Generic Brand name Dosage & Route Classification Action Side Effects Adverse Effect NURSING RESPONSIBILITIES

Name

1.Medazol DORMICUM Adults: Tablet Dosage Benzodiazepin Dormicum has a Drowsiness during the Dormicum is well
am Range: 7.5-15 mg. es hypnotic and day, numbed emotions, tolerated. Slight ● Assess for 12 Rights.
/
sedative effect reduced alertness, decrease in arterial
MID Route: Oral ● Before administering, have
characterized by a confusion, fatigue, blood pressure and
AZOL oxygen and resuscitation
Onset: rapid onset and headache, dizziness, slight changes of heart equipment available in case of
EX
short duration of muscle weakness, rate and respiration are severe respiratory depression.
IV Conscious Sedation: IV: within 5 action. It also ataxia or double vision. fairly common.
In adults <60 years, the mins, exerts an These phenomena Severe ● Monitor and record patient
initial dose is 2.5 mg anxiolytic, occur predominantly at cardiorespiratory response to medication and
IM: 15 mins,
given 5-10 min before anticonvulsant the start of therapy adverse events have level of sedation.
Oral: 20 mins
the beginning of the and muscle- and usually disappear occurred on rare
procedure. ● Observe site closely for
relaxant effect. with repeated occasions. These have
extravasation.
Route: IV Peak: Dormicum impairs administration. included respiratory
psychomotor depression, apnea, ● Monitor for adverse reactions.
IV: 3-5 mins function after respiratory arrest
single and/or and/or cardiac arrest. ● Continuous cardiorespiratory
IM Administration: In IM: 15-30 mins
multiple doses but monitoring.
adults <60 years, the (Children), 30-
dose of Dormicum causes minimal
60mins (adults) ● Monitor BP and oxygen
ranges from 0.07-0.1 haemodynamic
saturation.
mg/kg according to the Oral: 20-30 changes
general condition of the mins ● Assess sedated infant for signs
patient. of pain (midazolam does not
The usual dose is 5 mg. possess analgesic properties).
Duration: 1-6
Route: IM hrs

2.Nalbuph NUBAIN Adults: 0.15-0.2 mg/kg. Synthetic Narcotic agonist- flushing (warmth, The most frequent ● Assess symptoms of respiratory
ine opioid agonist- analgesic of kappa tingling, or redness), adverse reaction in depression such as decreased
Hydrochl opiate receptors 1066 patients treated
 oride antagonist and partial nausea, in clinical studies with respiratory rate.
antagonist of mu NUBAIN was sedation ● Be alert for excessive sedation
Children: 0.1-0.2 mg/kg vomiting,
opiate receptors; 381 (36%). of mood changes. Notify
up to a total single dose
inhibits ascending stomach cramps or physician immediately if
of 10 mg.
pain pathways, pain, patients is unconscious or
Onset: thus altering having difficulty waking up.
Less frequent reactions
response to pain; upset stomach, ● Use pain scale to document
IV: 2-3 mins were: sweaty/clammy
Maybe given SC, IM or produces whether this drug is successful
dizziness, 99 (9%),
IV. SC and IM: analgesia, in relieving pain.
nausea/vomiting 68
15mins respiratory spinning sensation, (6%), dizziness/vertigo ● Assess BP.
depression, and dry mouth, 58 (5%), dry mouth 44 ● Assess dizziness that may affect
sedation (4%), and headache 27 gait, balance and other
Peak: bitter or unpleasant (3%). activities.
taste in your mouth,
IV: 1-3mins
sweating,
IM: 30mins
skin itching or burning
sensation,
Duration: 3-
rash,
6hrs
headache,

nervousness,

restlessness,

depression,

strange dreams,

slurred speech, or

blurred vision.

