Too-rapid IV injection will cause intense anxiety, restlessness, and then drowsiness. Reduce rate of injection in peds patients. Term hydrocortisone sodium succinate Solu-Cortef IV push. Hormone, anti-inflammatory, antiemetic Action: Contains the principal hormone secreted by the adrenal cortex and has both glucocorticoid and mineralocorticoid properties. Agents of choice for adrenocortical insufficiency, occassionally used for asthma or shock. Do occur but are usually reversible: Alteration of glucose metabolism, Cushing's syndrome, electrolyte and calcium imbalance, euphoria or other psychic disturbances, increased BP.
Each mg or fraction thereof over 30 seconds to 1 minute. Extend to 10 minutes for larger doses. Term methylprednisolone sodium succinate Solu-Medrol IV push. Adrenocortical steroid with potent metabolic, anti-inflammatory actions and innumerable other effects. Has a greater ant-inflammatory potency than prednisolone and less tendency to cause excessive potassium and calcium excretion and sodium and water retention.
Supplementary therapy for severe hypersensitivity reaction, shock unresponsive to conventional therapy. May be repeated every 4 to 6 hours as necessary. Cushing's syndrome, electrolyte and calcium imbalance, euphoria, glycosuria, hyperglycemia. Contraindicated in long-term therapy, except in life-threatening situations. Each mg or fraction thereof over 2 to 3 minutes or longer. Term ketorolac tromethamine Toradol IV push.
NSAID with peripheral analgesic, anti-inflammatory, and antipyretic actions. Short-term management of moderately severe, acute pain no longer than 5 days. May be repeated every 6 hours. Diarrhea, dizziness, dyspepsia, drowsiness, edema. Inhibits platelet aggregation and may prolong bleeding time. A single dose over a minimum of 15 seconds; evenly distributed over 1 to 2 minutes is preferred.
Term diazepam Valium IV push. Benzodiazepine, sedative-hypnotic, antianxiety agent, anticonvulsant, amnestic, skeletal muscle relaxant Action: Depresses the central, autonomic, and peripheral nervous systems in an undetermined manner. Management of moderate to severe anxiety disorders or short-term relief of symptoms of anxiety. Preoperative medication, including endoscopic procedures. Maximum dose in status epilepticus is 30 mg in 8 hours. Usually 2 to 15 mg, varies. Apnea, ataxia, blurred vision, bradycardia, cardiac arrest.
Do not mix with any other drug or solution in syringe or solution. Do not use with open-angle glaucoma unless receiving appropriate therapy. Term ondansetron hydrochloride Zofran IV push. Selective antagonist of serotonin receptors. Chemotherapeutic agents such as cisplatin increase the release of serotonin from specific cells in the GI tract, causing emesis. Prevention of nausea and vomiting.
Although repeat doses are not recommended by the manufacturer, they have been given. Agitation, arrhythmias, chest pain, cold sensations, constipation. A single 4-mg dose over at least 30 seconds; 2 to 5 minutes preferred. Term bumetanide Bumex IV push. Sulfonamide diuretic, antihypertensive, and antihypercalcemic agent related to the thiazides. Edema associated with congestive heart failure, cirrhosis of the liver with ascites, renal diseases including nephrotic syndrome.
May be repeated at 2- to 3-hour intervals. Can be used for patients allergic to furosemide. Usually occur in prolonged therapy, serious ill patients, or following large doses. Abdominal pain, arthritic pain, azotemia, dizziness, headache. Do not use with anuria, causes excessive potassium depletion with corticosteroids, thiazide diuretics. A single dose by IV injection over 1 to 2 minutes. Term heparin sodium Heparin IV push. Anticoagulant with immediate and predictable effects on the blood.
Dosage is repeated every 4 to 6 hours and adjusted according to coagulation rest results. Usually 5, to 10, units. Bruising, epistaxis, hematuria, hemorrhage, tarry stools or any other signs of bleeding. Do not administer others through same IV line. First 1, units or fraction thereof over 1 minute. After this test done, any single injection 5, units or fraction thereof may be given over 1 minute. Term fentanyl citrate Fentanyl.
Opium derivative, narcotic analgesic, which is a descending CNS depressant. Approximately times more potent than morphine. Definite respiratory-depressant actions that outlast its analgesic effect. Adjunt to general and regional anesthesia. Short-term analgesia during perioperative period. Bradycardia, diaphoresis, hypersensitivity reactions, hypertension, hypotension. Concurrent use of Valium use with higher doses of fentanyl may produce vasodilation. Administer over a minimum of 3 to 5 minutes.
