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Therapeutics Effects Nursing ResponsibilitiesIndications Contraindication Desired Untoward

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Drug FeaturesGeneric Name: AMINOPHYLLINE Brand Name: Phil Pharmawealth / Atlantic Aminophylline amp Theofil ampDrug Classes:

PO Chronic bronchospasm as hydrate

hypersens. to drug/class/compon.

caution if PUD, active

caution if seizure disorder

caution if arrhythmias

Increases the level of cAMP resulting in bronchodilation

Nausea, vomiting, abdominal pain, diarrhea, headache, insomnia, dizziness, anxiety,restlessness; tremor, palpitations.

Potentially Fatal:

Administer to pregnant patients only when clearly needed—neonatal tachycardia, jitteriness, and withdrawalapnea observed when mothers received xanthines up until delivery.

Caution patient not to chew or crush enteric-coated timed-release forms.

Give immediate-release, liquid

Antiasthmatic & COPD preparations

Dosage: Initial: 225-450 mg twice daily, increased if needed. IV Acute severe bronchospasm.Loading dose: 5mg/kg (ideal body wt).Maintenance: 0.5 mg/kg/hr. Rate should not exceed 25 mg/min

caution if CHF

caution if pulmonary edema, acute

caution if cor pulmonale

caution if hepatic impairment

caution if hypothyroidism

caution if febrile

caution if sepsis w/ multi-organ failure

caution if shock

caution if smoking habit changes

caution in neonates or infants

caution in elderly pts

Convulsions, cardiac arrhythmias, hypotension and suddendeath after too rapid IV injection.

dosage forms with food if GI effects occur.

Do not give timed-release forms with food; these should be given on an empty stomach 1 hr before or 2 hr after meals.

Maintain adequate hydration. Monitor results of serum

theophylline levels carefully, and arrange for reduced dosage if serum levels exceed therapeutic range of 10–20 mcg/mL.

Take serum samples to determine peak theophylline concentration drawn 15–30 min after an IV loading dose.

Monitor for clinical signs of adverse effects, particularly if serum theophylline levels are not available.

Ensure that diazepam is readily available to treat seizures.

Take this drug exactly as prescribed; if a timed-release product is prescribed, take this drug on an empty stomach,1 hr before or 2 hr after meals.

Instruct patient not to chew or crush timed-release preparations.

Administer rectal solution or suppositories after emptying the rectum.

Instruct patient to avoid excessive intake of coffee, tea, cocoa, cola beverages, chocolate.

Informed patient that Smoking cigarettes or other tobacco products impacts the drug's effectiveness. Encourage not to smoke. Instruct patient to notify the 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

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications Contraindication Desired Untoward

Generic Name:AMIODARONE HYDROCHLORIDE Brand Name:Anoion tab Cordarone Cordarone inj Sandoz Amiodarone HCl tabDrug Classes:Cardiac DrugsDrug Dosage:PO Initial: 200 mg 3 times/day for 1 wk, reduce to 200 mg twice daily for a further wk. Maintenance: 200mg/day or lowest effective dose. IV Initial: 5 mg/kg infusion via central venous catheter. Max: 1.2 g/24 hr.

Ventricular and supraventricular arrhythmias.

Amiodarone Hydrochloride Injection is contraindicated in patients with known hypersensitivity to any of the components of amiodarone including iodine, or in patients with cardiogenic shock, marked sinus bradycardia, and second- or third-degree AV block unless a functioning pacemaker is available.

Blocks potassium chloride leading to prolongation of action potential duration.

grey discoloration of skin, photosensitivity, peripheral neuropathy, paraesthesia,myopathy, ataxia, tremor, nausea, vomiting, metallic taste, hypothyroidism, hyperthyroidism, alopecia, sleepdisturbances, 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

•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 duringinitiation 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,

arrhythmias and rareserious liver injury. Generally in patients with high doses and having preexisting abnormalities of diffusion capacity.

monitor light exposure); nausea, vomiting, loss of appetite (take with meals; eat small, frequent meals); sensitivity to thesun (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 thatrequire 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, difficultybreathing, cough; swelling of ankles or fingers; palpitations; difficulty with vision.

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications Contraindication Desired Untoward

Generic Name:ATROPINE SULFATEBrand Name:Anespin amp Atropol amp Euro-Med Atropine Sulfate amp Isopto Atropine eye drops PhilPharmawealth/Atlantic Atropine ampDrug Classes:Cardiovascular Drugs, Muscle Relaxants,

IV Bradycardia 500 mcg every 3-5 mins. Total: 3 mg.

IV/IM Organophosphorus poisoning 2mg 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

Contraindicated in the presence of hypersensitivity to anticholinergic drugs.

Systemic administration: Contraindicated in the presence of glaucoma, adhesions between iris and lens, stenosing peptic ulcer,

An anti-cholinergic that inhibits acetylcholine at the parasympathetic neuroeffector junction, enhances theconduction of AV node and increases heart rate

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

•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•Take as prescribed, 30

Mydriatic Drugs, Antidotes, Detoxifying Agents &Drugs Used in Substance Dependence

Overdosage w/ other compd having muscarinic actions 0.6-1 mg,repeat 2 hrly.

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.

pyloroduodenal obstruction, paralytic ileus, intestinal atony, severe ulcerative colitis, toxic megacolon, symptomatic prostatic hypertrophy, bladder neck obstruction, bronchial asthma, COPD, cardiac arrhythmias, tachycardia, myocardial ischemia, impaired metabolic, liver or kidney function, myasthenia gravis.