3.Ephedri Akovaz and Adults: 25-50mg (SC or Alpha/Beta Ephedrine is a With large doses of ephedrine may ● Supervise continuously patients
 ne Corphedra IM) Adrenergic direct and indirect ephedrine sulfate most produce palpitations, receiving ephedrine IV. Take
Agonist sympathomimetic patients will experience headache, dizziness, baseline BP and other vital signs.
5-25mg administered Check BP repeatedly during first
amine. Ephedrine nervousness, insomnia, nausea, vomiting,
slowly, repeated in 5- 5 min, then q3–5min until
activates vertigo, headache, restlessness, and
10mins (IV) stabilized.
Onset: IM- 10- adrenergic α and tachycardia, palpitation anxiety. Ephedrine is
β-receptors as and sweating. Some also arrhythmogenic, ● Monitor I&O ratio and pattern,
20mins
especially in older male patients.
well as inhibiting patients have nausea, and caution should be
Children: Encourage patient to void
norepinephrine vomiting and anorexia. used during
before taking medication
0.5mg/kg o body weight Peak: reuptake, and Vesical sphincter spasm administration to (see ADVERSE EFFECTS).
every 4-6hrs (SC or IM) increasing the may occur and result in patients who are ● Monitor for systemic effects of
release of difficult and painful predisposed to nose drops that can occur
Duration: SC- norepinephrine urination. Urinary arrhythmias or taking because of excessive dosage
1hr from vesicles in retention may develop other arrhythmogenic from rapid absorption of drug
nerve cells. in males with medications, solution through nasal mucosa.
prostatism. particularly digitalis. This is most likely to occur in
When used long term, older adults.
the catecholamine
excess can result in ● Family education on abused
contraction band drug. Learn adverse effects and
dangers; take
necrosis of the
medication ONLY as prescribed.
myocardium which
● Advise family to OTC
predisposes the heart medications for coughs, colds,
to ventricular allergies, or asthma unless
arrhythmias. approved by physician.
Ephedrine is a common
ingredient in these preparations.
● Advice family to not breast feed
while taking this drug without
consulting physician.
4.Morphine MSiR®, MS- Oral: 10-30mg Opioids Morphine is used Breathing problems; Respiratory depression ● Monitor blood pressure prior to
Contin®, Analgesics for the is among the more administration. Hold if systolic
SC and IM: 10mg (5- BP < 100 mm Hg or 30 mm Hg
 Roxanol®, 20mg) 70 kg or as management of drowsiness, dizziness; serious adverse below baseline.
RMS®, directed by physician. chronic, moderate reactions with opiate ● Monitor patient's respiratory
Onset: IV- constipation, nausea, rate prior to administration.
Kadian® and to severe pain. use that is especially
IV: 2.5-15mg/70kg of 10mins vomiting; ● Reassess pain after
oramorph important to monitor
body weight in 4-5ml Opiods, including administration of morphine.
SR®. sweating; or. in the postoperative
water for injection morphine, are ● Monitor for respiratory
patient population.
administered over 4- Peak: 15- effective for the numbness, tingling, or depression and hypotension
5min or as directed by 30mins short term cold feeling in your Morphine can also frequently up to 24 hours after
the physician. management of hands and feet. affect the administration of morphine.
pain. Patients cardiovascular system ● Place call light signal close to
IV Infusion: 0.1-1mg/ml patient. Accompany patient if
taking opioids and reportedly can
in 5% dextrose water by need to get out of bed to
long term may cause flushing,
controlled infusion Duration: minimize risk of falls.
need to be bradycardia,
device. Depending ● Instruct patient to avoid alcohol
monitored for the hypotension, and
upon and other CNS depressants
Rectal: 10-30mg or as development of syncope. It is also while under the influence of
directed by the preparation physical important to note that morphine.
physician. provide pain dependence, patients can ● Instruct patient to avoid tasks
relief in opioid addiction experience pruritis, requiring alertness like driving
naïve patients disorder, and drug urticaria, edema, and and operating heavy machinery
from 4-10hrs. abuse. other skin rashes. while under the influence of
morphine.

