Hematologic & Immune System Medications

CLASSIFICATION
NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS
AND !ATIENT
EDUCATION
Cyto"an
Antineoplastic,
immunosuppressa
nts
Death of rapidly
replicating malignant
cells.
or prevent an immune
response and suppress
the immune system
Cancers, lymphomas,
myelomas, leukemias.
Prevent organ transplant
rejection.
Tx for autoimmune
diseases
! suppression"
#pancytopenia$,
%&'&D, hepatotoxic,
alopecia, cardio(
pulmo. fi)rosis
*x for infection.
*x for hemorrhage
!onitor '+
!onitor kidney fx
#, fluids$
Take meds -&
meals.
Folic Acid
Antianemic,
vitamin
!aintains and restores
normal erythropoiesis.
Prevention and Tx of
megalo)lastic anemias.
During pregnancy"
promotes normal fetal
gro-th. Prevent %TD.
Allergic *x
*ashes
fever
!onitor folate and
./ levels
0 1 0
2ncourage to eat
foods , in 3olic
acid"
#veggies, organ
meats$
Cyanoco#alamin
e
$%it& '()*
Antianemic,
vitamin
Corrects manifestations
of pernicious anemia.
#!egalo)lastic anemia,
45 lesions, and neuro
damage$
'it../ deficiency, to
meet demands.
Confirmed -& +chilling
Anaphylaxis
Diarrhea
5tching
0ypokalemia
Pain at inj. site
4iven 5!
6ife(long
medication
4ive -& meals
2ncourage to eat
animal products
Fe++ous Sul,ate
5ron supplement,
antianemic
Prevent and Tx iron
deficiency.
%eed for hemoglo)in
formation.
Prevent and Tx iron
deficiency anemia.
45 upset #constipation,
dk stools$,
hypotension,
+ei7ures, stains teeth
#P8$ or skin #5!$,
Anaphylaxis
Assess )o-el fx9
dk stool #( occult
)ld$
!onitor P and
0*9 010
2ncourage to eat
gr. leafy veggies
and organ meats9
take -& 8: to ,
a)sorp.
P8" ;se stra-9 <(
track 5!
Lo-eno"
#2noxaprin$
Anticoagulant,
lo- molecular
heparin
Prophylactic&
Prevention of further
throm)us #clot$
formation.
D'T,
P2( throm)oem)oli,
ischemic complications9
(prevents clots, especially in
immobile patients).
leeding, anemia,
throm)ocytopenia,
di77iness, 0A,
constipation, %&'
Assess s&s of
)leeding and
hemorrhage
Assess nuero 1
pulmonary fx
!onitor CC
Antidote"
!+otamine sul,ate
E.ogen
#2rythropoetin$
0ormone,antiane
mic
!aintains and may
elevate *Cs
Tx of anemia assoc. -&
renal failure or A5D+
therapy.
0T%, arthralgias,
fatigue, 0A,
+25<;*2+
!onitor P, CC
2ncourage foods ,
in iron
.
ast+ointestinal System Medications
CLASSIFICATION
NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS AND
!ATIENT EDUCATION
Lactulose
8smotic, laxative
, -ater content and
softens the stool.
p0 of colon= %0>
Tx of chronic
constipation
!anagement of
hepatic
encephalopathy.
elching, cramps,
distention,
flatulence, diarrhea,
hyperglucemia
Assess a)dominal
distention, )o-el sounds,
stools
!onitor mental status,
4, %0>
Take -& fruit juice
Desmo.+essin
#DDA'P$
0ormone,
antidiuretic &
vasopressin
Controls )leeding in
hemophilia.
Prevents nocturnal
enuresis
!aintains approp.
-ater content in
Dia)etes 5nsip.
Controls )leeding in
hemophilia
!anagement of
nocturnal enuresis9
Tx of D.5.
Dro-siness,
pharyngitis, dry
mouth, anaphylaxis
Assess allergy symptoms,
lung sounds and )ronchial
secretions
!aintain fluid intake
.?@@(/@@@ ml&day
Avoid 28T0
Neomycin
#Aminoglycosides$
Anti(infectives
acterialcidal action.
