EMERGENCY DRUGS

CARDIAC DRUGS

Contraindications
Hypersensitivity
With acute angle closure glaucoma, obstructive
uropathy, obstructive disease of GI tract,

ATROPINE SULFATE

paralytic ileus, toxic megacolon, intestinal

atony, unstable CV status in acute hemorrhage,

Isopto Atropine

asthma, or myasthenia gravis.

Pregnant women.

Classification
Anticholinergics

Nursing Management
Monitor VS.

Dosage
Bradycardia: 0.5 mg IV every 3-5 mins, max of
0.04 mg/kg

Report HR
Monitor for constipation, oliguria.
Instruct to take 30 mins before meals

Cardiac Arrest: 1 mg every 3-5 mins

Eat foods high in fiber and drink plenty fluids.

Nerve and Organophosphate symptoms: may

Can cause photophobia

repeat in 2 mg increments q 3 mins titrated to

relief symptoms

Instruct client not to drive a motor vehicle or

participate in activities requiring alertness.
Advise to use hard candy, ice chips, etc. for dry

Indication

mouth.

Pre-op meds/pre-anesthetic meds

To restore cardiac rate and arterial pressure
during anesthesia when vagal

NITROGLYCERINE

To lessen the degree of A-V heart block

To overcome severe carotid sinus reflex

Nitrostat

Antidote for cholinergic toxicity

Classification

Side effects

Antianginal

CNS: restlessness, ataxia, disorientation,

Nitrate

hallucinations, delirium, coma, insomnia,

Vasodilator,

agitation, confusion.

Coronary

CV: tachycardia, angina, arrhythmias, flushing.

EENT: photophobia, blurred vision, mydriasis.

GI: dry mouth, constipation, vomiting.

0.3-0.4 mg SL q 5 min, max 3 doses.

GU: urine retention.

Every 6 hrs except for midnight (cream)

Hematologic: leukocytosis

Wear 12 hrs a day for skin patch

Other: anaphylaxis

Dosage

Action
Adverse effects

Relaxes the vascular smooth system

CNS: headache, excitement.

CV: palpitations

Reduces myocardial oxygen consumption

GI: thirst, nausea

Reduces left ventricular workload

Reduces arterial BP

 Reduces venous return

May be repeated q 5 minutes to max. of 3

doses.

Indication
Angina pectoris
CHF associated with AMI

If the client doesnt experience relief, advise to

seek medical assistance immediately.
Keep in a dark colored container

Cardiac load reducing agent

Hypertensive Crisis
Side effects

MORPHINE SULFATE

CNS: headache, throbbing, dizziness, weakness.

GI: nausea, vomiting

Immediate-release tablets:

Skin: Rash

MSIR

Adverse Reactions

Timed-release:

CV: orthostatic hypotension, flushing, fainting.

Kadian, M-Eslon (CAN), MS Contin, Oramorph

EENT: sublingual burning.

SR

Skin: Cutaneous vasodilation, contact

Oral solution:

dermatitis (patch)

MSIR, Rescudose, Roxanol, Roxanol T

Rectal suppositories:

Contraindications
Contraindicated in patients hypersensitive to
nitrates
With early MI. (S.L. form), severe anemia,

RMS
Injection:
Astramorph PF, Duramorph, Epimorph (CAN)
Preservative-free concentrate for

increase ICP angle-closure glaucoma, IV

microinfusion devices for intraspinal use:

nitroglycerine is contraindicated in patients

Infumorph

with hypovolemia, hypotension, orthostatic

hypotension, cardiac tamponade restrictive

Classification

cardiomyopathy, constrictive pericarditis.

Opioid Agonist Analgesic

Nursing Management
Record characteristics and precipitating factors
of anginal pain.
Monitor BP and apical pulse before
administration and periodically after dose.
Have client sit or lie down if taking drug for the
first time.

Dosage
Oral: 1030 mg q 4 hr PO. Controlled-release:
30 mg q 812 hr PO or as directed by
physician; Kadian: 20100 mg PO daily24-hr
release system; MS Contin: 200 mg PO q 12 hr.
SC and IM:10 mg (520 mg)/70 kg q 4 hr or as
directed by physician.

Client must have continuing EKG monitoring for

IV administration
Cardioverter/ defibrillator must not be
discharged through paddle electrode overlying
Nitro-Bid ointment or the Transderm-Nitro Patch.
Assist with ambulating if dizzy.
Instruct to take at first sign of anginal pain.

