Generic Name (Brand Name) Drug Classificat ion & Indication Dosage, Route, Frequenc y Mechanism of Action Adverse Reaction Contraindicati on Nursing Responsibility Methergine (methylergon ovine maleate) PC: Ergot Alkaloid and Derivative TC: oxytocic, lactation stimulant Indication: Prevention and treatment of postpartum and postabortio n hemorrhage caused by uterine atony or subinvoluti IV: 0.2 mg after delivery of anterior shoulder , after delivery of placenta , or during puerperi um; may be repeated as required at interval s of 2-4 hours Methergin ↓ Stimulates uterine smooth muscles ↓ producing sustained contraction s ↓ thereby shortens the third stage of labor Cardiovascul ar: hypertension , temporary chest pain, palpitation CNSHallucina tions, dizziness, seizure, headache Gastrointest inal: Nausea, vomiting, diarrhea, foul taste Local: Thrombophleb itis > contraindicate d in patients hypersensitive to methylergonovi ne or any component of the formulation. >ergot alkaloids are contraindicate d with potent inhibitors of CYP3A4 (includes protease inhibitors, azole antifungals, and some macrolide antibiotics); >Be alert for adverse reactions and drug interactions. >This drug should be used extremely carefully because of it's potent vasoconstricto r action. I.V. use may induce sudden hypertension and cerebrovascula r accidents. As a last resort, give I.V. slowly over several minutes and
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> contraindicated in patients hypersensitive to methylergonovine or any component of the formulation.
>ergot alkaloids are contraindicated with potent inhibitors of CYP3A4 (includes protease inhibitors, azole antifungals, and some macrolide antibiotics); hypertension; toxemia; pregnancy
>Be alert for adverse reactions and drug interactions.
>This drug should be used extremely carefully because of it's potent vasoconstrictor action. I.V. use may induce sudden hypertension and cerebrovascular accidents. As a last resort, give I.V. slowly over several minutes and monitor blood pressure closely.
Classifications: AUTONOMIC NERVOUS SYSTEM AGENT; ALPHA- AND BETA-ADRENERGIC AGONIST; BRONCHODILATOR
AnaphylaxisAdult: SC 0.1–0.5 mL of 1:1000 q10–15min prn IV 0.1–0.25 mL of 1:1000 q10–15minChild: SC 0.01 mL/kg of, 1:1000 q10–15min prn IV 0.01 mL/kg of 1:1000 q10–15minNeonate: IV Intratracheal 0.01–0.03 mg/kg (0.1–0.3 mL/kg of 1:10,000) q3–5min prn
Cardiac ArrestAdult: IV 0.1–1 mg (1–10 mL of 1:10,000) q5min as needed Intracardiac 0.1–1 mgChild: IV 0.01 mg/kg (0.1 mL/kg of 1:10,000) q5min as needed Intracardiac 0.05–0.1 mg/kg
AsthmaAdult: SC 0.1–0.5 mL of 1:1000 q20min–4h Inhalation 1 inhalation q4h prnChild: SC 0.01 mL/kg of 1:1000 q20min–4h Inhalation 1 inhalation q4h prn
Naturally occurring catecholamine obtained from animal adrenal glands; also prepared synthetically. Acts directly on both alpha and beta receptors; the most potent activator of alpha receptors. Strengthens myocardial contraction; increases systolic but may decrease diastolic blood pressure; increases cardiac rate and cardiac output.
Temporary relief of bronchospasm, acute asthmatic attack, mucosal congestion, hypersensitivity and anaphylactic reactions, syncope due to heart block or carotid sinus hypersensitivity, and to restore cardiac rhythm in cardiac arrest. Ophthalmic preparation is used in management of simple (open-angle) glaucoma, generally as an adjunct to topical miotics and oral carbonic anhydrase inhibitors; also used as ophthalmic decongestant. Relaxes myometrium and inhibits uterine contractions.
Special Senses: Nasal burning or stinging, dryness of nasal mucosa, sneezing, rebound congestion. Transient stinging or burning of eyes, lacrimation, browache, headache, rebound conjunctival hyperemia, allergy, iritis; with prolonged use: melanin-like deposits on lids, conjunctiva, and cornea; corneal edema; loss of lashes (reversible); maculopathy with central scotoma in aphakic patients (reversible). Body as a Whole: Nervousness, restlessness, sleeplessness, fear, anxiety, tremors, severe headache, cerebrovascular accident, weakness, dizziness, syncope, pallor, sweating, dyspnea.
