DRUG NAME

Generic Name:
Dobutamine HCl
Brand Name:
Dobutrex
Classification:
Beta-Adrenerdic
Agonist
Inotropic

MECHANIS
M OF
ACTION
Dobutamine
increases
contractility
and heart
rate by
stimulating
betaadrenergic
receptors in
the cardiac
tissues.
hr, CO
and SV
with minor
effects to HR.
elevated
ventricular
filling
pressure and
helps AV
node
conduction.

INDICATIO
N

CONTRAINDICA
TION

SIDE
EFFECTS

Inotropic
support in
patients w/
hypo
perfusion
states in
whom cardiac
output is
insufficient to
meet
circulatory
demands.
Abnormally
increased
ventricular
filling
pressures
introduce the
risk of
pulmonary
congestion
&edema.

Drug is
contraindicated
with idiopathic
hypertrophic sub
aortic stenosis and
patients with
hypersensitive to
drug or any of its
components.

CNS:
headache
Musculoskele
tal: mild leg
cramps or
tingling
sensation
CV: angina,
hypertension,
hypotension,
increased
heart rate,
nonspecific
chest pain,
phlebitis
GI: N&V
Respiratory:
asthma
attacks,
shortness of
breath.
Others:
anaphylaxis,
skin rash,
pruritus of
scalp, fever,
eosinophilia

NURSING
MANAGEMENT

Monitor CVP to
assess vascular
volume and cardiac
pumping efficiency.
(Elevated CVP may
indicate disruption
on CO, as in pump
failure or
Pulmonary edema;
low CVP may
indicate
hypervolemia).
Monitor ECG and
BP continuously
during drug
administration
because marked
increases in blood
pressure (systolic
pressure is the
most likely to be
affected) and heart
rate, or the
appearance of
arrhythmias or
other adverse
cardiac effects are

usually reversed
promptly by
reduction in
dosage.
Record I&O
because Urine
output and sodium
excretion generally
increase due to
improved cardiac
output and renal
Perfusion.

DRUG NAME

MECHANIS

INDICATIO

CONTRAINDICA

SIDE

NURSING

M OF
ACTION
Generic
Nitroglycerin
Brand
Nitrostat
Classification
Antianginal,
Nitrate,Vasodilator,
Coronary

Relaxes the
vascular
smooth
system
Myocardial
oxygen
consumption
left
ventricular
workload
arterial BP
venous
return

TION

Angina
pectoris CHF
associated
with AMI
Cardiac load
reducing
agent
Hypertensive
Crisis

Contraindicated in
patients
hypersensitive to
nitrates and in
those with early
MI. (S.L. form),
severe anemia,
increase ICP
angle-closure
glaucoma, IV
nitroglycerine is
contraindicated in
patients with
hypovolemia,
hypotension,
orthostatic
hypotension,
cardiac
tamponade
restrictive
cardiomyopathy,
constrictive
pericarditis.

EFFECTS

Adverse
Effects
CV:
orthostatic
hypotension,
flushing,
fainting
.EENT:
sublingual
burning.
Skin:
Cutaneous
vasodilation,
contact
dermatitis
(patch)
Side Effects
CNS:
headache,
throbbing,
dizziness,
weakness.
GI: nausea,
vomiting.
Skin: Rash

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.
Client must have
continuing EKG
monitoring for IV
administration
Cardioverter/
defibrillator must
not be discharged
through paddle
electrode
overlying Nitro-Bid
ointment or
theTransdermNitro Patch.
Assist with
ambulating if

dizzy.
Instruct to take at
first sign of
anginal pain.
May be repeated q
5 minutes to max.
Of 3 doses.
If the client
doesnt experience
relief, advise to
seek medical
assistance
immediately.

DRUG NAME

Generic
Atrophine Sulfate
Brand
Isopto Atropine
Classification

MECHANIS
M OF
ACTION

INDICATIO
N

CONTRAINDICA
TION

SIDE
EFFECTS

NURSING
MANAGEMENT

cholinergic
receptor sites
so response
to
acetylcholine
is decreased

As an antisialagogue
for pre
anesthetic
medication to
prevent or
reduce

Contraindicated in
patients
hypersensitive to
drug and those
with acute angle
closure glaucoma,
obstructive

Adverse
Effects
CNS:
restlessness,
ataxia,
disorientation
,

Monitor VS.
Report HR
Monitor for
constipation,
oliguria.
Atrophine could
result in CNS

Anticholinergics

secretions of
the
respiratory
tract
To restore
cardiac rate
and
arterial
pressure
during
anesthesia,
when vagal
stimulation
produced by
intraabdominal
surgical
traction
causes a
sudden
decrease in
pulse rate
and cardiac
action To
lessen the
degree of
atrioventricul
ar (A-V) heart
block when
increased
vagal tone is

uropathy,
obstructive
disease of GI
tract, paralytic
elius, toxic
magacolon,
intestinal atony,
unstable CV
status in acute
hemorrhage,
asthma, or
myasthenia
gravis. Also
contraindicated in
pregnant women.

