IV Push Labs and

Drug name Class Indication Mechanism of action Route Dilution Rate assessments S/E Adverse
150 mg over
10 min bradycardia,
IVP: followed by Monitor live & thyroid hypotension,
undiluted or 360mg over function & electrolytes, constipation, N/V,
Prolongs action potential &
20-30mL next 6 hrs resp status, BP/HR, chest hyper/hypothyroidism,
Ventricular refractory period. Inhibits
D5W or then 540mg xray Q3-6m, continuous dizziness, fatigue,
arrhythmias and other adrenergic stimulation.
Amiodarone antiarrhythmics PO IV IO 0.9% NaCl. over next ECG, regular eye exams, photosensitivity, poor
life-threatening slows sinus rate, increases
IVPB: 18hr. ACLS: NO grapefruit juice, coordination, pulm
tachycardias PR & QT intervals &
150mg in 300mg IVP, reversible blueish tint to fibrosis/toxicity,
vasodilation.
100mL may repeat w/ face. NO worsening arrythmias,
D5W. 150 mg IVP, breastfeeding/pregnancy. QT interval
Max dose 2.2 prolongation. ARDS
g/24hr
inhibits Ca transport into peripheral edema,
HTN, chronic stable
antihypertensive myocardial & vascular BP/HR prior. monitor ecg bradycardia,
angina, vasospastic
Amlodipine Ca Channel smooth muscle cells, PO NA NA periodically, assess s/s hypotension, gingival
angina, recend CAD
blocker resulting reduced BP, HF, assess gums hyperplasia, nausea,
w/o HF or EF <40%.
decreased angina attacks. dizzy
Serum cholesterol levels,
monitor liver function s.s
angina, rhapdomyolisis,
liver injury. Diet- fat
Lipid lowering Inhibits enzymes myalgia, abd cramps,
consumption. Monitor CK
agent, HMG- CoA hypercholesterolemia. responsible for catalyzing constipation, diarrhea,
Atorvastatin PO NA NA if c/o muscle tenderness.
reductase inhibitor mixed dyslipidemias early step in cholesterol drug induced hep,
Dc if CK >10. Avoid large
(statins) synthesis pancreatitis, erectile
amounts of grapefruit
dysfunction
juice. NO pregnancy,
breastfeeding, or smoking
Blurred vision, dry eyes,
Parkinson's, drug Bed rest 1 hour after hypotension,
Blocks cholinergicnactivity
Antiparkinson induced administering IM or IVP. tachycardia,
in CNS responsible for
Benztropine agent. extrapyramidal effects,
Parkinson's symptoms.
PO, IM, IVP NA IVP 1mg/1min Monitor BP/HR. Avoid constipation, dry mouth,
Anticholinergic & acute dystonic antidiarrheals and ileus, nausea, urine
Reduces rigidity & tremors
reactions. andtiacids 1-2 hr of med. retention, confusion,
weakness, sedation

Levodopa is converted to
dopamine in CNS where it
serves as a orthostatic hypotension,
Antiparkinson neurotransmitter. Carbidopa Monitor hepatic/renal constipation, N/V,
Carbidopa Parkinson's PO NA NA depression,
agent. Dopamine is a decarboxylase inhibitor, function. Assess for s/s
Levodopa agonist prevents peripheral toxicity- muscle twitching dyskinesias, involuntary
destruction of levodopa. movements
Relieves tremors and
rigidity in Parkinson's.
 IV Push Labs and
Drug name Class Indication Mechanism of action Route Dilution Rate assessments S/E Adverse
Dc 5-7 days before sx,
labor, or neuroaxial
acute coronary inhibits PLT aggregation by
blockade. Monitor
syndrome. STEMI MI. irreversibly inhibiting binding
Clopidogrel antiPLT
Non-STEMI MI. of ATP to PLT receptors,
PO NA NA bleeding times, prolonged Prolonged bleeding
is normal. s/s of bleeding.
unstable angina reducing risk of MI & stroke
monitor cbc & PLT. avoid
omeprazole
PO- w/ foods increases
B12 deficiency. Corrects manifestations of absorption. Intranasal: do
5g over 15
pernicious anemia. pernicious anemia. corrects not give within 1 hr of food HTN. Tachycardia.
antianemic. water PO, IV, IM, 200ml NaCl, min, additional
Cyanocabalamin part of Schilling test b12 deficiency. reverses or hot liquids. Labs: Hypokalemia.
soluble vit. SubQ D5W, or LR. 5g over 15-
(b12 absorption test). symptoms of cyanide monitor folic acid, B12, Thrombocytosis.
