Drugs Classification and Mechanism of action Dose, route and Contraindication Side effect Nursing responsibilities

indication frequency
Generic Classification . Oral Contraindicated CNS: headache, Observe 10 rights in
Furosemide diuretics Hypertension in patients vertigo, dizziness, giving
Brand Furosemide inhibits Adult: 40-80 mg hypersensitive paresthesia, medication
lasix Indication reabsorption of Na daily, alone or in to drug and weakness, Test if the patient is
and chloride mainly conjunction with those with restlessness, fever allergic to
Edema in the medullary other anuria CV: orthostatic the drug.
Hypertension portion of the antihypertensives. Use cautiously hypotension, To prevent nocturia,
ascending Loop of Oral in patients with thrombophlebitis with give PO
Henle. Excretion of Oedema associated hepatic IV administration and IM preparations in
potassium and with heart failure cirrhosis and in EENT: transient the
ammonia is also Adult: Initially, 20 those allergic deafness, blurred or morning. Give second
increased while uric mg daily or 40 mg to yellowed vision, dose in
acid excretion is every other day for sulfonamides. tinnitus early afternoon.
reduced. It increases mild cases, or 40 mg Use during GI: abdominal Monitor weight, blood
plasma-renin levels once daily adjusted pregnancy only discomfort and pain, pressure, and pulse
and secondary according to if potential diarrhea, anorexia, rate
hyperaldosteronism response. In some benefits to nausea, vomiting, routinely with long term
may result. cases, 80 mg or mother clearly constipation, use
Furosemide reduces more daily as a outweigh risks pancreatitis and during rapid
BP in hypertensives single dose or in 2 to fetu GU: nocturia, polyuria, dieresis. Use
as well as in divided doses may frequent urination, can lead to profound
normotensives. It be required. Max: oliguria water
also reduces 600 mg daily in HEMATOLOGIC: and electrolyte
pulmonary oedema severe cases. agranulocytosis, depletion.
before diuresis has Child: 1-3 mg/kg aplastic anemia, If oliguria or azotemia
set in daily. Max: 40 mg leucopenia, develops or increases,
daily. Observe 10 rights in drug
Parenteral giving may need to be
Oedema associated medication stopped.
with heart failure Test if the patient is Monitor fluid intake and
Adult: 20-50 mg IM allergic to output and electrolyte,
or slow IV Inj the drug. BUN,
increased by 20-mg To prevent nocturia, and carbon dioxide
increments every 2 give PO levels.
hr. Doses >50 mg and IM preparations in Watch for signs of
must be given as IV the hypokalemia, such as
infusion. morning. Give second muscle
dose in weakness and cramps.
Child: 0.5-1.5 mg/kg early afternoon. Consult prescriber and
daily. Max: 20 mg Monitor weight, blood
daily. pressure, and pulse
Intravenous rate
Pulmonary oedema routinely with long term
Adult: 40 mg via use
slow inj. If no and during rapid
adequate response dieresis. Use
within 1 hr, a further can lead to profound
80 mg may be given water
via infusion. and electrolyte
Intravenous depletion.
If oliguria or azotemia
develops or increases,
drug
may need to be
stopped.
Monitor fluid intake and
output and electrolyte,
BUN,
and carbon dioxide
levels.
Watch for signs of
hypokalemia, such as
muscle
weakness and cramps.
