Generic Brand Name Classification Action Indication Dose Nursing Responsibilities

Name
Diazepam Valium Antianxiety - Depress the CNS, -Adjunct in the management 10 mg - Monitor BP, PR,RR
agents, probably by of: IM prior to periodically
anticonvulsants, potentiating GABA, 1) Anxiety throughout therapy and
sedative/hyptonics, an inhibitory 2) Preoperative sedation frequently during IV
skeletal muscle neurotransmitter. 3) Conscious sedation therapy.
relaxants (centrally - Produces skeletal - Provides light anesthesia - Assess IV site
acting) muscle relaxation by and anterograde amnesia frequently during
inhibiting spinal - Treatment of status administration,
polysynaptic afferent epilepticus/ uncontrolled diazepam may cause
pathways. seizures phlebitis and venous
- Has anticonvul-sant - Skeletal muscle relaxant thrombosis.
properties due to - Management of the - Prolonged high-dose
enhanced presynaptic symptoms of alcohol therapy may lead to
inhibi- withdrawal psychological or
tion.Therapeutic physical dependence.
effects: Restrict amount of drug
(1) Relief of Anxiety CONTRAINDICATIONS: available to patient.
(2) Sedation - Hypersensitivity Observe depressed
(3) Amnesia - Cross-sensitivity with patients closely for
(4) Skeletal muscle other benzodiazepines may suicidal tendencies.
relaxant occurs - Observe and record
(5) Decreased seizure - Comatose patients intensity, duration and
activity - Pre-existing CNS location of seizure
depression activity. The initial
- Uncontrolled severe dose of diazepam offers
painUse cautiously in: seizure control for 15-
1) Hepatic dysfunction 20 min after
2) Severe renal impairment administration.
3) History of suicide - IM injections are
attempt or drug dependence painful and erratically
absorbed. If IM route is
used, inject deeply into
deltoid muscle for
maximum absorption.
- Caution patient to
avoid taking alcohol or
other CNS depressants
concurrently with this
medication.
- Effectiveness of
therapy can be
demonstrated by
decrease anxiety level;
control of seizures;
decreased
tremulousness.
 Generic Name Brand Name Classification Action Indication Dose Nursing
Responsibilities
diphenhydramine Benadryl Antihistamine, Antagonizes the parkinsonism or Tablet: 25, 50 Caution the client that
anticholinergic effect of histamine at drug-induced mg the medication may
antiparkinson H1 receptor sites; extrapyramidal Capsule: 25, 50 cause drowsiness,
agent does not bind or effects, mg creating difficulties or
inactivate histamine, Symptomatic relief Elixir: 12.5 mg/5 hazards or other
Antihistamines of allergies ml activities that require
prevent the Allergic reactions Parenteral: 10, alertness.
physiological actions Anaphylaxis 50 mg/ml vials, • Tell the client to take
of histamine by Acute dystonic prefilled syringe the medication with
preventing reactions Adult: food to decrease GI
histamines from upset.
reaching H1- and The standard • Explain to the client
H2-receptor sites. Contraindications dose of that arising quickly
Antihistamines diphenhydramine form a lying or sitting
provide short-lived Lower respiratory is 25-50 mg, position may cause
benefits and provide diseases such as either IM or IV. orthostatic
only symptomatic astma attacks hypotension.
relief. Antihistamine Patients taking Pediatric: 5 • When taking these
is specific for MAOIs mg/kg/24 hr q 6 medications, the client
conditions in which Hypersensitivity hr PO. 2-5 needs to have blood
histamine excess is Narrow-angle mg/kg IV or IM. cells counts, renal
present (for examle, glaucome function, hepatic
acute urticaria) but is function, and blood
adjunctive therapy in Onset & pressure monitored.
the treatment of Duration • Adverse effects of
anaphylactic shock these drugs occur
because epinephrine Onset: Maximal more commonly in
is more effenctive. effects 1-3 hr elderly clients.
Antihistamines are Duration: 6-12 • Explain to the client
quite specific for hr that use of these drugs
reversing in warm weather may
extrapyramidal increase the likelihood
 reactions and are of heatstroke.
probably efficacious
as drying agents in
upper respiratory
and sinus conditions

