Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Nursing

Contraindications Side Effects Responsibilities

Generic Name: Cardiac arrest: Action: Indications: Adverse Effects: Monitor V/S. and
epinephrine 1 mg IV of 1:10,000 Stimulates beta o Asthma check for cardiac
solution q 3-5 min; receptors in lung. o Bronchitis nervousness, tremor, dysrhythmias
Brand Name: double dose if o Emphysema vertigo, pain, widened
Injection, OTC nasal administering Relaxes bronchial o All cardiac pulse pressure, Drug increases rigidity
solution: via ET tube smooth muscle. arrest, hypertension nausea and tremor in patients
Adrenalin Chloride anaphylaxis with Parkinson’s
Anaphylaxis: 0.1- 1 Increases vital o Used for Side Effects: disease
Ophthalmic solution: mg SQ or IM of capacity symptomatic headache  Epinephrine therapy
Epifrin, Glaucon 1:1000 solution.  BP,  HR,  PR bradycardia. interferes with tests
o Relief of for urinary
Insect sting Asthma: 0.1-0.3 mg Decreases airway catecholamine
bronchospasm
emergencies: SQ or IM of 1:10,000 resistance.  Avoid IM use of
occurring
EpiPen Auto-Injector solution parenteral suspension
during
(delivers 0.3 mg IM Classification: into buttocks. Gas
anesthesia
adult dose), EpiPen Jr. Refractory Beta2 Adrenergic gangrene may occur
o Exercised-
Auto-Injector bradycardia and Agonists Massage site after
induced
(delivers 0.15 mg IM hypotension: 2- IM injection to
bronchospasm
for children) 10ug/min counteract possible
OTC solutions for vasoconstriction.
Contraindications:
 Observe patient
Contraindicate in
nebulization: closely for adverse
patients with angle-
AsthmaNefrin, reactions. Notify
closure glaucoma,
microNefrin, doctor if adverse
shock (other than
Nephron, S2 reaction develop
anaphylactic shock),
 If blood pressure
organic brain damage,
increases sharply,
cardiac dilation,
rapid-acting
arrhythmias, coronary
vasodilators such as
insufficiency, or
nitrates or alpha
cerebral
blockers can be given
arteriosclerosis. Also
1
contraindicated in to counteract
patient receiving
general anesthesia with
halogenated
hydrocarbons or
cyclopropane and in
patients in labor (may
delay second stage)

Some products
containing sulfites and
are contraindicated in
patients with sulfite
allergies except when
drug is used for serious
allergic reactions or in
other emergency
situations.

In conjunction with
local anesthesia,
epinephrine is
contraindicated for use
in finger, toes, ears,
nose, and genitalia.

Use cautiously with

long-standing
bronchial asthma and
emphysema, who have
developed
degenerative heart
disease and in those
with hyperthyroidism,
2
 CV disease,
hypertension,
psychoneurosis, or
diabetes.

In pregnant woman,
drug is contraindicated.

In breast feeding do
not use the drug or stop
breast feeding.

Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing
Contraindications Effects Responsibilities
Generic Name: 1-1.5 mg/kg IVP or Action: Indications: Adverse Effects: Monitor EKG, BP,
lidocane ETT (double dose if Decrease cardiac Decrease cardiac CNS: Confusion, pulse, rhythm,
giving via ET tube), excitability, cardiac excitability, cardiac tremor, lethargy, continuously.
Brand Name: may repeat q 5-10 contraction is delayed contraction is delayed somnolence, stupor,
Xylocaine min. max in the atrium and in the atrium and restlessness anxiety, Monitor serum
3 mg/kg; If ventricle ventricle hallucinations, lidocaine levels
conversion successful nervousness, seizure. throughout theraphy;
start an infusion of 2-4 Classification: Contraindications: CV: hypotension, therapreutic range 1.5-
mg/min Antiarrythmic and Contraindicated in bradychardia, new or 5 mcg/ml
Anesthetic patients hypersensitive worsened arrhythmias
to amide-type local EENT: tinnitus, Monitor intake and
anesthetics and in blurred or double output
those with Adams – vision.
Stoke syndrome. Respiratory: Do not mix in the
Wolff-Parkinsons- Respiratory same syringe with

3
 White Syndrome, or depression and arrest amphoterin B or
severe degrees of SA, Skin: soreness at cefazolin
AV, or intraventricular injection site
block in the absence of Other: anaphylaxis, Administer Lidocaine
pacemaker. TIV.
Side Effects:
sensation of cold, In case of circulatory
vomiting depression have
dopamine available

Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing
Contraindications Effects Responsibilities
Generic Name: 0.5-1 mg/kg slow IVP Action: Indications: Adverse Effects: Monitor serum
furosemide over 1-2 min, may inhibits sodium and Edema associated with vertigo, headache, glucose, and
Brand Name: repeat once at 2 chloride reabsorption CHF paresthesia, orthostatic electrolyte
mg/kg slow IVP over at the proximal and hypotension, D iet- K+ for
Apo-Furosemide 1-2 mins. distal tubules and the Cirrhosis with ascites thrombophlebitis, all except aldactone
ascending loop of or renal dysfunction abdominal pain, I ntake and
Furoside Henlen Hypokalemia, anemia, Output, daily weight
For hypertension or in muscle spasm U ndesirable
Lasix Classification: combination with effects; Fluid and
Loop Diuretics other antihypertensive electrolyte imbalance
Lasix Speacial medications. R eview HR,
BP and electrolytes
Novosemide  ICP, nephritic E lderly-
syndrome, hepatic Careful
Uritol cirrhosis T ake with or
after meals and in AM
Contraindications: I ncrease risk

4
 of orthosthatic
Contraindicated to hypotension; move
patients hypersensitive slowly
to drug or any of its C ancel alcohol
components and in
those with anuria.

Use cautiously in
patient with hepatic
cirrhosis.

Patients with allergies

to sulfonamides may
also be allergic to
furosemide.

In pregnant woman,
use only if benefits
outweighs the risk to
the fetus.

In breast feeding
woman, do not use
drug.

Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing
Contraindications Effects Responsibilities
Generic Name: Adults: For rapid Action: Indications: Adverse Effects: Monitor K+, Mg++,
digoxin digitalization, give 0.4 Inhibits the sodium- V-fib, V-flutter, CHF, CNS: hallucinations, ECG, liver/renal
to 0.6 mg I.V. initially, potassium ATP phase. pulmonary edema, paresthesia, stupor, function tests, drug
Brand Name: followed by 0.1 to 0.3 atrial fibrillation and vertigo. level (therapeutic level

5
Lanoxin, Digoxin, mg I.V. every 4 hours, Classification: or flutter, and CV: Arrythmias, heart 0.5-2.0 mg/ml,
Lanoxicap as needed and Cardiac Glycosides paroxysmal atrial failure, hypotension. toxicity is >2.0
tolerated, for 24 contractions EENT: blurred vision, mg/ml).
hours. diplopia, light flashes,
Contraindications: photophobia, yellow- Before each dose
Children: digitalizing Contraindicated in green halos around assess apical pulse for
dose is based on patients hypersensitive visual images. full minute, record and
child’s age and is to the drug or any of GI: anorexia, diarrhea, report changes in rate
given in three or more its components and in nausea, vomiting. or rhythm.
divided doses over the those with digitalis-
first 24 hours. First induced toxicity, Side Effects: Withhold drug and
dose is 50% of total ventricular fibrillation, CNS: agitation, contact provider if
dose; subsequent dose or ventricular dizziness, fatigue, pulse is < 60/min. or
are given q 4 to 8 tachycardia unless generalized weakness, >100 (adults) or <
hours as needed and caused by heart headache, malaise. 110/minute (children)
tolerated. failure. GI: Nausea
Weigh daily
Children age 10 years Use cautiously in Monitor I&O and
and older: For rapid patients with acute MI, signs of CHF
digitalization, give 8 in complete Av block,
to 12 mcg/kg I.V. over sinus bradycardia,
24 hours, divided as PVCs,, chronic
above, Maintenance constrictive
dose is 25% to 35% of pericarditis,
total digitalizing dose, hyperthropic
given daily as a single cardiomyopathy, renal
dose. insufficiency, severe
pulmonary disease, or
Children ages 5 to 10: hypothyroidism.
For rapid
digitalization, give 15
to 30 mcg/kg I.V. over
24 hours divided as
above. Maintenance
6
dose is 25% to 35% of
total digitalizing dose,
divided and given in
two or three equal
portions daily.

Children ages 2 to 5:
For rapid
digitalization: give 25
to 35 mcg/kg I.V. over
24 hours, divided as
above. Maintenance
dose is 25% to 35% of
total digitalizing dose,
divided and given in
two or three equal
portions daily.

Infants ages 1 month

to 2 years: For rapid
digitalization. Give 30
to 50 mcg/kg I.V. over
24 hours, divided as
above. Maintenance
dose is 25% to 35% of
the total digitalizing
dose, divided and
given in two or three
equal portions daily.

