Hematologic & Immune System Medications CLASSIFICATION NAME
Cyto"an
Antineoplastic, immunosuppressa nts
Folic Acid
MECHANISM OF ACTION
Death of rapidly replicating malignant cells. ↓ or prevent an immune response and suppress the immune system !aintains and restores normal erythropoiesis.
Antianemic, vitamin
Cyanoco#alamin e $%it '()*
Antianemic, vitamin Fe++ous Sul,ate 5ron supplement, antianemic
Lo-eno" #2noxaprin$
Anticoagulant, lo- molecular heparin
E.ogen #2rythropoetin$
0ormone,antiane mic
INDICATIONS
Cancers, lymphomas, myelomas, leukemias. Prevent organ transplant rejection. Tx for autoimmune diseases Prevention and Tx of megalo)lastic anemias. During pregnancy" promotes normal fetal gro-th. Prevent %TD.
Corrects manifestations of pernicious anemia. #!egalo)lastic anemia, 45 lesions, and neuro damage$
'it./ deficiency, to meet demands.
Prevent and Tx iron deficiency.
Prevent and Tx iron deficiency anemia.
Confirmed -& +chilling
%eed for hemoglo)in formation.
Prophylactic& Prevention of further throm)us #clot$ formation.
D'T, P2( throm)oem)oli, ischemic complications9 (prevents clots, especially in immobile patients).
!aintains and may elevate *Cs
Tx of anemia assoc. -& renal failure or A5D+ therapy.
SIDE EFFECTS
! suppression" #pancytopenia$, %&'&D, hepatotoxic, alopecia, cardio( pulmo. fi)rosis
NURSIN CONSIDERATIONS AND !ATIENT EDUCATION
*x for infection. *x for hemorrhage !onitor '+ !onitor kidney fx # fluids$ Take meds -& meals. Allergic *x !onitor folate and *ashes / levels fever 010 2ncourage to eat foods in 3olic acid" #veggies, organ meats$ Anaphylaxis 4iven 5! Diarrhea 6ife(long 5tching medication 0ypokalemia 4ive -& meals Pain at inj. site 2ncourage to eat animal products 45 upset #constipation, Assess )o-el fx9 dk stools$, dk stool #( occult hypotension, )ld$ +ei7ures, stains teeth !onitor P and #P8$ or skin #5!$, 0*9 010 Anaphylaxis 2ncourage to eat gr. leafy veggies and organ meats9 take -& 8: to a)sorp. P8" ;se stra-9 <( track 5! leeding, anemia, Assess s&s of throm)ocytopenia, )leeding and di77iness, 0A, hemorrhage constipation, %&' Assess nuero 1 pulmonary fx !onitor CC Antidote" !+otamine sul,ate 0T%, arthralgias, !onitor P, CC fatigue, 0A, 2ncourage foods +25<;*2+ in iron
/
ast+ointestinal System Medications CLASSIFICATION NAME
MECHANISM OF ACTION
Lactulose
-ater content and softens the stool. ↓ p0 of colon=↓ %0>
Controls )leeding in hemophilia. Prevents nocturnal enuresis
8smotic, laxative
Desmo.+essin #DDA'P$
0ormone, antidiuretic & vasopressin
!aintains approp. -ater content in Dia)etes 5nsip. acterialcidal action. Neomycin #Aminoglycosides$ Po-erful anti)iotics used to treat serious Anti(infectives infections caused )y gram #($ )acteria
/antac $Ranitidine* Tagamet $Cimetidine*
Antiulcer agents, histamine 0/ antagonist
INDICATIONS
SIDE EFFECTS
NURSIN CONSIDERATIONS AND !ATIENT EDUCATION
Tx of chronic constipation !anagement of hepatic encephalopathy.
elching, cramps, distention, flatulence, diarrhea, hyperglucemia
Controls )leeding in hemophilia !anagement of nocturnal enuresis9
Dro-siness, pharyngitis, dry mouth, anaphylaxis
Assess a)dominal distention, )o-el sounds, stools !onitor mental status, 4, %0> Take -& fruit juice Assess allergy symptoms, lung sounds and )ronchial secretions !aintain fluid intake ?@@(/@@@ ml&day Avoid 28T0
Tx of D.5.
