What are some agents used to treat shock, cardiac arrest, and anaphylaxis?
Norepinephrine
Dopamine
Epinephrine
Isoproterenol
Phenylephrine
Dobutamine hydrocholoride
Milrinone
Sodium nitropusside
Benadryl
Norepinephrine - Side Effects
-Headache
-Palpitations
-Nervousness
-Epigastric distress
-Agina, hypertension, tissue necrosis with extravasation.
Norepinephrine - Nursing Considerations
1. Is a vasoconstrictor to increase blood pressure and cardiac output.
2. Reflex bradycardia may occur with rise in BP.
3. Pt. should be attended at all times.
4. Monitor urinary output.
5. Infuse with dextrose solution, not saline.
6. Monitor blood press
Dopamine - Side Effects
-Increased ocular pressure.
-Ectopic beats.
-Nausea.
-Tachycardia, chest pain, dysrhytmias.
Dopamine - Nursing Considerations
1. Low-dose: Dilates renal and coronary arteries.
2. High-dose: Vasoconstrictor, increases myocardial oxygen consumptions.
3. Headache is an early symptom o f drug excess.
4. Monitor blood pressure, peripheral pulses, urinary output.
5. Use infusion pump.
Epinephrine - Side Effects
Nervousness, restlessness, dizziness, local necrosis of skin.
Epinephrine - Nursing Considerations
1. Stimulates alpha and beta adrenergic receptors.
2. Monitor BP.
3. Carefully aspirate syringe before IM and SC doses; inadvertent IV administration can be harmful.
4. Always check strength: 1:100 only for inhalation, 1:1000 for parenteral administration
Isoproterenol - Side Effects
Headache, palpitations, tachycardia, changes in BP, angina, bronchial asthma.
Isoproterenol - Nursing Considerations
1. Stimulates beta 1 and 2 adrenergic receptors.
2. Used for heart block, ventricular arrhythmias, and bradycardia.
3. Bronchodilator used for asthma and bronchospasms.
4. Don't give at hs - interrupts sleep patterns.
5. Monitor BP, pulse.
Phenylephrine - Side Effects
Palpitations, tachycardia, hypertension, dysrhythmia, angina, tissue necrosis with extravasation.
Phenylephrine - Nursing Considerations
1. Is a potent alpha 1 agonist.
2. Used to treat hypotension.
Dobutamine hydrocholoride - Side effects
Hypertension, PVCs, asthmatic episodes, headache.
Dobutamine hydrocholoride - Nursing Considerations
1. Stimulates beta 1 receptors.
2. Incompatible with alkaline solutation (e.g., sodium bicarbonate).
3. Administer through central venous catheter or large peripheral vein using an infusion pump.
4. Don't administer with other medications; incompatible.
5
Milrinone - Side Effects
Dysthythmia, thrombocytopenia, jaundice.
Milrinone - Nursing Considerations
1. Positive inotropic agent.
3. Smooth muscle relaxant used to treat severe heart failure.
Sodium nitropusside - Side effects
Hypotension.
Sodium nitropusside - Nursing considerations
1. Dilates cardiac veins and arteries.
2. Decreases preload and afterload.
3. Increases myocardial perfusion.
Benadryl - Side effects
Drowsiness, confusion, insomnia, headache, vertigo, photosensitivity.
Benadryl - Nursing consideration
1. Blocks effects of histamine on bronchioles, GI tract, and blood vessels.
What are important nursing considerations for all medications used to treat shock, cardiac arrest, and anaphylaxis?
1. Serious rebound effect may occur.
2. There is a distinct balance between underdosing and overdosing.
3. Monitor VS, measure urine output, assess for extravasation, observe extremities for color and perfusion.
What are some antianxiety agents?
Valium, Xanax/Kloopin/Ativan/Serax, Versed, BuSpar, Vistaril, Kava, Melatonin.
What is the action and indications for anti-anxiety agents?
Action: Affects neurotransmitters.
Indications: Anxiety disorders, insomnia, petit mal seizures, panic attacks, acute manic episodes.
What are common side effects of anti-anxiety medications?
Sedation, depression, confusion, anger, hostility, headache, dry mouth, constipation, bradycardia, urinary retention.
What are nursing considerations for anti-anxiety agents?
1. Monitor liver function.
2. Monitor for therapeutic blood levels.
3. Avoid alcohol.
4. Caution when performing tasks requiring alterness (e.g., driving a car.)
4. Benzodiazepines are used as muscle relaxants, sedatives, hypnotics, and anticonvulsants.
Valium - Side Effects
Lethargy, hangover, respiratory depression, hypotension.
Valium - Nursing Considerations
1. Is a CNS depression.
2. Used for anxiety, sedation, alcohol withdrawel, seizures.
3. May result in toxic build-up in the elderly.
4. Potential for physiological addiction/overdose.
5. Can develop tolerance and cross-tolerance.
6. Cigarette smoking incr
Xanax/Klonopin/Ativan/Serax - Side Effects
Drowsiness, light-headedness, hypotension, increases salivation, orthostatic hypotension, memory impairment/confusion.
Xanax/Klonopin/Ativan/Serax - Nursing Considerations
1. CNS depressant.
2. Safer for the elderly.
3. Don't combine with alcohol or other depressants.
4. Don't discontinue abruptly.
5. Teach about addictive potential.
Versed - Side Effects
Retrograde amnesia, euphoria, hypotension, dysrhythmia, cardiac arrest, respiratory depression.
Versed - Nursing Considerations
1. CNS depressant.
2. Use: Preoperative sedation, conscious sedation for endoscopic procedures and diagnostic tests.
BuSpar - Side Effects
Light-headedness, confusion, hypotension, palpitations.
Buspar - Nursing Considerations
1. Little sedation.
2. Requires 3 or more weeks to be effective; cannot be given as a PRN medication.
3. Useful for GAD.
4. No abuse potential, thus used for clients with previous addiction.
5. Avoid alcohol and grapefruit juice.
6. Monitor for worsening
Atarax - Nursing Considerations
1. Produces no dependence, tolerance, or intoxication. Can be used for anxiety relief for indefinite periods.
What are some antacid medications?
Aluminum hydroxide gel
Calcium carbonate
Magnesium hydroxide (Milk of Magnesia)
Maalox
What is the action and indications of antacid medications?
Action: Neutralizes gastric acids; inactivates pepsine.
Indications: Peptic ulcer, indigestion, reflex esophagitis, prevents stress ulcers.
What are common side effects of antacid medications?
Constipation, diarrhea, acid rebound between doses, metabolic acidosis.
What are nursing considerations for antacid medication administration?
1. Use medications with sodium content cautiously for clients with cardiac or renal disease.
2. Absorption of tetracyclines, quinolones, phenothiazides, iron preparations, and isoniazids are reduced when given with a antacid.
3. Effectiveness of oral cont