Drug Data Classification Mechanism of action Indications Contraindica Adverse Reactions Nursing

tion Responsibilities

Generic Name: Droperidol The exact mechanism of Droperidol is Innovar is -Postoperative Be alert for new
Droperidol/ (Inapsine, action is unknown, used to produce contraindicate hallucinatory seizures or increased
Fentanyl Droleptan, Dridol, however, droperidol causes tranquilization d in patients episodes seizure activity.
Xomolix, Innovar a CNS depression at and to reduce with known -Anaphylaxis Document the number,
Brand Name: [combination with subcortical levels of the the incidence of hypersensitivi -Dizziness duration, and severity
Innovar fentanyl]) is an brain, midbrain, and nausea and ty to the drug. -Chills of seizures, and report
antidopaminergic brainstem reticular vomiting in -Laryngospasm these findings
drug used as an formation. It may surgical and -Bronchospasm immediately to the
antiemetic (that is, antagonize the actions of diagnostic physician.
to prevent or treat glutamic acid within the procedures.
nausea) and as an extrapyramidal system. It Assess heart rate,
antipsychotic. may also inhibit ECG, and heart
cathecolamine receptors sounds, especially
and the reuptake of during exercise (See
neurotransmiters and has Appendices G, H).
strong central Report any rhythm
antidopaminergic action disturbances or
and weak central symptoms of increased
anticholinergic action. It arrhythmias, including
can also produce palpitations, chest
ganglionic blockade and discomfort, shortness
reduced affective response. of breath, fainting, and
The main actions seem to fatigue/weakness.
stem from its potent
Dopamine(2) receptor
antagonism with minor Assess motor function,
antagonistic effects on and be alert for
alpha-1 adrenergic extrapyramidal
receptors as well. symptoms. Report
these symptoms
immediately,
especially tardive
dyskinesia, because
this problem may be
irreversible.

Assess blood pressure

(BP) and report a
symptomatic decrease
in BP; that is,
hypotension that
results in dizziness and
syncope.

Assess symptoms of
bronchospasm and
laryngeal spasm,
including wheezing,
coughing, and
tightness in the throat
and chest. Perform
pulmonary function
tests as needed to
quantify suspected
changes in ventilation
and respiration.

Monitor excessive
sedation or changes in
mood and behavior
such as anxiety,
confusion,
restlessness, mental
depression,
nightmares, and
hallucinations. Notify
physician or nurse
immediately if these
changes become
problematic.
 If used to control
postoperative nausea
and vomiting, monitor
the frequency,
severity, and duration
of GI problems to help
document drug
effectiveness.

Drug Data Classification Mechanism of action Indications Contraindication Adverse Nursing

Reactions Responsibilities

Generic Midazolam is a The actions of Intravenous Contraindications for -headach. Before

name: short-acting benzodiazepines such as the use of midazolam -drowsiness administering, have
Midazolam hypnotic-sedative midazolam are mediated Indicated for include acute angle- -nausea oxygen and
drug with anxiolytic, through the inhibitory promoting closure glaucoma, -vomiting resuscitation
Brand muscle relaxant, neurotransmitter preoperative hypotension, and -hiccups equipment available
Name: anticonvulsant, gamma-aminobutyric sedation, shock. Careful dose -coughing in case of severe
Versed sedative, hypnotic, acid (GABA), which is anxiolysis, adjustment is -pain, redness, or respiratory
and amnesic one of the major anesthesia necessary in cases of hardening of the depression.
properties. It belongs inhibitory induction, or kidney and liver skin at the
to a class of drugs neurotransmitters in the amnesia. diseases, alcohol, injection site. Monitor and record
called central nervous system. and drug-dependent patient response to
benzodiazepines. Benzodiazepines individuals. Caution medication and level
This drug is unique increase the activity of is necessary for of sedation.
from others in this GABA, thereby pregnant individuals,
class due to its rapid producing a sedating children, and
onset of effects and effect, relaxing skeletal individuals with Observe site closely
short duration of muscles, and inducing comorbid psychiatric for extravasation.
action. sleep, anesthesia, and conditions.
amnesia. Administration in Monitor for adverse
Benzodiazepines bind to elderly individuals reactions.
the benzodiazepine site and acutely ill
on GABA-A receptors, patients requires
Continuous
which potentiates the caution to prevent
cardiorespiratory
effects of GABA by the accumulation of
monitoring.
increasing the frequency active metabolites.
of chloride channel Extra precautions
opening. These receptors should be taken in Monitor BP and
have been identified in critically ill oxygen saturation.
different body tissues individuals as dose
including the heart and accumulation can Assess sedated
skeletal muscle, occur. infant for signs of
although mainly appear pain (midazolam
to be present in the does not possess
central nervous system. analgesic
properties).

