EMERGENCY DRUGS DRUG
CLASSIFICATION
•
Alpha/Beta Agonist Antidote Ophthalmic Agent
•
Anti-glaucoma
•
Generic Name: EPHINEPHRINE Brand Name: ADRENALIN
•
•
Generic Name: AMINOPHYLLINE
Theophylline Derivative
USE
•
•
Treatment of bronchospasm, anaphylactic reactions, cardiac arrest, management of open-angle glaucoma
Bronchodilator Bronchodilator in reversible airway obstruction due to asthma or COPD; increase diaphragmatic contractility; neonatal idiopathic apnea of prematurity.
STOCK DOSE
•
• • •
Injection: Adrenalin®: 0.01 0.01 mg/mL [1:100,000] [1:100,000] (5 mL); 0.1 mg/mL [1:10,000] (3 mL, 10 mL); 1 mg/mL [1:1000] (1 mL, 2 mL, 30 mL)
Injection, IV: 25mg/ml (10 ml, 20 ml) Liquid, oral: 105 mg/5ml (240 ml) Tablet: 100 mg, 200 mg
NURSING CONSIDERATION
•
Rapid IV infusion may cause death from cerebrovascular hemorrhage or cardiac arrhythmias.
•
Monitor heart rate, BP, site of infusion for blanching, extravasations.
•
•
•
•
•
Generic Name: ATROPHINE SULFATE
Anti-cholinergic Anti-cholinergic agent; Antispasmodic Agent, Gastrointestinal; Ophthalmic Agent
•
Preopera Preoperative tive medicati medication on to inhibit bit salivati salivation on and secretions; antidote for organophosphate organophosphate pesticide poisoning; treatment of sinus bradycardia; treatment of exercise-induced bronchospam.
• •
Injection, as sulfate: 0.1 mg/mL (5 mL, 10 mL); 0.3 mg/mL (1 mL, 30 mL); 0.4 mg/mL (1 mL, 20 mL, 30 mL); 0.5 mg/mL (1 mL, 5 mL, 30 mL); 0.8 mg/mL (0.5 mL, 1 mL); 1 mg/mL (1 mL, 10 mL) Tablet, as sulfate: 0.4 mg Ointment, ophthalmic, ophthalmic, as sulfate: 0.5%, 1% (3.5 g)
•
• •
•
•
Generic Name: CAPTOPRIL Brand Name: CAPOTEN
•
AngiotensinConverting Enzyme (ACE) inhibitors
•
Management of hypertension; treatment of congestive heart failure, left ventricular dysfunction after myocardial infarction, diabetic nephropathy
•
Tablet: 12.5 mg, 50 mg, 100 mg
•
•
Generic Name: CLONIDINE Brand Name: CATAPRES
•
Alpha2 Agonist
•
Management of mild to moderate hypertension; either used alone or in combination combination with other antihypertensive antihypertensive
•
•
•
Generic Name: IPRATROPIUM & ALBUTEROL Brand Name: COMBIVENT
•
Bronchodilator
•
Treatment of chronic obstructive pulmonary disease (COPD) in those patents that are currently on a regular bronchodilator ator who continue to have broncho-spasms broncho-spasms and require a second bronchodilator
•
Injection, preservative free, as hydrochloride: 100 mcg/ml (10 ml) Patch, transdermal, as hydrochloride: 1, 2, and 3 (0.1, 0.2, .3 mg/day, 7-day duration) Tablet, as hydrochloride: 0.1 mg, 0.2 mg, 0.3 mg
Aerosol: Ipratropium bromide 18 mcg and albuterol sulfate 103 mcg per actuation [200 doses] (14.7 g)
•
•
•
Avoid I.M. injection, too painful; do not inject IV solution faster than 25 mg/minute. Encourage patient to drink adequate fluids to decrease mucous viscosity in airway. Monitor vital signs
Administer undiluted by rapid IV injection; slow injection may result in paradoxical bradycardia. bradycardia. Monitor hear rate, BP, pulse, mental status. IV administration requires a cardiac monitor Provide safety measures, it may cause drowsiness and restlessness Observe for tachycardia if patient has cardiac problems Anaphylactic reactions can occur. Angio-edema can occur at any time during treatment. Careful blood pressure monitor with first dose. Watch for hypotension effect within 1-3 hours of first dose or new higher dose Monitor blood pressure, standing/sitting/supine, respiratory rate and depth, pain relief, mental status, heat rate (bradycardia may be treated with atropine) Provide security measures because it causes drowsiness
Monitor signs of rapid respiration
Generic Name: HYDROCORTISONE Brand Name: SOLU-CORTEF
•
Corticosteroid
•
Management of adrenocortical insufficiency; relief of inflammation of corticosteroid responsive dermatoses; adjunctive treatment of ulcerative colitis
•
•
•
Generic Name: WARFARIN Brand Name: COUMADIN
Generic Name: DIAZEPAM Brand Name: DIASTAT VALIUM