Use caution in the presence of Down syndrome, brain damage, spasticity, hypertension, hyperthyroidism, lactation.

Ophthalmic solution: Contraindicated with glaucoma

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.

min before meals; avoid excessive dosage.•Avoid hot environments; pt. will be heat intolerant, and dangerous reactions may occur.•T h e s e s i d e e ff e c t s m a y o c c u r : D i z z i n e s s , c o n f u s io n ( u s e c a u ti o n d r i v i n g or p e r f o r m i n g h a z a r d o u s ta s k s ) ; constipation (ensure adequate fluid intake, proper diet); dry mouth (suck sugarless lozenges; perform frequentmouth 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 takingdrug).•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 inurination; constipation; sensitivity to light.

or tendency to glaucoma.

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications and

drug dosageContraindication Desired Untoward

Generic Name:BUMETANIDEBrand Name:Burinex amp Burinex tabDrug Classes:Sulfonamide Diuretics

PO edema 1 mg once daily, 2nd dose 6-8 hr later if needed.

Refractory edema Initial: 5mg/day, may increase dose depending on response. Max: 10 mg/day.

HTN 0.5-1 mg/day. Max: 5 mg/day.

IV P u l m o n a ry e d e m a 1 - 2 m g , r e p e a t 2 0 m i n s . l a t e r i f n e e d e d .

Bumetanide is contraindicated in anuria. Although Bumetanide can be used to induce diuresis in renal insufficiency, any marked increase in blood urea nitrogen or creatinine, or the development of oliguria during therapy of patients with progressive renal disease, is an indication for discontinuation of treatment with Bumetanide. Bumetanide is also contraindicated in patients in

Inhibits Sodium and Chloride reabsorption at the ascending loop of Henle

Muscle cramps, dizziness, hypotension, headache, nausea, impaired hearing, pruritus, ECG changes, musculoskeletal pain, rash, chest discomfort, renal failure, premature ejaculation, thrombocytopenia,hypokalemia, hypomagnesaemia, hyponatremia, hyperuricemia, hyperglycemia, hypocalcaemia.

•Give with food or milk to prevent GI upset.•Mark calendars or use 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.•Record alternate day or intermittent therapy on a calendar or dated envelopes.•Take the drug early in day so increased urination will not disturb sleep; take with food or meals to prevent GIupset.•Weigh pt. on a regular basis, at the same time, and in the same clothing; record the weight on your calendar.•These side effects may occur: Increased volume and frequency of urination; dizziness, feeling faint on arising,drowsiness (avoid rapid position changes; hazardous activities, such as driving; and alcohol consumption);sensitivity to sunlight (use

I V / I M E m e r g e n cy e d e m a 0 . 5 - 1 m g , t h e n a d j u s t according to response.

hepatic coma or in states of severe electrolyte depletion until the condition is improved or corrected. Bumetanide is contraindicated in patients hypersensitive to this drug.

sunglasses, sunscreen, wear protective clothing); increased thirst (suck sugarlesslozenges; use frequent mouth care); loss of body potassium (a potassium-rich diet, or supplement will be needed).

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications and drug

dosageContraindication Desired Untoward

Generic Name:CALCIUM GLUCONATEBrand Name:Phil Pharmawealth/Harson Calcium Gluconate ampDrug Classes:Electrolytes

PO Hypocalcaemia 10-50 mmol/day. IV Hypocalcaemic tetany 2.25 mmol via slow inj , then 5 8 - 7 7 m L o f 1 0 % s o l n d i lu t e d a n d a dm i n i s t e r e d a s a c o n ti n uo u s I V i n f u si o n .

A n ti d o t e i n s e v e r e hypermagnesaemia; Severe hyperkalaemia 10 mL of 10% soln, repeat every 10 mins if needed.

hypersens. to drug/class/compon.

hypercalcemia hypophosphatemia ventricular fibrillation

(IV use) digitalis toxicity (IV

use) nephrolithiasis (PO

use) caution if

hypercalciuria caution if

dehydration caution if renal

impairment caution if

hyperparathyroidism caution if vitamin D

toxicity caution if

Replaces Calcium and maintains Calcium level

G I i r r i t a ti o n ; s o ft ti s s u e c a l c i fi ca ti o n , s k i n s l ou g h i n g o r n e cr o s i s a ft e r I M/ S C i n j .

Hypercalcaemia characterised by anorexia, nausea, vomiting, constipation, abdominal pain, muscle weakness,mental disturbances, polydipsia, polyuria, nephrocalcinosis, renal calculi; chalky taste, hot flushes and

•Make sure prescriber specifies form of calcium to be given; crash carts may contain both calcium gluconate and calcium chloride.•Tell patient to take oral calcium 1 to 11/2 hours after meals if GI upset occurs.•Give I.M. injection in gluteal region in adults and in lateral thigh in infants. Use I.M. route only in emergencies when no I.V. route is available bec. of irritation of tissue by calcium salts.•Tell patient to take oral calcium with a full glass of water.•Monitor calcium levels frequently. Hypercalcemia

nephrolithiasis (IV use)

caution if GI bleed (PO use)

caution if GI obstruction (PO use)

peripheralvasodilation

Potentially Fatal: Cardiac arrhythmias and coma.

may result after large doses in chronic renal failure.