Drug Data Classification Mechanism of action Indications Contraindication Adverse Nursing

Reactions Responsibilities

GENERIC Lorazepam is a Lorazepam Lorazepam is FDA- Ativan (lorazepam) -drowsiness. ssess respiration after
NAME: short-acting and allosterically binds on approved for the is contraindicated in -dizziness. rapid IV
LORAZEPA rapidly cleared the benzodiazepine short-term relief of patients with: -tiredness. administration. Notify
M benzodiazepine receptors in the post- anxiety symptoms -weakness. physician
used commonly as synaptic GABA-A related to anxiety -hypersensitivity to -dry mouth. immediately if patient
BRAND a sedative and ligand-gated chloride disorders and anxiety benzodiazepines or -diarrhea. exhibits any
NAME: anxiolytic. channel in different associated with to any components -nausea. interruption in
ATIVAN sites of the central depressive symptoms of the formulation -changes in respiratory rate
nervous system such as anxiety- appetite. (apnea) or signs of
(CNS). This binding associated insomnia. respiratory depression
will result in an It is as well used as -acute narrow-angle such as rapid labored
increase on the an anesthesia glaucoma. breathing, cyanosis,
GABA inhibitory premedication in confusion, irritability,
effects which is adults to relieve sleepiness, headache,
translated as an anxiety or to produce and oxygen
increase in the flow of sedation/amnesia and desaturation.
chloride ions into the for the treatment of
cell causing status epilepticus. Monitor pulse
hyperpolarization and oximetry and perform
stabilization of the pulmonary function
cellular plasma tests to quantify
membrane. suspected changes in
ventilation and
respiratory function.

Continually monitor
for signs of cardiac
arrest, especially after
rapid IV
administration. Signs
include sudden chest
pain, pain radiating
into the arm or jaw,
shortness of breath,
dizziness, sweating,
anxiety, nausea, and
loss of consciousness.
Seek immediate
medical assistance if
patient develops these
signs.

Assess blood pressure

periodically and
compare to normal
values.. Report low
blood pressure
(hypotension),
especially if patient
experiences dizziness
or syncope.

Assess heart rate,

ECG, and heart
sounds, especially
during exercise.
Report an unusually
slow heart rate
(bradycardia) or signs
of other arrhythmias,
including
palpitations, chest
discomfort, shortness
of breath, fainting,
and fatigue/weakness.

Monitor daytime
drowsiness and
“hangover”
symptoms (headache,
nausea, irritability,
lethargy, dysphoria).
Repeated or excessive
symptoms may
require change in
dose or medication.

Report any behavioral

or personality
changes such as
confusion,
forgetfulness, slurred
speech, decreased
mental acuity, or
excessive excitation.

Assess dizziness,
drowsiness, and
ataxia that might
affect gait, balance,
and other functional
activities.. Report
 balance problems and
functional limitations
to the physician, and
caution the patient
and family/caregivers
to guard against falls
and trauma.

Drug Data Classification Mechanism of Indications Contraindication Adverse Nursing

action Reactions Responsibilities

Generic enzodiazepines, In general, Contraindications to Serious adverse - Assess baseline vital

Name: A benzodiazepine such as diazepam, diazepam is useful diazepam include effects of signs.
Diazepam with anticonvulsant, bind to receptors in in the symptomatic patients with a diazepam include:
anxiolytic, sedative, various regions of management of known - Assess blood
Brand muscle relaxant, and the brain and mild to moderate hypersensitivity to -Respiratory pressure, pulse and
Name: amnesic properties spinal cord. This degrees of anxiety diazepam. Diazepam depression respiration if IV
Valium and a long duration of binding increases in conditions is also -Suicidality administration.
action. Its actions are the inhibitory dominated by contraindicated in -Dependency and
mediated by effects of gamma- tension, excitation, patients under 6 abuse
aminobutyric acid agitation, fear, or months of age. Other - Provide frequent
enhancement of -Withdrawal sips of water for dry
gamma-aminobutyric (GABA). GABAs aggressiveness contraindications to symptoms
functions include such as may occur diazepam include mouth.
acid activity. It is used -Cardiovascular
in the treatment of CNS involvement in psychoneurosis, patients with severe collapse
severe anxiety in sleep induction. anxiety reactions respiratory -Bradycardia - Provide fluids and
disorders, as a Also involved in due to stress insufficiency, -Hypotension fibre for constipation.
hypnotic in the short- the control of conditions, and myasthenia gravis, -Syncope
term management of hypnosis, memory, anxiety states with sleep apnea -Paradoxical CNS - Evaluate therapeutic
insomnia, as a anxiety, epilepsy somatic expression. syndrome, and stimulation response, mental state
sedative and and neuronal severe hepatic
and physical
premedicant, as an excitability. insufficiency. It is
Common adverse dependency after
anticonvulsant, and in permissible in
effects of long-term use.
the management of patients with open-
angle glaucoma diazepam include:
alcohol withdrawal
syndrome. receiving appropriate
therapy but is -Sedation
contraindicated in -Fatigue
Martindale, The Extra acute narrow-angle -Confusion
Pharmacopoeia, 30th glaucoma -Anterograde
ed, p589) amnesia
-Depression
-Ataxia
-Irritability
-Disinhibition
-Local injection
site reaction
-Headache
-Tremor
-Dystonia
-Urinary retention
-Incontinence
-Nausea
-Constipation
-Diplopia
-Libido changes
-Rash
-Menstrual
irregularities
-ALT and/or AST
elevation