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ROLAND MARK RODEL DUMAGPI LAGOS DRUG DATA Generic Name: PROCAINAMIDE Trade Name: Pronestyl Patients Dose:

n/a Minimum Dose: 100mg IVTT q 5mins Maximum Dose: 600mg IVTT q 60mins Availability: Solution Route of Administration: IV, IM CLASSIFICATION Therapeutic: Antiarrhythmics (class IA) Pregnancy Risk Category: C MECHANISM OF ACTION Decrease myocardial exitability. Slows conduction velocity. May depress myocardial contractility Therapeutic: Suppression of arrhythmias. Onset: immediate Peak: 25 - 60 mins Duration: 3 4 hrs Half-Life: 2.5 4.7 hrs INDICATION General: Treatment of a wide variety of ventricular and atrial arrhythmias, including: Atrial premature contractions, Premature ventricular contractions, Ventricular tachycardia, Paroxysmal atrial tachycardia. Maintenance of normal sinus rhythm after conversion from atrial fibrillation or flutter ADVERSE/SIDE EFFECTS Contraindicated in CNS: hypersensitivity; AV block; Seizures, dizziness, Myasthenia gravis; confusion Hypersinsitiviity to tarrazine (FDC yellow dye CV: asystole, heart #5; present in some oral block, ventricular products) arrhythmias, hypotension Use catiously in known suspected CNS disorder, GI: renal impairment. diarrhea, anorexia, bitter taste, nausea, Drug Interaction: vomiting May have additive or antagonistic effects with Derm: other antiarryhtmics. rashes Additive neurologic toxicity (confusion, seizures) with lidocaine. Antihypertensives and nitrates may potentiate hypotensive effect. Potentiates neuromuscular blocking agents. May partially antagonize the therapeutic effects of anticholinesterase agents in myasthenia gravis. CONTRADICATION NURSING RESPONSIBILITIES Before: Check doctors order. Review drug preparation. Assess for clients heart rate. Inform therapeutic effect. Check venoclysis patency. During: Observe rights of administration. Administer drug on time. Monitor BP closely during administration. Assess for patients hypersensitivity. Inform patient of the possible adverse/side effects of drug. After: Monitor bowel elimination. Check Lab values leukocytes, eosinophils and platelets. Advise patient to report for allergic reactions. Advised to avoid activity that requires mental alertness. Notify health care professionals if no improvement w/in a few days.

Source: Deglin J. H., Vallerand A. H. (2008). Daviss Drug Guide for Nurses. (11th ed., pp. 1008 1010) 1915 Arch Street Philadelphia, PA 19103: F.A Davis Company. DOI: www.fadavis.com

ADVERSE/SIDE NURSING RESPONSIBILITIES EFFECTS Generic Name: Therapeutic: Contraindicated in CNS: Before: HYDRALAZINE Antihypertensive hypersensitivity; Some dizziness, drowsiness, Check doctors order. rpoducts contain tartazine headache Review drug preparation. Trade Name: and should be avoided in Assess for clients heart rate. Apresoline patients with known CV: tachycardia, agina, Inform therapeutic effect. Pharmacologic intolerance. arrhythmias, edema, Check venoclysis patency. Patients Dose: Vasodilator orthostatic During: n/a Use cautiously in hypotension Observe rights of Pregnancy Risk Cardiovascular or administration. Minimum Dose: Category: cerebrovascular disease; GI: Administer drug on time. 5mg C Severe renal and hepatic diarrhea, nausea, Monitor BP closely during fisease (dose modification vomiting administration. Maximum Dose: Onset: may be necessary); Assess for patients 40mg 5 - 20 mins hypersensitivity. Drug Interaction: Inform patient of the possible Availability: Peak: Increase hypotension with adverse/side effects of drug. Tablets, Injection, 15 - 30 mins acute ingestion of alcohol, After: Solution other antihypertensives, or Monitor BUN results. Duration: nitrates. MAO inhibitors Monitor liver function. Route of Administration: 2 6 hrs may exaggerate Arrange for pyridoxine if patient IV, IM, PO hypotension. May decrease develops symptoms of peripheral Half-Life: pressor response to neuritis. 2 8 hrs epinephrine. NSAIDS may Advised to avoid activity that decrease antihypertensive requires mental alertness. response. Notify health care professionals if no improvement w/in a few days. th Source: Deglin J. H., Vallerand A. H. (2008). Daviss Drug Guide for Nurses. (11 ed., pp. 633 635) 1915 Arch Street Philadelphia, PA 19103: F.A Davis Company. DOI: www.fadavis.com DRUG DATA CLASSIFICATION CONTRADICATION