Po-erful anti)iotics
used to treat serious
infections caused )y
gram #($ )acteria
To suppress 45
)acteria= %0>
=preventing hepatic
coma.
Tx for skin -ounds
and infections
8totoxicity,
nephrotoxicity,
hypomagnesium,
muscle paralysis,
hypersensitivity
+hort(term 5' or 5!
Assess for infection, 5&8,
daily -eight,
0earing loss
!onitor mental status,
renal fx
/antac
$Ranitidine*
Tagamet
$Cimetidine*
Antiulcer agents,
histamine 0/
antagonist
0ealing and preventing
ulcers. symptoms of
42* and secretions of
gastric acid.
Prevents acid
inactivation of
pancreatic en7ymes.
42*D, multiple
peptic ulcers.
Prevent and Tx
heart)urn, acid
indigestion, sour
stomach
Confusions, 0A,
di77iness,
arrhythmias,
impotence,
gynecomastia,
throm)ocytopenia
Take meds )efore meals
and )edtime
DonAt stop taking meds
a)ruptly
%o 28T0 or other C%+
depressants
Avoid taking meds
antacids
*educe stress and help
heal ulcers
Assess a)dominal pain,
occult )lood,
!onitor CC
/
Neu+ological System Medications
CLASSIFICATION
NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS
AND !ATIENT
EDUCATION
Rilu0ole
$Rilute1*
4lutamate
antagonist
2xact mechanism of
action in A6+ is
unkno-n.
+lo-s the deterioration
of motor neurons )y
counteracting the
excitatory
glutaminergic
path-ays.
+lo-s the progress
of Amyotrophic
6ateral +clerosis.
!ay delay the need
for a tracheostomy,
not a cure for A6+.
Di77iness, tiredness,
upset stomach, stomach
pain, diarrhea,
muscle -eakness or
aches, anorexia, 0A
!onitor liver function"
, liver en7ymes.
!onitor BC.
Take on an empty
stomach #. hour
)efore or / hours after
meals$. Avoid drinking
or eating a lot of
caffeine. Avoid eating
charcoal()roiled
foods.
!+ostigmin
$neostigmine*
Anticholinesteras
e
Antimyasthenics,
cholinergics
Provide symptomatic
relief )y , concent. 8f
availa)le Ach at
neuromuscular junction
= , muscle fx.
5mproved )ladder(
emptying in pt -ith
urinary retention.
5mprovement in
muscle strength in
!4.
Prevention and Tx
of post(op )ladder
distention and
urinary retention or
ileus.
+25<;*2+, di77iness ,
)ronchospasm, n&v&d,
C+ secretions,
)radycardia, a)dominal
cramps, hypotension
Assess '+,
neuromuscular status.
Assess for under&over(
dosage #cholinergic
crisis$. ;se Tensilon
test to distinguish.
!onitor a)domen&
)ladder status, 5&8,
Maintain sta#le
#lood le-els o, Ac2
med& i-e ON TIME
& 34 ,ood
Tensilon
#Ed+o.2onium Cl$
Anticholinesterase
+tops )reakdo-n of
Ach=, Ach
availa)ility.
Tensilon is given 5'
/mg (.@mg. After
D@sec facialE.F
-eakness resolves and
ptosis in ?min.
Immediate
im.+o-ement5
.ositi-e test &
con,i+ms d"&
Diagnostic test for
myasthenia gravis.
ecause )rief
duration of action,
itAs not
recommended for
maintenance
therapy in !4.
+25<;*2+, Capillary
constriction, diplopia,
laryngospasm,
arrhythmias, t-itching,
C8= hypotension,
a)dominal cramps,
%&'&D, urinary freF.
8)serve for severe
cholinergic reaction
#stop meds$.
!yasthenic crisis #,
meds$ 8)served for
)radycardia or cardiac
standstill and
cholinergic reactions if
an overdose is given.
4ive At+o.ine @.> mg
to control s&e of
Tensilon #)radycardia,
s-eating, cramps$
D
'aclo,en
Antispasticity
agents, skeletal
muscle relaxants
5nhi)its reflexes at
spinal level.
muscle spasticity9
)o-el and )ladder fx
may also )e improved.
