Emergency Drugs.lavly

Nifedipine - Antianginals A- Thought to inhibit calcium ion influx across cardiac and smooth-muscle cells, decreasing contractility and oxygen demand. Also may dilate coronary arteries and arteriole I- •Vasospastic angina, classic chronic stable angina pectoris •Hypertension S/E- Dizziness, light-headedness, headache, weakness, peripheral edema, flushing, nausea, Syncope, nervousness, hypotension, palpitations, nasal congestion, diarrhea, constipation, abdominal discomfort, muscle cramps, dyspnea, pulmonary edema, cough, rash, puritus Nx Res: • Don’t give immediate-release form within 1 week of acute MI or in acute coronary syndrome • Alert: despite the previously widespread SL use nifedipine capsule, avoid this route of administration. Excessive hypotension, MI, and death may result • Monitor blood pressure regularly, especially in patients who take beta blockers or antihypertensive • Watch for symptoms of heart failure Clonidine hydrochloride – Antihypertensives A- Decreases the release of adrenergic hormones from the brain, resulting in a decrease in the peripheral vascular resistance and blood pressure I- Essential renal and malignant hypertension S/E- Drowsiness, dizziness, fatigue, sedation, nervousness, headache, orthostatic hypotension, bradycardia, urine retetion, impotence, transient glucose intolerance (after large dose), constipation, pruritis, dermatitis NX RES: • Monitor blood pressure and pulse rate. • May be given rapidly lower blood pressure in some hypertensive emergencies. • Rising slowly and avoid sudden position change to prevent orthostatic hypotension. Remove patch before defribrillation to prevent arcing Ranitidine HCL - Anri- ulcer A- Completely inhibits action of histamine on the H2 at receptor sites of parietal cells, decreasing gastric acid secretions I- Duodenal and gastric ulcers, Maintenance therapy for gastric and duodenal ulcer, GERD, Erosive esophagitis, Heartburn S/E- Vertigo, malaise, headache, blurred vision, jaundice, burning and itching at injection site NX RES:

•Assess patient for abdominal pain. Note presence of blood in emesis, stool, or gastric aspirate •Ranitidine may be added to total parenteral nutrition solution •Instruct patient on proper use of OTC preparation as indicated. •Remind patient to take once daily prescription drug at bedtime for best results •Instruct patient to take without regard to meals because absorption isn’t affected by food Furosemide - Loop Diuretics A- inhibits sodium and chloride reabsorption at the proximal and distal tubules and the ascending loop of Henle I- acute pulmonary edema, edema, hypertension S/E - vertigo, dizziness, headache, paresthesia, orthostatic hypotension, thrombophlebitis, abdominal pain, Hypokalemia, anemia, muscle spasm NX RES: • To prevent nocturia, give preparation in the morning and early in the afternoon • Watch for signs of hpokalemia • do not confuse with Torsemide or Lasix with Lonox • advise patient to take drug with food to prevent GI upset inform patient of possible need for potassium or magnesium supplements Calcium gluconate - Electrolytes and replacement solutions A- Replaces and maintains calcium I- Hypocalcemia, hypocalcemic tetany, magnesium toxicity, hypoparathyroidism S/E- GI irritation, hemorrhage, constipation, vomiting , thirst, renal canaliculi, hypercalcemia, polyuria NX RES: • Use cautiously in patients with sarcoidosis and renal or cardiac disease and in digitalized patients. • monitor blood calcium level frequently. Phenobarbital - CNS DRUGS- HYPNOTICS/ SEDATIVES A- Depressant and anticonvulsant effects may be related to its ability to increase the inhibitory activity of GABA on nerve impulses I- Short-term treatment of insomnia, long- term treatment of generalized toni-clonic seizures S/E - PRECAUTION: Impaired renal, hepatic cardiac or resp. functions ADVERSE RXN

Dizziness, headache, hangover, confusion in elderly, GI disturbances, allergic reactions, sedation and depression may occur NX RES: >instruct pt. to avoid alcohol and other CNS depressant to prevent inc. depression > withdrawal insomnia may occur after shortterm use, insomnia improves in 1-3 nights >on empty stomach, 30-60 mins before bedtime for expected sleeplessness >advice pt to change positions slowly to prevent orthostatic hypotension

action on the tissues, especially the Purkinje network. I - Ventricular arrhythmias caused by MI, cardiac manipulation, or cardiac glycosides S/E -confusion, tremor, lethargy, somnolence, stupor, restlessness anxiety, hallucinations, nervousness, seizure. CV: hypotension, bradychardia, new or worsened arrhythmias EENT: tinnitus, blurred or double vision. GI: vomiting Respiratory: Respiratory depression and arrest Skin: soreness at injection site Other:

SalbutamoL – Bronchodilator A- Facilitates/ potentiates the inhibitory activity of GABA at the limbic system and reticular formation to reduce anxiety, promote calmness and sleep I- Reversible airway obstruction including bronchial asthma, chronic bronchitis S/E- Fine tremor of skeletal muscle, feeling of tension, a compensory small increase in heart rate, headache, muscle cramps NX RES: > drug may be decrese sensitivity of spirometry used for diagnosis of asthma >syrup may be taken as young as age 2 >monitor for evidence of allergic rxn

anaphylaxis, sensation of cold

DIAZEPAM - anti-anxiety ( Anticonvulsant/Hypnotics/Sedatives/Anxiolytics ) A- Facilitates/ potentiates the inhibitory activity of GABA at the limbic system and reticular formation to reduce anxiety, promote calmness and sleep I- Symptomatic relief of anxiety, agitation, tension S/E- fatigue, blurred vision, dependence, withdrawal reactions NX RES: > inform pt. that drug may be taken with food >advice pt. not to abruptly discontinue drug after long term use >advice pt. to avoid driving and activities that require alertness bec, drug can cause drowsiness >inform pt. that smoking may decrease effect

A - Relaxes bronchial smooth muscle by

NX RES: Monitor drug level and for toxicity Monitor patient’s response, especially blood pressure and electrolytes Stop infusion and notify prescriber if arrhythmias worsen or ECG changes If signs of toxicity such as dizziness occur, stop at once and inform prescriber Use cautiously and in reduced dosages in patients with complete or second degree heart block or sinus bradychardia Epinephrine - Bronchodilators stimulating beta2 receptors; also stimulates alpha and beta receptors in the sympathetic nervous system. I - Bronchospasm, hypersensitivity reaction S/E- nervousness, tremor, vertigo, pain, headache, widened pulse pressure, hypertension nausea NX RES: Drug increases rigiditiy and tremor in patients with Parkinson’s disease Epinephrine therapy interferes with tests for urinary catecholamines Avoid IM use of parenteral suspension into buttocks. Gas gangrene may occur Massage site after IM injection to counteract

Lidocaine (hydrochloride) - Antiarrhythmics

possible vasoconstriction. Observe patient closely for adverse

A - A class IB anti-arrhythmic that decreases the

reactions. Notify doctor if adverse reaction

depolarization, automaticity, and excitability in

develop

the ventricles during the diastolic phase by direct

If blood pressure increases sharply, rapidacting vasodilators such as nitrates or alpha blockers can be given to counterac