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Generic
Brand
Selected Adverse Effects
PHARMACY CATEGORY
Consideration
Buprenorphine   Buprenex   1. Respiratory depression 2. Dizziness 3. Sedation   Analgesic, Opioid   ISMP High-alert medication  
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Fentanyl   Sublimaze   1. Constipation 2. Confusiondizziness 3. Respiratory depression   Analgesic, Opioid   ISMP High-alert medication  
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Hydromorphone   Dilaudid   1. Constipation 2. Flushing 3. Hypotension 4. Itching 5. Respiratory depression   Analgesic, Opioid   ISMP High-alert medication  
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Ketorolac   Toradol   1. Dyspepsia 2. GI symptoms (nausea, abdominal pain, constipation, diarrhea) 3. GI bleeding (rare but serious)   NSAIDS    
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Morphine   Duramorph, Infumorph   1. Constipation 2. Drowsiness 3. Nausea/ vomiting 4. Respiratory depression   Analgesic, Opioid   ISMP High-alert medication Use only preservative-free solutions for epidural administration  
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Ketamine   Ketalar   1. Prolonged emergence from anesthesia (confusion, delirium, dreamlike state, hallucinations, vivid imagery)   Antidepressant; General Anesthetic   ISMP High-alert medication  
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Lidocaine   Xylocaine   1. Dizziness 2. Nausea vomiting 3. Paresthesia 4. Hypotension   Antiarrhythmic Agent, Class Ib; Local Anesthetic   ISMP High-alert medication  
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Propofol   Diprivan   1. Apnea 2. Hypotension 3. Injection site pain 4. Hypertriglyceridemia   General Anesthetic   ISMP High-alert medication Expires 12 hours from opening. All tubing and unused portions should be discarded at that time.  
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Fosphenytoin   Cerebyx   1. Ataxia 2. Nystagmus 3. Somnolence   Antiseizure Agent, Hydantoin   Rate infusion:not faster than 150 mg PE/ minute  
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Levetiracetam   Keppra   1. Hypertension 2. Vomiting 3. Somnolence   Antiseizure Agent, Miscellaneous    
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Phenytoin   Dilantin   1. Exfoliate dermatitis 2. Stevens-Johnson syndrome 3. Blood dyscrasias 4. CNS toxicity   Antiseizure Agent, Hydantoin   Rate of infusion: do not infuse faster than 50 mg/minute  
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Valproate   Depacon   1. Thrombocytopenia 2. Tremor 3. Diplopia   Antimanic Agent; Antiseizure Agent, Miscellaneous; Histone Deacetylase Inhibitor    
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Haloperidol lactate   Haldol   1. Extrapyramidal reactions 2. Hyperkinesia 3. Akathisia   First Generation (Typical) Antipsychotic   Note salt formulation: haloperidol lactate can be administered IM or IV; haloperidol decanoate is a long-acting formulation and is only for IM injection - should never be given IV.  
