VIII. DRUG STUDY (with patient teaching with label….

Anesthesia used)

Drug Name Indication Action Side Effect/ Adverse Effect Nursing Consideration
Date ordered: • Use for injection only • Synthetic, broad – • Hypersensitivity, N&V, • Do not confuse penicillamine with penicillin
August 5, 2010 for bacterial meningitis spectrum antibiotic suitable gastritis, stomatitis. Abdominal (an antibiotic)
due to Neisseria for gram – negative cramps thrush/yeast infection, • Give an empty stomach 1 hr before or 2 hr
Generic Name: meningitis , E. coli, bacteria. Acid resistant, sore mouth/tongue after meals; wait 1 hr after ingestion of any
Ampicillin listeria monocytogens destroy by penicillinase. • Hepatic – toxic hepatitis (rare) other food, milk, or drug.
Sodium and group B hepatic dysfunction • Take temperature nightly during the first few
streptococci. Addition of intrahepatic cholestitis. months of therapy. A fever may indicate a
Brand name: an aminoglycoside may • Hematologic – hemolytic hypersensitivity reaction. Report any evidence
Ampicilln enhance effectiveness anemia, agranulocytosis, of fever, sore throat, chills, skin rash, bruising,/
Sodium against gram – negative aplastic anemia bleeding; early S&S of granuloccytopenia.
bacteria • GI – altered taste perception, • Report cloudy urine or urine that is smoky
Classification: epigastric pain, reactivation of brown (signs of protenuria and hematuria)
Antibacterial • Use of the injection only peptic ulcer, gingivosomatitis
septicemia and • CNS – tinninus, myasthenia,
Dosage : endocarditis due to peripheral sensory and motor
500mg I.V q6 streptococcus species neuropathies
penicillin G susceptible • Miscellaneous –
staphylococci, thrombophelebitis,
enterococci, E. coli, P. hyperpyrexia, polymyositis
mirabilis and
salmonella. Addition of
an aminoglycoside may
enhance effectiveness
when treating
streptococcal
endocarditis.
 Drug Name Indication Action Side Effect/ Adverse Effect Nursing Consideration