Tx of reversi)le
spasticity due to
!+ or spinal cord
lesion
+25<;*2+,
dro-siness, di77iness,
fatigue, confusion, 0A,
edema, hypotension,
nausea, constipation,
hyperglycemia, ataxia
Assess muscle
spasticity.
8)serve for adverse
effects.
!onitor 4 and liver
en7ymes.
Administer -& milk or
food to gastric
irritation.
Le-odo.a
Antiparkinson
agent, Dopamine
agonist
*elief of tremor and
rigidity in ParkinsonAs
syndrome.
Converts to dopamine
in C%+, serves as
neurotransm.
#, dopamine$
ParkinsonAs disease.
%ot useful for drug(
induced 2P+.
Dyskinesia, involuntary
movements, anxiety,
di77iness, )lurred
vision, %&', anorexia,
dry mouth, hemolytic
anemia, BC
Assess parkinsonian
symptoms
Assess P and pulse
freF.
4ive -ith meals
!onitor )o-el fx
!onitor 5&8
!onitor hepatic and
renal fx
Neu+ological System Medications
CLASSIFICATION
NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS
AND !ATIENT
EDUCATION
Symmet+el
Antiparkinson
agent, antiviral
Antiviral that 6 t2e
+elease o, do.amine&
*elief of parkinsonian
symptoms.
Prevent and Tx
influen7a A
+ymptomatic initial
and adjunct Tx of
ParkinsonAs disease.
Prophylaxis and Tx
of influen7a A viral
infections
Confusion, ataxia,
di77iness, insomnia,
)lurred vision,
hypotension, mottling.
!onitor )lood
pressure freF. #80$
!onitor 5&8
!onitor '+ and
mental status.
Do not give close to
)edtime
'eta Inte+,e+ons
Avonex, *e)if
#interferone )eat(
.a$
etaseron
#interferon )eta(
.)$
interferons,
Anti(!+ agents
Anti viral and
immunoregulatory
properties = T(cell
proliferation.
incidence of relapse
#neurologic
dysfunction$ and slo-
physical disa)ility.
!ultiple +clerosis 3lu(like symptoms,
sei7ures, 0A, mental
depression, -eakness,
%&'&D, conjunctivitis,
s-eating,
photosensitivity,
neutropenia,
injection(site reaction
#-& )eta(.)$, myalgia,
chills, fever, pain
Assess freF. of
exacer)ations of !+.
!onitor for signs of
depression.
!onitor 0g), BC,
platelets, and )lood
chemistry and liver
function.
!ay give analgesic for
flu(like symptoms.
Take measures to
prevent
photosensitivity
reactions.
>
enitou+ina+y System Medications
CLASSIFICATIO
N NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS AND
!ATIENT EDUCATION
DIURETICS
Loo. Diu+etics
3urosemide
#6asix$
umetanide
#umex$
2thacrynic acid
#2decrin$
5nhi)it sodium 1
chloride rea)sorption
from loop of 0enle and
distal renal tu)ule.
, renal excretion of
0/8, %a, Cl, !g, 0, and
Ca.
,'asodilation=periph
eral resistance=P
2dema associated
-ith"
C03
0epatic or
renal
disease
Adjunct therapy
for control of
0T%.
Di77iness, 0A, tinnitus,
hypotension, %&'&D,
constipation, dehydration,
hypokalemia,
hyperglycemia,
hyperuricemia,
neutropenia,
agranulocytosis, cramps,
Throm)ocytopenia,
spasms
!onitor '+ #P 1 P$
and fluid status freF.
!onitor daily -eight,
5&8, serum electrolyte
values.
Assess edema #amount
1 location$, lung
sounds, skin turgor,
mucous mem)ranes.
!onitor potassium
levels #D.?(?.@$.
!onitor )lood glucose
#.@@ mg&d6$
(in loop&thia7ide
diuretics.
!otassium7
s.a+ing
Diu+etics
+pironolactone
#Aldactone$
Amiloride
#!idamor$
Triamterene
#Dyrenium$
Beak diuretic and
antihypertensive.
locks effects of
aldosterone in renal
tu)ule, causing loss of
%a and 0/8 and
retention of potassium.
Prevents
hypokalemia
caused )y other
diuretics.
;sed -ith other
diuretics to treat
edema or 0T%.