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications and

drug dosageContraindication Desired Untoward

Generic Name:CAPTOPRILBrand Name:Ace-Bloc tab Capomed tab Capotec tab Capoten tab Captor tab Captril tab Cardiovaz tabConamid tab Hartylox tab Normil tab Phil Pharmawealth/Panion & BF Captopril tab Prelat tab Primace tabRetensin tab SpecAce tab Tensoril tab Unihype tab Vasostad tabDrug Classes:ACE Inhibitors

P O H T N I n i ti a l : 1 2 . 5 m g t w i c e d a i l y . M a i n t e n a nc e : 2 5 - 5 0 m g t w i c e d a i l y . M a x : 5 0 m g 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

Captopril Tablets are contraindicated in patients who are hypersensitive to this product or any other angiotensin-converting enzyme inhibitor

inhibits ACE, reduces Sodium and water retention, lowers blood pressure

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.

•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.•M o n i t o r p a ti e n t c l o s e l y f o r f a l l i n B P s e c o n d a r y t o r e d u cti o n i n fl u i d v o l u m e ( e x c e s s i v e pe r s p i r a ti o n a n d 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

divided doses if needed and tolerated.

HTN in diabetic nephropathy 75-100 mg/day in divided doses

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.

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications and

drug dosageContraindication Desired Untoward

Generic Name:CLONIDINEBrand Name:Catapin amp Catapres amp Catapres tabDrug Classes:Antihypertensives

PO HTN Initial: 50-100 mcg 3 times/day. Max: 2,400 mcg/day.

Menopausal flushing;

should not be used in patients with known hypersensitivity to clonidine

s ti m u l a t e s a lp h a 2 r e c e p to r s a n d i n h ib i t s c e n t r a l v a s o m o t o r ce n t e r s , l o w er s p e r i p h e r al v a s c u l a r res

Dry mouth, drowsiness, dizziness, headache, constipation, impotence, vivid dreams, urinary retention; dry, itching, burning

•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

Migraine prophylaxis 50 mcg twice daily, up to 75 mg twice daily.

IV Hypertensive crisis 150-300 mcg via slow inj. Max: 750mcg over 24 hr.

Epidural Severe cancer pain Initial: 30 mcg/hr as continuous infusion in combination w/ an opioid.

Transdermal HTN As patch releasing 100-300 mcg clonidine base/day at constant rate: Apply once wkly.

istance, blood pressure, and heart rate

sensation in the eye; fluid or electrolyte imbalance, GI upset, paralytic ileus, orthostatic hypotension, weakness, sedation, pruritus, myalgia, urticaria, nausea, insomnia, arrhythmias, agitation. Reduced GI motility at times may cause paralytic ileus.

Potentially Fatal: Transient hypertension or profound hypotension, respiratory depression, convulsion. Clonidine withdrawal syndrome could be life threatening.Bradycardia, coma and disturbances in conduction (in individuals with preexisting diseases of SA/AV nodes, overdose or on digitalis).

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.•Take this drug exactly as prescribed. Do not miss doses. Do not discontinue the drug unless so instructed. Do not discontinue abruptly; life-threatening adverse effects may occur. If you travel, take an adequate supply of drug.•Use the transdermal system as prescribed; refer to directions in package insert, or contact your health care provider with questions. Be sure to remove old systems before applying new ones.•Attempt lifestyle changes that will reduce your BP: stop smoking and using alcohol; lose weight; restrict intake of sodium (salt); exercise regularly.•Use caution with alcohol. Your sensitivity

may increase while using this drug.•These side effects may occur: Drowsiness, dizziness, light-headedness, headache, weakness (often transient; observe caution driving or performing other tasks that require alertness or physical dexterity); dry mouth (suck on sugarless lozenges or ice chips); GI upset (eat small, frequent meals); dreams, nightmares (reversible); dizziness, light-headedness when you change position (get up slowly; use caution climbing stairs); impotence, other sexual dysfunction, decreased libido (discuss with care providers); breast enlargement, sore breasts; palpitations.•Report urinary retention, changes in vision, blanching of fingers, rash.

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndication Contraindication Desired Untoward

Generic Name:DIAZEPAM Brand Name:ValiumDrug Classes:AnxiolyticsDrug Dosage:10mg/2ml

relief of anxiety, agitation &tension due to psychoneurotic states & transient situational disturbances

Diazepam should not be administered in patients with liver or kidney disorders; myasthenia gravis; acute alcohol intoxication; depressive conditions; psychosis; brain diseases; shock; coma; drug abuse or drug

a benzodiazepine that probably potentiates the effects of GABA, depresses the CNS & suppresses the spread of seizure activity

drowsiness, dysarthria, slurred speech, tremor, transient amnesia, fatigue, ataxia, headache, insomnia, paradoxical anxiety, hallucination

•Do not administer intra-arterially; may produce arteriospasm, gangrene.•Change from IV therapy to oral therapy as soon as possible.•Do not use small veins (dorsum of hand or wrist) for IV injection.•Reduce dose of narcotic analgesics with IV diazepam; dose should be reduced by at least one-third or eliminated.•Carefully monitor P, BP, respiration during IV administration.•Maintain patients receiving parenteral benzodiazepines in bed for 3 hr; do not permit ambulatory patients to operate a vehicle following an injection.

dependence; glaucoma; hyperkinesis; hypoalbuminemia; porphyria; chronic obstructive pulmonary disease; apnea; pregnancy in the first and the last trimester; lactation; dysphagia in childhood; hypersensitivity to the benzodiazepines.