MECHANISM OF INDICATION ACTION Direct-acting General: peripheral arteriolar Moderate to severe vasodilator. hypertension (with a diuretic). Unlabeled Therapeutic: uses: CHF unresponsive Lowering of blood to conventional therapy pressure in with digoxin and hypertensive diuretics patients and decreased afterload in patients with CHF.

DRUG DATA Generic Name: HYDROCORTISONE SOIUM SUCCINATE

CLASSIFICATION Therapeutic: Antiasthmatics, corticosteroid

Before: Check doctors order. Review drug preparation. Assess for clients heart rate. Trade Name: Inform therapeutic effect. A-hydroCort, Solu-Cortef Check venoclysis patency. Pharmacologic Therapeutic: Use cautiously in chronic During: Patients Dose: corticosteroids Suppression of treatment Observe rights of n/a inflammation and CV: hypertension administration. Pregnancy Risk modification of the Drug Interaction: Administer drug on time (before Minimum Dose: Category: normal immune Increase isk of hypokalemia GI: 9AM to mimic normal diurnal 4mg C response. with thiazide and loop Peptic ulceration, corticosteroid levels). diuretics, or amphotericin anorexia, nausea, Monitor BP closely during Maximum Dose: Onset: B. Hypokalemia may vomiting administration. 10mg rapid increase risk of digoxin Assess for patients toxicity. hypersensitivity. Availability: Peak: Inform patient of the possible Tablets, Injection, unknown adverse/side effects of drug. Solution After: Duration: Monitor BP hourly. Route of Administration: unknown No virus vaccine for patients IV, IM, PO taking this medication. Half-Life: Provide antacids before meals 1.5 2 hrs to prevent peptic ulcer. Advised to avoid activity that requires mental alertness. Notify health care professionals if no improvement w/in a few days. Source: Deglin J. H., Vallerand A. H. (2008). Daviss Drug Guide for Nurses. (11th ed., pp. 350 357) 1915 Arch Street Philadelphia, PA 19103: F.A Davis Company. DOI: www.fadavis.com

MECHANISM OF ACTION Replace endogenous cortisol in deficiency states. Have potent mineralocorticoid activity.

INDICATION General: Management adrenocortical insufficiency.

CONTRADICATION Contraindicated in active of untreated infections (maybe used in patients being treated for some forms of meningitits).

ADVERSE/SIDE EFFECTS CNS: Depression, euphoria, headache, increased intracranial pressure, personality change, psychoses, restlessness

NURSING RESPONSIBILITIES

DRUG DATA Generic Name: ISOSORBIDE MONONITRATE Trade Name: Apo-ISMN, IMDUR Patients Dose: n/a Minimum Dose: 2.5mg Maximum Dose: 5mg Availability: Tablets, Injection, Solution Route of Administration: IV, IM, PO

CLASSIFICATION Therapeutic: antianginals

Pharmacologic nitrates Pregnancy Risk Category: C

MECHANISM OF ACTION Produce vasodilation (venous greater than arterial). Decrease left ventricular enddiastolic pressure and left ventricular endvolume(preload). Net effect is reduced myocardial oxygen consumption. Increase coronary blood flow by dilating coronary arteries and improving collateral flow to ischemic regions. Therapeutic: Relief and prevention of angina attacks Onset: unknown Peak: unknown Duration: 12 hrs

INDICATION General: Acute treatment of angina attacks (SL only). Prophylactic management of angina pectoris. Treatment of chronic CHF(unlabeled)

ADVERSE/SIDE EFFECTS Contraindicated in CNS: hypersensitivity; Dizziness, headache concurrent use of sildenafil, vardenafil or CV: hypotension, tadalafil. tachycardia, paradoxic bradycardia, syncope Use cautiously in volume depleted patients; right GI: ventricular infarction; nausea, vomiting hypertrophic cardiomyopathy CONTRADICATION Drug Interaction: Concurrent use of sildenafil, tadalafil, or vardenafil may result in significant and potentially fatal hypotension.