5.Fentanyl Duragesic Adults: Opioids Fentanyl produces drowsiness. Fentanyl's side effects ● Assess respiration, and notify
Analgesics; strong analgesia are similar to those of physician immediately if patient
injection solution: stomach pain. exhibits any interruption in
Synthetic, through its heroin, which produce
Schedule II respiratory rate (apnea) or signs
Opioids. activation of gas. euphoria, confusion,
opioid receptors. respiratory depression of respiratory depression,
● 0.05mg/mL
heartburn. (which, if extensive and including decreased respiratory
Surgery Premedication rate, confusion, bluish color of
Onset: <60 sec weight loss. untreated, may lead to
the skin and mucous
50-100 mcg/dose IM or arrest), drowsiness,
difficulty urinating. membranes (cyanosis), and
slow IV 30-60 min prior nausea, visual difficult, labored breathing
to surgery disturbances, (dyspnea).
Adjunct to regional changes in vision. dyskinesia, ● Monitor signs of laryngeal
anesthesia: 25-100 hallucinations, spasm and bronchospasm,
Peak: 2-5mins anxiety. including tightness in the throat
mcg/dose slow IV over delirium, a subset of
1-2 min the latter known as and chest, wheezing, cough, and
"narcotic delirium," severe shortness of breath.
General Anesthesia Notify physician or nursing staff
analgesia, constipation,
immediately if these reactions
Minor surgical Duration: 30- narcotic ileus, muscle
occur.
procedures: 0.5-2 60mins rigidity, constipation,
● Be alert for excessive sedation
mcg/kg/dose IV addiction, loss of or changes in mood and
consciousness, behavior (confusion,
Major surgery: 2-20
hypotension, coma, restlessness). Notify physician or
mcg/kg/dose initially; 1-
and even death. nurse immediately if patient is
2 mcg/kg/hr
Alcohol and other unconscious or extremely
maintenance infusion
drugs (i.e., cocaine, difficult to arouse.
IV; discontinue infusion ● Use appropriate pain scales
heroin) can
30-60 min prior to end (visual analogue scales, others)
synergistically
of surgery; limit total to document whether this drug
exacerbate fentanyl's
fentanyl doses to 10-15 is successful in helping manage
side effects, creating
mcg/kg for fast tracking the patient's pain.
multi-layered clinical
and early extubation
scenarios that can be
● Assess dizziness that might
Adjunct to general complex to manage.
affect gait, balance, and other
anesthesia (rarely used): These substances, functional activities.
20-50 mcg/kg/dose IV taken together, ● Implement appropriate manual
generate undesirable therapy techniques, physical
Analgesia (Off-label) conditions that agents, and therapeutic
Analgesia: 1-2 mcg/kg IV complicate the exercises to reduce pain and
bolus or 25-100 patient's prognosis help wean patient off opioid
mcg/dose PRN or 1-2 analgesics as soon as possible.
mcg/kg/hr by
continuous IV infusion
or 25-200 mcg/hr  
Severe pain: 50-100
mcg/dose IV/IM q1-2hr
PRN (patients with prior
opioid exposure may
tolerate higher initial
doses)

Patient controlled
anesthesia (PCA): 10
mcg/mL IV (usual
concentration); 20 mcg
demand dose with 5-10
min lockout time
interval and base rate of
≤50mcg/hr

Children:

Surgery Premedication
(Off-label)

1-12 years: 0.5-2 mcg/kg

IV given 3 min prior to
procedure; may repeat
q1-2hr

>12 years: 0.5-2

mcg/kg/dose; not to
exceed 50 mcg/dose;
give 3 min prior to
procedure; may repeate
in 5 min if necessary; if
 more than two doses
needed, may repeat up
to 5 times at 25
mcg/dose maximum