•Monitor EEG in patients treated for status epilepticus; seizures may recur after initial control, presumably because of short duration of drug effect.•Monitor liver and kidney function, CBC during long-term therapy.•Taper dosage gradually after long-term therapy, especially in epileptic patients.•Arrange for epileptic patients to wear medical alert ID indicating that they are epileptics taking this medication.•Discuss risk of fetal abnormalities with patients desiring to become pregnant.

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications Contraindication Desired Untoward

Generic Name:DIGOXINBrand Name: Digitek, Lanoxicaps, Lanoxin, Novo-Digoxin (CAN)Drug Classes:InotropicsDrug Dosage:5mg/2ml

Cardiac failure accompanied by atrial fibrillation

management of chronic cardiac failure where systolic dysfunction or ventricular dilatation is dominant

management of certain supraventric

A history of electrolyte or vitamin problems (such as low or high blood potassium, calcium, magnesium, or thiamine levels).

Being allergic to any of the ingredients in the drug

Having ventricular

inhibits sodium-potassium activated adenosine triphosphate, promoting movement of calcium fromextracellular to intra-cytoplasm and strengthening myocardial contraction, also acts on CNS to enhance vagal tone

nausea, vomiting, anorexia, headache, facial pain, fatigue, weakness, dizziness, drowsiness, disorientation, mental confusion, bad dreams, convulsions

•Monitor apical pulse for 1 min before administering; hold dose if pulse < 60 in adult or < 90 in infant; retake pulse in 1 hr. If adult pulse remains < 60 or infant < 90, hold drug and notify prescriber. Note any change from baseline rhythm or rate.•Check dosage and preparation carefully. •Avoid IM injections, which may be very painful.•Follow diluting instructions carefully, and use diluted solution promptly.•Avoid giving with meals; this will delay absorption.•Have emergency equipment ready; have K+ salts, lidocaine, phenytoin, atropine, cardiac monitor

ular arrhythmias, particularly chronic atrial flutter & fibrillation.

fibrillation, a serious heart rhythm problem 

on standby in case toxicity develops.•Monitor for therapeutic drug levels: 0.5–2 mg/mL

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications Contraindication Desired Untoward

Generic Name:DIPHENHYDRAMINEBrand Name:BenadrylDrug Classes:antihistamineDrug Dosage:50mg/ml

Hay fever ,urticaria, vasomotor rhinitis, angioneuroticedema, drug sensitization, serum & penicillinreaction,contact dermatitis,atopic eczema, other allergic dermatoses,pruritus,food sensitivity,parkinsonism,motion sickness.

Neonates asthma bladder

obstruction breast-feeding cardiac disease

children chronic

obstructive pulmonary disease (COPD)

closed-angle glaucoma

contact lenses driving or

operating machinery

elderly GI obstruction hepatic disease ileus pregnancy prostatic

hypertrophy urinary

retention

prevents histamine mediated responses, drug provides local anesthesia and suppresses cough reflex

CV and CNS effects, blood disorders, GI disturbances, anti-muscarinic effects and allergic reactions.

•Monitor carefully, assess for confusion, delirium, other anticholinergic side effects and fall risk. Institute measures to prevent falls.•Assess movement disorder before and after administration.•C a u ti o n p a ti e n t n o t t o u s e o r a l O T C d i p h e n h y d r a m i n e p r o d u c t s w i t h a n y o t h e r pr o d u c t c o n t a i n i n g diphenhydramine, including products used topically.•It can cause excitation in children. Caution parents or caregivers about proper dose calculation; overdosage, especially in infants and children, can cause hallucinations, seizures or death Inform patient that this drug may cause dry mouth. Frequent oral rinses, good oral hygiene, and sugarless gum or candy may minimize this effect. Notify dentist if dry mouth persists for more than 2 weeks.

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications a Contraindication Desired Untoward

Generic Name:EPINEPHRINEBrand Name:Epinephrine BitartrateAerosols: Primatene MistEpinephrine BorateOphthalmic solution: EpinalEpinephrine HydrochlorideInjection, OTC nasal solution: Adrenalin ChlorideOphthalmic solution: Epifrin, GlauconInsect sting emergencies: EpiPen Auto-Injector (delivers 0.3 mg IM adult dose), EpiPen Jr. Auto-Injector (delivers0.15 mg IM for children)OTC solutions for nebulization: AsthmaNefrin, microNefrin, Nephron, S2Drug Classes:

Acute asthmatic attacks,

Advanced cardiac life support

Conditions:Dilated Cardiomyopathy, Parkinson Symptoms, Closed Angle Glaucoma, High Blood Pressure, Heart Attack, Angina, Disease of the Arteries of the Heart, Sinus Tachycardia, Abnormal Heart Rhythm, Hardening of the Arteries in the Brain, Blood Circulation Failure due to Serious Heart Condition, Overactive Thyroid Gland, Diabetes, Bleeding causing Blood Pressure or Heart Problems

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 (beta12 receptors); decreased production of aqueous humor.

drowsiness, headache, nervousness, tremors, cerebral hemorrhage, dizziness, weakness, vertigo, pain

•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 cardios elective beta-blocker, such as atenolol, should be used in patients with respiratory distress) readily available in case cardiac arrhythmias occur.

