DRUGS

ACTION

INDICATION
Blood pressure control in certain acute hypotensive states. As an adjunct in the treatment of cardiac arrest and profound hypotension.

CONTRAINDICATION Pregnancy (Category D)

ADVERSE EFFECTS

NURSING RESPONSIBILITY

Generic Name Powerful Norepinephrine peripheral vasoconstrictor Brand Name (alpha-adrenergic action) & as LEVOPHED potent inotropic Classification stimulator of the heart & dilator of CV Drugs coronary arteries (Cardiac (beta-adrenergic Glycosides) action). Dosage amp - 1mg/4ml

 Ischemic injury  Monitor VS, ECG, I&O  Bradycardia ratio, cyanosis,  Arrythmias neurological status &  Anxiety adverse effects during therapy.  Transient Assess for signs of headache extravasation (eg.  Respiratory Blanching & Coolness difficulty of skin over vein) at  Extravasation infusion site. necrosis at  Inform pt. to inform injection site physician if using drugs  Plasma volume such as Sodium depletion on Bicarbonate, MAOIs, prolonged Trycyclics, Oxytocics, administration Anti-histamine.  Advise pt. to notify nurse if IV site feels cool or painful.  Caution pt. to avoid sudden position changes to prevent Orthostatic Hypotension.

DRUGS

ACTION

INDICATION
Anxiety & tension states; Depressive mood; Nervous tension; Agitation & Insomnia. Functional disturbances of the CV & Respiratory systems, GIT, GUT. Adjuvant to psychotherapy in psychoneurosis.

CONTRAINDICATION Pregnancy (Category D) Lactation Myasthenia Gravis Hypersensitivity

ADVERSE EFFECTS
 Acute Anxiety  Insomnia  Excitation (Discontinue)  Hallucinations

NURSING RESPONSIBILITY
 Assess degree of anxiety & level of sedation.  Monitor VS, adverse effects, laboratory examination, doses for elderly, malnourished pt. with liver or renal function, & w/ CV diseases.  Caution pt. to avoid taking alcohol or other CNS depressants concurrently with this medication.  Advise pt. that drug may impair ability to drive vehicles & to operate machinery.  Teach pt. that during course of therapy, tolerance to sedative effects usually develops.

Generic Name Depress the Bromazepam CNS, probably by potentiating Brand Name GABA, an inhibitory LEXOTAN neurotransmitter. Classification Produces skeletal muscle relaxation CNS Drugs (Benzodiazepines) by inhibiting spinal polysynaptic afferent Dosage pathways. tab 1.5mg

DRUGS
Generic Name Phenobarbital Brand Name LUMINAL Classification CNS Drugs (HypnoticsSedative Barbiturates) Dosage amp 130mg/1ml

ACTION
Depressant & anticonvulsant effects may be related to its ability to increase &/or mimic the inhibitory activity of GABA on nerve impulses (depress CNS synaptic transmission & increase seizure activity threshold in the motor cortex). As a sedative, it may also interfere with the transmission of impulses from the thalamus to the brain cortex.

INDICATION
Short treatment of Insomnia. Long treatment of generalized tonic-clonic & cortical focal seizures. Emergency control of acute convulsions. Pre-anesthetic sedation.

CONTRAINDICATION Pregnancy (Category D) Hypersensitivity to Barbiturates Porphyria Severe Renal, Hepatic, or Respiratory impairment

ADVERSE EFFECTS
 Dizziness  Headache  Hangover  Confusion (elderly)  Paradoxical excitation  Exacerbation of pre-existing pain  Hypotension  Bradycardia  GI disturbances  Allergic reaction  Blood Dyscrasias  Sedation & Depression  Prolonged administration results to folate deficiency & megaloblastic anemia

NURSING RESPONSIBILITY
 Assess pt. condition (mental status) before therapy & regularly thereafter to monitor drug effectiveness.  Assess seizures activity: type, location, duration & character.  Monitor VS & for possible drug induced adverse reactions.  Instruct pt. to monitor for & report drug induced adverse reactions.  Caution pt. to avoid taking alcohol or other CNS depressants concurrently with this medication.  Advise pt. to avoid sudden position changes to prevent Orthostatic Hypotension.