IV:2.515 mg/70 kg of body weight in 45 mL

water for injection administered over 45 min,
or as directed by physician. Continuous IV
infusion: 0.11 mg/mL in 5% dextrose in water
by controlled infusion device.

 Rectal:1030 mg q 4 hr or as directed by
physician.

GI: Nausea, vomiting, anorexia, biliary tract

spasm; increased colonic motility in patients
with chronic ulcerative colitis

Action
Acts as agonist at specific opioid receptors in

GU: Ureteral spasm, spasm of vesical

sphincters, urinary retention or hesitancy,

the CNS to produce analgesia, euphoria,

oliguria, antidiuretic effect, reduced libido or

sedation

potency
Respiratory:Respiratory depression, apnea,

Indication
Relief of moderate to severe acute and chronic

circulatory depression, respiratory arrest,

shock, cardiac arrest

pain
Preoperative medication

Contraindications

Analgesic adjunct during anesthesia

Hypersensitivity to opioid

Component of most preparations that are

Diarrhea caused by poisoning until toxins are

referred to as Brompton's cocktail or mixture

Intraspinal use with microinfusion devices for
the relief of intractable pain
Unlabeled use: Dyspnea associated with acute
left ventricular failure and pulmonary edema

eliminated
During labor or delivery of a premature infant
After biliary tract surgery or following surgical
anastomosis
Pregnancy
Labor

Side Effects
GI: dry mouth, constipation.

Nursing Management

Skin: Tissue irritation and induration (SC

Interventions

injection).
Other: sweating,physical tolerance and
dependence, psychological dependence

Caution patient not to chew or crush controlledrelease preparations.

Dilute and administer slowly
Tell patient to lie down during IV administration.

Adverse Effects
CNS: Light-headedness, dizziness,
sedation, euphoria, dysphoria, delirium,
insomnia, agitation, anxiety, fear,
hallucinations, disorientation, drowsiness,
lethargy, impaired mental and physical
performance, coma, mood changes, weakness,

Keep opioid antagonist and facilities for assisted

or controlled respiration readily available
during IV administration.
Use caution when injecting SC or IM into chilled
areas or in patients with hypotension or in
shock
Reassure patients that they are unlikely to

headache, tremor, seizures, miosis, visual

become addicted

disturbances, suppression of cough reflex

Teaching points

CV: Facial flushing, peripheral circulatory

Take this drug exactly as prescribed. Avoid

collapse, tachycardia, bradycardia, arrhythmia,

alcohol, antihistamines, sedatives,

palpitations, chest wall rigidity, hypertension,

tranquilizers, over-the-counter drugs.

hypotension, orthostatic hypotension, syncope

Dermatologic: Pruritus, urticaria, Respiratory:
laryngospasm, bronchospasm, edema

Swallow controlled-release preparation (MS

Contin, Oramorph SR) whole; do not cut, crush,
or chew them.

 Do not take leftover medication for other

GI: abnormal liver function, anorexia,

disorders, and do not let anyone else take your

constipation, diarrhea, nausea and vomiting

prescription.
These side effects may occur: Nausea, loss of

Contraindications

appetite, constipation, dizziness, sedation,

Hypersensitivity

drowsiness, impaired visual acuity

Sick sinus syndrome

Report severe nausea, vomiting, constipation,

shortness of breath or difficulty breathing, rash.

2nd or 3rd degree AV block

CHF
Cardiogenic shock
Concurrent IV beta-blocker

VERAPAMIL
Nursing Management
Calan, Isoptin, Verelan, Covera HS

Monitor BP and pulse before therapy, during

titration and therapy

Classification
Anti-anginal

Monitor ECG, I&O, serum potassium and weight.