To suppress 45 )acteria= ↓ %0> =preventing hepatic coma. Tx for skin -ounds and infections
0ealing and preventing Prevents acid ulcers. ↓ symptoms of inactivation of 42* and secretions of pancreatic en7ymes. gastric acid. 42*D, multiple peptic ulcers. Prevent and Tx heart)urn, acid indigestion, sour stomach
8totoxicity, nephrotoxicity, hypomagnesium, muscle paralysis, hypersensitivity
+hort(term 5' or 5! Assess for infection, 5&8, daily -eight, 0earing loss !onitor mental status, renal fx
Confusions, 0A, di77iness, arrhythmias, impotence, gynecomastia, throm)ocytopenia
Take Take meds )efore meals and )edtime Dont stop taking meds a)ruptly %o 28T0 or other C%+ depressants Avoid Avoid taking meds antacids *educe stress and help heal ulcers Assess a)dominal pain, occult )lood, !onitor CC
Neu+ological System Medications CLASSIFICATION NAME
MECHANISM OF ACTION
Rilu0ole $Rilute1*
2xact mechanism of action in A6+ is unkno-n. +lo-s the deterioration of motor neurons )y counteracting the excitatory glutaminergic path-ays.
+lo-s the progress Di77iness, tiredness, !onitor liver function" of Amyotrophic upset stomach, stomach liver en7ymes. 6ateral +clerosis. pain, diarrhea, !onitor BC. !ay delay the need muscle -eakness or Take Take on an empty for a tracheostomy, aches, anorexia, 0A stomach # hour not a cure for A6+. )efore or / hours after meals$. Avoid drinking or eating a lot of caffeine. Avoid eating charcoal()roiled foods.
Provide symptomatic relief )y concent. 8f availa)le Ach at neuromuscular junction = muscle fx. 5mproved )ladder( emptying in pt -ith urinary retention.
5mprovement in muscle strength in !4. Prevention and Tx of post(op )ladder distention and urinary retention or ileus.
+25<;*2+, di77iness , )ronchospasm, n&v&d, + secretions, )radycardia, a)dominal cramps, hypotension
Diagnostic test for myasthenia gravis.
+25<;*2+, Capillary constriction, diplopia, laryngospasm, arrhythmias, t-itching, ↓C8= hypotension, a)dominal cramps, %&'&D, urinary freF.
4lutamate antagonist
!+ostigmin $neostigmine*
Anticholinesteras e Antimyasthenics, cholinergics
+tops )reakdo-n of #Ed+o.2onium Cl$ Ach= Ach availa)ility. Tensilon is given 5' Anticholinesterase /mg (@mg. After @sec facialEF -eakness resolves and ptosis in ?min. Immediate im.+o-ement5 .ositi-e test & con,i+ms d" Tensilon
INDICATIONS
ecause )rief duration of duration of action, its not recommended for maintenance therapy in therapy in !4.
SIDE EFFECTS
NURSIN CONSIDERATIONS AND !ATIENT EDUCATION
Assess '+, neuromuscular status. Assess for under&over( dosage #cholinergic crisis$. ;se Tensilon test to distinguish. !onitor a)domen& )ladder status, 5&8, Maintain sta#le #lood le-els o, Ac2 med i-e ON TIME & 34 ,ood 8)serve for severe cholinergic reaction cholinergic reaction #stop meds$. !yasthenic crisis # crisis # meds$ 8)served for )radycardia or cardiac standstill and standstill and cholinergic reactions cholinergic reactions if an overdose is given. 4ive At+o.ine @.> mg to control s&e of Tensilon Tensilon #)radycardia, s-eating, cramps$
> 'aclo,en
Antispasticity agents, skeletal muscle relaxants
Le-odo.a
Antiparkinson agent, Dopamine agonist
5nhi)its reflexes at spinal level. ↓ muscle spasticity9 )o-el and )ladder fx may also )e improved.
Tx of reversi)le spasticity due to !+ or spinal cord lesion
*elief of tremor and rigidity in Parkinsons syndrome.
