b Sr no. 1.

Brand Name Transm ucosal tablets: Nirtogar d, Nirtogar d-SR Extende d release buccal tabs:Nitr ogard IV:Nitro -Bid Ointme nt:NitroBid,Nitr ol SL:Nitro stat,Nitr oQuick Transde rmal:De ponit, ministra n Translin gual spray:Ni

Chem ical Name Nitro glyce rine

Class

Action

Dosage/Rout

Indication

Contraindication Hypersensiti vity to this product or nitrites, severe anemia, increased intracranial pressure, cerebral hemorrhage, closed angle glaucoma, cardiac tamponade, cardiomyopa thy, constrictive pericarditis

Sideeffects CNS:Head ache,flushi ng, dizziness

Nursing Responsibilities

Functi onal Class: Coronat y vasodil ator, antiangi nal Chemi calm class: Nitrate

Decrease s preload, afterload, which is responsib le for decreasin g left ventricul ar end diastolic pressure, systemic vascular resistance dilates coronary arteries, improves blood flow through coronary vasculatu re, dilates arterial, venous bed systemati cally.

SL:Dissolve tab under tongue when pain begins, may repeat q5min until relief occurs,take no more than 3 tabs/15min, use 1 tab prophylactica lly 5- 10 min before activities, SUS CAP:q612hr on empty stomach, TOP:1-2 in q8hr, increase to 4 in q4hrs as needed IV:5mcg/min ,then increase by 5mcg/min q3-5min,if

Acute angina, prophylaxi sof angina, Angina unresponsi ve to recommen ded dose of organic nitrates or blockers,p erioperativ e hypertensi on,CHF associated with acute MI

Assess Pain:duration, time started, activity being perfomed, CV:Postura character l Orthostatic B/P, hypotensio pulse prior toand n, after tachycardia administation , collapse, Tolerance if taken syncope, over long period palpitations Headache, lightheadedness, GI:Nausea, decreased B/P, vomiting may indicate a need for INTEG:Pa decreased dosage llor, Administration: sweating, P/O route rash Swallow sus rel ptroducts whole, do not break, crush or chew 2 hr after meals SL should be dissolved under toungue,not swallowed Aeosole sprayed

trolingua l Translin gual spray

no response after 20mcg/min,i ncreased by 10-20 mcg/minuntil desired response TRANS PATCH:app ly a pad daily to a site free of hair, remove patch at bedtime to provide 1012 hr nitrate free intervalto avoid tolerance Buccal:1mgq 5hr

nder toungue, not inhaled Transdermal route: Transmucosal tab should be placed between cheek and gum line Topical ointment should be measured on paper supplied Apply new TD patch daily and remove after 1214 hr to prevent tpolerance IV route Diluted in amount specified D5, 0.9NaCl for infusion Evulate Therapeutic response:decrease , prevention of angina pain

Sr no. 2.

Brand Name

Chemi cal Name Atreza, Atropi atropin ne sulfate, Atopen , SalTropin e

Class

Action

Dosage/Ro ut Bradycard ia/bradydy srhythmia: IV BOL 0.5 -1mg given q35min max 2 mg Orgaanop hosphate poisoning:I M/IV 2 mg q hr until muscarinic symptoms disappear, may need 6 mg q hr Presurger y:SubCute/ IM/IV0.4 0.6mg before anaeshesia

Indicatio n Bradycar dia <4050bpm, bradydys rhythmia, reversal of anticholi nesterase agents, insecticid e poisoning , blocking cardiac vagal reflexes, decreasin g secreatio ns before surgery, antispas modic with GU, biliary surgery, bronchod ilator,

Contraindication Obsstructive diseaase of GI tract, obstructive uropathy,un stable cardiovascul ar status in acute hemorrhage, intestinal atony of the elderly or debilitated patient, thyrotoxicos is, tachycardia

Side-effects

Nursing Responsibilities

Blocks acetycholi ne at parasympa thetic neuroeffec tor sites, increase cardiac output, heart rate by blocking Chemica vagal stimulatio l class:Bell n in hear, adonna dries alkaloid secretion by blocking vagus Function al class:Ant idysrhyth mic, anticholinerg ic parasymp atholytic, antimuscarini c

CNS:Headac Assess: he, dizziness, I&O ratio,check involuntory for urinary movement, retention, daily confusion, output psychosis, For bowel sounds, anxiety chek for coma, constipation flushing, Respiratory drowsiness, status:rate, insomnia, rhythm,cyanosis, weakness, wheezing, delirium dyspnea, CV:Hypoten engorged neck sion veins ,paradoxical Increased bradycardia, intraocular angina, pressure:eye pain, PVCs, nausea, vomiting, hypertension, blurred vision, tachycardia, increased tearing EENT:Blurr Cardiac rate: ed vision, rhythm, character, photophobia, B/P continuously glaucoma, Allergic reaction: eye pain, rash, urticaria pupil Administer: dilation, PO route nasal Increased bulk, congestion water in diet if

