DRUG PRESENTATION On Emergency and CPR Drugs

DRUG PRESENTATION
CPR AND EMERGENCY DRUGS
BY
B.Shibi Benny,
B.SC Nursing – Second Year,
Bishop’s College of Nursing,
Dharapuram.
EMERGENCY DRUGS
Emergency drugs are chemical compounds
used in patients during life threatening
conditions so that the symptoms can be
controlled and the life of a patient can be
saved.
CPR [ CARDIO PULMONARY
RESUSCITATION ]
Cardio Pulmonary Resuscitation (CPR) is a technique of basic life
support for the purpose of oxygenation to the heart, lungs and brain
until and unless the appropriate medical treatment can come and
restore the normal cardiopulmonary function.
EMERGENCY DRUGS AND CPR DRUGS :
1. Nitroglycerin
2. Morphine Sulfate
3. Epinephrine
4. Atropine Sulfate
5. Amiodarone Hydrochloride
6. Vasopressin
NITROGLYCERIN
Nitroglycerin
Brand name : Nitromist

Dosage :
Inj - 0.5mg/mL, 5mg/mL, 10mg/mL (IV)
Sublingual tab – 0.3mg, 0.4mg, 0.6mg
Buccal tab – 2mg, 3mg
Frequency:
Tab – q8-12h
Inj - q3-5min prn
Action :
• Relaxes vascular smooth muscle
• Reduces myocardial oxygen
consumption
• Reduces left ventricular workload
• Reduces arterial BP
• Reduces venous return
Indication :
• Angina pectoris
• CHF associated with acute
myocardial infsection
• Cardiac load reducing agent
• Hypertensive crisis
Pharmacokinetics :
• Absorption : Significant loss to first
pass metabolism after oral dosing
• Onset : SL-2min, PO-3min
• Duration : SL-30min, PO-3to5 hr
• Distribution – Widely distributed; not
known if distributed to breast milk
• Metabolism : Extrensively metabolized
in liver
• Elimination : Inactive metabolites
excreted in urine
• Half-life : 1-4 min
Side Effects:
• CNS – weakness, throbbing, dizzin,
headache
• GI – nausea, vomiting
• Skin – rash, contact dermatitis ( patch )
• CV – orthostatic hypotension, flushing,
fainting
• EENT – sublingual burning
MORPHINE
Morphine Sulfate
Brand Name : Kadian, Avinza, Epimorph, Santex
Dosage :
Tab – 10mg, 15mg, 30mg
Inj – 0.5mg/mL, 1mg/mL, 2mg/mL, 4mg/mL,
5mg/mL, 8mg/mL, 10mg/mL, 15mg/mL,
25mg/mL, 50mg/mL (IV/IM/SC)
Suppositories – 5mg, 10mg, 20mg, 30mg
Frequency :
Tab/ Inj/ Suppositories – q4h prn
Action :
• Acts as agonist at specific opioid
receptors in the CNS to produce
analgesia, euphoria, sedation.
Indication :
• Relief of moderate to severe
acute and chronic pain.
• Preoperative medication.
• Cardiac pain indicative of MI.
Pharmacokinetics :
• Absorption : Variably absorbed from
GI tract
• Peak : PO-60 min, PR-20to60 min,
SC-50to90 min, IM-30to60 min,
IV-20 min
• Duration : Upto 7 he
• Distribution : Crosses blood-brain
barrier and placenta; distributed in
breast milk
• Metabolism : Metabolized primarily in
liver
• Elimination :
1. 90% of drug and metabolites
excreted in urine in 24 hrs
2. 7-10% excreted in bile
Side Effects :
• GI – dry mouth, constipation
• CNS – dizziness, sedation, euphoria,
dysphoria, insomnia, anxiety, fear
• CV – tachycardia, bradycardia,
arrhythmia, palpitations, hypertension
• Dermatologic – pruritus, urticaria
• GU – urinary retention, reduced libido
• Resp – Apnea, respiratory depression
EPINEPHRINE
Epinephrine
Trade Name : Adrenaline, Epifrin, Glaucon