Neonates: for rapid

digitalization, give 20
to 30 mcg/kg I.V. over
24 hours, divided as
7
 above. Maintenance
dose is 25% to 30% of
the total digitalizing
dose, divided and
given in two or three
equal portions daily.

Premature Infants: For

rapid digitalization,
give 15 to 25 mcg/kg
I.V. over 24 hours,
divided as above.
Maintenance dose is
20% to 30% of the
total digitalizing dose,
divided and given into
two or three equal
portions daily.

Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Nursing

Contraindications Side Effects Responsibilities
Generic Name: 1 mEq/kg IVP, may Action: Indications: Adverse Effects: Monitor urinary pH,
Sodium Bicarbonate repeat 0.5 mEq/kg 10 Neutralizes gastric o Hyperacidity GI: Gastric distention, calcium, electrolytes
min. acid o Peptic ulcer belching, flatulence. and phosphate levels.
Brand Name: Arm o Hyperkalemia Metabolic: metabolic
and Hammer Pure Decrease pepsin o Tricyclic alkalosis, Record amount and
Baking Soda, activity antidepressant hypernatremia, consistency of stools.
Citrocarbonate, Soda OD hypokalemia,
Mint Classification: o Shock associated hyperosmolarity (with Clients on low-
Alkalizing Agent, with severe overdose). sodium diets should
Buffer, Antacid, diarrhea, Other: Pain and evaluate sodium
electrolyte dehydration, irritation at injection contents of antacids.

8
 uncontrolled DM site.
o Reflux
esophagitis

Contraindications:
Contraindicated in
patients with metabolic
or respiratory alkalosis;
patients who are losing
chlorides from vomiting
or continuous GI
suction; patients taking
diuretics known to
produce hypochloremia
alkalosis; and patients
with hypocalcemia in
which alkalosis may
produce tetany,
hypertension, seizures,
or heart failure. Oral
sodium bicarbonate is
contraindicated in
patients with acute
ingestion of strong
mineral acids.

9
Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing
Contraindications Effects Responsibilities
Generic Name: Adults: initially, 1 to 5 Action Indications: Adverse Effects: Blood is not a
Dopamine HCl. mcg/kg/minute by I.V. Stimulates To treat shock and Cv: anginal pain, substitute for blood or
infusion. Adjust dose dopaminergic and correct hemodnamic arrythmias, fluid volume deficit. If
Brand Name: to desired alpha and beta imbalances, improve bradycardia, deficit occurs, replace
Intropin; Revimine hemodynamic or renal receptors of the perfusion of vital conduction fluid deficit first
response, increase by sympathetic nervous organs, to increase disturbances ectopic before giving meds.
1 to 4 mcg/kg/minute system. Action is dose- cardiac output, and to breasts,hypertension,
at 10 to 30-minute related; large doses can correct hypotension. hypotension, During infusion,
intervals. cause mainly alpha palpitations, frequently monitor
stimulation. Contraindications: tachycardia, ECG, BP, cardiac
Contraindicated in vasoconstriction, output, CVP,
Classification: patient with widening of QRS pulmonary artery
Inotropic, vasopressor uncorrected complex. wedge pressure, pulse
tachyarrhythmias, rate, urine output, and
pheocromocytoma, or GI: vomiting. color and temperature
ventricular fibrillation. of the limbs.
- Use cautiously in GU: azotemia
patients with occlusive Respiratory: asthma If diastolic pressure
vascular disease, cold attacks, dyspnea rises
injuries, diabetic disproportionately,
endarteritis, and Skin: decrease perfusion rate
arterial embolism; in necrosis,piloerection, and watch out
pregnant woman; with tissue sloughing with carefully for further
a history of sulfite extravasation. signs of
sensitivity; and in vasoconstriction
those taking MAO Other: anaphylaxis. unless such action is
inhibitor. desired.
Side Effects:
CNS: headache Observe for adverse
GI: nausea reaction.

10
 Check for urine
output. If urine flow is
decrease without
hypotension, notify
physician.

After drug is stopped,

Tamper dosage slowly
to evaluate stability of
blood pressure.

Acidosis decrease
effectiveness of
dopamine.

