Question

1.Adenosine

2.Amiodarone

3.Atropine

4.Epinephrine

5.Glucose

6.Lidocaine

7.Magnesium Sulfate

8.Milrinone

9.Naloxone

10.Procainamide

11.Sodium Bicarbonate

12.Insulin Humalog (Insulin Pump)

13 .Solumedrol 20mg IV every 8 hours  

14 .Aminophylline 200 mg IV every 8 hours

15. Protonix 20 mg PO every 12 hours

16. Cefazolin 250mg IV every 8 hours

6.Panadol (Acetaminophen 5 ml PO, PRN)

write down the therapeutic effect , adverse reactions , interactions , precautions ,contraindication and significant nursing activities for each medication

Answer 1

1.adenosine:

A >therapeutic effect: (adenosine injection) slows conduction time through the A-V node, can interrupt the reentry pathways through the A-V node, and can restore normal sinus rhythm in patients with paroxysmal supraventricular tachycardia (PSVT), including PSVT associated with Wolff-Parkinson-White Syndrome.

>adverse reactions

Side effects of adenosine include:facial flushing.

difficulty breathing.,chest pain,.heart attack.

lightheadedness,.dizziness.

tingling in arms,.numbness.

>contraindications

contraindications for medications include:

Sensitivity or allergy to the medication

Pregnancy

Lactation

Renal disease

Hepatic disease.

>Precautions: The occurrence of angina, severe bradycardia, severe hypotension, respiratory failure (potentially fatal), or asystole/cardiac arrest (potentially fatal), should lead to immediate discontinuation of administration. Adenosine may trigger convulsions in patients who are susceptible to convulsions.

>interactions: no known serious interactions

Moderate interactions of adenosine include: dipyridamole.

...M

Mildinteractions of adenosine include:

acebutolol.

atenolol.

betaxolol.

bisoprolol.

caffeine.

carvedilol.

celiprolol.

esmolol.

>nursing activities

Cardiac monitor should be used on patients receiving adenosine IV boluses. Flush IV port with flush solution (e.g., normal saline) immediately after IV bolus. Use only clear solutions; discard unused medication. Warn patient of possibility of transient warmth and flushing of skin immediately following injection.

2.Amiodarone

>therapeutic effect

This medication is used to treat certain types of serious (possibly fatal) irregular heartbeat (such as persistent ventricular fibrillation/tachycardia). It is used to restore normal heart rhythm and maintain a regular, steady heartbeat. Amiodarone is known as an anti-arrhythmic drug.

>adverse reactions

The most common side effects that can occur with amiodarone oral tablet include:

nausea.

vomiting.

fatigue.

tremor.

lack of coordination.

constipation.

insomnia.

headache.

>interactions

Important Amiodarone (Cordarone) Drug Interactions

Drug Result of interaction

Digoxin22 Elevated digoxin plasma concentration

Warfarin (Coumadin)21 Elevated prothrombin time

Simvastatin (Zocor)24 Increased incidence of myopathy when simvastatin dosage is higher than 20 mg per day.

>contraindications

>Precautions

Amiodarone may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

if you are pregnant or plan to become pregnant. You should not become pregnant while using amiodarone. Amiodarone may harm an unborn baby.Amiodarone passes into breast milk and may have undesirable effects on a nursing infant. Breast-feeding is not recommended while using this drug.

>nursing activities

Monitor blood pressure and apical pulse prior to administration. Cardiac monitor should be used on patients receiving amiodarone therapy. Baseline chest x-ray and pulmonary function test is recommended before beginning PO therapy. Baseline assessments should be checked of liver function and thyroid function.

3.Atropine

Therapeutic effect

Atropine is a prescription medicine used to treat the symptoms of low heart rate (bradycardia), reduce salivation and bronchial secretions before surgery or as an antidote for overdose of cholinergic drugs or mushroom poisoning. Atropine may be used alone or with other medications.

