Generic Name Dosage
Responsibility
1. Dobutamine Adults: 2.5 – 10
Hydrochloride mcg/kg/min IV is
usual rate to increase
cardiac output; rarely
rates up to 40
mcg/kg/min needed.
2. Dopamine Adults:
Hydrochloride
Patients likely to
respond to the
modest increments of
cardiac contractility
and renal perfusion:
Initially 2-5
mcg/kg/min IV.
Patients who are more
seriously ill: Initially, 5
mcg/kg/min IV.
Increase in
increments of 5-10
mcg/kg/min up to rate
of 20-50 mcg/kg/min.
Check urine output
frequently if doses
>16 mcg/kg/min.
Therapeutic Action Classification Contraindication Side Effects Nursing
Positive inotropic Sympathomimetic  Contraindicated  CNS: Headaches  Arrange to
effects are mediated with IHSS; digitalize
by betaadrenergic hypovolemia; acute  CV: Increase in patients who
Beta1-selective
receptors in the heart: MI; general heart rate, have atrial
adrenergic agonist
increases the force of anesthesia with increase in fibrillation with a
mycardial contracion halogenated systolic BP, rapid ventricular
with relatively minors hydrocarbons or increase in rate before
effects on heart rate, cyclopropane, ventricular giving
arrythmogenesis: has which sensitize the ectopic beats bobutamine-
minor effects of blood myocardium to (PVC’s), anginal dobutamine
vessels. catecholamine; pain, facilitates AC
pregnancy. palpitations, conduction
shortness of  Monitor urine
 Use cautiously with breath flow, cardiac
diabetes mellitus; output,
lactation; allergy to  GI: Nausea pulmonary
sulfites more wedge pressure,
common in ECG, and BP
asthmatic patients. closely during
infusion; adjust
dose and rate
accordingly.
Drug acts directly and Sympathomimetic CV: Ectopic bets, Monitor blood
by the release of
 Contraindicated
tachycardia, anginal
with pressure, pulse,
norepinephrine from pain, palpitations, peripheral
Alpha-adrenergic pheochromocytoma
sympathetic nerve hypotension, pulses, and
agonist , Tachyarrythmias,
terminals; vasoconstriction, urinary output at
dopaminergic ventricular dyspnea, bradycardia,
fibrillation, intervals
receptors mediate Beta1-selective hyper tension, prescribed by
dilation of vessels in hypovolemia, widened QRS.
adrenergic agonist physician.
the renal and general anesthesia
with halogenated Precise
splanchnic beds, GI: Nausea, vomiting measurements
Dopaminergic drug hydrocarbons or
which maintains renal are essential for
perfusion and cyclopropane which Other: Headache,
sensitize the accurate
function; alpha piloerection, titration of
receptors, which are myocardium to azotemia, gangrene
catecholamines. dosage.
activated by higher with prolonged use.
doses of dopamine,  Use cautiously with Report the
mediate atherosclerosis, following
vasoconstriction, arterial embolism, indicators
which can override Raynaud’s disease, promptly to
the vasodilating cold injury, physician for use
effects; beta1 frostbite, diabetic in decreasing or
receptors mediate a endarteritis, temporarily
positive inotropic Buerger’s disease suspending
effect on the heart. (monitor the color dose: Reduced
and temperature of urine flow rate in
 extremities), absence of
pregnancy, hypotension;
lactation. ascending
tachycardia;
dysrhythmias;
disproportionate
rise in diastolic
pressure
(marked
decrease in
pulse pressure);
signs of
peripheral
ischemia (pallor,
cyanosis,
mottling,
coldness,
complaints of
tenderness,
pain, numbness,
or burning
sensation).
Monitor
therapeutic
effectiveness. In
addition to
improvement in
vital signs and
urine flow, other
indices of
adequate
dosage and
perfusion of vital
organs include
loss of pallor,
increase in toe
temperature,
adequacy of nail
bed capillary
filling, and
reversal of
confusion or
comatose state.

3. Midazolam Exact mechanism of Benzodiazepine  Contraindicated Blurred vision; Do not use
 Preoperative
action not (short-acting) with changes in blood small veins for IV
sedation, understood; acts pressure, breathing,
hypersensitivity to injection.
anxiety, mainly at the limbic and heartbeats;
CNS depressant benzodiazepines; Administer IM
amnesia: <60 system and reticular coughing; dizziness;
psychoses, acute injections deep
yr: 70-80mcg/kg
 IM 1 hr before formation; potentiates narrow-angle drowsiness; dry into muscle.
surgery (usual the effects of GABA, glaucoma, shock, mouth; headache; Monitor IV
dose 5 mg). >60 an inhibitory coma, acute hiccups; low blood injection site for
yr or debilitated: neurotransmitter; alcoholic pressure (children); extravasation.
