DRUG PHARMACOLOGIC DOSE NAME ACTION Tramadol Binds to mu-opiod 50mg/ tab hydrochloride receptors and inhibits the

reuptake of norepinephrine and serotonin; causes many effects similar to the opiods but does not have the respiratory depressant effects

INDICATION Relief of moderate to severe chronic pain in adults who need around-theclock treatment for extended periods (ER tablets) Unlabeled uses: premature ejaculation: restless leg syndrome

ADVERSE EFFECT Sedation, dizziness, headache, confusion dreaming, sweating, anxiety, seizures, hypotension, bradycardia. Tachycardia, pruritis, rash, pallor, constipation, flatulence, dry mouth, nausea and vomiting

NURSING RESPONSIBILITY Hypersensitivity to tramadol; acute intoxication with alcohol, opioids, psychotropic drugs or other centrally acting analgesics; seizures; concomitant use of CNS depressants or MAOIs; renal or hepatic impairment; past or present history of opioid addiction Skin color, texture, lesions; orientation, reflexes, bilateral grip strength, affect; P, auscultation, BP; bowel sounds, normal output; liver and kidney function tests

Control environment (temperature, lighting) if sweating or CNS effects occur. Report severe nausea, dizziness severe constipation Assess for the allergy to folic acid preparations Assess for skin lesions, color: R, adventitious sounds: CBC, Hgb, Hct, serum folate Administer orally if at all possible Test for Schiling test and serum vitamin b12 levels to rule out pernicious anemia. Report rash. DOB,

Folic Acid

Required nucleoprotein synthesis maintenance normal erythropoeisis

for 5mg/tab and of

Treatment for Allergic megaloblastic reactions anemias due to sprue, nutritional deficiency, pregnancy, infancy, and childhood

Levotyroxine sodium

Increases the 2 tabs metabolic rate of body tisues, thereby increasing oxygen consumption; respitration and GR

Replacement Tremors, therapy in headache, hypothyroidism nervousness, insomnia, Pituitary TSH Palpitations, suppression in tachycardia, the treatment angina, and prevention Allergic skin of euthyroid reactions, goiters and in partial loss of the hair, management of Diarrhea, thyroid cancer nausea, vomiting, Treatment of gagging, myxedema choking coma

pain or discomfort at injection site Do not use for weight loss Use caution with patient with CV disease Administer oral drug as a single daily dose before breakfast with a full glass of water For children and other patients who cannot swallow tablets, crush and suspend in a small amount of water or formula, or sprinkle soft food. Administer immediately. Report headache, chest pain palpitations, fever, weight loss, sleeplessness, nervousness, irritability, unusual

Prednisone

Enters target cells 1mg/tab and binds to intracellular corticosteroid receptors, initiating many complex reactions that are responsible for its anti-inflammatory and immunosuppressive response.

sweating, intolerance to heat, diarrhea. Endocrine Vertigo, Administer once a Disorders: headache, day doses before paresthesias, 9 am to mimic Primary or seizures, normal peak secondary increased IOP, corticosteroid adrenocortical hypotension, blood levels insufficiency shock, sodium and fluid Increase dosage if Congenital retention, patient is subject adrenal vomiting, to stress hyperplasia muscle Nonsuppurative weakness, Instruct patient not thyroiditis to stop taking drug without asking the Hypercalcemia doctor associated with cancer Instruct patient to avoid infection Rheumatic Disorders: Rheumatoid arthritis, including juvenile rheumatoid arthritis Ankylosing Report unusual weight gain, muscle weakness, fever

spondylitis Acute and subacute bursitis Acute nonspecific tenosynovitis Acute arthritis gouty

Post-traumatic osteoarthritis Synovitis of osteoarthritis Epicondylitis

Collagen Diseases: Systemic lupus erythematosus Systemic dermatomyositis (polymyositis) Acute rheumatic carditis

Zinc Gluconate

Zinc gluconate is 1tab OD essentially zinc molecules combined with sugar for rapid and efficient absorption of zinc into the human bloodstream. It is the most common form of zinc when used as a dietary supplement

Multivitamins Syrup

Dietary supplement 5mL OD for treatment of vitamin and mineral deficiency. Vitamins are necessary for normal growth and development

Preventing and treating blood levels of zinc that are too low (zinc deficiency). Zinc deficiency may occur in severe diarrhea, conditions that make it hard for the bowel to absorb food, liver cirrhosis and alcoholism, after major surgery, and during long-term use of tube feeding in the hospital Indicated to patients with vitamin and mineral deficiencies

Fever, coughing, stomach pain, fatigue, diarrhea, metallic taste

Teach patient and family about the adverse effects Teach patients to avoid taking this medication with foods high in calcium and phosphorus.

Urine discoloration, allergic reactions to preservatives, additives

Teach about this medication to patients Ask patients for sensitivity to preservatives, aditives