Flashcards in Precautions-Table 1 Deck (39):
Use caution with COPD patients; Monitor long-term high concentrations in neonates as retronatal fibroplasia may develop; open flames
Can cause local irritation, therefore, use large vein when possible. seizure activity may reoccur due to its lipid solubility; use with caution in patients with myasthenia gravis, impaired renal or hepatic function, obstetrical patients and the elderly.
Hypersensitivity to benzodiazepines, acute narrow-angle glaucoma, coma, shock acute alcohol intoxication
Hypersensitivity to Benzodiazapines, acute narrow-angle glaucoma, coma shock, and acute alcohol intoxication.
Never paralyze without adequate sedation
Protect from Light; Can be deactivated by sodium bicarbonate, flush IV line between administration of EPI and bicarb, Effects can be intensified by antidepressants
Use with caution in patients with epilepsy, migraine, asthma, heart failure, or angina pectoris
CNS depression may occur in doses greater than 300mg/hr liver or renal disease, CHF, hypovolemia, shock, myasthenia gravis
Use with caution in severe liver disease, pregnancy, nursing mothers
May worsen bradycardia associated with 2nd Degree Mobitz II and 3rd Degree AV block thus consider TCP first. Use with caution in patients with signs and symptoms of acute myocardial ischemia, myocardial infarction, glaucoma.
Place patient in semi-Fowler position as patients will typically develop arrhythmias at the time of conversion. Use cautiously in patients with asthma.
Avoid patients receiving oral beta-blockers; Monitor for hypotension resulting from peripheral vasodilation. Use with cation in CHF
Metoprolol (Lopressor, Toprol-XL)
Impaired hepatic or renal function, CHF controlled by digitalis or diuretics, do not mix with IV calcium channel blockers.
In doses 20 mcg/kg/min or greater, its alpha effects dominates and it causes severe vasoconstriction. Monitor BP q 3-5 minutes. Can be deactivated by sodium bicarbonate.
Can increase myocardial oxygen demand. Can be deactivated by sodium bicarbonate. Preexisting HTN or A-Fib. Hypotension from hypovolemia; always try volume restoration first.
Peptic ulcer disease, asthma
Nitroglycerin (Nitrostat, Nitro-Bid, Tridil)
Protect from light and air; Monitor vitals closely as it may cause orthostatic hypotension. Phosphodiesterase-type 5 (PDE-5) inhibitors: Viagra (sildenafil), Cialis (Tadalafil), Levitra (Vardenafil)
Sodium Bicarbonate (NaHCO3)
Not recommended for routine use in cardiac arrest; Dosage must be specific to prevent metabolic alkalosis and is thus weight-based.
Renal Failure, patients taking digoxin, concomitant used of other CNS depressants or neuromuscular blocking agents.
Can cause over stimulation of the uterus resulting in uterine rupture thus vitals and uterine tone should be mentioned.
Albuterol (Proventil, Ventolin)
Consider monitoring peak expiratory flow rates (PEFR) monitor vitals and respiratory status during treatments.
Ipratropium Bromide (Atrovent)
Use with caution in pregnancy and lactation
Paitients with peptic ulcer disease, CHF and TB
50% Dextrose in Water D50W
Use with caution in patients with increasing ICP as added glucose may worsen the cerebral edema. Consider blood glucose monitoring before and after administration. Monitor for localized venous irritation.
Glucagon is only effective if there are sufficient stores of glycogen in the liver.
Not considered a primary drug for the treatment of severe allergic reactions or anaphylaxis. Use with caution if the patient has narrow-angle glaucoma.
History of seizures, parkinson’s disease
Use Caution on narcotic physically-dependant patients as naloxone can cause abrupt reversal of narcotic effects.
Usage in pregnancy should be limited to life-threatening situations as furosemide may cause fatal abnormalities. Protect from light. Renal or hepatic insufficiencies
Transient severe hypertension secondary to infusion.
Flush IV line between calcium chloride and bicarbonate use as precipitate will form. Monitor for tissue necrosis at injection site.
Activated Charcoal (Actidose)
Protect airway and monitor mental status and vitals. Use caution in patients with an altered mental status unless nasogastric tube is in place and airway is protected.
Administer slowly and titrate to effect; undiagnosed abdominal injury.
Increased ICP, severe respiratory disorders, hypotension, bradydysrhythmias
Use cautiously with CHF and cirrhosis patients due to renal failure.
Acetaminophen (Tylenol, APAP)
Anemia, hepatic and renal disease, alcoholism
Pregnancy, peptic ulcer disease, pulmonary edema, HTN