Continuous
Sedation/Analgesia

0.5-2 mcg/kg/hr; titrate

to desired effect

Adjunct Anesthesia

<2 years: Safety and

efficacy not established

>2 years: 2-3 mcg/kg

IV/IM q1-2hr PRN

6.Propofol Diprivan Most adult patients Sedative- The action of Fast or slow heart rate, Transient local pain at ● Monitor hemodynamic status
under 55 years of age hypnotic agent propofol involves the injection site is the and assess for dose-related
high or low blood
require 2 mg/kg to 2.5 a positive most common adverse hypotension.
pressure,
mg/kg. modulation of the reaction. This may be ● Take seizure precautions.
Onset: <1 min inhibitory function injection site reactions decreased by Tonic-clonic seizures have
of the (burning, stinging, or administering IV occurred following general
Most patients aged 3 neurotransmitter pain), lidocaine before anesthesia with propafol.
years through 16 Peak: gama- propofol bolus. ● Be alert to the potential for
years require 2.5 aminobutyric acid apnea,
drug induced excitation (e.g.,
 mg/kg to 3.5 mg/kg.  (GABA) through rash, and Hypotension twitching, tremor,
GABA-A receptors. hyperclonus) and take
Duration: An itching. Myoclonus
Rapid - time to appropriate safety measures.
induction dose
onset of Occasionally has been ● Provide comfort measures;
of propofol will
unconsciousness seen to cause EKG pain at the injection site is
have a clinical
is 15-30 seconds, changes (QT interval quite common especially
effect for
due to rapid prolongation). This is when small veins are used.
approximately
distribution from rarely clinically
10 minutes.
plasma to the significant.
The prolonged
CNS.
or repeated Discolored urine (a
administration green tint); this
will accumulate adverse event is
in peripheral exceedingly rare
tissues and will
cause an
increased
duration of
action. 

7.Bupivacain SENSORCAIN Infiltration Anesthesia Central Anesthetic of the Nausea, vomiting, Body as a ● Monitor for signs of inadvertent
e E Nervous amide type. headache, back pain, Whole: Hypersensitivit intravascular injection, which
Adult: IM Local can produce a transient
System Agent; Decreases sodium dizziness, chills, y [cutaneous lesions,
infiltration, sympathetic "epinephrine response"
Local flux into nerve shivering or problems urticaria, sneezing,
block 0.25% solution; (increased heart rate or systolic
Anesthetic cell, inhibiting with sexual function. diaphoresis, syncope,
Lumbar epidural 0.25%, BP or both, circumoral pallor,
(Amide-Type) initial hyperthermia,
0.5%, 0.75% solutions; palpitations, nervousness)
depolarization, angioneurotic
Caudal block, within 45 seconds in the
and prevents edema (including
peripheral nerve block unsedated patient and an
Onset: 4- propagation and laryngeal edema),
0.25%, 0.5% solutions; increase by 20 bpm or more in
7mmin for conduction of the anaphylaxis, heart rate for at least 15
Retrobulbar block
epidural, nerve impulse. anaphylactoid seconds in sedated patient.
0.75% solution
caudal, Progression of reaction]. CNS: Nervo ● Vasoconstrictor-containing
peripheral, or anesthesia, usness, unusual solution should be administered
 sympathetic related to anxiety, excitement, cautiously, if at all, to areas with
block; within 1 diameter, dizziness, drowsiness, end arteries (e.g., digits, penis)
Child: IM 1–3.7 mg/kg or to areas that have a
min for spinal myelination, and tremors, convulsions,
block. conduction unconsciousness, respir compromised blood supply;
velocity of atory arrest. Special ischemia and gangrene can
affected fibers is Senses: Pupillary result. Inspect areas for
evidence of reduced perfusion
manifested constriction; blurred or
because of vasospasm: pale,
clinically as double vision;
Peak: cold, sensitive skin.
sequential loss of tinnitus. GI: Nausea, ● Note: Systemic reactions
nerve function. vomiting. Other: Infla (toxicity) are more apt to occur
May stimulate or mmation or sepsis at in children or older adults and
depress the CNS injection site, chills, may develop rapidly or be
Duration: 3–5 or do both. pupillary delayed for as long as 30 min
h for epidural, constriction. Associate after administration.
d with Epidural ● Monitor for toxicity: CNS
caudal,
Anesthesia, Body as stimulation (unusual anxiety,
peripheral, or
a Whole: Total spinal excitement, restlessness) usually
sympathetic
block, persistent occurs first, followed by CNS
block; 1.25–2.5 depression (drowsiness,
h for spinal analgesia,
unconsciousness, respiratory
block.  paresthesia. Urogenit
arrest). However, because
al: Urinary retention,
stimulation is apt to be transient
fecal incontinence, loss or absent, drowsiness may be
of perineal sensation the first sign in some patients
and sexual (especially children and older
function. Other: Slowi adults).
ng of labor, increased ● Monitor BP and fetal heart rate
incidence of forceps continuously during labor
delivery, cranial nerve because maternal hypotension
palsies (with may accompany regional
inadvertent intrathecal anesthesia. Place mother on left
injection). side with legs elevated.
● Monitor cardiac and respiratory
 status continuously in patients
receiving retrobulbar and dental
blocks.

