DRUGS STUDY

Name of Classification Mechanism of Indication Contraindication Adverse Reactions Nsgr.

Drug Action Ressponsibilities
Generic General Causes a >Isoflurane may be >contraindicated in > Respiratory >Used with caution
Name: Classification: reversible loss of used for induction patients with known depression, hypotension, in patients with
Isoflurane consciousness and and maintenance of sensitivity to arrhythmias, malignant coronary artery
Inhaled General pain sensations, general anesthesia. isoflurane or other
hyperthermia. disease
Trade Name: Anesthetics suppression of halogenated
Forane voluntary motor >Sedation of anesthetics > Shivering, nausea, >Monitor blood
activity, ventilated patients
vomiting, ileus. pressure and
Dosages modification of in the intensive >contraindicated in
autonomic therapy unit for up patients with known temperature to
>Breath holding, detect residual
Inhalation reflexes, and to 48 hr. or suspected genetic
coughing and
induction: depression of the susceptibility to hypotension and the
initial 0.5 % respiratory and malignant laryngospasm. possibility of
v/v with the CV system. hyperthermia. malignant
oxygen or >Rarely, postoperative
hepatic dysfunction and hyperthermia.
oxygen and >contraindicated in
nitrous oxide, patients with hepatitis. >Must be given with
increase to porphyria
>Hypersensitivity a licensed
1.5- 3 % v/v.
reactions. Transient WBC anesthesiologist
Maintenance elevation. >Emergency kit must
dose:
1-2.5% v/v be made available
with oxygen
only.
Name of Drug Classificati Mechanism of Indication Contraindication Adverse Reactions Nsgr. Ressponsibilities
on Action
Generic Name: General >Ketamine is a >Used in general >Patient w/ HTN, >Emergence reactions ● Assess level of
Ketamine HCl Classificati noncompetitive N- anesthesia for eclampsia or pre- including vivid & consciousness frequently
on: methyl-D- diagnostic or eclampsia unpleasant dreams, throughout therapy.
Trade Name: aspartate receptor short surgical confusion, hallucination,
Ketamine produces a
Etamine Intraveno antagonist that operations that >severe coronary or irrational behavior.
us blocks glutamate. do not require myocardial disease dissociative state. The
Dosage: General skeletal muscle >Increased muscle tone. patient does not appear to
General Anesthesia Anestheti It has a direct relaxation; >cerebrovascular Depressed respiration; be asleep and experiences a
IV (Adults): cs action on the accident or cerebral apnea, laryngospasm; feeling of dissociation from
Induction—1– 2 cortex and limbic >For the trauma. diplopia, nystagmus; the environment.
mg/kg (range 1– 4.5 system. induction of nausea & vomiting,
mg/kg)– 2 mg anesthesia to be > Presence of eye lacrimation, ● Monitor BP, ECG, and
produces 5– 10 min It produces a maintained w/ injury or increased IOP. hypersalivation; respiratory status frequently
of surgical anesthesia cataleptic-like other drugs transient skin rashes & throughout therapy. May
or 1– 2 mg/kg as a state wherein the pain at inj site.
cause hypertension and
single injection or patient is >supplementary
infused at 0.5 mg/ withdrawn from anesthesia tachycardia. May cause
min. May be used the surrounding increased CSF pressure and
with concurrent environment. increased intraocular
diazepam. pressure.
Maintenance—
Increments of to 1⁄2 ● Toxicity and Overdose:
the full induction Respiratory depression or
dose may be apnea may be treated with
repeated as needed.
mechanical ventilation or
If given with
concurrent analeptics.
diazepam, an
● Administer on an empty
infusion of 0.1– 0.5
mg/min may be stomach to prevent vomiting
used, augmented by and aspiration.
2– 5 mg doses of
diazepam. IV ● May be administered
(Children): 0.5– 2 concurrently with a drying
mg/kg, use smaller agent (atropine,
doses (0.5– 1
scopolamine); ketamine
mg/kg)for minor
procedures. IM increases salivary and
(Adults): 3– 8 mg/kg tracheobronchial mucous
(10 mg/kg produces gland secretions. Atropine
12– 25 min of may also increase the
surgical anesthesia). incidence of unpleasant
IM (Children): 3– 7 dreams.
mg/kg. PO (Children):
6– 10 mg/kg for 1 ● Patients may experience a
dose (mix in cola or state of confusion
other beverage) 30
(emergence delirium) during
min prior to
procedure. recovery from ketamine.
Sedation/Analgesia Administering a
(Unlabeled) IV benzodiazepine and
(Adults): 200– 750 minimizing verbal, tactile,
mcg (0.2– 0.75 and visual stimulation may
mg)/kg over 2– 3 min
prevent emergence delirium.
initially, followed by
5– 20 mcg (0.005– Severe emergence delirium
0.02 mg)/kg/min as may be treated with short-
an infusion. or ultra-short-acting
IV (Children): 5– 20 barbiturates.
mcg/kg/min. IM
(Adults): 2– 4 mg/kg ● PO: Use 100 mg/mL IV
initially, then 5– 20 solution and mix appropriate
mcg (0.005– 0.02 dose in 0.2– 0.3 mL/kg of
mg)/kg/min as an IV cola or other beverage.
infusion.
Name of Drug Classification Mechanism of Indication Contraindication Adverse Reactions Nsgr. Ressponsibilities
Action
Generic NSAIDs (Non- >Ketorolac >Short-term >Hypersensitivity. >Stomach upset, >Renal impairment,Impaired
Name: Steroidal Anti- reversibly inhibits management >Incomplete or partial nausea, vomiting, hearing,allergies, hepatic,
