Health Systems Lab Drugs #1-11 (Counseling Points)

regular insulin (Humulin R/Novolin R)

Indications - Hyperglycemia, hyperkalemia (administer with dextrose unless blood glucose is elevated)

Warnings - High alert medication; verify insulin type, concentration, dose, and route

dextrose injection (D50W, D10W)

Indications - Severe hypoglycemia; administered with IV regular insulin for hyperkalemia

Calcium gluconate

Indications - stabilization of the myocardium in hyperkalemia with ECG changes

Warnings - not used to lower serum potassium

calcium chloride

Warnings - Vesicant, administer via central line whenever possible due to risk of severe tissue necrosis if extravasation occurs

magnesium sulfate

Indications - torsades de pointes, seizure prevention in preeclampsia/eclampsia

sodium bicarbonate

Indications - severe metabolic acidosis, sodium channel blocker toxicity (e.g. tricyclic antidepressant overdose)

Warnings - Not recommended for routine use during cardiac arrest

potassium chloride

Warnings - high alert medication, never administer IV push or IV bolus

potassium phosphate

Warnings - contains both phosphorus and potassium

Notes - consider serum potassium when choosing between potassium phosphate and sodium phosphate

sodium phosphate

Warnings - contains both phosphorus and sodium

Notes - may be preferred over potassium phosphate when additional potassium is undesirable

glucagon (GlucaGen)

Indications - severe hypoglycemia, antidote for beta-blocker toxicity

lipid emulsion 20% (Intralipid)

Indications - antidote for local anesthetic systemic toxicity (LAST)

Side effects - hypertriglyceridemia