8. Lidocain Lidocaine Ventricular arrhythmias Local Lidocaine is a local Drowsiness, dizziness, Lidocaine is thought to ● Check BP and cardiac monitor
e CV and anesthetic anesthetic of the nausea, vomiting, be more neurotoxic prior to administration of
Adult: OV 50-100 mg lidocaine.
Lidopen amide type. It is feeling hot or cold, than other local
bolus at a rate of 20-50 ● For stable patient, doses should
used to provide confusion, ringing in anesthetics, especially
mg/min, may repeat in 5 be given slow IV pish at 25
Onset: local anesthesia your ears, blurred when high
min mg/minute.
by nerve blockade vision, double vision or concentrations applied
IV: immediate ● Monitor blood pressure and
Child: IV 0.5-1 mg/kg at various sites in numbness in places directly to nervous
cardiac monitor during therapy
bolus dose, then 10-50 IM: 5-15mins the body. It does where the medicine is tissue. Use of highly
with lidocaine.
mcg/kg/min infusion so by stabilizing accidentally applied. concentrated lidocaine ● Assess neurological and
Topical: 30- the neuronal (2.5 to 5%) for spinal respiratory status frequently for
60sec membrane by anesthesia correlates signs and toxicity.
Anesthetic uses inhibiting the ionic with a greater ● When treating a patient for
fluxes required for incidence of transient ventricular dysrhythmias with
Adult: infiltration 0.5 1% the initiation and radicular irritation lidocaine, an IV infusion (drip)
solution, Nerve block 1- conduction of syndrome, which is a mist be started soon after the
2% solution, Epidural 1- Peak:
impulses, thereby self-limiting painful bolus or serum level will drop
2% solution, Caudal 1- IV: Immediate effecting local condition affecting the below therapeutic range and
1.5% solution, Spinal 5% anesthetic action calves, thighs, and ventricular dysrhythmias will
with glucose, Saddle IM: 10mins return.
buttocks
block 1.5% with ● Therapeutic serum level is 1.5 –
Topical:
dextrose, Topical 2.5-5% 5 mcg/ml.
unknown ● If patient appears upset or
jelly, ointment, cream,
agitated, consider lidocaine
or solution
toxicity. If toxicity is evident,
Duration: 2 hrs simply discontinue IV infusion-
without serum levels drop in 10-20mins.
Post-herpetic neuralgia epinephrine,
Adult: Topical apply up 3hrs with
to 3 patches over intact epinephrine.
 skin in most painful
areas once for up to 12
hr per 24 period