120 min
Cyanide poisoning. poisoning iron, hgb, hct, k levels for
pt w/ pernicious anemia.
BP- report severe HTN.
Labs: monitor serum
antianemic.
stimulates erythropoiesis. ferririn, transferrin, & iron. HTN. MI. Stroke.
hormone.
CKD, anemia, maintains & may elevate 1:1 ratio 1-3 min at end Hgb. Sx: implement DVT Increasedtumor growth.
Epoetin Beta erythropoiesis IV SubQ
reduction of RBCs RBCs to decrease need for NaCl of dialysis. prophylaxis. For IV: Resumption of
stimulating agent
transfusion Seizure prcautiosn in pt's menses/fertility.
(ESA)
woth 4 point increase in
HCT in 2wk period.
monitor mood changes.
assess sexual function or
seratonin syndrome
major deppressive
(tachy, labile BP,
disorder. generalized SIADH. Nausea.
hyperthermia,
anxiety disorder. panic selectively inhibits reputake Diarrhea. HypoNa. Inc
antidepressant. hyperrefelexia, N/V/D,
Escitalopram disorder. OCD. PTSD. of serotonin in CNS causing PO NA NA
hallucinations). Avoid
appetite. Suicidal
SSRI
social anxiety disorder. antidepressant action. thoughts. insomnia.
driving. If pregnant, taper
premenstrual serotonin syndrome
in 3rd trimester to avoid
dysphoric disorder.
neonatal seratonin
syndrome. Takes 4-6 wk
to be effective.
short tx of
duodenal/benign
gastric ulcers. GERD. a histamine antagonist May inhibit gastric
Antulcer agent, H2 Premixed. 20mg- 2 min,
heartburn. acid inhibitsdaytime and absorption of constipation, diarrhea,
Famotidine antagonist, Gastric PO IV 20mg vial w/ >20 min 15-
ingestion. sour notcturnal basal gastric acid ketoconazole & decrease dizzy, headache
acid inhibitor 5-10mL NS 30min
stomach. gastric secretions. cyclosporine levels
hypersecretion. GI s/e
d/t NSDAIDs.
partial seizures-
HTN. ABN vision. Wt
immediate release.
analgesic. affects transport of amino changes in behavior. gain. Gingivitis.
postherpetic neuralgia.
Gabapentin anticonvulsant. acids across & stabilize PO NA NA seizure activity. restless Rhabdomyolysis.
restless leg syndrome.
mood stabilizer neuronal membranes. leg s/s. Labs: leukopnia Ataxia. Dizzoness.
neuropathy. bipolar.
Drowsiness. Sedation.
prevention migraine.
 IV Push Labs and
Drug name Class Indication Mechanism of action Route Dilution Rate assessments S/E Adverse
IM- use Z
Alters effects of doapmine track, 2" 21g
IVP-
Acute or chronic in CNS. Anticholinergic and no more than hypotension,,
antipsychotic 5mg/min assess mental status,
Haloperidol psychotic disorders. & alpha adrenergic blocking PO IM IVP
can be
3mL per site. blurred/dry eyes,
butyrophenones monitor BP/I&O
N/V from sx or chemo activity. diminished s/s of keep in constipation, dry mouth
undiluted
psychosis and tourette's recumbent for
30 min.
Lowers BP by direct
Monitor CBC and Orthostatic
HTN, Vasodilation in relaxation of smooth muscle
Antihypertensive IM, IV, PO Adult >1 min electrolytes with prolonged hypotension,
Hydralazine cardiogeneic shock, of arteries and arterioles. undiluted
Vasodilator CRUSHABLE Ped >3-5min therapy. Hold if BP tachycardia, dependent
eclampsia HR, cardiac output, and
<90/60. edema
stroke volume increase.
