sevoflurane (Sevorane)

CLASSIFICATION MECHANISM INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITIES

OF ACTION

General induces a state in induction and >hypersensitive > agitation > Check the name of the patient and
Anesthetics which the CNS maintenance of >history of malignant > dizziness the time of administration.
is altered so that general hyperpyrexia > drowsiness > Monitor vital signs.
Functional varying degrees anesthesia > increased cough > Monitor all the body systems.
General Anesthetics of pan relief, > increased saliva > Continuous monitoring of pulse
depression of >lightheadedness oximetry.
consciousness, > nausea > Postural BP should be taken.
Induction Adult & skeletal muscle > shivering > Take note of that time that the
childn relaxation and > vomiting drug has expired.
Up to 8%, w/ or w/o reflex reduction
O2 or O2/N2O. are produced

Maintenance Adult
& childn Adverse Effect:
0.5-3% w/ or w/o >Anaphylaxis
concomitant N2O. >Irregular
heartbeat >Stop durg immediately, administer
>Seizure oxygen
>Yellowing of the >Start rapid fluid resuscitation
skin or eyes >Make sure client is well ventilated
>Hypotension >Seizure precation
>Administer epinephrine
 tetracaine hydrochloride (Pontocaine)
CLASSIFICATION MECHANISM INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITIES
OF ACTION

General Tetracaine acts >Spinal >Hypersensitivity to p- > Mild erythema > Check the name of the patient and
Anesthetics by preventing anesthesia aminobenzoic acid or its at the application the time of administration.
the generation >Topical derivatives, local site, > Check labs for low plasma-
Functional and transmission anesthesia anaesthesia of the ester >slight oedema or sholinesterase concentration
Local anesthetics; of impulses type. >Low plasma- pruritus, > Do not administer to inflamed or
Topical anesthetics; along nerve cholinesterase >blistering of the traumatized surfaces
Spinal anesthetics fibres and at concentrations, skin, > Do not instill into the middle ear
nerve endings; >Complete heart block >stinging
Subarachnoid depolarisation >Bronchoscopy or sensation
Spinal anaesthesia and ion- cytoscopy >Application to
Adult: 1% solution exchange are inflamed traumatised or
diluted with an equal inhibited. In highly vascular surfaces
volume of CSF general, loss of >Instillation into the
immediately prior to pain occurs middle ear.
admin or 5 mg of before loss of
powder dissolved in 1 sensory, Adverse Effects:
ml of CSF and admin autonomic and >Stop durg immediately, administer
slowly at a rate of 1 motor functions. >Anaphylaxis oxygen
ml/5 sec. > Eye irritation >Start rapid fluid resuscitation
Elderly: Dose >Watering >Make sure client is well ventilated
reduction may be >Increased >Administer epinephrine
needed. sensitivity to light >Advise patient to keep out of light
Ophthalmic and dim room if sensitivity to light
Anaesthesia of the occurs
eye
Adult: Instil 0.5-1%
tetracaine solution or
0.5% ointment.
 ketorolac tromethamine (Toradol)
CLASSIFICATION MECHANISM INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITIES
OF ACTION