20-50 mcg/kg IM anxiolytic and intoxication; nausea; pain during Arrange to
1 hr before amnesia effects occur pregnancy; injection; pain, reduce dosage
surgery (usual at doses below those neonates. redness, or of midazolam if
dose, 1-3 mg). needed to cause  Use cautiously in tenderness at the patient is also
sedation, ataxia; has elderly or injection site; short- being given
 Conscious little effect on cortical debilitated patients; term memory loss; oploid
sedation for function. with impaired liver slurred speech; analgesics;
short or renal function, vomiting. reduce dosage
procedures: <60 lactation. Severe allergic by at least 50%
yr: 1-1.5 mg IV reactions (rash; hives; and monitor
initially, difficulty breathing; patient closely.
maintenance tightness in the chest; Monitor level of
dose of 25% of swelling of the mouth, consciousness
initial dose. >60 face, lips, or tongue); before, during,
yr: 1-2.5 mg IV agitation; chest pain; and for at least
initially, combativeness; 2-6 hr after
maintenance irregular breathing administration of
dose of 25% patterns; pain, midazolam.
initial dose. swelling, or redness Carefully
at the injection site; monitor P, BP,
 Induction of slow or difficult and respirations
anesthesia: <55 breathing; unusual or during
yr: 300-350 involuntary muscle administration.
mcg/kg IV (up to movements or muscle
a total of 600 tremor.
mcg/kg). >55 yr:
150-300 mcg/kg
IV as initial dose.

 Sedation in
critical care
areas: 10-50
mcg/kg (0.5-4
mg usual dose)
as loading dose:
may repeat q
10-15 min until
desired effect is
seen; continuous
infusion of 20-
100mcg/kg/hr to
sustain effect.
4. Meperidine Adults: Acts as agonist at Opioid agonist  Contraindicated Transient Administer to
Hydrochloride  Relief of pain: specific opioid analgesic with hyper hallucinations, lactating women
individualize receptors in the CNS sensitivity to transient hypotension 4-6 hr before
to produce analgesia, (high doses), visual
 dosage; 50- euphoria, sedation; narcotics, diarrhea disturbances. Active the next feeding
150mg IM, the receptors caused by metabolite may to minimize the
subcutaneously mediating these poisoning (before accumulate in renal amount of milk.
or PO q 3-4hr as effects are thought to toxins are dysfunction, leading
needed. Diluted be the same as those eliminated), to an increased risk of
Reduce dosage
solution may be mediating the effects bronchial asthma, CNS toxicity. of meperidine by
give by slow IV of endogenous COPD, cor 25%-50% in
injection. OM opioids (enkephalins, pulmonale, Use with caution patients
route is endorphins). respiratory during lactation, in receiving
preferred for depression, anoxia, older, or debilitated phenothiazines
repeated kyphoscoliosis, clients. Use with or other
injections. acute alcoholism, extreme caution in tranquilizers.
 Preoperative increased ICP, clients with asthma. Give each dose
medication: 50- pregnancy, seizure Atropine-like effects of the oral syrup
100 mg IMor disorder, renal may aggravate in half glass of
subcutaneously, dysfunction. glaucoma, especially water. If taken
30-90 min Contraindicated to when given with other indiluted, it may
before beginning premature infants. drugs used with effect on
anesthesia.  Use cautiously with caution in glaucoma. mucous
acute abdominal membranes.
 Support of
anesthesia: conditions, CV Reassure
Dilute to 10 disease, patient that
mg/ml, and give supraventricular addiction is
repeated doses tachycardias, unlikely; most
by slow IV myxedema, patients who
injection, or delirium tremens, receive opiates
dilute to 1mg/ml cerebral for medical
and infuse arteriosclerosis, reasons do not
continuously. ulcerative colitis, develop
Individualize fever, Addison’s dependence
dosage. disease, prostatic syndromes.
 Obstetric hypertrophy,
analgesia: When urethral stricture,
contractions recent GI or GU
become regular, surgery, toxic
50-100 mg IM or psychosis, labor or
subcutaneously; delivery, renal or
repeat q 1-3 hr. hepatic dysfunction,
lactation.
5. Ca Gluconate IV infusion preferred. Essential elements of Electrolyte  Contraindicated CV: Slowed heart rate, Give drug
1g contains 90mg the body; helps with allergy to tingling, “beat waves” hourly for first 2
(4.5 mEq) calcium. maintain the calcium, renal (rapid administration); wk when
Antacid
0.5-2g as required; functional integrity of calculi, peripheral treating acute
daily dose 1-15g. the nervous and Hypercalcemia, vasodilation, local ulcer. During
muscular systems; ventricular burning, drop in BP. healing stage,
helps maintain fibrillation during administer 1-3
cardiac function, cardiac Local: Local hr after meals
blood coagulation; is resuscitation and irritations, severe and hs.
an enzyme cofactor patients with the necrosis. Sloughing, Have patient
and affects the risk of existing and abscess remain
secretory activity of digitalis toxicity. formation. recumbent for a
endocrine and  Use cautiously with short time after
exocrine glands; renal dysfunction, Metabolic: IV injection.
neutralizes or reduces pregnancy, Hypercalcemia,
gastric acidity (oral lactation. rebound hyperacidity
use). and milk –
alkalisyndrome.