Download EMERGENCY-DRUGS

EMERGENCY DRUGS
1. Aminophylline
Brand Name: (Aminosol)
Classification: Anti-asthmatic and COPD Preparation
Stock Dose: 25mg/10mg/amp
Use:
 Treat the acute symptoms of asthma, bronchitis, emphysema, and other
lung diseases in a hospital setting.
Nursing Responsibilities:
 Advise to take this drug on an empty stomach, 1 hour before or 2 hours
after meals.
 Do not to chew or crush timed-release preparations.
 It may be necessary to take this drug around-the-clock for adequate
control of asthma attacks.
 Avoid excessive intake of coffee, tea, cocoa, cola beverages, and
chocolate.
 Smoking cigarettes or other tobacco products impacts the drug’s
effectiveness. Try not to smoke. Notify your health care provider if
smoking habits change while taking this drug.
 Frequent blood tests may be necessary to monitor the effect of this drug
and to ensure safe and effective dosage; keep all appointments for blood
tests and other monitoring.
 Tell the patient that they may experience these side effects: Nausea, loss
of appetite (taking this drug with food may help if taking the immediaterelease or liquid dosage forms); difficulty sleeping, depression, emotional
lability (reversible). Report nausea, vomiting, severe GI pain, restlessness,
seizures, irregular heartbeat.
2. Amiodarone
Brand Name: (Cordarone)
Classification: Anti-arrhythmic
Stock Dose: 150mg/amp
Use:
 Ventricular Fibrillation or Pulseless Ventricular Tachycardia
 Ventricular Tachycardia with pulse
 Tachycardia rate control
Nursing Responsibilities:
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Check pulse daily once stabilized, or as prescribed. Report a pulse <60.
Take oral drug consistently with respect to meals.
Become familiar with potential adverse reactions and report those that are
bothersome to the physician.
3. Amlodipine
Brand Name: (Norvasc)
Classification: Anti-Anginal
Stock Dose: 5mg/10mg/tab
Use:
 Lower hypertension (high blood pressure) in adults and children.
Nursing Responsibilities:
 Monitor patient carefully (BP, cardiac rhythm, and output) while adjusting
drug to therapeutic dose; use special caution if patient has CHF.
 Monitor BP very carefully if patient is also on nitrates.
 Monitor cardiac rhythm regularly during stabilization of dosage and
periodically during long-term therapy.
 Administer drug without regard to meals.
4. Atropine Sulfate
Brand Name: (Isopto Atropine)
Classification: Anticholinergic
Stock Dose: 1mg/ml/amp
Use:
 Symptomatic Bradycardia
 Specific toxins/overdose (e.g., organophosphates)
Nursing Responsibilities:
 Advise to take as prescribed, 30 minutes before meals; avoid excessive
dosage.
 Avoid hot environments; you will be heat intolerant, and dangerous
reactions may occur.
5. Bumetanide
Brand Name: (Burinex)
Classification: Loop Diuretics
Stock Dose: 2mg/4ml
Use:
 Treat edema (fluid retention; excess fluid held in body tissues) caused by
various medical problems, including heart, kidney, and liver disease.
Nursing Responsibilities:
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Give with food or milk to prevent GI upset.
Mark calendars or uses reminders if intermittent therapy is best for treating
edema.
Give single dose early in day so increased urination will not disturb sleep.
Avoid IV use if oral use is possible.
Arrange to monitor serum electrolytes, hydration, liver function during
long-term therapy.
Provide diet rich in potassium or supplemental potassium.
6. Calcium Gluconate
Brand Name: (Calcinate)
Classification: Electrolytes
Stock Dose: 1gm/amp
Use:
 Treat conditions arising from calcium deficiencies such as hypocalcemic
tetany, hypocalcemia related to hypoparathyroidism, and hypocalcemia
due to rapid growth or pregnancy.