AV heart block

GI:Dry mouth,nause a,vomiting,a bdoinal pain, anoexia, Constipation, paralytic ileus, abdominal distension, altered teste GU:Retentio n,hesitancy impotence, dysuria INTEG:Ras h,urticaria, contact dermatitis, dry skin, flushing

constipation occurs hr before meals IM route Atropine flush may occur in children and is not harmful IV route Undiluted or diluted with 10 ml sterile water, give at 0.6mg/min, do not add to IV solution, may cause paradoxical bradycardia lasting 2 min Evaluate Therapeutic response: decreased dysrhythmias, increased heart rate, secretions, GI, GU spasm, bronchodilation. Teach patient /family: To report blurred vision, chest pain, allergic reactions, constipation, urinary retention

Not to perfom strenuous activity in high temperatures, heat stroke may result To take as prescribed, not to skip or double doses Not to operate machinery if drowsiness occurs

Sr no. 3.

Brand Name Avil AllerChlorate

Chemic al Name Chlorp henira mine

Class

Action

Dosage/ Route Tab:25 mg 2-3 times daily or 50mg twice daily. Inj.Amp 1-2 ml twice daily IM

Indicati on Allergi c dermati tis, allergy, rhinitis, commo n cold, insect bite, motion sicknes s.

Contraindication Hypersensi tivity, Newborn

Side-effects

Nursing Responsibilities

Func. Class:Antih istamine Chem. Class:Alkyl amine, H1receptor antagonist

Acts on blood vessels, GI system, respiratory system, by competing with histamine for H1receptor site, decreases allergic response by blocking histamine.

CNS:Dizzin ess, drowsiness, poor coordination , fatigue, anxiety, euphoria, confusion, paresthesia, neuritis EENT:Blur red vision, dilated pupil, tinnitus, nasal stuffiness, dry nose, throat, mouth GI:Nausea, anorexia, diarrhea GU:Retenti on, dysuria, urinary frequency HEMA:Thr ombocytope

Assess: Be alert for urinary retention, frequency, dysuria, product should be discontinued Respiratory status:rate, rhythm, increase in bronchial secretion, wheezing, chest tightness Administer: Avoid concurrent use with other CNS depressants PO route With meals for GI symptoms, absorption may slightly decreases IV route Use only 10mg/ml for IV use Storage in tight container at room temperatures

nia, Evaluate: agranulocyt Therapeutic osis, response:absence hemolytic of running, anemia congested nose, INTEG:Pho rashes, tosensitivity conjunctivitis RESP:Incre Teach patient/family ased thick All aspects of secretion, product use, to wheezing, notify prescriber chest of tightness confusion/sedatio n/hypotension, difficulty voiding To avoid driving, other hazardous activity if drowsiness occurs, especially geriatric patients To avoid concurrent use of alcohole Treatment of overdose:Administer diazepam, vasopressors, phenytoin IV

Sr no. 4.

Brand Name Novodia pam Diastat Valium

Chem Class ical Name Diaze Func. pam Class:Anti anxiety, anticonvul sant, skeletal muscle relexant Chem. Class: Benzodiaz epine, long acting

Action

Dosage/Ro ut

Potentiate s the action of GABA,es pecially in limbic system, reticular formation, enhances presympat hetic inhibition, inhibits spinal polysynap tic afferent paths

Indicatio Contran indicatio n Anxiety, Pregnanc Tab Anxiety:2- acute y, 10 mg 2-3 alcohol hypersen times daily; withdra sitivity to Insomnia:5 wal, benzodia - 30 mg adjunct zepines, orally at in closedbed time seizure angle Muscle disorder glaucoma spasm:10s, , coma, 30 mg preopera myasthes daily orally tively as ia gravis, Pemedicati a ethanol on:5-30mg relaxant, intoxicati before skeletal on, operation muscle hepatic relaxatio disease Inj Premedicat n, ion:10mg rectally i.v for acute Endoscopic repetitiv procedures: e 10-20mg seizures i.v Status epilapticus: 10mg i.v. can

Side-effects

Nursing Responsibilities

CNS:Dizziness Assess: , drowsiness, B/P , pulse, confusion, respiratory rate, if headache,anxie systolic rate, if ty, tremors, systolic B/P drops stimulation, 20mm Hg, hold fatigue, product, notify depression, prescriber, insomnia, respiration every 15 hallucination, min if given IV ataxia, fatigue Blood studies:CBC CV:orthostatic during long term hypotension, therapy, blood ECG changes, dyscrasis, hepatic tachycardia, studies :ALT, AST hypotension, Degree of anxiety, EENT:Blurred what precipitates vision, tinnitus, anxiety and whether mydriasis, product controls nystagmus symptoms GI:constipatio For alcohol n, dry mouth, withdraw nausea, symptoms, vomiting, including anorexia, hallucination, diarrhea delirium, HEMA:Neutro irritability, penia agitation, fine to

repaeated if seizure[ersi st, upto 10 mg in 24hours Tetanus:10 -20mg i.v., to be repeated as required