Spironolactone:
0yperaldosteronis
m. !anagement of
C03.
Di77iness, 0A, cramps,
%&'&D, urinary freFuency,
-eakness, hyperkalemia.
Spironolactone:
Clumsiness,
gynecomastia, amenorrhea
Change position slo-ly
to prevent 80.
5f receiving digoxin,
-atch for digitalis
toxicity.
, foods high in
potassium #)ananas,
oranges, potatoes, meat,
fish, raisins$
Take in A! to avoid
sleep distur).
?
Osmotic
Diu+etics
!annitol
#8smitrol,
*esectisol$
Pulls -ater into )lood
vessels and nephrons
from surrounding
tissues= inhi)its
rea)sorption of
0/8 and electrolyes,
along -ith toxins from
kidney.
Adjunct tx of "
8 acute oliguric
renal
failure
8 edema
8 ,5CP or
intraocular
pressure
8 excretion of
toxic su)stances.
Confusion, 0A,
hypotension, rash, nausea,
anorexia, dry mouth,
thirst, diuresis,fluid and
electrolyte im)alances.
*eport to !D" rapid
0* or syncope, -eight
gain /l)s or more.
*eport adverse effects"
%&'&D
0ypokalemia #muscle
-eakness 1 t-itching,
lethargy, irregular
pulse$
enitou+ina+y System Medications
CLASSIFICATIO
N NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS AND
!ATIENT EDUCATION
!2os.2ate
'inde+s
Se-elame+
#*enagel$
electrolyte
modifiers
inds -ith phosphate
in the 45 tract,
preventing its
a)sorption.
*eduction of the
level of
phosphorus in the
)lood of patients
-ith end(stage
renal disease
#2+*D$.
%ausea
'omiting
Diarrhea
Dyspepsia
Constipation
3latulence
Assess 45 side effects.
!onitor serum
phosphorus, calcium,
)icar)onate, chloride
levels
+-allo- -hole #DonAt
crush or che-$
Take all other
medicines at least one
hour )efore or three
hours after.
Take -ith meals.
Aluminum
2yd+o"ide
#Alu(Cap$
antacids,
phosphate
)inders
Prevent a continuing
rise in serum phosphate
levels )y decreasing the
a)sorption of
phosphate from
intestinal tract
%eutrali7es gastric acid
and inactivates pepsin
Treatment for
0yperphosphatemi
a, hypocalcemia in
C*3.
Adjuct therapy in
treating gastric
ulcers,
hyperacidity,
indigestion.
Constipation
0ypophosphate
mia
** Prolong use leads to
toxicity: neuro symptoms
and osteomalacia. M
may recommend !alcium
!arbonate instead**
Assess gastric pain.
!onitor phosphate and
calcium levels.
Take -ith full glass of
-ater
+hould )e s-allo-ed
-hole .@(.? minutes
)efore meals.
G
Calcium Salts
Calcium
acetate
#Calphron,
Phos6o$
Calcium
ca+#onate
#Titralac, Calci(
che-$
Calcium
gluconate
#Halcinate$
!ineral 1
electrolyte
replace&
supplements
!aintain cell
mem)rane and
capillary permea)ility.
*eplacement of
calcium deficiency.
Control of
hyperphosphatemia in
end(stage renal disease
-ithout promoting
aluminum a)sorption.
!alcium carbonate:
!+otects 2ea+t ,+om
e,,ects o,
2y.e+1alemia&
Tx and prevention
of hypocalcemia.
2mergency tx of
hyperkalemia and
hypermagnesemia
and adjunct in
cardiac arrest.
!alcium acetate:
Control of
hyperphosphatemi
a in 2+*D.
!alcium
carbonate:
!ay )e used as
antacid.
Cardiac Arrest
Arrhythmias
radycardia
Constipation
Phle)itis
+yncope
Tingling
Calculi
0ypercalciuria.
!onitor '+ #P 1 P$
and 2C4 freF.
8)serve for s&s of
hypocalcemia
#paresthesia, muscle
t-itching, colic$
!onitor pt on digitalis
glycosides for signs of
toxicity.
!onitor phosphate
levels and electrolytes.
3or
0yperphosphatemia,
hypocalcemia9 must
take -ith food.