S y m p a t h o m i m eti c , A l p h a -a d r e n e r g i c a g on i s t , B e t a 1a n d b e t a 2-a d r e n e r g i c a g on i s t , C a r d i a c stimulant, Vasopressor, Bronchodilator, Antasthmatic drug, Nasal decongestant, Mydriatic, Antiglaucoma drugDrug Dosage:1mg/ml

•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.•U s e t o p i c a l n a s a l s o l u ti o n s o n l y f o r a c u t e s t a t e s ; d o n o t u s e f o r l o n g e r t h a n 3 – 5 d a y s , a n d d o n o t e x c e e d recommended dosage. Rebound nasal congestion can occur after vasoconstriction subsides.•Do not exceed recommended dosage; adverse effects or loss of effectiveness may result•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).

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications Contraindication Desired Untoward

Generic Name:FUROSEMIDEBrand Name:Apo-Furosemide (CAN), Furoside (CAN), Lasix, Myrosemide (CAN)Drug Classes:loop diureticsDrug Dosage:20mg/2ml

edema, hypertension

contraindicated in patients with anuria and in patients with a history of hypersensitivity to furosemide.

inhibits Sodium and Chloride reabsorption at the proximal and distal tubules and the ascending loop of Henle

vertigo, headache, dizziness, paresthesia, weakness, restlessness, fever, nocturia, oliguria,polyguria

•Monitor BP after administration•Administer with food or milk to prevent GI upset.•Reduce dosage if given with other antihypertensives; readjust dosage gradually as BP responds.•Give early in the day so that increased urination will not disturb sleep.•Avoid IV use if oral use is at all possible.•Do not mix parenteral solution with highly acidic solutions with pH below 3.5.•Do not expose to light, may discolor tablets or solution; do not use discolored drug or solutions.•Discard diluted solution after 24 hr.•Refrigerate oral solution.•Measure and record weight to monitor fluid changes.•Arrange to monitor serum electrolytes, hydration, liver function.•Arrange for potassium-rich diet or supplemental potassium as needed.

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications Contraindication Desired Untoward

Generic Name:HYDRALAZINE HYDROCHLORIDEBrand Name:SupresDrug Classes:antihypertensionDrug Dosage:20mg/ml

For hypertensive patient

conditions like Rheumatic mitral valvular heart disease, Angina, Hypersensitivity.

a direct acting peripheral vasodilator that relaxes arteriolar smooth muscles

t a c h y c a r d i a , p a l pi t a ti o n , a n g i n a pe c t o r i s , s e v e r e he a d a c h e , d i z z i n es s , w e i g h t g a i n , G I disturbances, pruritus, rashes, nausea and vomiting

•Give oral drug with food to increase bioavailability (drug should be given in a consistent relationship ti ingestion of food for consistent response to therapy).•D r u g m a y c a u s e a s y n d r o m e r e se m b l i n g s y s t e m i c l u p u s e r y t h e ma t o s u s ( S L E ) . A r r a n g e f o r C B C , L E c e l l preparations, and ANA titers before and periodically during prolonged therapy, even in the asymptomatic patient. Discontinue if blood dyscrasias occur. Re-evaluate therapy if ANA or LE tests are positive.•Arrange for pyridoxine if patient develops symptoms of peripheral neuritis.•Monitor patient for orthostatic hypotension which is most marked in the morning and in hot weather, and with alcohol or exercise

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications Contraindication Desired Untoward

Generic Name:HYDROCORTISONE SODIUM SUCCINATEBrand Name:A-hydroCort, Solu-Cortef Drug Classes:corticosteroid hormonesDrug Dosage:100 mg/ 2 mL, 250 mg/ 2 mL

endocrine, hematologic, rheumatic & collagen disorders, dermatologic, ophth, GI, resp & neoplasticdiseases, edematous states, control of severe incapacitating allergic conditions, TB meningitis w/ subarachnoidblock or impending block when used

contraindicated in systemic fungal infections and patients with known hypersensitivity to the product and its constituents.

Decreases inflammation, mainly by stabilizing leukocyte lysosomal membranes, suppresses immuneresponse, stimulates bone marrow and influences protein, fat, and carbohydrate metabolism

fluid and electrolyte disturbances, decreased carbohydrate tolerance, impaired wound healing, thin fragile skin, muscle weakness, steroid myopathy, osteoporosis, aseptic necrosis, peptic ulceration w/possible perforation, cataracts, increased

•Give daily before 9 AM to mimic normal peak diurnal corticosteroid levels and minimize HPA suppression.•Space multiple doses evenly throughout the day.•Do not give IM injections if patient has thrombocytopenic purpura.•Rotate sites of IM repository injections to avoid local atrophy.•Use minimal doses for minimal duration to minimize adverse effects.•Taper doses when discontinuing high-dose or long-term therapy.•Arrange for increased dosage when patient is subject to unusual

concurrently with appropriate anti-TB chemotherapy, shock secondary toadrenocortical insufficiency or shock unresponsive to conventional therapy when adrenocortical insufficiency maybe present

intraocular and intracranial pressure, growth retardation, Cushingoidstate, protein catabolism, psychic derangements, exophthalmos, masking of infections, gasping syndrome,seizures, menstrual irregularities.

