Medications in Nursing Essay Example | Topics and Well Written Essays - 1750 words

Medications in Nursing - Essay Example 228). As a nondepolarizing agent, this drug causes skeletal muscle paralysis by blocking the myoneural junction, interfering acetylcholine’s bid for cholinergic receptor sites and then binding with the nicotinic cholinergic receptor at the postjunctional membrane (Stoelting and Miller, 2007). Unlike other depolarizing agents however, vecuronium does not have much agonist activity and has no depolarizing impact at the motor endplate (McEvoy, et.al., 2009). As a muscle relaxant, this drug acts first on the eyelids and the jaw, then acts on the limbs, the abdomen, and then the diaphragm and the intercostals (Bledsoe, Clayden, and Papa, 2005). Adverse reactions of the drug may include skeletal muscle weakness and prolonged respiratory insufficiency or apnea (NDH, 2006). The intubating dose of 0.1mg/kg is sufficient to create intubating conditions within 3 minutes with effects lasting up to 45 minutes (Kovacs and Law, 2008). Co-administration with antibiotics can enhance neuromuscu lar blockade, thereby also causing increased muscle relaxation and increasing the potency of the drug (NDH, 2006). Using the drug with opioid analgesics can also increase neuromuscular blockade, thereby also causing increased skeletal muscle relaxation. ... This drug also acts on the CNS to improve the vagal tone, thereby, slowing the conduction through the nodes and thereby ensuring antiarrhythmic effect (NDH, 2006). Digoxin has a significant role in reducing ventricular rate in supraventricular arrhythmias in atrial fibrillations; hence it is the better drug choice for Mr. Jian. It can however cause fatigue, muscle weakness, agitation, headache, anorexia, vomiting, and diarrhea (NDH, 2006). In relation to other drugs, co-administration with verapamil and quinidine can increase the blood digoxin levels and provoke atrioventricular block; administering it with diuretics can cause hypokalemia which can increase the risk of ventricular arrhythmias (Berger, 2010). This drug is not advised for those with hypersensitivity to digoxin, for those with digitalis-induced toxicity, ventricular fibrillation, or ventricular tachycardia (NDH, 2006). For the nurse, there are various nursing precautions which should be considered in the administration of digoxin. After administration of the drug, the nurse needs to monitor Mr. Jian’s pulse rate because extreme slowing of the pulse may indicate digitalis toxicity (NDH, 2006). The nurse also needs to monitor the patient’s potassium levels carefully and take appropriate action before hypokalemia occurs. Before the drug is administered, the nurse needs to take the apical-radial pulse for 1 minute. She then needs to notify the prescriber for any changes (any significant increase or decrease in pulse). If such increase of decrease is seen, the patient’s BP needs to be checked and for an ECG to be performed (NDH, 2006). Question 3: Flecainide and Dofetilide Flecainide is a Class Ic