Generic Name

1. Epinephrine
Children 1
month-2 yrs.
0.3-0.5 mg/kg;
children .2 yrs.
Adults 0.4-0.5
mg/k

Brand Name
Adrenaline

Classification
Adrenergic
Agonist Agent;
Bronchodilator

Mechanism of Action
Stimulates alpha-,
beta-, and beta2adrenergic receptors
resulting
in relaxation of
smooth muscle of the
bronchial tree,
cardiac stimulation,
and
dilation of skeletal
vasculature; small
doses can cause
vasodilation via
beta2vascular receptors;
large doses may
produce constriction
of skeletal and
vascular smooth
muscle; decreases
production of
aqueous humor and
increases
aqueous outflow;
dilates the pupil by
contracting the
dilator muscle.

Indication
Bronchospasms,
anaphylactic
reactions, cardiac
arrest

Adverse Effect
CV: Pounding
heartbeat, tachycardia,
flushing, Hypertension
CNS: Nervousness,
restlessness, dizziness,
headache, insomnia,
lightheadedness
GI: Nausea, vomiting
Neuromuscular &
Skeletal: Weakness,
trembling
Miscellaneous:
Diaphoresis

Nursing Respo
Monitor heart r
pressure,
pulse, site of in
blanching
Assess lung so
before & after
Note amount,
character of sp
produced

Acts by selectively

Adjunct in

CNS:

Monitor vital si

2. Atropine
Sulfate

Isopto Atropine

Anticholinergic

blocking all
muscarinic responses
to
acetylcholine (ACh),
whether excitatory or
inhibitory. Selective
depression of CNS
relieves rigidity and
tremor of Parkinson's
syndrome.
Antisecretory action
(vagolytic
effect)suppresses
sweating,l
acrimation,
salivation, and
secretions from nose,
mouth, pharynx, and
bronchi. Blocks vagal
impulses to heart
with resulting
decrease in AV
conduction time
,increase in heart
rate and cardiac
output, and
shortened PR
interval.

symptomatic
treatment of GI
disorders (e.g.,
peptic ulcer,
pylori spasm, GI
hyper
motility, irritable
bowel syndrome)
and spastic
disorders
of biliary tract.
Relaxes upper GI
tract and colon
during hypotonic
radiography.

Headache, ataxia,
dizziness, excitement,
irritability, convulsions,
drowsiness, fatigue,
weakness; mental
depression, confusion,
disorientation,
hallucinations.
CV:
Hypertension or
hypotension,
ventricular tachycardia,
palpitation, paradoxical
bradycardia,
AVdissociation, atrial or
ventricular fibrillation.
GI:
Dry mouth witht hirst,
dysphasia, loss of
taste; nausea,
vomiting, constipation,
delayed gastric
emptying, paralytic
ileus.
Urogenital:
Urinary hesitancy and
retention, dysuria,
impotence.
Skin:
Flushed, dry skin;
anhidrosis, rash,
urticaria, contact
dermatitis, allergic

a sensitive ind
of patient's res
atropine. Be al
changes in qua
and rhythm of
respiration and
changes in BP
temperature.
Initial paradox
bradycardia fol
atropine usuall
only 12 min;
most likely occ
IV is administe
(more than 1 m
when small do
than0.5 mg) a
Postural hypot
occurs when p
ambulates too
parenteral
administration

4. Amiodarone

Cordarone

Anti-arrhytmics

Blocks Na channels,
prolonging
myocardial cell action
potential and
refractory period.
Non competitive
alpha and beta
adrenergic blockage.

Life threatening
recurrent
arrhythmias,
ventricular
fibrillation,
ventricular
tachycardia

conjunctivitis, fixeddrug eruption.

Special Senses:
Mydriasis, blurred
vision, photophobia,
increased intraocular
pressure, cyclopedia,
eye dryness, local
redness.
Dizziness; flushing;
headache; lightheadedness; stomach
pain
Exacerbation of
arrhythmias,
bradycardia, SA node
dysfunction, heart
block, sinus arrest,
flushing, fatigue,
malaise, involuntary
movements, ataxia,
dizziness, paresthesia,
decreased libido,
insomnia, headache,
sleep disturbance,
visual impairment,
blindness.

