Drugs

Action

Uses

Side Effects

Nursing Considerations

Epinephrine

vasoconstriction, increased contractility, bronchodilation, CNS stimulation

Atropine

bronchospasm, anaphylaxis, allergic reactions, cardiac arrest, shock Antidysrhythmics are used for PVCs, tachycardia, increase HR, SVR, and hypertension, atrial fibrillation, angina BP, increase action pectoris potential

tremors, anxiety, HA, dizzy, confuse, cerebral hemorrhage, weak, tachycardia, Assess: EKG continous, BP, pulse, CVP, PAWP, SVR, admin site, increased T wave, anorexia, N, V, dry sensitivity, I&O, glucose in D eyes, sweating, dyspnea

N, V, dehydration, hypovolumia, hypotension, HTN, lower extremity edema, bradycardua, dizzy, confuse, depression, fever

Assess: EKG, IV infusion, I&O ration, BP, K, edema Assess: EKG, IV infusion <4mg/min, BP, blood levels (1.5-5 mcg/ml), I&O, K, Na, Cl, malignant hyperthermia, tachypnea, tachycardia, RR, lung sounds,

Lidocaine

suppress dysrhythmias, Ventricular tachycardia, HA, dizzy, sz, confuse, hypotension, increases elect stimulation threshold of ventricular dysrhythmias, heart block, tinnitus, N, V, anorexia, ventricle, His-Purkinje cardiac surgery, dig tox, rash, edema, rever, phlebitis at inj site, dyspnea cardia cath, system SVT, as a diagnostic aid to assess myocardial perfusion defects in CAD, Wolff-ParkinsonWhite (WPW) syndrome

Adenosine slows HR & conduction via AV node Lasix

dizzy, tinglling, numbness, apprehension, HA, chest pn, sweating, facial flush, hypotension, N, dyspnea, metallic taste, Assess: I&O ratio, K, Na, Cl, BP, bronchospasm, groin pressure RR, EKG, PVC, lung sounds orthostatic hypotension, chest pn, EKG changes, circulatory collapse, loss of hearing, ear pn, tinnitus, hypokalemia, hypocalcemia, hyponatremia, metabolic alkalosis, hyperglycemia, renal fail, thrombocytopenia. Agranulocytosis, leukopenia, anemia, rash, StevensJohnsons, sweating, photosensitivity, cramps

Pulmonary edema; edema in CHF, hepatic disease, nephrotic syndrome, ascites, rapid diuresis, venous hypertension, prevention vasodilation, inhibit of hemodynamic effects reab Na and Cl at distal associated with blood tube product transfusion regulates contractility, Increases osmotic pressure, draws fluid into colon, neutralizes HCl, moves bowels cardiac arrest, CPR, digitoxin/digoxin toxicity, torsade de pointes, ventricular fibrillation/tachycardia
angina pectoris due to

Assess: S&S metabolic alkalosis, postural hypotension, temp, hearing, daily weight, I&O, RR, BP. Na, K, Cl, BUN, glucose, CBC, serum creatinine, pH, ABGs, uric acid, Ca, Mg, turgor, edema, mucousa

Magnesium Sulfate

weakness, flush, sweating, confuse, depressed reflexes, hypothermia, hypotension, heart block, circulatory collapse, vasodilation, N, V, D, anorexia, cramps, prolonged bleeding time, elect Assess: I&O, bowel movements, lyte & fluid imbalance, respi depress bowel sounds

Diltiazem (Cardizem)

Dopamine

Dobutamine

inhibits Ca influx acrosscoronary artery spasm, cell membrane, relaxes hypertension, IV atrial coronary vasculuture, fibrillation, flutter, dilates, slows SA/AV paroxysmal condution, dilates supraventricular peripheral arteriesslows tachycardia, Unstable conduction, decrease angina, proteinuria, contractility cardiomyopathy Shock, increased perfusion, hypotension, cardiogenic/septic shock, uses: Bradycardia, cardiac arrest, CPR, increase CO, BP, and acute renal failure, renal blood flow, cirrhosis, barbiturate vasocontrict intoxication Cardiac decompensation due to organic heart disease or cardiac surgery, Cardiogenic shock in children; congenital heart disease increase contractility & in children undergoing CP w/out increased HR cardiac cath enhance contractility

HA, fatigue, dizzy, weakness, tremor, dysrhythmias, edema, CHF, bradycardia, hypotension, heart block, N, V, D, gastric upset, Assess: BP, P, RR, EKG and PR, constipation, increased LTF, renal QRS, QT intervals, (low BP hold and call), fail, rash, flush, rhinnitis, dyspnea