Give in AM. BP. If on Dig
assess for dig tox. I/O.
increases excretion of Na & DW. assess for edema. hypotension.
mild-mod HTN. Edema
H2o by inhibiting Na Allergy to sulfonamides. hypokalemia. hyperCa.
d/t HF, renal
Hydrochlorothi- AntiHTN. thiazide
dysfunction, cirrhosis,
reabsorption in distal tubule.
PO NA NA
Monitor electrolytes (esp dehydration. hypoNa.
azide diuretic Promotes excretion of Cl, K, K), BUN/Cr, and uric acid. HypoPhos. HypoMg.
gluccocorticoid and
Mg, & Bicarb. Arteriolar Change positions slowly. cramping. dizziness.
estrogen therapy
dilation. Sunscreen. No alcohol. lethargy.
May affect NB, report if
breastfeeding.
dry mouth, constipation
(especially in older
Anxiety. Allergies. blocks action of histamine. It assess mood changes,
adults), confusion
Hydroxyzine antihistamine Puritis. Pre-Op also works by decreasing PO IM NA NA sedation, allergies, and
(especially in older
sedation activity in the brain. skin. Fall risk for elderly.
adults), dizziness
headache
IV- maintain supine for 3
hours after. VS 5-15 orthostatic hypotension,
Antianginal, HTN, Vasodilation in
Labetalol (HIGH 5mg/mL >2 during, I/O, daily weight, erectile dysfunction,
antiHTN, beta cardiogeneic shock, blocks beta stimulation PO IV undiluted
ALERT) min JVD, DC if jaundice or fatigue, weakness,
blocker eclampsia
hepatic impairment. HOLD pulmonary edema
IF AP <50
Erosive esophagitis,
Binds to enzyme in the
duodenal ulcer, gastric May increase AST/AST, hypomangnesia,
presence of acidic gastric
ulcer, GERD, for NG tube mix granules diarrhea, dizzy,
Lansoprazole Antiulcer PPI pH preventing final transport PO NA NA
with 40mL apple juice, headache, Vit b12
pathological
of hydrogen ions into gastric
hypersecretion monitor bowels deficiency
lumen
conditions, heartburn
HTN. HF. Reduction of ACE inhibitors block hypotension. edema.
Monitor bun/cr/k. check
antiHTN. ACE risk of death or conversion of angiotensin 1 tachycardia.
Lisinopril PO NA NA BP/HR. Asssess for
inhibitors development of HF to angiotesin 2. systemic hyperkalemia. cough.
angioedema & s/s HF.
following MI. vasodilation. angioedema.
 IV Push Labs and
Drug name Class Indication Mechanism of action Route Dilution Rate assessments S/E Adverse
ECG changes, edema,
avoid large changes in Na hypotension,
intake. assess mental hypothyroidism,
status. I/O's. weight q3m. anorexia, leukocytosis,
2-3L/day. Labs: renal, muscle weakness,
acute manic/mixed
thyroid, WBC w/ diff, rigidity, tremors,
episodes d/t bipolar 1 alters cation transport in
Lithium mood stabilizer PO NA NA electrolytes, glucose. impaired memory,
disorder. tx of bipolar 1 nerve & muscle.
Serum lithium therapeutic drowsiness. lithium tox:
disorder.
levels 0.5-1.5 mEq/L. V/D, slurred speech,
Acute manis 0.6-1.2 lightheadedness,
mEq/L. should not exceed drowsy, muscle
2. weakness, tremors,
twittching.
apnea, cardiac arrest,
depresses CNS by Dilute with
anesthetic anjunct, assess renal/hepatic & hypotension,
PO: anxiety, IM/IV: potentiating GABA & equal
antianxiety agent, hematological function. bradycardia, lethargy,
Lorazepam sedative/hypnotic,
status epilepticus, inhibitory neurotransmitter. PO, IM, IV amount of 2mg/min
Antidote: flumazenil, DC dizzy, forgetfullness,
preanesthetic Decreases anxiety & sterile water
benzodiazepine slowly resp depression,
seizures, produces sedation 0.9% NaCl
dependence
No St. John's wort or GF
peripheral edema.
juice. BP/AP before.
HTN-ER only. systemic vasodilation bradycardia.