Date ordered: • Short term uses (5 Tramadol is centrally – acting • Constipation, • Do not exceed the recommended dose.
August 5, 2010 days or less) for synthetic opioid analgesic. Its somnolence, increased • Tramadol may cause psychological and physical
management of mechanism is not completely sweating, nausea, diarrhea, dependence of the morphine – type. Withdrawal
Generic Name: acute pain. Note : known but both tramadol and its anorexia, dizziness, dry symptoms may occur if ultracet is discountinued
Tramadol onset of analgesia is active metabolite bind opioid mouth, insomia, pruritus, abruptly
less than 1 hr and receptors and they are weak prostatic disorder. • Store from 15 – 30’C
Brand name: faster than tramadol inhibitors of norepinephrine and • Hypersensitivity –
Ultracet alone serotonin re uptake. Tramadol is anaphylactoid,
only partially antagonized by bronchospasm, angioedema,
Classification: naloxone. Acetaminophen may toxic epidermal necrolysis.
Narcotic/non narcotic cause analgesia by inhibiting
analgesic combination CNS prostaglandin synthesis,
drug although it has no anti –
inflammatory activity.
Dosage :
50 mg I.V q6
GENERIC BRAND DOSAGE INDICATION MECHANISM CONTRAINDIC ADVERSE NURSING
NAME NAME OF ATION EFFECT RESPONSIBILITIES
ACTION
GENERIC
Ketorolac BRAND DOSAGE
Toradol 30mg/amp1 INDICATION
Short term MECHANISM
- Inhibits CONTRAINDICAT
- Hypersensitivity ADVERSE
- CNS: - Patients who haveNURSING
asthma, aspirin-induced
NAME NAME amp IM management of OF
prostaglandin ION
- Cross-sensitivity EFFECT
1)drowsiness allergy, and nasal RESPONSIBILITIES
polyps are at increased risk for
Date pain (not to ACTION
synthesis, with other 2) abnormal thinking developing hypersensitivity reactions. Assess for
Celebrex
ordered: Celecoxib ADULTS exceed •Acute and
5 days Analgesic and •Contraindicated
producing NSAIDs may with •CNS: Headache, dizziness,
3) dizziness •Administer drug with
rhinitis, asthma, andfood or after meals
urticaria.
Initially, 100 totallong-term
for all anti-
peripherally allergies
exist¨Pre- or to somnolence,
4) euphoria insomnia, - Assess pain (noteiftype, GI upset occurs.
location, and intensity)
Drug 6,
August mg PO bid; treatment
routes of inflammatory perioperative
mediated sulfonamides,
use fatigue, tiredness, dizziness,prior• to
5) headache- Establish
and 1-2 safety measures
hr following if CNS, visual
administration.
classes:
2010 may increase combined)
signs and activities
analgesia celecoxib,
- Known NSAIDs,
alcohol tinnitus,
- RESP: ophthamologic - Ketorolac therapy disturbances occur. be given
should always
NSAID to 200 mg/day symptoms of related
- Also has to or aspirin;
intoleranceUse 1) asthmaeffects • Arrange
initially by the IMfororperiodic
IV route. ophthalmologic
Oral therapy
Analgesic PO bid as rheumatoid antipyretic
inhibitionand of the cautiously
significant
in: renal •Dermatologic:Rash,
2) dyspnea pruritus, should examination during
be used only as along-term therapy.
continuation of
(nonopioid) needed. arthritis and COX-2
anti- impairment;
1) History of GI sweating,
- CV: dry mucous • If overdose occurs, institute
parenteral therapy. emergency
Specific •Acute pain, osteoarthritis inflammatory
enzyme, pregnancy;
bleeding lactation. membranes,
1) edema stomatitis - Caution procedures—gastric
patient to avoidlavage, induction
concurrent use ofof
COX-2 dysmenorrhea: • Reduction of properties. which is 2)• Renal
Use cautiously
impair- with •GI:2) Nausea,
pallor abdominal alcohol, aspirin, emesis, supportive
NSAIDs, therapy. or
acetaminophen,
enzyme 400 mg, then the number of - Therapeutic
activated in impaired
ment hearing,
(dosage pain,dyspepsia,
3)vasodilationflatulence,other GI OTC • Provide further
medications comfort
without measureshealth
consulting to
blocker 200 mg PO colorectal effect:Decreased
inflammation to reduction hepatic
may and
be - GI: bleed reduce pain (eg positioning,
care professional.
bid. polyps in cause
painthe signs cardiovascular
required) •Hematologic:
1) GI BleedingNeutropenia, environmental
- Advise patient to consult if rash, itching, visual
Date •FAP: 400 mg familial and symptoms 3) Cardiovascular
conditions. 2)eosinophilia,
abnormal taste leukopenia,disturbances,
control), and toweight
tinnitus, reducegain,
inflammation (eg
edema, black
ordered: PO bid adenomatous associated with disease pancytopenia,
3) diarrhea warmth, positioning, rest).
stools, persistent headche, or influenza-like
polyposis inflammation; 4) thrombocytopenia,
dry mouth syndromes (chills,fever,muscles aches, pain)
August 6, (FAP) does not affect agranulocytosis,
5) dyspepsia occur.
2010 • Management the COX-1 granulocytopenia,
6) GI pain aplastic- Effectiveness of therapy can be demonstrated
of acute pain enzyme, which 7)anemia,
nausea decreased by decrease in severity of pain. Patients who do
• Treatment of protects the hemoglobin
- GU: or hematocrit, not respond to one NSAIDs may respond to
primary lining of the GI bone marrow depression,
1) oliguria another.
dysmenorrhea tract and has 2) renalmenorrhagia
toxicity
blood clotting •Other: frequency
3) urinary Peripheral edema,
and renal anaphylactoid
- DERM: reactions to
functions. 1)anaphylactic
pruritis shock
2) purpura
3) sweating
4) urticaria
- HEMAT:
1) prolonged bleeding time
- LOCAL:
1) injection site pain
- NEURO:
1) paresthesia
- MISC:
1) allergic reaction,
anaphylaxis