NURSING RESPONSIBILITIES Before: Check doctors order. Review drug preparation. Assess for clients heart rate. Inform therapeutic effect. Check venoclysis patency. During: Observe rights of administration. Administer drug on time. Monitor BP closely during administration. Assess for patients pain. Inform patient of the possible adverse/side effects of drug. After: Monitor BP and heart rate hourly. Assess for patients pain levels. bedrest. Advised to avoid activity that requires mental alertness. Notify health care professionals if no improvement w/in a few days.

Half-Life: 5 hrs Source: Deglin J. H., Vallerand A. H. (2008). Daviss Drug Guide for Nurses. (11th ed., pp. 707 708) 1915 Arch Street Philadelphia, PA 19103: F.A Davis Company. DOI: www.fadavis.com

DRUG DATA Generic Name: MAGNESIUM SULFATE Trade Name: Elin Magnesium Sulfate Patients Dose: n/a Minimum Dose: 1 - 6g /day Maximum Dose: 8 12g / day Availability: Tablets, Injection, Solution Route of Administration: IV, IM, PO

CLASSIFICATION Therapeutic: Mineral and electrolyte repalcements / supplements

MECHANISM OF ACTION Essential for the activity of many enzymes. Plays an important role in neurotransmission and muscular excitability.

INDICATION General: Treatment/prevention of hypomagnesemia. Treatment of hypertension. Anticonvulsant associated severe eclampsia, preeclampsia, or acute nephritis.

Pharmacologic Therapeutic: Mineral/electrolytes Replacements in deficiency states. Pregnancy Risk Resolution of Category: eclampsia. D Onset: immediate Peak: unknown Duration: 30 mins Half-Life: unknown

ADVERSE/SIDE EFFECTS Contraindicated in CNS: hypermagnesemia; Drowsiness hypocalcemia; Anuria; Hear block; Respi: decreased respiratory rate Use cautiously in any degree of renal CV: arrhythmias, insufficiency; Digitalized bradycardia, patients. hypotension CONTRADICATION Drug Interaction: GI: Potentiate calcium channel diarrhea blockers and neuromuscular blocking agents.

NURSING RESPONSIBILITIES Before: Check doctors order. Review drug preparation. Assess for clients heart rate. Inform therapeutic effect. Check venoclysis patency. During: Observe rights of administration. Administer drug on time. Monitor BP closely during administration. Assess for patients pain. Inform patient of the possible adverse/side effects of drug. After: Monitor BP and heart rate hourly. Monitor for Ca, Mg, K levels. Monitor for renal function. Advised to avoid activity that requires mental alertness. Notify health care professionals if no improvement w/in a few days.

Source: Deglin J. H., Vallerand A. H. (2008). Daviss Drug Guide for Nurses. (11th ed., pp. 768 357) 1915 Arch Street Philadelphia, PA 19103: F.A Davis Company. DOI: www.fadavis.com