Assess cardiov
status before s
Assess pulmon
hepatic and th
function before
surgery
Monitor fluid a
electrolytes, I
NA, and CI
Monitor ECG an
Assess vision
Monitor BP and
before therapy
Assess for CHF
Monitor ECG, I
serum potassiu
weight
Drug-induced
arrhythmias m
increase the se
of heart failure
hypotension.
Before giving
dose, obtain ba

5. Verapamil

Calan

Anti-anginal,
anti-arrhytmics,
antihypertensive,
vascular
headache
suppressants

Inhibit calcium
transport into
myocardial smooth
muscle cell.
Decreases SA and AV
conduction and
prolongs AV node
refractory period in
conduction tissue

Hypertension,
angina pectoris,
supraventricular
arrhythmia, atrial
fibrillation

6. Digoxin

Lanoxin

Inotropic
antiarrhythmic
cardiac glycoside

Inhibit sodiumpotassium-activated
adenosine
triphosphatase,
promoting movement
of calcium from
extracellular to intra
cellular cytoplasm
and strengthening
myocardial
contraction. Also acts

Heart failure,
paroxysmal
supraventricular
tachycardia,
atrial fibrillation
and flutter

Abnormal dreams,
anxiety, confusion,
dizziness, headache,
blurred vision,
epistaxis, tinnitus, CHF,
chest pain,
bradycardia,
hypotension,
palpitations, dysuria,
nocturia, polyuria,
abnormal liver
function, anorexia,
constipation, nausea
and vomiting
CNS:generalized
muscle weakness,
agitation,
hallucinations,
CV:
arrhythmias, heart
block.
EENT:
yellow-green halos
around visual images
blurred vision, light

data (heart rat

rhythm, blood
and electrolyte
patient about u
of cardiac glyc
within the prev
weeks.
Loading dose i
divided over th
24hours with
approximately
loading dose g
first dose.
Before giving d
apical-radial pu
1minute. Reco
notify prescrib
significant chan
(sudden increa
decrease in pu
pulse deficit, ir
beats and, par
regularization
previously irre
rhythm). If the
occur, checbloo
pressure

on CNS to enhance
vagal tone, slowing
conduction through
the SA and AV nodes

7. Dopamine

Intropine

Adrenergic drugs

Stimulates
dopaminergic and
alpha and beta
receptors of the
sympathetic nervous
system resulting in
positive inotropic
effect and increased
CO

flashes, photophobia,
diplopia.
GI:
Anorexia ,nausea

To treat shock
and correct
hemodynamic
imbalances, to
correct
hypotension, to
improve
perfusion of vital
organs, to
increase CO

Headache, anxiety,
angina, palpitations,
vasoconstriction, n/s.

Most patients r
less than 20mc
During infusion
ECG, BP, CO, P
color and temp
Check urine ou

Dobutamine

Therapeutic class:
Inotrope
Pharmacologic
class:
Adrenergic beta
antagonist

levophed

Norepinephrine
bitartrate

Therapeutic class:
Vasopressor
Pharmacologic
class:
Direct acting
adrenergic

Stimulates the
heart beta1
receptors to
increase myocardial
contractility and
stroke volume

Stimulates alpha
and beta1
receptors in
sympathetic
nervous system,
causing
vasoconstriction

Increased cardiac
output in short
term treatment of
cardiac
decomposition
caused by
depressed
contractility such as
during refractory
heart failure;
adjunctive therapy
in cardiac surgery

To restore blood
pressure in acute
hypotension; severe
hypotension during
cardiac arrest

CNS: Headache
CV: HPN, increased
heart rate, angina,
PVCs, phlebitis, non
specific chest pain,
palpitations,
ventricular ectopy,
hypotension.
GI: N/V
RESP: asthma
attack, SOB

CNS: headache,
anxiety, weakness,
dizziness, tremor,
restlessness, insomnia
CV: bradycardia,
severe hypertension,
arrhythmias.

Continuo
monitor E
pulmona
wedge pr
cardiac o
urine out
Monitor e
levels. D
lower po
level.

