DRUGS

INDICATIONS

ACTIONS

Date Ordered: Generic Name: Amiodarone hydrochloride Brand Name: Cordarone Classification: Antiarrhythmic, class III Dosage: 50 mg/ml amp Route: Frequency:

 Cardiac arrhythmias: Supraventricular arrhyth mias, junctional arrhythmias; ventricular arrhythmias: Paroxysmal tachycardia, extrasystoles, ventricularflutter & fibrillation.

Blocks sodium channels at rapid pacing frequencies, causing an increase in the duration of the myocardial cell action potential and refractory period, as well as alpha- and betaadrenergic blockade

SIDE EFFECTS/ADVERSE EFFECTS  Reversible corneal microdeposits; hyper or hypothyroidism. Bradycardia, nausea, superficial phlebitis, elevated serum transferases, transient fall in BP. Rarely, photosensitization & pigmentation, reversible diffuse interstitial pneumopathy or peripheral neuropathy.

NURSING CONSIDERATIONS  Correct potassium or Mg deficiencies before initiation of therapy since antiarrhythmics may be ineffective  When initiating amiodarone therapy, gradually discontinue other antiarrhythmic drugs  To minimize side effects, determine the lowest effective dose  Store the injection at room temperature protected from light

PATIENT TEACHING

 Avoid direct exposure to sunlight  Report if crystals develop on the skin, producing a bluish color, so dosage can be adjusted  Complaints of painful breathing, wheezing, fever, coughing, or SOB are S & S of pulmonary problems and require prompt attention  Report all side effects, especially abnormal swelling, bleeding, or bruising

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INDICATIONS

ACTIONS

Date Ordered: Generic Name: Atropine Sulfate Brand Name:

 Bradycardia  Organophosphor us poisoning

Classification: Cholinergic blocking drug Dosage: 1mg amp Route: Frequency:

Atropine is an anticholinergic agent which competitively blocks the muscarinic receptors in peripheral tissues such as the heart, intestines, bronchial muscles, iris and secretory glands. Some central stimulation may occur. Atropine abolishes bradycardia and reduces heart block due to vagal activity. Smooth muscles in the bronchi and gut are relaxed while glandular secretions are reduced. It also has mydriatic and cycloplegic effect.

SIDE NURSING CONSIDERATIONS EFFECTS/ADVERSE EFFECTS  Dry mouth, dysphagia,  Have the patient void first constipation, flushing before administration and dryness of skin,  Ensure adequate hydration tachycardia,  Avoid excessive dosages palpitations,  Have physostigmine available arrhythmias, in the event of overdose mydriasis, photophobia, cycloplegia, raised intraocular pressure.

PATIENT TEACHING

 Review indications for drug use, frequency of use and route of administration  Increase fluids and add bulk to diet to ensure hydration and diminish constipating effects  Drug inhibits salivation use sugarless candies and gums to decrease dry mouth symptoms

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INDICATIONS

ACTIONS

Date Ordered: Generic Name: Calcium Gluconate Brand Name: Euromed/B.Brau n Classification: Electrolytes Dosage: 10 mL of 10% soln Route: Frequency:

 For hypocalcemic. severe hyperkalaemia and antidote in severe hypermagnesaem ia

Calcium gluconate is used to prevent or treat negative calcium balance. It also helps facilitate nerve and muscle performance as well as normal cardiac function.

SIDE EFFECTS/ADVERSE EFFECTS  GI irritation; softtissue calcification, skin sloughing or necrosis after IM/SC inj. Hypercalcaemia characterised by anorexia, nausea, vomiting, constipation, abdominal pain, muscle weakness, mental disturbances, polydipsia, polyuria, nephrocalcinosis, renal calculi; chalky taste, hot flushes and peripheral vasodilation.

NURSING CONSIDERATIONS

PATIENT TEACHING

 If a precipitate is noted in the syringe, do not use  Give by intermittent IV infusion at a rate not exceeding 200 mg/min.

 Tell patient to take oral calcium 1 to 11/2 hours after meals if GI upset occurs.

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INDICATIONS

ACTIONS

Date Ordered: Generic Name: Chlorpheniramin e Brand Name: Antamin Classification: Antihistamines & Antiallergics Dosage: 10 mg amp Route: Frequency:

 Allergy, allergic rhinitis, bronchia l asthma, vasomot or rhinitis, dermatoses of allergic etiology, urticari a, drug sensitization, ser um sickness,anaphyl actic shock, insect bites.

Competes with histamine for H1receptor site on effector cells; decreases allergic response by blocking histamine

SIDE EFFECTS/ADVERSE EFFECTS  Sedation, lassitude, elation or depression, irritability, paranoid psychosis, delusion, hallucination. Muscular weakness, incoordination. GIT disturbances. Headache, tinnitus. Difficulty in micturition. CV effects.