Nursing Responsibilities:
 Assess for cutaneous burning sensations and peripheral vasodilation, with
moderate fall in BP, during direct IV injection.
 Monitor ECG during IV administration to detect evidence of
hypercalcemia: decreased QT interval associated with inverted T wave.
 Observe IV site closely.
7. Captopril
Brand Name: (Capomed)
Classification: ACE Inhibitor
Stock Dose: 25mg/tab
Use:
 Used alone or together with other medicines to treat high blood pressure
(hypertension).
Nursing Responsibilities:
 Monitor blood pressure and pulse frequently during initial dose adjustment
and periodically during therapy. (for patients treated with hypertension).
 For patients treated with CHF, monitor weight and assess patient routinely
for resolution of fluid overload. Signs of fluid overload are: peripheral
edema, rales or crackles, dyspnea, weight gain and jugular vein
distention.
 The nurse should keep in mind that Captopril may cause false-positive
result for urine acetone.
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The drug should be administered 1 hour before or 2 hours after meals.
It may be crushed if the patient has difficulty swallowing.
Keep this medication in the container it came in, tightly closed, and out of
reach of children.
Store it at room temperature and away from excess heat and moisture
(not in the bathroom).
Throw away any medication that is outdated or no longer needed.
8. Clonidine HCl
Brand Name: (Catapres)
Classification: Anti-hypertensive
Stock Dose: 75 mg; 150 mg tab
Use:
 Used alone or with other medications to treat high blood pressure
(hypertension).
Nursing Responsibilities:
 Take this drug exactly as prescribed. Do not miss doses. Do not
discontinue the drug unless so instructed. Do not discontinue abruptly; lifethreatening adverse effects may occur.
 If you travel, take an adequate supply of drug.
9. Coralan
Brand Name: (Ivabradine)
Classification: Anti-Anginal
Stock Dose: 5mg;7.5 mg tab
Use:
 Used to treat heart failure.
Nursing Responsibilities:
 Instruct patient to take ivabradine as directed.
 Advise patient to avoid taking grapefruit juice during therapy; may
increase risk of side effects.
10. Diazepam
Brand Name: (Lorecam)
Classification: Anxiolytic
Stock Dose: 5mg/10mg/tab
Use:
 To relieve anxiety and to control agitation caused by alcohol withdrawal.
Nursing Responsibilities:
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Take this drug exactly as prescribed. Do not stop taking this drug (longterm therapy, antiepileptic therapy) without consulting your health care
provider.
11. Digoxin
Brand Name: (Lanoxin)
Classification: Cardiac Drugs
Stock Dose: 0.5 mg/2ml
Use:
 To treat heart failure and abnormal heart rhythms (arrhythmias).
 Helps control your heart rate.
Nursing Responsibilities:
 Report to physician if pulse falls below 60 or rises above 110 or if you
detect skipped beats or other changes in rhythm, when digoxin is
prescribed for atrial fibrillation.
 Suspect toxicity and report to physician if any of the following
occur: Anorexia, nausea, vomiting, diarrhea, or visual disturbances.
 Weigh each day under standard conditions. Report weight gain >1 kg (2
lb)/d. Take digoxin PRECISELY as prescribed, do not skip or double a
dose or change dose intervals, and take it at same time each day.
12. Diphenhydramine
Brand Name: (Soniphen)
Classification: Antihistamine
Stock Dose: 50mg/ml/amp
Use:
 To relieve red, irritated, itchy, watery eyes; sneezing; and runny nose
caused by hay fever, allergies, or the common cold.
 It is also used to relieve cough caused by minor throat or airway irritation.
Nursing Responsibilities:
 Monitor cardiovascular status especially with pre-existing cardiovascular
disease.
 Monitor for adverse effects especially in children and the older adult.
 Supervise ambulation and use side-rails as necessary. Drowsiness is
most prominent during the first few days of therapy and often disappears
with continued therapy.