Assess for CHF

Anti-arrhythmics
Anti-hypertensive
Vascular headache suppressants

DILTIAZEM

Dosage

Cardizem, Dilacor, Novo-Diltiazem, Tiamate

PO 80-120 mg 3x daily, increases as needed

and Tiazac

Action

Classification

Inhibits calcium transport into myocardial

smooth muscle cells
Decreases SA and AV conduction and prolongs
AV node refractory period in conduction tissue

Anti-anginals

Antiarrhythmics

Antihypertensive

Ca channel blocker

Indication
Hypertension

Dosage

Angina Pectoris
Supraventricular Arrhythmia

PO: 30-120 mg, 3-4x daily or 60-120 mg twice

daily as SR capsules

IV:

0.25 mg/kg

Atrial flutter/fibrillation
Action
Side Effects and Adverse Reactions

Inhibits calcium transport into myocardial

smooth muscle cells

CNS:abnormal dreams, anxiety, confusion,

Systemic and coronary vasodilation

dizziness and headache

EENT: blurred vision, epistaxis and tinnitus

Indication

Hypertension

hypotension and palpitations

Angina Pectoris

GU: dysuria, nocturia and polyuria

Supraventricular Arrhythmia

CV: arrhythmia, CHF, chest pain, bradycardia,

Atrial flutter/fibrillation

Increases electrical stimulation of ventricle and

His-purkinje system by direct action on tissues,

Side Effects and Adverse and Reactions

resulting to decrease depolarization,

CNS:abnormal dreams, anxiety, confusion,

automaticity and excitability in ventricles

dizziness and headache

EENT: blurred vision, epistaxis and tinnitus

CV: arrhythmia, CHF, chest pain, bradycardia,

hypotension and palpitations

during diastolic phase

Indication

Anesthesia

GU: dysuria, nocturia and polyuria

Arrhythmias

GI: abnormal liver function, anorexia,

Control of Status epilepticus refractory to

constipation, diarrhea, nausea and vomiting

other treatments

Contraindications

Side Effects and Adverse Reactions

Hypersensitivity

GI disturbances, bradycardia, hypotension,

Sick sinus syndrome

convulsion, numbness of tongue, muscle

twitching, restlessness, nervousness, dizziness,

CHF

tinnitus, blurred vision, fetal intoxication, light

Cardiogenic shock

headedness, drowsiness, apprehension,

Concurrent IV beta-blocker

euphoria, vomiting, sensation of heat,

nd

or 3 degree AV block
rd

respiratory arrest and CV collapse

Nursing Management

Monitor BP and pulse before therapy, during

titration and therapy

Contraindications

Hypersensitivity

Monitor I&O and weight

Heart block

Assess for CHF

Hypovolemia

Routine serum digoxin monitoring

Adams stroke syndromes

Infection at site of injection

LIDOCAINE
Xylocaine

Nursing Management

Assess pt before and after therapy

Pts infusion must be on cardiac monitor

Monitor ECG, if QT or QRS increases by 50% or

Classification

CV drugs: Anti-arrhythmics

Anesthetic

more, withhold the drug

hrs

Dosage
Arrhythmia:

IV: 0.7-1.4 mg/kg body weight. No more than

200 mg within 1 hour period

Monitor BP, check for rebound HPN after 1-2

Assess respiratory status, oxygenation and
pulse deficits

Assess renal and liver function

Monitor CNS symptoms

Monitor blood levels

IM: 4-5 mg/kg body weight

Action

AMIODARONE

Cordarone

2nd or 3rd degree AV block

Hypersensitivity

Classification
Anti-arrhythmics
Nursing Management

Dosage

Assess cardiovascular status before therapy

Recurrent ventricular arrhythmias:

Assess pulmonary, hepatic and thyroid

PO800-1600 mg/day for 1-2 wks

PSVT, symptomatic atrial

function before and during therapy

flutter: PO 600-800 mg/day for 1 month

Monitor fluid and electrolytes, I&O, K, Na and

Cl

Arrhythmias with CHF: 200 mg/day

Monitor ECG, BP

Ventricular dysrrhythmias: 150 mg over

Assess vision

the 1 10 mins then slow 360 mg over the next

st

6 hrs
PROCAINAMIDE
Action

Pronestyl, Procan-SR, Procanbid

Blocks Na channels, prolonging myocardial cell

action potential and refractory period

Classification

Non competitive alpha and beta adrenergic

blockage

Antiarrhythmics

Indication

Dosage

Life threatening recurrent arrhythmias

Arrhythmias: 50 mg/kg/day in divided doses 3-

Ventricular fibrillation

6 hourly

Ventricular tachycardia
Action
Side Effects and Adverse Reactions

Blocks open Na channels and prolongs the

Exacerbation of arrhythmias, bradycardia, SA

cardiac action potential. This results in slowed

node dysfunction, heart block, sinus arrest;

conduction and ultimately the decreased rate

flushing, fatigue, malaise, abnormal

of rise of the action potential may result on the

involuntary movements, ataxia, dizziness,

widening of QRS on ECG

paresthesia, decreased libido, insomnia,

headache, sleep disturbances, visual
impairment, blindness, corneal microdeposits,
photophobia, abnormal taste, nausea,

Indication

Supraventricular and ventricular arrhythmias.