hallucinations
, delirium,
coma,
insomnia,
agitation,
confusion.
CV:
tachycardia,
angina,
arrhythmias,
flushing.
EENT:
photophobia,
blurred vision,
mydriasis.
GI: dry
mouth,
constipation,
vomiting.
GU: urine
retention.
Hematologic:
leukocytosis
Other:
anaphylaxis
Side Effects
CNS:
headache,
excitement.
CV:
palpitations

stimulation
(confusion,excitem
ent) or drowsiness
Instruct to take 30
mins before meals
Eat foods high in
fiber and drink
plenty fluids.
Avoid OTC
antihistamines.
Instruct client not
to drive a motor
vehicle or
participate in
activities requiring
alertness.
Advise to use hard
candy, ice chips,
etc. for dry mouth.

a major
factor in the
conduction
defect, as in
some cases
due to
digitalis To
overcome
severe
carotid sinus
reflex
Antidote for
cardiovascula
r collapse
from the
injudicious
use of a
cholinergic
drug.

GI: thirst,
nausea.

DRUG NAME

Morphine Sulfate
Brand
Immediate-release
tablets:
MSIR
Timed-release:
Kadian, M-Eslon
(CAN), MSContin,
Oramorph SR
Oral solution:
MSIR, Rescudose,
Roxanol,Roxanol T
Rectal
suppositories:
RMS
Injection:
Astramorph PF,
Duramorph,Epimorp
h (CAN)
Preservative-free
concentrate for
microinfusion
devices for
intraspinal use:
Infumorph
Classification

MECHANISM
OF ACTION

INDICATIO
N

CONTRAINDICAT
ION

SIDE
EFFECTS

Principal opium
alkaloid; acts
as agonist at
specific opioid
receptors in the
CNS to produce
analgesia,
euphoria,
sedation; the
receptors
mediating these
effects are
thought to be
the same as
those mediating
the effects of
endogenous
opioids(enkepha
lins,
endorphins).

Relief of
moderate to
severe acute
and chronic
pain
Preoperative
medication
to sedate
and allay
apprehensio
n, facilitate
induction of
anesthesia,
and reduce
anesthetic
dosage
Analgesic
adjunct
during
anesthesia
Component
of most
preparations
that are
referred to
as
Brompton's
cocktail or

Contraindicated
with
hypersensitivity to
opioids; diarrhea
caused by
poisoning until
toxins are
eliminated; during
labor or delivery of
a premature infant
(may cross
immature blood
brain barrier more
readily); after
biliary tract surgery
or following surgical
anastomosis; pregn
ancy; labor
(respiratory
depression in
neonate;
may prolong
labor).Use
cautiously with
head injury and
increased
intracranial
pressure; acute

Adverse
Effect
CNS:
Lightheadedness,
dizziness,
sedation,
euphoria,
dysphoria,
delirium,
insomnia,
agitation,
anxiety, fear,
hallucination
s,
disorientatio
n,
drowsiness,
lethargy,
impaired
mental and
physical
performance,
coma, mood
changes,
weakness,
headache,
tremor,

NURSING
MANAGEMENT
Caution patient
not to chew or
crush controlledrelease
preparations.
Dilute and
administer slowly
IV to minimize
likelihood of
adverse effects.
Tell patient to lie
down during IV
administration.
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

Opioid agonist
analgesic

mixture, an
oral alcoholic
solution that
is used for
chronic
severe pain,
especially in
terminal
cancer
patients
Intra spinal
use with
micro
infusion
devices for
the relief of
intractable
pain
Unlabeled
use:
Dyspnea
associated
with acute
left
ventricular
failure and
pulmonary
edema

asthma, COPD,
corpulmonale,
preexisting
respiratory
depression,
hypoxia,
hypercapnia (may
decrease
respiratory drive
and increase airway
resistance);lactatio
n (wait 46 hr
after administration
to nurse the baby);
acute abdominal
conditions, CV
disease,
supraventricular
tachycardias,
myxedema, seizure
disorders, acute
alcoholism,
delirium tremens,
cerebral
arteriosclerosis,
ulcerative colitis,
fever,
kyphoscoliosis,
Addison's disease,
prostatichypertroph
y, urethral stricture,

seizures,
miosis, visual
disturbances
suppression
of cough
reflex
CV:
Facial
flushing,
peripheral
circulatory
collapse,
tachycardia,
bradycardia,
arrhythmia,
palpitations,
chest wall
rigidity,
hypertension
,
hypotension,
orthostatic
hypotension,
syncope
Dermatologic
:
Pruritus,
urticaria,
Respiratory:
laryngospas
m,

shock;
impaired
perfusion may
delay absorption;
with repeated
doses, an
excessive
amount may be
absorbed when
circulation is
restored.
Reassure
patients that
they are unlikely
to become
addicted;
most patients
who receive
opioids for
medical reasons
do not develop
dependence
syndrome.