Endoc+ine System Medications
CLASSIFICATIO
N NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS AND
!ATIENT EDUCATION
Synt2+oid
#levothyroxine$
0ormones,
thyroid
preparations
, meta)olic rate of
)ody tissues.
*estores normal
hormone )alance.
+uppresses thyroid
cancer.
*eplacement&su)st
itution in
diminished or
a)sent thyroid
function.
Thyroid cancer
#thyrotropin(
dependent$
5rrita)ility, 5nsomnia,
0A, arrhythmias,
tachycardia, -eight
loss, Cardiovascular
Collapse, 0T%, , C8
Assess AP 1 P. 3or
tachyarrhythmias 1
chest pain.
!onitor thyroid
function9 )lood 1 urine
glucose.
4ive )efore )reakfast
#to avoid insomnia$
I
Ta.a0ole
#methima7ole$
!+o.ylt2iou+acil
#PT;$
Thioamides,
Antit2y+oid
agents
Prevents the formation
of thyroid hormone
-ithin the thyroid
cells= serum levels
of thyroid hormone.
"loc#s the utili$ation o%
iodine& prevents
synthesis o% thyroid
hormone
Palliative
treatment of
hyperthyroidism.
*ash, %&', lethargy,
dro-siness,
)radycardia,
Agranulocytosis
Methima$ole:
! suppression
P'(:
45 distress
Monito+
2y.e+t2y+oidism
+es.onse #tachycardia,
palpitations, insomnia,
fever, heat
intolerance, tremors, -t
loss$
Monito+
2y.ot2y+oidism
#intolerance to cold,
constipation, dry skin, 0A,
-eakness$
Assess skin for rashes
or s-ollen nodes.
4ive )efore )reakfast.
+eafood and iodine
may )e restricted.
!onitor CC 1
differential.
!onitor for s&s of
infection or )leeding.
'+omoc+i.tine
#Parlodel$
Dopamine
agonist&
antineoplastic
Direct dopamine
agonist on dopamine
receptor sites in
su)stantia nigra.
5nhi)its 40 secretion.
Antiparkinson agent.
Tx of acromegaly.
Tx of Parkinson9
hyperprolactinemi
a assoc. -ith
pituitary
adenomas, female
infertility assoc.
-ith
hyperprolactinemi
a.
Confusion, di77iness,
hypotension, %&', 0A,
visual distur)ances,
a)dominal pain, leg
cramps, fatigue, nasal
congestion
!onitor thyroid
function, glucose
tolerance, and 40
levels.
Assist -ith am)ulation.
Avoid tasks that reFuire
alertness, motor skills
until response to drug.
Teach contraceptives
#other than P8$
Calcium
gluconate
!ineral 1
electrolyte
replace&
supplements
Act as activator in
transmission of nerve
impulses and
contraction of cardiac,
skeletal, and smooth
muscle.
3or
hypoparathyroidis
m.
*eplacement of Ca
in deficient states.
Arrhytmias,
constipation, phle)itis,
cardiac arrest
Assess 1 monitor" P,
2C4, 1 renal fx
Assess 1 monitor
electrolytes" !g, Ph, H
!onitor serum and
urine Ca levels
5'( push slo-ly, ta)s
D@ min(.hr after meals,
liFuids )efore meals.
Mine+al7
co+ticoids
Flud+oco+tison
e
#3lorinef$
0ormones&
corticosteroids
, %a rea)sorption in
renal tu)ules and , H
and 0 excretion= %a
1 0/8 retention
Adrenal
insufficiency
#AddisonAs$9
replacement
therapy in
com)ination -ith
glucocorticoid.
Tx of salt(losing
adrenogenital
syndrome.
3rontal and occipital
0A, arthralgia,
-eakness, , )lood
volume, edema, 0T%,
C03, rash, anaphylaxis,
hypokalemia
Assess '+, )reath
sounds, -eight, tissue
turgor9 reflexes and
)ilateral grip strength,
serum electrolyte.
!onitor for
hypokalemia.
