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hf acquisition co llc, dba healthfirst - epinephrine (unii: ykh834o4bh) (epinephrine - unii:ykh834o4bh) - epinephrine epinephrine’s cardiac effects may be of use in the treatment and prophylaxis of cardiac arrest due to various causes in the absence of ventricular fibrillation and attacks of transitory atrioventricular (av) heart block with syncopal seizures (stokes-adams syndrome), but it is not used in cardiac failure or in hemorrhagic, traumatic or in cardiogenic shock. epinephrine may be used to stimulate the heart in syncope due to complete heart block or carotid sinus hypersensitivity. epinephrine is also used for resuscitation in cardiac arrest following anesthetic accidents. in cardiopulmonary resuscitation, intracardiac puncture and intramyocardial injection of epinephrine may be effective when external cardiac compression and attempts to restore the circulation by electrical defibillation or use of a pacemaker fail. epinephrine is seldom used as a vasopressor except in the treatment of anaphylactic shock and under certain conditions in insulin shock. epinephrine should not be used in the presence of car

United States - English - NLM (National Library of Medicine)

hf acquisition co llc, dba healthfirst - phenylephrine hydrochloride (unii: 04ja59tnsj) (phenylephrine - unii:1ws297w6mv) - phenylephrine hydrochloride is an alpha-1 adrenergic receptor agonist indicated for increasing blood pressure in adults with clinically important hypotension resulting primarily from vasodilation, in such settings as septic shock or anesthesia. the use of phenylephrine hydrochloride is contraindicated in patients with: hypersensitivity to it or any of its components 8.1 pregnancy pregnancy category c animal reproduction studies have not been conducted with intravenous phenylephrine. it is also not known whether phenylephrine can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. phenylephrine hydrochloride should be given to a pregnant woman only if clearly needed. 8.2 labor and delivery the most common maternal adverse reactions reported in studies of phenylephrine use during neuraxial anesthesia during cesarean delivery include nausea and vomiting, which are commonly associated with hypotension, bradycardia, reactive hypertension, and transient arrhythmias. phenylephrine does not appear to cause a decrease in placental perfusion sufficient to alter either the neonate apgar scores or blood-gas status. 8.3 nursing mothers it is not known whether this drug is excreted in human milk. 8.4 pediatric use safety and effectiveness in pediatric patients have not been established. 8.5 geriatric use clinical studies of phenylephrine did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. other reported clinical experience has not identified differences in responses between the elderly and younger patients. in general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. 8.6 hepatic impairment in patients with liver cirrhosis [child pugh class a (n=3), class b (n=5) and class c (n=1)], dose-response data indicate decreased responsiveness to phenylephrine. consider using larger doses than usual in hepatic impaired subjects. 8.7 renal impairment in patients with end stage renal disease (esrd) undergoing hemodialysis, dose-response data indicates increased responsiveness to phenylephrine. consider using lower doses of phenylephrine hydrochloride in esrd patients.

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hf acquisition co llc, dba healthfirst - naloxone hydrochloride (unii: f850569pqr) (naloxone - unii:36b82amq7n) - naloxone hydrochloride injection is indicated for the complete or partial reversal of opioid depression, including respiratory depression, induced by natural and synthetic opioids, including propoxyphene, methadone and certain mixed agonist-antagonist analgesics: nalbuphine, pentazocine, butorphanol and cyclazocine. naloxone hydrochloride is also indicated for diagnosis of suspected or known acute opioid overdosage. naloxone hydrochloride injection may be useful as an adjunctive agent to increase blood pressure in the management of septic shock (see clinical pharmacology; adjunctive use in septic shock). naloxone hydrochloride injection is contraindicated in patients known to be hypersensitive to naloxone hydrochloride or to any of the other ingredients in naloxone hydrochloride. naloxone hydrochloride is an opioid antagonist. physical dependence associated with the use of naloxone hydrochloride has not been reported. tolerance to the opioid antagonist effect of naloxone hydrochloride is not known to occur. instructions for use 1. hold the syringe by the glass barrel with the cap pointing up and unscrew the cap. do not touch the sterile syringe tip (luer-lock). 2. peel open the safety needle (surguard® 3 safety hypodermic needle) outer packaging. attach and screw the syringe to the needle using aseptic technique. grip the base of the needle, not the safety sheath, and turn the syringe clockwise. 3. move the safety sheath away from the needle and towards the syringe barrel to the angle shown, prior to removing the needle cap. pull shield straight off needle to avoid damaging the needle point. 4. gently tap the syringe to remove any visible bubbles and expel air from the syringe prior to administration. 5. post administration, use a one-handed technique to activate the safety mechanism to cover the needle using any one of the 3 methods illustrated below: (activation is verified by an audible and/or tactile “click” and can be visually confirmed.) 6. dispose used needles and materials following the policies and procedures of your facility as well as federal and local regulations for sharps disposal. distributor: dr. reddy's laboratories, inc. princeton, nj 08540 made in india issued: 0919