GERIATRIC PATIENTSOR
IMPAIRED ADULTS
Use caution.
Respiratory
depression may
occur in the

recent GI or GU
surgery,
toxic psychosis,
renal or hepatic
dysfunction.

bronchospas
m
,edema
GI:
Nausea,
vomiting
, anorexia,
biliary tract
spasm;
increased
colonic
motility in
patients with
ulcerative
colitis
GU:
Ureteral
spasm,
spasm of
vesical
sphincters,
urinary
retention or
hesitancy,
oliguria,
antidiuretic
effect,
reduced
libido or
potency
Respiratory:

elderly, the very

ill, those with
respiratory
problems.
Reduced dosage
may be
necessary.
Epidural Use
extreme caution;
Injection of < 5
mg in the lumbar
region may
provide adequate
pain relief for up
to 24 hr.
Take this drug
exactly as
prescribed.
Avoid
alcohol,
antihistamines,
sedatives,
tranquilizers,
over-the-counter
drugs.
Swallow
controlledrelease
preparation (MS
Contin,Oramorph
SR) whole;
do notcut, crush,

Respiratory
depression,
apnea,
circulatory
depression,
respiratory
arrest, shock,
cardiac
arrest
Side Effects
GI: dry
mouth,
constipation.
Skin: Tissue
irritation and
induration
(SC
injection).
Other:
sweating,
physical
tolerance
and
dependence
psychological
dependence

or chew them.
Do not take
leftover
medication for
other disorders
,and do not let
anyone else take
your prescription.
These side
effects may
occur: Nausea,
loss of appetite
(take with food,
lie quietly);
constipation (use
laxative);
Dizziness,
sedation,
drowsiness,
impaired visual
acuity (avoid
driving or
performing tasks
that require
alertness and
visual acuity).
Report severe
nausea,
vomiting, and
constipation,
shortness of
breath or

difficulty
breathing, rash.

DRUG NAME

Aminophylline

MECHANIS
M OF
ACTION

INDICATIO
N

CONTRAINDICA
TION

Increases the
level of cAMP
resulting
in bronchodila
tion

PO Chronic
bronchospas
m as hydrate

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

SIDE
EFFECTS

NURSING
MANAGEMENT

JUN CARY V. SUITOS, SN

Arellano University 0900252 College of Nursing Batch 2011III Muscarinics / Group 64
DRUG STUDY ON EMERGENCY DRUGS
1) AMINOPHYLLINEBrand 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: 5mg/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 suddendeath after too rapid IV
injection.
Nursing Measures
:

Administer to pregnant patients only when clearly neededneonatal tachycardia, jitteriness, and withdrawalapnea
observed when mothers received xanthines up until delivery.

Caution patient not to chew or crush enteric-coated timed-release forms.

Give immediate-release, liquid dosage forms with food if GI effects occur.

Do not give timed-release forms with food; these should be given on an empty stomach 1 hr before or 2 hr after
meals.

Maintain adequate hydration.

Monitor results of serum theophylline levels carefully, and arrange for reduced dosage if serum levels
exceedtherapeutic range of 1020 mcg/mL.

Take serum samples to determine peak theophylline concentration drawn 1530 min after an IV loading dose.

Monitor for clinical signs of adverse effects, particularly if serum theophylline levels are not available.

Ensure that diazepam is readily available to treat seizures.

Take this drug exactly as prescribed; if a timed-release product is prescribed, take this drug on an empty stomach,1
hr before or 2 hr after meals.

Do not to chew or crush timed-release preparations.

Administer rectal solution or suppositories after emptying the rectum.

It may be necessary to take this drug around the clock for adequate control of asthma attacks.

Avoid excessive intake of coffee, tea, cocoa, cola beverages, chocolate.

Smoking cigarettes or other tobacco products impacts the drug's effectiveness. Try not to smoke. Notify the
careprovider if smoking habits change while taking this drug.

Frequent blood tests may be necessary to monitor the effect of this drug and to ensure safe and effective
dosage;keep all appointments for blood tests and other monitoring.

These side effects may occur: Nausea, loss of appetite (taking this drug with food may help if taking theimmediaterelease or liquid dosage forms); difficulty sleeping, depression, emotional lability (reversible).

Report nausea, vomiting, severe GI pain, restlessness, seizures, irregular heartbeat

http://www.scribd.com/doc/19887902/Drug-Study-on-Emergency-Drugs