension or profound hypotension, respiratory depression, convulsion. Clonidine withdrawal syndrome
could be life threatening. Bradycardia, coma and disturbances in conduction (in individuals with
preexisting diseases of SA/AV nodes, overdose or on digitalis).
Nursing Responsibilities:
• Take drug 1 hr before or 2 hr after meals; do not take with food. Do not stop without consulting your
health care provider.
• Be careful of drop in blood pressure (occurs most often with diarrhea, sweating, vomiting, dehydration); if
light-headedness or dizziness occurs, consult your health care provider.
• Avoid over-the-counter medications, especially cough, cold, allergy medications that may contain
ingredients that will interact with ACE inhibitors. Consult your health care provider.
• These side effects may occur: GI upset, loss of appetite, change in taste perception (limited effects, will
pass); mouth sores (perform frequent mouth care); rash; fast heart rate; dizziness, light-headedness
(usually passes after the first few days; change position slowly, and limit your activities to those that do
not require alertness and precision).
• Report mouth sores; sore throat, fever, chills; swelling of the hands, feet; irregular heartbeat, chest
pains; swelling of the face, eyes, lips, tongue, difficulty breathing.
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

• Take this drug exactly as prescribed. Do not miss doses. Do not discontinue the drug unless so
instructed. Do not discontinue abruptly; life-threatening adverse effects may occur. If you travel, take an
adequate supply of drug.
• Use the transdermal system as prescribed; refer to directions in package insert, or contact your health
care provider with questions. Be sure to remove old systems before applying new ones.
• Attempt lifestyle changes that will reduce your BP: stop smoking and using alcohol; lose weight; restrict
intake of sodium (salt); exercise regularly.
• Use caution with alcohol. Your sensitivity may increase while using this drug.
• These side effects may occur: Drowsiness, dizziness, light-headedness, headache, weakness (often
transient; observe caution driving or performing other tasks that require alertness or physical dexterity);
dry mouth (suck on sugarless lozenges or ice chips); GI upset (eat small, frequent meals); dreams,
nightmares (reversible); dizziness, light-headedness when you change position (get up slowly; use
caution climbing stairs); impotence, other sexual dysfunction, decreased libido (discuss with care
providers); breast enlargement, sore breasts; palpitations.
• Report urinary retention, changes in vision, blanching of fingers, rash.

8) DIAZEPAM

Brand name: Valium

Classification: Anxiolytics
Dosage: 10mg/2ml
Indication: relief of anxiety, agitation & tension due to psychoneurotic states & transient situational
disturbances
Action: a benzodiazepine that probably potentiates the effects of GABA, depresses the CNS &
suppresses the spread of seizure activity
Adverse Reaction: drowsiness,dysarthria, slurred speech, tremor, transient amnesia, fatigue, ataxia,
headache, insomnia, paradoxical anxiety, hallucination
Nursing Responsibilities:
• Do not administer intra-arterially; may produce an injection.
arteriospasm, gangrene. • Monitor EEG in patients treated for status
• Change from IV therapy to oral therapy as soon as epilepticus; seizures may recur after initial control,
possible. presumably because of short duration of drug
• Do not use small veins (dorsum of hand or wrist) effect. Monitor liver and kidney function, CBC during
for IV injection. long-term therapy.
• Reduce dose of narcotic analgesics with IV • Taper dosage gradually after long-term therapy,
diazepam; dose should be reduced by at least one- especially in epileptic patients.
third or eliminated. • Arrange for epileptic patients to wear medical alert
• Carefully monitor P, BP, respiration during IV ID indicating that they are epileptics taking this
administration. medication.
• Maintain patients receiving parenteral • Discuss risk of fetal abnormalities with patients
benzodiazepines in bed for 3 hr; do not permit desiring to become pregnant.
ambulatory patients to operate a vehicle following

9) DIGOXIN
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

Brand name: Digitek, Lanoxicaps, Lanoxin, Novo-Digoxin (CAN)

Classification: Inotropics
Dosage: 5mg/2ml
Indication: Cardiac failure accompanied by atrial fibrillation; management of chronic cardiac failure where
systolic dysfunction or ventricular dilatation is dominant; management of certain supraventricular
arrhythmias, particularly chronic atrial flutter & fibrillation.
Action: inhibits sodium-potassium activated adenosine triphosphate, promoting movement of calcium
from extracellular to intra-cytoplasm and strengthening myocardial contraction, also acts on CNS to
enhance vagal tone
Adverse Reaction: nausea, vomiting, anorexia, headache, facial pain, fatigue, weakness, dizziness,
drowsiness, disorientation, mental confusion, bad dreams, convulsions.
Nursing Responsibilities:
• Monitor apical pulse for 1 min before • Follow diluting instructions carefully, and use
administering; hold dose if pulse < 60 in adult or < diluted solution promptly.
90 in infant; retake pulse in 1 hr. If adult pulse • Avoid giving with meals; this will delay absorption.
remains < 60 or infant < 90, hold drug and notify • Have emergency equipment ready; have K+ salts,
prescriber. Note any change from baseline rhythm lidocaine, phenytoin, atropine, cardiac monitor on
or rate. standby in case toxicity develops.
• Check dosage and preparation carefully. • Monitor for therapeutic drug levels: 0.5–2 ng/mL.
• Avoid IM injections, which may be very painful.

10) DIPENHYDRAMINE

Brand name: Benadryl

Classification: antihistamine
Dosage: 50mg/ml
Indication: Hay fever, urticaria, vasomotor rhinitis, angioneurotic edema, drug sensitization, serum &
penicillin reaction, contact dermatitis, atopic eczema, other allergic dermatoses, pruritus, food sensitivity,
parkinsonism, motion sickness.
Action: prevents histamine mediated responses, drug provides local anesthesia and suppresses cough
reflex
Adverse Reaction: CV and CNS effects, blood disorders, GI disturbances, anti-muscarinic effects and
allergic reactions.
Nursing Responsibilities:
• Monitor carefully, assess for confusion, delirium, other anticholinergic side effects and fall risk. Institute
measures to prevent falls.
• Assess movement disorder before and after administration.
• Caution patient not to use oral OTC diphenhydramine products with any other product containing
diphenhydramine, including products used topically.
• It can cause excitation in children. Caution parents or caregivers about proper dose calculation;
overdosage, especially in infants and children, can cause hallucinations, seizures or death Inform patient
that this drug may cause dry mouth. Frequent oral rinses, good oral hygiene, and sugarless gum or candy
may minimize this effect. Notify dentist if dry mouth persists for more than 2 weeks.

