Pharmacology can be overwhelming for the new nurse, and even the seasoned nurse. Hopefully these pharmacology mnemonics will help you simplify some difficult concepts.
The first one covers general medication administration, and while it’s not necessarily a mnemonic, it provides an easy way to remember the
6 rights of drug administration.
6 “R’s” (Rights) of Drug Administration
Nurses are involved in the administration of medication in many various settings. It is important to prevent medication errors by knowing the 6 rights of drug administration:
Right patient – Use 2 identifiers to verify right patient – check or scan the ID band for name & medical record #
Right medication – Verify that the drug name & the form of medication matches the doctor’s order
Right dose – Verify order & confirm the correct dosage calculation
Right route – Check the order & confirm if it is oral, IV, SQ, IM, etc.
Right time – Check the frequency & confirm the last time given
Right documentation – Document administration after giving medication – chart time, route, & other specifics (injection site, lab value, vital sign related to drug)
Emergency drugs to LEAN on – These are drugs that help prevent a patient from deteriorating to an arrest situation.
Lidocaine – antiarrhythmic (and topical/local anesthetic)
Decreases depolarization & excitability of ventricles during diastole – used for ventricular arrhythmias
Epinephrine – adrenergic agonist, catecholamine
Increases heart rate, causes vasoconstriction, & is a bronchodilator – used for anaphylactic reactions, bronchial asthma, hypersensitivity reactions
Atropine – anticholinergic, antiarrhythmic
Increases cardiac rate, decreases respiratory secretions, treats sinus bradycardia, reverses effects of anticholinesterase medication
Narcan – narcotic antagonist
Blocks narcotic effects, used to counteract opioid-induced respiratory depression or toxicity
Drugs for bradycardia & hypotension:
Isoproterenol – Relaxes blood vessels & helps the heart pump blood more efficiently to resolve low blood pressure.
Dopamine – Increases the pumping strength of the heart to resolve low blood pressure.
Epinephrine – Constricts peripheral blood vessels, which shunts blood to the central circulation & increases blood flow to the heart & brain.
Atropine – Anticholinergic drug that blocks parasympathetic vagal stimulation. It is the drug of choice to treat symptomatic sinus bradycardia.
Remember ABCDE for Atrial / Supraventricular Arrhythmias.
An arrhythmia is a change in the heart’s normal rate or rhythm – an atrial arrhythmia occurring in either the left or right atrium. They can range from being annoying but not dangerous to those that produce significant cardiac symptoms or loss of consciousness. A variety of medicines are available to restore normal heart rhythm, remember:
Anticoagulants – given to prevent embolization
Beta blockers – given to block the effects of certain hormones on the heart to slow the HR
Calcium channel blockers – slow the HR, decrease the contractility of the heart, & cause smooth muscle relaxation
Digoxin – slows the HR by blocking the number of electrical impulses that pass through the AV node into the ventricles
Electrocardioversion – electric currents are used to reset the heart’s rhythm back to a regular pattern
PALS for Ventricular Arrhythmias
Ventricular arrhythmias are abnormal rapid heart rhythms originating in the ventricles of the heart. Ventricular tachycardia & ventricular fibrillation are both life threatening & commonly associated with heart attacks. To prevent the arrhythmia from recurring, anti-arrhythmic medications are given:
Procainamide – decreases myocardial excitability & depresses myocardial contractility
Amiodarone – slows electrical conduction, electrical impulse from sinoatrial node, & conduction through accessory pathways
Lidocaine – given IV in ACLS as an alternative to the other antiarrhythmic drugs
Sotalol – a beta blocker that reduces cardiac output & BP, depresses sinus HR, & prolongs the refractory period in the atria & ventricles.