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1 Furosemide (Lasix) F: Loop Diuretic C: Sulfonamide Derivative Action: Inhibits reabsorption of sodium and chloride at proximal and distal tubes at loop of Henle Indication: Pubmonary edema, CHF, hepatic dz, nephritic syndrome, ascites and HTN Safe Dose Range: 20-40mg increase by 20mg q 24h Dilute: NS or DW Rate of administration: 20mg or less/min Side effects: headache, fatigue, weakness, OH, tinnitus, blurred vision, metabolic alkalosis, Hypokalemia, Hyponatremia, hyperglycemia, nausea, diarrhea, dry mouth, vomiting, polyguria, renal failure, thrombocytopenia, neutropenia, anemia, rash, purities, sweating, photosensitivity,
2 Digoxin (Lanoxin) High Alert F: Cardiac glycoside, antidysrhythmic C: Digoxin preparation Action: Increase cardiac output (positive inotropic effect), increase force of contraction, and decrease heart rate (negative chronotropic effect). The heart work smarter, not harder. Indication: heart failure, Afib, atrial flutter, atrial tachycardia, cardiogenic shock, paroxysmal atrial tachycardia Safe Dose Range: 0.6 1mg given as 50% of the dose initially, additional fractions given at 4-8h intervals Dilute: Undiluted or 1ml/4ml of sterile water, D5, or NS Rate of Administration: MORE than 5 min
3 Prochlorperazine (Compazine) F: Antiemetic, antipsychotic C: Phenothiazine, piperazine derivative Action: D2 (dopamine) receptor antagonist Indication: Nausea, vomiting, psychotic disorders Safe Dose: 5-10mg Dilute: NaCl, 5mg/9ml Rate: 5mg or less/min Side effects: depression, drowsiness, restlessness, tremor, dizziness, headache, tachycardia, hypotension, nausea, vomiting, anorexia, dry mouth, diarrhea, constipation, weight loss, metallic taste, cramps, agranulocytosis, respiratory depression, neuroleptic malignant syndrome, tardive
4 Cardizem (Diltiazem) F: Calcium Channel Bocker C: Benzothiazepine Action: Inhibits calcium ion influx across cardiac depolarization, produce relaxation of coronary vascular smooth muscle, dilates coronary arteries Indication: Angina, HTN, Afib, paroxysmal supraventricular tachycardia Safe Dose: 0.25 mg/kg over 2 min initially, then 0.35mg/kg over 15min Dilute: IV undiluted over 2 min or diluted 125mg/100mm of DSW, NaCl Rate: 2 min Side Effects: headache, fatigue, drowsiness, weakness, insomnia, dysrhythmia, bradycardia
5 Hydralazine (Apresoline) F: Antihypertensive, direct acting peripheral vasodilator C: Phyhalazine Action: vasoldilates arteriolar smooth muscles by direct relaxation (decrease in b/p, with reflex increase in heart rate, stroke volume, cardiac output) Indication: HTN, unlabeled: CHF Safe Dose: 10-20mg q 4-6h Dilute: IV undiluted Rate: 10mg/min or MORE Side Effects: headache, tremors, dizziness, anxiety, palpitations, tachycardia, shock, rebound
6 Metoclopramide (Reglan) F: Cholinergic, Antiemetic C: Central Dopamine receptor antagonist Action: Increase response to acctylcholine lines in upper GI, cause contraction of gastric muscle, decrease secretions, bocks dopamine in chemoreceptors triggers Indication: Prevent nausea, vomiting induced by chemotherapy, radiation, delayed gastric emptying, gastroesophageal reflux Safe Dose: 1-2mg/kg Dilute: Undiluted if dose is less or equal to 10mg; giver over 2 min. MORE + 10mg: dilute 50ml or more D5W, NaCl, LR, given over 15 min Rate: See above
7 Famotidine (Pepcid) F: H2 Histamine receptor antagonist Action: Inhibits histamine H2 receptor site, decrease gastric secretions Indication: treatment for duodenal ulcer, gastric ulcers, gastroesophageal reflux disease, heartburn Safe Dose: 20 mg q 12h Dilute: dilute 2ml of product (10mg/1ml) in 0.9% NaCl Rate: Over 2 min Side effects: Headache, dizziness, paresthesia, depression, anxiety, insomnia, fever, dysrythmias, taste change, tinnitus, constipation, nausea, cramps, diarrhea, abnormal hepatic enzymes, thrombocytopenia, aplastic anemia, rash, pneumonia
8 Ondansetron (Zofran) F: Antiemetic C: 5-HT3 receptor antagonist Action: Prevents nausea, vomiting by blocking serotonin, peripherally, centrally and in the small intestines Indication: Prevention of nausea, vomiting associated with cancer chemotherapy, radiotherapy and postoperative nausea, vomiting Safe: Cancer Chemo: 1.15mg/kg over 15 min or 32mg dilute in 50ml of D5 or 0.9% NaCl Postoperative: 4mg undiluted over 30 sec Dilute: yes for chemo (32mg dilute in 50ml of D5, 0.9% NaCl), postoperative (undiluted) Single dose in 50ml of NS or D5W, 1/2NS over 15 min