11) EPINEPHRINE
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

Brand name:
Epinephrine Bitartrate
Aerosols: Primatene Mist
Epinephrine Borate
Ophthalmic solution: Epinal
Epinephrine Hydrochloride
Injection, OTC nasal solution: Adrenalin Chloride
Ophthalmic solution: Epifrin, Glaucon
Insect sting emergencies: EpiPen Auto-Injector (delivers 0.3 mg IM adult dose), EpiPen Jr. Auto-Injector
(delivers 0.15 mg IM for children)
OTC solutions for nebulization: AsthmaNefrin, microNefrin, Nephron, S2
Classification: Sympathomimetic, Alpha-adrenergic agonist, Beta1and beta2-adrenergic agonist, Cardiac
stimulant, Vasopressor, Bronchodilator, Antasthmatic drug, Nasal decongestant, Mydriatic, Antiglaucoma
drug
Dosage: 1mg/ml
Indication: Acute asthmatic attacks, Advanced cardiac life support
Action: 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 (beta2 receptors); decreased production
of aqueous humor.
Adverse Reaction: drowsiness, headache, nervousness, tremors, cerebral hemorrhage, dizziness,
weakness, vertigo, pain
Nursing Responsibilities:
• Monitor heart rate.
• Use extreme caution when calculating and preparing doses; epinephrine is a very potent drug; small
errors in dosage can cause serious adverse effects. Double-check pediatric dosage.
• Use minimal doses for minimal periods of time; "epinephrine-fastness" (a form of drug tolerance) can
occur with prolonged use.
• Protect drug solutions from light, extreme heat, and freezing; do not use pink or brown solutions. Drug
solutions should be clear and colorless (does not apply to suspension for injection).
• Shake the suspension for injection well before withdrawing the dose.
• Rotate SC injection sites to prevent necrosis; monitor injection sites frequently.
• Keep a rapidly acting alpha-adrenergic blocker (phentolamine) or a vasodilator (a nitrate) readily
available in case of excessive hypertensive reaction.
• Have an alpha-adrenergic blocker or facilities for intermittent positive pressure breathing readily
available in case pulmonary edema occurs.
• Keep a beta-adrenergic blocker (propranolol; a cardioselective beta-blocker, such as atenolol, should be
used in patients with respiratory distress) readily available in case cardiac arrhythmias occur.
• Do not exceed recommended dosage of inhalation products; administer pressurized inhalation drug
forms during second half of inspiration, because the airways are open wider and the aerosol distribution is
more extensive. If a second inhalation is needed, administer at peak effect of previous dose, 3–5 min.
• Use topical nasal solutions only for acute states; do not use for longer than 3–5 days, and do not exceed
recommended dosage. Rebound nasal congestion can occur after vasoconstriction subsides.
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

• Do not exceed recommended dosage; adverse effects or loss of effectiveness may result. Read the
instructions that come with respiratory inhalant products, and consult your health care provider or
pharmacist if you have any questions.
• To give eye drops: Lie down or tilt head backward, and look up. Hold dropper above eye; drop medicine
inside lower lid while looking up. Do not touch dropper to eye, fingers, or any surface. Release lower lid;
keep eye open, and do not blink for at least 30 sec. Apply gentle pressure with fingers to inside corner of
the eye for about 1 min; wait at least 5 min before using other eye drops.
• These side effects may occur: Dizziness, drowsiness, fatigue, apprehension (use caution if driving or
performing tasks that require alertness); anxiety, emotional changes; nausea, vomiting, change in taste
(eat frequent small meals); fast heart rate. Nasal solution may cause burning or stinging when first used
(transient). Ophthalmic solution may cause slight stinging when first used (transient); headache or brow
ache (only during the first few days).
• Report chest pain, dizziness, insomnia, weakness, tremor or irregular heart beat (respiratory inhalant,
nasal solution), difficulty breathing, productive cough, failure to respond to usual dosage (respiratory
inhalant), decrease in visual acuity (ophthalmic).

12) FUROSEMIDE

Brand name: Apo-Furosemide (CAN), Furoside (CAN), Lasix, Myrosemide (CAN)

Classification: loop diuretics
Dosage: 20mg/2ml
Indication: edema, hypertension
Action: inhibits Sodium and Chloride reabsorption at the proximal and distal tubules and the ascending
loop of Henle
Adverse Reaction: vertigo, headache, dizziness, paresthesia, weakness, restlessness, fever, nocturia,
oliguria, polyguria
Nursing Responsibilities:
• Monitor BP after administration • Do not expose to light, may discolor tablets or
• Administer with food or milk to prevent GI upset. solution; do not use discolored drug or solutions.
• Reduce dosage if given with other • Discard diluted solution after 24 hr.
antihypertensives; readjust dosage gradually as BP • Refrigerate oral solution.
responds. • Measure and record weight to monitor fluid
• Give early in the day so that increased urination changes.
will not disturb sleep. • Arrange to monitor serum electrolytes, hydration,
• Avoid IV use if oral use is at all possible. liver function.
• Do not mix parenteral solution with highly acidic • Arrange for potassium-rich diet or supplemental
solutions with pH below 3.5. potassium as needed.

13) HYDRALAZINE HYDROCHLORIDE

Brand name: Supres

Classification: antihypertension
Dosage: 20mg/ml
Indication: For hypertensive patient
Action: a direct acting peripheral vasodilator that relaxes arteriolar smooth muscles
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

Adverse Reaction: tachycardia, palpitation, angina pectoris, severe headache, dizziness, weight gain, GI
disturbances, pruritus, rashes, nausea and vomiting
Nursing Responsibilities:
• Give oral drug with food to increase asymptomatic patient. Discontinue if blood
bioavailability(drug should be given in a consistent dyscrasias occur. Reevaluate therapy if ANA or LE
relationship ti ingestion of food for consistent tests are positive.
response to therapy). • Arrange for pyridoxine if patient develops
• Drug may cause a syndrome resembling systemic symptoms of peripheral neuritis.
lupus erythematosus (SLE). Arrange for CBC, LE • Monitor patient for orthostatic hypotension which is
cell preparations, and ANA titers before and most marked in the morning and in hot weather,
periodically during prolonged therapy, even in the and with alcohol or exercise.

14) HYDROCORTISONE SODIUM SUCCINATE

Brand name: A-hydroCort, Solu-Cortef

Classification: corticosteroid hormones
Stock Dose:100 mg/ 2 mL, 250 mg/ 2 mL
Indication: endocrine, hematologic, rheumatic & collagen disorders, dermatologic, ophth, GI, resp &
neoplastic diseases, edematous states, control of severe incapacitating allergic conditions, TB meningitis
w/ subarachnoid block or impending block when used concurrently with appropriate anti-TB
chemotherapy, shock secondary to adrenocortical insufficiency or shock unresponsive to conventional
therapy when adrenocortical insufficiency may be present
Action: Decreases inflammation, mainly by stabilizing leukocyte lysosomal membranes, suppresses
immune response, stimulates bone marrow and influences protein, fat, and carbohydrate metabolism
Adverse Reactions: fluid and electrolyte disturbances, decreased carbohydrate tolerance, impaired wound
healing, thin fragile skin, muscle weakness, steroid myopathy, osteoporosis, aseptic necrosis, peptic
ulceration w/ possible perforation, cataracts, increased intraocular and intracranial pressure, growth
retardation, Cushingoid state, protein catabolism, psychic derangements, exophthalmos, masking of
infections, gasping syndrome, seizures, menstrual irregularities.
Nursing Responsibilities:
• Give daily before 9 AM to mimic normal peak • Taper doses when discontinuing high-dose or
diurnal corticosteroid levels and minimize HPA long-term therapy.
suppression. • Arrange for increased dosage when patient is
• Space multiple doses evenly throughout the day. subject to unusual stress.
• Do not give IM injections if patient has • Use alternate-day maintenance therapy with short-
thrombocytopenic purpura. acting corticosteroids whenever possible.
• Rotate sites of IM repository injections to avoid • Do not give live virus vaccines with
local atrophy. immunosuppressive doses of hydrocortisone.
• Minimal doses for minimal duration to minimize • Provide antacids between meals to help avoid
adverse effects. peptic ulcer.