Treatment of Wolf-Parkinson-White Syndrome

vomiting, constipation, anorexia, abdominal

pain, abnormal salivation, coagulation
abnormalities, non-specific hepatic disorders,
pulmonary inflammation, dyspnea, toxicosis,
death, edema, hypo and hyperthyroidism

Side Effects and Adverse Reactions

Severe hypotension, ventricular fibrillation and

asystole.

Drug induced SLE syndrome, blood disorders,

fever, myocardial depression, heart failure,

Contraindications

Severe sinus node dysfunction

agrunulocytosis, psychosis, angioedema,

hepatomegaly, skin irritation,

hypergammaglobulinemia, GI and CNS effects
Contraindications

Heart block

Heart failure

Hypotension

Myesthenia gravis

Digoxin toxicity

Lactation

Increases vital capacity

Increases BP, HR, PR
Decreases airway resistance.
Indication
Asthma
Bronchitis
Emphysema
All cardiac arrest, anaphylaxis
Used for symptomatic bradycardia.
Relief of bronchospasm occurring during
anesthesia
Exercised-induced bronchospasm

Side Effects/Adverse Reactions

Side Effects:
nervousness, tremor, vertigo, pain, widened
pulse pressure, hypertension nausea
Adverse Effects:
headache

Nursing Management

Assess cardiovascular status before therapy

Assess pulmonary, hepatic and thyroid

function before and during therapy

Monitor fluid and electrolytes, I&O, K, Na and

Cl

Monitor ECG, BP

Assess vision

EPINEPHRINE
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
Beta2 Adrenergic Agonists
Dosage
Cardiac arrest: 1 mg IV of 1:10,000 solution q
3-5 min; double dose if administering via ET
tube
Anaphylaxis: 0.1- 1 mg SQ or IM of 1:1000
solution.
Asthma: 0.1-0.3 mg SQ or IM of 1:10,000
solution
Refractory bradycardia and hypotension: 210ug/min
Action
Stimulates beta receptors in lung.
Relaxes bronchial smooth muscle.

Contraindications
With angle-closure glaucoma, shock (other than
anaphylactic shock), organic brain damage,
cardiac dilation, arrhythmias, coronary
insufficiency, or cerebral arteriosclerosis. Also
contraindicated in patient receiving general
anesthesia with halogenated hydrocarbons or
cyclopropane and in patients in labor (may
delay second stage)
In conjunction with local anesthesia, epinephrine
is contraindicated for use in finger, toes, ears,
nose, and genitalia.
In pregnant woman, drug is contraindicated.
In breast feeding do not use the drug or stop
breast feeding.
1.
2.
3.
4.
5.
6.
7.

Nursing Management
Monitor V/S. and check for cardiac
dysrrhythmias
Drug increases rigidity and tremor in patients
with Parkinsons disease
Epinephrine therapy interferes with tests for
urinary catecholamine
Avoid IM use of parenteral suspension into
buttocks. Gas gangrene may occur
Massage site after IM injection to counteract
possible vasoconstriction.
Observe patient closely for adverse reactions.
Notify doctor if adverse reaction develop
If blood pressure increases sharply, rapidacting vasodilators such as nitrates or alpha
blockers can be given to counteract

VASOPRESSIN
Pitressin

Classification

MAGNESIUM SO4

Pituitary Hormones
ADH
Classification
Dosage

Anti-convulsant

Prevent and treat abdominal distention: initially

Anti-arrhythmics

5 units IM gives subsequent injections q3-4

Dosage

hours increasing to 10 units if needed.