Name of the Drug Dosage/Route/Timing Action/Classification Indication/ Adverse Effects/ Nursing

Contraindications Side Effects Responsibilities
Generic 0.3-0.4 mg SL q 5 min, Action: Indication: Adverse Effects Record characteristics
Nitroglycerin max 3 doses. Relaxes the vascular Angina pectoris CV: orthostatic and precipitating
Brand smooth system CHF associated with hypotension, flushing, factors of anginal
Nitrostat AMI fainting. pain.
 Myocardial oxygen EENT: sublingual
consumption Cardiac load reducing burning. Monitor BP and apical
agent Skin: Cutaneous pulse before
 left ventricular vasodilation, contact administration and
workload Hypertensive Crisis dermatitis (patch) periodically after
 arterial BP Side Effects dose.
Contraindication: CNS: headache,
 venous return Contraindicated in throbbing, dizziness, Have client sit or lie

11
 patients hypersensitive weakness. down if taking drug
Classification to nitrates and in those GI: nausea, vomiting. for the first time.
Antianginal, Nitrate, with early MI. (S.L. Skin: Rash
Vasodilator, Coronary form), severe anemia, Client must have
increase ICP angle- continuing EKG
closure glaucoma, IV monitoring for IV
nitroglycerine is administration
contraindicated in
patients with Cardioverter/
hypovolemia, defibrillator must not
hypotension, be discharged through
orthostatic paddle electrode
hypotension, cardiac overlying
tamponade restrictive Nitro-Bid ointment or
cardiomyopathy, the Transderm-Nitro
constrictive Patch. Assist with
pericarditis. ambulating if dizzy.

Instruct to take at first

sign of anginal pain.

May be repeated q 5
minutes to max. of 3
doses.

If the client doesn’t

experience relief,
advise to seek medical
assistance
immediately.

12
Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing
Contraindications Effects Responsibilities
Generic Bradycardia: 0.5 -1 Action Indication Adverse Effects Monitor VS.
Atrophine Sulfate mg IV (may give via cholinergic receptor As an anti-sialagogue CNS: restlessness,
ETT at double dose) q sites so response to for preanesthetic ataxia, disorientation, Report  HR
Brand 3-5 min, max 0.04 acetylcholine is medication to prevent hallucinations,
Isopto Atropine mg/kg decreased or reduce secretions of delirium, coma, Monitor for
Cardiac arrest: 1 mg the respiratory tract insomnia, agitation, constipation, oliguria.
q 3-5 min, max 0.04 Classification confusion.
mg/kg Anticholinergics To restore cardiac rate CV: tachycardia, Atrophine could result
and arterial pressure angina, arrhythmias, in CNS stimulation
Nerve gas and during anesthesia, flushing. (confusion,
organophosphate when vagal EENT: photophobia, excitement) or
symptoms, may blurred vision, drowsiness
repeat in 2 mg stimulation produced mydriasis.
increments q 3 min by intra-abdominal GI: dry moth, Instruct to take 30
tiltrated to relief surgical traction constipation, mins before meals
symptoms. causes a sudden vomiting.
decrease in pulse rate GU: urine retention. Eat foods high in
and cardiac action Hematologic: fiber and drink plenty
leukocytosis fluids.
To lessen the degree of Other: anaphylaxis
atrioventricular (A-V) Avoid OTC
heart block when Side Effects antihistamines.
increased vagal tone is CNS: headache,
a major factor in the excitement. Instruct client not to
conduction defect, as CV: palpitations drive a motor vehicle
in some cases due to GI: thirst, nausea. or participate in
digitalis activities requiring
alertness.
To overcome severe
carotid sinus reflex Advise to use hard
Antidote for candy, ice chips, etc.
for dry mouth.
13
cardiovascular
collapse from the
injudicious use of a
cholinergic drug.

Contraindication
Contraindicated in
patients hypersensitive
to drug and those with
acute angle closure
glaucoma, obstructive
uropathy, obstructive
disease of GI tract,
paralytic elius, toxic
magacolon, intestinal
atony, unstable CV
status in acute
hemorrhage, asthma,
or myasthenia gravis.
Also contraindicated
in pregnant women.

