TEMPLATES FOR COMMONLY TRANSPORTED PHARMACOLOGIC AGENTS

Size: px

Start display at page:

Download "TEMPLATES FOR COMMONLY TRANSPORTED PHARMACOLOGIC AGENTS"

Pierce Farmer
6 years ago
Views:

1 TEMPLATES FOR COMMONLY TRANSPORTED PHARMACOLOGIC AGENTS Page 91

2 Acyclovir Sodium Zovirax Herpes simplex virus and herpes zoster virus IV, PO IV: PO: 5 mg/kg over 1 hour; given every 8 hours for five days 20 mg/kg over five days Headache, seizures, nausea and vomiting, phlebitis at injection site None Page 92

3 Aminophylline Aminophyllin, Somophyllin Respiratory difficulties due to asthma, COPD, or pulmonary edema IV 5-6 mg/kg over 20 minutes Nervousness, headache, arrhythmias, nausea and vomiting Caution advised when using other catecholamine agents. Do not mix with beta blockers. Page 93

4 Ampicillin Trihydrate Omnipen, Polycillin, Totacillin Bacterial infections IV or IM 2 to 12 grams IV or IM daily Seizures, nausea and vomiting, thrombocytopenia, nephropathy Drug may be given with probenecid to increase antibitiotic levels Page 94

5 Amrinone Lactate Inocor Third line agent in the treatment of severe CHF IV bolus.75 mg/kg bolus over 2-3 minutes. Followed by an IV infusion of 5-15 mcg/kg/min. Titrate to the desired effect. Hypotension, nausea and vomiting, arrhythmias Caution advised when administering digitalis. A precipitate will form when amrinone and lasix are administered together. Amrinone and dextrose are not compatible. Page 95

6 Bumetanide Bumex Pulmonary edema and hypertension IV or IM mg over 2 minutes. Total daily dosage not to exceed 10 mg. Headache, hypotension, nausea and vomiting, hypovolemia Watch for signs of dehydration Page 96

7 Butorphanol Stadol Severe pain IV or IM mg every 3 hours. Titrate to the desired level of effect Drowsiness, euphoria, hypotension, respiratory depression 2 mg of stadol is the equivalent of 10 mg of morphine. May cause withdrawal symptoms in patients addicted to opioid narcotics. Page 97

8 Calcium Salts Calcium chloride Calcium gluconate Hyperkalemia Hypocalcemia IV Calcium chloride: Calcium gluconate: 2-4 mg/kg 5-8 ml slow IV bolus Syncope, cardiac arrest, arrhythmias, nausea and vomiting, extravasation may cause tissue sloughing. Calcium and sodium bicarbonate will precipitate if mixed together. Digitalis and calcium should be used together with caution. Page 98

9 Ceftriaxone Sodium Rocephin Bacterial infections IV or IM 1 to 2 grams IV or IM daily Headache, dizziness, anaphylaxis, nausea and vomiting, phlebitis None Page 99

10 Cefazolin Sodium Ancef, Kefzol, Zolicef Bacterial infections IM or IV 250 mg to 1.5 grams every 6 to 8 hours Diarrhea, thrombocytopenia, nausea and vomiting, urticaria, pruritis None Page 100

11 Chlorpromazine Promapar, Thorazine Acute psychosis and alcohol withdrawal IM 25 mg Drowsiness, headache, hypotension, tachycardia Be cautious when using with other anticholinergic agents. Hypotension may ensue when mixed with other antihypertensive agents. Page 101

12 Dexamethasone Decadron, Hexadrol Shock, cerebral edema, allergic reactions IV 100 mg for shock 10 mg for cerebral edema 4 mg for allergic reactions Headache, depression, restlessness, hypokalemia, hypertension Not to be mixed with other agents Page 102

13 Digitalis Lanoxin CHF, atrial arrhythmias with a rapid ventricular response IV mcg/kg bolus Nausea and vomiting, yellowed blurred vision around light sources, arrhythmias, anorexia. Avoid simultaneous use of beta blockers and digitalis Page 103