Avoid infections9 avoid
fresh fruits and veggies
or -ash very carefully
J
Endoc+ine System Medications
CLASSIFICATIO
N NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS
AND !ATIENT
EDUCATION
luco7
co+ticoid
Celestone
#)etamethasone$
Co+tisone
#Cortone
Acetate$
Co+te,
#hydrocortisone$
Med+ol
#methyprednisol
one$
Delta7Co+te,
#prednisolone$
Deltasone
#prednisone$
Corticosteroids
5nitiate complex
reactions responsi)le
for
anti(inflammatory and
immunosuppressive
effects.
Causes release of
epinephrine from
adrenal medulla.
+timulate , of glucose
levels for energy.
Bhen com)ined -ith
mineralocorticoids
some of these drugs
can )e used in
replacement therapy
for adrenal
insufficiency.
!anagement of adrenal
insufficiency.
;sed systemically and
locally for chronic
diseases including"
inflammatory, allergic,
hematologic,
neoplastic, autoimmune
disorders.
5mmunosupressant s in
prevention of organ
rejection.
!anagement of acute
spinal cord injury
(methylprednisolone)
Depression
euphoria
0T%
Peptic ulcers
%&'
-ound healing
Adrenal
suppression
0yperglycemia
Beight gain
%a 1 0
/
8
retention
C03
5mmunosuppressi
on
8steoporosis
!uscle -asting
Cushingoid
appearance.
Administer daily in
A!.
Do not discontinue
a)ruptly.
Protect from
infection or invasive
procedures.
Caution in pts -ith
D! or peptic ulcers.
!onitor 5&8, daily
-eight 1
electrolytes.
+igns of fluid
retention.
4ive -ith meal.
!onitor for s&s of
adrenal insufficiency
#0A, hypotension,
-t. loss, -eakness$
K
Multi7System Medications
CLASSIFICATION
NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS AND
!ATIENT EDUCATION
Sil-e+
sul,adia0ine
#+ilvadene$
Anti(infective&
)actericidal
Anti)acterial and
antifungal agent.
Adjunct for
prevention and
treatment of
-ound sepsis in
patients -ith /L
and DL )urns.
urning feeling at
site, %&'&D, 0A,
anorexia,
photosensitivity,
joint pain,
hemolytic
anemia,
hypoglycemia,
6upus,
6iver&kidney
pro)lems
!onitor CC 1
hepatic&renal fx.
!onitor for leucopenia for
/(D days.
5f )urns are extensive or
prolonged therapy" monitor
electrolytes, ;A,CC
Cover entire -ound
!ay cause )ro-n(gray
discoloration.
Ma,enide
acetate
#+ulfamylon$
acteriostatic for
many gram(
negative and gram(
positive organisms,
Control )acterial
infection -hen
used under moist
dressings over
meshed
autografts on
excised )urn
-ounds.
Pain or )urning
sensation, allergic
reaction, )leeding
or oo7ing of skin,
or meta)olic
acidosis
Apply -ith sterile gloves& M
dressing FGL.
!onitor A4s #d&c if
acidosis$.
4ive analgesic prior, may
cause severe )urning pain
for up to /@ mins after
application.
Mo+.2ine
8pioid agonist,
narcotic
Acts as agonist at
specific opioid
receptors in C%+ to
produce analgesia,
euphoria, and
sedation.
*elief of
moderate to
severe acute or
chronic pain.
Pulmonary
edema.
Pain assoc. -ith
!5.
Confusion,
sedation,
*espiratory
depression,
hypotension,0*,
constipation, %&',
shock, urinary
retention
Assess pain, 68C, P,
pulses, respirations, )o-el
fx.
!onitor for dependence or
tolerance.
0ave %arcan availa)le for
8D
%e+sed
#mida7olam$
+edatives&
hypnotics
)en7odia7epines
Acts at many levels
of C%+ to
produced
generali7ed C%+
depression.
+hort(term
sedation9
post(op amnesia.
+edation,
anxiolysis and
amnesia )efore
procedure
5nduction of
anesthesia9
continuous
sedation of
intu)ated
patients.
*espiratory
depression,
laryngospasm,
cardiac arrest,
dro-siness, 0A,
C+ sedation, %&',
arrhythmias,
phle)itis
!onitor '+, respirations
and level of sedation F D(
?min.
4ive *oma7icon for 8D.
