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Drug Study – Operating Room/Common Medications
Hydrocortisone (Solu-Cortef®) Classification: Corticosteroid, Glucocorticoid Mechanism: Suppresses inflammation and decreases immune response. Indications: Adrenal insufficiency, severe allergy, asthma, shock. Side Effects: Hyperglycemia, insomnia, increased appetite, fluid retention. Adverse Effects: Infection, GI bleeding, adrenal suppression, hypertension. Nursing Responsibilities: Monitor BP, blood glucose, electrolytes, and signs of infection.
Norepinephrine (Levophed®) Classification: Vasopressor Mechanism: Causes vasoconstriction and increases blood pressure. Indications: Septic shock, severe hypotension. Side Effects: Headache, anxiety, palpitations. Adverse Effects: Arrhythmias, severe hypertension, tissue necrosis. Nursing Responsibilities: Monitor BP continuously, urine output, and IV site.
Dexamethasone (Decadron®) Classification: Corticosteroid Mechanism: Inhibits inflammatory mediators and suppresses immune response. Indications: Cerebral edema, allergies, inflammation, PONV prevention. Side Effects: Hyperglycemia, mood changes, increased appetite. Adverse Effects: Infection, GI ulceration, adrenal suppression. Nursing Responsibilities: Monitor glucose levels and signs of infection.
Diphenhydramine (Benadryl®) Classification: Antihistamine Mechanism: Blocks H1 receptors to reduce allergic symptoms. Indications: Allergic reactions, anaphylaxis adjunct, motion sickness. Side Effects: Drowsiness, dry mouth, dizziness. Adverse Effects: Respiratory depression, urinary retention, confusion. Nursing Responsibilities: Monitor consciousness and respiratory status.
Tramadol (Tramal®, Ultram®) Classification: Opioid Analgesic Mechanism: Binds opioid receptors and inhibits serotonin/norepinephrine reuptake. Indications: Moderate to severe pain. Side Effects: Nausea, dizziness, constipation. Adverse Effects: Respiratory depression, seizures, dependence. Nursing Responsibilities: Assess pain and monitor respirations.
Metoclopramide (Plasil®, Reglan®) Classification: Antiemetic, Prokinetic Mechanism: Blocks dopamine receptors and promotes gastric emptying. Indications: Nausea, vomiting, GERD, gastroparesis. Side Effects: Drowsiness, diarrhea, restlessness. Adverse Effects: Extrapyramidal symptoms, tardive dyskinesia. Nursing Responsibilities: Observe for involuntary movements and bowel activity.
Furosemide (Lasix®) Classification: Loop Diuretic Mechanism: Promotes sodium, chloride, and water excretion. Indications: Edema, hypertension, heart failure. Side Effects: Polyuria, dizziness, dehydration. Adverse Effects: Hypokalemia, ototoxicity, hypotension. Nursing Responsibilities: Monitor I&O;, electrolytes, and BP.
Dopamine (Intropin®) Classification: Inotrope, Vasopressor Mechanism: Increases cardiac output and blood pressure. Indications: Shock, hypotension, heart failure. Side Effects: Nausea, headache, tachycardia. Adverse Effects: Arrhythmias, tissue necrosis. Nursing Responsibilities: Continuous ECG and BP monitoring.
Dobutamine (Dobutrex®) Classification: Inotrope Mechanism: Stimulates beta-1 receptors to improve cardiac output. Indications: Heart failure, cardiogenic shock. Side Effects: Palpitations, headache. Adverse Effects: Arrhythmias, hypertension. Nursing Responsibilities: Monitor ECG, BP, and cardiac status.
Atropine Sulfate (Atropen®) Classification: Anticholinergic Mechanism: Blocks parasympathetic activity, increasing heart rate. Indications: Bradycardia, organophosphate poisoning. Side Effects: Dry mouth, blurred vision, tachycardia. Adverse Effects: Arrhythmias, urinary retention. Nursing Responsibilities: Monitor heart rate and urinary output.
Nicardipine (Cardene®) Classification: Calcium Channel Blocker Mechanism: Causes vasodilation and lowers BP. Indications: Hypertensive emergencies, hypertension. Side Effects: Flushing, headache, dizziness. Adverse Effects: Severe hypotension, reflex tachycardia. Nursing Responsibilities: Monitor BP and cardiac rhythm.
Paracetamol (Tylenol®, Biogesic®) Classification: Analgesic, Antipyretic Mechanism: Reduces pain and fever through CNS action. Indications: Pain, fever. Side Effects: Nausea, rash. Adverse Effects: Hepatotoxicity, liver failure. Nursing Responsibilities: Monitor dosage and liver function.
Epinephrine (Adrenalin®) Classification: Adrenergic Agonist Mechanism: Stimulates alpha and beta receptors causing bronchodilation and vasoconstriction. Indications: Anaphylaxis, cardiac arrest, severe asthma. Side Effects: Anxiety, tremors, palpitations. Adverse Effects: Arrhythmias, hypertension. Nursing Responsibilities: Monitor airway, ECG, and BP.
Ketorolac (Toradol®) Classification: NSAID Mechanism: Inhibits prostaglandin synthesis. Indications: Short-term moderate to severe pain. Side Effects: Dyspepsia, nausea. Adverse Effects: GI bleeding, renal impairment. Nursing Responsibilities: Monitor pain, renal function, and bleeding.
Propofol (Diprivan®) Classification: General Anesthetic Mechanism: Enhances GABA-mediated CNS depression. Indications: Induction/maintenance of anesthesia, procedural sedation. Side Effects: Injection-site pain, hypotension. Adverse Effects: Apnea, respiratory depression. Nursing Responsibilities: Continuous airway, ECG, and oxygen monitoring.
Rocuronium (Esmeron®, Zemuron®) Classification: Nondepolarizing Neuromuscular Blocker Mechanism: Blocks acetylcholine at neuromuscular junctions causing paralysis. Indications: Intubation and muscle relaxation during surgery. Side Effects: Tachycardia, injection-site discomfort. Adverse Effects: Respiratory arrest, prolonged paralysis, anaphylaxis. Nursing Responsibilities: Ensure ventilatory support, monitor neuromuscular function, and provide adequate sedation.