Consult prescriber and

thrombocytopenia,
azotemia, anemia
HEPATIC: hepatic
dysfunction, jaundice
METABOLIC: volume
depletion and
dehydration,
asymptomatic
hyperuricemia,
impaired glucose
tolerance,
hypokalemia,
 hypochloremic
alkalosis,
hyperglycemia,
dilutional
hyponatremia,
hypocalcemia,
hypomagnesemia
MUSCULOSKELETAL:
muscle spasm
SKIN: dermatitis,
purpura,
photosensitivity
reactions, transient
pain at IM injection site
Other: g

Drugs Classification and Mechanism of action Dose, route and frequency Contraindication Side effect Nursing responsibilities
indication
Generic name Classification • Contraindicated with Nursing considerations
epinephrine Therapeutic actions Cardiac arrest: 0.5–1 mg allergy or Assessment
Drug classes Naturally occurring (5–10 mL of 1:10,000 hypersensitivity to Adverse effects •
Brand name Sympathomimetic neurotransmitter, the solution) IV or by epinephrine or Systemic administration History: Allergy or
Epifrin, Alpha-adrenergic effects of which are intracardiac components of • hypersensitivity to
agonist mediated by alpha or injection into left preparation (many CNS: Fear, anxiety, epinephrine or
Beta1 and beta2- beta ventricular chamber; of the inhalant and tenseness, components of drug
adrenergic agonist receptors in target during resuscitation, 0.5 ophthalmic products restlessness, headache, preparation; narrow-angle
Cardiac stimulant organs. Effects on mg q 5 min. contain sulfites: light-headedness, glaucoma; shock other
Vasopressor alpha receptors Intraspinal sodium bisulfite, dizziness, drowsiness, than anaphylactic shock;
Bronchodilator include 0.2–0.4 mL of a 1:1,000 sodium or tremor, insomnia, hypovolemia; general
Antasthmatic drug vasoconstriction, solution added to potassium hallucinations, anesthesia with
Nasal decongestant contraction anesthetic spinal fluid metabisulfite; check psychological halogenated
Mydriatic of dilator muscles of mixture. label before using disturbances, seizures, hydrocarbons or
Antiglaucoma drug iris. Effects on beta • any CNS depression, cyclopropane;
receptors include Other use with local of these products in weakness, blurred organic brain damage,
positive chronotropic anesthetic: Concentrations a sulfite-sensitive vision, ocular cerebral arteriosclerosis;
and of 1:100,000–1:20,000 are patient); narrow- irritation, tearing, cardiac dilation and
photophobia, symptoms
Indication IV: inotropic effects on usually used. angle glaucoma; of paranoid coronary
In ventricular the heart 1:1,000 solution shock schizophrenia insufficiency;
standstill after other (beta1 receptors); • other than • tachyarrhythmias;
measures have failed bronchodilation, Respiratory distress: 0.3– anaphylactic shock; CV:Arrhythmias, ischemic heart disease;
to restore circulation, vasodilation, and 0.5 mL of 1:1,000 solution hypovolemia; hypertension resulting in hypertension; renal
given by trained uterine (0.3–0.5 mg), SC or IM, q general anesthesia intracranial hemorrhage, dysfunction; COPD;
personnel by relaxation 20 with halogenated CV collapse diabetes mellitus;
intracardiac puncture (beta2 receptors); min for 4 hr. hydrocarbons or with hypotension, hyperthyroidism; prostatic
and intramyocardial decreased production 1:200 suspension (for SC cyclopropane; palpitations, hypertrophy;
injection; of aqueous humor. administration only) organic brain tachycardia, precordial history of seizure
treatment and • damage, cerebral pain in patients with disorders;
prophylaxis of cardiac Respiratory distress: 0.1– arteriosclerosis; ischemic heart disease psychoneuroses; labor
arrest and attacks of 0.3 mL (0.5–1.5 mg) SC. cardiac dilation and • and delivery; lactation;
transitory AV heart Inhalation (aerosol) coronary GI:Nausea, vomiting, contact
block with syncopal Begin treatment at first insufficiency; anorexia lens use, aphakic patients
seizures (Stokes- symptoms of tachyarrhythmias; • (ophthalmic preparations)
Adams syndrome); bronchospasm. ischemic heart GU: Constriction of •
syncope due to Individualize dosage. Wait disease; renal blood vessels Physical: Weight; skin
carotid 1–5 min hypertension; renal and decreased urine color, temperature, turgor;
sinus syndrome; between inhalations to dysfunction (drug formation (initial orientation, reflexes, IOP;
acute hypersensitivity avoid overdose. may initially parenteral P,
(anaphylactoid) decrease renal administration), dysuria, BP; R, adventitious
reactions, serum blood vesical sphincter sounds; prostate
sickness, flow); COPD spasm resulting in palpation, normal urine
urticaria, patients who have difficult output; urinalysis,
angioneurotic edema; developed and painful urination, kidney function tests,
in acute asthmatic degenerative heart urinary retention in blood and urine glucose,
attacks to relieve disease; diabetes males with prostatism serum electrolytes, thyroid
bronchospasm mellitus; • function tests, ECG
not controlled by hyperthyroidism; Other:Pallor, respirator Interventions
inhalation or SC lactation. Opthalmic y difficulty, orofacial •
injection; relaxation of preparations are dystonia, sweating Use extreme caution
uterine musculature; contraindicated Local injection when calculating and
additive to local for those wearing • preparing doses;
anesthetic solutions contact lenses (drug Local: Necrosis at sites epinephrine is a very
for injection to prolong may discolor the of repeat injections (due potent drug; small errors
their duration of contact lens), to intense in dosage can cause
action and limit aphakic vasoconstriction) serious adverse effects.
systemic absorption patients Nasal solution Double-
• (maculopathy with • check pediatric dosage.