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Olanzapine   Zyprexa   1. Drowsiness 2. Extrapyramidal symptoms   Antimanic Agent; Second Generation (Atypical) Antipsychotic    
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Ziprasidone   Geodon   1. Drowsiness 2. Extrapyramidal symptoms   Antimanic Agent; Second Generation (Atypical) Antipsychotic    
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Diazepam   Valium   1. Drowsiness 2. Slow breathing rate   Benzodiazepine    
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Lorazepam   Ativan   1. Drowsiness 2. Slow breathing rate   Benzodiazepine   ISMP High-alert medication  
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Midazolam   Versed   1. Drowsiness 2. Slow breathing rate 3. Decreased tidal volume   Benzodiazepine   ISMP High-alert medication Some formulations contain benzyl alcohol; use a preservative-free injection formulation in neonates  
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Acetylcysteine   Acetadote   1. Anaphylaxis   Antidote; Mucolytic Agent   Should be administered through an in-line filter  
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Atropine   Atropine   1. Anticholinergic side effects (dry mucous membranes, urinary retention) 2. Tachycardia   Anticholinergic Agent, Ophthalmic; Ophthalmic Agent, Mydriatic    
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Flumazenil   Romazicon   1. Vomiting 2. Tremor 3. Ataxia   Antidote   May precipitate seizures in patients who have been on long-term benzodiazepine therapy  
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Leucovorin     1. GI side effects (nausea/vomiting/diarrhea) 2. Fatigue   Antidote    
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Naloxone   Narcan   1. Dizziness 2. Flushing 3. Injection site reactions 4. Nausea/vomiting   Antidote; Opioid Antagonist   Because naloxone has a short half-life, it may need to be administered multiple times until opioid wears off  
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Octreotide   Sandostatin   1. Abdominal pain, diarrhea, flatulence, 2. Hyperglycemia   Antidiarrheal; Antidote; Somatostatin Analog    
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Zoledronic acid   Reclast; Zometa   1. Bone pain 2. Arthralgia 3. Hypotension   Bisphosphonate Derivative   Administer through a separate IV line. Do not mix with any calcium or divalent cation containing solutions.  
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Dexamethasone   Decadron   1. Fluid retention 2. Fragile skin 3. Hyperglycemia 4. Hypertension 5. Mood changes   Anti-inflammatory Agent; Antiemetic; Corticosteroid,    
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Hydrocortisone   Solu-Cortef   1. Fluid retention 2. Fragile skin 3. Hyperglycemia 4. Hypertension 5. Mood changes   Corticosteroid    
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Methylprednisolone sodium succinate   Solu-Medrol   1. Fluid retention 2. Fragile skin 3. Hyperglycemia 4. Hypertension 5. Mood changes   Corticosteroid    
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Diphenhydramine   Benadryl   1. Sedation 2. Anticholinergic effects (e.g., urinary retention, dry mouth)   Histamine H1 Antagonist, First Generation   Diphenhydramine injection can cause local skin necrosis and should never be given subcutaneous or intradermal. For IM injections, make sure they are given deep IM.  
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Promethazine   Phenergan   1. Bradycardia 2. Sedation 3. Phlebitis   Histamine H1 Antagonist, First Generation   ISMP High-alert medication Vesicant, can cause severe tissue damage/necrosis. Should not be administered IM or IV push. Should be diluted and administered slowly as an IV intermittent infusion or via a central line to avoid extravasation.  
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Ranitidine   Zantac   1. Constipation 2.Diarrhea 3. Nausea   Histamine H2 Antagonist    
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Ondansetron   Zofran   1. Constipation 2. Diarrhea 3. Headache   Selective 5-HT3 Receptor Antagonist    
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Pantoprazole   Protonix   1. Constipation 2. Diarrhea 3. Headache   PPI    
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Infliximab   Remicade   1. Infusion-related reactions (e.g., chills, fever, rigors, myalgias, headache, cough) 2. Upper respiratory tract infection   Immunosuppressant Agent, TNF-alpha   ISMP High-alert medication Short-stability medication - use within 3 h and use in-line ≤1.2 micron low protein binding filter. not infuse or mix with other solutions . May require premedications prior to infusion to decrease infusion-related reactions.  
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Rituximab   Rituxan   1. Infusion-related reactions (e.g., chills, fever, rigors, myalgias, headache, cough) 2. Fatigue   Immunosuppressant Agent; Monoclonal Antibody   ISMP High-alert medication Patients should be premedicated prior to infusion and infusions should be titrated upwards to decrease infusion-related reactions.  
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Oxytocin   Pitocin   1. Headache 2. Nausea, vomiting   Oxytocic Agent   ISMP High-alert medication NIOSH recommends using double gloves and wearing protective gown when preparing solutions. Many institutions develop an oxytocin infusion protocol in order to improve maternalfetal safety and reduce medication errors.  
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