14
Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing
Contraindications Effects Responsibilities
Generic Adults individualized: Action Indication Adverse Effects Monitor CVP to assess
Dobutamine 2.5-15 mcg/kg/min. Enhancing the force of Short term treatment CV: angina, vascular volume and
Hydrochloride myocardial contraction of cardiac hypertension, cardiac pumping
Rate of administration decompensation in hypotension, efficiency.
Brand and duration of  HR,  CO, and  organic heart disease increased heart rate,
Dobutrex therapy depend on the SV with minor effects of cardiac surgical nonspecific chest pain, (Elevated CVP may
response of client as to HR. pressures. phlebitis, PVCs. indicate disruption on
determined by HR,  elevated ventricular GI: nausea and CO, as in pump failure
presence of activity, filling pressure and Contraindication vomiting. or
BP and urine flow helps AV node Contraindication in Respiratory: asthma Pulmonary edma; low
conduction patients hypersensitive attacks, shortness of CVP may indicate
to drug or any of its breath. hypovolemia)
Classification components and in Others: anaphylaxis.
Inotropic, Adrenergic those with idiopathic Monitor ECG and BP
hypertrophic subaortic Side Effects continuously during
stenosis. CNS: headache drug administration
Musculoskeletal: mild
leg crams or tingling Record I&O
sensation.
Monitor glucose in
diabetes patients

Drug is administered
IV to improve cardiac
function thus
increasing BP and
improving urine
output.

Report any chest pain,

increase SOB,
headaches or IV site
15
 pain.

Name of the Drug Dosage/Route Action/Classification Indication/ Adverse Effects/ Side Nursing
Contraindications Effects Responsibilities
Generic ADULTS Action Indication Adverse Effect Assessment
Morphine Sulfate Oral Principal opium Relief of moderate to CNS: Light- History:
One-third to one-sixth alkaloid; acts as severe acute and headedness, dizziness, Hypersensitivity to
Brand as effective as agonist at specific chronic pain sedation, euphoria, opioids; diarrhea
Immediate-release parenteral opioid receptors in the dysphoria, delirium, caused by poisoning;
tablets: administration CNS to produce Preoperative insomnia, agitation, labor or delivery of a
MSIR because of first-pass analgesia, euphoria, medication to sedate anxiety, fear, premature infant;
Timed-release: metabolism; 10– sedation; the receptors and allay hallucinations, biliary tract surgery or
Kadian, M-Eslon 30 mg q 4 hr PO. mediating these effects apprehension, disorientation, surgical anastomosis;
(CAN), MS Contin, Controlled-release: are thought to be the facilitate induction of drowsiness, lethargy, head injury and
Oramorph SR 30 mg q 8–12 hr PO same as those anesthesia, and reduce impaired mental and increased intracranial
Oral solution: or as directed by mediating the effects anesthetic dosage physical performance, pressure; acute
MSIR, Rescudose, physician; Kadian: of endogenous opioids coma, mood changes, asthma, COPD, cor
Roxanol, Roxanol T 20–100 mg PO daily– (enkephalins, Analgesic adjunct weakness, headache, pulmonale, preexisting
Rectal suppositories: 24-hr release system; endorphins). during anesthesia tremor, seizures, respiratory depression;
RMS MS Contin: 200 mg miosis, visual acute abdominal
Injection: PO q 12 hr. Component of most disturbances, conditions, CV
Astramorph PF, SC and IM Classification preparations that are suppression of cough disease,
Duramorph, 10 mg (5–20 mg)/70 Opioid agonist referred to as reflex supraventricular
Epimorph (CAN) kg q 4 hr or as analgesic Brompton's cocktail or tachycardias,
Preservative-free directed by physician. mixture, an oral CV: Facial flushing, myxedema, seizure
concentrate for IV alcoholic solution that peripheral circulatory disorders, acute
microinfusion devices 2.5–15 mg/70 kg of is used for chronic collapse, tachycardia, alcoholism, delirium
for intraspinal use: body weight in 4–5 severe pain, especially bradycardia, tremens, cerebral
Infumorph mL water for injection in terminal cancer arrhythmia, arteriosclerosis,
administered over 4–5 patients palpitations, chest wall ulcerative colitis,
min, or as directed by rigidity, hypertension, fever, kyphoscoliosis,