15) ISOSORBIDE-5- MONONITRATE

Brand name: Imdur

Classification: anti- anginal drug
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

Stock Dose: SL: 5 mg/mL ; Oral: 30 mg, 60 mg

Indication: prophylactic treatment of angina pectoris
Action: Thought to reduce cardiac oxygen demand by decreasing preload and afterload. Drug also may
increase blood flow through the collateral coronary vessels
Adverse Reactions: headache, hypotension w/ dizziness and nausea, tachycardia
Nursing Responsibilities:
• Monitor BP and heart rate.
• Assess location, duration, intensity, and precipitating factors of anginal pain.

16) ISOSORBIDE DINITRATE

Brand name: Isoket IV
Classification: anti – anginal drug
Stock: IV amp 10 mg/ 10 mL
Dose: 10 mg/10mL
Indication: unresponsive left ventricular failure secondary to acute MI, severe or unstable angina pectoris
Action: Isosorbide dinitrate is a smooth muscle relaxant. It is particularly effective on vascular and
bronchial smooth muscle. Its systemic cardiovascular effects are mainly due to a decrease in venous
return (pooling of blood in the peripheral venous system). Consequently, ventricular end-diastolic pressure
and volume are diminished, thus reducing cardiac work and implicitly myocardial oxygen requirements.
The arterial vessels are dilated as well, though to a lesser degree. This results in a slight drop in aortic
and systemic blood pressure relieving the myocardium from a part of its afterload. These nitrate-induced
changes account for both the antianginal effects of isosorbide dinitrate and for its beneficial effects in the
treatment of congestive heart failure.
Side effects/ adverse reactions: severe cerebral flow deficiency and decreased coronary perfusion may
develop, nitrate headache and nausea.
Nursing Responsibilities:
• Monitor BP and heart rate.
• Assess location, duration, intensity, and precipitating factors of anginal pain.

17) MAGNESIUM SULFATE

Brand name: Elin Magnesium Sulfate

Classification: anticonvulsant
Dosage: 250 mg/10 mL
Indication: treatment of hypomagnesemia accompanied by signs of tetany, control of HTN,
encephalophathy & convulsions, prevention & control of convulsions in patients w/ preeclampsia or
eclampsia, prevention of hypomagnesemia in patients receiving TPN
Action: may decrease acetylcholine released by nerve impulses, but its anticonvulsant mechanism is
unknown
Adverse Reactions: flushing, sweating, hypotension, muscular weakness, sedation & confusion;
decreased deep tendon reflexes; resp. paralysis
Nursing Responsibilities:
• Monitor the following: I.V.: Rapid administration: ECG monitoring, vital signs, deep tendon reflexes;
magnesium, calcium, and potassium levels; renal function during administration. Obstetrics: Patient status
including vital signs, oxygen saturation, deep tendon reflexes, level of consciousness, fetal heart rate,
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

maternal uterine activity. Oral: Renal function; magnesium levels; bowel movements.

18) MEPERIDINE HYDROCHLORIDE

Brand name: Demerol

Classification: antivertigo drug
Dosage: 100 mg/ 2mL
Indication: relief of moderate to severe pain, pre-op medication, support of anesth & obstet analgesia
Action: binds with opiate receptors in the CNS, altering perception of and emotional response to pain
Adverse Reactions: resp. depression, circulatory depression, resp arrest, shock, cardiac arrest, GI
disturbance, light headedness, dizziness, sedation, nausea, vomiting, sweating, euphoria, dysphoria,
weakness, headache, tremor, agitation, uncoordinated muscle movements, severe convulsions, transient
hallucinations & disorientation, visual disturbance, flushing, tachycardia, bradycardia, palpitation,
hypotension, syncope, phlebitis, urinary retention, allergic reactions, pain at injection site and local tissue
irritation.
Nursing Responsibilities:
• Make position changes slowly and in stages may impair ability to perform tasks requiring mental
particularly from recumbent to upright posture. Lie alertness and therefore to.
down immediately if light-headedness or dizziness • Do not take alcohol or other CNS depressants
occurs. unless approved by physician.
• Lie down when feeling nauseated and to notify • Hyperactive cough may be lessened by avoiding
physician if this symptom persists. Nausea appears irritants such as smoking, dust, fumes and other air
to worsen with ambulation. pollutants. Humidification of ambient air may
• Avoid driving and other potentially hazardous provide some relief.
activities until reaction to drug is known. Codeine • Do not breast feed while taking this drug.

19) METOCLOPRAMIDE

Brand name: Apo-Metoclop (CAN), Maxeran (CAN), Maxolon, Nu-Metoclopramide (CAN), Octamide PFS,
Reglan
Classification: antiemetic & anti-spasmodic
Dosage: 10 mg/ 2mL
Indication: disturbances of GI motility, nausea & vomiting of central & peripheral origin associated w/
surgery, metabolic diseases, infectious & drug induced diseases, facilitate small bowel intubation &
radiological procedures of GIT
Action: stimulates motility of upper GI tract, increases lower esophageal sphincter tone, and blocks
dopamine receptors at the chemoreceptor trigger zone
Adverse Reactions: extrapyramidal reactions, drowsiness, fatigue & lassitude, anxiety, less frequently,
insomnia, headache, dizziness, nausea, galactorrhea, gynecomastia, bowel disturbances.
Nursing Responsibilities:
• Monitor BP carefully during IV administration. compromised by alterations in timing of food
• Monitor for extrapyramidal reactions, and absorption.
consult physician if they occur. • Keep diphenhydramine injection readily
• Monitor diabetic patients, arrange for alteration available in case extrapyramidal reactions occur
in insulin dose or timing if diabetic control is (50 mg IM).
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

• Have phentolamine readily available in case of undiagnosed pheochromocytoma).