Generic Name Brand Classification Action Indication Dose Nursing

Name Responsibilities
NALBUPHINE Nubaine Narcotic Nalbuphine acts Relief of moderate to Available Forms: •Reassess patient’s
HYDROCHLORIDE agonist- as an agonist at severe pain level of pain at least
antagonist specific opioid Injection – 10 15 and 30 minutes
analgesic, receptors in the Preoperative after parenteral
mg/ml, 20mg/ml
administration
Opioid Agonist- CNS to produce analgesia, as a
Antagonist analgesia, supplement to surgical Adults: •Nalbuphine acts as
sedation but also anesthesia, and for an opioid antagonist
acts to cause obstetric analgesia Usual dose is 10 and may cause
hallucinations during labor and mg/70kg, SC, IM withdrawal
and is an delivery. or IV q 3-6h as syndrome. For
antagonist at µ patients who have
necessary.
receptors Contraindications: received log-term
Individualize opioids, give 25% of
hypersensitivity to
nalbuphine, sulfites; dosage. In the usual dose
nontolerant initially. Watch for
lactation.
sings of withdrawal.
Use cautiously with patients, the
emotionally unstable recommended •Alert: Drug causes
clients or those with a single maximum respiratory
history of narcotic dose is 20mg, depression, which
abuse; pregnancy at 10mg is equal to
prior to labor, labor or with a maximum respiratory
delivery, bronchial total daily dose of depression
asthma, COPD, 160mg. Patients produced by 10 mg
respiratory depression, dependent on
anoxia, increased narcotics may of morphine
intracranial pressure, experience
acute MI when nausea •Monitor
withdrawal circulatory and
and vomiting are
symptoms. respiratory status,
present, biliary tract bladder and bowel
surgery. function. If
respirations are
Pediatric patients shallow or rate is
< 18 yr : Not below 12
breaths/minute,
recommended withhold dose and
notify prescriber
Geriatric patients
or patients with •Constipation is
renal or hepatic often severe with
impairment: maintenance
Reduce dosage therapy. Make sure
stool softener or
Adults other laxative is
Subcutaneous / ordered.
IM / IV 10 mg
•Psychological and
per 70 kg q 3
physical
to 6 h as
dependence may
needed.
occur with
Individualize
prolonged use.
dosage. In
nontolerant • Remind patient
patients, do not not to confuse
exceed 20  Nubain with
mg/dose or Navane.
160 mg/day
 Generic Name Brand Classification Action Indication Dose Nursing
Name Responsibilities
CLONIDINE Catapres, cardiovascular Centrally acting Step 2 drug in Hypertension Assessment & Drug
HYDROCHLORIDE Catapres- agent; central- antiadrenergic stepped-care approach Adult: PO 0.1 mg Effects
TTS, acting derivative. to treatment of b.i.d. or t.i.d.,
Dixaril , antihypertensive; hypertension, either may increase by Monitor BR
Stimulates
Duraclon analgesic alone or with diuretic 0.1–0.2 mg/d closely.
alpha2- or other until desired Determine
adrenergic antihypertensive response is
receptors in agents. Epidural achieved (max: positional
CNS to inhibit administration as 2.4 changes (supine,
sympathetic adjunct therapy for mg/d) Transderm sitting, standing).
vasomotor severe pain. al 0.1 mg patch
once q7d, may With epidural
centers. Central
CONTRAINDICATI increase by 0.1 administration,
actions reduce ON mg q1–2 wk frequently monitor BP
plasma Pregnancy (category Geriatric: PO and HR. Hypotension
concentrations C), lactation. Use of Start with 0.1 mg is a common side
of clonidine patch in once daily effect that may require
norepinephrine. polyarteritis nodosa, Child: PO 5–10 intervention.
It decreases scleroderma, SLE mcg/kg/d divided
q8–12h, may Monitor BP closely
systolic and
increase to 5–25 whenever a drug is
diastolic BP and mcg/kg/d divided added to or withdrawn
heart rate. q6h (max: 0.9 from therapeutic
Orthostatic mg/d) regimen.
effects tend to
be mild and Severe Pain Monitor I&O during
occur Adult: Epidural period of dosage
start infusion at adjustment. Report
infrequently.
30 mcg/h and change in I&O ratio or
Also inhibits titrate to
renin release change in voiding
response. Use
from kidneys. rates >40 mcg/h
 with caution
Child: Epidural pattern.
start infusion at
0.5 mcg/kg/h and Determine weight
titrate to response daily. Patients not
receiving a
ADDH concomitant diuretic
Child: PO 5 agent may gain weight,
mcg/kg/d in 4 particularly during first
divided doses 3 or 4 d of therapy,
(average dose, because of marked
0.15–0.2 sodium and water
mg/d) Transderm retention.
al 0.2–0.3 mg/d
q5–7d Supervise closely
patients with history of
mental depression, as
they may be subject to
further depressive
episodes.

Generic Name Brand Name Classification Action Indication Dose Nursing Responsibilities
FUROSEMIDE Lasix Rapid-acting potent Treatment of Tablets: • Observe patients
Electrolytic sulfonamide “loop” edema associated 20, 40, receiving parenteral
and water diuretic and with CHF, and drug carefully;
balance antihypertensive with cirrhosis of liver, 80mg. closely monitor BP
agent; pharmacologic effects and kidney Oral and vital signs.
and uses almost disease, including solution: Sudden death from
loop
 identical to those of nephrotic 10 cardiac arrest has
diuretic ethacrynic acid. Exact syndrome. May mg/ml, been reported.
mode of action not be used for 40 mg/5 • Monitor BP during
clearly defined; management of ml. periods of diuresis
decreases renal vascular hypertension, Injection: and through period
resistance and may alone or in 10 mg/ml of dosage
increase renal blood combination with adjustment.
flow. other • Observe older adults
antihypertensive closely during period
agents, and for of brisk diuresis.
treatment of Sudden alteration in
hypercalcemia. fluid and electrolyte
Has been used balance may
concomitantly precipitate
with mannitol for significant adverse
treatment of reactions. Report
severe cerebral symptoms to
edema, physician.
particularly in • Lab tests: Obtain
meningitis. frequent blood
count, serum and
urine electrolytes,
CO2, BUN, blood
sugar, and uric acid
values during first
few months of
therapy and
periodically
thereafter.
• Monitor for S&S of
hypokalemia (see
Appendix F).
• Monitor I&O ratio
and pattern. Report
 decrease or unusual
increase in output.
Excessive diuresis
can result in
dehydration and
hypovolemia,
circulatory collapse,
and hypotension.
Weigh patient daily
under standard
conditions.
• Monitor urine and
blood glucose &
HbA1C closely in
diabetics and
patients with
decompensated
hepatic cirrhosis.
Drug may cause
hyperglycemia.
• Note: Excessive
dehydration is most
likely to occur in
older adults, those
with chronic cardiac
disease on prolonged
salt restriction, or
those receiving
sympatholytic
agents.
 Generic Name Brand Classification Action Indication Dose Nursing
Name Responsibilities
DOPAMINE Dopastat, autonomic nervous Naturally To correct Shock Assessment & Drug
HYDROCHLORIDE Intropin, system agent; occurring hemodynamic Adult/Child: Effects
Revimine alpha- and beta- neurotransmitter imbalance in shock IV 2–5
and immediate syndrome due to MI mcg/kg/min • Monitor blood
adrenergic agonist
precursor of (cardiogenic shock), increased pressure, pulse,
(sympathomimetic norepinephrine. trauma, endotoxic gradually up to peripheral pulses,
) Major septicemia (septic 20–50 and urinary output
cardiovascular shock), open heart mcg/kg/min if at intervals
effects produced surgery, and CHF. necessary prescribed by
by direct action on physician. Precise
alpha- and beta- Contraindication: Renal Failure measurements are
adrenergic Adult: IV 2–5 essential for
receptors and on mcg/kg/min accurate titration
specific Pheochromocytoma of dosage.
dopaminergic ; tachyarrhythmias Dopamine • Report the
receptors in or ventricular Calculation: following
mesenteric and fibrillation. Safe use indicators
renal vascular during pregnancy promptly to
beds. (category C), physician for use
lactation, or Drip Rate= in decreasing or
children is not [(orders) x temporarily
established. (kg) x (drip suspending dose:
set)] / Reduced urine
flow rate in
concentration
absence of
in 1 mL hypotension;
 ascending
tachycardia;
Conversion dysrhythmias;
factor: disproportionate
1mg=1000mc rise in diastolic
g pressure (marked
decrease in pulse
1kg=2.2lbs pressure); signs of
peripheral
ischemia (pallor,
cyanosis, mottling,
coldness,
complaints of
tenderness, pain,
numbness, or
burning
sensation).