 Older adults are especially likely to manifest dizziness, sedation, and
hypotension.
13. Epinephrine
Brand Name: (Epix)
Classification: Cardiac drugs
Stock Dose: 1mg/ml/amp
Use:
 Anaphylaxis
 Symptomatic bradycardia
 Shock
 Cardiac Arrest
Nursing Responsibilities:
 Take medication only as prescribed and immediately notify physician of
onset of systemic effects of epinephrine.
 Discard discolored or precipitated solutions.
 Do not breast feed while taking this drug without consulting physician.
14. Furosemide
Brand Name: (Lasix)
Classification: Loop diuretics
Stock Dose: 20mg/ml
Use:
 Most commonly used both for acute and chronic heart failure
 Immediate decrease of pulmonary congestion and severe edema
Nursing Responsibilities:
 Reduce dosage if given with other antihypertensives; readjust dosage
gradually as BP responds.
 Administer with food or milk to prevent GI upset.
 Give early in the day so that increased urination will not disturb sleep.
 Avoid IV use if oral use is at all possible.
15. Hydralazine
Brand Name: (Aprezal)
Classification: Anti-hypertensive
Stock Dose: 20mg/ml/amp
Use:
 Arteriolar dilator
 It is helpful in increasing cardiac output
Nursing Responsibilities:
 Monitor the client’s blood pressure and pulse frequently during initial
dosage adjustment and periodically throughout therapy.
 Report significant changes to the physician.
 Monitor frequency of prescription refills to determine adherence.
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Prior to and periodically during prolonged therapy the following lab values
should be monitored: CBC, electrolytes, LE Cell Prep and ANA titer.
IM or IV route should be used only when the drug cannot be given orally.
16. Hydrocortisone
Brand Name: (Cortin)
Classification: Corticosteroid
Stock Dose: 100mg /vial
Use:
 To treat a variety of skin conditions (such as insect bites, poison oak/ivy,
eczema, dermatitis, allergies, rash, itching of the outer female genitals,
anal itching).
 It reduces the swelling, itching, and redness that can occur in these types
of conditions.
Nursing Responsibilities:
 Do not ignore dyspepsia with hyperacidity. Report symptoms to physician
and do NOT self-medicate to find relief.
 Do NOT use aspirin or other OTC drugs unless prescribed specifically by
the physician. Note: A high protein, calcium, and vitamin D diet is
advisable to reduce risk of corticosteroid-induced osteoporosis.
17. Isosorbide Dinitrate
Brand Name: (Isordil), (Isoket)
Classification: Anti Anginal
Stock Dose: 5mg/tab, 10mg/10ml/amp
Use:
 To prevent angina (chest pain) caused by coronary artery disease.
Nursing Responsibilities:
 Make position changes slowly, particularly from recumbent to upright
posture, and dangle feet and ankles before walking.
 Lie down at the first indication of light-headedness or faintness.
 Keep a record of anginal attacks and the number of sublingual tablets
required to provide relief.
 Do not drink alcohol because it may increase possibility of lightheadedness and faintness.
18. Leviteracetam
Brand Name: (Keppra)
Classification: Anti-convulsant
Stock Dose: 500mg/vial, 250mg, 500mg/tab
Use:
 Used alone and along with other medications to control partial-onset
seizures (seizures that involve only one part of the brain) in adults,
children, and infants 1 month of age or older.
Nursing Responsibilities:
 Do not drive or engage in potentially hazardous activities until response to
drug is known.
 Do not abruptly discontinue drug. MUST use gradual dose reduction/taper.
Notify physician of intention to become pregnant.
 Do not breast feed while taking this drug without consulting physician
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19. Losartan
Brand Name: (Lifezar)
Classification: Angiotensin II Antagonist
Stock Dose: 100mg/tab
Use:
 Consider this drug for patients intolerant to ACE inhibitors due to
incessant cough
Nursing Responsibilities:
 Notify physician of symptoms of hypotension (e.g., dizziness, fainting).