9 Methyiprednisolone (Soln-Medrol) F: Corticosteroid C: Glucocorticoid, immediate acting Action: Decrease inflammation, suppress leukocyte and fibroblast (framework) migration, and decrease capillary permeability Indication: severe infamm, shock, adrenal insufficiency, collagen disorders, spinal cord injuries, MS Safe Dose: Inflamm; mg q 2-6h Bronchospasm, prophylaxis; 40-80mg/day in 1-2 divided dose Dilute: yes, 500 mg or less/1 min or longer (Dilutant not provided in book, states after diluting with dilutent provided) Rate: 1 min or longer
10 Toradol (Ketorolac) F: Nonsteroidal anti-inflammatory, non-opioid analgesic C: Acetic Acid Action: inhibit prostaglandin synthesis, analgesic, anti-inflammatory, antipyretic effects Indication: Mild to moderate pain Safe Dose: 15-30mg or 15mg q6h, max 60mg/day for 5 days Dilute: Undiluted over>or equal to 15 sec, D5W, 0.9NaCl, LR, D5 Rate: over 15 sec Side Effects: dizziness, drowsiness, tremors, seizures, HTN, flushing, syncope, pallor, edema, vasodilation, MI, stroke, tinnitus, hearing loss, blurred vision, nausea, vomiting, diarrhea, constipation, dry mouth, GI bleed, taste change, hepatic failure, nephrotoxicity, dysuria
11 Morphine (Morphine Sulfate) F: Opioid Analgestc C: Alkaloid Action: Depress pain impulse transmission at the spinal cord level, interrupts opionoid receptors Indication: Moderate to severe pain Safe Dose: mg diluted in 4-5 ml of H2O over 5 min Dilute: 5 ml or more sterile water, or NS Rate: over 5 min Side Effects: drowsiness, dizziness, confusion, headache, sedation, seizure, palpitations, bradychardia, change in b/p, shock, cardiac arrest, chest pain, hypo/hypertension, edema, tachycardia, tinnitus, blurred vision, nausea, vomiting, constipation, cramps, rash, bruising, flushing, diaphoresis
12 Dilaudid (Hydromorphone) F: Opiate analgesic C: Semisynthetic phenanthrene Action: inhibit ascending pain pathway in CNS, increase pain threshold, alters pain perception Indication: moderate to severe pain Safe Dose: 1-2 mg q4-6 prn, may be increased Dilute: direct, diluted with 5 ml of sterile H2O, or NS Rate: 2mg or less/3-5 min Side Effects: drowsiness, dizziness, headache, sedation, seizures, palpitation, bradychardia, change in b/p, tachycardia, peripheral vasoldilation, tinnitus, blurred vision, nausea, vomiting, constipation, dry mouth, paralytic ileus, increased urinary output, dysuria, rash, uriticaria, bruising, flushing,
13 Meperidine (Demerol) F: Opioid analgesic C: Phenylpiperidine derivative Action: depress pain impulse transmission at the spinal cord level by interacting with opioid receptors Indicators: Moderate to severe pain, preoperative and postoperatively Safe Dose: mg/hr Dilute: with 5 ml or more of H2O or NS, give over 4-5min Rate: 4 5 min. Side Effects: drowsiness, dizziness, confusion, sedation, seizure, palpitations, barycardia, hypotension, change in b/p, tachycardia, tinnitus, blurred vision, nausea, vomiting, constipation, cramps, paralytic ileus, urinary, bruising, flushing, diaphoresis, respiratory depression, anaphylaxis
14 Benadryl (Diphenhydramine) F: Antihistamine C: Ethanolamine derivative, H1 receptor antagonist Action: decrease allergic response by blocking histamine Indication: allergy symptoms, rhinitis, motion sickness, nonproductive cough, nighttime sedation Safe Dose: mg, max 300mg/day Dilute: undiluted, give 25mg/1 min w/0.9nacl, d5w, nacl, d10w, LR Rate: 25mg/1min Side Effects: drowsiness, poor coordination, fatigue, confusion, seizures, hypotension, palpitations, blurred vision, dilated pupils, tinnitus, nasal stuffiness, dry (mouth, nose, throat), nausea,
15 Valium (diazepam) F: antianxiety, anticonvulsant, skeletal muscle relaxant C: benzodiazepine Action: potentiates actions of GABA, esp in limbic system (emotion, behavior and mood) Indication: anxiety, acute alcohol withdrawal, seizure disorder, preoperative, skeletal muscle relaxant Safe Dose: 2-10 mg q3-4h Dilute: 5 mg or less/1 min or total dose over 3 min or more, do not dilute or mix Rate: see above Side effects: dizziness, drowsiness, confusion, headache, anxiety, tremors, fatigue, hallucinations, OH, ECG changes, tachycardia, hypertension, blurred vision, tinnitus, constipation, dry mouth, nausea, vomiting, anorexia, neutropenia, rash, dermatitis, itching, respiratory
16 Protonix (pantoprazole) F: Proton pump inhibitor C: Benzimidazole Action: suppress gastric secretions by inhibiting enzymes, blocks acid production Indication: gastroesophageal reflux disease (GERD), severe erosive esohagitis Safe Dose: 80 mg q 12 h Dilute: w/10 ml NaCl, further dilute w/80 ml LR, d5, nacl (0.8mg/ml), give over 15 min or as IV push over 2 min Rate: 2 min
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