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Week 13 drug card
Pharmacology (NSG 124)
Herzing University
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Uses: Bradycardia <40-50 bpm, brady-dysrhythmia, reversal
####### of anticholinesterase agents, insecticide poisoning, blocking
####### cardiac vagal reflexes, decreasing secretions before surgery,
####### antispasmodic with GU, biliary surgery, bronchodilator, AV heart
####### block
Nursing Considerations: (labs, VS, etc)
####### Assess:
- 180 ratios; check for urinary retention, daily output
- VS during treatment, ECG for ectopic ventricular beats, PVC,
####### tachycardia in cardiac patients
- For bowel sounds, constipation, abdominal distention, if
####### constipation Occurs add fluids, bulk in diet
- Beers: avoid in older adults; highly anticholinergic, high risk of
####### delirium, in men decreased urinary flow Evaluate:
####### Therapeutic response: decreased dysrhythmias, increased
####### heart rate, secretions; GI, GU spasms; bronchodilation
Side/Adverse Effects:
####### CNS: Headache, dizziness, involuntary movement, confusion,
####### flushing, drowsi-
####### ness
####### CV: Tachycardia, bradycardia
####### EENT: Blurred vision, photophobia, dry
####### eves
####### Gl: Dry mouth, constipation
####### Resp: Tachypnea, pulmonary edema
####### GU: Retention, hesitancy, impotence
####### INTEG: Flushing, decreased sweating
Route of Administration and Dosage:
####### Inj 0, 0, 0, 0, mg/mL; AtroPen 0, 0, 1, 2 mg/0.
####### ML inj prefilled autoinjectors
####### Adult and child: IM/IV 1-2 mg 920-
####### 30min until muscarinic symptoms disappear; may need 6 mg
####### every hr
Unlabeled Uses: Stress endocardiopathy
Contraindications:
####### Hypersensitivity to belladonna alkaloids, closed-angle
####### glaucoma, Gl obstructions, myasthenia gravis,
####### thyrotoxicosis, ulcer alive colitis, prostatic hypertrophy,
####### tachy-cardia/tachy dysrhythmias, asthma, hemorrhage,
####### severe hepatic disease, myocardial ischemia, paralytic
####### ileus.
####### Precautions: Pregnancy, breastfeeding, children <6 y;
####### geriatric patients, renal disease, HF; hyperthyroidism,
####### COPD, hyper-tension, intraabdominal infection, Down
####### syndrome, spastic paralysis,
Patient Teaching and Safety:
####### Teach patient/family:
- To report blurred vision, chest pain, allergic reactions,
####### constipation, urinary retention; to use sunglasses to
####### protect the
####### eyes
- Not to perform strenuous activity in high temperatures;
####### heat stroke may result
- To take as prescribed; not to skip or double doses
- Not to operate machinery if drowsiness occurs
- Not to take OTC products, herbals, supplements
####### without approval of prescriber
- Not to freeze or expose to light (Atro-Pen)
- To use sunglasses for photophobia
####### Pregnancy/breastfeeding: identify if pregnant or
####### breastfeeding; use only if benefits outweigh fetal risk
Generic Name: atropine
Trade Name: Atro-Pen
Functional Classification:
####### Antidysrhythmic, anticholinergic parasympatholytic,
####### antimuscarinic
Antidotes “treatment of overdose” (if
applicable): Oz, artificial ventilation, ECG; administer
####### DOPamine for circulatory depression; administer
####### diazePAM or thiopental for seizures.
####### assess need for
Mechanism of Action: (How does it
work?) Blocks acetylcholine at parasympathetic
####### neuroeffector sites; increases cardiac output, heart rate
####### by blocking vagal stimulation in heart; dries secretions
####### by blocking vagus
Patient Teaching and Safety:
- That fainting occasionally occurs after 1st dose, to take
####### 1st dose at bedtime; not to drive or operate machinery
####### for 4 hr after 1st dose, that full effect may take 4-6 wk
####### ◦
- To change positions slowly to prevent orthostatic
####### hypotension
- To avoid OTC medications, alcohol unless approved
####### by prescriber, not to crush, chew caps
####### Not to discontinue abruptly.
