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 and medical record number
- Right medication: Verify that the drug name and the form of medication matches the doctor’s order
- Right dose: Verify order and confirm the correct dosage calculation
- Right route: Check the order and confirm if it is oral, IV, SQ, IM, etc.
- Right time: Check the frequency and confirm the last time given
- Right documentation: Document administration after giving medication – chart time, route, and other specifics (injection site, lab value, vital sign related to drug)
LEAN
These are drugs that help prevent a patient from deteriorating to an arrest situation.
- Lidocaine – antiarrhythmic (and topical/local anesthetic): Decreases depolarization and excitability of ventricles during diastole, used for ventricular arrhythmias
- Epinephrine – adrenergic agonist, catecholamine: Increases heart rate, causes vasoconstriction, and 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
IDEA
Drugs for bradycardia and hypotension:
- Isoproterenol: Relaxes blood vessels and 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 and increases blood flow to the heart and brain.
- Atropine: Anticholinergic drug that blocks parasympathetic vagal stimulation. It is the drug of choice to treat symptomatic sinus bradycardia.
ABCDE
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, and 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
Ventricular arrhythmias are abnormal rapid heart rhythms originating in the ventricles of the heart. Ventricular tachycardia and ventricular fibrillation are both life-threatening and commonly associated with heart attacks.
To prevent the arrhythmia from recurring, anti-arrhythmic medications are given:
- Procainamide: decreases myocardial excitability and depresses myocardial contractility
- Amiodarone: slows electrical conduction, electrical impulse from sinoatrial node, and 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 and BP, depresses sinus HR, and prolongs the refractory period in the atria and ventricles