16
physician. Continuous Intraspinal use with hypotension, Addison's disease,
IV infusion: 0.1– microinfusion devices orthostatic prostatic hypertrophy,
1 mg/mL in 5% for the relief of hypotension, syncope urethral stricture,
dextrose in water by intractable pain recent GI or GU
controlled infusion Dermatologic: surgery, toxic
device. Unlabeled use: Pruritus, urticaria, psychosis, renal or
Rectal Dyspnea associated Respiratory: hepatic dysfunction;
10–30 mg q 4 hr or as with acute left laryngospasm, pregnancy; lactation
directed by physician. ventricular failure and bronchospasm, edema
Epidural pulmonary edema Physical: T; skin
Initial injection of Contraindication GI: Nausea, vomiting, color, texture, lesions;
5 mg in the lumbar anorexia, biliary tract orientation, reflexes,
region may provide spasm; increased bilateral grip strength,
pain relief for up to 24 Contraindicated with colonic motility in affect; P, auscultation,
hr. If adequate pain hypersensitivity to patients with chronic BP, orthostatic BP,
relief is not achieved opioids; diarrhea ulcerative colitis perfusion; R,
within 1 hr, caused by poisoning adventitious sounds;
incremental doses of until toxins are GU: Ureteral spasm, bowel sounds, normal
1–2 mg may be given eliminated; during spasm of vesical output; urinary
at intervals sufficient labor or delivery of a sphincters, urinary frequency, voiding
to assess premature infant (may retention or hesitancy, pattern, normal
effectiveness, up to cross immature blood– oliguria, antidiuretic output; ECG; EEG;
10 mg/24 hr. For brain barrier more effect, reduced libido thyroid, liver, kidney
continuous infusion, readily); after biliary or potency function tests
initial dose of 2–4 tract surgery or
mg/24 hr is following surgical Respiratory: Interventions
recommended. anastomosis; Respiratory Caution patient not to
Further doses of 1– pregnancy; labor depression, apnea, chew or crush
2 mg may be given if (respiratory depression circulatory controlled-release
pain relief is not in neonate; may depression, preparations.
achieved initially. prolong labor). respiratory arrest,
Intrathecal shock, cardiac Dilute and administer
Dosage is usually Use cautiously with arrest slowly IV to minimize
one-tenth that of head injury and likelihood of adverse
17
epidural dosage; a increased intracranial Side Effects effects.
single injection of pressure; acute GI: dry mouth,
0.2–1 mg may provide asthma, COPD, cor constipation. Tell patient to lie
satisfactory pain relief pulmonale, preexisting Skin: Tissue irritation down during IV
for up to 24 hr. Do not respiratory depression, and induration (SC administration.
inject > 2 mL of the hypoxia, hypercapnia injection).
5 mg/10 mL ampule (may decrease Other: Keep opioid
or > 1 mL of the respiratory drive and sweating,physical antagonist and
10 mg/10 mL ampule. increase airway tolerance and facilities for assisted
Use only in the resistance); lactation dependence, or controlled
lumbar area. Repeated (wait 4–6 hr after psychological respiration readily
intrathecal injections administration to nurse dependence available during IV
are not recommended; the baby); acute administration.
use other routes if abdominal conditions,
pain recurs. For CV disease, Use caution when
epidural or intrathecal supraventricular injecting SC or IM
dosing, use tachycardias, into chilled areas or in
preservative-free myxedema, seizure patients with
morphine preparations disorders, acute hypotension or in
only. alcoholism, delirium shock; impaired
tremens, cerebral perfusion may delay
PEDIATRIC arteriosclerosis, absorption; with
PATIENTS ulcerative colitis, repeated doses, an
Do not use in fever, kyphoscoliosis, excessive amount may
premature infants. Addison's disease, be absorbed when
SC or IM prostatic hypertrophy, circulation is restored.
0.05–0.2 mg/kg (up to urethral stricture, Reassure patients that
15 mg per dose) q 4 hr recent GI or GU they are unlikely to
or as directed by surgery, toxic become addicted;
physician. psychosis, renal or most patients who
hepatic dysfunction. receive opioids for
GERIATRIC medical reasons do
PATIENTS OR not develop
IMPAIRED dependence
18
ADULTS syndromes
Use caution.
Respiratory Teaching points
depression may occur
in the elderly, the very Take this drug exactly
ill, those with as prescribed. Avoid
respiratory problems. alcohol,
Reduced dosage may antihistamines,
be necessary. sedatives,
Epidural tranquilizers, over-the-
Use extreme caution; counter drugs.
injection of < 5 mg in
the lumbar region Swallow controlled-
may provide adequate release preparation
pain relief for up to 24 (MS Contin,
hr. Oramorph SR) whole;
Intrathecal do not cut, crush, or
Use lower dosages chew them.
than recommended for
adults above. Do not take leftover
medication for other
disorders, and do not
let anyone else take
your prescription.

These side effects may

occur: Nausea, loss of
appetite (take with
food, lie quietly);
constipation (use
laxative); dizziness,
sedation, drowsiness,
impaired visual acuity
(avoid driving or
19
performing tasks that
require alertness and
visual acuity).

Report severe nausea,

vomiting,
constipation, shortness
of breath or difficulty
breathing, rash.

20