Ketorolac Inflammatory cyclooxygenase-1 of moderate syndrome nasal polyps, bloating, gas, loss of
Drugs) and -2 (COX-1 to severe angioedema, appetite, black stools, >Skin color and
Trade name: and -2) enzymes, post-op pain. brochospasm due to persistent lesions,orientation,
Ketovex; which results in NSAIDs, advanced renal stomach/abdominal reflexes,peripheral
Toradol decreased >As impairment or failure, pain, coffee-like vomit
sensation,clotting times,
formation of Ophthalmic: CV bleeding,
Dosage: prostaglandin Ocular itching hemorrhagic diathesis, >GI pain, peptic ulcers, CBC,adventitious sounds.
IM/IV inj over precursors. It associated w/ incomplete hemostasis, dyspepsia, flatulence, GI
>Be aware that patientmay
not <15 sec exhibits minimal seasonal patients at high risk of fullness, stomatitis,
Initially 10 anti- allergic bleeding. excessive thirst, GI be at risk for CVevents, GI
mg, then 10- inflammatory conjunctivitis > Obstet pre-op bleeding, perforation bleeding,renal toxicity,
30 mg every effect at its medication or monitoraccordingly.
4-6 hr if analgesic dose. >Prophylaxis analgesia. Intrathecal >sweating, dizziness,
necessary. and reduction or epidural blurred vision, dry >Keep emergencyequipment
Max dose: 90 of post-op eye administration. 2nd & mouth, irritation at inj readilyavailable at time of
mg daily. inflammation 3rd trimester of site, abnormal taste, initialdose, in case of
Elderly & pregnancy. ringing of ears(tinnitus), severehypersensitivity
patients , rash, itching, swelling,
reaction.
weighing <50 troubled breathing,
kg Max: 60 vasodilation, pallor, >Protect drug vials fromlight.
mg daily. headache, nervousness,
abnormal thinking, >Administer every 6 hrs
*Another depression, euphoria,
tomaintain serum levelsand
source: bronchospasm,
30mg (3 anaphylaxis, purpura, control pain.
doses) asthma, abnormal vision
Route: & liver function.
IVTT
Frequency:
Every 6 hours
Name of Drug Classification Mechanism of Indication Contraindication Adverse Reactions Nsgr. Ressponsibilities
Action
Generic Name: Local Lidocaine is an >Lidocaine is Known >Arrhythmia, bradycardia, When Lidocaine is administered as an
Lidocaine HCl Anesthetics amide type local a local hypersensitivity arterial spasms, CV antiarrhythmic the nurse should
2% Injection, (amide group) anaesth. It anaesthetic of to anaesthetics of collapse, oedema, flushing,
monitor the ECG continuously. Blood
the amide the amide type; hert block, hypotension,
USP stabilizes the hypovolemia; sinus node suppression, pressure and respiratory status should
group.
neuronal >Lidocaine complete heart agitation, anxiety, coma, be monitored frequently during the
Trade name: membrane and confusion, drowsiness, drug administration.
Hydrochloride block.
hallucinations, euphoria,
Xylocaine; inhibits Na ion Injection BP is headache, hyperaesthesia, When administered as an anesthetic,
Enducaine movements, for use in Solutions hypoaesthesia, the numbness of the affected part
infiltration containing lightheadedness, lethargy,
which are should be assessed.
anaesthesia, adrenaline nervousness, psychosis,
Dosage: necessary for (epinephrine) seizure, slurred speech, Serum Lidocaine levels should be
intravenous
(*see info conduction of regional should not be unconsciousness, monitored frequently during prolonged
below table) impulses. anaesthesia used in areas of somnolence, nausea, use. Therapeutic serum lidocaine levels
the body supplied vomiting, metallic taste,
and nerve range from 1.5 to 5 mcg/ml.
tinnitus, disorientation,
>In the heart, blocks. by end arteries or If signs of overdose occur (listed
dizziness, paraesthesia,
otherwise having
lidocaine reduces resp depression and above), stop the infusion immediately
a compromised convulsions. Patch:
depolarisation of blood supply and monitor the patient closely.
Bruising, depigmentation,
the ventricles such as digits, petechiae, irritation. Ophth: For throat sprays, make sure that the
during diastole nose, ear or Conjunctival hyperaemia, patient’s gag reflex is intact before
and automaticity penis. Solutions corneal epithelial changes, allowing the patient to eat or drink.
containing diplopia,visual changes.
in the His- When IM injections are used, the
adrenaline
Purkinje system. medication should be administered in
(epinephrine)
Duration of should not be the deltoid muscle only while
action potential given frequently aspirating to prevent IV
and effective intravenously. injection.
refractory period For direct IV injection only 1% and 2%
are also reduced. solutions are used.
Undiluted IV loading dose of Lidocaine
Onset: 45-90 sec is administered at 1 mg/kg at a rate of
(IV); approx 4 hr 25 to 50 mg over 1 minute. The dose
(transdermal); 20 may be repeated after 5 minutes.
sec to 5 min
(ophth). .
Epidural
Epidural anaesthesia
Adult: 2-3 mL administered for each dermatome to be anaesthesised. Recommended doses are: Lumbar epidural 250-300 mg (as 1% soln) for analgesia and
225-300 mg (as 1.5% soln) or 200-300 mg (as 2% soln) for anaesth; for thoracic epidural: 200-300 mg (as 1% soln). For obstetric caudal analgesia, 200-300 mg
(as 1% soln); for surgical caudal anaesth: 225-300 mg (as 1.5% soln). For continuous epidural or caudal anaesth, not to repeat max doses more frequently than
1.5 hrly.