Parkinsons disease. %ot useful for drug( induced 2P+.
Converts to dopamine in C%+, serves as neurotransm. # dopamine$
+25<;*2+, dro-siness, di77iness, fatigue, confusion, 0A, edema, hypotension, nausea, constipation, hyperglycemia, ataxia
Assess muscle spasticity. 8)serve for adverse effects. !onitor 4 and liver en7ymes. Administer -& milk or food to ↓ gastric irritation. Dyskinesia, involuntary Assess parkinsonian movements, anxiety anx iety,, symptoms di77iness, )lurred Assess P and pulse vision, %&', anorexia, freF. dry mouth, hemolytic 4ive -ith meals anemia, ↓ BC !onitor )o-el fx !onitor 5&8 !onitor hepatic and renal fx
Neu+ological System Medications CLASSIFICATION NAME
Symmet+el
Antiparkinson agent, antiviral
MECHANISM OF ACTION
Antiviral that 6 t2e +elease o, do.amine *elief of parkinsonian symptoms. Prevent and Tx influen7a A
Anti viral and immunoregulatory Avonex, *e)if properties =↓ T(cell T(cell #interferone )eat( proliferation. a$ ↓ incidence of relapse etaseron #neurologic #interferon )eta( dysfunction$ and slo)$ physical disa)ility. disa)ility.
'eta Inte+,e+ons
interferons, Anti(!+ agents
INDICATIONS
SIDE EFFECTS
+ymptomatic initial Confusion, ataxia, and adjunct Tx of di77iness, insomnia, Parkinsons disease. )lurred vision, Prophylaxis and Tx hypotension, mottling. of influen7a A viral infections !ult !ultip iple le +cle +clero rosi siss
3lu( 3lu(li like ke symp sympto tom ms, sei7ures, 0A, mental depression, -eakness, %&'&D, conjunctivitis, s-eating, photosensitivity, photosensitivity, neutropenia, injection(site reaction #-& )eta()$, myalgia, chills, fever, pain
NURSIN CONSIDERATIONS AND !ATIENT EDUCATION
!onitor )lood pressure freF. #80$ !onitor 5&8 !onitor '+ and mental status. Do not give close to )edtime Assess freF. of exacer)ations of !+. !onitor for signs of depression. !onitor 0g), BC, platelets, and )lood chemistry and liver function. !ay give analgesic for flu(like symptoms. Take measures to prevent photosensitivity reactions.
?
enitou+ina+y enitou+ina+y System Medications CLASSIFICATIO N NAME
MECHANISM OF ACTION
INDICATIONS
SIDE EFFECTS
NURSIN CONSIDERATIONS AN !ATIENT EDUCATION
DIURETICS Loo. Diu+etics
3urosemide #6asix$ umetanide #umex$ 2thacrynic acid #2decrin$
5nhi)it sodium 1 chloride rea)sorption from loop of 0enle and distal renal tu)ule. renal excretion of 0/8, %a, Cl, !g, 0, and Ca. 'asodilation=↓periph eral resistance=↓P
2dema associated -ith" C03 • 0epatic or • renal disease Adjunct therapy for control of 0T%.
Di77iness, 0A, tinnitus, hypotension, %&'&D, constipation, dehydration, hypokalemia, hyperglycemia, hyperuricemia, neutropenia, agranulocytosis, cramps, Throm)ocytopenia, spasms
!onitor '+ #P 1 P$ and fluid status freF. !onitor daily -eight, 5&8, serum electrolyte values. Assess edema #amount 1 location$, lung sounds, skin turgor, mucous mem)ranes. !onitor potassium levels #.?(?.@$.
!otassium7 s.a+ing Diu+etics
+pironolactone #Aldactone$ Amiloride #!idamor$ Triamterene #Dyrenium$
Beak diuretic and Beak antihypertensive. locks effects of aldosterone in renal tu)ule, causing loss of %a and 0/8 and retention of potassium.
Prevents hypokalemia caused )y other diuretics. ;sed -ith other diuretics to treat edema or 0T%. Spironolactone: 0yperaldosteronis m. !anagement of C03.
