Drug Study On Emergency Drugs
Drug Study On Emergency Drugs
Drug Study On Emergency Drugs
SUITOS, SN
Arellano University – 0900252
College of Nursing – Batch 2011
III – Muscarinics / Group 64
1) AMINOPHYLLINE
2) AMIODARONE HYDROCHLORIDE
Brand Names: Anoion tab Cordarone Cordarone inj Sandoz Amiodarone HCl tab
Classification: Cardiac Drugs
Dosage: PO Initial: 200 mg 3 times/day for 1 wk, reduce to 200 mg twice daily for a further wk. Maintenance: 200
mg/day or lowest effective dose. IV Initial: 5 mg/kg infusion via central venous catheter. Max: 1.2 g/24 hr.
Indication: Ventricular and supraventricular arrhythmias.
Action: Blocks potassium chloride leading to prolongation of action potential duration.
Adverse Reactions: Blue-grey discoloration of skin, photosensitivity, peripheral neuropathy, paraesthesia,
myopathy, ataxia, tremor, nausea, vomiting, metallic taste, hypothyroidism, hyperthyroidism, alopecia, sleep
disturbances, corneal microdeposits, hot flushes, sweating. Heart block, bradycardia, sinus arrest, hepatotoxicity,
heart failure. Potentially Fatal: Pulmonary toxicity including pulmonary fibrosis and interstitial pneumonitis,
hepatotoxicity, thyrotoxicity. Ventricular arrhythmias, pulmonary alveolitis, exacerbation of arrhythmias and rare
serious liver injury. Generally in patients with high doses and having preexisting abnormalities of diffusion capacity.
Nursing Measures:
• Monitor cardiac rhythm continuously.
• Monitor for an extended period when dosage adjustments are made.
• Monitor for safe and effective serum levels (0.5–2.5 mcg/mL).
• Doses of digoxin, quinidine, procainamide, phenytoin, and warfarin may need to be reduced one-third to one-half
when amiodarone is started.
• Give drug with meals to decrease GI problems.
• Arrange for ophthalmologic exams; reevaluate at any sign of optic neuropathy.
• Arrange for periodic chest x-ray to evaluate pulmonary status (every 3–6 mo).
• Arrange for regular periodic blood tests for liver enzymes, thyroid hormone levels.
• Drug dosage will be changed in relation to response of arrhythmias; you will need to be hospitalized during
initiation of drug therapy; you will be closely monitored when dosage is changed.
• Have regular medical follow-up, monitoring of cardiac rhythm, chest x-ray, eye exam, blood tests.
• These side effects may occur: Changes in vision (halos, dry eyes, sensitivity to light; wear sunglasses, monitor
light exposure); nausea, vomiting, loss of appetite (take with meals; eat small, frequent meals); sensitivity to the
sun (use a sunscreen or protective clothing when outdoors); constipation (a laxative may be ordered); tremors,
twitching, dizziness, loss of coordination (do not drive, operate dangerous machinery, or undertake tasks that
require coordination until drug effects stabilize and your body adjusts to it).
• Report unusual bleeding or bruising; fever, chills; intolerance to heat or cold; shortness of breath, difficulty
breathing, cough; swelling of ankles or fingers; palpitations; difficulty with vision.
3) ATROPINE SULFATE
Brand Names: Anespin amp Atropol amp Euro-Med Atropine Sulfate amp Isopto Atropine eye drops Phil
Pharmawealth/Atlantic Atropine amp
Classification: Other Cardiovascular Drugs, Muscle Relaxants, Mydriatic Drugs, Antidotes, Detoxifying Agents &
Drugs Used in Substance Dependence
Indication/Dosage: IV Bradycardia 500 mcg every 3-5 mins. Total: 3 mg. IV/IM Organophosphorus poisoning 2
mg every 10-30 mins until muscarinic effects disappear or atropine toxicity appears. IM/SC Premed in anesth 300-
600 mcg 30-60 mins before anesth. IV/IM/SC Overdosage w/ other compd having muscarinic actions 0.6-1 mg,
repeat 2 hrly. Ophth Inflammatory eye disorders As 0.5-1% soln: 1-2 drops 4 times/day. Eye refraction As 1% soln:
1 drop twice daily for 1-2 days before procedure.
Action: An anti-cholinergic that inhibits acetylcholine at the parasympathetic neuroeffector junction, enhances the
conduction of AV node and increases heart rate
Adverse Reactions: Dry mouth, dysphagia, constipation, flushing and dryness of skin, tachycardia, palpitations,
arrhythmias, mydriasis, photophobia, cycloplegia, raised intraocular pressure. Toxic doses cause tachycardia,
hyperpyrexia, restlessness, confusion, excitement, hallucinations, delirium and may progress to circulatory failure
and respiratory depression. Eye drops: Systemic toxicity especially in children, on prolonged use may lead to
irritation, hyperemia, edema and conjunctivitis. Increased intraocular pressure. Inhalation: Dryness of mouth,
throat. Potentially Fatal: Atrial arrhythmias, AV dissociation, multiple ventricular ectopics.