Intramuscular
Emergency treatment of ventricular arrhythmias
Adult: 300 mg injected into the deltoid muscle, repeat after 60-90 min if necessary.

Intraspinal
Spinal anaesthesia
Adult: As hyperbaric soln of 1.5% or 5% lidocaine in 7.5% glucose soln. Normal vaginal delivery: Up to 50 mg (as 5% soln) or 9-15 mg (as 1.5% soln). Caesarian
operation: Up to 75 mg (as 5% soln). Other surgical procedures: 75-100 mg.

Intravenous
Pulseless ventricular fibrillation or ventricular tachycardia
Adult: 1-1.5 mg/kg repeated as necessary. Max: 3 mg/kg. For ventricular arrhythmias in more stable patients: Usual loading dose: 50-100 mg as an IV inj at 25-50
mg/min, may repeat once or twice up to a max of 200-300 mg in 1 hr, followed by 1-4 mg/min via continuous IV infusion. May need to reduce dose if the infusion is
longer than 24 hr.

Intravenous
Intravenous regional anaesthesia
Adult: As 0.5% soln w/o epinephrine: 50-300 mg. Max: 4 mg/kg.

Mouth/Throat
Surface anaesthesia
Adult: As 2% soln: For pain: 300 mg rinsed and ejected for mouth and throat pain; or gargled and swallowed if necessary for pharyngeal pain. Not to be used
more frequently than every 3 hr. Max (topical oral soln): 2.4 g/day. As 4% soln: Before bronchoscopy, bronchography, laryngoscopy, oesophagoscopy,
endotracheal intubation, and biopsy in the mouth and throat: 40-200 mg. As 10% soln: For dentistry and otorhinolaryngology procedures: 10-50 mg sprayed to
mucous membrane. As 4% soln: For laryngotracheal anaesth: 160 mg sprayed or instilled as a single dose into the lumen of the larynx and trachea.