9.Atracuriu TRACRIUM A dose of Tracrium of Neuromuscular Atracurium Skin flushing or CV: bradycardia, ● Lab tests: baseline serum
m 0.4 to 0.5 mg/kg (1.7 to Blockers antagonizes the redness, injection site tachycardia electrolytes, acid-base balance,
Besylate 2.2 times the ED95), neurotransmitter reactions, hives, and renal function as part of
given as an intravenous action of itching, wheezing, pre-anesthetic assessment
bolus injection, is the Onset: 2mins acetylcholine by shortness of breath, Respiratory: respiratory ● Note: personnel and equipment
recommended initial binding allergic reactions, depression required for endotracheal
dose for most patients. competitively with inadequate intubation, administration of
Peak: 20mins cholinergic musculoskeletal oxygen under positive pressure,
receptor sites on Other: increased artificial respiration, and
the motor end- salivation, anaphylaxis assisted or controlled ventilation
plate. This must be immediately available
antagonism is
Duration: 40- inhibited, and ● Evaluate degree of
45mins neuromuscular neuromuscular blockade and
block reversed, by muscle paralysis to avoid risk of
acetylcholinestera overdosage by qualified
se inhibitors such individual using peripheral nerve
stimulator
as neostigmine,
● Monitor BP, pulse, and
edrophonium, and
respirations and evaluate
pyridostigmine.
patient’s recovery from
neuromuscular blocking (curare-
like) effect as evidenced by
ability to breathe naturally or to
take deep breaths and cough,
keep eyes open, lift head
keeping mouth closed,
adequacy of hand-grip strength.
 Notify physician if recovery is
delayed
10. Diazepa Valium, Adult: IV/IM 5-10 mg, Anticonvulsant; Diazepam is a Drowsiness, dizziness, Loss of control of ● Assess baseline vital signs.
m Distat,Diastat repeat if needed at 10- anxiolytic benzodiazepine tiredness, muscle bodily movements, ● Assess blood pressure, pulse
Acudial. 15 mins intervals up to that exerts weakness, headache, uncontrollable shaking and respiration if IV
30 mg, then repeat if anxiolytic, dry mouth, nausea, of the body part. administration.
needed q2-4h sedative, muscle- constipation, ● Provide fluid and fiber for
Onset:
Slurred speech, slowed constipation.
relaxant, confusion, difficulty
PO: 1-2hrs breathing and ● Evaluate therapeutic response,
anticonvulsant urinating, frequent
heartbeat. mental state and physical
Child: IV/IM <5y, 0.2-0.5 IV: 1-5mins and amnestic urination, changes in
dependency after long term use.
mg slowly q2-5min up to effects sex drive or ability. ● Educate the patient to not use
5mg; >5y, 1 mg slowly IM: within
the drug for everyday stress, not
q2-5min up to 10 mg, 20mins
more than four months unless
repeat if needed q2-4h directed by a clinician, not take
more than the prescribed dose,
Peak: avoid non-prescribed
Adult: PO 2-10mg BID to medication unless approved by
PO: 1-2hr
QID or 15-30 mg/g a clinician.
IV: 15-30mins ● Instruct the client to avoid
sustained release IV/IM
driving or any other activities
2-10 mg, repeat is IM: 0.5-1.5hr requiring alertness, avoid other
needed in 3-4h psychotropic medication unless
prescribed, avoid alcohol, and to
Duration: discontinue abruptly after long
Geriatric: PO 1-2 mg 1-2 term use, withdrawal symptoms
times/d (max: 10 mg/d) PO: up to 24hrs may occur.
IV: 15-16mins

Child: PO >6mos, 1-2.5 IM: unknown

mg BID or TID

11. PROMET Phenergan Adult: PO/PR/IM/IV 25 Antiemetic Long-acting Drowsiness, dizziness, Deep sleep, coma,
HASINE mg BID Agents derivative of ringing in your ears, convulsions, cardio- ● Supervise ambulation.
phenothiazine double vision, feeling respiratory symptoms, Promethazine sometimes
Child: 12.5-25 mg BID
with marked nervous, dry mouth, or extrapyramidal produces marked sedation and
ONSET: 20min antihistamine tired feeling, sleep reactions, nightmares dizziness
PO/PR/IM; activity and problems (insomnia) (in children), CNS ● Be aware that antiemetic action
Nausea prominent stimulations, abnormal may mask symptoms of
5min IV
Adult: PO/PR/IM/IV sedative, amnesic, movements unrecognized diseases and signs
DURATION: 2- antiemetic, and of drug overdosage as well as
12.5-25 mg q4-6h prn
8hrs anti-motion dizziness, vertigo, or tinnitus
Child: 0.25-0.5 mg/kg sickness actions Respiratory: irregular associated with toxic doses of
q4-6h prn respirations, aspirin or other ototoxic drugs
respiratory depression, ● Monitor respiratory function in
apnea patients with respiratory with
Allergies respiratory problems,
particularly children. Drug may
Adult: PO/PR/IM/IV 12.5
GI: anorexia, nausea, suppress cough reflex and cause
mg QID or 25 mg HS
vomiting, constipation thickening of bronchial
Child: 6.25-12.25 mg secretions
QID or 25 mg HS
Hematologic:
leukopenia, Health Teaching
Sedation agranulocytosis ● For motion sickness: take initial
Adult: PO/PR/IM/IV 25- dose 30-60 min before
50 mg preoperatively or anticipated travel and repeat at
HS 8-12h intervals if necessary. For
duration of journey, repeat dose
Child: 12.5-25 mg
on arising and again at evening
preoperatively or HS
meal