stress.•Use alternate-day maintenance therapy with short-acting corticosteroids whenever possible.•Do not give live virus vaccines with immunosuppressive doses of hydrocortisone.•Provide antacids between meals to help avoid peptic ulcer

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications Contraindication Desired Untoward

Generic Name:ISOSORBIDE-5- MONONITRATEBrand Name:Imdur Drug Classes:anti- anginal drugDrug Dosage:SL: 5 mg/mL ; Oral: 30 mg, 60 mg

prophylactic treatment of angina pectoris

Should not be used in cases of acute myocardial infarction with low filling pressures, acute circulatory failure (shock, vascular collapse), or very low blood pressure, hypertrophic obstructive cardiomyopathy (HOCM), constrictive pericarditis, cardiac tamponade, low cardiac filling pressures, aortic/mitral valve stenosis and diseases associated with a raised intra-cranial pressure e.g. following a head trauma and including cerebral haemorrhage.

Patients with a known sensitivity to isosorbide mononitrate, the listed ingredients or other nitrates.

Should not be used in patients with marked anaemia, severe hypotension, closed angle glaucoma or hypovolaemia.

Thought to reduce cardiac oxygen demand by decreasing preload and afterload. Drug also may increaseblood flow through the collateral coronary vessels

headache, hypotension w/ dizziness and nausea, tachycardia

•Monitor BP and heart rate.•Assess location, duration, intensity, and precipitating factors of anginal pain.

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications Contraindication Desired Untoward

Generic Name:ISOSORBIDE DINITRATEBrand Name:Isoket IVDrug Classes:anti – anginal drugDrug Dosage:10 mg/10mL

unresponsive left ventricular failure secondary to acute MI, severe or unstable angina pectoris

Allergic reactions to organic nitrates are extremely rare, but they do occur. The isosorbide dinitrate tablet is contraindicated in patients who are allergic to ISDN or any of its other ingredients.

Isosorbide dinitrate is a smooth muscle relaxant. It is particularly effective on vascular and bronchialsmooth muscle. Its systemic cardiovascular effects are mainly due to a decrease in venous return (pooling of b l o o d i n t h e p e r i p h e r a l v e n o u s s y st e m ) . C o n s e q u e n t l y , v e n t r i c u l a r e n d -d i a s t o l i c p r e s s u r e a n d v o l u m e a r e diminished, thus reducing cardiac work and implicitly myocardial oxygen requirements. The arterial vessels aredilated as well, though to a lesser degree. This results in a slight drop in aortic and systemic blood pressurer e l i e v i n g t h e m y o c a r d i u m f r om a p a r t o f i t s a ft e r l o a d . T h e s e n i t r a t e - i n d u c e d c h a n g e s a c c o u n t f o r b o t h t h e antianginal effects of isosorbide dinitrate and for its beneficial effects in the treatment of congestive heart failure.

Severe cerebral flow deficiency and decreased coronary perfusion may develop, nitrate headache and nausea.

•Monitor BP and heart rate.•Assess location, duration, intensity, and precipitating factors of anginal pain.

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications Contraindicati

onDesired Untoward

Generic Name:MAGNESIUM SULFATEBrand Name:Elin Magnesium SulfateDrug Classes:

treatment of hypomagnesemia accompanied by signs of tetany, control of HTN, encephalophathy &c o n v u l s i o n s , p r e v e n ti o n & c

Heart block

may decrease acetylcholine released by nerve impulses, but its anticonvulsant mechanism is unknown

flushing, sweating, hypotension, muscular weakness, sedation & confusion; decreased deeptendon reflexes; resp. paralysis

•Monitor the following: I.V.: Rapid administration: ECG monitoring, vital signs, deep tendon reflexes; magnesium,calcium, and potassium levels; renal function during administration. Obstetrics: Patient status including vital signs,oxygen saturation, deep tendon reflexes, level of consciousness, fetal heart

anticonvulsantDrug Dosage:250 mg/10 mL

o n t r o l o f c o n vu l s i o n s i n p a ti en t s w / p r e e c l am p s i a o r e c l a mp s i a , p r e v e n ti on o f hypomagnesemia in patients receiving TPN

rate, maternal uterine activity. Oral:Renal function; magnesium levels; bowel movements.

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications Contraindication Desired Untoward

Generic Name:MEPERIDINE HYDROCHLORIDEBrand Name:DemerolDrug Classes:antivertigo drugDrug Dosage:100 mg/ 2mL

relief of moderate to severe pain, pre-op medication, support of anesth & obstet analgesia

contraindicated in patients with hypersensitivity to meperidine or to any of its ingredients

binds with opiate receptors in the CNS, altering perception of and emotional response to pain

resp. depression, circulatory depression, resp arrest, shock, cardiac arrest, GI disturbance,light headedness, dizziness, sedation, nausea, vomiting, sweating, euphoria, dysphoria, weakness, headache,tremor, agitation, uncoordinated muscle movements, severe convulsions, transient hallucinations & disorientation,visual disturbance, flushing, tachycardia, bradycardia, palpitation, hypotension, syncope, phlebitis, urinaryretention, allergic reactions,

•Make position changes slowly and in stages particularly from recumbent to upright posture. Lie down immediately if light-headedness or dizziness occurs.•Lie down when feeling nauseated and to notify physician if this symptom persists. Nausea appears to worsen with ambulation.•Avoid driving and other potentially hazardous activities until reaction to drug is known. Codeine may impair ability to perform tasks requiring mental alertness and therefore to.•Do not take alcohol or other CNS depressants unless approved by physician.•Hyperactive cough may be lessened by avoiding irritants such as smoking, dust, fumes and other air pollutants. Humidification of ambient air may provide some relief.•Do not breast feed while taking this drug.

pain at injection site and local tissue irritation.