Arrhythmia: IV 1-6 grams over several minutes,

Action

then continuous IV infusion 3-20 mg/min for 5-

Increase permeability of renal tubular

48 hours.

epithelium to adenosine monophosphate and

Action

water, the epithelium promotes reabsorption of

water and concentrated urine

Decreased acetylcholine released

Indication

Indication

Diabetes Insipidus

Mg replacement

Abdominal Distention

Arrhythmia

GI bleeding

Esophageal varices

Side Effects and Adverse Reactions

paralysis, hypothermia

Side Effects and Adverse Reactions

CNS: tremor, headache, vertigo

CV: vasoconstriction, arrhythmias, cardiac

arrest, myocardial ischemia, circumollar pallor,

EENT: diplopia

decreased CO, angina

Respiratory: respiratory paralysis

Metabolic: hypocalcemia
Skin: diaphoresis

GI: abdominal cramps

GU:uterine cramps

Respi: bronchoconstriction

Skin: diaphoresis, gangrene and urticaria

Contraindications

With chronic nephritis and nitrogen retention

Hypersensitivity

Contraindications

Heart block and myocardial damage

Toxemia of pregnancy
Nursing Management

Give 1-2 glass of H20 to reduce adverse

reactions and improve therapeutic response

Monitor I&O. make sure urine output is 100 ml

or more in 4 hrs pd before each dose

Nursing Management

CV: hypotension, flushing, bradycardia,

circulatory collapse, depressed cardiac function

CNS: drowsiness, depressed reflexes, flaccid

Take appropriate seizure precautions

Keep IV Ca gluconate at bedside

Warm vasopressin in your hands and mixed

until it is distributed evenly in the solution

Monitor urine Sp. Gravity and I&O to aid

evaluation of drug effectiveness

Na HCO3
Arm and Hammer; Baking Soda

Classification
Antihypertensive, Vasodilator

Classification

Alkalinizers

Dosage
0.25-0.3 mcg/kg/minute

Dosage

Action
Relaxes arteriolar and venous smooth muscle

Metabolic Acidosis: Usually 2-5 meq/kg IV

infuse over 4-8 hr period

Cardiac Arrest: 1 meq/kg IV of 7.5 or 8.4%

sol, then 0.5 meq/kg IV q 10 mins depending
on ABG

Indication
Hypertensive crisis
To produce controlled hypotension during
anesthesia
To reduce preload and afterload in cardiogenic
shock
Side Effects/Adverse Reactions
Headache, dizziness, increased ICP, loss of
consciousness, restlessness, bradycardia,
nausea, abdominal pain, methemoglodinemia,
muscle twitching, pink-colored rash, irritation
at infusion site

Action
Restore buffering capacity of the body and
neutralizes excessive acid
Indication

Metabolic Acidosis

Cardiac Arrest
Side Effects/Adverse Reactions

CNS: tetany

CV: edema

GI: gastric distention, belching and flatulence

Metabolic: hypokalemia, metabolic alkalosis,

hypernatremia, hyperosmolarity with overdose

Skin: pain @ injection site

1.
2.
3.

Contraindications
Hypersensitivity
Compensatory hypotension
Inadequate cerebral circulation
Acute heart failure with reduced PVR
Congenital optic atrophy
Tobacco-induced ambylopia
Nursing Management
Obtain VS before giving the drug
Place pt in supine
Giving excessive doses of 500 mcg/kg
delivered faster than 2 mcg/kg/min or using
max infusion rate of 10 mcg/kg/min for more
than 10 mins can cause cyanide toxicity

Contraindications

Metabolic and respiratory alkalosis

Pt losing Cl because of vomiting or continuous

GI suction or those receiving diuretics that
produces hypochloremic alkalosis
Nursing Management

Obtain blood pH, PaO2, PaCo2 and electrolyte

levels

SIVP
HYPERTENSIVE CRISIS
Na NITROPRUSSIDE
Nittropress

FUROSEMIDE
Lasix
Classification
Loop Diuretics
Dosage
Pulmonary edema: 40 mg IV
Edema: 20 to 80 mg PO every day in the
morning
HPN: 40 mg PO bid. Dosage adjusted based on
response
Action
Inhibits Na and Cl reabsorption at the proximal
and distal tubules and in the ascending loop of
Henle
Indication

 Acute pulmonary edema

Edema
Hypertension

Action
Increases osmotic pressure of glomerular
filtrate, inhibiting tubular reabsorption of water

Side Effects/Adverse Reactions

Signs of hypotension, hypokalemia and
hyperglycemia

and electrolytes; drug elevates plasma

osmolarity, increasing water flow into
extracellular fluid

Contraindications
Hypersensitivity
Anuria
1.
2.
3.
4.
5.

