DOPAMINE HYDROCHLORIDE

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(doe’pa-meen)
Dopastat, Intropin, Revimine 
Classifications: autonomic nervous system agent; alpha- and beta-adrenergic agonist (sympathomimetic)
Prototype: Epinephrine
Pregnancy Category: C

NURSING IMPLICATIONS

Assessment & Drug Effects

• Monitor blood pressure, pulse, peripheral pulses, and urinary output at intervals prescribed by physician. Precise measurements are essential for accurate titration of dosage.
• Report the following indicators promptly to physician for use in decreasing or temporarily suspending dose: Reduced urine flow rate in absence of hypotension; ascending tachycardia; dysrhythmias; disproportionate rise in diastolic pressure (marked decrease in pulse pressure); signs of peripheral ischemia (pallor, cyanosis, mottling, coldness, complaints of tenderness, pain, numbness, or burning sensation).
• Monitor therapeutic effectiveness. In addition to improvement in vital signs and urine flow, other indices of adequate dosage and perfusion of vital organs include loss of pallor, increase in toe temperature, adequacy of nail bed capillary filling, and reversal of confusion or comatose state.

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• DOBUTAMINE HYDROCHLORIDE (doe-byoo’ta-meen) Dobutrex Classifications: autonomic nervous system agent; beta-adrenergic agonist; catecholamine Prototype: Isoproterenol Pregnancy Category: C NURSING IMPLICATIONS Assessment & Drug Effects Correct hypovolemia by administration of appropriate volume expanders prior to initiation of therapy. Monitor therapeutic effectiveness. At any given dosage level, drug takes 10–20 min to produce
• METOPROLOL TARTRATE (me-toe’proe-lole) Apo-Metoprolol, Betaloc , Lopressor, Norometoprol , Toprol XL Classifications: autonomic nervous system agent; beta-adrenergic antagonist (sympatholytic); antihypertensive Prototype: Propranolol Pregnancy Category: C NURSING IMPLICATIONS Assessment & Drug Effects Take apical pulse and BP before administering drug. Report to physician significant changes in rate, rhythm, or quality of pulse or variations in
• NOREPINEPHRINE BITARTRATE (nor-ep-i-nef’rin) Levarterenol, Levophed, Noradrenaline Classifications: autonomic nervous system agent; alpha- and beta-adrenergic agonist (sympathomimetic) Prototype: Epinephrine Pregnancy Category: D NURSING IMPLICATIONS Assessment & Drug Effects Monitor constantly while patient is receiving norepinephrine. Take baseline BP and pulse before start of therapy, then q2min from initiation of drug until stabilization
• VASOPRESSIN INJECTION (vay-soe-press’in) Pitressin Classifications: hormones and synthetic substitutes; pituitary (antidiuretic) Pregnancy Category: X NURSING IMPLICATIONS Assessment & Drug Effects Monitor infants and children closely. They are more susceptible to volume disturbances (such as sudden reversal of polyuria) than adults. Establish baseline data of BP, weight, I&O pattern and
• MIDAZOLAM HYDROCHLORIDE (mid’az-zoe-lam) Versed Classifications: central nervous system agent; benzodiazepine anxiolytic; sedative-hypnotic Prototype: Lorazepam Pregnancy Category: D Controlled Substance: Schedule IV NURSING IMPLICATIONS Assessment & Drug Effects Inspect insertion site for redness, pain, swelling, and other signs of extravasation during IV infusion. Monitor for hypotension, especially if the patient is premedicated