>adverse reactions

Common side effects of atropine sulfate include:

dry mouth,

blurred vision,

sensitivity to light,

lack of sweating,

dizziness,

nausea,

loss of balance,

hypersensitivity reactions (such as skin rash), >contraindications

overactive thyroid gland.

myasthenia gravis.

a skeletal muscle disorder.

closed angle glaucoma.

high blood pressure.

coronary artery disease.

chronic heart failure.

chronic lung disease.

>interactions

>Precautions

Precautions

Photophobia And Blurred Vision

Photophobia and blurred vision due to pupil unresponsiveness and cycloplegia may last up to 2 weeks.

Elevation Of Blood Pressure

Elevation in blood pressure from systemic absorption has been reported following conjunctival instillation of recommended doses of atropine sulfate ophthalmic solution, USP 1%.

>nursing activities

Monitor apical pulse prior to administration. Cardiac monitor should be used on patients receiving atropine IV boluses. Doses of 0.5 mg or less may result in paradoxical slowing of heart rate. Eye preparations generally used only for procedures and have only localized effects on optic muscles.

4) Epinephrine

>therapeutic effect

This medication is used in emergencies to treat very serious allergic reactions to insect stings/bites, foods, drugs, or other substances. Epinephrine acts quickly to improve breathing, stimulate the heart, raise a dropping blood pressure, reverse hives, and reduce swelling of the face, lips, and throat.

>interactions

Adrenaline has many drug-drug interactions. Tricyclic antidepressants, monoamine oxidase inhibitors, nonselective β-adrenoceptor antagonists, general anesthetics, cocaine, and antipsychotics such as chlorpromazine are listed as drugs that interact with adrenaline.

>adverse reactions

skin redness, swelling, warmth, or tenderness at the site of injection.

difficulty breathing.

pounding, fast, or irregular heartbeat.

nausea.

vomiting.

sweating.

dizziness.

>contraindications include hypersensitivity to sympathomimetic drugs, closed-angle glaucoma, anesthesia with halothane. Another unique contraindication to be aware of is catecholaminergic polymorphic ventricular tachycardia.

>Precautions

Do not inject this medicine into your hands or feet. There is already less blood flow to the hands and feet, and epinephrine could make that worse and cause damage to these tissues. If you accidentally inject epinephrine into your hands or feet, check with your doctor or go to the hospital emergency room right away.

>nursing activities

Patients should be monitored for heart rate, cardiac rhythm, and blood pressure frequently if an IV drip is to be infused. Never interrupt an intravenous infusion of medication to administer an IVPB or other medication. Extravasation of epinephrine may cause tissue necrosis to skin.

6 Lidocaine

therapeutic effect:

Lidocaine helps to reduce sharp/burning/aching pain as well as discomfort caused by skin areas that are overly sensitive to touch. Lidocaine belongs to a class of drugs known as local anesthetics. It works by causing a temporary loss of feeling in the area where you apply the patch.

>side effects

Common Side effects of Lidocaine include:

Low blood pressure (hypotension)

Swelling (edema)

Redness at injection site.

Small red or purple spots on skin.

Skin irritation.

Constipation.

Nausea.

Vomiting.

>interactions

Serious Interactions of lidocaine include:

axitinib.

bosutinib.

cobimetinib.

eliglustat.

fentanyl.

fentanyl intranasal.

fentanyl iontophoretic transdermal system.

fentanyl transdermal.

>contraindications

contraindications for the use of lidocaine include: Heart block, second or third degree (without pacemaker) Severe sinoatrial block (without pacemaker) Serious adverse drug reaction to lidocaine or amide local anesthetics.

>Precautions

Do not chew gum or food while your mouth or throat feels numb after you use this medicine. You may accidentally bite your tongue or the inside of your cheeks. Heat can cause the lidocaine in the patch to be absorbed into your body faster. This may increase the chance of serious side effects or an overdose

>nursing activities

Check BP and cardiac monitor prior to administration of lidocaine. For stable patients, doses should be given slow IV push at 25 mg/minute. Monitor blood pressure and cardiac monitor during therapy with lidocaine. Assess neurological and respiratory status frequently for signs of toxicity.