Monitor
therapeutic
effectiveness. In
addition to
improvement in
vital signs and
urine flow, other
indices of adequate
dosage and
perfusion of vital
organs include loss
of pallor, increase
in toe temperature,
adequacy of nail
bed capillary
 filling, and reversal
of confusion or
comatose state.

Generic Brand Name Classification Action Indication Dose Nursing Responsibilities

Name
Nicardipine Cardene Calcium Inhibits calcium Chronic stable Initially • Patients with
channel ion influx across
blocker cardiac and angina 20 mg hepatic
(dihydropyridi smooth muscle P.O Tid impairment should
ne). cells, thus Contraindication:
receive lower dose
decreasing hypertens
• Monitor blood
myocardial ion
Patient who pressure.
contractility and 20 to 40
oxygen demand are mg P.O • Allow atleast 3
and coronar hypersensitive t.i.d days
arteries and to increase
nicardipine between dosage
arterioles. dosage
depends adjustment to
on the achieve
patients
response steady plasma
levels.

Advise patient to
report
immediately if
experiencing chest
pa
 Generic Brand Classification Action Indication Dose Nursing
Name Name Responsibilities
Mannitol Osmitrol, Diuretic It raises the 1. Acute oliguric renal Adult Assessment – Monitor
Resectisol osmotic failure the following:
pressure of the 2. Toxic overdose Oliguria: 50-100 g as a
plasma 3. Edema 5-25% solution. 1. 1. Vital signs
4. Increased 2. 2. Intake and output
allowing water to intracranial pressure Intracranial/Intraocula 3. 3. Central venous
(ICP) r pressure: 0.25-2 g/kg pressure
be drawn out of
5. Intraocular pressure as 15-25% solution 4. Pulmonary artery
body tissues 6. (IOP) administered for 30-60 pressure
7. Pulmonary minutes. 5. Signs and symptoms
congestion of dehydration (e.g.
Children poor skin turgor, dry
In the oliguric or skin, fever, thirst)
phase of acute oedema; intracranial Oliguria: 0.25-2 g/kg 6. Signs of electrolyte
renal failure, as a 15-20% solution imbalance/deficit
bleeding;
Mannitol for 2-6 hours (e.g. muscular
weakness,
increases CHF; metabolic
Intracranial/Intraocula paresthesia,
osmotic pressure edema with abnormal numbness,
(pressure needed capillary fragility; anuria r pressure: 1-2 g/kg as
a 15-20% solution confusion, tingling
to stop the due to severe renal sensation of
disease; severe administered for 30-60
absorption of minutes. extremity and
dehydration. excessive thirst)
something or
osmosis) of the 7. (for increase ICP)
Neurologic status
glumerular
and intracranial
filtrate, thereby, pressure readings.
promoting 8. (for increase IOP)
diuresis (treating Elevating eye pain
the oliguric phase or decreased visual
of renal failure)
 acuity.
and excretes
toxic materials Laboratory Tests
(management for
toxic overdose). 1. Renal function
(BUN and
Creatinine)
It also elevates 2. Serum Electrolyte
blood plasma (Sodium and
osmolality thus, Potassium)
inhibiting the
reabsorption of
Precaution
water and
electrolytes (for
relief of edema) Pregnancy and lactation
and mobilizing (safe use during these
fluids in the conditions is not
cerebral and established)
ocular spaces
(lowers Interventions
intracranial or
intraocular 1. Observe the IV
pressure). site regularly for
infiltration.
2. Administration
rate for oliguria
should be titrated
to produce a urine
output. (about 30-
50 ml/hr in adult
and 2-6 hours in
children)
 Generic Brand Name Classification Action Indication Nursing Responsibilities
Name /Dose
Ranitidine Zantac GASTROINTESTIN Completely inhibits •Active Duodenal Ulcer •Instruct patient on
HCL AL AGENT; action of histamine Adults: PO 150mg b.i.d. or proper use of OTC
ANTISECRETORY on the H2 at 300 mg at bedtime. preparation as indicated.
(H2-RECEPTOR receptor sites of Maintenance dose is 150 mg
ANTAGONIST) parietal cells, •Instruct patient on
at bedtime.
decreasing gastric proper use of OTC
IM/IV/Intermittent IV 50 mg preparation as indicated.
acid secretions
every 6 to 8 h.
•Assess patient for
Children 1 mon -16 y/o: PO 2 abdominal pain. Note
to 4 mg/kg twice daily (max, presence of blood in
300 mg/day). emesis, stool, or gastric
aspirate
•Maintenance therapy for
Duodenal and Gastric Ulcers •Ranitidine may be
Adults: 150mg P.O at bedtime added to total parenteral
nutrition solution
Children 1 mon -16 y/o: PO 2
to 4 mg/kg daily up to 150mg •Remind patient to take
once daily prescription
daily
drug at bedtime for best
•Pathologic Hypersecretory results
Conditions •Instruct patient to take
Adults: PO 150 mg twice without regard to meals
daily. Individualize. because absorption isn’t
affected by food
•GERD and Erosive
Esophagitis • Remind patient not to
Adults: PO 150mg b.i.d. confuse ranitidine with
rimantadine: don’t
Children 1 mon -16 y/o: PO 5 confuse Zantac with
to 10 mg/kg daily usually Xanax or Zyrtec
given in 2 divided doses.

