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Barbiturates
Carbamazepine
Omeprazole
Phenytoin
Rifampin
Increased in concentrations:
◦ Cimetidine
◦ Ciprofloxacin
◦ Clarithromycin
◦ Erythromycin
Type III anti arrhythmic that prolongs effective
refractory period of the atrial and ventricular
tissue.
Diluent: D5W only (glass or polyolefin containers
for maintenance infusion)
Loading dosage: 150 mg over 10 mins. (can
repeat), then 1 mg/min for 6 hrs
Maintenance concentration: 450 mg/250 ml =
1.8 mg/ml
Infusion rate: 0.5 mg/min (0.5 mg/min = 17
ml/hr)
Contraindicated in sick sinus syndrome, 2nd and
3rd degree heart block, bradycardia and
hypotension
Amiodarone
Amiodarone interactions
Decreased concentrations
Barbiturates, rifanpicin, dilantin,
carbamazepine
Increased concentrations
digoxin ,warfarin
Dose x kg =mcqtts/min
DF
Mcqtts/min x DF = ug/kg/min
kg
Start dopamine drip at 10uq/kg/min using
double concentration. Pt’s weighs 50kgs.
10ug/kg/min X 50 kgs
26.6
500 = 18.7 or 19 mcqtts/mjn
26.6
PRECAUTIONS:
Watch out for lidocaine toxicity (disorientation,
seizures,respiratory compromise).
Watch out for lidocaine heart block.
Calcium channel blocker used to treat
hypertension
Diluent: NS, D5W
Concentration: 25 mg/250 ml = 0.1
mg/ml
Infusion rate: 2–15 mg/hr
Monitor for hypotension
Organic nitrates that relaxes smooth muscle. Used in
anginal pain and hypertensive crisis.
Most effective agent used for acute pulmonary
edema.
Diluent: NS, D5W (glass or polyolefin containers only)
Concentration: 50 mg/250 ml = 200 µg/ml
Infusion rate: Initially 10 µg/min; titrate to effect (10
µg/min = 3 ml/hr)
Most frequent side effect is headache.
Sticks on IV plastic tubing, glass containers should be
used. Stable in room temperature at 48 hours and7
days in refrigeration. Flush the tubings if the line will
be used for another solution
Used to treat acidosis
Slow IV push at 1 meq/Kg initially,
then 0.5 meq/kg q 10 mins
Incompatible with cathecholamines
and calcium contining solutions
(precipitates)
50ml pre loaded syringe (8.4% sodium bicarb @ 50meq/50ml).
DOSE
1mEq/kg IV bolus then depending on ABG result thereafter.
PRECAUTIONS:
Watch out for respiratory depression.
Observe for hypotension.
Sodium bicarbonate can produce a variety of side effects
including the ff:
- Mixed venous intracellular acidosis.
-Hyper osmolality
-hyper natremia
-Metabolic alkalosis
- Acute hypokalemia
Penicillins and its derivatives testing (skin or
IV) is done prior to administration.
Aminoglycosides are mainly given via IV or
IM. Renal and vestibulocochlear
complications.
Tetracyclines are irritant to IV administration
and usually causes phlebitis.
Always read the drug literature prior to
administration of specific antibiotics.
Mannitol
Indications: cerebral edema, decrease
intraocular pressure, oliguric phase of acute
renal failure
Usual dose: varies w/ clinical indication
Mode of adm.: intermittent; give 200 mg/kg
to produce 40 ml of urine in 1 hr
Maj. Side effects: convulsions, blurred
vision, vertigo, headache, urinary
retention, polyuria ffd by oliguria, chills,
chest pain, edema, fluid and electrolyte
imbalance.
Nursing considerations: administer test
dose over 3-5 mins; monitor for inc urine
output, serum electrolytes, IV site;
maintain hydration; crystals must be
dissolved before adm; use a 170 – micron
in-line filter
Px/ caregiver education: instruct px to
report changes in sensorium.
Many injectable drugs cannot be mixed
together in syringes or infusions.