● Avoid sunlamps or prolonged

exposure to sunlight. Use
 sunscreen lotion during initial
drug therapy
12. Atropine Atropisol Adult: IV/IM/SQ 0.2-1 Anticholinergic Blocks the effect Dry mouth, blurred CNS: headache, ataxia, ● Monitor Apical pulse.
mg 30-60 min before /Alpha-agonist of acetylcholine. vision, sensitivity to dizziness, excitement, ● Monitor VS. HR is sensitive
surgery hypotensive Stimulate alpha- light, lack of sweating, irritability, convulsions, indicator of pts response to
agent adrenoceptors on dizziness, nausea, loss drowsiness, fatigue, atropine
the brain stem. of balance, weakness, mental ● Be alert to changes in quality,
Child: IV/IM/SQ <5 kg, hypersensitivity depression, confusion, rate, and rhythm of Hr and
0.02 mg/kg 30-60 min Onset: reactions (such as skin disorientation, hall respiration and to changes in BP
before surgery rash) urinations and temperature
● Monitor I&O, especially in older
CV: hyper or
Peak: adults and patient who have had
hypotension, surgery (drug may contribute to
ventricular tachycardia, urinary retention)
palpitation, paradoxical ● Monitor CNS status. Older
bradycardia, AV adults and debilitated patients
Duration: dissociation, atrial or sometimes manifest drowsiness
ventricular fibrillation or CNS stimulation (excitement,
GI: dry mouth with agitation, confusion) with usual
thirst, dysphagia, loss doses of drug or other
of taste, nausea, belladonna alkaloids
vomiting ● Follow measures to relieve dry
mouth: adequate hydration,
small frequent mouth rinses

● Discontinue ophthalmic
preparations and notify
physician if eye pain,
conjunctivitis, palpitation, rapid
pulse, or dizziness occurs
13. Neostig PROSTIGMIN Adult: PO 15-375 mg/d ANS AGENT, Produces Nausea, vomiting, CV: tightness in chest, ● Check pulse before giving drug
 mine in 3-6 divided doses. CHOLINERGIC reversible diarrhea, abdominal bradycardia, to bradycardic patients. If below
Bromide IM/IV/SQ 0.5-2.5 mg q1- (PARASYMPHA cholinesterase cramps, increased hypotension, elevated 60/min or other established
3h THOMIMETIC) inhibitor or saliva/mucus. Decrease BP parameter, consult physician
AGENT, inactivation. Has pupil size, increase ● Monitor pulse, respiration, and
Child: PO 7.5-15 mg TID
CHOLINESTERA direct stimulant urination, increased BP during period
or QID or 0.333 mg/kg
SE INHIBITOR action on sweating or cold sweat GI: nausea, vomiting, ● Record drug effect and duration
or 10 mg/m² 6 times/d.
voluntary muscle eructation, Epigastric of action
IM/IV/SQ 0.01=0.04 ONSET: 10-30
fibers and possibly discomfort, abdominal ● Report to physician if pt does
mg/kg q2-4h min IM or IV 2-
on autonomic cramps, diarrhea, not urinate within 1h after first
4h PO
Neonate: Po 1-4 mg q2- ganglia and CNS involuntary or difficult dose when used to relieve
3h IM 0.03 mg/kg q2-4h PEAK: 20-30 neurons defecation, urinary retention
min IM or IV 1-
2h PO Health Education:
Reversal of non- CNS: CNS stimulation
depolarizing ● Be aware that regulation of
neuromuscular blockage dosage interval is extremely
difficult, dosage must be
Adult: IV 0.5-2/5 mg adjusted for each pt to deal with
slowly unpredictable exacerbation and
remissions
Child: IV 0.025-0.08
● Be aware that drug therapy is
mg/kg
often required both day and
Infant: IV 0.025-0.1 night
mg/kg ● Keep a diary of peaks and
valleys of muscle strength

