DRUGS ACTION INDICATION CONTRAINDICATION ADVERSE EFFECTS NURSING RESPONSIBILITY Generic Name Norepineph rine Brand Name LEVOPHED Classifica tion CV Drugs (Cardiac Glycosides ) Dosage amp - 1mg/4ml Powerful peripheral vasoconstri ctor (alpha- adrenergic action) & as potent inotropic stimulator of the heart & dilator of coronary arteries (beta- adrenergic action). Blood pressure control in certain acute hypotensive states. As an adjunct in the treatment of cardiac arrest and profound hypotension . Pregnancy (Category D) Ischemic injury Bradycardi a Arrythmias Anxiety Transient- headache Respirator y difficulty Extravasat ion necrosis at injection site Plasma volume depletion on prolonged administra tion Monitor VS, ECG, I&O ratio, cyanosis, neurological status & adverse effects during therapy. Assess for signs of extravasation (eg. Blanching & Coolness of skin over vein) at infusion site. Inform pt. to inform physician if using drugs such as Sodium Bicarbonate, MAOI’s, Trycyclics, Oxytocics, Anti- histamine. Advise pt. to notify nurse if IV site feels cool or painful. Caution pt. to avoid sudden position changes to prevent Orthostatic
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Powerful peripheral vasoconstrictor (alpha-adrenergic action) & as potent inotropic stimulator of the heart & dilator of coronary arteries (beta-adrenergic action).
Blood pressure control in certain acute hypotensive states. As an adjunct in the treatment of cardiac arrest and profound hypotension.
Depress the CNS, probably by potentiating GABA, an inhibitory neurotransmitter. Produces skeletal muscle relaxation by inhibiting spinal poly-synaptic afferent pathways.
Anxiety & tension states; Depressive mood; Nervous tension; Agitation & Insomnia.Functional disturbances of the CV & Respiratory systems, GIT, GUT.Adjuvant to psychotherapy in psychoneurosis.
Pregnancy(Category D)
LactationMyasthenia GravisHypersensitivity
Acute AnxietyInsomniaExcitation
(Discontinue) Hallucinations
Assess degree of anxiety & level of sedation.
Monitor VS, adverse effects, laboratory examination, doses for elderly, malnourished pt. with liver or renal function, & w/ CV diseases.
Caution pt. to avoid taking alcohol or other CNS depressants concurrently with this medication.
Advise pt. that drug may impair ability to drive vehicles & to operate machinery.
Teach pt. that during course of therapy, tolerance to sedative effects usually develops.
Depressant & anticonvulsant effects may be related to its ability to increase &/or mimic the inhibitory activity of GABA on nerve impulses (depress CNS synaptic transmission & increase seizure activity threshold in the motor cortex). As a sedative, it may also interfere with the transmission of impulses from the thalamus to the brain cortex.
Short treatment of Insomnia.Long treatment of generalized tonic-clonic & cortical focal seizures.Emergency control of acute convulsions.Pre-anesthetic sedation.
Pregnancy(Category D)
Hypersensitivityto Barbiturates
PorphyriaSevere Renal, Hepatic,
or Respiratory impairment
DizzinessHeadacheHangoverConfusion
(elderly)Paradoxical
excitationExacerbation of
pre-existing pain
HypotensionBradycardiaGI disturbancesAllergic
reactionBlood
DyscrasiasSedation &
DepressionProlonged
administration results to folate deficiency & megaloblastic anemia
Assess pt. condition (mental status) before therapy & regularly thereafter to monitor drug effectiveness.
Monitor VS & for possible drug induced adverse reactions.
Instruct pt. to monitor for & report drug induced adverse reactions.
Caution pt. to avoid taking alcohol or other CNS depressants concurrently with this medication.
Advise pt. to avoid sudden position changes to prevent Orthostatic Hypotension.
DRUGS ACTION INDICATIONCONTRAINDICATIO
NADVERSE EFFECTS
NURSING RESPONSIBILITY
Generic NameMagnesium
Sulfate(MgSO4)
Brand NameMAGNESIUM
SULFATE
ClassificationCNS Drugs
(Anticonvulsant)
Dosagevial 5g/20ml
May decrease acetylcholine released by nerve impulses but anticonvulsant mechanism is unknown.
AnticonvulsantLowers ICPHypomagnesemia pt.’s receiving TPN; SeizuresAcute nephritis in children; EpilepsyGlomerulonephritis or HypothyroidismElectrolyte additive;Inhibits uterine contractions in tocolysis.Treatment of life-threatening arrhythmias such as atypical ventricular tachycardia
Pt.’s with heart block or myocardial damage.
FlushingSweatingHypotensionMuscular
WeaknessSedationConfusion
Assess pt. condition (mental status) before therapy & regularly thereafter to monitor drug effectiveness.
Monitor respiration: RR-16/min, renal status: I&O ratio, possible drug induced adverse reactions & magnesium toxicity.
Binds with opiod receptors in the CNS causing alteration of both perception of and emotional response to pain through unknown mechanism.
Relief of mod. to severe acute and chronic pain.Renal, intestinal colic; Cancer; MIPulmonary Edema due to increase pulmonary congestion; AntitussiveNarcotic; Hypnotic; Sedative
Binds w/ opiate receptors in the CNS; ascending pain pathways in limbic system, thalamus, midbrain, hypothalamus, altering perception of and emotional response to pain.Relieves pain.