hypertensive crisis (most likely to occur with

20) MIDAZOLAM HYDROCHLORIDE

Brand name: Dormicum

Classification: hypnotics & sedatives
Dosage: 5mg/5mL
Indication: tab: disturbances of sleep rhythm, insomnia esp difficulty in falling asleep either initially or after
premature awakening, tab/inj: sedation in premed before surgical or diagnostic procedures, induction &
maintenance of anesth.
Action: may potentiate the effects of GABA, depress the CNS, and suppress the spread of seizure
activity
Adverse Reactions: rarely cardioresp adverse events, nausea, vomiting, headache, hiccoughs,
laryngospasm, dyspnoea, hallucination, oversedation, drowsiness, ataxia, rash, paradoxical reactions,
amnesic episodes.
Nursing Responsibilities:
• Do not administer intra-arterially, which may flumazenil available as antidote if overdose should
produce arteriospasm or gangrene. occur.
• Do not use small veins (dorsum of hand or wrist) • Keep patients in bed for 3 hr; do not permit
for IV injection. ambulatory patients to operate a vehicle following
• Administer IM injections deep into muscle. an injection.
• Monitor IV injection site for extravasation. • Arrange to monitor liver and kidney function and
• Arrange to reduce dose of midazolam if patient is CBC at intervals during long-term therapy.
also being given opioid analgesics; reduce dosage • Establish safety precautions if CNS changes occur
by at least 50% and monitor patient closely. (use side rails, accompany ambulating patient).
• Monitor level of consciousness prior to, during, • Provide comfort measures and reassurance for
and for at least 2–6 hr after administration of patients receiving diazepam for tetanus.
midazolam. • Provide patient with written information regarding
• Carefully monitor P, BP, and respirations carefully recovery and follow-up care. Midazolam is a potent
during administration. amnesiac and memory may be altered.
• Keep resuscitative facilities readily available; have
21) MORPHINE SULFATE

Brand name: Morin

Classification: Analgesics (Opioid)
Dosage: Adult 5-20 mg IM/SC 4 hrly. Severe or chronic pain Childn 10 mg IM/SC 4 hrly, range: 5-20 mg;
6-12 yr 5-10 mg, 1-5 yr 2.5-5 mg, 1-12 mth 200 mcg/kg, <1 mth 150 mcg/kg 4 hrly. Max: 15 mg. Analgesic
effect Ped 100-200 mcg/kg SC 4 hrly, max: 15 mg/dose; or 50-100 mcg/kg slow IV. Pre-op 50-100 mcg/kg
IM, max: 10 mg/dose.
Indication: Relief of moderate to severe pain not responsive to non-narcotic analgesics. Premed.
Analgesic adjunct in general anesth esp in pain associated w/ cancer, MI & surgery. Alleviates anxiety
associated w/ severe pain. Hypnotic for pain-related sleeplessness.
Action: alters perception and emotional response to pain
Adverse Reactions: Lightheadedness, dizziness, sedation, nausea, vomiting, constipation & sweating.
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

Nursing Responsibilities:
• Caution patient not to chew or crush controlled- areas or in patients with hypotension or in shock;
release preparations. impaired perfusion may delay absorption; with
• Dilute and administer slowly IV to minimize repeated doses, an excessive amount may be
likelihood of adverse effects. absorbed when circulation is restored.
• Tell patient to lie down during IV administration. • Reassure patients that they are unlikely to become
• Keep opioid antagonist and facilities for assisted addicted; most patients who receive opioids for
or controlled respiration readily available during IV medical reasons do not develop dependence
administration. syndromes.
• Use caution when injecting SC or IM into chilled

22) NICARDIPINE HYDROCHLORIDE

Brand name: Cardepine

Classification: Calcium Antagonists
Dosage: IV infusion Dilute to 10-20 mg/100 mL (conc. of 1.01-0.02%). Initial infusion rate: 5 mg/hr; titrate
dose up to 15 mg/hr until desired therapeutic response is achieved (DBP <95 mmHg, SBP <140 mmHg).
Maintenance rate: Can be tapered down to ≤10 mg/hr. IV bolus inj 2-7 mg w/out dilution given over 1-2
min.
Indication: Hypertensive emergencies or urgencies, peri-op & post-op HTN, hypertensive states of NPO
patients.
Action: a Calcium channel blocker that inhibits Calcium ion influx across cardiac and smooth muscle
cells; also dilates coronary arteries and arterioles
Adverse Reactions: Peripheral edema, headache, tachycardia, palpitations, localized thrombophlebitis &
hypotension.
Nursing Responsibilities:
• Patients with hepatic impairment should receive lower dose.
• Monitor blood pressure. Allow at least 3 days between dosage adjustments to achieve steady plasma
levels.
• Advise patient to report immediately if experiencing chest pain

23) NTG PATCH

Brand name: Deponit, Minitran, Nitrek, Nitro-Dur, Nitrodisc, Transderm-Nitro

Classification: Anti-Anginal Drugs
Dosage: Starting dose: 0.2-0.4 mg/hr. Dosing schedule: Daily patch-on period of 12-14 hr & daily patch-off
period of 10-12 hr.
Indication: Prevention of angina pectoris due to coronary artery disease
Action: a nitrate that reduces cardiac oxygen demand by decreasing left ventricular end diastolic
pressure and to a lesser extent, systemic vascular resistance, also increases blood flow through collateral
coronary vessels
Adverse Reactions: Headache. Transient episodes of lightheadedness. Infrequently, hypotension.
Syncope, crescendo angina, rebound HTN, allergic & anaphylactoid reactions. Rarely severe, application
site irritation.
Nursing Responsibilities:
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

• Administer transdermal systems to skin site free or cardioversion.

of hair and not subject to much movement. Shave
areas that have a lot of hair. Do not apply to distal
extremities. Change sites slightly to decrease the
chance of local irritation and sensitization. Remove
transdermal system before attempting defibrillation
• To use transdermal systems, you may need to
shave an area for application. Apply to a slightly
different area each day. Use care if changing
brands; each system has a different concentration.

24) PARACETAMOL

Brand name: Aeknil

Classification: Analgesics (Non-Opioid) & Antipyretics
Dosage: Adult & childn ≥10 yr 2-3 mL, ≤10 yr 1-2 mL. Depending on severity of case, dose may be
repeated 4 hrly. In severe cases, dose may be administered by IV very slowly
Indication: Pyrexia of unknown origin. Fever & pain associated w/ common childhood disorders, tonsillitis,
upper resp tract infections post-immunization reactions, after tonsillectomy & other conditions. Prevention
of febrile convulsion. Headache, cold, sinusitis, muscle pain, arthritis & toothache
Action: produce analgesia by blocking pain impulses by inhibiting synthesis of prostaglandin in CNS,
relieves fever
Adverse Reactions: Hematological, skin & other allergic reactions
Nursing Responsibilities:
• Use liquid form for children and patients who have days.
difficulty swallowing. • Advise patient or caregiver that many over the
• In children, don’t exceed five doses in 24 hours. counter products contain acetaminophen; be aware
• Advise patient that drug is only for short term use of this when calculating total dailydose.
and to consult the physician if giving to children for • Warn patient that high doses or unsupervised long
longer than 5 days or adults for longer than 10 term use can cause liver damage.