Postoperative distention Keep an accurate record for physician of

and urinary retention your response to drug

Adult: IM/SQ 0.25 mg

q4-6h for 2-3d

14. Ketami Ketalar Injectable solution: GENERAL A rapid-acting Low blood pressure, CV: hypotension, ● Assess respiration and notify
 ne Schedule III ANESTHETICS, general anesthetic nausea, vomiting, loss bradycardia, physician immediately if patient
SYSTEMIC and NMDA of appetite, dream-like arrhythmia exhibits any interruption in
● 10mg/ml
receptor feeling, blurred vision, respiratory rate or signs of
● 50mg/ml ONSET: 3-5
antagonist used double vision, dizziness respiratory depression
● 100mg/ml mins
for induction of Respiratory: apnea, ● Monitor signs of laryngeal
Load PEAK: n/a anesthesia following rapid IV spasm, including tightness in the
diagnostic and administration of high throat and chest, wheezing,
● IV 1-4.5 mg/kg surgical cough, and severe SOB
doses, laryngospasm
slow IV once procedures ● Assess signs of increased
DURATION: 30-
IM 6.5-23 mg/kg IM 1hr typically in intracranial pressure, including
once combination with CNS tonic-clonic decreased consciousness,
a muscle relaxant. movements headache, lethargy, seizure and
vomiting
● Assess blood pressure and
General: anaphylaxis, compare to normal values
local paint and ● Monitor injection site for pain,
exanthema swelling, and irritation

● Be alert for residual muscle

rigidity and increased skeletal
muscle tone
● 12 Rights of Administering
medication.

15. Anektil Sexamethon Injectable solution PERIPHERALLY A depolarizing Jaw rigidity, low blood Irregular heartbeats ● Obtain baseline serum
ACTING skeletal muscle pressure (cardiac arrhythmias), electrolytes. Electrolytes
20mg/ml
MUSCLE relaxant used (hypotension), muscle breakdown od muscle imbalance can potentiate effects
100mg/ml RELAXANT adjunctly to fasciculation may result tissue of neuromuscular blocking
anesthesia and for in postoperative pain, (rhabdomyolysis), agents
skeletal muscle muscle relaxation cardiac arrest, ● Be aware that transient apnea
Adult: ONSET: 1min relaxation during resulting in respiratory excessive salivation, usually occurs at time of
intubation, depression to the fast or slow heart rate, maximal drug effect (1-2) min
Load PEAK: 2-3mins mechanical high potassium, high or ● Have immediately available:
0.3-1.1 mg/kg IV for 1 DURATION: ventilation and point. low blood pressure, facilities for emergency
dose, or 3-4 mg/kg IM 10mins surgical increased eye pressure endotracheal intubation,
for 1 dose procedures artificial respirations, and
assisted or controlled
respiration with oxygen
Short procedures: ● Monitor vital signs and keep
usually 0.6 mg/kg IV airway clear of secretions
injection ● Educate the patient that they
will experience post procedural
muscle stiffness and pain for as
Maintenance for long as 24-30h
prolonged procedures ● Instruct pt to report residual
muscle weakness to physician
● Follow 12 rights of drug
0.04-0.07 mg/kg IV administration.
every 5-10 minutes as
needed or 2.5 mg/min
IV infusion