Relief of mod. to severe pain.Pre-operatively analgesia.Supplement to balanced anesthesia.Surgical and Obstetrical Anesthesia.
Increase supply of oxygen to the heart by dilating both the arteries & veins which supply the heart itself.
Preventive & long-term treatment of angina pectoris/post MI angina.Treatment of severe CHF in combination w/ cardiac glycosides, diuretics, ACE-inhibitors, arterial vasodilators, pulmonary hypertension.
Acute MI w/ low-filling pressures (except in ICU
w/ continuous hemodynamic monitoring)
Left heart failure w/ low-filling pressures
ShockVery low BP
Transient Hypoxemia
Headache Decrease BP Rise in PR Dizziness Weakness Nausea Vomiting Transient skin
disordersAllergic
reactions
Assess for pain: location, type, character, intensity.
Monitor BP, PR during treatment.
Caution pt. to make position changes slowly to prevent Orthostatic Hypotension.
Warn pt. to avoid alcohol & OTC medications unless approved by the doctor.
Inform pt. that the drug may be taken before stressful activity.
Advise pt. to avoid hazardous activities if dizziness occurs & sudden position changes to prevent Orthostatic Hypotension.
Assess pt. condition (mental status) before therapy.
Monitor possible drug induced adverse reactions.
DRUGS ACTION INDICATIONCONTRAINDICATIO
NADVERSE EFFECTS
NURSING RESPONSIBILITY
Generic NameMefenamic
Acid
Brand NameISTAN
ClassificationAnalgesics,
Antipyretics,Muscle
Relaxants(NSAID’s)
Dosagecap 500mg
Aspirin-like drug that has analgesic, antipyretic & anti-inflammatory activities. These activities appear to be due to its ability to inhibit cyclooxygenase & also antagonize certain effects of prostaglandins.Displays central & peripheral activities.
Relief of pain including muscular, rheumatic, traumatic, dental, post-operative & post-partum pain, headache, migraine, fever & dysmenorrhea.Therapy should not exceed 7 days.
Pregnancy & LactationHypersensitivity
Active ulceration of lower or upper GI tract
GI discomfort:DiarrheaConstipationGas painNauseaVomitingDrowsinessDizziness
Assess for pain: location, type, character, intensity.
Monitor possible drug induced adverse reactions.
Instruct pt. not to take drug for more than 7 days.
Advice pt. to immediately report persistence or failure to relieve pain.
Analgesic, anti-inflammatory & antipyretic. Inhibits prostaglandin synthesis by inhibition of cyclo-oxygenase enzyme.It also inhibits leukotriene synthesis, help stabilize lysosomal membranes & exert anti-bradykinin activity.
Ophthalmic:Treatment of allergic conjunctivitis & for prophylaxis & reduction of inflammation & associated symptoms following ocular surgery.Short-term management of moderate to severe acute post-operative pain.
Active peptic ulcer disease
GI bleeding or perforationModerate to severe renal
impairmentHypovolemia
Labor & DeliveryHypersensitivity to aspirin or NSAID’s
Ophthalmic: Transient stinging & burning on instillation, ocular irritation
Allergic reaction
GI ulceration, bleeding, perforation
Post-operative bleeding
Acute renal failure
HypertensionNauseaDizzinessSweatingEdemaInjection site
pain
Assess pt.’s pain before & 1hr after treatment: type, location, intensity & ROM.
Assess for hypersensitivity reactions.
Monitor possible drug induced adverse reactions.
Advice pt. to report persistence or worsening of pain.
Instruct pt. to use caution when driving because drowsiness & dizziness may occur.
Caution pt. that this drug may cause eye redness & burning if soft contact lenses are worn.
Assess & document apical pulse for 1full min before giving drug. If pulse <60bpm in adult or <90bpm in an infant or significantly different, reassess after 1hr, inform the physician.
Monitor cardiac status, electrolytes, renal function & ECG continuously during parenteral loading doses & w/ suspected toxicity.
Monitor possible drug induced adverse reactions.
Advise pt. to maintain a Na-restricted diet & take K supplements to prevent toxicity.
Inhibits Na & Cl reabsorption at the proximal tubules, distal tubules & ascending loop of Henley leading to excretion of water together w/ Na, Cl, & K.DiureticAnti-hypertensive
Treatment of edema associated with CHF, hepatic cirrhosis, & renal disease, HPN.
Hypersensitivity to sulfonylurea
Anuria
Orthostatic Hypotension
Thrombophlebtis
Chronic aortitis
Vertigo Headache Dizziness Restlessne
ss Fever Photosensi
tivity Urticaria Metabolic
Alkalosis Muscle
Spasm Weakness
Assess pt. condition (mental status) before therapy.
Neutralizes gastric acidity thus reduces the total acid load of the GI tract. The elevated gastric pH reduces pepsin activity, strengthens gastric mucosal barrier & increases esophageal sphincter tone.
Peptic, Gastric, Duodenal ulcers; Hyperphospha-temia in chronic renal failure; reflux esophagilitis, hyperacidity, heartburn, stress ulcer prevention in critically ill, GERD.
Acts by relaxing both skeletal muscles & vascular smooth muscles.Demonstrates a variety of effects such as reduction of myotomia, improvement of circulation, & suppression of the pain reflex.
Spastic Paralysis in cerebrovascular disease; Improvement of muscular hypertonic symptoms in conditions such as cervical syndrome, lumbago.