Monitor ECG. I/O's DW. s.
antianginal. prevention of decreases BP. coronary hypotension.
Nifedipine migraines. vasodilation decreases PO PO-ER NA NA
s HF. dig toxicty. asses
aniHTN. Ca photosensitivity.
(Procardia) angina, location, duration,
Channel blocker management of HF or frequency & severity of epistaxis. gingival
intensity, and casue. Labs:
cardiomyopathy angina attacks hyperplasia. HA.
K, renal, liver, may casue
tinnitus.
+ ANA & Coomb's.
Selective antagonist of Diarrhea, fever
serotonin receptors (5HT3) headache, agitation,
Dilution not
Antiemetic 5HT3 located in the chemo trigger IVP IM PO IVP- atleast 30 arrhythmias/ECG
required,
Ondanserton Receptor N/V zone. Chemo agents (liquid, tab,
premixed
sec; 2-5 min Assess N/V alterations. Inants:
Antagonist increase release of ODT) preferred bronchospasm Peds:
solution
serotonin from specific GI wound problems,
tract, causing emesis. anxiety
IVP-
Binds to an enzyme in the 40mg/10mL
Proton Pump presence of acidic gastric NS IV infuse IVP >2min
IV PO DON'T abd pain, blood in stool,
Pantoprazole Inhibitor Antiulcer pH, preventing
Erosive esophagitis d/t GERD. the final
Duodenal ulcers d/t H. Pylori 40- infusion NA
CRUSH emesis, blurred vision
agen transport of hydrogen ions 80mg/100m >15min
into the gastric lumen. L D5W, NS,
or LR
 IV Push Labs and
Drug name Class Indication Mechanism of action Route Dilution Rate assessments S/E Adverse
IM comes
with dilutent,
ix w/ 2mL.
deltoid 1"
needle.
mood changes, mental
Schizophrenia. Acute Gluteal 2" orthostatic hypotension.
status, or
manic or mixed needle. tachycardia. rhinitis. GI
Antigonizes dopamine & depression/suicide
episodes d/t Bipolar1 Must be changes. decreased
Antipsychotic. seratonin in CNS. thoughts. initial
Disorder (PO only). administere libido. dizziness.
Risperdone Mood stabilizer. Decreases symptoms of PO IM SubQ NA weight/BMI. Orthostatic
Maintenance tx of d within 6 increased sleep or
Benzisoxaloes. psychosis, bipolar mania, or BPs during initial
Bipolar1 (IM only). hrs of insomnia. cough.
autism. dose/titration. WBC. May
Irritability d/t autism mixing. Neuromalignant
increase AST/ALT. Use
(PO only). refridgerate. syndrome. Leukopenia.
sunscreen
Allow med
to reach
room temp
before
giving.
BP/HR. Monitor
electrolytes, Bun/Cr.
Akasthesia. Dystonia. Hypotension.
Inihbits rewabsorption of Na
pseudoparkinson's. Photosensitivity.
& Cl from loop of Henle &
Tardive dyskinesia. DW. Hearing loss. Tinnitus.
AntiHTN Loop edema d/t HF, hepatic, distal renal tubule.
Torsemide PO NA NA I/O's. Edema. Lung Hypovolemia. Decrease
diuretic or renal disease. HTN Increases excretion of H2o,
sounds. Skin turgor. electrolytes. Muscle
Na, Cl, Mg, H, & Ca.
Mucous membranes. If on cramps. Dizziness. Dry
Decreases BP.
Dig, dig toxicity risk is mouth.
high. Change positions
slowly.
MRSA, staph
endocarditis,
prophylaxis in selected necrosis/sloughing at IV
sx, prevention of 100ml or renal function, IVPB- Vanc site, hypotension or
Antibacterial Bactericidal against Garm +
Group B strepococcal 250 if dose >60 min single Troph (refer to facility cardiac arrest can occur
Vancomycin Tricylic- organisms. INhibits cell wall PO IV
disease in neonates, >500 NaCl dose. policy when to hold, if given too fast.
glycopeptide synthesis.
penicillin allergy and or D5W usually >20) nephro/ototoxicity,
staph infection, neutropenia
septiciemia. PO- C-
Diff