> Shortening the dosing interval

General May inhibit PO: >Hypersensitivity CV: recommended will lead to an
NSAIDS prostaglandin short term (up Vasodilation, increased frequency and duration of
synthesis. to ) five days >History of nasal polyps Pallor side effects
Functional Posesses anti- management of
Analgesic inflammatory severe acute >Angioedema GI: > Correct hypovolemia prior to
analgesic and pain that GI-pain, peptic administering
Adult: antipyretic requires >Bronchospastic activity ulcer, nausea,
PO Moderate to effects analgesia at the dyspepsia, > Determine any liver or renal
severe pain 10 mg 4-6 opiate level >Allergic renal flatulence, G.I. dysfunction
hrly. Max: 40 impairement Bleeding
mg/day. Max IM/IV: > Assess hydration
duration: 7 days. Use with >Advance renal CNS:
IV/IM morphine and impairement Headache, > Drug may cause drowsiness,
Moderate to severe meperidine nervousness, dizziness, avoid activities that
pain 60 mg via IM inj shows an >Incomplete hemostatis abnormal require mental alertness
or 30 mg via IV inj. oploid-sharing use with aspirin thinking
effect, depression, > Avoid alcohol, NSAIDs, ASA
Ophth combination euphoria without approval
Ocular itching can be used for
As 0.5% soln: Instill break through Miscellaneous:
1 drop 4 times/day. pain Purpura, asthma,
abnormal vision,
Post-op eye Opthalmic: abnormal liver
inflammation Releive itching function
As 0.5% soln: Instill caused by
1 drop 4 times/day for seasonal
2 wk, starting 24 hr allergic
after surgery for 2 conjunctivitis
wk. post-operative
inflammation
 Cystoid macular following
oedema cataract Adverse Effects:
As 0.5% soln: Instill surgery.
1-2 drops 6-8 hrly GI: > Administer after ANST
starting 24 hr before Perfuration,
surgery, continue for > Stop drug immediately,
3-4 wk after surgery. Hypersensitivity: administer oxygen, start rapid fluid
Bronchospasm, resuscitation make sure the client is
Pain and Anaphylaxis well ventilated, administer
photophobia after epinephrine
incisional refractive
surgery
As 0.5% soln: Instill
1 drop 4 times/day for
up to 3 days after
surgery.
 ephedrine sulfate (Pretz-D)
CLASSIFICATION MECHANISM INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITIES
OF ACTION

General Releases PO: >Angle closure glaucoma, CNS: > Asses mental status and
Sympathomimetic norepinephrine Temporarily >anesthesia with Nervousness, pulmonary functions
from synaptic relieves the cyclopropane or halothane shakiness,
Functional storage sites. Has shortness of >thyrotoxicosis, confusion, > Notify provider if SOB is
Nasal Decongestant direct effects on breath, tightness >diabetes, delirium unrelieved by medication and is
alpha, beta-1 and of chest and >lactation accompanied by chest pain,
Adult: beta -2 receptors, wheezing due to CV: dizziness or palpitations
PO Diabetic causing bronchial Precordial pain
neuropathic oedema increased BP due asthma > With males, report any difficulty
30-60 mg 3 to arteriolar GU: or pain when voiding
times/day. constriction and Parenteral: Difficult and
cardiac Allergic painful urination
IV Reversal of stimulation, disorders,
spinal or epidural bronchodilation, Vasopressor in Miscellaneous:
anesth-induced relaxation of GI shock Pallor, respiratory
hypotension tract smooth difficulty,
As 3 mg/mL soln: 3-6 muscle and nasal Nasal: hypersensitivity
mg, up to 9 mg, may decongestion, Nasal reaction
repeat every 3-4 mins mydriasis and congestion due
if needed. increase tone of to common Adverse Effects:
the bladder sold, sinusitis
trigone and sinus drainage CV: > monitor blood pressure regularly
vesicle sphincter Excessive dose
may cause
hypertension
sufficent to result
in cerebral
hemorrhage
 lidocaine hydrochloride (Xylocaine)
CLASSIFICATION MECHANISM INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITIES
OF ACTION

> Document CNS status

General Shortens the IV: >Hypersensitivy to amide- Body as a whole:
Anesthesia refractory period Acute type local anesthetics Malignant > Report sudden mental status
and suppresses ventricular hyeprthermia changes
Functional the automaticity arrhytmias >Stokes Adams Syndrome characterized by
Antiarryhtmic of ectopi foci tachycardia; > Symptoms such as dizziness,
without affecting Infiltration or >Wolff-Parkinson-White tachypnea, labile visual disturbances twitching and
Surface anesth For conduction of regional syndrome BP, metabolic tremors may preclude convulsion
pain: impulses through anesthesia acidosis
As 2% soln: 300 mg, cardiac tissue, >Severe SA, AV or
not more often than 3 increase Buccal mucosal intraventricular block CV:
hrly.Regional anesth electrical anesthesia Precipitation or
50-300 mg (0.5% stimulation >Lactation aggravation of
soln w/o adrenaline). threshold arrythmias,
Max: 4 mg/dose >Presence of liver or hypotension
kidney disease
Epidural anesth CNS:
2-3 mL soln for each Dizziness,
dermatome to be apprehension,
anaesthesized. euphoria,
Lumbar epidural: lightheadednes,
250-300 mg (1% nervouseness,
soln) for analgesia drowsiness
and 225-300 mg
(1.5% soln) or 200- Allergic:
300 mg (2% soln) for Rash, Edema
anesth and thoracic
epidural: 200-300 mg
(1% soln). In
obstetric caudal
analgesia, up to 300
mg (0.5 or 1% soln). Adverse Effect:

