69 Medications Every New ER Nurse Must Master!

[Michael M. Heuninckx]

Are you a brand new nurse that just obtained the first job in the Emergency Room? Or an experienced nurse that has decided to master a new specialty? Well, whichever boat you might be in, here is a head start for you. Below is a list of medications that I promise you will be using time and time again while working in the Emergency Room. This looks like it might be an extensive list, but as time goes on, you will know the entire list inside and out.

In alphabetical order and not limited to. . .

1. Acetaminophen
2. Albuterol
3. All of your fluids NS 0.9, Dextrose 5% NS 0.9, Lactated Ringers. . .
4. Alteplase
5. Amiodarone (Push and Infusion)
6. Aspirin
7. Ativan
8. Atropine
9. Atrovent
10. Azithromycin
11. Bacitracin
12. Cardiac Arrest Medications (See your ACLS Textbook)
13. Cardizem (Push and Infusion)
14. Catapres
15. Cefepime
16. Ciprodex (Otic Drops)
17. Ciprofloxacin
18. D50 Push
19. Decadron
20. Dilaudid
21. Diphenhydramine
22. Dobutamine
23. Dopamine
24. Epinephrine (Push and Infusion)
25. Esmolol
26. Etomidate
27. Fentanyl
28. Flagyl
29. Fluorescein Strips
30. GI cocktail: Maalox, Donnatal & Lidocaine (PO Mixture)
31. Haldol
32. Heparin
33. Ibuprofen
34. Insulin
35. Kayexalate
36. Ketamine
37. Ketorolac
38. Labetalol
39. Levophed
40. Lidocaine (Injection, IV Push & Infusion)
41. Magnesium
42. Mannitol
43. Metoprolol
44. Morphine
45. Narcan
46. Neosynephrine, (nasal spray & IV Infusion)
47. Nitroglycerine (Pills, Paste & IV Infusion)
48. Ondansetron
49. Pepcid
50. Phenergan
51. Plavix
52. Prednisone
53. Propofol
54. Protamine Sulfate
55. Protonix
56. Rocephin
57. Rocuronium
58. 56. Romazicon
59. Silvadene Cream
60. Silver Nitrate sticks
61. Sodium Bicarbonate (Push and Infusion)
62. Solumedrol
63. Succinylcholine
64. Tetracaine (Ophthalmic Drops)
65. Tylenol
66. Unasyn
67. Vancomycin
68. Verapamil
69. Versed

Some of the medications are listed as the brand name and some of the medications are listed as the generic name. It is imperative that you are comfortable with both. Yes, I did do this on purpose, to not include both within this article. I am a teacher at heart, and I could not write this article without some homework involved!

Also, know what your hospital's policy is for the administration of all of the medications listed above. What might be normal practice at one facility, could get you a write up at another. Along with that, as always, never forget the medication administrations safety rules we all were taught in nursing school.

Oh yeah, and how could I forget the life-saving enemas! Saline and Mineral Oil.

Lastly, I will leave you with another tip for all new Emergency Room Nurses. Go through all of the body systems and learn what the emergencies are for those systems. Master those and you will feel comfort in knowing that when you are drowning, you have ruled out all of the time-sensitive emergencies for your patients. Once this has occurred, go down that list again and prioritize your patients from there. The Emergency Room is a no joke place to work, very fast paced and stressful. Mastering this list will help take away some of the stress and improve your overall flow. Give the department some time though, when it gets difficult don't quit. It can be very overwhelming at first, but I promise it will get better.

Extra Medication Safety Tip

Set your medication pumps up for success, not failure. When programming your pump to administer a high alert medication, set the rate to match the volume to be infused. This will prevent the entire bag/bottle of medication being accidentally administered to the patient due to your programming error. If this safety measure is not in place, it could lead to a catastrophic and life-threatening event for your patient. Imagine if an entire bag of Cardizem was administered, or the whole bag of Insulin or the whole bottle of Nitroglycerin?! Yikes! It only takes an extra second and when the hour is up: go back to set the pump again, reassess your patient, ensure that they are improving and not getting any worse, and continue on with the rest of your patients that need your services.

[MD married to RN]

I would add Zosyn and hope droperidol makes a comeback.

[Liisa444 BSc]

suga_junkie said:

I've always been surprised at how US nurses usually refer to drugs by their brand names. I'm often stumped by meds they're talking about until I Google them and find out the generic name. I'd bet you'd know almost all those drugs if the generic name was used!

Here in Australia we almost always use generic names to avoid confusion. Some common drugs have 3+ different brand names!

Yes, I agree. I am in Canada and in my nursing school we learn the generic names.

[Liisa444 BSc]

MunoRN said:

Kayexalate has been removed from commonly referenced hyperkalemia treatment recommendations. There's no evidence it works as intended, the only thing it's been proven to do is cause bowel necrosis.

For excretion of excess potassium in a patient with adequate kidney function, a potassium wasting diuretic is recommended with fluid replacement as needed. For intracellular sequestration of excess potassium, insulin with glucose as needed is recommended as well as inhaled beta agonists (ie albuterol) is recommended.

This is good to know! Maybe that is why I did not hear about it when I was learning pharm in nursing school. 

[offlabel]

zmansc said:

I am curious to poll the ED nurses here on use of romazicon at their facility. I have never seen it used at my facility. Every provider I talk to feels the potential side effects out weigh the potential benefit. Is it used at your facility? How frequently? What is the criteria where the docs decide it is worth the potential side effects? How often does it induce seizures?

It's on the ER formulary primarily to reverse procedural sedation with Versed (that's midazolam for anyone unfamiliar with brands) if necessary. Use in an overdose would be pretty rare.