DRUGS
Generic Name Magnesium Sulfate (MgSO4) Brand Name MAGNESIUM SULFATE Classification CNS Drugs (Anticonvulsant) Dosage vial 5g/20ml

ACTION
May decrease acetylcholine released by nerve impulses but anticonvulsant mechanism is unknown.

INDICATION
Anticonvulsant Lowers ICP Hypomagnesemia pt.s receiving TPN; Seizures Acute nephritis in children; Epilepsy Glomerulonephritis or Hypothyroidism Electrolyte additive; Inhibits uterine contractions in tocolysis. Treatment of lifethreatening arrhythmias such as atypical ventricular tachycardia

CONTRAINDICATION Pt.s with heart block or myocardial damage.

ADVERSE EFFECTS
 Flushing  Sweating  Hypotension  Muscular Weakness  Sedation  Confusion

NURSING RESPONSIBILITY
 Assess pt. condition (mental status) before therapy & regularly thereafter to monitor drug effectiveness.  Monitor respiration: RR-16/min, renal status: I&O ratio, possible drug induced adverse reactions & magnesium toxicity.

DRUGS
Generic Name Morphine Brand Name MORPHINE SULFATE Classification Analgesics, Antipyretics, Muscle Relaxants (Opiates & Antagonists) Dosage amp 16mg/1ml

ACTION
Binds with opiod receptors in the CNS causing alteration of both perception of and emotional response to pain through unknown mechanism.

INDICATION
Relief of mod. to severe acute and chronic pain. Renal, intestinal colic; Cancer; MI Pulmonary Edema due to increase pulmonary congestion; Antitussive Narcotic; Hypnotic; Sedative

CONTRAINDICATION Pregnancy Hypersensitivity Existing Intestinal Obstruction (Ileus) Anastomoses Asthma Brain damage Epilepsy Chronic alcohol abuse Treatment w/ Antidepressant Severe obstruction of the gut

ADVERSE EFFECTS
 Allergic Reactions  GI disturbances  Urinary retention  Depression  Delirium & Convulsion  Nausea  Xerostomia  Emesis  Anorexia  Facial Flushing  Chills  Palpitations  Syncope  General Asthenia  Cardiac Failure  Headache  Vertigo  Perspiration  Mood swings  Insomnia

NURSING RESPONSIBILITY
 Assess pain: location, type, character, intensity before therapy & regularly thereafter to monitor drug effectiveness.  Monitor for allergic reactions, respiratory depression, possible drug induced adverse reactions, I&O ratio & CNS changes.  Warn pt. about performing activities without assistance.  Advise pt. to report any symptoms of allergic reactions.  Caution pt. to avoid CNS depressants for at least 24hrs after taking the drug.

GUDLUCK.!!! =P

DRUGS
Generic Name NALBUPHINE Brand Name Nubain Classification Analgesics, Antipyretics, Muscle Relaxants (Opiates & Antagonists) Dosage amp 10mg/1ml

ACTION
Binds w/ opiate receptors in the CNS; ascending pain pathways in limbic system, thalamus, midbrain, hypothalamus, altering perception of and emotional response to pain. Relieves pain.

INDICATION
Relief of mod. to severe pain. Pre-operatively analgesia. Supplement to balanced anesthesia. Surgical and Obstetrical Anesthesia.

CONTRAINDICATION Pregnancy (Category D) Hypersensitivity

ADVERSE EFFECTS
 Sedation  Drowsiness  Sweating  Nausea  Dry mouth  Dizziness  Headache  Vomiting

NURSING RESPONSIBILITY
 Assess pt. condition (mental status) & pain: location, type, character, intensity before therapy & regularly thereafter to monitor drug effectiveness.  Monitor VS, respiratory depression, allergic reactions, & possible drug induced adverse reactions.  Caution pt. to avoid taking alcohol or other CNS depressants concurrently with this medication.  Advise pt. to avoid sudden position changes to prevent Orthostatic Hypotension & getting up without assistance.