INTEG:Rash, dermatitis, itching RESP:Respirat ory depression

coarse tremors For muscle spasm, pain relief Hepatic studies:AST, ALT, bilirubin, creatinin, LDH IV site for thrombosis or phlebitis, which may occur rapidly Mental status:mood, sensorium, affect, sleeping pattern, drowsiness, dizziness, dizziness, suicidal tendencies Physical dependency, withdrawal symptoms:headache , nausea, vomiting, muscle pain, weakness after long term use Administer With food or milk for GI symptoms, crushed if patient is unable to swallow medication whole Suarless gum, h, ard candy, frequent sips

of water for dry mouth Reduced opiod dose by 1/3 if given concomitantly with diazepam IV route: Into large vein, give IV 5 mg or less/1min or total dose over 3min or more, continuousinf is not recommended, inject, inject as close as to vein insertion as possible, do not dilute or mix with other products Evaluate Therapeutic response:decreased anxiety, restlessnss, insomnia Teach/Family: That product may be taken with food That product may not be used every day stress or used longer than 4 months unless

directed by presciber, no more than prescribed amount, may be habit forming To avoid driving, activities that require To avoid alcohol, other psychotropic medication unless directed by presciber, that smoking may decreases diazepam effect by increasing diazepam metabolism To rise slowly or faintining may occur, especially in geriatric patients

Sr no. 3.

Brand Name Avil AllerChlorate

Chemical Name Chlorphe niramine

Class Func. Class:Anti histamine Chem. Class:Alk ylamine, H1receptor antagonist

Action Acts on blood vessels, GI system, respiratory system, by competing with histamine for H1receptor site, decreases allergic response by blocking histamine.

Dosage/ Route Tab:25 mg 2-3 times daily or 50mg twice daily. Inj.Amp 1-2 ml twice daily IM

Indicati on Allergi c dermati tis, allergy, rhinitis, commo n cold, insect bite, motion sicknes s.

Contraindication Hypersensiti vity, Newborn

Sideeffects CNS:Dizz iness, drowsines s, poor coordinati on, fatigue, anxiety, euphoria, confusion, paresthesi a, neuritis EENT:Blu rred vision, dilated pupil, tinnitus, nasal stuffiness, dry nose, throat, mouth GI:Nausea , anorexia, diarrhea GU:Retent ion, dysuria, urinary frequency

Nursing Responsibilities Assess: Be alert for urinary retention, frequency, dysuria, product should be discontinued Respiratory status:rate, rhythm, increase in bronchial secretion, wheezing, chest tightness Administer: Avoid concurrent use with other CNS depressants PO route With meals for GI symptoms, absorption may slightly decreases IV route Use only 10mg/ml for IV use Storage in tight container at room temperatures Evaluate:

HEMA:Th Therapeutic rombocyto response:absence penia, of running, agranuloc congested nose, ytosis, rashes, hemolytic conjunctivitis anemia Teach patient/family INTEG:Ph All aspects of otosensitiv product use, to ity notify prescriber RESP:Incr of eased confusion/sedatio thick n/hypotension, secretion, difficulty voiding wheezing, To avoid driving, chest other hazardous tightness activity if drowsiness occurs, especially geriatric patients To avoid concurrent use of alcohole Treatment of overdose:Administer diazepam, vasopressors, phenytoin IV

Sr no. 4.

Brand Name Novodia pam Diastat Valium

Chemical Name Diazepam

Class

Action

Func. lClass:Ant ianxiety, anticonvul sant, skeletal

Indicatio Contran indicatio n Potentiates Tab Anxiety, Pregnanc the action Anxiety acute y, of :2-10 alcohol hypersen GABA,esp mg 2-3 withdra sitivity to ecially in times wal, benzodia limbic daily; adjunct zepines, system, Insomn in closedreticular ia:5- 30 seizure angle formation, mg disorder glaucoma enhances orally s, , coma, presympath at bed preopera myasthes etic time tively as ia gravis, inhibition, Muscle a ethanol inhibits spasm: relaxant, intoxicati spinal 10-30 skeletal on, polysynapti mg muscle hepatic c afferent daily relaxatio disease paths orally n, Pemedi rectally cation:5 for acute -30mg repetitiv before e operati seizures on Inj Premed ication: 10mg