Di77iness, 0A, cramps, %&'&D, urinary freFuency, freFuency, -eakness, hyperkalemia. Spironolactone: Clumsiness, gynecomastia, amenorrhea
!onitor )lood glucose #@@ mg&d6$ (in loop&thia7ide diuretics. Change position slo-l to prevent 80. 5f receiving digoxin, -atch for digitalis toxicity. foods high in potassium #)ananas, oranges, potatoes, mea fish, raisins$ Take in A! to avoid sleep distur).
G Osmotic Diu+etics
!annitol #8smitrol, *esectisol$
Pulls -ater into )lood vessels and nephrons from surrounding tissues= inhi)its rea)sorption of 0/8 and electrolyes, along -ith toxins from kidney.
Adjunct tx of " 8 acute oliguric renal failure 8 edema 8 5CP or intraocular pressure 8 excretion of toxic su)stances.
Confusion, 0A, hypotension, rash, nausea, anorexia, dry mouth, thirst, diuresis,fluid and electrolyte im)alances.
*eport to !D" rapid 0* or syncope, -eight gain /l)s or more. *eport adverse effects" %&'&D 0ypokalemia #muscle -eakness 1 t-itching, lethargy, lethargy, irregular pulse$
enitou+ina+y enitou+ina+y System Medications CLASSIFICATIO N NAME
MECHANISM OF ACTION
INDICATIONS
SIDE EFFECTS
NURSIN CONSIDERATIONS AND !ATIENT EDUCATION
!2os.2ate 'inde+s Se-elame+ #*enagel$
inds -ith phosphate in the 45 tract, preventing its a)sorption.
electrolyte modifiers
Aluminum 2yd+o"ide #Alu(Cap$
antacids, phosphate )inders
Prevent a continuing rise in serum phosphate levels )y decreasing the a)sorption of phosphate from intestinal tract %eutrali7es gastric acid and inactivates pepsin
*eduction of the level of phosphorus in the )lood of patients -ith end(stage renal disease #2+*D$.
Treatment for 0yperphosphatemi a, hypocalcemia in C*3. Adjuct therapy in treating gastric ulcers, hyperacidity, indigestion.
• • • • • •
%ausea 'omiting Diarrhea Dyspepsia Constipation 3latulence
Assess 45 side effects. !onitor serum phosphorus, calcium, )icar)onate, chloride levels +-allo- -hole #Dont crush or che-$
• •
Constipation 0ypophosphate mia
** Prolong use leads to toxicity: neuro symptoms and osteomalacia. M may recommend !alcium !arbonate instead**
Take all other medicines at least one hour )efore or three hours after. Take -ith meals. Assess gastric pain. !onitor phosphate and calcium levels. Take Take -ith full glass of -ater +hould )e s-allo-ed -hole @(? minutes )efore meals.
I Calcium Salts Calcium acetate #Calphron, Phos6o$ Calcium ca+#onate #Titralac, #Titralac, Calci( che-$ Calcium gluconate #Halcinate$
!ineral 1 electrolyte replace& supplements
!aintain cell mem)rane and capillary permea)ility. permea)ility. *eplacement of calcium deficiency. Control of hyperphosphatemia in end(stage renal disease -ithout promoting aluminum a)sorption. !alcium carbonate: !+otects 2ea+t ,+om e,,ects o, 2y.e+1alemia
Tx and prevention of hypocalcemia. 2mergency tx of hyperkalemia and hypermagnesemia and adjunct in cardiac arrest.
• • • • • • •
!alcium acetate: Control of hyperphosphatemi a in 2+*D.
• •
Cardiac Arrest Arrhythmias radycardia Constipation Phle)itis +yncope Tingling Calculi 0ypercalciuria.
!onitor '+ #P 1 P$ and 2C4 freF. 8)serve for s&s of hypocalcemia #paresthesia, muscle t-itching, colic$ !onitor pt on digitalis glycosides for signs of toxicity. !onitor phosphate levels and electrolytes.
!alcium carbonate: !ay )e used as antacid.