Rapid administration may result in apnea or respiratory paralysis. Term potassium acetate and potassium chloride IVPB. Electrolyte replenisher, antihypokalemic Action: Principal cation of intracellular fluid. Participates in carb utilization and protein synthesis. Critical in the regulation of nerve conduction and muscle contraction, particularly in the heart.
Changes in acid-base balance of the body are reflected by the changes in chloride concentration. Alternate source of bicarbonate by metabolic conversion in the liver. Prophylaxis or treatment of potassium deficiency. Abdominal pain, diarrhea, nausea, vomiting. Potentiated by angiotensin-converting enzyme inhibitors. Impaired renal function or adrenal insufficiency can cause potassium intoxication, which can develop rapidly and without symptoms.
Broad-spectrum, third-generation cephalosporin antibiotic. Bactericidal to selected gram-negative, gram-positive, and anaerobic organisms. Effective against many otherwise resistant organisms. Inhibits bacterial cell wall synthesis. Treatment of serious lower respiratory tract, urinary tract, skin and skin structure, bone and joint, and intraabdominal infections. Allergic pneumonitis, bleeding episodes, burning, discomfort, and pain at injection site, diarrhea, others.
Do not use with diluents containing calcium such as Ringer's solution or Hartmann's solution, to reconstitute. A single dose over 30 minutes. H2 antagonist, altiulcer agent, gastric acid inhibitor Action: Histamine H2 antagonist, it inhibits both daytime and nocturnal basal gastric acid secretion. It also inhibits gastric acid secretion stimulated by food, histamine, bentazole, and pentagastric.
Not an anticholinergic agent. Does not lower calcium levels. Onset is prompt and effective for 6 to 8 hours. Five to 12 times more potent than cimetidine. Short-term treatment of intractable duodenal ulcers and pathologic hypersecretory conditions in the hospitalized patient, treatment of active benign gastric ulcers in those patients unable to take oral medication, others. Abdominal discomfort, burning and itching at IV site, constipation, diarrhea, headache, and nausea and vomiting are most common.
No additives into premixed solution. Too-rapid administration has precipitated rare instances of bradycardia, tachycardia, and PVCs. Definition Class; Antibiotic Action: Aminoglycoside antibiotic with neuromuscular blocking action. Bactericidal against specific gram-negative bacilli, including E. Coli, Klebsiella, Proteus, and Pseudomonas. Not effective for fungi or viral infections.
Treatment of serious infections of the GI, respiratory, and urinary tracts, CNS, skin, bone, soft tissue, septicemia, and bacterial neonatal sepsis. Occur more frequently with impaired renal function, higher doses or prolonged administration, in dehydrated or elderly patients, and in patients receiving other ototoxic or nephrotoxic drugs. Anorexia, burning, dizziness, fever, headache, hypertension, hypotension, itching, lethargy, muscle twitching, nausea, numbness, rash, roaring in ears, seizures, tingling sensation, tinnitus, urticaria, vomiting, weight less.
Inactivated in solution with penicillins but is synergistic when used in combination with beta-lactam antibiotics. Each single dose, properly diluted, over 30 to 6 minutes, up to 2 hours in peds patients. Antimicrobial agent that combines the extended-spectrum penicillin piperacillin with the potent beta-lactamase inhibitor tazobactam. May be used in suspected polymicrobial infections due to its broad spectrum of activity. Measurement of both drugs is included in the total dose. For every 1 g of piperacillin there is 0.
Abdominal pain, agitation, anxiety, chest pain, constipation, diarrhea, others. Do not mix with other drugs in a syringe or infusion bottle. A single dose over 30 minutes as an intermittent infusion. Discontinue primary IV infusion during administration. Slow infusion rate for pain along venipuncture site. The addition of sulbactam improves ampicillin's bactericidal activity against beta-lactamase-producing strains resistant to penicillins and cephalosporins.
Broad-spectrum antibiotic and beta-lactamase inhibitor effective against selected gram-positive, gram-negative, and anaerobic organisms. Treatment of skin and skin structure and intraabdominal and gynecologic infections due to susceptible strains of specific organisms. All commercial preparations in US have 2: Burning discomfort, and pain at injection site, diarrhea, rash, thrombophlebitis most common.