 Notify physician immediately of pregnancy. Do not breast feed while taking
this drug.
20. Magnesium Sulfate
Classification: Anti-convulsant
Stock Dose: 250 mg/10ml/amp
Use:
 Cardiac Arrest or pulseless Torsades
 Torsades de Pointes with pulse
Nursing Responsibilities:
 Drink sufficient water during the day when drug is administered orally to
prevent net loss of body water.
 Recommended daily allowances of magnesium are obtained in a normal
diet.
 Rich sources are whole-grain cereals, legumes, nuts, meats, seafood,
milk, most green leafy vegetables, and bananas.
 Do not breast feed while taking this drug without consulting physician.
21. Meperidine
Brand Name: (Demerol)
Classification: Analgesic (Opioid)
Stock Dose: 100mg/2ml/amp
Use:
 To relieve moderate to severe pain.
Nursing Responsibilities:
 Do not smoke and walk without assistance after receiving the drug. Bed
side rails may be advisable.
 Be aware nausea, vomiting, dizziness, and faintness associated with fall
in BP are more pronounced when walking than when lying down (these
symptoms may also occur in patients without pain who are given
meperidine).
 Symptoms are aggravated by the head-up position.
 Do not drive or engage in potentially hazardous activities until any
drowsiness and dizziness have passed.
22. Metoclopramide
Brand Name: (Clomitene)
Classification: Anti emetic
Stock Dose: 10mg/2ml/amp
Use:
 To treat the symptoms of slow stomach emptying (gastroparesis) in
patients with diabetes.
Nursing Responsibilities:
 Avoid driving and other potentially hazardous activities for a few hours
after drug administration.
 Avoid alcohol and other CNS depressants. Report S&S of acute dystonia,
such as trembling hands and facial grimacing, immediately.
 Do not breast feed while taking this drug without consulting physician.
23. Midazolam
Brand Name: (Sedoz)
Classification: Sedatives
Stock Dose: 5mg/5ml/amp
Use:
 Used before medical procedures and surgery to cause drowsiness, relieve
anxiety, and prevent any memory of the event.
 It is also sometimes given as part of the anesthesia during surgery to
produce a loss of consciousness.
Nursing Responsibilities:
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Do not drive or engage in potentially hazardous activities until response to
drug is known.
You may feel drowsy, weak, or tired for 1–2 d after drug has been given.
Be prepared for amnesia to prevent an upsetting postoperative period.
Review written instructions to assure future understanding and
compliance.
Patient teaching during amnestic period may not be remembered. Even if
dose is small and depth of amnesia is unclear, relearn information.
24. Morphine Sulfate
Classification: Analgesic (Opioid)
Stock Dose: 16mg/ml/amp
Use:
 To help relieve moderate to severe pain.
Nursing Responsibilities:
 Avoid alcohol and other CNS depressants while receiving morphine.
 Do not use of any OTC drug unless approved by physician.
 Do not smoke or ambulate without assistance after receiving drug.
 Bedside rails are advised.
25. Nicardipine
Brand Name: (Cardepine)
Classification: Calcium Antagonist
Stock Dose: 10mg/10ml/amp
Use:
 It is used by intravenous and intracerebral arterial infusion to prevent
cerebral vasospasm associated with stroke.
Nursing Responsibilities:
 Record and report any increase in frequency, duration, and severity of
angina when initiating or increasing dosage.
 Keep a record of nitroglycerin use and promptly report any changes in
previous anginal pattern.
 Increased incidence and severity of angina has occurred in some patients
using nicardipine.
 Do not change dosage regimen without consulting physician.
 Be aware that abrupt withdrawal may cause an increased frequency and
duration of chest pain. This drug must be gradually tapered under medical
supervision.
 Rise slowly from a recumbent position; avoid driving or operating
potentially dangerous equipment until response to nicardipine is known.
