EPINEPHRINE

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(ep-i-ne’frin)
Bronkaid Mist, Epi-E-Zpen, Epinephrine Pediatric, EpiPen Auto-Injector, Primatene Mist Suspension
EPINEPHRINE BITARTRATE
AsthmaHaler, Bronkaid Mist Suspension, Bronitin Mist Suspension, Epitrate, Medihaler-Epi, Primatene Mist Suspension
EPINEPHRINE HYDROCHLORIDE
Adrenalin Chloride, Bronkaid Mistometer, Dysne-Inhal, Epifrin, Glaucon, SusPhrine

 

NURSING IMPLICATIONS

Assessment & Drug Effects

• Monitor BP, pulse, respirations, and urinary output and observe patient closely following IV administration. Epinephrine may widen pulse pressure. If disturbances in cardiac rhythm occur, withhold epinephrine and notify physician immediately.
• Keep physician informed of any changes in intake-output ratio.
• Use cardiac monitor with patients receiving epinephrine IV. Have full crash cart immediately available.
• Check BP repeatedly when epinephrine is administered IV during first 5 min, then q3–5min until stabilized.
• Advise patient to report to physician if symptoms are not relieved in 20 min or if they become worse following inhalation.
• Advise patient to report bronchial irritation, nervousness, or sleeplessness. Dosage should be reduced.
• Monitor blood glucose & HbA1c for loss of glycemic control if diabetic.

Patient & Family Education

• Be aware intranasal application may sting slightly.
• Administer ophthalmic drug at bedtime or following prescribed miotic to minimize mydriasis, with blurred vision and sensitivity to light (possible in some patients being treated for glaucoma).
• Transitory stinging may follow initial ophthalmic administration and that headache and browache occur frequently at first but usually subside with continued use. Notify physician if symptoms persist.
• Discontinue epinephrine eye drops and consult a physician if signs of hypersensitivity develop (edema of lids, itching, discharge, crusting eyelids).
• Learn how to administer epinephrine subcutaneously. Keep medication and equipment available for home emergency. Confer with physician.
• Note: Inhalation epinephrine reduces bronchial secretions and thus may make mucous plugs more difficult to dislodge.
• Report tolerance to physician; may occur with repeated or prolonged use. Continued use of epinephrine in the presence of tolerance can be dangerous.
• Take medication only as prescribed and immediately notify physician of onset of systemic effects of epinephrine.
• Discard discolored or precipitated solutions.
• Do not breast feed while taking this drug without consulting physician.

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• MOXIFLOXACIN HYDROCHLORIDE (mox-i-flox’a-sin) Avelox, Vigamox Classifications: antiinfective; antibiotic; quinolone Prototype: Ciprofloxacin Pregnancy Category: C NURSING IMPLICATIONS Assessment & Drug Effects Monitor therapeutic effectiveness indicated by clinical improvement of infection. Monitor for and notify physician immediately of adverse CNS effects. Notify physician immediately for S&S of hypersensitivity (see Appendix F). Lab tests: C&S
• AMPICILLIN SODIUM AND SULBACTAM SODIUM (am-pi-sill’in/sul-bak’tam) Unasyn Classifications: antiinfective; antibiotic; aminopenicillin Prototype: Ampicillin Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Determine previous hypersensitivity reactions to penicillins, cephalosporins, and other allergens prior to therapy. Lab tests: Baseline C&S tests prior to initiation of therapy; start drug pending results. Report promptly unexplained
• ENOXAPARIN (e-nox’a-pa-rin) Lovenox Classifications: blood formers, coagulators, and anticoagulants; low molecular weight heparin Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Lab tests: Baseline coagulation studies; periodic CBC, platelet count, urine and stool for occult blood. Monitor platelet count closely. Withhold drug and notify physician if platelet
• DIGOXIN (di-jox’in) Lanoxicaps, Lanoxin Classifications: cardiovascular agent; cardiac glycoside; antiarrhythmic Pregnancy Category: A NURSING IMPLICATIONS Assessment & Drug Effects Be familiar with patient’s baseline data (e.g., quality of peripheral pulses, blood pressure, clinical symptoms, serum electrolytes, creatinine clearance) as a foundation for making assessments. Lab tests: Baseline and
• ALBUTEROL (al-byoo’ter-ole) Accuneb, Novosalmol , Proventil, Proventil HFA, Proventil Repetabs, Salbutamol, Ventolin, Ventolin Rotocaps, Volmax Classifications: autonomic nervous system agent; beta-adrenergic agonist (sympathomimetic); bronchodilator (respiratory smooth muscle relaxant) Pregnancy Category: C NURSING IMPLICATIONS Assessment & Drug Effects Monitor therapeutic effectiveness which is indicated by significant subjective improvement in pulmonary function within 60–90 min