Term
phenytoin sodium (Dilantin)
IV push
Class: Anticonvulsant |
|
Definition
Action: Selectively stabilizes seizure threshold and depresses seizure activity in the motor cortex. May take 15 to 20 minutes to take effect.
Indications: Control of grand mal and psychomotor seizures. Treatment of status epilepticus.
Usual dose: Loading dose 10 to 15 mg/kg. Do not exceed total dose of 1.5 g. Lethal dose estimated at 2 to 5 g. Maintenance doses 100 mg every 6 to 8 hours.
Side effects: Ataxia, confusion, dizziness, drowsiness.
Interactions: Do not add to IV solutions or mix with other meds.
Nursing Implications: Very alkaline; follow with sterile NS to reduce local venous irritation. Best before and after. Adults: 25 to 50 mg or fraction thereof over 1 minute. Do not exceed 50 mg/min. |
|
|
Term
prochlorperazine edisylate (Compazine)
IV push
Class: Anti-emetic |
|
Definition
Action: As a potent antiemetic acts both centrally at the chemoreceptor trigger zone and peripherally by blocking the vagus nerve in the GI tract. Onset of action is prompt and lasting.
Indications: Control of severe nausea and vomiting.
Usual dose: Single IV dose not to exceed 10 mg. Max daily IV dose should not exceed 40 mg. Normal dose 2.5 to 10 mg; may be repeated one time in 1 to 2 hours if indicated.
Side effects: Extrapyramidal reactions, orthostatic hypotension, blurred vision, constipation, dry mouth, urine retention, mild photosensitivity reactions.
Interactions: Do not use in comatose or severely depressed states or in the presence of large amounts of CNS depressants.
Nursing Implications: Deliver each 5 mg or fraction |
|
|
Term
hydromorphone hydrochloride (Dilaudid)
IV push
Class: Narcotic analgesic |
|
Definition
Action: Provides potent analgesia without significant hypnotic effects. Six times more potent than morphine. Onset of action 10 to 15 minutes and lasts 2 to 3 hours.
Indication: Moderate to severe acute or chronic pain, especially in situations in which a hypnotic effect is not desirable, such as postoperatively or in some malignancies.
Usual dose: 0.5 to 1 mg every 3 hours as needed. May increase up to 4 mg every 4 to 6 hours if pain is severe.
Side effects: Constipation, dizziness, dry mouth, dysphoria, euphoria, flushing, light-headedness, nausea, pruritus, sweating, and vomiting.
Nursing Implications: Schedule II narcotic. Administer 2 mg or fraction thereof over 2 to 5 minutes. |
|
|
Term
digoxin (Lanoxin)
IV push
Class: Antiarrhythmic
|
|
Definition
Action: Onset of action within 5 to 30 minutes and lasts 2 to 3 days. Positive inotropic action, increasing the strength of myocardial contraction, Also alters electric behavior of heart muscle through actions on myocardial automaticity, conduction velocity, and refraction.
Indications: CHF, atrial fibrillation, atrial flutter, selected paroxysmal tachycardia or AV junctional rhythm, selected supraventricular tachycardias, cardiogenic shock, and pre/intra/post-op because of stress on the heart.
Usual dose: 0.25 to 0.5 mg (1 to 2 mL) as the initial dose, followed by 0.25 to 0.5 mg (1 to 2 mL) at 4- to 6-hour intervals until digitalized (approx 4 to 6 hours).
Side effects: Seldom lasts more than 3 days after drug is DC'ed. Any form of digoxin may cause partial or AV block and almost any arrhythmia, including paroxysmal tachycardia, atrial tachycardia, fibrillation or standstill.
Nursing Implications: Each single dose over a minimum of 5 minutes. |
|
|
Term
furosemide (Lasix)
IV push
Class: Diuretic, antihypertensive |
|
Definition
Action: Extremely potent and has rapid onset of action. Effectiveness is noted within 5 minutes and may last for 2 hours. Acts on proximal and distal ends of the tubule and the ascending limb of the loop of Henle to excrete water, sodium, chlorides, and potassium.
Indication: Edema associated with CHF, cirrhosis of liver with ascites, and renal disease including the nephrotic syndrome, acute pulmonary edema, hypercalcemia, hypertension.
Usual dose: 20 to 40 mg. May be repeated in 1 to 2 hours. If necessary, increase dosage by 20-mg increments until desired diuresis is obtained. IV bolus dose should not exceed 1 g/day. If larger dose needed, give as infusion.
Side effects: Usually occur in prolonged therapy, seriously ill patients, or following large doses. Anemia, anorexia, blurring of vision, reversible deafness.
Interactions: Potentiates antihypertensive drugs.
Nursing Implications: Each 40 mg or fraction thereof should be given over 1 to 2 minutes. A 10-g bolus must be given over at least 30 minutes; up to 3 hours is preferred. |
|
|
Term
morphine sulfate (Astramorph PF, Duramorph PF)
IV push
Class: Narcotic analgesic |
|
Definition
Action: Pain relief effected almost immediately and lasts up to 4 to 5 hours. Induces sleep and inhibits perception of pain by binding to opiate receptors, decreasing sodium permeability, and inhibiting transmission of pain impulses.
Indications: Relief of moderate to severe acute and chronic pain. Analgesic of choice in pain associated with myocardial infarction.
Usual dose: 2.5 to 15 mg. Repeat every 2 to 4 hours as necessary.
Side effects: Anxiety, confusion, constipation, depression of cough reflex.
Interactions: Alcohol, other CNS depressants.
Nursing Implications: Schedule II narcotic. Deliver 15 mg or fraction thereof over 4 to 5 minutes. |
|
|
Term
diltiazem hydrochloride (Cardizem)
IVPB
Action: Calcium channel blocker, antiarrhythmic
|
|
Definition
Action: Directly inhibits the influx of calcium ions through slow channels during membrace depolarization of cardiac and vascular smooth muscle. Slows conduction through the AV node, prolongs the effective refractory period, reduces ventricular rates, and helps to prevent embolic complications.
Indications: Temporary control of rapid ventricular rate in atrial fibrillation or atrial flutter unless associated with an accessory bypass tract, rapid conversion of paroxysmal supraventricular tachycardia (PSVT) to normal sinus rhythm.
Usual dose: 0.25 mg/kg of body weight initially (20 mg for the average patient). Second dose of 0.25 mg/kg may be given in 15 minutes if needed to achieve HR reduction (25 mg for average patient).
Side effects: Arryhthmia, flushing, hypotension, and injection site reactions (burning, itching).
Interactions: Many, including regular insulin, Lasix.
Nursing Implications: Each single dose equally distributed over 2 minutes. |
|
|