25) PHENYTOIN

Brand name: Dilantin

Classification: Anticonvulsants
Dosage: Adult Initially 100 mg tid. Maintenance: 300-400 mg daily. Childn ≥6 yr Initially 100 mg tid,
subsequent dosage should be adjusted according to therapeutic response, <6 yr 30 mg bid, may be
increased to 30 mg tid or qid. Pedia 5 mg/kg/day Initially in 2-3 equally divided doses. Max: 300 mg daily.
Maintenance: 4-8 mg/kg/day
Indication: Tonic-clonic & complex partial (psychomotor, temporal lobe), prevention & treatment of
seizures occurring during or following neurosurgery
Action: may stabilize neuronal membranes and limit seizure activity by either by increasing efflux or
decreasing influx of Na ions across cell membrane in the motor cortex during generation of nerve
impulses
Adverse Reactions: GI disturbances; ataxia, slurred speech; diplopia, nystagmus & mental confusion w/
headache, dizziness, gingival hyperplasia, hirsutism, hyperglycemia, osteomalacia
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

Nursing Responsibilities:
• Assess location, duration, frequency, and characteristics of seizure activity. EEG may be monitored
periodically throughout therapy, Assess oral hygiene. Vigorous oral cleaning beginning within 10 days of
initiation of phenytoin therapy may help control gingival hyperplasia.

26) TERBUTALINE

Brand name: Bricalin

Classification: Antiasthmatic & COPD Preparations
Dosage: Antiasthmatic & COPD Preparations
Indication: For reversible airways obstruction, in asthma, COPD. Decreases uterine contractility & may be
used to arrest premature labor
Action: relaxes bronchial smooth muscles by stimulating beta-2 receptors
Adverse Reaction: Fine tremor of skeletal muscle esp hands, palpitations, tachycardia, nervous tension,
headache, peripheral vasodilation.
Nursing Responsibilities:
• Use minimal periods of time; drug tolerance can occur with prolonged use.
• Keep beta-adrenergic blocker readily available in case cardiac arrhythmias occur.
• Do not recommended dosage.

27) VERAPAMIL HYDROCHLORIDE

Brand name: Calan, Calan SR, Covera-HS, Isoptin, Isoptin SR, Verelan, Verelan PM
Classification: Calcium Antagonists
Dosage: Isoptin tab Adult 40-80 mg tid-qid. Max: 480 mg daily. Childn >6 yr 40-120 mg bid-tid, up to 360
mg daily, childn ≤6 yr 40 mg bid-tid. Isoptin SR 180 Coronary insufficiency 1 tab bid. Usual daily dose:
240-480 mg. Hypertension 1 tab in the morning. Isoptin SR 240 1 tab in the morning. If required after 2
wk, increase dose to 2 tab daily. Isoptin amp 5 mg slow IV, if required, 5 mg after 5-10 min. Then, if
required, continuous drip infusion of 5-10 mg/hr up to 100 mg/day. Angina pectoris & rapid elimination of
tachyarrhythmias 1-2 amp IV, if required bid-tid
Indication: Isoptin/Isoptin SR 180 Essential hypertension, chronic coronary insufficiency, angina pectoris,
paroxysmal supraventricular tachycardia, tachyarrhythmias, long-term treatment after MI. Isoptin SR 240
Essential hypertension
Action: decreases myocardial contractility and oxygen demand, it also dilates coronary arteries and
arterioles
Adverse Reactions: Constipation, dizziness, nausea. Rarely, vertigo, headache, hypotension, ankle
edema, flushing, fatigue, nervousness, erythromelalgia, paraesthesia, neuropathy; bradycardiac
arrhythmias, CHF. Dyspnea
Nursing Responsibilities:
• Monitor patient carefully (BP, cardiac rhythm, do not cut, crush, or chew them.
and output) while drug is being titrated to • Administer sustained-release form in the
therapeutic dose. Dosage may be increased morning with food to decrease GI upset.
more rapidly in hospitalized patients under close • Protect IV solution from light.
supervision. • Monitor patients with renal or hepatic
• Ensure that patient swallows SR tablets whole: impairment carefully for possible drug
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

accumulation and adverse reactions.

28) IPRATROPIUM INHALATION

Brand name: Atrovent

Classification: Antiasthmatic & COPD Preparations, anticholinergics or antimuscarinics
Stock: 0.5 mg/2 mL
Dosage: Adult (including elderly) & adolescent >12 yr Acute attacks 1 vial, may repeat doses until patient
is stable. Maintenance: 1 vial tid-qid.
Indication: Bronchodilator for treatment of bronchospasm associated w/ COPD, including chronic
bronchitis, emphysema and asthma
Action: it works by binding to specific receptors (called muscarinic receptors) in the airway, helping to
relax the smooth muscle of the airway. When used to treat a runny nose, it works by decreasing the
production of fluid in the glands that line the nasal passages
Adverse Reaction: Headache, nausea, dry mouth, increased heart rate & palpitations, ocular
accommodation disturbances, GI motility disturbances, urinary retention, ocular side effects, cough, local
irritation, bronchoconstriction, skin rash, angioedema, urticaria, laryngospasm, anaphylactic reactions.
Nursing Responsibilities:
• Protect solution for inhalation from light. Store • Ensure adequate hydration, control environmental
unused vials in foil pouch. temperature to prevent hyperpyrexia.
• Use nebulizer mouthpiece instead of face mask to • Have patient void before taking medication to
avoid blurred vision or aggravation of narrow-angle avoid urinary retention.
glaucoma. • Teach patient proper use of inhalator.
• Can mix albuterol in nebulizer for up to 1 hr.

29) FENOTEROL/IPRATROPIUM BROMIDE

Brand name: Berodual

Classification: Antiasthmatic & COPD Preparations
Dosage: Berodual inhalation soln Adult (including elderly) & adolescent >12 yr Treatment of 1 mL for
immediate symptom relief. Intermittent & long-term treatment 1-2 mL for each administration, up to qid.
Moderate bronchospasm or w/ assisted ventilation 0.5 mL. Childn 6-12 yr Treatment of attacks 0.5-1 mL.
Intermittent & long-term treatment 0.5-1 mL for each administration, up to qid. Moderate bronchospasm or
w/ assisted ventilation 0.5 mL. Childn <6 yr (<22 kg body wt) Up to 0.5 mL up to tid. Berodual F UDV Adult
& childn >12 yr Acute asthma episodes 1 vial, in very severe cases, 2 vials are needed. Intermittent &
long-term treatment 1 vial up to qid.
Indication: prevention and treatment of symptoms in chronic obstructive airway disorders with reversible
bronchospasm
Action: for the prevention and treatment of reversible bronchospasm associated with bronchial asthma
and especially chronic bronchitis with or without emphysema
Adverse Reactions: Fine tremor of skeletal muscles, nervousness, restlessness, palpitations; less
frequently tachycardia, dizziness or headache. Dry mouth, throat irritation or allergic reactions, cough,
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

paradoxical bronchoconstriction (rare). Urinary retention may occur in particular, in patients w/ preexisting
outflow tract obstruction.
Nursing Responsibilities:
• Protect solution for inhalation from light. Store • Ensure adequate hydration, control environmental
unused vials in foil pouch. temperature to prevent hyperpyrexia.
• Use nebulizer mouthpiece instead of face mask to • Have patient void before taking medication to
avoid blurred vision or aggravation of narrow-angle avoid urinary retention.
glaucoma. • Teach patient proper use of inhalator.
• Can mix albuterol in nebulizer for up to 1 hr.