Assess for hypovolumia, O2 sat, BP, for chest pn, LOC, EKG, P, for vein distentions, I&O ration, lung HA, anxiety, tachycardia, hypertension, sounds, peripheral P, PCWP, CVP, angina, wide QRS, hypotension, N, V, D, for parethesias in extremities, inj tissue necrosis, gangrene, dyspnea site

Calcium Chloride

HA, anxiety, dizzy, tachycardia, hyper/hypotension, PVCs, angina, hypokalemia, heartburn, N, V, leg cramps, dyspnea short QT, heart block, hypotension, Assess for decreased QT and T Electrolyte abnormalities bradycardia, dysrhythmias, V, N, constipation, hypercalcemia, pn/burn at wave inversion, Ca levels (8.5in cardiac arrest, CPR 11.5g/dl), CVP, PAWP, for Dig tox site, necrosis

Assess for hypovolumia, O2 sat, BP, for chest pn, LOC, EKG, P, S3, dyspnea, neck vein distension, bibasilar crackles, cardiomyopathy, peripheral pulses, mottling, EKG, CVP, PCWP, CO, lytes

Nicardipine (Cardene)

Lorazepam (Ativan)

dilate, reduce SVR, Inhibits calcium influx across cell membrane during cardiac Chronic stable angina depolarization; relaxes pectoris, hypertension coronary vasculature, peripheral vasculature; dilates coronary arteries; increases myocardial oxygen
sedate - Potentiates the actions of GABA, especially in the limbic system and reticular formation Anxiety, irritability in psychiatric or organic disorders, preoperatively, insomnia, adjunct in endoscopic procedures

Digoxin

Procainamide (Pronestyl)

Nitroglycerin

Antidysrhythmics are used for PVCs, increase contractility, tachycardia, slow HR and prolongs hypertension, atrial the effective refractory fibrillation, angina periodconductionnode pectoris slows in the AV Depresses excitability of cardiac muscle to electrical stimulation and slows conduction in atrium, bundle of Atrial fibrillation, flutter, His, and ventricle Life-threatening increases refractory ventricular dysrhythmias period relax smooth muscle and vasodilate - ilate coronary arteries, causing decreased preload, and dilate systemic arteries, causing decreased afterload

HA, dizzy, anxiety, confuse, parathesia, flush, edema, bradycardia, hypotension, polmo edema, chest pn, tachycardia, CHF, arrhythmias, N, V, constipation, hepatitis, abd cramp, dry mouth, polyuria, rash, Stevens-Johnsons,SOB, impotence, sweating dizzy, confuse, HA, anxiety, tremors, insomnia, hallucinations, orthostatic hypotension, EKG chgs, tachycardia, hypotension, apnea, cardiac arrestn, tinnitus, constipation, dry mouth, N, V, anorexia, D, rash, acidosis

Teach: no grapefruit. Assess BP, RR, EKG, pn, K, renal & hepatic labs, daily weight, lung sounds, for vein distension, I&O, No pregnant, elders or pedi. Assess: P, BP (hold if systolic drops 20), AST, ALT, bili, creatinine, LDH, LOC, for suicide.

dysrhythmias, N, V, dehydration, hypovolumia, hypotension, HTN, edema Assess EKG, IV rate, I&O, BP, K in feet and legs, blurred vision, HA, and for edema yellow halos Assess EKG for increase PR or QRS segs (discont), blood levels (310mcg/ml), CBC, platelets, I&O, HA, dizzy, confuse, psychosis, hypotension, heart block, cardiovascular lytes, weekly weight, tox (confuse, collapse, arrest, N, V, D, hepatomegaly, drowzy, N, V, oliguria, tachydysrhythmias), ANA titer, HR, pn, bitter taste, agranulocytosis, RR, lung sounds, psychosis, thrmobocytopenia, hemolytic anemia, seizures, parathesias (discont) rash, edema, flus, angioedema

sed in chronic stable angina pectoris, unstable angina, vasospastic postural hypotension, flush, dizzy, edema, N, rash, fatigue, dysrhythmias angina,
dizzy, HA, agitation, twitch, decreased Hypertensive crisis, to reflex, restless, bradycardia, N, V, abd decrease bleeding by pn, sweating, bradycardia, EKG chgs, creating hypotension during tachycardia, hypotension, flush, surgery, acute CHF hypothyroid, acidosis

Assess P, BP, for pn, tolerance, HA. Teach storage, no OTCs, and medi ID Ass lytes, glucose, O2 sats, BUN & creatinine lev, AST, ALT, BP, for vein distension, PCWP, daily weight, I&O, for edema, turgor, lung sounds, PCO2 pH

Sodium Nitroprusside

Directly relaxes arteriolar, venous smooth muscle, resulting in reduction in cardiac preload, afterload