If patient h
deficit repl
fluids befor
vasopresso
Keep emer
drugs on h
reverse eff

and cardiac
stimulation

Calcium
gluconate

Therapeutic class:
Calcium
supplement
Pharmacologic
class: Calcium salts

Replaces calcium
and maintains
calcium levels

-Hypocalcemic
emergency
-Hypocalcemic tetany
-Adjunctive treatment
of magnesium
intoxication
-Drug exchange
transfusions
-Hyperphosphatemia

RESP: asthma attacks,

respiratory difficulties
Skin: irritation with
extravasations,
necrosis, and gangrene
secondary to
extravasations

drug: atrop
reflex, brad
phentolam
decrease v
effects, an
propranolo
arrhythmia

CNS: Tingling
sensations, sense of
oppression or heat
waves with IV use,
syncope with rapid IV
use
CV: bradycardia,
arrhythmias, cardiac
arrest with rapid IV
use, mild drop in BP,
vasodilation
GI: constipation,
irritation, chalky taste,
hemorrhage, N/V,
thirst, abdominal pain.
GU: polyuria, renal
calculi
Metabolic:
hypercalcemia
Skin: local reaction,
including burning

Monitor ca
levels frequ
Maintain ca
of 9 to 10.
Sign and s
of severe
hypercalce
include stu
confusion d
and coma.
Sign and s
of mild hyp
may includ
nausea and
Warn patie
the meal b
takes calciu
shouldnt h
rhubarb, sp
bran and w
cereals or

lasix

furosemide

Therapeutic class:
Anti-hypertensive
Pharmacologic
class: loop diuretic

Inhibits sodium
and chloride
reabsorption at the
proximal and distal
tubules and the
ascending loop of
Henle

-Acute pulmonary
edema
-Edema
-Hypertension

necrosis, tissue
sloughing, cellulites,
soft tissue calcification
with IM use

products; t
interfere w
absorption

CNS: vertigo,
headache, dizziness,
parethesia, weakness,
restlessness, fever
CV: orthostatic
hypotension,
thrombophlebitis with
IV administration
EENT: transient
deafness, blurred or
yellow vision, tinnitus
GI: abdominal
discomfort, pain ,
diarrhea, anorexia,
N/V, constipation,
pancreatitis
GU: azotemia,
nocturia, polyuria,
frequent urination ,
oliguria
Hematologic: hepatic
dysfunction, jaundice
Metabollic:
hypokalemia,
hypocalcemia,
hypomagnesemia
Musculoskeletal:
muscle spasm

Monitor we
pulse rate
with long t
Monitor flu
and output
electrolyte
carbon dio
Monitor glu
in a Diabet
Monitor uri
levels
Monitor eld
patients, w
especially s
to excessiv
Drug may
fetal birth

hydrocortisone

Therapeutic class:
Corticosteroid
Pharmacologic
class: corticosteroid

Dilantin

Phenytoin

Therapeutic class:
Anti convulsant
Pharmacologic
class: Hydantoin
derivative

Diffuses across cell

membranes to
form complexes
with cytoplasmic
receptors, showing
anti inflammatory,
antipruritic,
vasoconstrictive
and
antiproliferative
activity.

Inflammation and
pruritus from
corticosteroid
responsive
dermatoses
adjunctive topical
management of
seborrheic dermatitis
of the scalp
Inflammation from
proctitis

Topical
GU: glycosuria
Metabolic:
hyperglycemia
Skin: burning, pruritus,
irritation , dryness,
erythema
Rectal
CNS: seizure,
increased intracranial
pressure, vertigo ,
headache
CV: hypertension
EENT: cataracts,
glaucoma
GI: peptic ulcer,
pancreatitis, abdominal
destintion,
GU: menstrual
irregularities

If an occlu
dressing is
and fever d
report imm
Avoid using
pants or tig
diapers on
areas in yo
children
Monitor pa
and electro
Drug may
skin reactio

May stabilize
neuronal
membranes and
limit seizure
activity either by
increasing efflux or
decreasing influx
sodium ions across
cell membranes in
the motor cortex

To control tonicclonic (grandma) and

complex partial
(temporal lobe)
seizure
To prevent and treat
seizures occurring
during neurosurgery
Status epilepticus

CNS: Ataxia, decreased

coordination, slurred
speech, dizziness,
headache, insomnia,
nervousness
CV: periarteritis
nodosa, hypotension
EENT: diplopia,
nystagmus. Blurred
vision

Dont stop
suddenly b
may worse
seizure
Monitor cb
calcium lev
Monitor dru
Therapeuti
10-20mcg/
Maintain se

during generation
of nerve impulses

Hematologic:
agranulocytosis,
leucopenia,
pancytopenia,
thrombocytopenia
Hepatic: Toxic hepatitis
Osteomalacia
Hyperglycemia
Skin: Steven-Johnson
syndrome, toxic
epidermal necrolysis

precaution
Closely mo
patients fo
in behavior
Doubling th
doesnt dou
level but m
toxicity
If rash app
the drug
Mononucle
decrease le
for increas