•Erosive Esophagitis:
Maintenance dosage is 150mg
P.O. q.i.d.

•Heartburn
Adults and Children 1 mon
-12 y/o and older: 75mg of
Zantac 75 P.O. as symptoms
occur, up to 150mg daily, not
to exceed 2 weeks of
continuous treatment.

CONTRAINDICATION

•Contraindicated in patients
hypersensitive to drug and
those with porphyria

•Use cautiously in patients

with hepatic dysfunction.
Adjust dose in patients with
impaired renal function
 Generic Brand Name Classification Action Indication Dose Nursing Responsibilities
Name
Calcium Calcium Calcium is essential Parenteral
Gluconate supplements for the functional administration of
integrity of the calcium is indicated
nervous, muscular, where the
and skeletal systems. pharmacological
It plays a role in action of a high
normal cardiac calcium ion
function, renal concentration is
function, respiration, required, as for
blood coagulation, example, in acute
and cell membrane hypocalcaemia,
and capillary cardiac resuscitation
permeability. Also, and some cases of
calcium helps to neonatal tetany.
regulate the release Intravenous
and storage of injections of calcium
neurotransmitters have been used in
and hormones, the the treatment of the
uptake and binding of acute colic of lead
amino acids, poisoning, and as an
absorption of vitamin adjunct in the
B 12, and gastrin treatment of acute
secretion. The major fluoride poisoning.
fraction (99%) of Also, for the
calcium is in the prevention of
skeletal structure hypocalcaemia in
primarily as exchange
hydroxyapatite, Ca transfusions
10(PO 4) 6(OH) 2;
small amounts of Contraindication:
calcium carbonate Hypercalcaemia
and amorphous
calcium phosphates (e.g. in
are also present. hyperparathyroidism,
hypervitaminosis D,
neoplastic disease
with decalcification
of bone), severe
hypercalciuria,
severe renal failure,
patients receiving
cardiac glycosides.

Adverse Reactions:
If Calcium Gluconate
Injections is
administered too
rapidly, nausea,
vomiting, hot
flushes, sweating,
hypotension and
vasomotor collapse,
possibly fatal, may
occur. Soft tissue
calcification due to
extravasation of
calcium solutions
has been reported
 Generic Brand Name Classification Action Indication Dose Nursing Responsibilities
Name
Potassium Electrolyte Potassium chloride is Potassium
Chloride used to prevent or to deficiency.
treat low blood levels
of potassium
(hypokalemia). Contraindication:
Potassium levels can Excess of
be low as a result of a potassium ions
disease or from taking produces
certain medicines, or depression of
after a prolonged the heart and
illness with diarrhea may cause
or vomiting. cardiac arrest.
Poisoning may
occur from the
intravenous
injection of even
small doses of
potassium ions
when excretion
is delayed, as in
the presence of
renal
insufficiency.
 Adverse
Reactions:
nausea,
vomiting,
diarrhea,
stomach ache,
and flatulence.

Generic Brand Name Classification Action Indication Dose Nursing Responsibilities

Name
Salbutamol Beta-2 agonist Salbutamol is Indications: It is
chemically related to used for relief of
isoprenaline. It is not bronchospasm in
metabolised by
patients with
COMT and MAO,
therefore the action of reversible
the drug lasts longer obstructive airway
than isoprenaline. It disease and
acts by stimulating relaxation of
the Beta-2 receptor uterine smooth
cells of the smooth muscle to delay
muscles in the
threatened
bronchioles and
uterus. It has minimal abortion.
cardiac stimulant
effect and does not
cause hypertension.
Contraindication
: It is
contraindicated in
 patients with
hypersensitivity to
the drug and
thyrotoxicosis.

