Furosemide
Safe dose range: Adult IM/IV 20-
aka: Lasix 40mg, increased by 20mg q2hr IV
renal failure 100-200mg, max 600-
800mg
Class: Loop Diuretic
Rate of administration: Give UNDILUTED
ACTION: inhibits reabsorption of electrolytes through Y tube; give 20mg or less/min
in the loop of henle, decreasing reabsorption
of Na& Cl and increasing secretion of K. INDICATION: Pulmonary edema, edema
Responsible for slight antihypertensive effect in HF, nephrotic syndrome, ascites,
and peripheral vasodilation hepatic disease, HTN
Side Effects: Nursing Considerations:
loss of hearing assess fluid status, HTN,
hypokalemia
hyponatremia ototoxicity, hypokalemia (tachy,
alkalosis muscle weakness, drowsiness,
hyperglycemia (+ polyuria) lethargy) hyponatremia
nausea (increased bp, cold, clammy,
n/v, HA, confusion, fatigue)
monitor electrolytes, BUN, ,
blood pH, glucose, CBC
,Digoxin
Target range: Safe dose range: Adult IV: 10mcg/kg Rapid IV
<1.3nmol/L (loading dose):50% over 5 min, then 25% at
therapeutic range: 4-8hrs after initial dose, then 25% at 8-16 hrs
0.5-2ng/mL after initial dose
Class: Inotropic antidysrhythmic/ cardiac
glycoside Rate of administration: may be given UNDILUTED
or each 1ml may be diluted in 4ml of sterile water,
ACTION: Inhibits Na K ATPase, making NS, D5W, or LR.
Inject over at least 5 min via Y site, in pts with
calcium more available for contractile proteins pulmonary edema administer over 10-15 min (do not
resulting in increased cardiac output; flush following)
increased force of contraction, decreased
heart rate, decreased AV conduction INDICATION: Afib, HF
Therapeutic Outcome: decreased edema,
Nursing Considerations:
pulse, respiration, crackles
assess& document apical pulse for
1min
Monitor electrolytes, renal, liver, Side Effects:
hct, therapeutic range Headache
monitor ECG continuously during hypotension
loading doses and for 6 hours after bradycardia
watch for bradycardia Dysrhythmias
check iv site for redness, AV block
inflammation, infiltration
, aka: Lopressor
Metoprolol
Safe dose range: Adult IV BOL (early treatment for
Class: B-blocker, Antihypertensive, MI) 5mg q2min x 3 doses, then 50 mg PO 15 min
Antianginal after last dose and q6hr x48 hr maintenance dose
50-100mg bid (max 400mg a day)
ACTION: reduces elevated renin plasma
levels blocking b2-adrenergic receptors in Rate of administration: Give 1mg/ml over i min
bronchial, vascular smooth muscle only at Check dose with another person!!
high doses, negative chronotropic effect
Indication: HTN, MI, angina, HF,
Nursing Considerations:
monitor BP & pulse before and during cardiomyopathy
(hold if apical HR <50 & if <40 Therapeutic Outcome:decreased BP,
Atropine may be needed; notify MD)
monitor baseline renal and liver function heart rate, av conduction
assess for edema, daily weight I+Os
rise slowly Side Effects:
insomnia, dizziness, palpitations,
hypotension
nausea/ vomiting/ diarrhea
HF, bradycardia, edema, chest pain,
agranulocytosis, thrombocytopenia,
bronchospasm
Safe dose range: Adult IM/IV 20-
aka: Lasix 40mg, increased by 20mg q2hr IV
renal failure 100-200mg, max 600-
800mg
Class: Loop Diuretic
Rate of administration: Give UNDILUTED
ACTION: inhibits reabsorption of electrolytes through Y tube; give 20mg or less/min
in the loop of henle, decreasing reabsorption
of Na& Cl and increasing secretion of K. INDICATION: Pulmonary edema, edema
Responsible for slight antihypertensive effect in HF, nephrotic syndrome, ascites,
and peripheral vasodilation hepatic disease, HTN
Side Effects: Nursing Considerations:
loss of hearing assess fluid status, HTN,
hypokalemia
hyponatremia ototoxicity, hypokalemia (tachy,
alkalosis muscle weakness, drowsiness,
hyperglycemia (+ polyuria) lethargy) hyponatremia
nausea (increased bp, cold, clammy,
n/v, HA, confusion, fatigue)
monitor electrolytes, BUN, ,
blood pH, glucose, CBC
,Digoxin
Target range: Safe dose range: Adult IV: 10mcg/kg Rapid IV
<1.3nmol/L (loading dose):50% over 5 min, then 25% at
therapeutic range: 4-8hrs after initial dose, then 25% at 8-16 hrs
0.5-2ng/mL after initial dose
Class: Inotropic antidysrhythmic/ cardiac
glycoside Rate of administration: may be given UNDILUTED
or each 1ml may be diluted in 4ml of sterile water,
ACTION: Inhibits Na K ATPase, making NS, D5W, or LR.
Inject over at least 5 min via Y site, in pts with
calcium more available for contractile proteins pulmonary edema administer over 10-15 min (do not
resulting in increased cardiac output; flush following)
increased force of contraction, decreased
heart rate, decreased AV conduction INDICATION: Afib, HF
Therapeutic Outcome: decreased edema,
Nursing Considerations:
pulse, respiration, crackles
assess& document apical pulse for
1min
Monitor electrolytes, renal, liver, Side Effects:
hct, therapeutic range Headache
monitor ECG continuously during hypotension
loading doses and for 6 hours after bradycardia
watch for bradycardia Dysrhythmias
check iv site for redness, AV block
inflammation, infiltration
, aka: Lopressor
Metoprolol
Safe dose range: Adult IV BOL (early treatment for
Class: B-blocker, Antihypertensive, MI) 5mg q2min x 3 doses, then 50 mg PO 15 min
Antianginal after last dose and q6hr x48 hr maintenance dose
50-100mg bid (max 400mg a day)
ACTION: reduces elevated renin plasma
levels blocking b2-adrenergic receptors in Rate of administration: Give 1mg/ml over i min
bronchial, vascular smooth muscle only at Check dose with another person!!
high doses, negative chronotropic effect
Indication: HTN, MI, angina, HF,
Nursing Considerations:
monitor BP & pulse before and during cardiomyopathy
(hold if apical HR <50 & if <40 Therapeutic Outcome:decreased BP,
Atropine may be needed; notify MD)
monitor baseline renal and liver function heart rate, av conduction
assess for edema, daily weight I+Os
rise slowly Side Effects:
insomnia, dizziness, palpitations,
hypotension
nausea/ vomiting/ diarrhea
HF, bradycardia, edema, chest pain,
agranulocytosis, thrombocytopenia,
bronchospasm