DRUGS
Generic Name Isosorbide Dinitrate / Mononitrate Brand Name ISOKET ISORDIL Classification CV Drugs (Anti-anginal DrugsOrganic Nitrates) Dosage tab 5mg amp 5mg/2ml

ACTION
Increase supply of oxygen to the heart by dilating both the arteries & veins which supply the heart itself.

INDICATION
Preventive & long-term treatment of angina pectoris/post MI angina. Treatment of severe CHF in combination w/ cardiac glycosides, diuretics, ACEinhibitors, arterial vasodilators, pulmonary hypertension.

CONTRAINDICATION Acute MI w/ low-filling pressures (except in ICU w/ continuous hemodynamic monitoring) Left heart failure w/ lowfilling pressures Shock Very low BP

ADVERSE EFFECTS
 Transient Hypoxemia  Headache  Decrease BP  Rise in PR  Dizziness  Weakness  Nausea  Vomiting  Transient skin disorders  Allergic reactions

NURSING RESPONSIBILITY
 Assess for pain: location, type, character, intensity.  Monitor BP, PR during treatment.  Caution pt. to make position changes slowly to prevent Orthostatic Hypotension.  Warn pt. to avoid alcohol & OTC medications unless approved by the doctor.  Inform pt. that the drug may be taken before stressful activity.  Advise pt. to avoid hazardous activities if dizziness occurs & sudden position changes to prevent Orthostatic Hypotension.

DRUGS
Generic Name Isoxsuprine HCl Brand Name ISOXILAN Classification CNS Drugs (cerebral & peripheral vasodilators) Dosage tab 10mg

ACTION
Chemically similar to sympathomimetic amines & often described as beta adrenergic agonist.

INDICATION
Peripheral & cerebral vascular insufficiency w/ spastic component showing symptom (eg. Dizziness, Forgetfulness, Confusion, Visual, Auditory, Speech abnormalities, Coldness & Numbness of limbs, Color changes, Ischemic ulcers.) Raynauds Disease. Cerebrovascular Insufficiency. Uterine hypermotility disorders.

CONTRAINDICATION Renal arterial hemorrhage Heart Disease Severe Anemia Premature Labor Should not be administered immediately in post-partum

ADVERSE EFFECTS
 Transient Flushing & Palpitations  Hypotension  Rashes  GI disturbances  Maternal pulmonary edema  Fetal Tachycardia  Dizziness

NURSING RESPONSIBILITY
 Assess pt. condition (mental status) before therapy.  Monitor possible drug induced adverse reactions.

DRUGS
Generic Name Mefenamic Acid Brand Name ISTAN Classification Analgesics, Antipyretics, Muscle Relaxants (NSAIDs) Dosage cap 500mg

ACTION
Aspirin-like drug that has analgesic, antipyretic & antiinflammatory activities. These activities appear to be due to its ability to inhibit cyclooxygenase & also antagonize certain effects of prostaglandins. Displays central & peripheral activities.

INDICATION
Relief of pain including muscular, rheumatic, traumatic, dental, post-operative & post-partum pain, headache, migraine, fever & dysmenorrhea. Therapy should not exceed 7 days.

CONTRAINDICATION Pregnancy & Lactation Hypersensitivity Active ulceration of lower or upper GI tract

ADVERSE EFFECTS
 GI discomfort:  Diarrhea  Constipation  Gas pain  Nausea  Vomiting  Drowsiness  Dizziness

NURSING RESPONSIBILITY
 Assess for pain: location, type, character, intensity.  Monitor possible drug induced adverse reactions.  Instruct pt. not to take drug for more than 7 days.  Advice pt. to immediately report persistence or failure to relieve pain.

