Indication/ Side effect/Adverse

Mechanism of Action Nursing considerations

Contraindication effect
Generic name: Indications: Naturally occurring Special Senses: o Monitor BP,
Epinephrine o Temporary relief catecholamine obtained Nasal burning or pulse, respirations,
of bronchospasm, from animal adrenal stinging, dryness of and urinary output
Classification: acute asthmatic glands; also prepared nasal mucosa, sneezing, and observe patient
Autonomic nervous attack, mucosal synthetically. Acts rebound congestion. closely following IV
system agent; alpha and congestion, directly on both alpha Transient stinging or administration.
beta adrenergic agonist; hypersensitivity and and beta receptors; the burning of eyes, Epinephrine may
bronchodilator anaphylactic most potent activator of lacrimation, browache, widen pulse
reactions, syncope alpha receptors. headache, rebound pressure. If
Dosage due to heart block or Strengthens myocardial conjunctival hyperemia, disturbances in
1:1000mL 1mL carotid sinus contraction; increases allergy, iritis; with cardiac rhythm
hypersensitivity, and systolic but may prolonged use: melanin- occur, withhold
to restore cardiac decrease diastolic blood like deposits on lids, epinephrine and
rhythm in cardiac pressure; increases conjunctiva, and cornea; notify physician
arrest. cardiac rate and cardiac corneal edema; loss of immediately.
o Ophthalmic output. lashes (reversible); o Keep physician
preparation is used maculopathy with informed of any
in management of central scotoma in changes in intake-
simple (open-angle) aphakic patients output ratio.
glaucoma, generally (reversible). o Use cardiac
as an adjunct to monitor with patients
topical miotics and Body as a Whole: receiving
oral carbonic Nervousness, epinephrine IV.
anhydrase inhibitors; restlessness, Have full crash cart
also used as sleeplessness, fear, immediately
ophthalmic anxiety, tremors, severe available.
decongestant. headache, o Check BP
o Relaxes cerebrovascular repeatedly when
myometrium and accident, weakness, epinephrine is
inhibits uterine dizziness, syncope, administered IV
contractions; pallor, sweating, during first 5 min,
 prolongs action and dyspnea. then q3–5min until
delays systemic stabilized.
absorption of local Digestive: o Advise patient to
and intraspinal Nausea, vomiting. report to physician if
anesthetics. symptoms are not
o Used topically to Cardiovascular: relieved in 20 min or
control superficial Precordial pain, if they become worse
bleeding. palpitations, following inhalation.
hypertension, MI, o Advise patient to
Contraindication: tachyarrhythmias report bronchial
including ventricular irritation,
o Preexisting fibrillation. nervousness, or
hypertension sleeplessness.
o Occlusive Respiratory: Dosage should be
Bronchial and reduced.
vascular disease
pulmonary edema. o Monitor blood
o Angle closure
glaucoma (eyedrops) glucose & HbA1c
Urogenital: for loss of glycemic
o Hypersensitivity
Urinary retention. control if diabetic.
o Cardiac
arrhythmias or Skin: Tissue necrosis
tachycardia with repeated injections.
o When used in
addition to local Metabolic:
anesthetic Metabolic acidoses,
o Procedures elevated serum lactic
involving digits, acid, transient elevations
ears, nose, penis or of blood glucose.
scrotum
Nervous System:
Altered state of
perception and thought,
psychosis.
 Indication/ Side effect/Adverse
Mechanism of Action Nursing considerations
Contraindication effect
Generic name: Indications: is an amide type local Adverse drug reaction: Special precaution:
2% Lidocaine o Pulseless ventricular anaesthetic. It stabilises
fibrillation or the neuronal membrane o Dizziness, o Hepatic or renal
Classification: ventricular and inhibits sodium ion o Paraesthesia, impairment
Antiarrhythmic, tachycardia movements, which are o Drowsiness, o CHF and
Anesthetic (local and o Sympathetic nerve necessary for following cardiac
o Confusion,
general) block conduction of impulses. surgery
o Respiratory
In the heart, lidocaine o Bradycardia
Dosage reduces phase 4 depression
Contraindication: o Respiratory
5mL (100mg/5mL) depolarisation and o Convulsions.
o Hypovolemia depression
o Heart block or automaticity. Duration
Potentially fatal: o Porphyria
other conduction of action potential and
effective refractory o Hypotension and o Elderly or
distrubances debilitated patients
period are also reduced bradycardia leading
to cardiac arrest o Pregnancy
o Anaphylaxis Drug interactions
O Additive cardiac
effects with IV
phenytoin
O Effects
antagonized by
hypokalaemia caused
by acetazolamide,
loop diuretics and
thiazides.
O Dose
requirements may be
increased with long-
term use of
phenytoin and other
 enzyme-inducers.

Potentially Fatal:
O Cimetidine and
propranolol increase
plasma concentration
and toxicity.
O Increased risk of
myocardial
depression with beta
blockers and other
antiarrhythmics
 Indication/ Side effect/Adverse
Drug Mechanism of Action Nursing considerations
Contraindication effect
Generic name: Indications: a long-acting Most common: o Can lead to
Diazepam o Anxiety disorders benzodiazepine with o Drowsiness addiction
o For the treatment of anticonvulsant, o Fatigue (dependency),
Classification: agitation, tremors, anxiolytic, sedative, o ataxia (loss of especially when
Benzodiazepine , delirium, seizures, muscle relaxant and balance). higher dosages are
Anxiolytic and hallucinations amnestic properties. It Rare used over prolonged
resulting from increases neuronal O Muscle spasm periods of time.
Dosage alcohol withdrawal membrane permeability O Confusion o Diazepam is
10mg/2ml o Treatment of to chloride ions by O Depression excreted in breast
seizures and relief of binding to O Speech problems milk and can affect
muscle spasms in stereospecific O Double vision nursing infants.
some neurological benzodiazepine Therefore, diazepam
diseases. receptors on the should not be used by
postsynaptic GABA women who are
Contraindication: neuron within the CNS nursing.
o Pregnancy and enhancing the o Alcohol or
o Nursing mothers GABA inhibitory medications that
o Hypersensitivity effects resulting in cause sedation may
o Myasthenia hyperpolarisation and add to the sedative
gravis, stabilization. GABA is effects of diazepam.
o Preexisting CNS a neurotransmitter (a Patients taking
chemical that nerve benzodiazepines
depression or coma
cells use to should avoid such
o respiratory
communicate with each combinations.
depression;
other) that inhibits o The following
o acute pulmonary
activity in the brain. It drugs may prolong
insufficiency is believed that the effects of
o sleep apnoea excessive activity in the diazepam by
syndrome;
o severe hepatic brain may lead to inhibiting liver
impairment; anxiety or other enzymes that break
o acute narrow psychiatric disorders. down diazepam.
angle glaucoma; Dosages may need to
o children <6 mth be decreased when
(oral) these drugs are used
with diazepam.
− Cimetidine
(Tagamet)
− Ketoconazole
(Nizoral),
− Omeprazole
(Prilosec,
Rapinex),
− Fluvoxamine
(Luvox), and
− Fluoxetine
(Prozac)