DRUG STUDY

Patient : Palao, Apple Diagnosis: open cholecystectomy Generic Dosage and Action Name Frequency (Brand Name) Dosage: Generic Bactericidal: name: IM Inhibits Cefoxitin IV(Adults)1synthesis 2g (6-8 of bacterial cell Brand hr)(Infants)8 wall, causing name: 0-160 cell death. Mefoxin mg/kg/dayIM &IV divide doses q 4-6 hr. Do not exceed12g/d ay Prescribed 1g, TIV,1 hour prior to OR and Q6 was given to the client. Age: 19 Admission date: January 24, 2014 Classifica Indication Contraindicatio tion n

Adverse reaction

Nursing Responsibilities

Antibiotic

Perioperative prophylaxis, intra- abdominal infections

Contraindicated with allergy to cephalosporins or penicillins. Use cautiously with renal failure, lactation, pregna ncy

CNS: headache, dizziness, lethargy, parasthe sis GI : Nausea, vomitting, diarrhea, anorexia, abdominal pain, flatulence GU : Nephrotoxicity HEMATOLOGIC : Bone marrows, depressions, decreased WBC, decreased platelets, deacreased Hct. LOCAL : Pain, abscess at injections site, inflammation at IV site

Inform patient to Avoid alcohol while taking this drug and for 3days after because severe reactions often occur. You may experience these side effects: stomach upset, diarrhea. Report severe diarrhea, difficulty breathing, unusual tiredness or fatigue, pain at injection site Inform the patient that he/she has the right to refuse therapy provided that she sign a waiver Evaluate patient response to therapy/ medication Document date, time, of admission Assess for sensitivity test of the patient to drug

Generic Name: Ketorolac Brand name: Toradol

30mg, IM/IV, to a maximum of 120mg/day Prescribed: Dosage: 30mg Frequency: Q6 Route: IVT

Inhibits prostaglandin synthesis by decreasing the activity of the enzyme, cyclooxygenase , which results in decreased formation of prostaglandin precursors, chemicals that cells of the immune system make that cause the redness, fever, and pain of inflammation and that also are believed to be important in the production of noninflammator y pain.

Nonsteroi dal Antiinflammat ory Drugs (NSAIDs) Non opiod analgesics

Short term management of pain ( up o 5 days)

Hypersensitivity to ketorolac, aspirin, other NSAIDs, or any component of the formulation; patients who have developed nasal polyps, angioedema, or bronchospastic reactions to other NSAIDs; active or history of peptic ulcer disease; recent or history of GI bleeding or perforation; patients with advanced renal disease or risk of renal failure; labor and delivery; nursing mothers; prophylaxis before major surgery.

Rash Ringing in the ears Headaches Dizziness Drowsiness Abdominal Pain Nausea Diarrhea Constipation Heartburn Fluid Retention

Assess for rhinitis, asthma, and urticaria. Assess pain (note type, location, and intensity) prior to and 1-2 hr following administration. Ketorolac therapy should always be given initially by the IM or IV route. Inform patient to avoid concurrent use of alcohol, aspirin, NSAIDs, acetaminophen, or other OTC medications without consulting health care professional. Advise patient to consult if rash, itching, visual disturbances, tinnitus, weight gain, edema, black stools, persistent headche, or influenza-like syndromes (chills,fever,muscles aches, pain) occur. Effectiveness of therapy can be demonstrated by decrease in severity of pain. Patients who do not respond to one NSAIDs may respond to another. Inform the patient that she has the right to refuse therapy/ medication provided that she sign the waiver Evaluate patient response to medicine after 30 minutes. Document date and time of time of admission