4rapefruit juice
meta)olism 1 ,effects
!onitor 68C and sedation
.@
Digo"in
#6anoxin$
Digitalis
glycosides
, force of
myocardial
contraction.
, cardiac output
and heart rate.
Tx of C03, atrial
fi)rillation 1
atrial flutter,
tachyarrhythmias
0A, -eakness,
dro-siness, visual
distur)ances, %&'
arrhythmias,
fatigue,
)radycardia, 45
upset
!onitor apical pulse for .
min )efore administration.
0old if NG@ )pm.
!onitor pulse, -t., 5&8 and
2C4.
Adm. 5' slo-ly O? min,
avoid 5!.
!onitor electrolytes 1
digoxin levels
Therapeutic level" @.?(/9
toxic O/
0ave Digoxin immune 3A
availa)le.
Multi7System Medications
CLASSIFICATIO
N NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS AND
!ATIENT EDUCATION
Do.amine
vasopressor&adre
nergic
+m. Doses
stimulate
dopaminergic
receptors,
producing renal
vasodilation. 6g.
doses stimulate
dopaminergic and
)eta. adrenergic
receptors,
producing cardiac
stimulation and
renal vasodilation
, Cardiac output,
P, and improves
renal )lood flo-.
Tachycardia,
ectopic )eats,
anginal pain,
hypotension,
dyspnea, %&', 0A
!onitor P, 0*, 2C4,
cardiac output, and urinary
output continuously.
*eport chest pain, dyspnea,
num)ness, tingling, or
)urning of extremities.
Inde+al
#propanalol$
eta )lockers
locks )eta(
adrenergic
receptors in the
heart and kidney,
has a mem)rane(
sta)ili7ation effect
and influence of
sympathetic
nervous system.
0* 1 P,
suppression of
arrhythmias 1
prevent !5
!anagement of
0T%9 angina
pectoris9
arrhythmias.
Prevention and
management of
!5.
Prevent vascular
0A.
!anage
thyrotoxicosis.
radycardia,
C03, cardia
arrhythmias, heart
)locks, C'A,
pulmonary
edema, gastric
pain, flatulence,
%&'&D, exercise
tolerance,
impotence.
!onitor P and Pulses
Pts on 5' must have
continuous 2C4 monitor.
0ypotensive effect is
associated -ith cardiac
output.
DonAt stop med a)ruptly, it
thro-s in .L heart )lock
..
Code D+ugs
CLASSIFICATION
NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS
AND !ATIENT
EDUCATION
E.ine.2+ine
Adrenergic,
sympathomimetic
*eacts at alpha(
and )eta(
receptor sites in
the +%+ to
cause
)ronchodilation,
, 0*, **, P.
Treatment of shock,
)ronchospasm.
!anagement of
severe allergic
reactions, cardiac
arrest.
%ervousness, tremor
restlessness, angina,
arrhythmias, 0T%,
tachycardia, 0A, %&'
insomnia,
hyperglycemia
Assess pulmonary
function" lung sounds,
respiratory pattern9
pulse, P.
!onitor 2C49 for
arrhythmias, chest
pain.
Correct hypovolemia
prior to 5' use.
!ay cause serum H
and , glucose.
Sodium
'ica+#onate
Antiulcer,
alkalini7ing
%eutrali7es or
gastric
acidity=,
gastric p0.
Acts as
alkalini7ing
agent )y
releasing
)icar)onate
ions.
*elief of
hyperacidity9
!anagement of
meta)olic acidosis9
Treatment of certain
drug intoxications.
!eta)olic alkalosis,
gas,
4astric acid re)ound,
hypernatremia,
hypocalcemia,
hypokalemia, %a 1
0/8 retention
Assess 45 1 renal
function, serum
electrolytes.
Assess signs of
acidosis&alkalosis,
A4s
Do.amine
Adrenergic,
sympathomimetic
inotropics,
vasopressors
+timulates
dopaminergic
receptors"
,cardiac output,
, P, and
improved renal
)lood flo-
Choice for tx of
shock.
Arrhythmias, angina,
0ypotension,
tachycardia, dyspnea,
%&', 0A,
!onitor P, 0*,
2C4, C8.
!onitor urinary output
freFuently.
Palpate peripheral
pulses and assess
appearance of
extremities.