30) BUDESONIDE

Brand name: Symbicort

Classification: Corticosteroids
Dosage: 80/4.5 mcg x 60 doses; 160/4.5 mcg x 60 doses; 320/9 mcg x 60 doses
Indication: regular treatment of asthma where use of a combination (inhaled corticosteroid and long acting
beta 2 agonist) is appropriate
Action: work by reducing inflammation, which helps with several conditions ranging from asthma to
allergies toCrohn’s disease
Adverse Reactions: Abdominal pain, conjunctivitis (pinkeye), cough, diarrhea, ear infection or
inflammation, fever, fungal infection in mouth, headache, nasal or sinus inflammation, nosebleed, pain,
rash, respiratory infection, stomach or intestinal inflammation, throat inflammation, viral infection, vomiting,
wheezing
Nursing Responsibilities:
• Taper systemic steroids carefully during transfer to have patient rinse mouth after each use.
inhalational steroids; deaths from adrenal • Use aerosol within 6 mo of opening. Shake well
insufficiency have occurred. before each use.
• Arrange for use of decongestant nose drops to • Store Respules upright and protected from light;
facilitate penetration if edema, excessive secretions gently shake before use; open envelopes should be
are present. discarded after 2 wk.
• Prime unit before use for Pulmicort Turbuhaler;

31) ALBUTEROL AND IPRATROPIUM INHALATION

Brand name: Combivent

Classification: Bronchodilators
Stock: 2.5 mL
Dose: MDI Adult 2 puffs tid-qid. Max 12 puffs/day. Unit dose vial Adult & childn >12 yr 1 vial every 6-8 hr.
Childn 2-12 yr 3 drops/kg/dose (max: 2500 mcg of salbutamol) every 6-8 hr.
Indication: management of reversible bronchospasm associated with obstructive airway diseases in
patients who require more than a single bronchodilator
Action: muscles in the airways and increase air flow to the lungs
Adverse Reactions: Fine tremor of skeletal muscle; palpitations; headache, dizziness, nervousness;
dryness of mouth, throat irritation; urinary retention
Nursing Responsibilities:
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

• Use nebulizer mouthpiece instead of face mask to temperature to prevent hyperpyrexia.

avoid blurred vision or aggravation of narrow-angle • Have patient void before taking medication to
glaucoma. avoid urinary retention.
• Can mix albuterol in nebulizer for up to 1 hr. • Teach patient proper use of inhalator.
• Ensure adequate hydration, control environmental

32) SALBUTAMOL

Brand name: Aero-Vent

Classification: bronchodilator
Stock: 1 mg/1 mL
Dose: Adult & childn 2.5-5 mg. May repeat qid by hlebitis. Delivery of aerosol may be by face mask of “T”
piece. Use undiluted. For prolonged delivery time, dilute w/ sterile water or normal saline for inj.
Indication: treatment of acute, severe asthma and in routine management of chronic bronchospasm
unresponsive to conventional therapy
Action: used with anti-inflammatory medication to prevent asthma attacks, Some of these medicines are
used to treat the symptoms of asthma, chronic bronchitis, emphysema, and other lung diseases, while
others are used to prevent the symptoms
Adverse Reactions: Dizziness, severe; feeling of choking, irritation, or swelling in throat; flushing or
redness of skin; hives; increased shortness of breath; skin rash; swelling of face, lips, or eyelids; tightness
in chest or wheezing, troubled breathing
Nursing Responsibilities:
• Assess lung sounds, pulse, and blood pressure professional immediately.
before administration and during peak of • Instruct mother to take missed dose as soon as
medication. Note amount, color, and character of remembered, spacing remaining doses at regular
sputum produced. intervals. Do not double doses or increase the dose
• Monitor pulmonary function tests before initiating or frequency of doses.
therapy and periodically throughout course to • Inform the mother not to smoke near the child and
determine effectiveness of medication. to avoid respiratory irritants.
• Observe for paradoxical bronchospasm • Advise the mother to rinse the child’s mouth with
(wheezing). If condition occurs, withhold medication water after each inhalation dose to minimize dry
and notify physician or other health care mouth.

33) TERBUTALINE SULFATE

Brand name: Pulmonyl

Classification: Antiasthmatic/ Brochodilator
Stock: 2.5 mg/ml
Dose: Adult 5-10 mg, Children 2-5mg
Indication: relief of bronchospasm in obstructive airway diseases
Action: It works by dilating (opening) the bronchioles of the lungs by relaxing the muscles around them.
This allows for easier airflow into and out of the lungs
Adverse Reactions: Headache, nausea, vomiting, palpitations, tachycardia, sweating & drowsiness
Nursing Responsibilities:
• Use minimal periods of time; drug tolerance can occur with prolonged use.
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

• Keep beta-adrenergic blocker readily available in case cardiac arrhythmias occur.

• Do not recommended dosage.

34) HEPARIN SODIUM

Brand name: Britton Heparin Na

Classification: Anticoagulants, Antiplatelets & Fibrinolytics (Thrombolytics)
Dosage: 5000 iu/1 mL; 25000 iu/1 mL
Indication: treatment and prophylaxis of thromboembolic disorders
Action: Accelerates formation of antithrombin III-thrombin complex and deactivates thrombin, preventing
conversion of fibrinogen to fibrin
Adverse Reactions: Slight fever, headache, chills, nausea, vomiting, constipation, epistaxis, bruising,
slight haematuria, skin necrosis (SC inj), osteoporosis, alopecia. Hypersensitivity reactions include
urticaria, conjunctivitis, rhinitis, asthma, angioedema and anaphylactic shock. Priapism. Potentially Fatal:
Heparin-induced thrombocytopenia with or without thrombosis; bleeding
Nursing Responsibilities:
• Baseline blood coagulation tests, Hct, Hgb, RBC • Pts vary widely in their reaction to heparin; risk of
and platelet counts prior to initiation or therapy and hemorrhage appears greatest in women, all patients
at regular intervals throughout therapy > 60 y, and patients with liver disease or renal
• Monitor APTT levels closely insufficiency.
• Draw blood for coagulation tests 30 min before • Monitor vitals, report fever, drop in BP, rapid pulse
each scheduled SC or intermittent IV dose and and other S&S of hemorrhage
approximately q4h for pts receiving continuous IV • Observe all needle sites daily for hematoma and
heparin during dosage adjustments period. After signs of inflammation
dosage is established, tests may be done once • Have on hand protamine sulfate, specific heparin
daily antagonist

35) ESMOLOL HYDROCHLORIDE

Brand name: Brevibloc

Classification: Beta blockers
Dosage: 100mg/10ml
Indication: supraventricular tachycardia; post-operative tachycardia or hypertension; non-compensatory
sinus tachycardias; intra-operative tachycardia or hypertension; unstable angina, non ST segment
elevation MI
Action: A Class II antiarrythmic and ultra-short-acting selective beta blocker that decreases heart rate,
contractility and blood pressure
Adverse Reactions: Hypotension, bradycardia, heart failure, local irritation, diaphoresis, peripheral
ischaemia, dizziness, somnolence, confusion, fatigue, paraesthesia, peripheral neuropathy, headache,
weakness, irritability, dyspnoea, nausea, vomiting, blurred vision, urinary retention, fever, rigor, muscular
pain. Potentially Fatal: Profound bradycardia, AV block, cardiogenic shock, asystole, bronchospasm.
Nursing Responsibilities:
• Monitor patient carefully (BP, cardiac rhythm, and output) while drug is being titrated to therapeutic dose.
Dosage may be increased more rapidly in hospitalized patients under close supervision.
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

• Monitor cardiac rhythm regularly during stabilization of dosage and periodically during long-term therapy.

