IVP PP purpose dosage infusion time common side effects lab valuesR

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Reg

lan

5mg/

mL antimetic

Tx: N&V, hiccups & migraines.

Blocks dopamine receptors in chemoreceptors. Stimulates upper GI and ↑ gastric emptying

N & V:5-10mg

3mL NS/ Med/ 3mL NS

5- mg/mindoses over 10mg should be diluted in 50 ml over 15 min.

• Rate: slowly over 1-2 minutes, too fast causes a transient but intense feeling of anxiety and restlessness followed by drowsiness.

drowsiness, EPS, NMSHA, anxiety, depressionRestlessness, hypotension, visual disturbances, nausea

Onset Peak Drtn1-3min 60-

90min1-2 hr

• May alter hepatic function test results• May cause ↑ serum prolactin and aldosterone concentrations

Nursing Considerations: may effect absorption of other PO meds as a result of effect on GI motility; Assess: ABD N&V, ABD distention, bowel sounds. EPS - Diphenhydramine (Benadryl) 1mg/kg IV prophylactically 15 min prior to metoclopramide IV infusion. Admin IV dose 30 min before admin of chemotherapeutic agent and 30 min before meals or bedtime for Geri. contraindicated in Parkinson’s, gi obstructions, hx of seizure disorders, diabetes,

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IVP PP purpose dosage infusion time common side effects lab valuesPe

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9NS

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100

mL/

hr.

Adm

inis

ter I

VP

Pepc

id 2

0mg.

Ava

ilabl

e: P

epci

d 10

mg/

/ml Antiulcer agent.

short term tx ulcers, GERD, acid indigestion, upper GI bleeding, adjunct: aspiration pneumonitis, urticaria action: H2 antagonistinhibits gastric acid secretions.

10mg/mL,dilute with 5-10mL NS

20 mg q 12hrs or 40mg q day

Renal Impairment: 10-50ML/ MIN Q 24 HR or 50% Dose at Normal Dosing intervals

20 mg over 2 min

• Direct IV: Diluent: 0.9% NaCl for injection. Concentration: not >4 mg/mL• Rate: Administer at a rate of 10 mg/min over at least 2 min.

Rapid administration may cause hypotension

ARRHYTHMIAS, AGRANULOCYTOSIS, APLASTIC ANEMIA,confusion,Hypersensitivity

CBC

» May cause false-negative results in skin tests using allergenic extracts. Histamine antagonists should be discontinued 24 hr prior to the test

» May cause an ↑ in serum transaminases and serum creatinine

» May cause false-positive results for urine protein; test with sulfosalicylic acidOnset Peak Drtn1hr 0.5-3hr 8-15hr

Nursing Considerations: Assess for Epigastric or ABD pain, Frank or Occult blood in stool, emesis, or gastric aspirate. Assess elderly for confusion. Avoid NSAIDS. Contraindicated in breastfeeding mothers – infant side effects

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IVP PP purpose dosage infusion time common side effects lab valuesSo

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Solu

Med

rol 6

0 m

g.A

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Sol

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rol 1

25 m

g/2m

L Anti-inflammatory Immunosuppressant/ Synthetic CorticosteroidTx: inflammation, allergic, autoimmune disordersAdj: ↑K+, N&V-chemo.

Action: suppresses inflammation and normal immune response

10-250mg q 4-6 hrs.

Onset Peak Drtnrapid rapid UNK

Reconstitute with provided solution (Act-O-Vials, Univials, ADD-Vantage vials) or 2 mL of bacteriostatic water (with benzyl alcohol) for injection.

10-40mg (one – several minutes)

Concentration: Maximum of 125 mg/mL

• Rate: Low dose (C1.8 mg/kg or C125 mg/dose): May be administered direct IV push over 3–15 min

PEPTIC ULCERATION, THROMBOEMBOLISM, depression, euphoria (ICP in peds), HTN, anorexia, nausea, acne, ↓ wound healing, ecchymoses, fragility, hirsutism, petechiae, adrenal suppression, muscle wasting, osteoporosis, cushingoid appearance (moon face, buffalo hump)↑ risk of adverse GI effects w/NSAIDSfluid retention, CHF, muscle weakness, convulsions.