Generic Name: prazosin
Trade Name: Minipress
Uses: Hypertension, benign prostatic hypertrophy to
####### decrease urine outflow obstruction
Nursing Considerations: (labs, VS, etc)
####### Assess:
- Hypertension/HF: B/P (sitting, standing) during initial
####### treatment, periodically thereafter; pulse, jugular venous
####### distention, orthostatic hypotension usually occurs on first dose
- BUN, uric acid if patient receiving long-term therapy
- Weight daily, I&O; edema in feet, legs daily
- Benign prostatic hypertrophy (unlabeled): urinary patterns,
####### frequency, stream, dribbling; flow before, during,
####### and after therapy
####### -Beers: avoid use as an antihypertensive in older adults; high
####### risk of orthostatic hypotension
- Pregnancy/breastfeeding: use only if benefits outweigh fetal
####### risk; cautious use in breastfeeding, excreted in breast
####### milk
Side/Adverse Effects:
####### CNS: Dizziness, headache, drowsiness, anxiety, depression,
####### vertigo, weakness, fatigue, syncope
####### CV: Palpitations, orthostatic hypotension, tachycardia.
####### edema, rebound hypertension.
####### EENT: Blurred vision, epistaxis, tinnitus, dry mouth, red sclera
####### GI: Nausea, vomiting, diarrhea, constipation, abdominal pain,
####### pancreatitis
####### GU: Urinary frequency, incontinence, impotence, priapism;
####### water, sodium
####### retention
Functional Classification:
####### Antihypertensive
Route of Administration and Dosage:
PO: Caps 1, 2, 5 mg
Antidotes “treatment of overdose” (if
applicable):
####### Administer volume expanders or vasopressors,
####### discontinue product, place patient in supine position
Mechanism of Action: (How does it
work?) Blocks a-mediated vasoconstriction of
####### adrenergic receptors, thereby inducing peripheral
####### vasodilation
Unlabeled Uses: Heart failure, hypertensive
####### urgency, Raynaud's phenomenon, posttraumatic stress
####### disorder (PTSD)
Contraindications: Hyper-
####### sensitivity
####### Precautions: Pregnancy, breastfeeding, children,
####### geriatric patients, prostate cancer, ocular surgery,
####### orthostatic hypotension
Patient Teaching and Safety:
-About the reason for product administration -Inhalation: to rinse mouth after use to prevent dryness after inhalation, not to spray near eyes, teach correct use -To take exactly as prescribed, if on scheduled regimen, take missed dose as soon as remembered, space remaining doses evenly. Do not double dose. Contact prescriber immediately if shortness of breath is not relieved or diaphoresis, dizziness, or chest pain occurs. -To consult prescriber before taking any OTC, Rx medications, supplements, or herbals -To use bronchodilator before using other products -To maintain adequate fluid intake (2000-3000ml/day) to help liquefy secretions -To notify prescriber if pregnancy is planned or suspected or if breastfeeding -Autoinjector: how to use for anaphylaxis; remove cap, place injector end tip on thigh at 90-degree angle, hold 10 sec, remove
Generic Name: epinephrine
Trade Name: Adrenalin
Uses: Acute asthmatic attacks, hemostasis,
bronchospasm, anaphylaxis, allergic reactions,
cardiac arrest, adjunct in anesthesia, shock
Nursing Considerations: (labs, VS, etc)
-Asthma: auscultate lungs, pulse, B/P, respirations, sputum
(color, character), monitor pulmonary function studies before
and during
-Vasopressor: ECG during administration continuously; if BP
increases, decrease dose; BP, pulse q5mins after parenteral
route; CVP, ISVR, PCWP during infusion if possible;
inadvertent high arterial BP can result in angina, aortic
rupture, cerebral hemorrhage
-Inj. Site: tissue sloughing; administer phentolamine with NS
-Sulfite sensitivity: may be life threatening
-Cardiac status, I&O; blood glucose in diabetes
-Allergic reactions, bronchospasm: (swelling of
face/lips/eyelids, rash, difficulty breathing): withhold dose,
notify prescriber
Side/Adverse Effects:
Tremors, anxiety, insomnia, headache, dizziness,
confusion, hallucinations, weakness, drowsiness,
palpitations, tachycardia, hypertension,
dysrhythmias, increased T wave, anorexia, nausea,
vomiting, sweating, dry eyes, dyspnea, paradoxical
bronchospasm (inhalation), hypoglycemia
Functional Classification:
Bronchodilator nonselective adrenergic agonists,
vasopressor
Route of Administration and Dosage:
IM/SUBCUT: 0.3-0 may repeat q10-15 mins or q20min-4hr IV: 0.1-0 q5-15 mins then 1-4 mcg/min continuous infusion if needed
Antidotes “treatment of overdose” (if
applicable): Administer a-blocker and B-
blocker
Mechanism of Action: B1- and B2-agonists
####### causing increased levels of cAMP, thereby producing
####### bronchodilation, cardiac, and CNS stimulation; high doses
####### cause vasoconstriction via a-receptors; low doses can cause
####### vasodilation via B2-vascular receptors
Unlabeled Uses:
Bradycardia, chloroquine overdose
Contraindications: Hypersensitivity to
####### sympathomimetics, sulfites, closed-angle glaucoma, non-
####### anaphylactic shock during general anesthesia
####### Precautions: pregnancy, breastfeeding, cardiac disorders,
####### hyperthyroidism, diabetes mellitus, prostatic hypertrophy,
####### hypertension, organic brain syndrome, local anesthesia of
####### certain areas, labor, cardiac dilation, coronary insufficiency,
####### cerebral arteriosclerosis, organic heart disease
Patient Teaching and Safety:
To take immediately after meals; to take
medication at bedtime to prevent effect of
orthostatic hypotension.