14 Diltiazem Hydrochloride Cardizem Angina, hypertension, and SVT PO or IV.25 mg/kg IV bolus over 2 minutes. If unsuccessful bolus with.35 mg/kg IV bolus. Continuous infusion of 10 mg/hr. Headache, edema, flushing, arrhythmias, CHF, AV block Lasix and diltiazem form a precipitate when mixed. Beta blockers and diltiazem may prolong conduction times. If patient is on cimetidine, toxicity may result. Page 104

15 Dobutamine Dobutrex Pulmonary edema and hypotension IV 2-20 mcg/kg/min Headache, hypertension, arrhythmias, shortness of breath Beta blockers may negate the effect of dobutamine. Tricyclic anitdepressants may increase the potential for hypertension. Page 105

16 Doxycycline Doxylin, Vibramycin Gram negative and gram positive bascteria IV or PO IV dose: 200 mg per day Diarrhea, nausea and vomiting, photosensitivity, urticaria None Page 106

17 Epinephrine Infusion Adrenalin chloride Cardiopulmonary arrest, refractory bradycardia IV 1 mg mixed in 250 cc. Infuse at 2-10 mcg/min VF, excitability, arrhythmias None Page 107

18 Erythromycin Erythromycin base Bacterial infections IV or PO 500 mg every 6 hours Abdominal pain and cramping, anaphylaxis, urticaria, venous irritation Digitalis toxicity may ensue when mixed with this agent Page 108

19 Haloperidol Haldol Psychosis IM 2-5 mg IM Sedation, confusion, respiratory depression, hypotension May increase hypotension when used with antihypertensives. Phenobarbital may increase the effect of haldol. Page 109

20 Heparin Heparin DIC, adjunct to treatment for AMI, and pulmonary embolus IV 5,000 to 10,000 units IV push. Followed by infusion of 1,000 units per hour Allergic reactions, bruising, epistaxis, hematuria Protect patient from rough handling. Verify drug dosage. Page 110

21 Hydromorphone Dilaudid Severe pain IV or IM IV: IM: 1 mg IV bolus titrate to effect 2-4 mg every 4-6 hours Drowsiness, confusion, hypotension, bradycardia Watch for signs of respiratory depression Page 111

22 Insulin Humulin, Novolin Hyperglycemia, hyperkalemia (with D50) IV and SQ.33 units/kg IV bolus. Followed by an infusion of.1 units/kg/hr IV insulin is usually continued until glucose levels drop below 250 mg/dl, then SQ therapy begins Hypoglycemia, rebound hyperglycemia Use insulin syringes calibrated for that concentration of insulin. Do not rub injection site after administration of insulin SQ. Page 112

23 Magnesium Sulfate Magnesium sulfate Pre-eclampsia, eclampsia, torsades de pointes IV 2-4 grams of 10% solution over 3 minutes. IV infusion after the bolus of 1-2 grams/hour. Drowsiness, respiratory depression, arrhythmias, hypotension Do not administer via rapid IV bolus. May cause respiratory depression and/or heart block. Maintain close watch over blood pressure. Page 113

24 Mannitol Osmitrol Increasing intracranial pressure IV grams/kg Headache, confusion, CHF, pulmonary edema, dehydration Must use an in-line filter. Be alert for CNS depression when mannitol is given simultaneously with other CNS depressant drugs. Watch for signs of decreased skin turgor. Page 114

25 Meperidine Demerol Severe pain IV or IM Infusion: IM: mg/hr mg every 3-4 hours Headache, confusion, hypotension, bradycardia, respiratory depression Often given with phenergan. Watch for signs of respiratory depression. Page 115

26 Methylprednisolone A-methaPred, Medrol, Solu-medrol Severe inflammation or immuno-suppression IV or IM mg bolus either IV or IM Depression, euphoria, restlessness, hypertension, hyperglycemia When used with diuretics there stands an increased risk for hypokalemia Page 116