Nursing Measures:
• Ensure adequate hydration; provide environmental control (temperature) to prevent hyperpyrexia.
• Have patient void before taking medication if urinary retention is a problem.
• When used preoperatively or in other acute situations, incorporate teaching about the drug with teaching about the
procedure; the ophthalmic solution is used mainly acutely and will not be self-administered by the patient; the
following apply to oral medication for outpatients:
• Take as prescribed, 30 min before meals; avoid excessive dosage.
• Avoid hot environments; you will be heat intolerant, and dangerous reactions may occur.
• These side effects may occur: Dizziness, confusion (use caution driving or performing hazardous tasks);
constipation (ensure adequate fluid intake, proper diet); dry mouth (suck sugarless lozenges; perform frequent
mouth care; may be transient); blurred vision, sensitivity to light (reversible; avoid tasks that require acute vision;
wear sunglasses in bright light); impotence (reversible); difficulty in urination (empty the bladder prior to taking
drug).
• Report rash; flushing; eye pain; difficulty breathing; tremors, loss of coordination; irregular heartbeat, palpitations;
headache; abdominal distention; hallucinations; severe or persistent dry mouth; difficulty swallowing; difficulty in
urination; constipation; sensitivity to light.
4) BUMETANIDE
6) CAPTOPRIL
Brand Names: Ace-Bloc tab Capomed tab Capotec tab Capoten tab Captor tab Captril tab Cardiovaz tab
Conamid tab Hartylox tab Normil tab Phil Pharmawealth/Panion & BF Captopril tab Prelat tab Primace tab
Retensin tab Spec-Ace tab Tensoril tab Unihype tab Vasostad tab
Classification: ACE Inhibitors
Indication/Dosage: PO HTN Initial: 12.5 mg twice daily. Maintenance: 25-50 mg twice daily. Max: 50 mg 3
times/day. Heart failure Initial: 6.25-12.5 mg 2-3 times/day. Max: 50 mg 3 times/day. Post MI Start 3 days after MI.
Initial: 6.25 mg/day, may increase after several wk to 150 mg/day in divided doses if needed and tolerated. HTN in
diabetic nephropathy 75-100 mg/day in divided doses.
Action: inhibits ACE, reduces Sodium and water retention, lowers blood pressure
Adverse Reactions: Hypotension, tachycardia, chest pain, palpitations, pruritus, hyperkalaemia. Proteinuria;
angioedema, skin rashes; taste disturbance, nonproductive cough, headache. Potentially Fatal: Neutropenia,
usually occurs within 3 mth of starting therapy especially in patients with renal dysfunction or collagen diseases.
Hyperkalaemia. Anaphylactic reactions.
Nursing Measures:
• Administer 1 hr before or 2 hr after meals.
• Alert surgeon and mark patient's chart with notice that captopril is being taken; the angiotensin II formation
subsequent to compensatory renin release during surgery will be blocked; hypotension may be reversed with
volume expansion.
• Monitor patient closely for fall in BP secondary to reduction in fluid volume (excessive perspiration and
dehydration, vomiting, diarrhea); excessive hypotension may occur.
• Reduce dosage in patients with impaired renal function.
• Take drug 1 hr before or 2 hr after meals; do not take with food. Do not stop without consulting your health care
provider.
• Be careful of drop in blood pressure (occurs most often with diarrhea, sweating, vomiting, dehydration); if light-
headedness or dizziness occurs, consult your health care provider.
• Avoid over-the-counter medications, especially cough, cold, allergy medications that may contain ingredients that
will interact with ACE inhibitors. Consult your health care provider.
• These side effects may occur: GI upset, loss of appetite, change in taste perception (limited effects, will pass);
mouth sores (perform frequent mouth care); rash; fast heart rate; dizziness, light-headedness (usually passes
after the first few days; change position slowly, and limit your activities to those that do not require alertness and
precision).
• Report mouth sores; sore throat, fever, chills; swelling of the hands, feet; irregular heartbeat, chest pains; swelling
of the face, eyes, lips, tongue, difficulty breathing.
