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General induces a state in induction and >hypersensitive > agitation > Check the name of the patient and
Anesthetics which the CNS maintenance of >history of malignant > dizziness the time of administration.
is altered so that general hyperpyrexia > drowsiness > Monitor vital signs.
Functional varying degrees anesthesia > increased cough > Monitor all the body systems.
General Anesthetics of pan relief, > increased saliva > Continuous monitoring of pulse
depression of >lightheadedness oximetry.
consciousness, > nausea > Postural BP should be taken.
Induction Adult & skeletal muscle > shivering > Take note of that time that the
childn relaxation and > vomiting drug has expired.
Up to 8%, w/ or w/o reflex reduction
O2 or O2/N2O. are produced
Maintenance Adult
& childn Adverse Effect:
0.5-3% w/ or w/o >Anaphylaxis
concomitant N2O. >Irregular
heartbeat >Stop durg immediately, administer
>Seizure oxygen
>Yellowing of the >Start rapid fluid resuscitation
skin or eyes >Make sure client is well ventilated
>Hypotension >Seizure precation
>Administer epinephrine
tetracaine hydrochloride (Pontocaine)
CLASSIFICATION MECHANISM INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITIES
OF ACTION
General Tetracaine acts >Spinal >Hypersensitivity to p- > Mild erythema > Check the name of the patient and
Anesthetics by preventing anesthesia aminobenzoic acid or its at the application the time of administration.
the generation >Topical derivatives, local site, > Check labs for low plasma-
Functional and transmission anesthesia anaesthesia of the ester >slight oedema or sholinesterase concentration
Local anesthetics; of impulses type. >Low plasma- pruritus, > Do not administer to inflamed or
Topical anesthetics; along nerve cholinesterase >blistering of the traumatized surfaces
Spinal anesthetics fibres and at concentrations, skin, > Do not instill into the middle ear
nerve endings; >Complete heart block >stinging
Subarachnoid depolarisation >Bronchoscopy or sensation
Spinal anaesthesia and ion- cytoscopy >Application to
Adult: 1% solution exchange are inflamed traumatised or
diluted with an equal inhibited. In highly vascular surfaces
volume of CSF general, loss of >Instillation into the
immediately prior to pain occurs middle ear.
admin or 5 mg of before loss of
powder dissolved in 1 sensory, Adverse Effects:
ml of CSF and admin autonomic and >Stop durg immediately, administer
slowly at a rate of 1 motor functions. >Anaphylaxis oxygen
ml/5 sec. > Eye irritation >Start rapid fluid resuscitation
Elderly: Dose >Watering >Make sure client is well ventilated
reduction may be >Increased >Administer epinephrine
needed. sensitivity to light >Advise patient to keep out of light
Ophthalmic and dim room if sensitivity to light
Anaesthesia of the occurs
eye
Adult: Instil 0.5-1%
tetracaine solution or
0.5% ointment.
ketorolac tromethamine (Toradol)
CLASSIFICATION MECHANISM INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITIES
OF ACTION
General Releases PO: >Angle closure glaucoma, CNS: > Asses mental status and
Sympathomimetic norepinephrine Temporarily >anesthesia with Nervousness, pulmonary functions
from synaptic relieves the cyclopropane or halothane shakiness,
Functional storage sites. Has shortness of >thyrotoxicosis, confusion, > Notify provider if SOB is
Nasal Decongestant direct effects on breath, tightness >diabetes, delirium unrelieved by medication and is
alpha, beta-1 and of chest and >lactation accompanied by chest pain,
Adult: beta -2 receptors, wheezing due to CV: dizziness or palpitations
PO Diabetic causing bronchial Precordial pain
neuropathic oedema increased BP due asthma > With males, report any difficulty
30-60 mg 3 to arteriolar GU: or pain when voiding
times/day. constriction and Parenteral: Difficult and
cardiac Allergic painful urination
IV Reversal of stimulation, disorders,
spinal or epidural bronchodilation, Vasopressor in Miscellaneous:
anesth-induced relaxation of GI shock Pallor, respiratory
hypotension tract smooth difficulty,
As 3 mg/mL soln: 3-6 muscle and nasal Nasal: hypersensitivity
mg, up to 9 mg, may decongestion, Nasal reaction
repeat every 3-4 mins mydriasis and congestion due
if needed. increase tone of to common Adverse Effects:
the bladder sold, sinusitis
trigone and sinus drainage CV: > monitor blood pressure regularly
vesicle sphincter Excessive dose
may cause
hypertension
sufficent to result
in cerebral
hemorrhage
lidocaine hydrochloride (Xylocaine)
CLASSIFICATION MECHANISM INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITIES
OF ACTION
General Inhibits >Myasthenia >Obstruction of intestine, CNS: >Monitor V/S respiration during
Cholinergic Stimulant destruction of gravis renal system Dizziness, rest
acetylcholine, >nondepolarizin >Bromide sensitivity headache,
Functional which increases g >Peritonitis sweating, >Administer on empty stomach for
Aminoglycosides, concentration at neuromuscular >urinary tract obstruction weakness, better absorption
anticholinergic, sites where blocker ileus drowsiness
antidepressant acetylcholine is >antagonist >Give only with atropine sulfate
released, this >bladder Precaution CV: available for cholinergic crisis
Reversal of facilitates distention >Pregnancy C Tachycardia,
neuromuscular transmission of >post-operative >Bradycardia bradycardia,
blockade impulses across ileus >Hypotension hypotension, Av
Adult the myoneural >Seizure disorders block, ECG
0.5-2.5 mg (0.05- junction >Bronchial asthma changes
0.07 mg/kg) >Coronary occlusion
neostigmine EENT:
methylsulphate w/ Miosis, blurred
atropine sulphate 0.6- vision,
1.2 mg (0.02-0.03 lacrimation,
mg/kg). Max: 5 mg. visual changes
Childn
0.05 mg/kg GI:
neostigmine Nausea, diarrhea,
methylsulphate w/ vomiting, cramps
atropine sulphate 0.02
mg/kg. Max: 2.5 mg. GU:
Doses to be given by Frequency,
slow IV inj incontinence,
simultaneously in urgency
separate syringes over
1 min.
INTEG:
Myasthenia gravis Rach, urticaria,
Adult flushing
1-2.5 mg IM/SC at
intervals throughout Adverse Effects:
the day if needed (eg
mornings & before CNS: >Monitor for bradycardia,
meals), giving a total Seizures, hypotension, bronchospasm,
dose of 5-20 mg. paralysis headache, dizziness, seizure,
Childn respiratory depression
0.2-0.5 mg inj as CV:
required. Neonate Dysrythmias, >Discontinue if toxicity occurs
0.05-0.25 mg IM cardiac arrest
every 2-4 hr, ½ hr >Seizure precaution
before feeding. RESP:
Treatment is not Respiratiory >O2 ready at bedside
usually required >8 depression,
wk of age. bronchospasm, >Have atropine sulfate available if
constriction, toxicity occurs
laryngospasm,
respiratory arrest,
dyspnea