Injection: Relief from decreased visual Local: Rebound •
respiratory distress of acuity may occur). congestion, local Use minimal doses for
bronchial asthma, • burning and stinging minimal periods of time;
chronic bronchitis, Ophthalmic solutions "epinephrine-fastness" (a
emphysema, other • form of
COPDs CNS: Headache, brow drug tolerance) can occur
• ache, blurred with prolonged use.
Aerosols and vision, photophobia, •
solutions for difficulty with night Protect drug solutions
nebulization: vision, pigmentary from light, extreme heat,
Temporary relief from (adrenochrome) and freezing; do not use
acute attacks of deposits in the cornea, pink orbrown solutions.
bronchial asthma, conjunctiva, or lids Drug solutions should be
COPD with prolonged use clear and colorless (does
• • not apply tosuspension for
Topical nasal Local: Transitory injection).
solution: Temporary stinging on initial •
relief from nasal and instillation, eye pain or Shake the suspension for
nasopharyngeal ache, conjunctival injection well before
mucosal hyperemia withdrawing the dose.
congestion due to a Interactions •
cold, sinusitis, hay Rotate SC injection sites
fever, or other upper to prevent necrosis;
respiratory allergies; monitor injection sites
adjunctive therapy in frequently.
middle ear infections •
by decreasing Keep a rapidly acting
congestion around alpha-adrenergic blocker
eustachian ostia (phentolamine) or a
vasodilator (a
nitrate) readily available in
case of excessive
hypertensive reaction.
•
Have an alpha-adrenergic
blocker or facilities for
intermittent positive
pressure
breathing readily available
in case pulmonary edema
occurs.
•
Keep a beta-adrenergic
blocker (propranolol; a
cardioselective beta-
blocker, suchas atenolol,
should be used in patients
with respiratory distress)
readily availablein case
cardiac arrhythmias
occur.
•
Do not exceed
recommended dosage of
inhalation products;
administer
pressurized inhalation
drug forms during second
half of inspiration,
because the
airways are open wider
and the aerosol
distribution is more
extensive. If a second
inhalation is needed,
administer at peak effect
of previous dose, 3–5
min.
•
Use topical nasal
solutions only for acute
states; do not use for
longer than 3–5days, and
do not exceed
recommended dosage.
Rebound nasal
congestion canoccur after
vasoconstriction subsides
Drugs Classification and Mechanism of Dose, route and frequency Contraindication Side effect Nursing
indication action responsibilities
Generic Classification Usual Dosage: 2 inhalations Contraindicated in patients Nursing
Name: bronchodilator Albuterol may repeated every 4 to 6 hours hypersensitive to drug or its Considerations/
Albuterol (respiratory smooth reduce chemical Available forms: ingredients. CNS: tremor, Responsibilities:
muscle mediator release o o nervousness, o
Brand relaxant), beta-agonist from pulmonary Solution for inhalation: Use cautiously in patients with dizziness, insomnia, Drug may decrease
Name: mast cells and 0.083%, 0.5%, 0.63 mg/ml, CV disorders (including coronary headache, sensitivity of
Salbutamol indication: improve ability of 1.25 mg/3 ml insufficiency and hypertension), hyperactivity, spirometry used for
, Ventolin, To relieve cilia to clear o hyperthyroidism, or diabetes weakness, CNS diagnosis of
Ventolin bronchospasm mucus. Syrup: 2 mg/5 ml mellitus and in those who are stimulation, malaise. asthma.