Nursing Management
Monitor wt., BP and PR
Monitor fluid, I&O, electrolyte, BUN and CO2
levels frequently
WOF signs of hypokalemia
Monitor uric acid levels
Monitor glucose levels esp in DM pts

Indication

Test dose for marked oliguria or suspected

inadequate renal function

Oliguria

To induced intraocular or intracranial pressure

Diuresis in drug intoxication

Irrigating solution during TURP

Side Effects/Adverse Reactions

MORPHINE SO4
(Discussed earlier)
NEUROSURGICAL DRUGS

CN: seizures, headache and fever

EENT: blurred vision and rhinitis

GI: thirst, dry mouth, nausea, vomiting and

MANNITOL
Osmitrol
Classification

diarrhea

GI: urine retention

Metabolic: dehydration

Skin: local pain

Diuretics
Dosage

CV: edema, thrombophlebitis, hypotension

and heart failure

Others: chill
Contraindications

Hypersensitivity

Anuria, severe pulmonary congestion, frank

Test dose for marked oliguria or

pulmonary edema, active intracranial bleeding

suspected inadequate renal function: 200

during craniotomy, severe dehydration,

mg/kg or 12.5 gram as a 15% to 20% IV

metabolic edema, progressive heart failure or

solution over 3-5 mins response is adequate if

pulmonary congestion after drug

30-50 ml of urine/hr is adequate, a second

dose is given if still no response after 2nd dose
stop the drug

Oliguria: 50 over 90 mins to several hrs

To induced intraocular or intracranial

pressure: 1.5-2 gram/kg as a 15 % to 20% IV
solution over 30-60 min

Diuresis in drug intoxication: 12.5% to

Nursing Management

Monitor VS,CVP,I&O, renal function fluid

balance and urine K levels daily.

Drug can be used to measure GFR

Do not give electrolyte free solutions with

blood. If blood id given simultaneously, add at
least 200 meq of NaCL to each liter

10% solutions up to 200 g IV

Irrigating solution during TURP: 2.5-5%

POISONING

NALOXONE HCL

Classification
Antidote

Narcan

Dosage
25-30 ml followed immediately by H2O

Classification

Action
Irritates the stomach lining and stimulate the
vomiting center

Miscellaneous antagonists and antidotes

Dosage
For suspected opioid induced respiratory
depression: 0.4 to 2 mg IV, IM and SQ. repeat

Indication
Poisoning
Overdose

doses q 2-3 mins PRN

Side Effects
Diarrhea, drowsiness, stomach cramps,
vomiting, itching, DOB, swelling of the mouth,
rash and hives

For postoperative opiod depression: 0.01 to 0.2

mg IV q 2-3 mins, PRN. Repeat dose within 1-2
hr, if needed.
Action
Reverse the effects of opiods, psychotomimetic
and dysphoric effects of agonist-antagonists
Indication
For suspected opioid induced respiratory

depression
For postoperative opiod depression

1.
2.
3.

Side Effects/Adverse Reactions

CNS: seizures, tremors

Contraindications
Hypersensitivity
Given activated charcoal
Unconcious
Drowsy
Severely drunk
Having seizures
With no gag reflex
Nursing Management
Dont administer to unconscious
Pt should kept active and moving ff
administration
If vomiting does not occur after 2nd dose,
gastric lavage may be considered to remove
ingested substance

CV: ventricular fibrillation, tachycardia, HPN with

higher recommended doses, hypotension

ACTIVATED CHARCOAL

GI: nausea and vomiting

Respiratory: pulmonary edema
Skin: diaphoresis
Contraindications
Hypersensitivity
Use cautious with cardiac irritability or opiod
addiction.
Nursing Management
Assess respiratory status frequently
Respiratory rate increases within 1-2 mins

IPECAC SYRUP

Classification
Antidote
Dosage
30-100 g with at least 8 oz of water
Action
Inhibits GI absorption of toxic substances or
irritants
Hyperosmolarity
Indication
Poisoning
Side Effects
Pain, melena, diarrhea, vomiting and
constipation
Contraindications

 Cyanide, mineral acids, organic solvents,

intestinal obstruction, bleeding with fructose
intolerance, broken GI tract, concomitant use
of charcoal with sorbitol
Nursing Management
Do not mix with chocolate and together with
ipecac syrup
Notify doctor if caused swelling or pain in the
stomach