36) D 50-50

Brand name: Phil Pharmawealth/Atlantic 50% Dextrose

Classification: Intravenous & Other Sterile Solutions
Dosage: 50ml/vial
Indication: for hypoglycemia
Action: A simple water soluble sugar that minimizes glyconeogenesis and promotes anabolism in
patients whose oral caloric intake is limited
Adverse Reactions: Local pain, vein irritation, thrombophlebitis & tissue necrosis in the event of
extravasation. Fluid & electrolyte imbalance eg hypokalemia, hypomagnesemia & hypophosphatemia;
edema or water intoxication
Nursing Responsibilities:
• Monitor infusion rate frequently; if signs of fluid overload, turn off IV drip. Infusion may result in fluid
overload.
• Check IV site frequently and if infiltration is noted, turn off IV drip.
• Watch out for signs of fluid overload (distended neck veins (JVD), rapid respirations, shallow tidal
volume, fine auscultatory crackles, dyspnea, and peripheral edema)
• Watch out for signs of infiltration (swelling and pain around IV site).

37) POTASSIUM CHLORIDE

Brand name: Phil Pharmawealth/Atlantic Potassium Chloride

Classification: Electrolytes
Dosage: 40 meqs/20 ml
Indication: for hypokalemia, acute MI
Action: Replaces potassium and maintains potassium level
Adverse Reactions: GI ulceration (sometimes with haemorrhage and perforation or with late formation of
strictures) following the use of enteric-coated K chloride preparation; hyperkalaemia. Oral: Nausea,
vomiting, phlebiti and abdominal cramps. IV: Pain or phlebitis; cardiac toxicity.
Nursing Responsibilities:
• Monitor serum potassium levels, renal function, in the stool. This occurrence is not significant.
and serum bicarbonate. • Instruct patient to avoid salt substitutes or low-salt
• Explain to patient purpose of the medication and milk or food unless approved by health care
the need to take as directed,especially when professional.
concurrent digoxin or diuretics are taken. A missed • Patient should be advised to read all labels to
dose should be taken as soon as remembered prevent excess potassium intake.
within 2 hr; if not, return to regular doseschedule. • Advise patient regarding sources of dietary
Do not double dose. potassium.
• Emphasize correct method of administration. GI • Encourage compliance with recommended diet.
irritation or ulceration may result from chewing • Instruct patient to report dark, tarry, or bloody
enteric-coated tablets or insufficient dilution of liquid stools; weakness; unusual fatigue; or tingling of
or powder forms. Some extended-release tablets extremities.
are contained in a wax matrix that may be expelled • Notify health care professional if nausea, vomiting,
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

diarrhea, or stomach discomfort persists. importance of regular follow-up exams to monitor

• Dosage may require adjustment. Emphasize the serum levels and progress.

38) LIDOCAINE HYDROCHLORIDE

Brand name: Abbott Lidocaine

Classification: Anaesthetics - Local & General
Dosage: 50 ml/vial
Indication: local or regional anesthesia
Action: A class IB antiarrythmic that decreases the depolarization, automaticity, and excitability in the
ventricles during the diastolic phase by direct action on the tissues especially the Purkinje network
Adverse Reactions: Restlessness, nervousness, dizziness, tinnitus, blurred vision; GI upsets; muscle
twitching, convulsions; numbness of the tongue; hypotension, bradycardia; methemoglobinaemia; fetal
intoxication.
Nursing Responsibilities:
• Check drug concentration carefully; many spinal anesthetic remain lying flat for 6–12 hr
concentrations are available. afterward, and ensure that they are adequately
• Reduce dosage with hepatic or renal failure. hydrated to minimize risk of headache.
• Continuously monitor response when used as • Check lidocaine preparation carefully; epinephrine
antiarrhythmic or injected as local anesthetic. is added to solutions of lidocaine to retard the
• Keep life-support equipment and vasopressors absorption of the local anesthetic from the injection
readily available in case severe adverse reaction site. Be sure that such solutions are used
(CNS, CV, or respiratory) occurs when lidocaine is • only to produce local anesthesia. These solutions
injected. should be injected cautiously in body areas supplied
• Establish safety precautions if CNS changes by end arteries and used cautiously in patients with
occur; have IV diazepam or short-acting barbiturate peripheral vascular disease, hypertension,
(thiopental, thiamylal) readily available in case of thyrotoxicosis, or diabetes.
seizures. • Use caution to prevent choking. Patient may have
• Monitor for malignant hyperthermia (jaw muscle difficulty swallowing following use of oral topical
spasm, rigidity); have life-support equipment and IV anesthetic. Do not give food or drink for 1 hr after
dantrolene on standby. use of oral anesthetic.
• Titrate dose to minimum needed for cardiac • Treat methemoglobinemia with 1% methylene
stability, when using lidocaine as antiarrhythmic. blue, 0.1 mg/kg, IV over 10 min.
• Reduce dosage when treating arrhythmias in CHF, • Apply lidocaine ointments or creams to a gauze or
digitalis toxicity with AV block, and geriatric patients. bandage before applying to the skin.
• Monitor fluid load carefully; more concentrated • Monitor for safe and effective serum drug
solutions can be used to treat arrhythmias in concentrations (antiarrhythmic use: 1–5 mcg/mL).
patients on fluid restrictions. Doses > 6–10 mcg/mL are usually toxic
• Have patients who have received lidocaine as a

39) SODIUM BICARBONATE

Brand name: Hospira Sodium Bicarbonate

Classification: Alkalinizers
Dosage: 10mEq/10ml; 50mEq/50ml
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

Indication: metabolic acidosis, systemic or urinary alkalinization, antacid, cardiac arrest

Action: Restores buffering capacity of the body and neutralizes excess acid
Adverse Reaction: Tetany, edema, gastric distention, belching, flatulence, hypokalemia, metabolic
alkalosis, hypernatremia, chemical cellulitis because of alkalinity, pain, irritation, tissue necrosis,
ulceration or sloughing at the site of infiltration
Nursing Responsibilities:
• do not take drug with milk to avoid hypercalcemia, abnormally high alkalinity in tissues and fluids, or
kidney stones.
• do not give to patients with metabolic or respiratory alkalosis, and in those with hypocalcemia in which
alkalosis may produce tetany, hypertension, seizures, or heart failure.
• monitor for alkalosis by obtaining blood pH, PaO2, PCO2, and electrolyte levels