• Monitor serum electrolytes and glucose. May cause hyperglycemia, hypokalemia. Prolonged therapy should routinely have hematologic values, serum electrolytes, and serum and urine glucose evaluated. ; May ↓ WBC counts. May ↓ serum K+ and Ca+ and increase serum Na+» test stools for positive guaiac presence. » May ↑ serum cholesterol and lipid values. May ↓ uptake of thyroid » Suppresses reactions to allergy skin tests» Periodic adrenal function tests may be ordered to assess degree of hypothalamic-pituitary-adrenal axis suppression in systemic and chronic topical therapy

Nursing Considerations: contraindicated with untreated infections and w/admin of live virus vaccines. Caution: chronic tx – use lowest possible dose for shortest time. Use preservative-free diluent for use in neonates.↓ growth – peds, Additive hypokalemia w/ thiazide and loop diuretics and some antibiotics. May ↑ need for insulin. Sensitivity to sulfites (some injectable forms contain sulfites)

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Prot

onix

/ pa

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ient

has

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VP

Prot

onix

40

mg.

Ava

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roto

nix

40 m

g po

wde

r in

vial

. antiulcer agent/Proton pump inhibitoraction: binds to enzyme in presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen. To decrease heartburn symptoms with GERD, adjunct tx of ulcers w/H. pylori

40mg dilute with 10 mL NS

peptic ulcer: 4-80mg q day

40mg/10mL over 2 min

Reconstitute each vial with 10 mL of 0.9% NaCl. Reconstituted solution is stable for 6 hr at room temperatureRate: Administer over at least 2 min

no life threatening or most frequent adverse or side effects. Others are headache, ABD pain, diarrhea, eructation (belching), flatulence, hyperglycemia.

Onset Peak Drtn15-30min

2hr UNK

• May cause abnormal liver function tests, including ↑ AST, ALT, alkaline phosphatase, and bilirubin

if on warfarin monitor INR/PT

Nursing Considerations: Disc. Breastfeeding due to potential for serious adverse reactions in infants. Not compatible w/ midazolam & zinc.May ↓ absorption of drugs requiring acid pH. May ↑ risk of bleeding with warfarin, and ↓ the antiplatelet effects of clopidogrel.

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Las

ix /

furo

sem

ide

5. P

atie

nt h

as a

SL

.A

dmin

iste

r IV

P La

six

20 m

g.A

vaila

ble:

Las

ix 4

0 m

g/4

ml v

ial Diuretic/ loop

diureticfor edema due to HF, Renal disease, hepatic impairment, HTNAction: inhibits reab of NA and CL in loop of Henley. ↑ excretion of water Na, CL Ma, K and Ca

Max 20-40 mg/24 hr ?? may repeat in 1-2 hrs.600mg/24 hr80mg/dose

Onset Peak Drtn5min 30min 2hr

20 mg/minslowly over 1-2min

Concentration: 10 mg/mL

APLASTIC ANEMIA, AGRANULOCYTOSIS, dehydration, ( hypo: Cl, K, Ma, Na)Hypovolumeia, Metabolic Alkalosis

may ↑ risk of digoxin toxicity, oto toxicity w/ aminoglycosides.NSAIDs ↓ effects of furosemide

wt, I/O, sounds lungs hrt, skin turgor, membranes,BP, HR before and duringLab Test Considerations• Monitor electrolytes, renal and hepatic function, serum glucose, and uric acid levels before and periodically throughout therapy. Commonly ↓ serum potassium. May cause ↓ serum sodium, calcium, and magnesium concentrations. May also cause ↑ BUN, serum glucose, creatinine, and uric acid levels

Nursing Considerations: Known hypersensitivity to furosemide or sulfonamides, anuria, electrolyte imbalance. May lead to interactions w/ aminoglycoside antibiotics, digitalis and lithium. use cautiously in electrolyte depletion, DM, ↑ azotemia, alcohol intolerance. Geri ! Allergies to sulfonamides?? give no later than 5pm

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