7) CLONIDINE
8) DIAZEPAM
9) DIGOXIN
10) DIPENHYDRAMINE
11) EPINEPHRINE
Brand name:
Epinephrine Bitartrate
Aerosols: Primatene Mist
Epinephrine Borate
Ophthalmic solution: Epinal
Epinephrine Hydrochloride
Injection, OTC nasal solution: Adrenalin Chloride
Ophthalmic solution: Epifrin, Glaucon
Insect sting emergencies: EpiPen Auto-Injector (delivers 0.3 mg IM adult dose), EpiPen Jr. Auto-Injector (delivers
0.15 mg IM for children)
OTC solutions for nebulization: AsthmaNefrin, microNefrin, Nephron, S2
Classification: Sympathomimetic, Alpha-adrenergic agonist, Beta1and beta2-adrenergic agonist, Cardiac
stimulant, Vasopressor, Bronchodilator, Antasthmatic drug, Nasal decongestant, Mydriatic, Antiglaucoma drug
Dosage: 1mg/ml
Indication: Acute asthmatic attacks, Advanced cardiac life support
Action: Naturally occurring neurotransmitter, the effects of which are mediated by alpha or beta receptors in target
organs. Effects on alpha receptors include vasoconstriction, contraction of dilator muscles of iris. Effects on beta
receptors include positive chronotropic and inotropic effects on the heart (beta1 receptors); bronchodilation,
vasodilation, and uterine relaxation (beta2 receptors); decreased production of aqueous humor.
Adverse Reaction: drowsiness, headache, nervousness, tremors, cerebral hemorrhage, dizziness, weakness,
vertigo, pain
Nursing Measures:
• Monitor heart rate.
• Use extreme caution when calculating and preparing doses; epinephrine is a very potent drug; small errors in
dosage can cause serious adverse effects. Double-check pediatric dosage.
• Use minimal doses for minimal periods of time; "epinephrine-fastness" (a form of drug tolerance) can occur with
prolonged use.
• Protect drug solutions from light, extreme heat, and freezing; do not use pink or brown solutions. Drug solutions
should be clear and colorless (does not apply to suspension for injection).
• Shake the suspension for injection well before withdrawing the dose.
• Rotate SC injection sites to prevent necrosis; monitor injection sites frequently.
• Keep a rapidly acting alpha-adrenergic blocker (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, such as atenolol, should be used in
patients with respiratory distress) readily available in 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 3–5 days, and do not exceed
recommended dosage. Rebound nasal congestion can occur after vasoconstriction subsides.
• Do not exceed recommended dosage; adverse effects or loss of effectiveness may result. Read the instructions
that come with respiratory inhalant products, and consult your health care provider or pharmacist if you have any
questions.
• To give eye drops: Lie down or tilt head backward, and look up. Hold dropper above eye; drop medicine inside
lower lid while looking up. Do not touch dropper to eye, fingers, or any surface. Release lower lid; keep eye open,
and do not blink for at least 30 sec. Apply gentle pressure with fingers to inside corner of the eye for about 1 min;
wait at least 5 min before using other eye drops.
• These side effects may occur: Dizziness, drowsiness, fatigue, apprehension (use caution if driving or performing
tasks that require alertness); anxiety, emotional changes; nausea, vomiting, change in taste (eat frequent small
meals); fast heart rate. Nasal solution may cause burning or stinging when first used (transient). Ophthalmic
solution may cause slight stinging when first used (transient); headache or brow ache (only during the first few
days).
• Report chest pain, dizziness, insomnia, weakness, tremor or irregular heart beat (respiratory inhalant, nasal
solution), difficulty breathing, productive cough, failure to respond to usual dosage (respiratory inhalant), decrease
in visual acuity (ophthalmic).
12) FUROSEMIDE
19) METOCLOPRAMIDE
Brand name: Apo-Metoclop (CAN), Maxeran (CAN), Maxolon, Nu-Metoclopramide (CAN), Octamide PFS, Reglan
Classification: antiemetic & anti-spasmodic
Dosage: 10 mg/ 2mL
Indication: disturbances of GI motility, nausea & vomiting of central & peripheral origin associated w/ surgery,
metabolic diseases, infectious & drug induced diseases, facilitate small bowel intubation & radiological procedures
of GIT
Action: stimulates motility of upper GI tract, increases lower esophageal sphincter tone, and blocks dopamine
receptors at the chemoreceptor trigger zone
Adverse Reactions: extrapyramidal reactions, drowsiness, fatigue & lassitude, anxiety, less frequently, insomnia,
headache, dizziness, nausea, galactorrhea, gynecomastia, bowel disturbances.
Nursing Measures:
• Monitor BP carefully during IV administration.
• Monitor for extrapyramidal reactions, and consult physician if they occur.
• Monitor diabetic patients, arrange for alteration in insulin dose or timing if diabetic control is compromised by
alterations in timing of food absorption.
• Keep diphenhydramine injection readily available in case extrapyramidal reactions occur (50 mg IM).
• Have phentolamine readily available in case of hypertensive crisis (most likely to occur with undiagnosed
pheochromocytoma).
24) PARACETAMOL