26. Norepinephrine
Brand Name: (Norepin)
Classification: Dyslipidemic
Stock Dose: 4mg/4ml/amp
Use:
 To treat life-threatening low blood pressure (hypotension) that can occur
with certain medical conditions or surgical procedures.
Nursing responsibilities:
 Monitor constantly while patient is receiving norepinephrine. Take baseline
BP and pulse before start of therapy, then q2min from initiation of drug
until stabilization occurs at desired level, then every 5 min during drug
administration.
 Adjust flow rate to maintain BP at low normal (usually 80–100 mm Hg
systolic) in normotensive patients. In previously hypertensive patients,
systolic is generally maintained no higher than 40 mm Hg below
preexisting systolic level.
 Observe carefully and record mental status (index of cerebral circulation),
skin temperature of extremities, and color (especially of earlobes, lips, nail
beds) in addition to vital signs.
 Monitor I&O. Urinary retention and kidney shutdown are possibilities,
especially in hypovolemic patients. Urinary output is a sensitive indicator
of the degree of renal perfusion.
 Report decrease in urinary output or change in I&O ratio.
27. NTG Patch
Classification: Anti Anginal
Stock Dose: 5mg
Use:
 To prevent episodes of angina (chest pain) in people who have coronary
artery disease (narrowing of the blood vessels that supply blood to the
heart).
Nursing Responsibilities:
 Store tablet form in its original container.
 Sit or lie down upon first indication of oncoming anginal pain.
 Spit out the rest of your sublingual tablet as soon as pain is completely
relieved, especially if you are experiencing unpleasant adverse effects
such as headache.
 Relax for 15–20 min after taking tablet to prevent dizziness or faintness.
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Be aware that pain not relieved by 3 sublingual tablets over a 15-min
period may indicate acute MI or severe coronary insufficiency.
Contact physician immediately or go directly to emergency room.
Note: Sublingual tablets may be taken prophylactically 5–10 min prior to
exercise or other stimulus known to trigger angina (drug effect lasts 30–60
min).
28. Nubain
Brand Name: (Nalbuphine HCl)
Classification: Analgesic (Opioid)
Stock Dose: 10mg/ml/amp
Use:
 To treat moderate to severe pain.
 It is also used for treating pain just after surgery or childbirth.
Nursing Responsibilities:
 Do not drive or engage in potentially hazardous activities until response to
drug is known.
 Avoid alcohol and other CNS depressants.
 Do not breast feed while taking this drug without consulting physician.
29. Propofol
Brand Name: (Spiva)
Classification: Anesthetic
Stock Dose: 10mg/ml
Use:
 To help you relax before and during general anesthesia for surgery or
other medical procedure.
Nursing Responsibilities:
 Monitor hemodynamic status and assess for dose-related hypotension.
 Take seizure precautions. Tonic-clonic seizures have occurred following
general anesthesia with propofol.
 Be alert to the potential for drug induced excitation (e.g., twitching, tremor,
hyper clonus) and take appropriate safety measures.
 Provide comfort measures; pain at the injection site is quite common
especially when small veins are used.
30. Tramadol
Brand Name: (Tramal)
Classification: Analgesic
Stock Dose: 50mg/ml/amp
Use:
 To relieve moderate to moderately severe pain, including pain after
surgery.
 The extended-release capsules or tablets are used for chronic ongoing
pain.
Nursing Responsibilities
 Exercise caution with potentially hazardous activities until response to
drug is known.
 Understand potential adverse effects and report problems with bowel
and bladder function, CNS impairment, and any other bothersome
adverse effects to physician.
31. Paracetamol
Brand Name: (Aeknil)
Classification: Analgesic
Stock Dose: 300mg/2ml/amp
Use:
 To treat aches and pain.
 It can also be used to reduce a high temperature.
Nursing Responsibilities
 Do not take other medications (e.g., cold preparations) containing
acetaminophen without medical advice; overdosing and chronic use can
cause liver damage and other toxic effects.