Rotocaps, associated with acute or o o unusually responsive to o o
Volmax chronic Therapeutic Effect: Tablets: 2 mg, 4 mg adrenergics. CV: tachycardia, When switching
Functional asthma,bronchitis, or Albuterol is a o o palpitations, patient from regular
other reversible direct-acting agent Tablets (extended-release): Use extended-release tablets hypertension. to extended-release
obstructive that 4 mg, 8 mg cautiously in patients with GI o tablets,remember that
airway diseases. Also relaxes smooth narrowing. EENT: dry and a regular 2-mg
used toprevent muscle walls irritated nose and tablet every 6 hours
exercise-induced bronc of the bronchi, throat with is equivalent toan
hospasm. uterus, and inhaled form, nasal extended-release 4-
skeletal muscle congestion, epistaxis, mg tablet every 12
vascular bed. hoarseness. hours.
o o
GI: heartburn, nausea, Syrup contains no
vomiting, anorexia, alcohol or sugar and
altered taste, increase may be taken by
d children as
appetite. young as age 2.
o o
Metabolic: In children, syrup
hypokalemia. may rarely cause
o erythema multiforme
Musculoskeletal: or
muscle cramps. Stevens-Johnson
o syndrome.
Respiratory: o
bronchospasm, cough, The HFA form
wheezing, dyspnea, uses the propellant
bronchitis,
 increased sputum. hydrofluroalkane
o (HFA) instead
Other: hypersensitivity of
reactions. chlorofluorocarbons.
o
Alert: Patient may
use tablets and
aerosol together.
Monitor these
patients closely for
signs and symptoms
of toxicity.
o
Look alike-sound
alike: Don't confuse
albuterol with atenolol
or
Albutein.

Drugs Classification and Mechanism of Dose, route and frequency Side effect Nursing
indication action responsibilities
Generic Classification Nursing
name Antiarrhythmics, Increases the force Dosage: (IV)Adult:Digitilizin Contraindications: Hypersensitivity Responsibilities:
inotropics of myocardial g Dose – I0.6-1 mg (10-15 , uncontrolled ventricular  Monitor apical
Lanoxin contraction. mcg/kg) given as 50% of the arrhythmias, AV block, idiopathic Adverse Reactions: pulse before
Brand Prolongs refractory dose initially hypertrophic subaortic stenosis, CNS: fatigue, administering.
name period of and additional fractions constrictive pericarditis, known headache, weakness  Monitor blood
Digoxin Indication the AV node. given at 4-8 hr interval. alcohol intolerance EENT: blurred vision, pressure periodically
Treatment of Decreases (PO)Adult: Digitalizing (elixir only).. yellow vision in patients receiving
CHF, Tachyarrhythmias conduction through dose – 0.75-1.25 mg (10-15 CV: Arrhythmias, IV dogoxin.
, atrial fibrillation and the SA and AV mg/kg) given as 50% of bradycardia, ECG  Monitor intake
atrial flutter, Paroxysmal nodes. Increased thedose initially and changes and output ratios and
atrial tachycardia. cardiacoutput additional fractions given at GI: anorexia, nausea, daily weights.
(positive inotropic 4-8 hr vomiting, diarrhea  Observe patient
effect) and slowing intervals. Maintenance dose Endo: gynecomastia for signs and
of the heart rate –0.063-0.5 mg/day as Hemat: symptoms of toxicity.
(negative tablets or 0.350-0.5 mg/day thrombocytopenia  Oral
chronotropiceffect) as gelatin capsules, preparations can be
. depending onpatient’s lean administered without
body weight, renal function, regard to meals.
 and serum level.  Before
administering initial
loading dose,
determine whether
patient has taken
any digitalis
preparations in the
preceding 2-3

Drugs Classification and Mechanism of action Dose, route and Contraindications: Side effect Nursing
indication frequency responsibilities
Generic name Classification Relaxes bronchial Tablets—100, 200 mg; Contraindicated with Administer to pregnant
smooth muscle, CR tablets—225 mg; hypersensitivity to any patients only when
aminophylline Bronchodilator causing liquid—105 mg/5 mL; xanthine or to clearly needed—
Xanthin bronchodilation and injection— ethylenediamine,peptic Serum theophylline neonatal tachycardia,
Brand name increasing vital 250 mg/10 mL; ulcer, active gastritis; levels < 20 jitteriness, and
Phyllocontin capacity, suppositories—250, rectal or colonic irritation mcg/mL: Adverse effects withdrawal apnea
Indication which has been 500 mg or infection (use uncommon observed when
Symptomatic relief or impaired by Dosages rectalpreparations). • mothers received
prevention of bronchial bronchospasm and air Individualize dosage: • Serum theophylline xanthines up
asthma and reversible trapping; in higher Base adjustments on Use cautiously with levels > 20–25 until delivery.
