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DRUG CLASSES:
Antiarrhythmic
Local Anesthetic
THERAPEUTIC ACTION:
Antiarrhythmic: decreases diastolic depolarization,
decreasing automaticity of ventricular cells,
increases ventricular fibrillation threshold.
Local Anesthetic: Blocks the generation and
conduction of action potentials in sensory
nerves by reducing sodium permeability,
reducing height and rate of the action potential,
increasing excitation threshold, and slowing
conduction velocity.
INDICATION:
Contraindicated with allergy to lidocaine or
amide-type local anesthetics, heart failure,
cardiogenic shock, second-or third-degree
heart block.
ADVERSE EFFECT:
Antiarrhythmic with systemic administration
CNS: Dizziness or light headedness, fatigue,drowsiness,
unconsciousness, tremors, twitching, vision changes,
may progress to seizures.
CV: Cardiac arrhythmias, cardiac arrest, vasodilation,
hypotension.
GI: Nausea and vomiting.
Hypersensitivity: Rash, anaphylactoid reactions.
NURSING CONSIDERATION:
ASSESSMENT
History
Allergy to lidocaine or amide-type local
anesthetics, heart failure, cardiogenic shock,
second – or third – degree heart blocks.
Wolff – Parkinson – white syndrome, strokes
adam syndrome.
Physical
T; skin color, rashes, lesions, orientations,
speech, reflexes, sensation and movement
continous ECG monitoring during use as
antiarrythmic, edema; R, adrentitious sounds,
bowel sounds, liver evaluations; urine output;
serum electrolytes, LFT’s renal function tests.
INTERVENTION:
Check drug concentration carefully; many
concentrations are available.
R educed dosage with hepatic or renal failure.
Continuously monitor response when use as
anti arrhythmic or injected as local anesthetic.
OXYTOCIN (ax i toe’sin)
Pitocin
DRUG CLASSES:
Hormone
Oxytocin
THERAPEUTIC ACTION:
Synthetic form of an endogenous hormone
produced in the hypothalamus and stored in
the posterior pituitary; stimulates the uterus,
especially the gravid uterus just before
parturition, and causes myoepithelium of the
lacteal glands to contract, which results in milk
ejection in lactating women.
INDICATION:
Antepartum: to initiate or improve uterine contractions to
achieve vaginal delivery; stimulation or reinforcement of
labor in selected cases of uterine inertia; management of
inevitable or incomplete abortion; second trimester
abortion.
Postpartum: to produce uterine contractions during the third
stage of labor and to control postpartum bleeding or
hemorrhage.
Lactation deficiency
Unlabeled use: to evaluate fetal distress (oxytocin challenge
test), treatment of breast engorgement.
CONTRAINDICATION AND CAUTION:
Contraindicated with significant cephalopelvic
disproportion, unfavorable fetal positions or
presentations, obstetric emergencies that favor
surgical intervention, prolonged use in severe
toxemia, uterine inertia, hyportonic uterine
patterns, induction or augmentation of labor
when vaginal delivery is contraindicated, previous
cesarian section, pregnancy.
Use cautiously with renal impairment.
ADVERSE EFFECT:
CV: cardiac arrhythmia, PVCS, hypertension, subarachnoid
hemorrhage.
NURSING CONSIDERATION:
ASSESSMENT
History
Significant cephalopelvic disportion, unfavorable fetal positions or
presentations, severe toxemia, uterine inertia, hypertonic uterine
patterns.
Physical
Fetal heart rate ( continuous monitoring is
recommended); fetal positions; fetal – pelvic
proportions; uterine tone; timing and rate of
contractions.
INTERVENTION
Ensure fetal position and size and absence of
complications that are contraindicated with oxytocin
before therapy.
ASSESSME
NT
NURSING
DIAGNOSIS
PLANNING