NURSING CONSIDERATIONS

PATIENT TEACHING

 Monitor I & O  Assess symptoms of allergy  Assess respiratory status

 Do not exceed to prescribed dose  Take as directed

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INDICATIONS

ACTIONS

Date Ordered: Generic Name: Dexamethasone Brand Name: Scancortin Classification: Glucocorticoid Dosage: 5mg amp Route: Frequency:

 Suppression of inflammatory & allergic disorders; diagnosis of Cushing's disease, congenit al adrenal hyperplasia; cere bral edema; nausea & vomiting w/ chemotherapy; rh eumatic disease.

Dexamethasone is a synthetic glucocorticoid which decreases inflammation by inhibiting the migration of leukocytes and reversal of increased capillary permeability. It suppresses normal immune response.

SIDE EFFECTS/ADVERSE EFFECTS  Fluid & electrolyte retention, increased susceptibility to infection; growth retardation; Cushingoid states; amenorrhea; hyperhidrosis, mental disturbances; intracranial hypertension; acute pancreatitis; aseptic osteonecrosis.

NURSING CONSIDERATIONS

PATIENT TEACHING

 Monitor cardiac status  Note indications for therapy, characteristics of S&S, onset/contact, other agents traialed and outcome. Document/monitor BP, weight, mental status, serum glucose and electrolytes

 Use exactly as directed; do not exceed dose and do not stop abruptly unless ordered  May take with food to decrease upset  Report adverse effects, lack/loss of response, worsening of symptoms, excessive thirst and urinary frequency.

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INDICATIONS

ACTIONS

Date Ordered: Generic Name: Diazepam Brand Name: Valium Classification: Inotropics Dosage: 10 mg amp

 Anxiety, adjunct treatment for seizure disorders, status epilepticus, severe recurrent seizure, acute alcohol withdrawal, muscle spasm, preoperative sedation

A benzodiazepine that probably potentiates the effects of GABA, depressed the CNS and suppresses the spread of seizure activity

SIDE EFFECTS/ADVERSE EFFECTS  Paradoxical reactions, dependence withdrawal symptoms, blurring of vision

NURSING CONSIDERATIONS  When using oral solution, dilute dose just before giving  Monitor periodic hepatic, renal and hepatopoietic function studies in patient receiving repeated or prolonged therapy  Monitor elderly patients for dizziness, ataxia, mental status changes. Pts are at inc. risk for fall  Alert: Use of this drug may lead to abuse and addiction. Dont withdraw drug abruptly after long term use; withdrawal symptoms may occur.

PATIENT TEACHING

Route: Frequency:

 Warn pt to avoid activities that requires alertness and good coordination until effects of the drug are knwon  Tell patient to avoid alcohol while taking drug  Notify pt that smoking may decrease drugs effectiveness  Warn pt not to abruptly stop drug because withdrawal symptoms may occur.  Warn woman to avoid use during pregnancy

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INDICATIONS

ACTIONS

Date Ordered: Generic Name: Digoxin Brand Name: Lanoxin Classification: Inotropics Dosage: 500 mcg amp Route:
IV

 Heart failure, paroxysmal supraventricul ar tachycardia, atrial fibrillation and flutter

Ketorolac inhibits prostaglandin synthesis by decreasing the activity of the cyclooxygenase enzyme.

SIDE EFFECTS/ADVERSE EFFECTS  Dizziness, pain, fatigue, nausea and vomiting, mental confusion, bad dreams, anorexia, headache, drowsiness, disorientation

NURSING CONSIDERATIONS

PATIENT TEACHING

Frequency:

 Drug induced arrhythmias may increase the severity of the heart failure and hypotension  In children, cardiac arrhythmias, including sinus bradycardia, are usually early signs of toxicity  Monitor potassium level carefully. Take corrective action before hypokalemia occurs. Hyperkalemia may result from digoxin toxicity.  Pts with hypothyroidism are extremely sensitive to cardiac glycosides and may need lower doses.  Before giving loading dose, obtain baseline data (heart rate and rhythm, BP and electrolytes) and ask pt about use of cardiac glycosides within the previous 2 to 3 weeks

 Encourage pt to eat potassium-rich foods  Instruct pt to report adverse reactions promptly. Nausea, vomiting, diarrhea, appetite loss and visual disturbances may be indicators of toxicity  Tell pt to report pulse less than 60 bpm or more than 110 bpm or skipped beats or other rhythm changes  Stress importance of followup testing as directed by prescriber.