For surgical caudal CV:

analgesia: Bradycardia > Note any hypersensitivity to
225-300 mg (1.5% possible cardiac amide-type local anesthesia
soln). arrest
> Those with hepatic or renal diseas
Intraspinal Spinal CNS: will be watched closely for adverse
anesth Convulsions effects
Normal vag
delivery: Respiratory: > Note pulmonary functions
50 mg (5% Respiratory
hyperbaric soln) or 9- depression or >Asses for respiratory depression
15 mg (1.5% arrest
hyperbaric soln). > Monitor for hypertension
Caesarean Other:
operation: Venousthrombosi
Up to 75 mg (5% s, phlebitis
hyperbaric soln).
Other surgical
procedures:
75-100 mg.
 neostigmin methylsufate (Prostigmin)
CLASSIFICATION MECHANISM INDICATION CONTRAINDICATION SIDE EFFECTS NURSING RESPONSIBILITIES
OF ACTION

General Inhibits >Myasthenia >Obstruction of intestine, CNS: >Monitor V/S respiration during
Cholinergic Stimulant destruction of gravis renal system Dizziness, rest
acetylcholine, >nondepolarizin >Bromide sensitivity headache,
Functional which increases g >Peritonitis sweating, >Administer on empty stomach for
Aminoglycosides, concentration at neuromuscular >urinary tract obstruction weakness, better absorption
anticholinergic, sites where blocker ileus drowsiness
antidepressant acetylcholine is >antagonist >Give only with atropine sulfate
released, this >bladder Precaution CV: available for cholinergic crisis
Reversal of facilitates distention >Pregnancy C Tachycardia,
neuromuscular transmission of >post-operative >Bradycardia bradycardia,
blockade impulses across ileus >Hypotension hypotension, Av
Adult the myoneural >Seizure disorders block, ECG
0.5-2.5 mg (0.05- junction >Bronchial asthma changes
0.07 mg/kg) >Coronary occlusion
neostigmine EENT:
methylsulphate w/ Miosis, blurred
atropine sulphate 0.6- vision,
1.2 mg (0.02-0.03 lacrimation,
mg/kg). Max: 5 mg. visual changes
Childn
0.05 mg/kg GI:
neostigmine Nausea, diarrhea,
methylsulphate w/ vomiting, cramps
atropine sulphate 0.02
mg/kg. Max: 2.5 mg. GU:
Doses to be given by Frequency,
slow IV inj incontinence,
simultaneously in urgency
separate syringes over
1 min.
 INTEG:
Myasthenia gravis Rach, urticaria,
Adult flushing
1-2.5 mg IM/SC at
intervals throughout Adverse Effects:
the day if needed (eg
mornings & before CNS: >Monitor for bradycardia,
meals), giving a total Seizures, hypotension, bronchospasm,
dose of 5-20 mg. paralysis headache, dizziness, seizure,
Childn respiratory depression
0.2-0.5 mg inj as CV:
required. Neonate Dysrythmias, >Discontinue if toxicity occurs
0.05-0.25 mg IM cardiac arrest
every 2-4 hr, ½ hr >Seizure precaution
before feeding. RESP:
Treatment is not Respiratiory >O2 ready at bedside
usually required >8 depression,
wk of age. bronchospasm, >Have atropine sulfate available if
constriction, toxicity occurs
laryngospasm,
respiratory arrest,
dyspnea