Hypersensitivity to sympathomimetic amines; narrow-angle glaucoma; hemorrhagic, traumatic, or cardiogenic shock; cardiac dilatation, cerebral arteriosclerosis, coronary insufficiency, arrhythmias, organic heart or brain disease; during second stage of labor; for local anesthesia of fingers, toes, ears, nose, genitalia. Safety during pregnancy (category C) or lactation is not established.
Assessment & Drug Effects
Monitor BP, pulse, respirations, and urinary output and observe patient closely following IV administration. Epinephrine may widen pulse pressure. If disturbances in cardiac rhythm occur, withhold epinephrine and notify physician immediately. Keep physician informed of any changes in intake-output ratio. Use cardiac monitor with patients receiving epinephrine IV. Have full crash cart immediately available.
Depresses all levels of the CNS, including the Limbic andreticular formation, probably through the increase action of gammaaminobutyricacid (GABA), which is a major inhibitory neurotransmitter in thebrain
Anxiety
Adjunct treatment for seizure disorders
Preoperative sedation
Muscle spasm
`Adults: Depending on the severity, 2-10 mg PO bid – tid. Or, 2-10 mg IM or Iv q 3-4 hours PRN`Children age 6 months & older: 1-2.5 mg PO tid or qid, increase gradually as needed & tolerated`Elderly patients: Initially, 2-2.5 mg once daily or bid, increase gradually
`Adult: 2-10 mg PO bid – qid
`Adults: 10 mg IM (preferred) or IV before surgery`Adults: 2-10 mg PO bid – qid. Or, 5-10 mg IV or IM initially; then 5-10 mg IV or IM q 3-4 hours PRN
hypersensitivity, cross-sensitivty with other benzodiazepines mayoccur, comatose patients, pre-existing CNS depression, uncontrolled severe pain,narrow angle glaucoma, pregnancy or lactation
Indication Contraindication Side Effects Nursing Consideration
Brand Name:Valium
Generic Name:Diazepam
Classification:Central Nervous System Drug
5-20 mg daily
PO
Facilitates/potentiates the inhibitory activity of GABA at limbic system and reticular formation to reduce anxiety, promote calmness and sleep.
Tablet: Symptomatic relief of anxiety, agitation, tension due to psychoneurotic states and transient situational disturbances, adjunct in major mental and organic disorders; relief of reflex muscle, spasm due to spinal and supraspinal interneurons.
Pregnancy (category D),Hypersensitivity,Dependence in other substance including alcohol, except in management of acute withdrawal reactions,Severe hypercapnia
Obtain history of patients underlying condition before therapy and reassess regularly thereafter.
Monitor signs of anxiety.
Monitor vital signs: BP, CR, and RR. Hold drug if BP drops 20mmHg and monitor respirations every 5-15 minutes if drug is given IV.
Name of Drug Dosage/Frequency/Route:
Mechanism of Action
Indication Contraindication Side Effects Nursing Considerations
Brand Name:Furosemide
Generic Name:Furosemide
Classification:Dueretic/Antihypertensive Drug
40mg BID
PO
Inhibits sodium and chloride reabsortion at the proximal tubules, distal tubules and ascending loop of Henley leading to excertion of water together with sodium, chloride and potassium. Diuretic/ antihypertensive
Treatment of edema associated with congestive heart failure (CHF) hepatic cirrhocis, and , renal disease, hypertension
Hypersensitivity to sulfony lureas; anuria
Orthostatic hypotension, thromboplebitis, chronic aortitis, vertigo, fever, headache, dizziness, parethesia, sensitivity, restlessness, photo- uticaria, pruritis, necrotizing anginitis, exfolative dermatitis, erythema multiforme, rash, occasionally, local irritation and pain with parenteral use.
Assess patient’s underlying condition before starting therapy.
Monitor for renal, cardiac, neurologic, GI, pulmonary manifestation of hypokalemia.
Monitor for CV, GI, neurologic manifestations for hyponatremia.
Monitor for neurologic, respiratory manifestations for hyperchloremia.
Assess fluid volume status.
Assess patient for tinnitus hearing loss, ear pain.
Assess the pt’s and
family’s knowledge of drug therapy.