DRUGS

ACTION

INDICATION
Vitamin K compounds are used in the treatment & prevention of hemorrhage associated with Vit. K deficiency.

CONTRAINDICATION Pronounced allergic diathesis Infants <1yr.

ADVERSE EFFECTS
 Hypotension  Cyanosis  Headache  Dizziness  Pruritic erythematosus plaques at IM site  Rash  Urticaria  Anaphylactic reactions

NURSING RESPONSIBILITY
 Assess pt. condition (mental status) before therapy & regularly thereafter to monitor drug effectiveness.  Assess for bleeding.  Monitor Pro-time during treatment to determine dosage effectiveness & possible drug induced adverse reactions.  Teach pt. necessary foods high in Vit.K to be included in the diet.  Caution pt. not to use OTC medications unless directed by the physician.  Advice pt. to avoid use of hard toothbrush, flossing, razors, & sharp objects until treatment is terminated.

Generic Name Synthetic analog Phytomenadione of Vit.K which is essential for Brand Name hepatic synthesis KONAKION of blood clotting factors II, VII, Classification IX & X. CV Drugs (Hemostatics) Dosage amp 10mg/1ml

DRUGS
Generic Name Ketorolac Brand Name KORTEZOR/ KETODOL Classification Analgesics, Antipyretics, Muscle Relaxants (NSAIDs) Dosage amp 30mg/1ml

ACTION
Analgesic, antiinflammatory & antipyretic. Inhibits prostaglandin synthesis by inhibition of cyclo-oxygenase enzyme. It also inhibits leukotriene synthesis, help stabilize lysosomal membranes & exert antibradykinin activity.

INDICATION
Ophthalmic: Treatment of allergic conjunctivitis & for prophylaxis & reduction of inflammation & associated symptoms following ocular surgery. Short-term management of moderate to severe acute postoperative pain.

CONTRAINDICATION Active peptic ulcer disease GI bleeding or perforation Moderate to severe renal impairment Hypovolemia Labor & Delivery Hypersensitivity to aspirin or NSAIDs

ADVERSE EFFECTS
 Ophthalmic: Transient stinging & burning on instillation, ocular irritation  Allergic reaction  GI ulceration, bleeding, perforation  Post-operative bleeding  Acute renal failure  Hypertension  Nausea  Dizziness  Sweating  Edema  Injection site pain

NURSING RESPONSIBILITY
 Assess pt.s pain before & 1hr after treatment: type, location, intensity & ROM.  Assess for hypersensitivity reactions.  Monitor possible drug induced adverse reactions.  Advice pt. to report persistence or worsening of pain.  Instruct pt. to use caution when driving because drowsiness & dizziness may occur.  Caution pt. that this drug may cause eye redness & burning if soft contact lenses are worn.

DRUGS

ACTION

INDICATION

CONTRAINDICATION

ADVERSE EFFECTS

NURSING RESPONSIBILITY

Generic Name Digoxin Brand Name LANOXIN Classification CV Drugs (Cardiac Glycosides) Dosage tab 0.25mg

Inhibits sodiumpotassium activated adenosine triphosphatase, thereby allowing influx of calcium into the intracellular space.

Chronic cardiac failure w/ atrial fibrillation Ventricular dilatation Supraventricular arrhythmias.

Hypersensitivity 2nd degree atrioventicular block especially w/ history of Stroke-Adams attack Hypertrophic obstructive cardiomyopathy

 Anorexia  Assess & document  GI disturbances apical pulse for 1full  CNS effects min before giving drug. If pulse <60bpm in  Atrial adult or <90bpm in an tachycardia infant or significantly  Gynecomastia different, reassess after 1hr, inform the physician.  Monitor cardiac status, electrolytes, renal function & ECG continuously during parenteral loading doses & w/ suspected toxicity.  Monitor possible drug induced adverse reactions.  Advise pt. to maintain a Na-restricted diet & take K supplements to prevent toxicity.