Ophthalmic
Surface anaesthesia
Adult: Apply 2 drops to ocular area where procedure will take place; may reapply to maintain effect.

Parenteral
Percutaneous infiltration anaesthesia
Adult: As 0.5% or 1% soln: 5-300 mg.

Parenteral
Sympathetic nerve block
Adult: As 1% soln: 50 mg for cervical block or 50-100 mg for lumbar block.

Parenteral
Peripheral nerve block
 Adult: As 1.5% soln: For brachial plexus block: 225-300 mg. As 2% soln: For dental nerve block: 20-100 mg. As 1% soln: For intercostal nerve block: 30 mg; for
paracervical block: 100 mg on each side, repeated not more frequently than every 90 min; for paravertebral block: 30-50 mg; for pudendal block: 100 mg on each
side. As 4% soln: For retrobulbar block: 120-200 mg.

Rectal
Haemorrhoids, Perianal pain and itching
Adult: Apply topically or using applicator insert rectally, up to 6 times daily.
Child: ≥12 yr Apply topically or using applicator insert rectally, up to 6 times daily.

Topical/Cutaneous
Surface anaesthesia
Adult: As 5% oint: Max: 20 g in 24 hr for skin and mucous membrane. As 2% gel: Approx 120-220 mg into urethra several min before examination. As 4% foam:
Apply 3-4 times daily for pain relief. As soln: Apply 40-200 mg to affected area. As patch: Apply patch to painful area for up to 12 hr w/in a 24-hr period. Max: 1
patch/24 hr.

Transdermal
Postherpetic neuralgia
Adult: As 5% patch: Apply to most painful area once daily for up to 12 hr w/in a 24-hr period. Max: Up to 3 patches in a single application.

Urethral
Surface anaesthesia
Adult: As 2% gel: Female: 60-100 mg inserted into the urethra several min before examination. Male: 100-200 mg before catheterisation and 600 mg before
sounding or cystoscopy.

Name of Classificati Mechanism of Action Indication Contraindication Adverse Nsgr. Ressponsibilities

Drug on Reactions
Generic Hypnotics Midazolam binds to PO: Preprocedural Contraindicated in: Hypersensitivity; CNS: agitation, Assessment
Name: and stereospecific sedation and Cross-sensitivity with other drowsiness, ● Assess level of sedation and
Midazola Sedatives benzodiazepine anxiolysis in benzodiazepines may occur; Shock; excess sedation, level of consciousness
m (Benzodia receptors on the pediatric patients. Comatose patients or those with headache. throughout and for 2– 6 hr
zepines) postsynaptic GABA IM, IV: Preoperative pre-existing CNS depression; EENT: blurred following administration.
Trade neuron at several sedation/anxiolysis/ Uncontrolled severe pain; Acute vision. Resp: ● Monitor BP, pulse, and
Name: sites w/in the CNS, amnesia. IV: angle-closure glaucoma; OB: APNEA, respiration continuously during
Dormizol including the limbic Provides Benzodiazepine drugs may inc. risk LARYNGOSPAS IV administration. Oxygen and
system, reticular sedation/anxiolysis/ of congenital malformations; use in M, resuscitative equipment should
formation. amnesia during the last weeks of pregnancy has RESPIRATORY be immediately available.
Enhancement of the therapeutic, caused CNS depression in the DEPRESSION, ● Toxicity and Overdose: If
inhibitory effect of diagnostic, or neonate; Lactation: Lactation; Pedi: bronchospasm, overdose occurs, monitor
GABA on neuronal radiographic Products containing benzyl alcohol coughing. CV: pulse, respiration, and BP
excitability results by procedures should not be used in neonates. Use CARDIAC continuously. Maintain patent
 increased neuronal (conscious Cautiously in: Pulmonary disease; ARREST, airway and assist ventilation as
membrane sedation): Aids in HF; Renal impairment; Severe arrhythmias. GI: needed. If hypotension occurs,
permeability to Cl the induction of hepatic impairment; Obese hiccups, nausea, treatment includes IV fluids,
ions, which results in anesthesia and as pediatric patients (calculate dose on vomiting. Derm: repositioning, and
hyperpolarisation (a part of balanced the basis of ideal body weight); rashes. Local: vasopressors.
less excitable state) anesthesia, As a >Pedi: Rapid injection in neonates phlebitisat IV ● The effects of midazolam can
and stabilisation. continuous infusion, has caused severe hypotension and site, pain at IM be reversed with flumazenil
Benzodiazepine provides sedation of eizures, especially when used with site (Romazicon).
receptors and effects mechanically fentanyl;
appear to be linked ventilated patients >Geri: Older patients (especially 70 >Potential Nursing Diagnoses
to the GABA-A during anesthesia or yr) are more susceptible to Ineffective breathing pattern
receptors. in a critical care cardiorespiratory depressant (Adverse Reactions) Risk for
setting, Status effects; decreased dosage required. injury (Side Effects)
epilepticus.
Dosage:

Intramuscular
Preoperative sedation
Child: 1-15 yr 50-150 mcg/kg. IM route should only be used in exceptional cases.

Intramuscular, Intravenous
Premedication in surgery
Adult: 70-100 mcg/kg (5 mg) given 20-60 min before surgery by deep IM inj; alternatively, 1-2 mg, repeated if required, given 5-30 min before surgery by IV inj.
Child: 1-15 yr 80-200 mcg/kg given 15-30 min before surgery by deep IM inj.
Elderly: 2-3 mg (dose range: 20-50 mcg/kg) given approx 20-60 min before surgery by deep IM inj; alternatively, an initial IV dose of 500 mcg, repeated slowly if
required, given 5-30 min before procedure.

Intravenous
Sedation for dental and minor surgical procedures
Adult: Initially, 2-2.5 mg given at a rate of 2 mg/min 5-10 min before procedure, w/ increments of 0.5-1 mg at intervals of at least 2 min. Total dose: 2.5-7.5 mg
(approx 0.07 mg/kg).
Child: 6 mth to 5 yr 50-100 mcg/kg up to a total of 600 mcg/kg. Max: 6 mg; 6-12 yr 25-50 mcg/kg up to a total of 400 mcg/kg. Max: 10 mg. Initial doses are given
over 2-3 min w/ an additional interval of 2-5 min.
Elderly: Initially, 0.5-1.5 mg at a max rate of 2 mg/min 5-10 min before procedure, w/ increments of 0.5-1 mg if required. Max total dose: 3.5 mg or until the desired
end-point is achieved.

Intravenous
Induction of anaesthesia
Adult: Total dose: 150-250 mcg/kg by slow inj in premedicated patients and 300-350 mcg/kg for those who have not received a premedicant. Additional doses
may be given, up to 600 mcg/kg may be used in resistant cases. For sedation in combined anaesth: 30-100 mcg/kg by inj repeated as required or by infusion in a
 dose of 30-100 mcg/kg/hr.
Child: >7 yr 150 mcg/kg by slow inj.
Elderly: 50-150 mcg/kg by slow inj in premedicated patients and 150-300 mcg/kg in those who have not received a premedicant.

Intravenous
Sedation in critical care
Adult: Loading dose: 0.03-0.3 mg/kg, may be given in increments of 1-2.5 mg injected slowly over 20-30 seconds, allowing 2 min between each dose.
Maintenance: 0.02-0.2 mg/kg/hr. For patients w/ hypothermia, hypovolaemia or vasoconstriction: Reduce or omit loading dose, and reduce maintenance dose.
Child: Neonates <32 wk 60 mcg/kg/hr by continuous infusion, reduced after 24 hr to 30 mcg/kg/hr. Max treatment duration: 4 days; Neonates ≥32 wk and infants
up to 6 mth 60 mcg/kg/hr. Max treatment duration: 4 days in neonates; ≥6 mth to 12 yr Loading dose: 50-200 mcg/kg given by slow inj over at least 3 min.
Maintenance: 30-120 mcg/kg/hr given as continuous infusion.
Elderly: Dosage reduction needed.

Oral
Preoperative sedation
Child: 6 mth to <16 yr 0.25-1 mg/kg as a single dose 20-30 min prior to procedure. Max: 20 mg.

Oral
Short-term management of insomnia
Adult: 7.5-15 mg at bedtime.
Elderly: 7.5 mg at bedtime.