3or 0yperphosphatemia, hypocalcemia9 must take -ith food.
Endoc+ine System Medications CLASSIFICATIO N NAME
MECHANISM OF ACTION
Synt2+oid meta)olic rate of #levothyroxine$ )ody tissues. *estores normal 0ormones, hormone )alance. thyroid +uppresses thyroid preparations cancer.
INDICATIONS
*eplacement&su)st itution in diminished or a)sent thyroid function. Thyroid cancer #thyrotropin( dependent$
SIDE EFFECTS
5rrita)ility, 5rrita)ility, 5nsomnia, 0A, arrhythmias, tachycardia, -eight loss, Cardiovascular Collapse, 0T%, C8
NURSIN CONSIDERATIONS AND !ATIENT EDUCATION
Assess AP 1 P. 3or tachyarrhythmias 1 chest pain. !onitor thyroid function9 )lood 1 urine glucose. 4ive )efore )reakfast #to avoid insomnia$
J Ta.a0ole #methima7ole$ !+o.ylt2iou+acil
#PT;$ Thioamides, Antit2y+oid agents
'+omoc+i.tine #Parlodel$
Dopamine agonist& antineoplastic
Calcium gluconate
!ineral 1 electrolyte replace& supplements
Mine+al7 co+ticoids Flud+oco+tison e #3lorinef$
0ormones& corticosteroids
Prevents the formation of thyroid hormone -ithin the thyroid cells= ↓serum levels of thyroid hormone.
Palliative treatment of hyperthyroidism.
Methima$ole: ! suppression P': 45 distress
"loc#s the utili$ation o% iodine& prevents synthesis o% thyroid thyroid hormone
Direct dopamine agonist on dopamine receptor sites in su)stantia nigra. 5nhi)its 40 secretion. Antiparkinson agent. Tx of acromegaly.
Act as activator in transmission of nerve impulses and contraction of cardiac, skeletal, and smooth muscle.
%a rea)sorption in renal tu)ules and H and 0 excretion= %a 1 0/8 retention
*ash, %&', lethargy, dro-siness, )radycardia, Agranulocytosis
Tx of Parkinson9 hyperprolactinemi a assoc. -ith pituitary adenomas, female infertility assoc. -ith hyperprolactinemi a.
3or hypoparathyroidis m. *eplacement of Ca in deficient states.
Adrenal insufficiency #Addisons$9 replacement therapy in com)ination -ith glucocorticoid. Tx of salt(losing adrenogenital syndrome.
Monito+ 2y.e+t2y+oidism +es.onse #tachycardia, palpitations, insomnia, fever, heat intolerance, tremors, -t loss$
Monito+ 2y.ot2y+oidism #intolerance to cold, constipation, dry skin, 0A, -eakness$
Assess skin for rashes or s-ollen nodes. 4ive )efore )reakfast. +eafood and iodine may )e restricted. !onitor CC 1 differential. !onitor for s&s of infection or )leeding. Confusion, di77iness, !onitor thyroid hypotension, %&', 0A, function, glucose visual distur)ances, tolerance, and 40 a)dominal pain, leg levels. cramps, fatigue, nasal Assist -ith am)ulation. congestion Avoid Avoid tasks that reFuire alertness, motor skills until response to drug. Teach Teach contraceptives #other than P8$ Arrhytmias, Assess 1 monitor" P, constipation, phle)itis, 2C4, 1 renal fx cardiac arrest Assess 1 monitor electrolytes" !g, Ph, H !onitor serum and urine Ca levels 5'( push slo-ly, ta)s @ min(hr after meals, liFuids )efore meals. 3rontal and occipital Assess '+, )reath 0A, arthralgia, sounds, -eight, tissue -eakness, )lood turgor9 reflexes and volume, edema, 0T%, )ilateral grip strength, C03, rash, anaphylaxis, serum electrolyte. hypokalemia !onitor for hypokalemia. Avoid Avoid infections9 avoid fresh fruits and veggies or -ash very carefully
K
Endoc+ine System Medications CLASSIFICATIO N NAME
MECHANISM OF ACTION
luco7 co+ticoid
5nitiate complex reactions responsi)le for Celestone #)etamethasone$ anti(inflammatory and immunosuppressive effects. Co+tisone #Cortone Causes release of Acetate$ epinephrine from adrenal medulla. Co+te, #hydrocortisone$ Med+ol #methyprednisol one$ Delta7Co+te, #prednisolone$ Deltasone #prednisone$
Corticosteroids
INDICATIONS
!anagement of adrenal insufficiency. ;sed systemically and locally for chronic diseases including" inflammatory, inflammatory, allergic, hematologic, neoplastic, autoimmune disorders.