Generic Brand Name Classification Action Indication Dose Nursing

Name Responsibilities
Aluminum Maalox peptic, gastric, ADULT-
magnesium duodenal ulcers, suspension 5-10 ml
hydroxide hyperphosphatemia 1 hr after meal at
in chronic failure, bedtime
reflux esophagitis, ORAL
hyperacidity, heart Administration: 600
burn, GERD mg 1 hr after meal
at bedtime, chewed
with milk or water.
GI bleeding:
Infant: Oral
administration 2-5
ml/ dose every 1-2
hrs.
Children Oral
Administration: 5-
15 ml/dose every 1-
2 hours.

hyperphosphatemia
in renal failure:
 Adult: suspension
500 mg- 2 2x- 4x a
day
Pharmacodynamics:
Onset: Varies

Peak: Unknown

Duration: 20- 60
minutes (Fasting)

3 hours
( taken 1 hour after
meal)

Generic Brand Name Classification Action Indication Dose Nursing

Name Responsibilities
Atropine atropine administration For IV administration
sulfate sulfate prior to ADULT 0.4-0.6 mg
anesthesia to every 4-6 hrs.
reduce or PEDIA 0.1-0.6 mg
prevent depending on weight
secretions of As Antidote 1-2 mg
respiratory every 20-30 mins until
tract; teratment the skin is flushed
of and dry, the pupils are
parkinsonism; dilated and tachycardia
irritation or has developed
inflammation of ADULT by subQ
 stomach; injection 0.5 mg 4-6
treatment of hrly.
alcohol PEDIA < 12 yrs, subQ
withdrawal 0.01 mg/kg body-
symptoms; weight
relief of motion REFRACTION; adult
sickness;short 1-2 drpos 1 hr before
treatment refracting
has and
prevention of
bronchospasm
associated with
chronic
bronchial
asthma,
bronchitis and
COPD. therapy
for certain
bradycardias
and heart
blocks.

Generic Brand Name Classification Action Indication Dose Nursing Responsibilities

Name
Magnesium Elin used as anti- Magnesium
Sulfate magnesium convulsan, lowers deficiency
sulfate intracranial 2 ml
pressure, injection
prevention and IM.
control of seizures Pre-
 in toxemia, acute eclampsia
nephritis in 8-10 ml
children and other added into
conditions like 250 ml of 5
epilepsy, % dextrose
glomerulonephritis or 0.9%
or sodium
hypothyroidism, chloride
also use for
arrythmias such as injection
atypical Pedia
ventricular Depression
tachycardia. of Seizures
0.08-
0.16ml/kg
BW of
25%
solution IM

Generic Name Brand Name Classification Action Indication Dose Nursing Responsibilities
PHENOBARBIT Luminal Sodium central nervous Long-acting barbiturate. Long-term Anticonvulsa Assessment & Drug Effects
AL SODIUM system agent; Sedative and hypnotic management of nt
anticonvulsant; effects of barbiturates tonic-clonic (grand Adult: PO 100–
sedative- appear to be due mal) seizures and 300 mg/d IV/IM • Observe patients
hypnotic; partial seizures; 200–600 mg receiving large doses
barbiturate primarily to interference status epilepticus, closely for at least 30 min to
up to 20
with impulse eclampsia, febrile mg/kg ensure that sedation is not
transmission of cerebral convulsions in Child: PO/IV 3– excessive.
cortex by inhibition of young children. Also 8 mg/kg or • Keep patient under
reticular activating used as a sedative 125 mg/m2/d constant observation when
system. CNS depression in anxiety or tension Neonate: drug is administered IV, and
states; in pediatrics PO/IV 3–4 record vital signs at least
may range from mild
as preoperative and mg/kg/d (max: every hour or more often if
sedation to coma, postoperative 5 mg/kg/d)
 depending on dosage, sedation and to indicated.
route of administration, treat pylorospasm Status • Lab tests: Obtain liver
degree of nervous in infants Epilepticus function and hematology
Adult/Child: IV tests and determinations of
system excitability, and
CONTRAINDICATION 15–18 mg/kg serum folate and vitamin D
drug tolerance. Initially, : in single or
barbiturates suppress levels during prolonged
divided doses therapy.
REM sleep, but with Sensitivity to (max: 20
chronic therapy REM barbiturates; mg/kg) • Monitor serum drug
Neonate: IV levels. Serum
sleep returns to normal. manifest hepatic or
15–20 mg/kg concentrations >50 mcg/mL
familial history of may cause coma.
in single or
porphyria; severe Therapeutic serum
divided doses
respiratory or concentrations of 15–40
kidney disease; Sedative mcg/mL produce
history of previous Adult: PO 30– anticonvulsant activity in
120 mg/d IV/IM most patients. These values
addiction to
100–200 mg/d are usually attained after 2
sedative hypnotics; or 3 wk of therapy with a
Child: PO 6
uncontrolled pain; dose of 100–200 mg/d.
mg/kg/d or
pregnancy • Expect barbiturates to
180 mg/m2 in
(particularly early 3 divided produce restlessness when
pregnancy) doses IV/IM given to patients in pain
(category D), 16–100 mg/d because these drugs do not
lactation; sustained (1–3 mg/kg) have analgesic action.
release formulation • Be prepared for
for children <12 y paradoxical responses and
of age. report promptly in older
adult or debilitated patient
and children (i.e., irritability,
marked excitement
[inappropriate tearfulness
and aggression in children],
depression, and confusion).