Oral
Seizure
Child: 3-6 mth Hospital setting: 2.5 mg; >6 mth to <1 yr 2.5 mg; 1-<5 yr 5 mg; 5-<10 yr 7.5 mg; 10-<18 yr 10 mg. Doses are given as single dose.

Name of Classifica Mechanism Indication Contraindication Adverse Reactions Nsgr. Ressponsibilities

Drug tion of Action
Generic Therapeut Neostigmine Improvement in Contraindicated in: CNS: SEIZURES, Assessment
name: ic: inhibits the muscle strength in Hypersensitivity; dizziness, weakness. ● Assess pulse, respiratory rate, and BP prior to administration. Report
Neostigmi antimyast hydrolysis of symptomatic Mechanical EENT: lacrimation, significant changes in heart rate.
ne henics acetylcholine treatment of obstruction of the miosis. Resp: ● Myasthenia Gravis: Assess neuromuscular status, including vital
by competing myasthenia gravis. GI or GU tract; bronchospasm, capacity, ptosis, diplopia, chewing, swallowing, hand grasp, and gait,
Trade Pharmaco w/ Prevention and Lactation: excess secretions. prior to administering and at peak effect. Patients with myasthenia
name: logic: acetylcholine treatment of Lactation. Use CV: bradycardia, gravis may be advised to keep a daily record of their condition and the
for its binding
Prostigmi cholinergi postoperative Cautiously in: hypotension. effects of this medication.
site on
n cs) bladder distention History of asthma; GI:abdominal ● Assess patient for overdose and underdose or resistance. Both have
acetylcholine
sterase. It and urinary retention Ulcer disease; cramps, diarrhea, similar symptoms (muscle weakness, dyspnea, dysphagia), but
facilitates or ileus. Reversal of Cardiovascular excess salivation, symptoms of overdose usually occur within 1 hr of administration,
impulse nondepolarizing disease; Seizure nausea, whereas underdose symptoms occur 3 or more hr after administration.
transmission neuromuscular disorder; Overdose (cholinergic crisis) symptoms may also include increased
 across blockers after Hyperthyroidism; vomiting.Derm:swe respiratory secretions and saliva, bradycardia, nausea, vomiting,
neuromuscul surgery. OB: May cause ating, rash. cramping, diarrhea, and diaphoresis. A Tensilon test (edrophonium
ar junctions uterine irritability chloride) may be used to distinguish between overdose and underdose.
thus, after IV ● Postoperative Ileus: Monitor abdominal status (assess for distention,
enhancing administration auscultate bowel sounds). A rectal tube may be inserted to facilitate
cholinergic near term; expulsion of flatus.
action. It also newborns may ● Postoperative Urinary Retention: Assess for bladder distention.
has a direct
display muscle Monitor intake and output. If patient is unable to void within 1 hr of
cholinomimeti
weakness. neostigmine administration, consider catheterization.
c effect on
skeletal ● Reversal of Nondepolarizing Neuromuscular Blocking Agents: Monitor
muscle and reversal of effects of neuromuscular blocking agents with a peripheral
possibly on nerve stimulator. Recovery usually occurs consecutively in the following
autonomic muscles: diaphragm, intercostal muscles, muscles of the glottis,
ganglion cells abdominal muscles, limb muscles, muscles of mastication, and levator
and neurons muscles of the eyelids. Closely observe the patient for residual muscle
of the CNS. weakness and respiratory distress throughout the recovery period.
Maintain airway patency and ventilation until recovery of normal
respiration occurs.
● Toxicity and Overdose: If overdose occurs, atropine is the antidote.
Potential Nursing Diagnoses Impaired physical mobility (Indications)
Ineffective breathing pattern (Indications)

Dosage:

Route/Dosage Myasthenia Gravis

PO (Adults): 15 mg q 3– 4 hr initially;qat daily intervals until optimal response is achieved. Usual maintenance dose is 150 mg/day (up to 375
mg/day may be needed).

PO (Children): 2 mg/kg/day (60 mg/m2 ) in 6– 8 divided doses.

Subcut, IM (Adults): 0.5 mg.

Subcut, IM (Children): 10– 40 mcg/kg q 2– 3 hr; may give with 10 mcg/kg atropine.

Bladder Atony, Abdominal Distention: Prevention

 IM, Subcut (Adults): 250 mcg q 4– 6 hr for 2– 3 days.