Dosage /Rout

Side-effects

Nursing Responsibilities

CNS:Dizziness Assess: , drowsiness, B/P , pulse, confusion, respiratory rate, if headache,anxie systolic rate, if ty, tremors, systolic B/P drops stimulation, 20mm Hg, hold fatigue, product, notify depression, prescriber, insomnia, respiration every hallucination, 15 min if given ataxia, fatigue IV CV:orthostatic Blood hypotension, studies:CBC ECG changes, during long term tachycardia, therapy, blood hypotension, dyscrasis, hepatic EENT:Blurred studies :ALT, vision, tinnitus, AST mydriasis, Degree of anxiety, nystagmus what precipitates GI:constipation anxiety and , dry mouth, whether product nausea, controls vomiting, symptoms anorexia, For alcohol diarrhea withdraw HEMA:Neutro symptoms, penia including

i.v Endosc opic procedu res:1020mg i.v Status epilapti cus:10 mg i.v. can repaeat ed if seizure[ ersist, upto 10 mg in 24hours Tetanus :1020mg i.v., to be repeate d as require d

INTEG:Rash, dermatitis, itching RESP:Respirat ory depression

hallucination, delirium, irritability, agitation, fine to coarse tremors For muscle spasm, pain relief Hepatic studies:AST, ALT, bilirubin, creatinin, LDH IV site for thrombosis or phlebitis, which may occur rapidly Mental status:mood, sensorium, affect, sleeping pattern, drowsiness, dizziness, dizziness, suicidal tendencies Physical dependency, withdrawal symptoms:headac he, nausea, vomiting, muscle pain, weakness after long term use Administer

With food or milk for GI symptoms, crushed if patient is unable to swallow medication whole Suarless gum, h, ard candy, frequent sips of water for dry mouth Reduced opiod dose by 1/3 if given concomitantly with diazepam IV route: Into large vein, give IV 5 mg or less/1min or total dose over 3min or more, continuousinf is not recommended, inject, inject as close as to vein insertion as possible, do not dilute or mix with other products Evaluate Therapeutic

response:decrease d anxiety, restlessnss, insomnia Teach/Family: That product may be taken with food That product may not be used every day stress or used longer than 4 months unless directed by presciber, no more than prescribed amount, may be habit forming To avoid driving, activities that require To avoid alcohol, other psychotropic medication unless directed by presciber, that smoking may decreases diazepam effect by increasing diazepam

metabolism To rise slowly or faintining may occur, especially in geriatric patients

Sr no . 5.

Bran d Nam e Ems et

Chemi Class cal Name Ondan Func. setron Class.:Antie metic Chem. Class:5-HT3 receptor antagonist

Action

Dosage/Rout

Indicatio Contran indication

Side-effects

Nursing Responsibilities

Blocks specific sites(5HT3), 5(hydroxytry ptamine) wh ich are associated with nausea and vomiting in the CTZ(chemo receptor trigger Zone)centra lly and specific sites peripherally and in small intestine

Prevention of nausea and vomitiing of cancer chemothera py:IV 0.15 mg/kg over 15min , 30min before start of cancer chemotherap y RECT:16mg /day 2hr prior to chemotherap y PO:8mg hr prior to chemotherap y, repeat 4,8 hr after 1st dose Prevention of nausea /vomiting of radiotherappr

Preventi on of nausea and vomitin g associat ed with cancer chemoth erapy, radiothe rapy, and preventi on of post operaitv e nausea, vomitin g

Hypersensi tivity,use cautiously with prgnancy, lactation.

CNS:Headac Assess: he,diziness, For absence of drowziness, nausea, vomiting fatigue during GI:Diarrhea, chemotherapy constipation, Hypersensitivity abdominal reaction:rash,bro pain, dry nchodilator mouth Administer: MISC:Rash, Oral bronchospas disintegrating m, tab:do not pish muscsuloskel through etal pain, foil,gently wound remove, problems, immediately shivering place on tongue fever, to dissolve, hypoxia, swallow with urinary saliva retention Ensure that the timing of drug doses corresponds to that of the chemotherapy or radiation. Teach patient/family: To report

ior to chemotherap y, repeat 4,8 hr after 1st dose Prevention of nausea /vomiting of radiotherap y:PO 8mg tid, may repeat q8hr Prevention of postoperativ e nausea and vomiting:IV /IM 4 mg undiluted over>30 sec prior to induction of anaesthesia Hepatic dose:PO/IM/ IV max dose 8mg/day Hyperemesi s gravidarum: PO/IV: 48mg bid tid

diarrhea, constiption, rash,or changes in respiration or discomfort at insertion site Headache requring analgesic is common.

Pruritus:PO 4 mg bid Alcoholism: PO 4 mcg/kg bid