MEDICATION Dosage/ MECHANISM OF INDICATION CONTRAINDICATI0N SIDE EFFECTS NURSNG
Name of Drug Dosage/Frequency/Route: Mechanism of Action
Indication Contraindication Side Effects Nursing Consideration
Brand Name:Solu-cortef
Generic Name: Hydrrocortisone
Classification: Hormones and Related Drug
30 mg 2x a day 1 tab
PO
Suppresses inflammatory and immune responses, mainly by inhibiting migration of leukocytes and phagocytes and decreasing inflammatory mediators.
Replacement Therapy in adrenocortical insufficiencyHyperglycemia due to cancerArthritisCollagen diseases Dermatologic diseasesAutoimmune and Hematologic disorderTrichinosisUlcerative colitisMultiple sclerosisProtitisNephritic syndromeAspiration pneumonia
Hypersensitivity to drug, alcohol,bisulfites or tartrazineSystemic fungal infectionsConcurrent use of other immunosuppressant CorticosteroidsConcurrent administration of live-virus vaccines
Check label of parenteral hydrocortisone because IM and IV preparations are not necessarily interchangeable.
Assess blood glucose levels in diabetic patients. Expect to increase insulin or oral hypoglycemic dosage
Urge patient to immediately report unusual weight gain, face or leg swelling, vomiting of blood, irregular menstrual cycle, prolonged sore throat, epigastric burning
Assess patient’s pain(location, type, character) before therapy & regularly thereafter to monitor effectiveness of the drug(give before pain becomes extreme)
Mechanism of Action Indication Contraindication Side Effects Nursing Consideraion
Brand Name: Novaluzid Atropine
Generic Name: Atropine
Classification: Antidotes
Adult:0.4-0.6mg/46hrPedia:0.1-0.6mg/46hr depending on weight
IV
Inhibits acetylcholine at parasympathetic neuro-effector junction, blocking vagal effect on the heart (SA node), exocrine glands, smooth muscles & urinary bladder. Drug increases heart rate, dries secretions, decreases sweating & salivation in low doses. Mydriallis (dilatation of the pupil) & cycloplegia (failure to accommodate for close vision) occur at moderate doses. Mobility of GI and GU systems are affected at high doses
Administration prior to anesthesia to prevent secretions of respiratory tract; to control rhinorrhea; treatment to parkinsonism; restoration of cardiac rate & arterial pressurein some situations; treatment of peptic ulcers; management of hypersecretion, irritation or inflammation of the stomach, intestines or pancrease; treatment of diarrhea; relief of infant colic
Hypersensitivity to anticholinergics; narrow-angle glaucoma; adhesions between iris and lens; prostatic hypertrophy; obstructive uropathy; myocardial ischemia; unstable cardiac status caused by hemorrhage; tachycardia, myasthenia, gravis; pyloric or intestinal obstruction asthma; hyperthyroidism; renal disease; hepatic disease; toxic megacolon; intestinal atony or paralytic ileus
Nephropathy Hematological, skin and other allergic reactions
instruct patient to takewith meals
have a plenty of waterwhen taking this drug
Name of Drug Dosage / Frequency/ Indication Adverse Effect Contraindication Nursing
Route Consideration
Sodium Bicarbonate
Brand name: Soda mint
Classification:Acidifiers and alkalinezers
Adult: PO Urine alkalinisation Up to 10 g/day in divided doses w/ sufficient fluid intake. Chronicmetabolic acidosis ≥4.8 g/day as needed. Dyspepsia 1-5 g when needed
IV Severe metabolic acidosis By slow inj of a hypertonic soln ≤8.4% or by continuous infusion of a weaker soln, usually 1.26%
Cardiac arrest, metabolic acidosis, systemic or urinary alkalinization, antacid
Tetany, edema, hypokalemia, metabolic alkalosis, hypernatremia,pain and irritation at injection site
Contraindicated in patients with metabolic or respiratory alkalosis and in those with hypocalcemia in which alkalosis may produce tetany, hypertension, seizures, or heart failure
To avoid alkalosis, obtain blood pH, partial pressure of arterial oxygen, partial pressure of arterial CO2 and electrolyte levels.
Keep prescriber informed of laboratory results.
Generic Name Dosage / Indication Adverse Effect Contraindication Nursing Consideration
Contraindicated in cancer patients with bone metastases and in patients with ventricular fibrillation, hypercalcemia, hypophosphatemia, or renal calculi
Use all calcium products with extreme caution.
Monitor calcium levels frequently.
To avoid constipation and bloating and to improve absorption, give calcium gluconate in divided doses.