• • • • • • •
• •
5mmunosupressant s in +timulate of glucose prevention of organ levels for energy. rejection. Bhen com)ined -ith mineralocorticoids some of these drugs can )e used in replacement therapy for adrenal insufficiency.
SIDE EFFECTS
!anagement of acute spinal cord injury (methylprednisolone)
•
• •
• • •
Depression euphoria 0T% Peptic ulcers %&' ↓ -ound healing Adrenal suppression 0yperglycemia Beight gain %a 1 0/8 retention C03 5mmunosuppressi on 8steoporosis !uscle -asting Cushingoid appearance.
NURSIN CONSIDERATIONS AND !ATIENT EDUCATION
Administer daily in A!. Do not discontinue a)ruptly. Protect from infection or invasive procedures. Caution in pts -ith D! or peptic ulcers. !onitor 5&8, daily -eight 1 electrolytes. +igns of fluid retention. 4ive -ith meal. !onitor for s&s of adrenal insufficiency #0A, hypotension, -t. loss, -eakness$
@
Multi7System Medications CLASSIFICATION NAME
Sil-e+ sul,adia0ine #+ilvadene$
MECHANISM OF ACTION
Anti)acterial and antifungal agent.
Anti(infective& )actericidal
Ma,enide acetate #+ulfamylon$
acteriostatic for many gram( negative and gram( positive organisms,
Mo+.2ine
Acts as agonist at specific opioid receptors in C%+ to produce analgesia, euphoria, and sedation.
8pioid agonist, narcotic
Acts at many levels of C%+ to produced +edatives& generali7ed C%+ hypnotics depression. )en7odia7epines +hort(term sedation9 post(op amnesia. %e+sed #mida7olam$
INDICATIONS
Adjunct for djunct for prevention and prevention and treatment of treatment of -ound sepsis in sepsis in patients -ith /L and L )urns.
SIDE EFFECTS
NURSIN CONSIDERATIONS CONSIDERATI ONS AND !ATIENT !A TIENT EDUCATION ED UCATION
urning feeling at !onitor CC 1 site, %&'&D, 0A, hepatic&renal fx. anorexia, !onitor for leucopenia for photosensitivity, photosensitivity, /( days. joint pain, 5f )urns are extensive or hemolytic prolonged therapy" monitor anemia, electrolytes, ;A,CC hypoglycemia, Cover entire -ound 6upus, !ay cause )ro-n(gray 6iver&kidney discoloration. pro)lems Control )acterial Pain or )urning Apply -ith sterile gloves& M infection -hen infection -hen sensation, allergic dressing FGL. used under moist moist reaction, )leeding reaction, )leeding !onitor A4s #d&c if dressings over or oo7ing of skin, acidosis$. meshed or meta)olic 4ive analgesic prior, may autografts on acidosis cause severe )urning pain excised )urn excised )urn for up to /@ mins after -ounds. application. *elief of Confusion, Assess pain, 68C, P, moderate to sedation, pulses, respirations, )o-el severe acute or *espiratory fx. chronic pain. depression, !onitor for dependence or Pulmonary hypotension,↓0*, tolerance. edema. constipation, %&', %&', 0ave %arcan availa)le for Pain assoc. -ith shock, urinary 8D !5. retention +edation, *espiratory !onitor '+, respirations anxiolysis and depression, and level of sedation F ( amnesia )efore laryngospasm, ?min. procedure cardiac arrest, 4ive *oma7icon for 8D. 5nduction of dro-siness, 0A, 4rapefruit juice anesthesia9 + sedation, %&', %&', ↓meta)olism 1 effects continuous arrhythmias, !onitor 68C and sedation sedation of phle)itis intu)ated patients.