DRUG DATA Generic Name: MEPERIDINE

CLASSIFICATION Therapeutic: Opiod analgesics

Before: Check doctors order. Review drug preparation. Trade Name: Assess for clients heart rate. Demerol Inform therapeutic effect. Pharmacologic Check venoclysis patency. Patients Dose: Opiod agonists Use cautiously in head During: n/a trauma; increased ICP; Observe rights of Pregnancy Risk severe renal, hepatic or EENT: blurred vision, administration. Minimum Dose: Category: Therapeutic: pulmonary disease diplopia, miosis. Administer drug on time. 50mg c Decrease in severity Monitor BP closely during of pain. Drug Interaction: Resp: respiratory administration. Maximum Dose: Potentiate calcium channel depression. Assess for patients pain. 150mg Onset: blockers and Inform patient of the possible immediate neuromuscular blocking CV: hypotension, adverse/side effects of drug. Availability: agents. bradycardia. After: Tablets, Injection, Peak: Instruct to change position Solution 5 7 mins GI: constipation, slowly. nausea, vomiting. Instruct to lie down when Route of Administration: Duration: feeling nauseated. IV, IM, PO 2 3 hrs Monitor for renal function. Advised to avoid activity that Half-Life: requires mental alertness. 2.5 4 hrs Notify health care professionals if no improvement w/in a few days. th Source: Deglin J. H., Vallerand A. H. (2008). Daviss Drug Guide for Nurses. (11 ed., pp. 784 357) 1915 Arch Street Philadelphia, PA 19103: F.A Davis Company. DOI: www.fadavis.com

MECHANISM OF ACTION Binds to opiate receptor in the CNS. Alters the perception of and response to painful stimuli, while producing generalized CNS depression.

INDICATION General: Moderate or severe pain (alone or with nonopiod agent). Anesthesia adjunct.

CONTRADICATION Contraindicated in hypersensitivity; hypersensitivity to bisulfites (some injectable products)

ADVERSE/SIDE EFFECTS CNS: SEIZURES, confusion, sedation, dysphoria, euphoria, floating feeling, hallucinations, headache, unusual dreams.

NURSING RESPONSIBILITIES

DRUG DATA Generic Name: METOCLOPRAMIDE Trade Name: Apo-Metoclop, Clopra Patients Dose: n/a Minimum Dose: 5mg Maximum Dose: 10mg Availability: Tablets, Injection, Solution Route of Administration: IV, IM, PO

CLASSIFICATION Therapeutic: antiemetics

Pregnancy Risk Category: B

MECHANISM OF ACTION Blocks dopamine receptors in chemoreceptor trigger zone of the CNS. Stimulates motility of the upper GI tract and accelerates gastric emptying.

INDICATION

CONTRADICATION Contraindicated in hypersensitivity; hypersensitivity to bisulfites (some injectable products) Use cautiously in head trauma; increased ICP; severe renal, hepatic or pulmonary disease Drug Interaction: Potentiate calcium channel blockers and neuromuscular blocking agents.

General: Prevention of chemotherapy-induced emesis. Treatment of postsurgical and diabetic gastric stasis. Facilitation of small bowel intubation in radiographic procedures. Therapeutic: Management of Decreased nausea esophagealreflux. and vomiting. Treatment and Decreased prevention of symptoms of gastric postoperative nausea stasis. and vomiting when nasogastric suctioning is Onset: undesirable. Unlabeled 1 3 min uses: Treatment of hiccups. Adjunct Peak: management of immediate migraine headaches. Duration: 1 2 hrs Half-Life: 2.5 6 hrs

ADVERSE/SIDE EFFECTS CNS: drowsiness, extrapyramidal reactions, restlessness, NEUROLEPTIC MALIGNANT SYNDROME, anxiety, depression, irritability, tardive dyskinesia. CV: arrhythmias (supraventricular tachycardia, bradycardia), hypertension, hypotension. GI: constipation, diarrhea, dry mouth, nausea.

NURSING RESPONSIBILITIES Before: Check doctors order. Review drug preparation. Assess for clients heart rate. Inform therapeutic effect. Check venoclysis patency. During: Observe rights of administration. Administer drug on time. Monitor BP closely during administration. Assess for patients pain. Inform patient of the possible adverse/side effects of drug. After: Instruct to change position slowly. Instruct to lie down when feeling nauseated. Keep diphenhydramine injection ready. Advised to avoid activity that requires mental alertness. Notify health care professionals if no improvement w/in a few days.