May be inactivated in solution with aminoglycosides, gentamicin. Do not mix in same solution. A single dose over a minimum of 10 to 15 minutes. Proton pump inhibitor Action: A proton pump inhibitor that suppresses the final step in gastric acid production. Acts at the secretory surface of the gastric parietal cell. Inhibits both basal and stimulated gastric acid secretion irrespective of the stimulus.
Short-term treatment 7 to 10 days of gastroesophageal reflux disease with a history of erosive esophagitis. Abscess, abdominal pain, blurred vision, chest pain, confusion, diarrhea, headache, rash, tinnitus, others. Do not give IM or SC. Many drug interactions including Reyataz. Dedicated line is preferred, but a Y-site may be used. IV line must be flushed before and after. Very potent tricyclic glycopeptide antibiotic bactericidal against gram-positive organisms.
Results from inhibition of cell wall synthesis. Also alters bacterial cell-membrane permeability and RNA synthesis. Serious gram-positive infections including endocarditis, septicemia, bone, lower respiratory tract, and skin and skin structure infections that do not respond or are resistant to other less resistant staphylococci. Chills, dizziness, fever, macular rashes, pain at injection site, pruritis, tinnitus, urticaria.
Solutions containing dextrose may be contraindicated in patients with allergies to corn or corn products. Many other incompatibilities including aminoglycosides. Too-rapid injection may cause severe hypotension and cardiac arrest. In 10 min, if IV form has been well tolerated, may start oral form at 50 mg PO twice daily. Use extreme caution with administering beta blockers after using calcium channel blockers.
Repeat every 5 min to a total of 0. Antidote for Cholinergic Agents: Bretylium No longer recommended for use: Calcium Channel Blocker Overdose: Angiotensin-coverting enzyme ACE inhibitor , antihypertensive. Start with a single dose of 6. IV — 20 to mg every 1 hour prn, PO — 20 to mg every 4 to 6 hours prn; dosage adjusted individually according to signs and symptoms of withdrawal. Anti-platelet Acute Coronary Syndrome: Acute Phase Malignant Hyperthermia: Post Acute Phase Malignant Hyperthermia: IV - 5 to 20 mg every 1 hour prn; PO — 5 to 20 mg every 4 to 6 hours; dosage adjusted individually according to signs and symptoms of withdrawal.
If ventricular rate does not slow in 15 min, give second dose of 0. Arsenic, Mercury, and Lead Poisonings: Those who do not respond may require further increments. Antiemetic, sedative-hypnotic, anesthesia adjunct. Maximum recommended initial dose is 2. Use caution in administering additional doses. Some cases have occurred in patients with no known risk factors for QT prolongation and some cases have been fatal.
Therefore, droperidol should be reserved for use in the treatment of patients who fail to show an acceptable response to other treatments. PO - Start with a single dose of 2. May repeat every 3 to 5 min. IV infusion — 0. May repeat at 10 to 15 min intervals for anaphylaxis, 20 min to 4 hours for asthma. IV drip — 0. IV drip - 0.
In younger children, start at 0. Has a short half-life of 2 to 9 min. Methanol, Ethylene Glycol Poisonings: Use the lower dose for children and non-drinkers, the higher dose for alcoholics. Reversal of Conscious Sedation: IV - initially 0. Additional doses of 0. If resedation occurs, repeat dose at min intervals; maximum of 1 mg at 0. Repeat dosing every 20 min prn. May be given IM if access is a problem. Dissolve in accompanying diluent and use immediately. Give IV for severe hypoglycemia.
Beta Blocker Overdose consider in calcium channel blocker overdose: If no response, repeat dose in 5 min. A repeat dose up to 10 to 20 mg may be given. If no response, repeat dose in 5 min up to 10 mg. Follow with maintenance IV infusion of 0. Consider if Thiamine needs to be given first: Sedation of the Agitated Patient: For mild agitation in the elderly — 0.
For moderate agitation — 2. For severe especially in younger children — 5 to 10 mg. Dose may be repeated every 30 to 60 min until the target symptoms are controlled. For low molecular weight heparin, see Enoxaprin. Start at 10 mg four times daily PO and increase to a maximum of 50 mg four times daily PO. Class III antiarrhythmic agent. Infuse 1 mg IV over 10 min. May repeat the 1 mg infusion 10 min after completing the first infusion.
If vomiting has not occurred within 30 min; repeat initial dose. Initial dose of 10 to 20 mg 0.