- Not to discontinue abruptly; to taper over 2
wks.
- Not to use otc medications
-report bradycardia, dizziness, confusion
depression.
-rise slowly to decrease orthostatic
hypotension
- monitor glucose level as it can cause
hyperglycemia
-report symptoms of heart failure
-To rereport Raynaud’s syndrome
- product may increase sensitivity to cold.
-carry emergency ID
Generic Name:
metoprolol
Trade Name:
Kapspargo Sprinkle/ Lopressor SR
Uses: Mild to moderate hypertension,
acute MI to reduce cardiovascular mor-
tality, angina pectoris, NYHA class IL, I
heart failure, cardiomyopathy
Nursing Considerations: (labs, VS, etc)
Black Box Warning: Abrupt withdraw-al:
may cause MI, ventricular dysrhythmias,
myocardial ischemia; taper dose over 7-
days.
-ECG Directly when giving IV during initial
treatment
-Monitor B/P during initial treatment
Pregnancy/breastfeeding: only use if
benefits outweigh harm, only use if clearly
needed.
-Evaluate therapeutic response: decreased
B/P after 1-2 weeks. Decreased anginal
pain.
-Baseline pf renal, hepatic studies before
therapy begin.
Side/Adverse Effects:
HEMA: Agranulocytosis, eosinophilia,
thrombocytopenia, purpura
CV: Hypotension, bradycardia, HE,
palpitations, dysrhythmias, cardiac arrest,
AV block, pulmonary/peripheral edema,
chest pain
CNS: Insomnia dizziness, mental changes,
hallucinations, depression. Headache
nightmare.
GI: Nausea vomiting, colitis, cramps,
diarrhea, flatulence, dry mouth, hiccups.
INTEG: Rah, purpura, alopecia, dry skin
RESP: Bronchospasm, dyspnea, wheezing
ENDO: hyper/hypoglycemia
Functional Classification:
antihypertensive
Route of Administration and Dosage:
Hypertension
- Adult: PO 50 mg bid or 100 mg/day; may give up to 100-450 mg in divided doses; EXT REL 25-100 mg daily, titrate at weekly intervals; max 400 mg/day
Antidotes “treatment of overdose” (if
applicable):Lavage, IV atropine for
bradycardia, IV theophylline for
bronchospasm, digoxin, O,, diuretic for
cardiac falure, hemodi alysis,
Mechanism of Action: (How does it
work?) Lowers B/P by B-blocking
effects; reduces elevated renin
plasma levels; blocks Bz-adrenergic
receptors in bronchial, vascular
smooth muscle only at high doses;
Unlabeled Uses:
N/A
Contraindications.
####### Hype-sensitivity to B-blockers, cardiogenic
####### shock, heart block (2nd, 3rd degree), sinus
####### bradycardia, sick sinus syndrome Precautions:
####### Pregnancy, breastfeeding, patients, major
####### surgery, diabetes mellitus, thyroid/renal/hepatic
####### dis-ease, COPD, CAD, nonallergic broncho-
####### spasm, bronchial asthma, CVA, children,
####### depression, vasospastic angina,
####### pheochromocytoma
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Week 13 drug card
Course: Pharmacology (NSG 124)
University: Herzing University