Name of the Dosage/Route Action/Classificatio Indication/ Adverse Nursing

Drug n Contraindications Effects/ Side Responsibilities
Effects
Generic Name: Cardiac arrest: Action: Indications: Adverse Monitor V/S. and
Effects: check for cardiac
epinephrine 1 mg IV of Stimulates beta o Asthma
o Bronchitis dysrhythmias
1:10,000 solution receptors in lung.
q 3-5 min; double o Emphysema
dose if o All cardiac
Brand Name: nervousness,
administering arrest,
Relaxes bronchial anaphylaxis tremor, vertigo, Drug increases
Injection, OTC nasal smooth muscle. o Used for pain, widened rigidity and tremor
solution: via ET tube
symptomatic pulse pressure, in patients with
Adrenalin Chloride bradycardia. hypertension Parkinson’s disease
o Relief of
Ophthalmic solution: nausea
Anaphylaxis: Increases vital bronchospas  Epinephrine
Epifrin, Glaucon m occurring
0.1- 1 mg SQ or IM capacity
during therapy interferes
Insect sting of 1:1000 solution. with tests for
 BP,  HR,  PR anesthesia
emergencies: Exercised- Side Effects:
o urinary
EpiPen Auto-Injector
induced catecholamine
(delivers 0.3 mg IM headache
bronchospas
adult dose), EpiPen Jr. Asthma: 0.1-0.3
Decreases airway m  Avoid IM use of
Auto-Injector (delivers mg SQ or IM of
0.15 mg IM for resistance. parenteral
1:10,000 solution
children) suspension into
Contraindications:
OTC solutions for
buttocks. Gas
Contraindicate in gangrene may
nebulization: Refractory Classification:
AsthmaNefrin, patients with angle- occur
bradycardia and closure glaucoma,
microNefrin, Nephron, Beta2 Adrenergic
S2 hypotension: 2- shock (other than
Agonists Massage site
10ug/min anaphylactic shock), after IM injection to
organic brain counteract possible
damage, cardiac
vasoconstriction.
dilation,
arrhythmias,  Observe
coronary patient closely for
insufficiency, or
cerebral adverse reactions.
arteriosclerosis. Also Notify doctor if
contraindicated in adverse reaction
patient receiving
develop
general anesthesia
with halogenated  If blood
hydrocarbons or pressure increases
cyclopropane and in
sharply, rapid-
patients in labor
acting vasodilators
(may delay second
such as nitrates or
stage)
alpha blockers can
be given to
counteract
Some products
containing sulfites
and are
contraindicated in
patients with sulfite
allergies except
when drug is used
for serious allergic
reactions or in other
emergency
situations.

In conjunction with
local anesthesia,
epinephrine is
contraindicated for
use in finger, toes,
ears, nose, and
genitalia.

Use cautiously with

long-standing
bronchial asthma
and emphysema,
who have developed
degenerative heart
disease and in those
with
hyperthyroidism, CV
disease,
hypertension,
psychoneurosis, or
diabetes.

In pregnant woman,
drug is
contraindicated.

In breast feeding do
not use the drug or
stop breast feeding.
Name of the Dosage/Route Action/Classificati Indication/ Adverse Effects/ Nursing
Drug on Contraindications Side Effects Responsibilities

Generic Name: 1 mEq/kg IVP, Action: Indications: Adverse Effects: Monitor urinary
may repeat 0.5 pH, calcium,
Sodium mEq/kg 10 min. Neutralizes gastric o Hyperacidity GI: Gastric electrolytes and
Bicarbonate acid o Peptic ulcer distention, phosphate levels.
o Hyperkalemia belching,
o Tricyclic flatulence.
antidepressan
Brand Name: Decrease pepsin t OD Metabolic: Record amount
Arm and Hammer activity o Shock metabolic and consistency of
Pure Baking Soda, associated
alkalosis, stools.
Citrocarbonate, with severe
diarrhea, hypernatremia,
Soda Mint hypokalemia,
Classification: dehydration,
Alkalizing Agent, uncontrolled hyperosmolarity
Clients on low-
Buffer, Antacid, DM (with overdose).
o Reflux sodium diets
electrolyte should evaluate
esophagitis Other: Pain and
irritation at sodium contents of
injection site. antacids.
Contraindications:

Contraindicated in
patients with
metabolic or
respiratory alkalosis;
patients who are
losing chlorides from
vomiting or
continuous GI
suction; patients
taking diuretics
known to produce
 hypochloremia
alkalosis; and
patients with
hypocalcemia in
which alkalosis may
produce tetany,
hypertension,
seizures, or heart
failure. Oral sodium
bicarbonate is
contraindicated in
patients with acute
ingestion of strong
mineral acids.

Name of the Dosage/Route/Timi Action/Classificati Indication/ Adverse Nursing

Drug ng on Contraindications Effects/ Side Responsibilities
Effects

Generic 0.3-0.4 mg SL q 5 Action: Indication: Adverse Effects Record

min, max 3 doses. characteristics and
Nitroglycerin Relaxes the vascular Angina pectoris CV: orthostatic precipitating
smooth system hypotension, factors of anginal
Brand CHF associated with flushing, fainting. pain.
AMI
Nitrostat EENT: sublingual
 Myocardial burning.
oxygen consumption Monitor BP and
Cardiac load Skin: Cutaneous apical pulse before
reducing agent vasodilation,
 contact administration and
dermatitis periodically after
 left ventricular Hypertensive Crisis (patch) dose.
workload
Side Effects
 arterial BP
Contraindication: CNS: headache, Have client sit or
throbbing, lie down if taking
Contraindicated in
dizziness, drug for the first
 venous return patients
weakness. time.
hypersensitive to
nitrates and in GI: nausea,
those with early MI. vomiting.
Classification (S.L. form), severe Client must have
anemia, increase Skin: Rash continuing EKG
Antianginal, Nitrate,
ICP angle-closure monitoring for IV
Vasodilator,
glaucoma, IV administration
Coronary
nitroglycerine is
contraindicated in
patients with
Cardioverter/
hypovolemia,
defibrillator must
hypotension,
not be discharged
orthostatic
through paddle
hypotension,
electrode overlying
cardiac tamponade
restrictive Nitro-Bid ointment
cardiomyopathy, or the Transderm-
constrictive Nitro Patch. Assist
pericarditis. 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
doesn’t experience
relief, advise to
seek medical
assistance
immediately.

Name of the Dosage/Route Action/Classificatio Indication/ Adverse Effects/ Nursing

Drug n Contraindications Side Effects Responsibilities

Generic Bradycardia: 0.5 Action Indication Adverse Effects Monitor VS.