27 Norepinephrine Levophed Hypotension IV Initiate infusion at mcg/min. Average therapeutic range is 2-12 mcg/min. Headache, anxiety, arrhythmias, extravasation may lead to tissue sloughing Monitor EKG and blood pressure closely. Titrate to desired blood pressure range. The use of beta blockers and norepinephrine may lead to hypertension. Page 117

28 Ofloxacin Floxin Bacterial infection IV or PO 400 mg IV or PO every 12 hours Seizures, nausea, phlebitis None Page 118

29 Oxytocin Pitocin, Syntocinon Induction of labor and to control postpartum hemorrhage IV or IM IV: IM: Units added to 1 liter of fluid; titrate to appropriate response 3-10 Units Seizures, coma, hypotension, arrhythmias May cause uterine rupture. Use with vasoconstrictors may cause hypertension. Page 119

30 Phenobarbital Luminal Treatment of seizures IV mg slow IV bolus Headache, drowsiness, hypotension, nausea and vomiting Monitor airway at all times. Phenobarbital may increase the effects of CNS depressants. Page 120

31 Phenytoin Dilantin Seizures, also exhibits an antiarrhythmic effect IV mg slow IV bolus Dizziness, nervousness, hypotension Dilantin may increase the effects of other CNS depressants Page 121

32 Potassium Infusion Potassium chloride Hypokalemia IV meq over 24 hours Bradycardia, cardiac arrest, confusion, diarrhea, respiratory distress Not compatible with dobutamine, mannitol, or penicillin Page 122

33 Procainamide Pronestyl, Promine, Procan Ventricular or supraventricular arrhythmias IV 20 mg/min IV infusion. Once infusion has been completed a maintenance drip is needed at 1-4 mg/min. Confusion, hypotension, prolongation of the Q-T interval which may lead to torsades de pointes. Keep close watch on the EKG and the patient s blood pressure Page 123

34 Promethazine Hydrochloride Phenergan Nausea and to potentiate the effects of narcotics IV or IM 25 to 50 mg IV or IM Drowsiness, sedation, dry mouth If giving IV do not exceed 25 mg/min. Shield from direct sunlight if given as an IV infusion. Page 124

35 Propranolol Inderal Control ventricular and supraventricular arrhythmias, hypertension, adjunctive therapy for MIs (normally metoprolol is used) IV 1-3 mg IV bolus every 5 minutes. Total dose is.1 mg/kg Weakness, bradycardia, wheezing, CHF, nausea and vomiting Monitor patient while administering the agent. Digitalis combined with this agent may greatly increase the bradycardic effect. Use with caution in patients with asthma. Page 125

36 Racemic Epinephrine MicroNEFRIN Croup Inhalation therapy Usually only used in pediatric patients ml/kg by inhalation Palpitations, fear, anxiety, nausea and vomiting Assess patient throughout the treatment. Page 126

37 Terbutaline Brethaire, Brethine, Bricanyl Dyspnea and to halt premature contractions SQ and inhalation SC:.25 mg repeated every minutes Inhalation: Two inhalations every 4-6 hours Nervousness, hypertension, arrhythmias Frequent assessment of vital signs during therapy is necessary Page 127

38 Vancomycin Hydrochloride Vancocin, Vancoled Bacterial infections refractory to traditional antibiotics IV 500 mg IV every 6 hours Tinnitus, nausea, fever, anaphylaxis Watch for signs of extravasation Page 128

39 Vitamin Infusion MVC Plus, MVI-12, MVI Replenish vitamins IV 5-10 ml every 24 hours. Dilute solution in 1,000 ml IV. Rare None Page 129

Chapter 9. Learning Objectives. Learning Objectives 9/11/2012. Cardiac Arrhythmias. Define electrical therapy

Chapter 9. Learning Objectives. Learning Objectives 9/11/2012. Cardiac Arrhythmias. Define electrical therapy Chapter 9 Cardiac Arrhythmias Learning Objectives Define electrical therapy Explain why electrical therapy is preferred initial therapy over drug administration for cardiac arrest and some arrhythmias