Digo"in #6anoxin$
Digitalis glycosides
force of myocardial contraction. cardiac output and ↓ heart rate.
Tx of C03, atrial fi)rillation 1 atrial flutter, tachyarrhythmias
0A, -eakness, !onitor apical pulse for dro-siness, visual min )efore administration. distur)ances, %&' 0old if NG@ )pm. arrhythmias, !onitor pulse, -t., 5&8 and fatigue, 2C4. )radycardia, 45 Adm. 5' slo-ly O? min, upset avoid 5!. !onitor electrolytes 1 digoxin levels Therapeutic level" @.?(/9 toxic O/ 0ave Digoxin immune 3A availa)le.
Multi7System Medications CLASSIFICATIO N NAME
MECHANISM OF ACTION
INDICATIONS
SIDE EFFECTS
Do.amine
+m. Doses stimulate dopaminergic receptors, producing renal vasodilation. 6g. doses stimulate dopaminergic and )eta adrenergic receptors, producing cardiac stimulation and renal vasodilation locks )eta( adrenergic receptors in the heart and kidney, has a mem)rane( sta)ili7ation effect and ↓ influence of sympathetic nervous system. ↓ 0* 1 P, suppression of arrhythmias 1 prevent !5
Cardiac output, P, and improves renal )lood flo-.
Tachycardia, ectopic )eats, anginal pain, hypotension, dyspnea, %&', 0A
!onitor P, 0*, 2C4, cardiac output, and urinary output continuously. *eport chest pain, dyspnea, num)ness, tingling, or )urning of extremities.
!anagement of 0T%9 angina pectoris9 arrhythmias. Prevention and management of !5. Prevent vascular 0A. !anage thyrotoxicosis.
radycardia, C03, cardia arrhythmias, heart )locks, C'A C'A, pulmonary edema, gastric pain, flatulence, %&'&D, ↓ exercise tolerance, impotence.
!onitor P and Pulses Pts on 5' must have continuous 2C4 monitor. 0ypotensive effect is associated -ith ↓ cardiac output. Dont stop med a)ruptly, it thro-s in L heart )lock
vasopressor&adre nergic
Inde+al #propanalol$
eta )lockers
NURSIN CONSIDERATIONS AND CONSIDERATIONS !ATIENT !A TIENT EDUCATION ED UCATION
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Code D+ugs CLASSIFICATION NAME
MECHANISM OF ACTION
INDICATIONS
SIDE EFFECTS
NURSIN CONSIDERATIONS AND !ATIENT EDUCATION
*eacts at alpha( and )eta( receptor sites in Adrenergic, the +%+ to sympathomimetic cause )ronchodilation, 0*, **, P.
Treatment of shock, )ronchospasm. !anagement of severe allergic reactions, cardiac arrest.
%ervousness, tremor restlessness, angina, arrhythmias, 0T%, tachycardia, 0A, %&' insomnia, hyperglycemia
%eutrali7es or ↓ gastric acidity= Antiulcer, gastric p0. alkalini7ing Acts as alkalini7ing agent )y releasing )icar)onate ions. +timulates Do.amine dopaminergic Adrenergic, receptors" sympathomimetic cardiac output, inotropics, P, and vasopressors improved renal )lood flo-
*elief of hyperacidity9 !anagement of meta)olic acidosis9 Treatment of certain drug intoxications.
!eta)olic alkalosis, gas, 4astric acid re)ound, hypernatremia, hypocalcemia, hypokalemia, %a 1 0/8 retention
Choice for tx of shock.
Arrhythmias, angina, 0ypotension, tachycardia, dyspnea, %&', %&', 0A,
Antidote for cholinergic 8D and mushroom poisoning. Pre(op to ↓ secretions. *estores cardiac rate and arterial pressure.
Dro-siness, )lurred Assess '+ and 2C4. vision, tachycardia, dry !onitor 5&8. mouth, urinary Assess a)domen and hesitancy, hesitancy, constipation, )o-el sounds. decreased s-eating. 8)serve for toxicity or 8D9 antidote physostigmine. 4ive @ mins. )efore meals.