-1 mg IV (may give
Atrophine via ETT at double cholinergic receptor As an anti- CNS: restlessness,
Sulfate dose) q 3-5 min, sites so response to sialagogue for ataxia, Report  HR
max 0.04 mg/kg acetylcholine is preanesthetic disorientation,
decreased medication to hallucinations,
Cardiac arrest: 1 prevent or reduce delirium, coma, Monitor for
Brand
mg q 3-5 min, max secretions of the insomnia, constipation,
Isopto Atropine 0.04 mg/kg respiratory tract agitation, oliguria.
Classification
 Anticholinergics confusion.
Atrophine could
Nerve gas and To restore cardiac CV: tachycardia, result in CNS
organophosphate rate and arterial angina, stimulation
symptoms, may pressure during arrhythmias, (confusion,
repeat in 2 mg anesthesia, when flushing. excitement) or
increments q 3 min vagal drowsiness
tiltrated to relief EENT:
symptoms. photophobia,
blurred vision,
stimulation mydriasis. Instruct to take 30
produced by intra- mins before meals
abdominal surgical GI: dry moth,
traction causes a constipation,
sudden decrease in vomiting.
pulse rate and Eat foods high in
cardiac action GU: urine fiber and drink
retention. plenty fluids.

Hematologic:
To lessen the leukocytosis Avoid OTC
degree of antihistamines.
atrioventricular (A- Other: anaphylaxis
V) heart block when
increased vagal Instruct client not
tone is a major to drive a motor
Side Effects
factor in the vehicle or
conduction defect, CNS: headache, participate in
as in some cases excitement. activities requiring
due to digitalis alertness.
CV: palpitations

GI: thirst, nausea. Advise to use hard

To overcome severe candy, ice chips,
carotid sinus reflex etc. for dry mouth.

Antidote for
cardiovascular
collapse from the
injudicious use of a
cholinergic drug.

Contraindication

Contraindicated in
patients
hypersensitive to
drug and those with
acute angle closure
glaucoma,
obstructive
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.
Name of the Dosage/Route Action/Classificati Indication/ Adverse Effects/ Nursing
Drug on Contraindications Side Effects Responsibilities