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications Contraindication Desired Untoward

Generic Name:METOCLOPRAMIDEBrand Name:Apo-Metoclop (CAN), Maxeran (CAN), Maxolon, Nu-Metoclopramide (CAN), Octamide PFS, ReglanDrug Classes:antiemetic & anti-spasmodicDrug Dosage:10 mg/ 2mL

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

Metoclopramide is contraindicated in phaeochromocytoma.

It should be used with caution in Parkinson's disease since, as a dopamine antagonist, it may worsen symptoms.

Long-term use should be avoided in patients with clinical depression as it may worsen mental state.

Also contraindicated with a suspected bowel obstruction.

stimulates motility of upper GI tract, increases lower esophageal sphincter tone, and blocks dopaminereceptors at the chemoreceptor trigger zone

extrapyramidal reactions, drowsiness, fatigue & lassitude, anxiety, less frequently, insomnia, headache, dizziness, nausea, galactorrhea, gynecomastia, bowel disturbances.

•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 byalterations in timing of food absorption.•Keep diphenhydramine injection readily available in case extrapyramidal reactions occur (50 mg IM).•H a v e p h e n t o l a m i n e r e a d i l y a v a il a b l e i n c a s e o f h y p e r t e n s i v e c r is i s ( m o s t l i k e l y t o o c c u r w i t h u nd i a g n o s e d pheochromocytoma).

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications Contraindication Desired Untoward

Generic Name:MIDAZOLAM HYDROCHLORIDEBrand Name:DormicumDrug Classes:hypnotics & sedativesDrug Dosage:5mg/5mL

tab: disturbances of sleep rhythm, insomnia esp difficulty in falling asleep either initially or after p r e ma t u r e a w ak e n i n g

t a b / i n j : s e d a ti o n in p r e m e d b e f o r e s u rg i c a l o r d ia g n o s ti c pr o c e d u r e s , i n d u c ti o n & maintenance of anesth

• Hypersensitivity to drug, its components, or other benzodiazepines• Acute closed-angle glaucoma• Allergy to cherries (syrup preparation)

may potentiate the effects of GABA, depress the CNS, and suppress the spread of seizure activity

rarely cardioresp adverse events, nausea, vomiting, headache, hiccoughs, laryngospasm,dyspnoea, hallucination, oversedation, drowsiness, ataxia, rash, paradoxical reactions, amnesic episodes.

•Do not administer intra-arterially, which may produce arteriospasm or gangrene.•Do not use small veins (dorsum of hand or wrist) for IV injection.•Administer IM injections deep into muscle.•Monitor IV injection site for extravasation.•Arrange to reduce dose of midazolam if patient is also being given opioid analgesics; reduce dosage by at least50% and monitor patient closely.•Monitor level of consciousness prior to, during, and for at least 2–6 hr after administration of midazolam.•Carefully monitor P, BP, and respirations carefully during administration.•Keep resuscitative facilities readily available; have flumazenil available as antidote if overdose should occur.•Keep patients in bed for 3 hr; do not permit ambulatory patients to operate a vehicle following an injection.•Arrange to monitor liver and kidney function and CBC at intervals during long-term therapy.•Establish safety precautions if CNS changes occur (use side rails, accompany ambulating patient).•Provide comfort measures and reassurance for patients receiving diazepam for tetanus.•Arrange to taper dosage gradually after long-term therapy.•Provide patient with written information regarding recovery and follow-up care. Midazolam

is a potent amnesiac and memory may be altered.

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications Contraindication Desired Untoward

Generic Name:MORPHINE SULFATE Brand Name:MorinDrug Classes:Analgesics (Opioid)Drug Dosage:Adult 5-20 mg IM/SC 4 hrly. Severe or chronic painChildn 10 mg IM/SC 4 hrly, range: 5-20 mg; 6-12 yr 5-10 mg, 1-5 yr 2.5-5 mg, 1-12 mth 200 mcg/kg, <1 mth 150 mcg/kg 4 hrly. Max: 15 mg. Analgesic effect Ped 100-200 mcg/kg SC 4 hrly, max: 15 mg/dose; or 50-100 mcg/kg slow IV. Pre-op 50-100 mcg/kg IM, max: 10 mg/dose.

R e l i e f o f m o d e r a t e t o s e v e r e painnot responsive to non-narcotic analgesics. Premed. Analgesicadjunct in general anesth esp in pain associated w/ cancer, MI & surgery. Alleviatesanxietyassociated w/ severepain. Hypnotic for pain-related sleeplessness.

Morphine Sulfate is contraindicated in patients with known hypersensitivity to morphine, morphine salts, or any components of the product.

Morphine Sulfate is contraindicated in patients with respiratory depression in the absence of resuscitative equipment.

Morphine Sulfate is contraindicated in patients with acute or severe bronchial asthma or hypercarbia.

Morphine Sulfate is contraindicated in any patient who has or is suspected of having paralytic ileus.

alters perception and emotional response to pain

Lightheadedness, dizziness, sedation, nausea, vomiting, constipation & sweating.