Generic Name: DIPHENHYDRAMINE Brand Name: BENADRYL
•
•
Anticoagulant
•
Benzodi azepine
•
Prophylaxis and treatment of venous thrombosis, pulmonary embolism; prophylaxis of systemic embolism after myocardial infarction
Management of anxiety disorders; alcohol withdrawal symptoms; skeletal muscle relaxant; convulsive disorders
•
•
• •
Powder for injection, as sodium, lyophilized: 2 mg, 5 mg Tablet, as sodium: 1 mg, 2 mg, 2.5 mg, 3 mg, 4 mg, 5 mg, 6 mg, 7.5 mg, 10 mg
Injection: 5 mg/mL (1 mL, 2 mL, 5 mL, 10 mL) Tablet: 2 mg, 5 mg, 10 mg
•
•
•
•
• • •
•
•
Antihistamine
•
Symptomatic relief of allergic symptoms caused by histamine release which include nasal allergies and allergicdermatosis;
•
• •
Generic Name: DOPAMINE Brand Name: INTROPIN
Injection, suspension: 25 mg/mL (5 mL, 10 mL); 50 mg/mL (5 mL, 10 mL) Injection, I.M./I.V./S.C.: 50 mg/mL (2 mL, 10 mL) : 100 mg, 250 mg, 500 mg, 1000 mg Tablet, oral: 5 mg, 10 mg, 20 mg
•
Adrenergic agent
agonist
• •
Adjunct in the treatment of shock (i.e., MI, open heart surgery, renal failure, cardiac decompensation, etc) which persists after adequate fluid volume replacement
•
Injection, as hydrochloride: 10 mg/mL (10 mL, 30 mL); 50 mg/mL (1 mL, 10 mL)
•
Monitor BP IV bolus: Dilute to 50 mg/ml and administered over 3-5 minutes
Should not be given in close proximity to other drugs because absorption may be decreased. Avoid all IM injections
Protect parenteral dosage from light Do not mix with other medications Monitor respiratory rate, heart rate, BP with IV use Provide safety measures (i.e., side rails, night light, call button; supervise ambulation
Raise bed rails, institute safety measures, assist with ambulation
Tablet/Capsule, as hydrochloride: 25 mg, 50 mg Syrup, as hydrochloride: 12.5 mg/5 mL (5 mL, 120 mL, 240 mL, 480 mL, 3780 mL) Infusion, as hydrochloride, in D 5W: 0.8 mg/mL (250 mL, 500 mL); 1.6 mg/mL (250 mL, 500 mL); 3.2 mg/mL (250 mL, 500 mL) Injection, as hydrochloride: 40 mg/mL (5 mL, 10 mL, 20 mL); 80 mg/mL (5 mL, 20 mL); 160 mg/mL (5 mL)
Single-dose vial injection: Beef lung source: 1000 units/mL (1 mL); 5000 units/mL (1 mL); 10,000 units/mL (1 mL); 20,000 units/mL (1 mL); 40,000 units/mL (1 mL)
•
•
Protect from light; solution that are darker than slightly yellow should not be used Monitor BP and heart rate
•
Generic Name: HEPARIN
Generic Name: ISOSORBIDE DINITRATE Brand Name: ISORDIL DILATRATE SORBITRATE Generic Name: LIDOCAINE Brand Name: XYLOCAINE LIDODERM
Generic Name:
•
Anticoagulant
•
• •
Vasodilator
Prophylaxis and treatment of thromboembolic disorders
Prevention and treatment of angina pectoris; for congestive heart failure; to relieve pain, dysphagia, and spam in esophageal spasm with GE reflux
• • • • •
•
•
Analgesic, Topical
•
Anti arrhythmic Agent Local Anesthetic
•
Diuretic, Osmotic
•
•
Local anesthetic and acute treatment of ventricular arrhythmias from myocardial infarction, cardiac manipulation, digitalis intoxication; topical local anesthetic
Reduction of increased intracranial pressure associated
• •
•
•
Capsule, sustained release: 40 mg Chewable: 5 mg, 10 mg Oral: 5 mg, 10 mg, 20 mg, 30 mg, 40 mg Sublingual: 2.5 mg, 5 mg, 10 mg Sustained release: 40 mg
I.M.: 10% [100 mg/mL] (3 mL, 5 mL) Direct I.V.: 1% [10 mg/mL] (5 mL, 10 mL); 20 mg/mL (5 mL) Liquid, as hydrochloride, viscous: 2% (20 mL, 100 mL)
Injection: 5% [50 mg/mL] (1000 mL); 10% [100
•
Monitor signs of bleeding Do not administer IM due to pain, irritation and hematoma formation
•
Report acute headache, rapid heartbeat
•
•
• •
•
•
Provide safety measure, it may cause drowsiness and restlessness
Lidocaine injection is stable at room temperature Constant EKG monitoring is necessary during IV administration. Monitor closely for signs and symptoms of CNS toxicity (confusion, seizures, respiratory arrest)
Should be stored at room temperature and protected
MANNITOL
Generic Name: NALOXONE Brand Name: NARCAN