 Do not self-medicate adults for pain more than 10 d (5 d in children)
without consulting a physician.
32. Terbutaline
Classification: Anti asthmatic
Stock Dose: 1ml/amp
Use:
 To prevent and treat wheezing, shortness of breath, and chest tightness
caused by asthma, chronic bronchitis, and emphysema.
 It works by relaxing and opening the airways, making it easier to breathe.
Nursing Responsibilities
 Adhere to established dosage regimen (i.e., do not change dose intervals
or omit, increase, or decrease the dose).
 Inhalator therapy: Review instructions for use of inhalator (included in the
package). Learn how to take your own pulse and the limits of change that
indicate need to notify the physician.
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Advise to consult physician if breathing difficulty is not relieved or if it
becomes worse within 30 min after an oral dose.
33. Verapamil
Brand Name: (Isoptin)
Classification: Calcium Antagonist
Stock Dose: 5mg/2ml/amp
Use:
 To treat high blood pressure and to control angina (chest pain).
Nursing Responsibilities
 Monitor radial pulse before each dose, notify physician of an irregular
pulse or one slower than established guideline.
 Adhere to established guidelines for exercise program.
 Do not drive or engage in potentially hazardous activities until response to
drug is known.
 Decrease intake of caffeine-containing beverage (i.e., coffee, tea,
chocolate).
 Change positions slowly from lying down to standing to prevent falls
because of drug-related vertigo until tolerance to reduced BP is
established.
34. Atrovent Nebule
Brand Name: (Ipratropium Br)
Classification: Anti Asthmatic
Nursing responsibilities
 Note: This medication is not an emergency agent because of its delayed
onset and the time required to reach peak bronchodilator.
 Review patient information sheet on proper use of nasal spray. Allow 30–
60 sec between puffs for optimum results.
 Do not let medication contact your eyes. Wait 5 min between this and
other inhaled medications.
 Check with physician about sequence of administration.
35. Salbutamol Nebule
Brand Name: (Hivent)
Classification: Anti Asthmatic
Nursing Responsibilities:
 Review directions for correct use of medication and inhaler.
 Avoid contact of inhalation drug with eyes do not increase number or
frequency of inhalations without advice of physician.
36. Budenoside Nebule
Brand Name: (Bronex)
Classification: Anti Asthmatic
Nursing Responsibilities:
 Notify the physician immediately for any of the following: itching, skin rash,
fever, swelling of face and neck, difficulty breathing, or if you develop S&S
of infection.
37. Heparin
Classification: Anti-Coagulant
Stock Dose: 5,000 I.U/vial, 25,000 I.U/vial
Use:
 It is also used to prevent blood clotting during open-heart surgery, bypass
surgery, kidney dialysis, and blood transfusions.
Nursing Responsibilities
 Advice the patient to engage in normal activities such as shaving with a
safety razor in the absence of a low platelet (thrombocyte) count. Usually,
heparin does not affect bleeding time.
 Caution: Smoking and alcohol consumption may alter response to heparin
and are not advised.
 Do not take aspirin or any other OTC medication without physician's
approval.
38. Lidocaine
Classification: Local Anesthetic
Stock Dose: 20mg/ml/50ml/vial
Use:
 Cardiac Arrest (Ventricular Fibrillation or Ventricular Tachycardia)
 Wide Complex Tachycardia with pulse
Nursing Responsibilities
 Swish and spit out when using lidocaine solution for relief of mouth
discomfort; gargle for use in pharynx, may be swallowed (as prescribed).
 Oral topical anesthetics (e.g., Xylocaine Viscous) may interfere with
swallowing reflex.
 Do NOT ingest food within 60 min after drug application; especially
pediatric, geriatric, or debilitated patients.
 Do not chew gum while buccal and throat membranes are anesthetized to
prevent biting trauma.