Amiodarone

Severe ventricular tachycardia, reduce afterload, supraventricular invol mvt, peripheral neuropathy, fatigue, reduce VR and tachycardia, ventricular ataxia, insomnia, hypotension, increases CI - Prolongs fibrillation not controlled bradycardia, sinus arrest, CHF, duration of action by first-line agents, Atrial dysrhythmias, SA node dysfunct, blurred potential , increases PR fibrillation Assess for pulmonary tax (dyspnea, vision, halos, photophobia, dry eyes, and QT intervals, treatment/prophylaxis, hypo/hyperthyroid, N, V, D, abd pn, cough, fatigue, chest pn - discont), decreases sinus rate, atrial flutter, cardiac EKG for PR, QRS and QT segs, anorexia, constipation, heatotox, rash, decreases peripheral arrest, cardiac surgery, alopecia, ecchymosis, necrosis, flush, PVC, BP, HR, I&O, lytes, AST, vascular resistance abnorm smell/taste, edema, salivation, ALT, bili, chest x-ray, lung sounds, CPR, heart failure, RR. Teach - sunscreen, dark PSVT, Wolff-Parkinson- coag probs, weak, pulmo fibrosis, glasses, hat, no grapefruit. ARDS, gasping White (WPW) syndrome peripheral vasoconstrictor Promotes reabsorption of water by action on renal tubular epithelium
drowzy, HA, lethargy, flus, hypertension, dysrhythmias, cardia arrest, shock, chest Assess P, BP, I&O, daily weight, pn, MI, congestion, rhinnits, N, lytes, for edema. Keep emerg eq heartburn, cramps, V, flatus, uterine cramping, tremors, sweating, bronchial near for coronary adverse effects. Teach no alcohol or OTCs. constriction

Vasopressin

Isoproterenol (Isuprel)

For mild or transient episodes of heart block that do not require electric shock or pacemaker therapy, serious episodes of heart accelerates conduction, block and Adams-Stokes HR, contractility, attacks , in cardiac arrest reduces VR, CO until electric shock or increase pacemaker therapy

palpitations, sinus tachy, mycardial necrosis, HA, dizzy, N, pulmo edema, hypotension, dyspnea, flush, sweating, Assess P, BP, EKG, pn, lung sounds, tremor, pallor, weak RR

Inderal (Propranolol)

depression hallucinations, dizzy, lethargy, paresthesia, chg LOC, hronic stable angina bradycardia, hypotension, CHF, AV pectoris, hypertension, block, vasodilation, cold extremities, supraventricular pulmo edema, laryngospasm, dry eyes, dysrhythmias, migraine N, V, D, colitis, constipation, prophylaxis, hepatomegaly, acute pancreatitis, decrease HR, CO, pheochromocytoma, impotence, decreased libido, UTI, contractility, HTN cyanotic spells related to agranulocytosis, thrombycytopenia, Nonselective -blocker hypertrophic subaortic rash, fever, hyper/hypoglycemia, facial with negative inotropic, stenosis, acute MI, portal swell, weight gn, muscle cramps, chronotropic, hypertension, unstable dyspnea, respi dysfunct, bronchospasm, dromotropic properties angina cough, vasoconstrict - Causes

Assess P, BP, RR, daily weight, I&O ration, for fluid overload, EKG, PCWP, CVP, AST, ALT, bili, for angina pn. Teach do not discont, no OTCs, monitor glucose, dress warmly, take P and BP & hold if <50 bpm or systolic <90.

Levophed increased contractility (Norepinephrin and heart rate by acting e) on -receptors in heart;

also acts on receptors, causing vasoconstriction in blood vessels; B/P is elevated, coronary blood flow improves, cardiac output increasescontractility, increase
Milrinone (Primacor)

Acute hypotension, shock

HA, anxiety, insomnia, cerebral hemorrhage, tachycardia, hypert4ension, angina, N, V, low urine out, cecrosis, gangrene, dyspnea

Assess I&O, EKG, BP, P, CVP, extremity temp and P, inj site and sensitivity

vasodilate - Positive inotropic agent, increases contractility of cardiac muscle with vasodilator properties; reduces preload and afterload by direct relaxation on vascular smooth muscle alkalinizer

Sodium Bicarbonate

Assess EKG for vent dysrhythmias, BP (stop infusion if drops dysrhythmia, hypotension, chest pn, N, 30mmHg), P, lytes, BUN, V, anorexia, abd pn, hepatox janudice, creatinine, Hct, Hgd, platelets thrombocytopenia, HA, hypokalemia, (<150k discont), ALT, AST, bili, I&O ration, daily weight, chg site Q48H. tremor, site reactions thirst, abd cramps, flatus, HA, V (coffee make your blood or urine grounds), N, anorexia, irritable, weak, slow RR, leg/feet edema, black stools, Assess for dehydration, bleeding, less acidic and peripheral edema. bld in uirine

Short-term management of advanced heart failure that has not responded to other medication; can be used with digoxin