United States - English - NLM (National Library of Medicine)

hf acquisition co llc, dba healthfirst - dopamine hydrochloride (unii: 7l3e358n9l) (dopamine - unii:vtd58h1z2x) - dopamine hydrochloride, usp is indicated for the correction of hemodynamic imbalances present in the shock syndrome due to myocardial infarction, trauma, endotoxic septicemia, open-heart surgery, renal failure, and chronic cardiac decompensation as in congestive failure. patients most likely to respond adequately to dopamine hydrochloride, usp are those in whom physiological parameters, such as urine flow, myocardial function, and blood pressure, have not undergone profound deterioration. multiclinic trials indicate that the shorter the time interval between onset of signs and symptoms and initiation of therapy with blood volume correction and dopamine hydrochloride, usp, the better the prognosis. where appropriate, blood volume restoration with a suitable plasma expander or whole blood should be accomplished prior to administration of dopamine hydrochloride, usp. poor perfusion of vital organs – urine flow appears to be one of the better diagnostic signs by which adequacy of vital organ perfusion can be monitored. nevertheless, the physician should also observe the patient for signs of reversal of confusion or reversal of comatose condition. loss of pallor, increase in toe temperature, and/or adequacy of nail bed capillary filling may also be used as indices of adequate dosage. clinical studies have shown that when dopamine hydrochloride, usp is administered before urine flow has diminished to levels of approximately 0.3 ml/minute, prognosis is more favorable. nevertheless, in a number of oliguric or anuric patients, administration of dopamine hydrochloride, usp has resulted in an increase in urine flow, which in some cases reached normal levels. dopamine hydrochloride, usp may also increase urine flow in patients whose output is within normal limits and thus may be of value in reducing the degree of pre-existing fluid accumulation. it should be noted that at doses above those optimal for the individual patient, urine flow may decrease, necessitating reduction of dosage. low cardiac output – increased cardiac output is related to dopamine’s direct inotropic effect on the myocardium. increased cardiac output at low or moderate doses appears to be related to a favorable prognosis. increase in cardiac output has been associated with either static or decreased systemic vascular resistance (svr). static or decreased svr associated with low or moderate movements in cardiac output is believed to be a reflection of differential effects on specific vascular beds with increased resistance in peripheral beds (e.g., femoral) and concomitant decreases in mesenteric and renal vascular beds. redistribution of blood flow parallels these changes so that an increase in cardiac output is accompanied by an increase in mesenteric and renal blood flow. in many instances the renal fraction of the total cardiac output has been found to increase. increase in cardiac output produced by dopamine is not associated with substantial decreases in systemic vascular resistance as may occur with isoproterenol. hypotension – hypotension due to inadequate cardiac output can be managed by administration of low to moderate doses of dopamine hydrochloride, usp which have little effect on svr. at high therapeutic doses, dopamine’s alpha-adrenergic activity becomes more prominent and thus may correct hypotension due to diminished svr. as in the case of other circulatory decompensation states, prognosis is better in patients whose blood pressure and urine flow have not undergone profound deterioration. therefore, it is suggested that the physician administer dopamine hydrochloride, usp as soon as a definite trend toward decreased systolic and diastolic pressure becomes evident. dopamine hcl should not be used in patients with pheochromocytoma. dopamine hcl should not be administered to patients with uncorrected tachyarrhythmias or ventricular fibrillation.

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hf acquisition co llc, dba healthfirst - dextrose monohydrate (unii: lx22yl083g) (anhydrous dextrose - unii:5sl0g7r0ok) - 50% dextrose injection is indicated in the treatment of insulin hypoglycemia (hyperinsulinemia or insulin shock) to restore blood glucose levels. the solution is also indicated, after dilution, for intravenous infusion as a source of carbohydrate calories in patients whose oral intake is restricted or inadequate to maintain nutritional requirements. slow infusion of hypertonic solutions is essential to ensure proper utilization of dextrose and avoid production of hyperglycemia. a concentrated dextrose solution should not be used when intracranial or intraspinal hemorrhage is present, nor in the presence of delirium tremens if the patient is already dehydrated. dextrose injection without electrolytes should not be administered simultaneously with blood through the same infusion set because of the possibility that pseudoagglutination of red cells may occur.