Classification
Adrenergic drugs
Dosage
Initially 2-5 mcg/kg/min by IV
Action

FLUMAZENIL
Romazicon
Classification
Benzodiazepine receptor antagonists

Stimulates dopaminergic and alpha and beta

receptors of the sympathetic nervous system
resulting in positive inotropic effect and
increased CO
Indication

Dosage
2 ml IV given over 15 seconds

To treat shock and correct hemodynamic

Action
Antagonizes the effects of benzodiazepines

To correct hypotension

Indication
Benzodiazepine-induced depression of the
ventilatory responses to hypercapnia and
hypoxia

To improve perfusion of vital organs

Side Effects
Nausea, vomiting, palpitations, sweating,
flushing, dry mouth, tremors, insomnia,
dyspnea, hyperventilation, blurred vision,
headache, pain at injection site
Contraindications
Control of ICP or status epilepticus.
Signs of serious cyclic antidepressant overdose
1.
2.
3.
4.
5.
6.

Nursing Management
Must individualize dosage. Give only smallest
amount effective.
Give through freely running IV infusion into
large vein to minimize pain at injection site
Note history of seizure or panic disorder
Assess evidence of increased ICP
Note evidence of sedative and benzodiazepine
dependence
Instruct to avoid alcohol and non-prescription
drugs for 1-24 hrs

imbalances

To increase CO
Side Effects
CNS: headache an anxiety
CV: tachy, angina, palpitations and
vasoconstriction
GI: nausea and vomiting
Contraindications
Hypersensitivity
With uncorrect tachyarrhythmias
Pheochromocytoma
Ventricular Fibrillation
Nursing Management
Most patients received less than 20 mcg/kg/min
Drugs isnt substitute for blood or fluid volume
deficit

SHOCK

During infusion, monitor ECG, BP, CO, PR and

color and temp of the limbs

DOPAMINE

Do not confuse dopamine to dobutamine

Check urine output often

Intropine

DOBUTAMINE
Classification
Dobutrex

Pancreatic Hormones

Classification

Dosage

Adrenergic drugs

0.5-1 mg SQ, IV, IM, repeat in 20 mins PRN

Dosage

Action

0.5-1 mcg/kg/min IV infusion, titrating to

Binds with glucagon receptor

optimum dosage of 2-20 mcg/kg/min

2.5 to 10 mcg/kg/min-usual effective range to

Indication

increase CO

Hypoglycemia

Action

Side Effects

Stimulates heart beta receptors to increase

Nausea, vomiting, hypotension, tachycardia

myocardial contractility and SV

and hypertension

Indication

Contraindications

To increase CO

Hypersensitivity

Treatment of cardiac decompensation

Pheochromocytoma
Insulinoma

Side Effects
CNS: headache
CV: HPN, tachycardia, palpitations and
vasoconstriction

Nursing Management
Monitor V/S and blood sugar level
Response within 20 mins after injection

GI: nausea and vomiting

Contraindications

ALBUTEROL

Hypersensitivity
Use cautiously in pts with hx of HPN and AMI
Nursing Management
Before starting therapy, give a plasma volume

Ventolin
Classification
Bronchodilator, Adrenergic

expander to correct hypovolemia and a cardiac

glycoside
Monitor ECG, BP, pulmonary artery wedge

Dosage
2 inhalations reputed q 4-6 hrs via neb

pressure and CO
Monitor electrolyte levels

Action

Dont confuse dobutamine to dopamine

Activation of beta adrenergic receptors on

airway smooth muscle

GLUCAGON

Indication
Asthma

 Prevention of exercise induced spasms

Dosage
Side effects

25-50 mg PO, IV or IM bid-tid

Palpitations
Tachycardia

Action

GI upset

Blocks the effects Hi receptor sites

Nervousness
Indication
Contraindications

Allergic reactions

Hypersensitivity

Motion sickness
Cough suppression

Nursing Management

Sedation

Monitor therapeutic effectiveness

Monitor HR, BP, ABG, s/sx of bronchospasm and
CNS stimulation

Side Effects
Xerostomia

Instruct on how to use inhaler properly

Urinary retention

Rinse mouth after use

Sedation
Contraindications

DIPHENHYDRAMINE HCL

Acute asthmatic attack

Benadryl

Nursing Management
Risk for photosensitivity- use sunscreen

Classification
Anti-histamine