Dosage :
Inj –
• 1mg IV of 1: 10000 solution
• 0.1-1mg SQ or IM of 1: 10000 solution
• 0.1-0.3mg SQ or IM of 1:10000 solution
Frequency :
Inj – q10-15min prn
Action :
• Stimulates beta receptors in lung
• Relaxes bronchial smooth muscle
• Increases vital capacity
• Decreases airway resistance
Indication :
• Asthma
• Bronchitis
• Emphysema
• All cardiac arrest, anaphylaxis
• Used for symptomatic bradycardia
• Relief of bronchospasm occurring during
anesthesia
• Exercised – induced bronchospasm
Pharmacokinetics :
• Absorption : Inactivated in GI tract
• Onset : 3-5 min, 1 hr on conjunctiva
• Peak : 20 min, 4-8 hr on conjunctiva
• Duration : 12-24 hr topically
• Distribution : Widely distributed; does
not cross blood-brain barrier, crosses
placenta
• Metabolism : Metabolized in tissue
and liver by monoline oxidase (MAO)
and catecholamine-methyltransferase
(COMT)
• Elimination : Small amount excreted
unchanged in urine ; excreted in breast
milk
Side Effects :
• CV – tachycardia, angina, palpitations, stress
• CNS – headache, paresthesia, tremor, stroke,
dizziness, memory impaired, syncope
• M/S – myonecrosis
• GU – urinary retention, difficult maturation
• GI – nausea, vomiting, bowel necrosis
• Resp – pulmonary edema, dyspnea,
bronchospasm, hypoxia of mucosa
• Dermatologic – pallor, diaphoresis
ATROPINE SULFATE
Atropine Sulfate
Brand Name: Atropen, Sal-Tropine, Atreza
Dosage :
Inj – 0.05mg/mL, 0.1mg/mL, 0.4mg/mL -
NaCl 0.9%
• IM – 2mg/0.7mL
• IV – 0.1mg/mL, 0.4mg/mL – NaCl 0.9%
Action :
• An anticholigernic that inhibits
acetylcholine at the parasympathetic
neuro effector junction.
• Blocking vagal effects on the SA and AV
nodes, thereby enhancing conduction
through the AV node and increasing the
heart rate.
Indication :
• Pre-op meds / pre-anesthetic meds
• To restore cardiac rate and arterial pressure
during anesthesia when vagal
• To learn the degree of A-V heart attack
• To overcome severe carotid sinus reflex
antidote for cholinergic toxicity.
Pharmacokinetics :
• Absorption – Well absorbed from all
administration sites
• Peak effect – IM-30 mins, IV-2to4 mins,
SC-1to2 hr, inhalation-1.5to4 hr,
topical-30to40 mins
• Duration – Inhibition of salivation 4 hr ;
myadriasis 7-14 days
• Distribution – Distributed in most body
tissues ; crosses blood brain barrier and
placenta
• Metabolism – metabolized in liver
• Excretion – 77-94% excreted in urine in
24 hr
• Half life – 2-3 hr
Side effects :
• CNS – restlessness, ataxia, hallucinations, coma,
insomnia, confusion, headache
• CV – tachycardia, angina, arrhythmia,
palpitations
• GI – dry mouth, constipation, vomiting
• GU – urine retention
• EENT – photophobia, blurred vision, myadriasis
AMIODARONE
HYDROCHLORIDE
Amiodarone Hydrochloride
Brand Name : Cordarone, Nexterone, Pacerone

Dosage :
Inj – 50mg/mL in 3mL samples ( IV )
Tab – 100mg, 200mg, 400mg
Frequency :
Tab - qd
Action :
• Blocks Na channels, prolonging myocardial
cell action potential and refractory period
• Non competitive alpha and beta
adrenergic blockage
•Slows electrical conduction, electrical impulse
generation from SA node and conduction
through accessory pathways
•It dilates blood vessels
Indication :
• Life threatening recurrent arrhythmias
• Ventricular fibrillation
• Ventricular tachycardia
Pharmacokinetics :
• Absorption – approximately 50%
absorbed (22-86%)
• Onset – 2-3 days to 1-3 week
• Peak – 3-7 hr
• Distribution – concentrates in adipose
tissue, lungs, kidneys, spleen, crosses
placenta
• Metabolism – Extensively hepatically
metabolized ; undergoes some
enterohepatic cycling
• Elimination – Excreted chiefly in bile
and feces ; also excreted in breast
milk
• Half life – Biphasic, initial 2.5-10
days, terminal 40-55 days
Side Effects:
• CV – hypotension, bradycardia, heart
arrest, cardiac arrhythmia, flushing
• Resp – bronchospasm, lung edema, dystonia,
cough, hypoxia
• CNS – dizziness, paresthesia, headache,
ataxia
• GI – nausea, constipation, abdominal pain,
vomiting, diarrhea
• M/S – muscle spasm, back pain, myopathy
• GU – impotence, epididymitis
THANK
YOU

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DRUG PRESENTATION

CPR AND EMERGENCY DRUGS

Brand name : Nitromist

Trade Name : Adrenaline, Epifrin, Glaucon

Brand Name : Cordarone, Nexterone, Pacerone

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