DRUGS

ACTION

INDICATION

CONTRAINDICATION

ADVERSE

NURSING

EFFECTS
Generic Name Furosemide Brand Name LASIX Classification CV Drugs (Loop Diuretics) Dosage tab 40mg Inhibits Na & Cl reabsorption at the proximal tubules, distal tubules & ascending loop of Henley leading to excretion of water together w/ Na, Cl, & K. Diuretic Antihypertensive Treatment of edema associated with CHF, hepatic cirrhosis, & renal disease, HPN. Hypersensitivity to sulfonylurea Anuria Orthostatic Hypotension Thrombophlebtis Chronic aortitis Vertigo Headache Dizziness Restlessness Fever Photosensitivity Urticaria Metabolic Alkalosis Muscle Spasm Weakness

RESPONSIBILITY
 Assess pt. condition (mental status) before therapy.  Assess fliud volume status, tinnitus, hearing loss.  Monitor VS, renal function, CNS, GI, & integumentary.  Instruct pt. to take w/ food or milk if GI symptom of nausea & anorexia occur.  Teach pt. to take record of own BP, PR & weight.  Advise pt. to wear protective clothing & sunscreen to prevent photosensitivity.  Instruct pt. to lie down when dizziness occurs.  Avoid sudden position changes to prevent Orthostatic HPN.

DRUGS
Generic Name Aluminum Hydroxide, Magnesium Hydroxide Brand Name MAALOX Classification GI Drugs (Antacids, Anti-reflux Agent, Antiulcerants) Dosage plain 1 tab

ACTION
Neutralizes gastric acidity thus reduces the total acid load of the GI tract. The elevated gastric pH reduces pepsin activity, strengthens gastric mucosal barrier & increases esophageal sphincter tone.

INDICATION
Peptic, Gastric, Duodenal ulcers; Hyperphosphatemia in chronic renal failure; reflux esophagilitis, hyperacidity, heartburn, stress ulcer prevention in critically ill, GERD.

CONTRAINDICATION Severe Debilitation Kidney Failure Hypophosphatemia Partial intestinal Obstruction Appendicitis Fecal Impaction Constipation

ADVERSE EFFECTS

NURSING RESPONSIBILITY

 Constipation  Assess pt.s discomfort  Diarrhea before therapy &  Stomach cramps regularly thereafter to  Fecal Impaction monitor drug effectiveness.  N/V  Hypophosphatemia  Assess pain symptoms.  Hypomagnesemia  Monitor for possible  Intestinal drug induced adverse Obstruction in reactions larger doses  Instruct pt. to increase fluids to 2000mL/day unless contraindicated.  Instruct to avoid phosphate-containing foods.  Instruct pt. that the stools may appear white or speckled, constipation may result.  Instruct pt. to separate other medications by 2hrs.

DRUGS
Generic Name Eperisone HCl Brand Name MYONAL Classification GI Drugs (Antispasmodic) Dosage 1tab 50mg

ACTION
Acts by relaxing both skeletal muscles & vascular smooth muscles. Demonstrates a variety of effects such as reduction of myotomia, improvement of circulation, & suppression of the pain reflex.

INDICATION
Spastic Paralysis in cerebrovascular disease; Improvement of muscular hypertonic symptoms in conditions such as cervical syndrome, lumbago.

CONTRAINDICATION Hypersensitivity Pregnancy & Lactation

ADVERSE EFFECTS

NURSING RESPONSIBILITY

 Shock  Monitor for renal  Anaphylactic function. reactions  Advise pt. to report  Steven Johnson adverse reactions. syndrome  Caution pt. to avoid  Toxic hazardous activities like Epidermal driving or using Necrosis machinery.  Anemia  Sleepiness  Headache  N/V  Anorexia  Abdominal Pain  Urinary retention

DRUGS
Generic Name Brand Name

ACTION

INDICATION

CONTRAINDICATION

ADVERSE EFFECTS

NURSING RESPONSIBILITY

Classification Dosage