Source: Deglin J. H., Vallerand A. H. (2008). Daviss Drug Guide for Nurses. (11th ed., pp. 810 812) 1915 Arch Street Philadelphia, PA 19103: F.A Davis Company. DOI: www.fadavis.com

DRUG DATA Generic Name: MIDAZOLAM Trade Name: Dormicum Patients Dose: n/a Minimum Dose: 1mg Maximum Dose: 3.5mg Availability: Tablets, Injection, Solution Route of Administration: IV, IM, PO

CLASSIFICATION Therapeutic: Antianiety agents

Pharmacologic: benzodiazepines

MECHANISM OF ACTION Acts at many levels of the CNS to produce generalized CNS depression. Effects may be mediatedby GABA, an inhibitory neurotransmitter. Therapeutic: Short-term sedation. Postoperative amnesia. Onset: 1 3 min Peak: immediate Duration: 1 2 hrs Half-Life: 2.5 6 hrs

INDICATION General: Provides sedation/ anxiolysis/ amnesia during therapeutic, diagnostic, or radiographic procedures (conscious sedation). Aids in the induction of anesthesia and as part of balanced anesthesia. As a continuous infusion, provides sedation of mechanically ventilated patients during anesthesia or in a critical care setting, Status epilepticus.

Pregnancy Risk Category: B

ADVERSE/SIDE EFFECTS Contraindicated in: CNS: agitation, Hypersensitivity; drowsiness, excess Crosssensitivity with other sedation, headache. benzodiazepinesmay occur; Shock; Comatose patients EENT: blurred vision. or those with pre-existing CNS depression; Resp: APNEA, Uncontrolled severe pain; LARYNGOSPASM, Products containing benzyl RESPIRATORY alcohol should not be used DEPRESSION, in neonates; bronchospasm, coughing. Use Cautiously in: Pulmonary disease; CHF; CV: CARDIAC ARREST, Renal impairment; Severe arrhythmias. hepatic impairment; Obese pediatric patients GI: hiccups, nausea, (calculate dose on the vomiting. Chronicbasis of ideal body weight); CONTRADICATION Drug Interaction: Increase CNS depression with alcohol, inantihistamines, opioid analgesics, and other sedative/hypnotics (midazolam dose by30 50% if used concurrently).

NURSING RESPONSIBILITIES Before: Check doctors order. Review drug preparation. Assess for clients heart rate. Inform therapeutic effect. Check venoclysis patency. During: Observe rights of administration. Administer drug on time. Monitor BP closely during administration. Assess for patients pain. Inform patient of the possible adverse/side effects of drug. After: Instruct to change position slowly. monitor IV site for extravasation. Arrange to reduce dose if given opion analgesics. Advised to avoid activity that requires mental alertness. Notify health care professionals if no improvement w/in a few days.

Source: Deglin J. H., Vallerand A. H. (2008). Daviss Drug Guide for Nurses. (11th ed., pp. 822 825) 1915 Arch Street Philadelphia, PA 19103: F.A Davis Company. DOI: www.fadavis.com

DRUG DATA Generic Name: MORPHINE

CLASSIFICATION Therapeutic: Antianiety agents

Before: Check doctors order. Review drug preparation. Trade Name: Assess for clients heart rate. none Inform therapeutic effect. Pharmacologic: Check venoclysis patency. Patients Dose: benzodiazepines During: n/a Observe rights of Use Cautiously in: Head EENT: blurred vision, administration. Minimum Dose: Therapeutic: trauma; Increased diplopia,miosis. Administer drug on time. 5mg Pregnancy Risk Decrease in severity intracranial pressure; Monitor BP closely during Category: of pain. Severe renal, hepatic, or Resp: RESPIRATORY administration. Maximum Dose: B pulmonary disease; DEPRESSION. Assess for patients pain. 20mg Onset: Hypothyroidism; Adrenal Inform patient of the possible rapid insufficiency; History of CV: hypotension, adverse/side effects of drug. Availability: substance abuse; bradycardia. After: Tablets, Injection, Peak: Instruct to change position Solution 20 mins Drug Interaction: GI: constipation, slowly. Use with extreme caution nausea, vomiting. monitor IV site for Route of Administration: Duration: in patients extravasation. IV, IM, PO 4 5 hrs receiving MAO inhibitors Arrange to reduce dose if given within 14 days prior (may opion analgesics. Half-Life: result in unpredictable, Advised to avoid activity that 2 4 hrs severe reactionsdecrease requires mental alertness. initial dose of morphine to Notify health care professionals 25% of usual dose). if no improvement w/in a few days. Source: Deglin J. H., Vallerand A. H. (2008). Daviss Drug Guide for Nurses. (11th ed., pp. 843 847) 1915 Arch Street Philadelphia, PA 19103: F.A Davis Company. DOI: www.fadavis.com

