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Drug Name Generic Name: Tramadol Brand name: Ultram

Classification Analgesic (centrally acting)

Dosage 50 mg IV q 6 hours PRN Epidural solution

Mechanism of Action Binds to opiate receptors in the CNS causing inhibition of ascending pain pathways, altering the perception of and response to pain; also inhibits the reuptake of norepinephrine and serotonin, which also modifies the ascending pain pathway.

Indication/ Contraindication Indication: Management of pain in the operation site.

Side Effects

Nursing Responsibilities
Assess type, location, and intensity of pain before and 2-3 hr (peak) after administratio n. Assess BP & RR before and periodically during administratio n. Assess bowel function routinely. Assess previous analgesic history. Prolonged use may lead to physical and psychologic al dependenc

Contraindication: Hypersensitivity to tramadol, -

opioids, or any component of the formulation; opioiddependent patients; acute intoxication with alcohol, hypnotics, centrally-acting analgesics, opioids, or psychotropic drugs

Dizziness Nausea Drowsiness Dry mouth Constipation Headache Sweating Vomiting Vertigo -

e and tolerance, although these may be milder than with opioids. Monitor patient for seizures. May occur within recommend ed dose range. Overdose may cause respiratory depression and seizures. Maintain adequate respiratory exchange.


Drug Name Generic Name: Cefuroxime Brand name: Ceftin

Classification Anti-infectives

Dosage 250 mg BID

Mechanism of Action Bind to bacterial cell wall membrane, causing cell death Therapeutic Effects: Bactericidal action

Indication/ Contraindication Indication: Treatment of It is effective for the treatment of penicillinaseproducingNeisseria gonorrhoea(PPNG). Effectively treats bone and joint infections, bronchitis, meningitis, gonorrhea, otitis media, pharyngitis/tonsilliti s, sinusitis, lower respiratory tract infections, skin and soft tissue infections, urinary tract infections, and is used for surgical prophylaxis, reducing or eliminating infection.

Side Effects GI: Diarrhea, nausea, antibioticassociated colitis. Skin: Ra sh , pruritus, urticaria. Urogenital: Increased serum creatinine and BUN, decreased creatinine clearance. Hemat: Hemolytic anemia MISC: Anaphylaxis

Nursing Responsibilities Before:

Determine history of hypersensitivity reacti ons to cephalosporins, penicillins, and history of allergies, particularly to drugs, before therapy is initiated.

Lab tests: Perform culture and sensitivity tests before initiation of therapy and periodically during therapy if indicated. Therapy may be instituted pending test results. Monitor periodically BUN and creatinine clearance.

DRUG STUDY Contraindication: Hypersensitivity to cephalosporins and related antibiotics; pregnancy (category B), lactation.


Inspect IM and IV injection sites frequently for signs of phlebitis.

Monitor for manifestations of hypersensitivity (see Appendix F). Discontinue drug and report their appearance promptly.

Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes.

Report onset of loose stools or diarrhea. Although

DRUG STUDY pseudomembranous colitis (see Signs & Symptoms, Appendix F) rarely occurs, this potentially lifethreatening complication should be ruled out as the cause of diarrhea during and after antibiotic therapy. After: Instruct patient to take medication around the clock at evenly spaced times and to finish the medication completely, even if feeling better Advise patient to report signs of superinfection and allergy Instruct patient to notify health professional if fever and diarrhea develop


Drug Name Generic Name: Mefenamic Acid Brand name: Ponstan

Classification Analgesic,nonsteroidal antiinflammatory and antirheumatic


Mechanism of Action Anthranilic acid derivative. Like ibuprofen inhibits prostaglandin synthesis and affects platelet function. No evidence that it is superior to aspirin.

Indication/ Contraindication Indication: For relief of mild to moderate pain.

Side Effects

>CNS: Drowsiness, insomia, dizziness, nervousness, confusion, headache. Contraindication: >GI: Severe diarrhea, ulceration, and Hypersensitivity to bleeding; nausea, drug; GI vomiting, abdominal inflammation, or ulceration. Safety in cramps, flatus, constipation, hepatic children<1/t y, toxicity. during pregnancy(category >Hematologic: prolonged C), or lactation is prothrombin time, not established severe autoimmune hemolytic anemia(long-term use), leukopenia, eosinophilia, agranulocytosis, thrombocytopenic porpura, megaloblastic anemia, pancytopenia, bone marrow hypoplasia. >Urogenital: Nephrotoxicity,

Nursing Responsibilities >Assess patients who develop severe diarrhea and vomiting for dehydration and electrolyte imbalance. >Lab test: with long-term therapy (not recommended) obtain periodic complete blood counts, Hct and Hgb, and kidney function test. >Discontinue drug promptly if diarrhea, dark stools, hematemesis, ecchymoses, epistaxis, or rash occur and do not use again. Contact physician.

DRUG STUDY dysuria, albuminuria, hematuria, elavation of BUN. >Skin: Urticaria, rash, facial edema. >Special Senses: Eye irritation, loss of color vision(reversible), blurred vision, ear pain> >Body as a Whole: Perspiration. >CV: Palpitation. >Respiratory: Dyspnea; acute exacerbation of asthma, bronchoconstriction(in patients sensitive to aspirin). >Notify physician if persistent GI discomfort, sore throat, fever, or malaise occur. >Do not drive or engage in potentially hazardous activities until response to drug is known. It may cause dizziness and drowsiness. >Monitor blood glucose for loss of glycemic control if diabetic.