Name of the Drug Generic Name: furosemide Brand Name: Apo-Furosemide Furoside Lasix Lasix Speacial Novosemide Uritol

Dosage/Route 0.5-1 mg/kg slow IVP over 12 min, may repeat once at 2 mg/kg slow IVP over 1-2 mins.

Action/Classification Action: inhibits sodium and chloride reabsorption at the proximal and distal tubules and the ascending loop of Henlen Classification: Loop Diuretics

Indication/ Contraindications Indications: Edema associated with CHF Cirrhosis with ascites or renal dysfunction For hypertension or in combination with other antihypertensive medications. ICP, nephritic syndrome, hepatic cirrhosis Contraindications: Contraindicated to patients hypersensitive to drug or any of its components and in those with anuria. Use cautiously in patient with hepatic cirrhosis. Patients with allergies to sulfonamides may also be allergic to furosemide. In pregnant woman, use only if benefits outweighs the risk to the fetus. In breast feeding woman, do not use drug.

Adverse Effects/ Side Effects Adverse Effects: vertigo, headache, paresthesia, orthostatic hypotension, thrombophlebitis, abdominal pain, Hypokalemia, anemia, muscle spasm

Nursing Responsibilities Monitor serum glucose, and electrolyte D iet- K+ for all except aldactone I ntake and Output, daily weight U ndesirable effects; Fluid and electrolyte imbalance R eview HR, BP and electrolytes E lderly-Careful T ake with or after meals and in AM I ncrease risk of orthosthatic hypotension; move slowly C ancel alcohol

Name of the Drug Generic Name: Sodium Bicarbonate Brand Name: Arm and Hammer Pure Baking Soda, Citrocarbonate, Soda Mint

Dosage/Route 1 mEq/kg IVP, may repeat 0.5 mEq/kg 10 min.

Action/Classification Action: Neutralizes gastric acid Decrease pepsin activity Classification: Alkalizing Agent, Buffer, Antacid, electrolyte

Indication/ Contraindications Indications: o Hyperacidity o Peptic ulcer o Hyperkalemia o Tricyclic antidepressant OD o Shock associated with severe diarrhea, dehydration, uncontrolled DM o Reflux esophagitis Contraindications: Contraindicated in patients with metabolic or respiratory alkalosis; patients who are losing chlorides from vomiting or continuous GI suction; patients taking diuretics known to produce hypochloremia alkalosis; and patients with hypocalcemia in which alkalosis may produce tetany, hypertension, seizures, or heart failure. Oral sodium bicarbonate is contraindicated in patients with acute ingestion of strong mineral acids.

Adverse Effects/ Side Effects Adverse Effects: GI: Gastric distention, belching, flatulence. Metabolic: metabolic alkalosis, hypernatremia, hypokalemia, hyperosmolarity (with overdose). Other: Pain and irritation at injection site.

Nursing Responsibilities Monitor urinary pH, calcium, electrolytes and phosphate levels. Record amount and consistency of stools. Clients on low-sodium diets should evaluate sodium contents of antacids.

Name of the Drug Generic Name: Dopamine HCl. Brand Name: Intropin; Revimine

Dosage/Route Adults: initially, 1 to 5 mcg/kg/minute by I.V. infusion. Adjust dose to desired hemodynamic or renal response, increase by 1 to 4 mcg/kg/minute at 10 to 30minute intervals.

Action/Classification Action Stimulates dopaminergic and alpha and beta receptors of the sympathetic nervous system. Action is dose-related; large doses can cause mainly alpha stimulation. Classification: Inotropic, vasopressor

Indication/ Contraindications Indications: To treat shock and correct hemodnamic imbalances, improve perfusion of vital organs, to increase cardiac output, and to correct hypotension. Contraindications: Contraindicated in patient with uncorrected tachyarrhythmias, pheocromocytoma, or ventricular fibrillation. - Use cautiously in patients with occlusive vascular disease, cold injuries, diabetic endarteritis, and arterial embolism; in pregnant woman; with a history of sulfite sensitivity; and in those taking MAO inhibitor.

Adverse Effects/ Side Effects Adverse Effects: Cv: anginal pain, arrythmias, bradycardia, conduction disturbances ectopic breasts,hypertension, hypotension, palpitations, tachycardia, vasoconstriction, widening of QRS complex. GI: vomiting. GU: azotemia Respiratory: asthma attacks, dyspnea Skin: necrosis,piloerection, tissue sloughing with extravasation. Other: anaphylaxis.

Nursing Responsibilities Blood is not a substitute for blood or fluid volume deficit. If deficit occurs, replace fluid deficit first before giving meds. During infusion, frequently monitor ECG, BP, cardiac output, CVP, pulmonary artery wedge pressure, pulse rate, urine output, and color and temperature of the limbs. If diastolic pressure rises disproportionately, decrease perfusion rate and watch out carefully for further signs of vasoconstriction unless such action is desired. Observe for adverse reaction.

Side Effects: CNS: headache GI: nausea

Check for urine output. If urine flow is decrease without hypotension, notify physician. After drug is stopped, Tamper dosage slowly to evaluate stability of blood pressure. Acidosis decrease effectiveness of dopamine.