40) DOPAMINE

Brand name: Intropin

Classification: Adrenergics (Sympathomimetics)
Dosage: 40 mg/Ml; 80 mg/mL; 160 mg/mL
Indication : shock and hemodynamic imbalances, hypotension
Action: Stimulates dopaminergic and alpha beta receptors for the sympathetic nervous system resulting
in a positive inotropic effect and increased cardiac output. Action is dose-related; large doses cause
mainly alpha stimulation
Adverse Reaction: ectopic beats, tachycardia, anginal pain, palpitation, hypotension, vasoconstriction,
ventricular arrhythmias, hypertension, headache, anxiety, dilated pupils, nausea, vomiting, decreased
urine output, dyspnea
Nursing Responsibilities:
• Monitor vital signs and ECG closely throughout wedge pressure if possible during infusion.
therapy. • Note significant changes in vital signs, ECG
• Monitor I&O regularly; note decreases in urine changes, deterioration of peripheral pulses, and/or
output. cold, mottled extremities
• Monitor central venous pressure or pulmonary

41) DOBUTAMINE

Brand name: Dobatrey

Classification: Adrenergics
Dosage: 12.5 mg/mL
Indication: increased cardiac output in short term treatment of cardiac decompensation caused by
depressed contractility
Action: Stimulates heart’s beta1 receptors to increase myocardial contractility and stroke volume.
Increases cardiac output by decreasing peripheral vascular resistance, reducing ventricular filling
pressure, and facilitating AV node conduction
Adverse Reaction: increased systolic BP, increased heart rate, chest pain, increased number of
premature ventricular beats, headache, tingling sensations, paresthesia. nausea, vomiting, dyspnea,
phlebitis, local inflammation after infiltration, leg cramps
Nursing Responsibilities:
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

• Monitor vital signs, ECG, cardiac output, pulmonary capillary wedge pressure, central venous pressure
and urinary output carefully throughout infusion.
• Monitor patency and placement of IV catheter to reduce risk of extravasation and phlebitis.
• Watch out for symptoms of overdosage such as excessive hypertension, tachycardia, nausea, vomiting,
tremor, headache, chest pain

42) LIDOCAINE PREMIXED

Brand name: Xylocaine

Classification: Antiarrhythmic agent, Local anesthetic
Dosage: 0.2% (2mg/ml); 0.4% (4g/ml); 0.8% (8g/ml)
Indication: ventricular arrhythmias caused by MI, cardiac manipulation or cardiac glycosides
Action: Acts as an anesthetic by stabilizing the neuronal membrane by inhibiting the ionic fluxes required
for the initiation and conduction of impulses, thereby effecting local anesthetic action. Also acts as an
antiarrhythmic by decreasing the depolarization, automaticity, and excitability in the ventricles during the
diastolic phase by a direct action on the tissues, especially the Purkinje network, without involvement of
the autonomic system. Neither contractility, systolic arterial blood pressure, atrioventricular (AV)
conduction velocity, nor absolute refractory period is altered by usual therapeutic doses
Adverse Reaction: bradycardia, cardiac arrest, CV collapse, hypotension, apprehension, confusion,
dizziness, drowsiness, hallucinations, headache, light-headedness, mood changes, nervousness,
tremors, conjunctival hyperemia, corneal epithelial changes, diplopia, tinnitus, visual disturbances,
nausea, vomiting, erythema, petechiae, edema, injection-site reactions, including bruising, burning,
contusion, hemorrhage, local reactions, including soreness at IM injection site, venous thrombosis or
phlebitis, extravasation, burning, stinging, sloughing, respiratory depression or arrest, hypersensitivity
reactions
Nursing Responsibilities:
• Explain that adverse reactions related to the CNS • Systemic effects can occur following topical use;
(eg, drowsiness, confusion, paresthesias, use lowest possible dose to avoid serious toxicity,
convulsions, respiratory arrest) can occur and are a shock, or heart block.
result of CNS toxicity. • Do not use in patients with congenital or idiopathic
• Advise patient that drug may cause dizziness or methemoglobinemia or in infants younger than
drowsiness and to avoid getting out of bed or 12 mo of age who are receiving methemoglobin-
walking without assistance. inducing drugs.
• Advise patients that skin reactions, including • Use with caution and in lower doses in patients
erythema, petechiae, and edema, may occur with with CHF, reduced cardiac output, digitalis toxicity,
intradermal injection. and in elderly patients

43) MANNITOL

Brand name: Osmitrol

Classification: osmotic diuretic
Dosage: 5% , 10%, 15%, 20%, 25% in 500cc/1,000cc
Indication: test dose for marked oliguria or suspected inadequate renal function, oliguria, to reduce
intraocular or intracranial pressure, diuresis in drug intoxication
Action: Increases osmotic pressure of glomerular filtrate; drug elevates plasma osmolality
JUNATHAN L. DELGADO BSN-2 SUBMITTED TO: RHONA MARIE NOQUIAO, MAN

Adverse Reaction: Increased urination, nausea, runny nose, vomiting, severe allergic reactions (rash,
hives, itching, difficulty breathing, tightness in the chest, swelling of the mouth, face, lips, or tongue),
blurred vision, chest pain, chills or fever, confusion, decreased alertness, difficulty urinating, extreme
dizziness, extreme thirst or dry mouth, fast or irregular heartbeat, headache, muscle cramps, pain,
redness, or swelling at the injection site, weakness
Nursing Responsibilities:
• Monitor vital signs, including CVP, and fluid excessive hypertension, tachycardia, nausea,
intake and output. vomiting, tremor, headache, chest pain
• Monitor weight, renal function, and serum sodium • To relieve thirst, give frequent mouth care and
and potassium levels daily fluids
• Watch out for symptoms of overdosage such as

44) DEXTROSE 5% IN WATER (D5W) SOLUTION

Brand name: None

Classification: Isotonic/Hypotonic Solution
Dosage: 250ml bottles (5g dextrose/100ml water)
Indication: fluid replacement and caloric supplementation in patients who can’t maintain adequate oral
intake or are restricted from doing so
Action: Provides some sugar for cellular metabolism and supplies body water
Adverse Reaction: Increases free water and may cause intracellular edema, fluid overload, infiltration
(swelling and pain at infusion site)

Nursing Responsibilities:

• Monitor infusion rate frequently; if signs of fluid overload, turn off IV drip. Infusion may result in fluid
overload.
• Check IV site frequently and if infiltration is noted, turn off IV drip.
• Watch out for signs of fluid overload (distended neck veins (JVD), rapid respirations, shallow tidal
volume, fine auscultatory crackles, dyspnea, and peripheral edema)
• Watch out for signs of infiltration (swelling and pain around IV site).
REFERENCE:

(October 21, 2009). EMERGENCY DRUGS: A drug study.. Retrieved from

http://nursingsource.blogspot.com/2009/10/emergency-drugs-drug-study.html