•Caution patient not to chew or crush controlled-release preparations.•Dilute and administer slowly IV to minimize likelihood of adverse effects.•Tell patient to lie down during IV administration.•K e e p o p i o i d a n t a g o n i s t a n d f a c i l i ti e s f o r a s s i s t e d o r c o nt r o l l e d r e s p i r a ti o n r e a d i l y av a i l a b l e d u r i n g I V administration.•Use caution when injecting SC or IM into chilled areas or in patients with hypotension or in shock; impaired perfusion may delay absorption; with repeated doses, an excessive amount may be absorbed when circulation is restored.•Reassure patients that they are unlikely to become addicted; most patients who receive opioids for medical reasons do not develop dependence syndromes.

Drug Features Therapeutics Effects Nursing Responsibilities

Indications Contraindication Desired UntowardGeneric Name:NICARDIPINE HYDROCHLORIDEBrand Name:CardepineDrug Classes:Calcium AntagonistsDrug Dosage:IV infusion Dilute to 10-20 mg/100 mL (conc of 1.01-0.02%). Initial infusion rate: 5 mg/hr; titrate dose upto 15 mg/hr until desired therapeutic response is achieved (DBP <95 mmHg, SBP <140 mmHg). Maintenancerate: Can be tapered down to ≤10 mg/hr. IV bolus inj 2-7 mg w/out dilution given over 1-2 min.

Hypertensive emergencies or urgencies, peri-op & post-op HTN, hypertensive states of NPO patients.

Nicardipine hydrochloride is contraindicated in patients with hypersensitivity to the drug.

Because part of the effect of nicardipine is secondary to reduced afterload, the drug is also contraindicated in patients with advanced aortic stenosis. Reduction of diastolic pressure in these patients may worsen rather than improve myocardial oxygen balance.

a Calcium channel blocker that inhibits Calcium ion influx across cardiac and smooth muscle cells, alsodilates coronary arteries and arterioles

P e r i p h e r a l e d e m a , h e ad a c h e , t a c hy c a r d i a , p a lp i t a ti o n s , l oc a l i z e d t h r om b o p h l e b i tis & hypotension

•Patients with hepatic impairment should receive lower dose.•Monitor blood pressure. Allow at least 3 days between dosage adjustments to achieve steady plasma levels.•Advise patient to report immediately if experiencing chest pain

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndication Contraindication Desired Untoward

Generic Name:NTG PATCHBrand Name:Deponit, Minitran, Nitrek, Nitro-Dur, Nitrodisc, Transderm-NitroDrug Classes:Anti-Anginal Drugs

Prevention of angina pectoris due to coronary artery disease

Use of nitroglycerin transdermal system is contraindicated in patients using sildenafil because sildenafil may amplify the vasodilatory effects of nitroglycerin

a nitrate that reduces cardiac oxygen demand by decreasing left ventricular end diastolic pressure and to a lesser extent,

Headache. Transient episodes of lightheadedness. Infrequently, hypotension. Syncope, crescendo angina, rebound HTN, allergic & anaphylactoid reactions. Rarely

•Administer transdermal systems to skin site free of hair and not subject to much movement. Shave areas that have a lot of hair. Do not apply to distal extremities. Change sites slightly to decrease the chance of local irritation and sensitization. Remove transdermal system before

Drug Dosage:Starting dose: 0.2-0.4 mg/hr. Dosing schedule: Daily patch-on period of 12-14 hr & daily patch-off period of 10-12 hr.

transdermal systems resulting in severe hypotension.

Allergic reactions to organic nitrates are extremely rare, but they do occur. Nitroglycerin is contraindicated in patients who are allergic to it. Allergy to the adhesives used in nitroglycerin patches has also been reported, and it similarly constitutes a contraindication to the use of this product.

systemic vascular resistance, also increases blood flow through collateral coronary vessels

severe, application site irritation.

attempting defibrillation or cardioversion.•To use transdermal systems, you may need to shave an area for application. Apply to a slightly different area each day. Use care if changing brands; each system has a different concentration.

Drug Features Therapeutics Effects Nursing ResponsibilitiesIndications Contraindication Desired Untoward

Generic Name:PARACETAMOLBrand Name:AeknilDrug Classes:Analgesics (Non-Opioid) & AntipyreticsDrug Dosage:Adult & childn ≥10 yr 2-3 mL, ≤10 yr 1-2 mL. Depending on severity of case, dose may

Pyrexia of unknown origin.Fever &painassociated w/ common childhood disorders,tonsillitis, upper resp tract infections post-immunization reactions,

Paracetamol is contraindicated in hypersensitivity, analgesic nephropathy, renal and hepatic impairment.

produce analgesia by blocking pain impulses by inhibiting synthesis of prostaglandin in CNS, relieves fever

Hematological, skin & other allergic reactions

•Use liquid form for children and patients who have difficulty swallowing.•In children, don’t exceed five doses in 24 hours.•Advise patient that drug is only for short term use and to consult the physician if giving to children for longer than 5days or adults for longer than 10 days.•Advise patient or caregiver that many over the counter products contain acetaminophen; be aware of this when calculating total daily dose.•Warn patient that high doses or unsupervised long term use can cause liver damage

be repeated 4hrly. In severe cases, dose may be administered by IV very slowly

after tonsillectomy & other conditions. Prevention of Headache,cold,sinusitis,muscle pain,arthritis&toothachefebrileconvulsion.