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hf acquisition co llc, dba healthfirst - vecuronium bromide (unii: 7e4php5n1d) (vecuronium - unii:5438723848) - vecuronium bromide for injection is indicated as an adjunct to general anesthesia, to facilitate endotracheal intubation and to provide skeletal muscle relaxation during surgery or mechanical ventilation. vecuronium bromide is contraindicated in patients known to have a hypersensitivity to it.

United States - English - NLM (National Library of Medicine)

hf acquisition co llc, dba healthfirst - potassium nitrate (unii: ru45x2jn0z) (nitrate ion - unii:t93e9y2844), silver nitrate (unii: 95it3w8jze) (silver cation - unii:57n7b0k90a) - indications: for cauterization of skin or mucous membrane and for removing warts and granulated tissue. silver salts stain tissue black due to deposition of reduced silver. the stain gradually disappears within a period of two weeks. prolonged ingestion or absorption of silver compounds leads to deposition of silver in connective tissues, producing a slate-blue discoloration of the skin known as argyria. this discoloration may also appear on mucous membranes such as the margins of gums. the sclera of the eye is also stained.

United States - English - NLM (National Library of Medicine)

hf acquisition co llc, dba healthfirst - adenosine (unii: k72t3fs567) (adenosine - unii:k72t3fs567) - intravenous adenosine injection is indicated for the following: conversion to sinus rhythm of paroxysmal supraventricular tachycardia (psvt), including that associated with accessory bypass tracts (wolff-parkinson-white syndrome). when clinically advisable, appropriate vagal maneuvers (e.g., valsalva maneuver), should be attempted prior to adenosine administration. it is important to be sure the adenosine injection solution actually reaches the systemic circulation (see dosage and administration). adenosine injection does not convert atrial flutter, atrial fibrillation, or ventricular tachycardia to normal sinus rhythm. in the presence of atrial flutter or atrial fibrillation, a transient modest slowing of ventricular response may occur immediately following adenosine administration. intravenous adenosine injection is contraindicated in: 1. second- or third-degree a-v block (except in patients with a functioning artificial pacemaker). 2. sinus node disease, such as sick sinus syndrome or sym

United States - English - NLM (National Library of Medicine)

hf acquisition co llc, dba healthfirst - sodium bicarbonate (unii: 8mdf5v39qo) (bicarbonate ion - unii:hn1zra3q20, sodium cation - unii:lyr4m0nh37) - sodium bicarbonate injection, usp is indicated in the treatment of metabolic acidosis which may occur in severe renal disease, uncontrolled diabetes, circulatory insufficiency due to shock or severe dehydration, extracorporeal circulation of blood, cardiac arrest and severe primary lactic acidosis. sodium bicarbonate is further indicated in the treatment of certain drug intoxications, including barbiturates (where dissociation of the barbiturate-protein complex is desired), in poisoning by salicylates or methyl alcohol and in hemolytic reactions requiring alkalinization of the urine to diminish nephrotoxicity of blood pigments. sodium bicarbonate also is indicated in severe diarrhea which is often accompanied by a significant loss of bicarbonate. treatment of metabolic acidosis should, if possible, be superimposed on measures designed to control the basic cause of the acidosis ― e.g., insulin in uncomplicated diabetes, blood volume restoration in shock. but since an appreciable time interval may elapse before

United States - English - NLM (National Library of Medicine)

hf acquisition co llc, dba healthfirst - vasopressin, unspecified (unii: y87y826h08) (vasopressin, unspecified - unii:y87y826h08) - vasostrict® is indicated to increase blood pressure in adults with vasodilatory shock (e.g., post-cardiotomy or sepsis) who remain hypotensive despite fluids and catecholamines. vasostrict® is contraindicated in patients with known allergy or hypersensitivity to 8-l-arginine vasopressin or chlorobutanol. 8.1 pregnancy pregnancy category c risk summary: there are no adequate or well-controlled studies of vasostrict® in pregnant women. it is not known whether vasopressin can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. animal reproduction studies have not been conducted with vasopressin [see clinical pharmacology ( 12-12.3)]. clinical considerations: because of increased clearance of vasopressin in the second and third trimester, the dose of vasostrict® may need to be up-titrated to doses exceeding 0.1 units/minute in post-cardiotomy shock and 0.07 units/minute in septic shock. vasostrict® may produce tonic uterine contractions that could threaten the continuatio