Bladder Atony, Abdominal Distention: Treatment

IM, Subcut (Adults): 500 mcg as needed; may repeat q 3 hr for 5 doses after bladder has been emptied for bladder atony.

Reversal of Nondepolarizing Neuromuscular Blockers

IV (Adults and Children): 0.03 mg/kg for neuromuscular blockers with short halflife (e.g. rocuronium); 0.07 mg/kg for neuromuscular blockers

Name of Classifica Mechanism of Indication Contraindication Adverse Reactions Nsgr. Ressponsibilities

Drug tion Action
Generic Barbiturat Thiopental >Induction of >Hypersensitivity to CNS: Headache, retrograde amnesia, Assessment & Drug Effects
Name: es sodium, a short- anesthesia; barbiturates; emergence delirium, prolonged
Thiopental acting barbiturate >history of somnolence and recovery. 
> Reduction of Monitor vital signs q3–5min before,
Sodium anaesthetic, is a paradoxic CV: Myocardial depression,
CNS depressant raised during, and after anesthetic administration
excitation; >absence arrhythmias, circulatory depression. until recovery and into postoperative
inducing intracranial
Trade of suitable veins for GI: Nausea, vomiting, regurgitation of period, if necessary.
hypnosis and pressure  Report increases in pulse rate or drop in
name: IV administration; gastric contents, rectal irritation,
Pentothal
anaesthesia but >management >status asthmaticus; cramping, rectal bleeding, diarrhea. blood pressure. Hypovolemia, cranial
not analgesia. It of Status acute intermittent Respiratory: Respiratory depression trauma, or premedication with opioids
has also been epilepticus increases potential for apnea and
used in the or other hepatic with apnea; hiccups, sneezing, coughing,
porphyrias. Safety bronchospasm, laryngospasm. symptoms of myocardial depression
control of (decreased cardiac output and arterial
refractory tonic- during pregnancy Body as a Whole:Hypersensitivity
pressure).
clonic status (category C), reactions, anaphylaxis (rare),
 Shivering, excitement, muscle twitching
epilepticus and to lactation, or hypothermia, thrombosis and sloughing
may develop during recovery period if
reduce increased children is not (with extravasation); salivation, shivering,
patient is in pain.
intracranial established. skeletal muscle hyperactivity.
pressure in
neurosurgical Patient & Family Education
patients.
Onset: IV: 30  Onset of drug effect is rapid, with loss of
sec. Rectal: 8-10 consciousness within 30–60 sec.
min.

with longer half– life (e.g. vecuronium, pancuronium); dose may be repeated to a total dose of 0.07 mg/kg or 5 mg, whichever is less; pretreat
with atropine IV (0.6– 1.2 mg for adults; 20 mcg/ kg for children)
Dosage:

Adult : IV Induction of anesth As 2.5 or 5% soln: 100-150 mg, repeat every 30-60 sec if needed. Max: 500 mg. Max in pregnant women: 250 mg. Status
epilepticus W/ assisted ventilation: As 2.5% soln: 75-125 mg. Reduction of raised intracranial pressure Intermittent bolus inj of 1.5-3.5 mg/kg, if adequate
ventilation is provided.

Dosage details:

Intravenous
Induction of anaesthesia
Adult: 100-150 mg of a 2.5 or 5% solution injected over 10-15 sec repeated every 30-60 sec according to response or as a continuous infusion of
a 0.2 or 0.4% solution. Max: 500mg. Max in pregnancy: 250mg.
Child: 2-7 mg/kg over 10-15 seconds; repeated after 1 minute if needed..
Elderly: Dose reduction may be needed.

Intravenous
Reduction of raised intracranial pressure
Adult: Intermittent bolus inj of 1.5-3.5 mg/kg, if adequate ventilation is provided.
Child: 3 mth-15 yr: initial 5-10-mg/kg IV followed by a continuous IV infusion at 1-4 mg/kg/hr.
Elderly: Dose reduction may be needed.

Intravenous
Status epilepticus
Adult: In conjunction with assisted ventilation: 75-125 mg as a 2.5% solution.
Child: 5 mg/kg by slow IV inj followed by, neonates: continuous iv infusion of 2.5 mg/kg/hr; >1 month: 2-8 mg/kg/hr. Adjust infusion dose
according to response.
Elderly: Dose reduction may be needed.