MECHANISM OF ACTION Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression.

INDICATION

CONTRADICATION

General: Contraindicated in: Severe Pain. Pulmonary Hypersensitivity; Some edema. Pain Associated products contain with MI. tartrazine, bisulfites, or alcohol and should be avoided in patients with known hypersensitivity.

ADVERSE/SIDE EFFECTS CNS: confusion, sedation, dizziness, dysphoria, euphoria, floating feeling, hallucinations, headstartache, unusual dreams.

NURSING RESPONSIBILITIES

DRUG DATA Generic Name: MORPHINE Trade Name: none Patients Dose: n/a Minimum Dose: 0.5mg Maximum Dose: 2.2mg Availability: Tablets, Injection, Solution Route of Administration: IV, IM, PO

CLASSIFICATION Therapeutic: Antianginals, antihypertensive

Pharmacologic: Calcium channel blockers

MECHANISM OF ACTION Inhibits the transport of calcium into myocardial and vascular smooth muscle cells, resulting in inhibition of excitationcontraction coupling and subsequent contraction. Therapeutic: Systemic vasodilation resulting in decreased blood pressure. Coronary vasodilation resulting in decreased frequency and severity of attacks of angina. Onset: Within min Peak: 45 mins Duration: 50 hrs Half-Life: 2 4 hrs

INDICATION General: Management of: Hypertension, Angina pectoris, Vasospastic (Prinzmetals) angina. Unlabeled buses: Management of CHF.

CONTRADICATION Contraindicated in: Hypersensitivity; Sick sinus syndrome; 2nd- or 3rddegree AV block (unless an artificial pacemaker is in place); BP <90mmHg; Advanced aortic stenosis. Use Cautiously in: Severe hepatic impairment

Pregnancy Risk Category: c

Before: Check doctors order. Review drug preparation. Assess for clients heart rate. Inform therapeutic effect. Check venoclysis patency. During: Observe rights of administration. Administer drug on time. Use Cautiously in: Severe EENT: blurred vision, Monitor BP closely during hepatic impairment (dose disturbed equilibrium, administration. reduction recommended); epistaxis, tinnitus. Assess for patients pain. Inform patient of the possible Drug Interaction: Resp: cough, dyspnea, adverse/side effects of drug. Additive hypotensionmay shortness of breath. After: occur when used Instruct to change position concurrently with fentanyl, CV: ARRHYTHMIAS, slowly. other antihypertensives, CHF, peripheral monitor IV site for nitrates, acute ingestion of edema, bradycardia, extravasation. alcohol, or quinidine. chest pain, Arrange to reduce dose if given Antihypertensive effects hypotension, opion analgesics. may beby concurrent use Advised to avoid activity that of NSAIDs. Concurrent use requires mental alertness. with beta blockers, digoxin Notify health care professionals if no improvement w/in a few days.

ADVERSE/SIDE EFFECTS CNS: abnormal dreams, anxiety, confusion, dizziness, drowsiness, headache, jitteriness, nervousness, psychiatric disturbances, weakness.

NURSING RESPONSIBILITIES

Source: Deglin J. H., Vallerand A. H. (2008). Daviss Drug Guide for Nurses. (11th ed., pp. 879 881) 1915 Arch Street Philadelphia, PA 19103: F.A Davis Company. DOI: www.fadavis.com