At+o.ine
Anticholinergic,
antiarrhythmic
5nhi)its the
action of
acetylcholine,
)locking the
effects of
parasympathetic
%+.
,0*, 45 1
respiratory
secretions.
Antidote for
cholinergic 8D and
mushroom poisoning.
Pre(op to
secretions.
*estores cardiac rate
and arterial pressure.
Dro-siness, )lurred
vision, tachycardia, dry
mouth, urinary
hesitancy, constipation,
decreased s-eating.
Assess '+ and 2C4.
!onitor 5&8.
Assess a)domen and
)o-el sounds.
8)serve for toxicity or
8D9
antidote
physostigmine.
4ive D@ mins. )efore
meals.
./
Lidocaine
Antiarrhythmic,
anesthetic
Control of
ventricular
arrhythmias.
6ocal
anesthesia.
!anagement of
ventricular
arrhythmias.
5nfiltration&
mucosal&topical
anesthetic.
+ei7ures, confusion,
dro-siness, Cardiac
arrest, stinging,
anaphylaxis,
hypotension, %&',
fatigue
!onitor 2C4 and P
and *espiratory status.
!onitor serum
electrolyte levels.
!onitor for toxicity
and 8D" serum levels"
1.5-5 g/mL
Code D+ugs
CLASSIFICATION
NAME
MECHANISM
OF ACTION
INDICATIONS SIDE EFFECTS NURSIN
CONSIDERATIONS AND
!ATIENT EDUCATION
Adenosine
antiarrhythmics
*estores
normal sinus
rhythm.
Treatment of
supraventricular
tachycardias,
#Diagnostic agent to
assess myocardial
perfusion$
+8, facial flushing,
transient arrhythmias,
0A, di77iness, chest
pain, hyperventilation,
nausea, s-eating,
hypotension
!onitor 0* #F.?(
D@min$ 1 2C4, P.
Assess *espiratory
status" )reath sounds
and rate.
Change positions
slo-ly # to 80$
*eport adverse effects.
Amiodo+one
antiarrythmics
+uppression of
arrhythmias.
locks )eta(
adrenergic
receptors in
heart.
6ife(threatening
ventricular
arrhythmias
!anagement of
supraventricular
tachycardia
Di77iness, fatigue,
malaise, A*D+,
0Apulmonary fi)rosis,
C03, )radycardia,
hypotension, anorexia,
constipation, %&',
hypothyroidism, ataxia,
peripheral neuropathy,
tremors
!onitor 2C4, 0* and
rhythm.
Assess signs of
pulmonary toxicity
#crackles, )reath
sounds, dyspnea$
Assess s&s of A*D+.
!onitor P.
!onitor liver and
thyroid function.
Assess for
hypokalemia,
hypomagnesemia
Assist -ith am)ulation.
!ay )e given -ith
meals or divided doses
.D
Nit+oglyce+ines
Antianginal,
nitrates
*elief or
prevention of
anginal attacks.
, cardiac output
P
Acute 1 long term
prophylactic
management of
angina pectoris.
Adjunct tx of C03
1 acute !5.
Production of
controlled
hypotension.
Di77iness, 0A,
hypotension,
tachycardia,
restlessness, )lurred
vision, rash, flushing,
%&', -eakness.
0A is common s&e.
Assess anginal pain.
!onitor P 1 pulse.
!onitor 2C4.
P8" Administer . hr
)efore or / hr after
meals -& full glass of
-ater.
+6" 0old ta)let under
tongue until dissolved9
avoid eating or
drinking.
Change position slo-ly
#prevent 80$
Do#ut+e"
#Do)utamine$
Adrenergics,
inotropics
5ncreased
cardiac output
-ithout
significantly
increased heart
rate.
Treatment of C03
)ecause ,
myocardial
contractility -ithout
much change in rate
and doesnAt , 8/
demand of heart
muscle.
0T%, ,0*, premature
ventricular
contractions, +8, 0A,
angina pectoris,
arrhythmias,
hypotension, %&',
phle)itis.
!onitor P, 0*, 2C4,
C8, urinary output.
Palpate peripheral
pulses and assess
extremities.
!onitor electrolytes,
;%, Creat,
prothrom)in time.
Check for signs of
extravasation.
.>