with cerebral edema; promotion of diuresis in the prevention and/or treatment of oliguria or anuria due to acute renal failure; r eduction of increases intraocular pressure; promoting urinary excretion of toxic substances; genitourinary irrigant in transurethral prostatic resection of other transurethral surgical procedures •
Antidote
•
•
Complete or partial reversal of opiod depression, including respiratory depression, induced by natural and synthetic opiods. Adjunctive agent to increase blood pressure in the management of septic shock
•
•
•
mg/mL] (500 mL, 1000 mL); 15% [150 mg/mL] (150 mL, 500 mL); 20% [200 mg/mL] (150 mL, 250 mL, 500 mL); 25% [250 mg/mL] (50 mL) Solution, urogenital: 0.54% [5.4 mg/mL] (2000 mL)
Injection, as hydrochloride: 0.4 mg/mL (1 mL, 2 mL, 10 mL); 1 mg/mL (2 mL, 10 mL) Injection, neonatal, as hydrochloride: 0.02 mg/mL (2 mL)
•
• • •
•
•
•
Generic Name: NICARDIPINE
Calcium Channel Blocker
•
Management of essential hypertension
• •
•
Generic Name: NITROGLYCERIN Brand Name: TRANSDERMAL -NTGPATCH
•
Vasodilator
Treatment of angina pectoris; IV for congestive heart failure (especially when associated with acute myocardial infarction); pulmonary hypertension; hypertensive emergencies occurring preoperatively (especially during cardiovascular surgery)
•
•
Caplet: 20 mg, 30 mg Sustained release: 30 mg, 45 mg, 60 mg Injection: 2.5 mg/mL (10 mL) Injection: 0.5 mg/mL (10 mL); 0.8 mg/mL (10 mL); 5 mg/mL (1 mL, 5 mL, 10 mL, 20 mL); 10 mg/mL (5 mL, 10 mL) Injection, solution in D 5W: 25 mg (250 mL), 50 mg (250 mL, 500 mL), 100 mg (250 mL), 200 mg (500 mL) Patch, transdermal, topical: Systems designed to deliver 0.1 mg/hr, 0.2 mg/hr, 0.4 mg/hr, 0.6 mg/hr, 2.5, 5, 7.5, 10, or 15 mg NTG over 24 hours
• • •
• •
•
•
Generic Name: PROMETHAZINE Brand Name: PHENERGAN
Anti emetic
•
Symptomatic treatment of various allergic conditions; anti emetic; motion sickness; sedative; analgesic adjunct for control of postoperative pain
•
•
Injection, as hydrochloride: 25 mg/mL (1 mL, 10 mL); 50 mg/mL (1 mL, 10 mL) Tablet, as hydrochloride: 12.5 mg, 25 mg, 50 mg
•
•
•
•
TETANUS TOXOID
Toxoid
•
TETANUS ANTITOXIN
Antitoxin
•
Selective induction of active immunity against tetanus in selected patients
•
Injection, adsorbed: Tetanus 10 Lf units per 0.5 mL dose (0.5 mL, 5 mL)
•
•
•
Tetanus prophylaxis or treatment of active tetanus only when tetanus immune globulin is not available.
•
•
Injection: 15 mg/mL (1 mL); 30 mg/mL (1 mL, 2 mL) Solution, ophthalmic: 0.5% (5 mL) Tablet: 10 mg
•
Injection: 100 mg/mL (10 mL)
•
Generic Name: KETOROLAC TROMETHAMINE Brand Name: TORADOL
Nonsteroidal AntiInflammatory Agent (NSAID)
•
Short-term management of pain
•
from freezing Monitor I and O
Protect from light Endotracheal: Dilute to 1-2 ml with normal saline Iv push: Administer over 30 seconds as undiluted preparation IV infusion: Dilute to 4 mcg/ml in D5W or normal saline Monitor respiratory rate, heart rate and BP Monitor closely for orthostasis Measure blood pressure 8 hours after dosing Ampoules must be diluted before use Monitor blood pressure and heart rate IV must be prepared in glass bottles and use special sets intended for nitroglycerin Clean skin before administering patches
Protect from light and freezing Avoid SC administration, promethazine is a chemical irritation which may produce necrosis Avoid IV use, if necessary may dilute to a maximum concentration of 25 mg/ml and infuse at a maximum rate of 25 mg/minute Provide additional safety measures, for it may cause drowsiness Refrigerate, do not freeze Inject Intramuscularly in the area of vastus lateralis (midthigh laterally) or deltoid Sensitivity teasting should be conducted in all individuals regardless of clinical history. Refrigerate, do not freeze
•
Monitor for signs of pain relief Sensitivity testing should be conducted
•
May be given by direct I.V. injection at a maximum
•
Generic Name: TRANEXAMIC ACID
Anti hemophilic Agent
•
Short term use to reduce or prevent hemorrhage
•
Tablet: 500 mg
rate of 100 mg/minute