bronchospasm concentrations, it clinical responses; cardiac arrhythmias, mcg/mL: Nausea, •
associated with also inhibits the monitor serum acute myocardial injury, vomiting, diarrhea, Caution patient not to
chronic bronchitis and release of slow- theophylline levels; CHF, corpulmonale, headache, insomnia, chew or crush enteric-
emphysema reacting substance of maintain therapeutic severe hypertension, irritability (75% of coated timed-release
• anaphylaxis (SRS-A) range of 10–20 severe hypoxemia, renal patients) forms.
Unlabeled uses: and mcg/mL; base dosage or hepatic • •
Respiratory stimulant histamine. on lean disease,hyperthyroidism, Serum theophylline Give immediate-
in Cheyne-Stokes body mass; 127 mg alcoholism, labor, levels > 30–35 release, liquid dosage
respiration; treatment aminophylline lactation. mcg/mL: Hyperglycemia forms with food if GI
of dihydrate = 100 mg , hypotension, effects occur.
apnea and theophylline cardiac arrhythmias, •
bradycardia in anhydrous. tachycardia (> 10 Do not give timed-
premature babies mcg/mL in premature release forms with
newborns);sei zures, food; these should be
brain damage given on an empty
• stomach 1 hr before or
CNS: Irritability 2 hr after meals.
(especially children); •
restlessness, dizziness, Maintain adequate
muscle twitching, hydration.
seizures, severe •
depression, stammering Monitor results of
speech; abnormal serum theophylline
behavior characterized levels carefully, and
by withdrawal, mutism, arrange for reduced
and unresponsiveness dosage if serum levels
alternating with exceed therapeutic
hyperactive range of 10–20
periods mcg/mL.
• •
CV:Palpitations, sinus Take serum samples
tachycardia, ventricular to determine peak
tachycardia, life- theophylline
threatening concentration drawn
ventricular arrhythmias, 15–30
circulatory failure min after an IV loading
• dose.
GI: Loss of appetite, •
hematemesis, epigastric Monitor for clinical
pain, gastroesophageal signs of adverse
reflux effects, particularly if
during sleep, increased serum theophylline
AST levels are not
• available.
GU: Proteinuria, •
increased excretion of Ensure that diazepam
renal tubular cells and is readily available to
RBCs; diuresis treat seizures
(dehydration), urinary
retention in men with
prostate enlargement
•
Respiratory: Tachypnea,
respiratory arrest
•
Other: Fever, flushing,
hyperglycemia, SIADH,
Drugs Classification and Mechanism of action Dose, route and Contraindications: Side effect Nursing
indication frequency responsibilities
Sodium Bicarbonate Classification Sodium bicarbonate raise 1 mEq/kg IVP, may Contraindications: Monitor urinary pH,
Brand Name: Arm Classification:Alkalizing s blood and urinary pH by repeat 0.5 Contraindicated in calcium,
and Agent, Buffer, Antacid, dissociation to mEq/kg 10 min patients electrolytes and
Hammer Pure Baking electrolyt with metabolic or Adverse Effects: phosphate
provide bicarbonate ions, GI: Gastric distention,
Soda, which neutralises the respiratory levels.
Citrocarbonate, Soda alkalosis; patients who belching, flatulence. Record amount and
hydrogen ion Metabolic: metabolic
Min concentration. It also are consistency of stools.
Indication losing chlorides from alkalosis, Clients on low-sodium
neutralises gastric acid via hypernatremia,
Hyperacidity production of carbon vomiting or continuous diets
o GI hypokalemia, should evaluate
dioxide. hyperosmolarity
Peptic ulcer suction; patients sodium
o taking (with overdose). contents of antacids.
Hyperkalemia diuretics known to Other: Pain and
o produce irritation at
Tricyclic hypochloremia injection site
antidepressant OD alkalosis; and
o patients with
Shock associated hypocalcemia in
with severe diarrhea, which alkalosis may
dehydration, produce
uncontrolled DM tetany, hypertension,
o seizures,
Reflux esophagiti or heart failure. Oral
sodium
bicarbonate is
contraindicated
in patients with acute
ingestion of strong
mineral
acids.