Generic ADULTS Action Indication Adverse Effect Assessment

Oral History:
Morphine Sulfate One-third to one-sixth Principal opium alkaloid; Relief of moderate to CNS: Light- Hypersensitivity to
as effective as acts as agonist at specific severe acute and chronic headedness, dizziness, opioids; diarrhea caused
parenteral opioid receptors in the pain sedation, euphoria, by poisoning; labor or
administration because CNS to produce analgesia, dysphoria, delirium, delivery of a premature
Brand of first-pass euphoria, sedation; the Preoperative medication insomnia, agitation, infant; biliary tract
metabolism; 10–30 mg receptors mediating these to sedate and allay anxiety, fear, surgery or surgical
Immediate-release q 4 hr PO. Controlled- effects are thought to be apprehension, facilitate hallucinations, anastomosis; head
tablets: release: 30 mg q 8–12 the same as those induction of anesthesia, disorientation, injury and increased
MSIR hr PO or as directed by mediating the effects of and reduce anesthetic drowsiness, lethargy, intracranial pressure;
Timed-release: physician; Kadian: 20– endogenous opioids dosage impaired mental and acute asthma, COPD,
Kadian, M-Eslon 100 mg PO daily–24- (enkephalins, endorphins). physical performance, cor pulmonale,
(CAN), MS Contin, hr release system; MS Analgesic adjunct during coma, mood changes, preexisting respiratory
Oramorph SR Contin: 200 mg PO q anesthesia weakness, headache, depression; acute
Oral solution: 12 hr. tremor, seizures, miosis, abdominal conditions,
MSIR, Rescudose, SC and IM Component of most visual disturbances, CV disease,
Roxanol, Roxanol T 10 mg (5–20 mg)/70 Classification preparations that are suppression of cough supraventricular
Rectal suppositories: kg q 4 hr or as directed referred to as Brompton's reflex tachycardias,
RMS by physician. Opioid agonist analgesic cocktail or mixture, an myxedema, seizure
Injection: IV oral alcoholic solution CV: Facial flushing, disorders, acute
Astramorph PF, 2.5–15 mg/70 kg of that is used for chronic peripheral circulatory alcoholism, delirium
Duramorph, Epimorph body weight in 4–5 mL severe pain, especially in collapse, tachycardia, tremens, cerebral
(CAN) water for injection terminal cancer patients bradycardia, arrhythmia, arteriosclerosis,
Preservative-free administered over 4–5 palpitations, chest wall ulcerative colitis, fever,
concentrate for min, or as directed by Intraspinal use with rigidity, hypertension, kyphoscoliosis,
microinfusion devices physician. Continuous microinfusion devices hypotension, orthostatic Addison's disease,
for intraspinal use: IV infusion: 0.1– for the relief of hypotension, syncope prostatic hypertrophy,
Infumorph 1 mg/mL in 5% intractable pain urethral stricture, recent
dextrose in water by Dermatologic: Pruritus, GI or GU surgery, toxic
controlled infusion Unlabeled use: Dyspnea urticaria, Respiratory: psychosis, renal or
device. associated with acute left laryngospasm, hepatic dysfunction;
Rectal ventricular failure and bronchospasm, edema pregnancy; lactation
10–30 mg q 4 hr or as pulmonary edema
directed by physician. Contraindication GI: Nausea, vomiting, Physical: T; skin color,
Epidural anorexia, biliary tract texture, lesions;
Initial injection of spasm; increased orientation, reflexes,
5 mg in the lumbar colonic motility in bilateral grip strength,
region may provide patients with chronic affect; P, auscultation,
pain relief for up to 24 Contraindicated with ulcerative colitis BP, orthostatic BP,
hr. If adequate pain hypersensitivity to perfusion; R,
relief is not achieved opioids; diarrhea caused GU: Ureteral spasm, adventitious sounds;
within 1 hr, by poisoning until toxins spasm of vesical bowel sounds, normal
incremental doses of are eliminated; during sphincters, urinary output; urinary
1–2 mg may be given labor or delivery of a retention or hesitancy, frequency, voiding
at intervals sufficient premature infant (may oliguria, antidiuretic pattern, normal output;
to assess effectiveness, cross immature blood– effect, reduced libido or ECG; EEG; thyroid,
up to 10 mg/24 hr. For brain barrier more potency liver, kidney function
continuous infusion, readily); after biliary tests
initial dose of 2–4 tract surgery or Respiratory:
mg/24 hr is following surgical Respiratory Interventions
recommended. Further anastomosis; pregnancy; depression, apnea, Caution patient not to
doses of 1–2 mg may labor (respiratory circulatory chew or crush
be given if pain relief depression in neonate; depression, controlled-release
is not achieved may prolong labor). respiratory arrest, preparations.
initially. shock, cardiac
Intrathecal Use cautiously with head arrest Dilute and administer
Dosage is usually one- injury and increased slowly IV to minimize
tenth that of epidural intracranial pressure; likelihood of adverse
dosage; a single acute asthma, COPD, cor Side Effects effects.
injection of 0.2–1 mg pulmonale, preexisting
may provide respiratory depression, GI: dry mouth, Tell patient to lie down
satisfactory pain relief hypoxia, hypercapnia constipation. during IV
for up to 24 hr. Do not (may decrease administration.
inject > 2 mL of the respiratory drive and Skin: Tissue
5 mg/10 mL ampule or increase airway irritation and Keep opioid antagonist
> 1 mL of the resistance); lactation and facilities for
10 mg/10 mL ampule. (wait 4–6 hr after induration (SC assisted or controlled
Use only in the lumbar administration to nurse injection). respiration readily
area. Repeated the baby); acute available during IV
intrathecal injections abdominal conditions, Other: sweating,physical administration.
are not recommended; CV disease, tolerance and
use other routes if pain supraventricular dependence, Use caution when
recurs. For epidural or tachycardias, myxedema, psychological injecting SC or IM into
intrathecal dosing, use seizure disorders, acute dependence chilled areas or in
preservative-free alcoholism, delirium patients with
morphine preparations tremens, cerebral hypotension or in
only. arteriosclerosis, shock; impaired
ulcerative colitis, fever, perfusion may delay
PEDIATRIC kyphoscoliosis, absorption; with
PATIENTS Addison's disease, repeated doses, an
Do not use in prostatic hypertrophy, excessive amount may
premature infants. urethral stricture, recent be absorbed when
SC or IM GI or GU surgery, toxic circulation is restored.
0.05–0.2 mg/kg (up to psychosis, renal or Reassure patients
15 mg per dose) q 4 hr hepatic dysfunction. that they are
or as directed by unlikely to become
physician.
addicted; most
GERIATRIC patients who
PATIENTS OR receive opioids for
IMPAIRED medical reasons do
ADULTS not develop
Use caution. dependence
Respiratory depression syndromes
may occur in the
elderly, the very ill,
those with respiratory
problems. Reduced
Teaching points
dosage may be
necessary.
Take this drug exactly
Epidural
as prescribed. Avoid
Use extreme caution;
alcohol, antihistamines,
injection of < 5 mg in
 the lumbar region may sedatives, tranquilizers,
provide adequate pain over-the-counter drugs.
relief for up to 24 hr.
Intrathecal Swallow controlled-
Use lower dosages release preparation (MS
than recommended for Contin, Oramorph SR)
adults above. whole; do not cut,
crush, 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, constipation,
shortness of breath or
difficulty breathing,
rash.

Generic Brand Name Classification Action Indication Dose Nursing Responsibilities

 Name
Omeprazol Tansinel Antisecretor Gastric-acid Short-term 20 mg Assessment:
e y pump treatment of 1 cap 1. History
drug inhibitor: active for :hypersensitivity to
suppresses duodenal two omeprazole or any of
gastric acid cancer weeks its components;
secretion by Short-term pregnancy, lactation
specific treatment of 2. Physical: skin
inhibition of active benign lesions; reflexes;
the gastric ulcer urinary output;
hydrogenpotassiu Eradication abdominal
m of examination;
ATPase Helicobacter respiratory
enzyme Pylori auscultation
system at First-line Interventions:
the therapy for 1. Administer before
secretory treatment of meals.
surface of heartburn or 2. Administer
the gastric symptoms of antacids with, if
parietal cells; GERD. needed.
blocks 3. Have regular
the final medical follow-up
step of acid visits.
production. 4. Report severe
headache, worsening
of symptoms, fever,
chills.
Generic Brand Name Classification Action Indication Dose Nursing Responsibilities
Name

Generic Brand Name Classification Action Indication Dose Nursing Responsibilities

Name

Generic Brand Name Classification Action Indication Dose Nursing Responsibilities

Name

Generic Brand Name Classification Action Indication Dose Nursing Responsibilities

Name

Generic Brand Name Classification Action Indication Dose Nursing Responsibilities

Name
 Generic Brand Name Classification Action Indication Dose Nursing Responsibilities
Name

LACAMPUINGAN, JOEMAR M.
ADAMSON UNIVERSITY
College of Nursing
BLOCK 403