E.ine.2+ine
Sodium 'ica+#onate
At+o.ine
Anticholinergic, antiarrhythmic
5nhi)its the action of acetylcholine, )locking the effects of parasympathetic %+. 0*, ↓ 45 1 respiratory secretions.
Assess pulmonary function" lung sounds, respiratory pattern9 pulse, P. !onitor 2C49 for arrhythmias, chest pain. Correct hypovolemia prior to 5' use. !ay cause ↓ serum H and glucose. Assess 45 1 renal function, serum electrolytes. Assess signs of acidosis&alkalosis, A4s
!onitor P, 0*, 2C4, C8. !onitor urinary output freFuently. Palpate peripheral pulses and assess appearance of extremities.
Lidocaine
Antiarrhythmic, anesthetic
Control of ventricular arrhythmias. 6ocal anesthesia.
!anagement of ventricular arrhythmias. 5nfiltration& mucosal&topical anesthetic.
+ei7ures, confusion, dro-siness, Cardiac arrest, stinging, anaphylaxis, hypotension, %&', fatigue
!onitor 2C4 and P and *espiratory status. !onitor serum electrolyte levels. !onitor for toxicity and 8D" serum levels" 1.5-5 μg/mL
Code D+ugs CLASSIFICATION NAME
Adenosine
antiarrhythmics
MECHANISM OF ACTION
*estores normal sinus rhythm.
INDICATIONS
Treatment of supraventricular tachycardias, #Diagnostic agent to assess myocardial perfusion$
Amiodo+one
antiarrythmics
+uppression of arrhythmias. locks )eta( adrenergic receptors in heart.
6ife(threatening ventricular arrhythmias !anagement of supraventricular tachycardia
SIDE EFFECTS
+8, facial flushing, transient arrhythmias, 0A, di77iness, chest pain, hyperventilation, nausea, s-eating, hypotension
NURSIN CONSIDERATIONS AND !ATIENT EDUCATION
!onitor 0* #F?( @min$ 1 2C4, P. Assess *espiratory status" )reath sounds and rate. Change positions slo-ly # to ↓ 80$ *eport adverse effects.
Di77iness, fatigue, !onitor 2C4, 0* and malaise, A*D+, rhythm. 0Apulmonary fi)rosis, Assess signs of C03, )radycardia, pulmonary toxicity hypotension, anorexia, #crackles, ↓)reath constipation, %&', sounds, dyspnea$ hypothyroidism, ataxia, Assess s&s of A*D+. peripheral neuropathy, !onitor P. tremors !onitor liver and thyroid function. Assess for hypokalemia, hypomagnesemia Assist -ith am)ulation. !ay )e given -ith meals or divided doses
> Nit+oglyce+ines
*elief or prevention of anginal attacks. cardiac output ↓P
Antianginal, nitrates
Do#ut+e" #Do)utamine$
Adrenergics, inotropics
5ncreased cardiac output -ithout significantly increased heart rate.
Acute 1 long term prophylactic management of angina pectoris. Adjunct tx of C03 1 acute !5. Production of controlled hypotension.
Di77iness, 0A, hypotension, tachycardia, restlessness, )lurred vision, rash, flushing, %&', %&', -eakness.
Treatment of C03 )ecause myocardial contractility -ithout much change in rate and doesnt 8/ demand of heart muscle.
0T%, 0*, premature !onitor P, 0*, 2C4, ventricular C8, urinary output. contractions, +8, 0A, Palpate peripheral angina pectoris, pulses and assess arrhythmias, extremities. hypotension, %&', !onitor electrolytes, phle)itis. ;%, Creat, prothrom)in time. Check for signs of extravasation.
0A is common s&e.
Assess anginal pain. !onitor P 1 pulse. !onitor 2C4. P8" Administer Administer hr )efore or / hr after meals -& full glass of -ater. +6" 0old ta)let under tongue until dissolved9 avoid eating or drinking. Change position slo-ly #prevent 80$
