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.