Hydroxyzine (iterax) Drug class: Anxiolytic/Antihistamine/Antiallergy.

Specific Actions: Pharmacology: Iterax is unrelated chemically to the phenothiazines, reserpine, meprobamate or the benzodiazepines. It is not a cortical depressant, but its action may be due to a suppression of activity in certain key regions of the subcortical area of the central nervous system. Primary skeletal muscle relaxation has been demonstrated experimentally. Bronchodilator activity and antihistaminic and analgesic effects have been demonstrated experimentally and confirmed clinically. An antiemetic effect, both by the apomorphine test and the viriloid test, has been demonstrated. Pharmacological and clinical studies indicate that hydroxyzine in therapeutic dosage does not increase gastric secretion or acidity and in most cases has mild antisecretory activity. Iterax has proven to be of value in relieving temporary anxiety eg, stress of dental and other minor surgical procedures, acute emotional problems and the management of anxiety associated with stomach and digestive disorders, skin problems. The antipruritic activity of Iterax has been thoroughly researched in the USA and results have been corroborated by a comprehensive world literature.

Indications: Symptomatic treatment of anxiety. Generalized anxiety disorder (GAD). As

premedication to general anesthesia. Symptomatic treatment of pruritus of allergic origin. The effectiveness of hydroxyzine as an antianxiety agent for long-term use, that is >4 months, has not been assessed by systematic clinical studies. The physician should reassess periodically the usefulness of the drug for the individual patient. Effective in pruritus accompanying various dermatological conditions: Atopic eczema, contact dermatitis, chronic urticaria, eczematous dermatitis, neurodermatitis, nummular dermatitis, miscellaneous dermatoses. Also effective in an extremely varied number of pruriginous conditions from rare forms of urticaria to acantholytic dermatosis, myxedematous lichen, insect bites and various parasitoses. Iterax overcomes iatrogenic allergic reactions whether reactions to aminophylline, allopurinol, influenza vaccines or other drugs.

Contraindications: Patients who have shown a previous hypersensitivity to hydroxyzine. Intermittent acute porphyria.

Dosages: Adults: Symptomatic Treatment of Anxiety: 50-100 mg/day (two to four 25-mg tabs

a day at night before sleep if anxiety is reflected in insomnia). Premedication to General Anesthesia: 100-200 mg/day the night before surgery, just before going to sleep. Symptomatic Treatment of Pruritus of Allergic Origin: 30-100 mg/day (from three 10-mg tabs to four 25-mg tabs a day). Children from 30 months to 15 years: The dose is calculated on the basis of body weight, at the rate of 1 mg/kg/day. The syrup dosage form will be preferred: 1 tsp=10 mg.

Side effects: Side effects reported with the administration of Iterax are usually mild and transitory

in nature. Anticholinergic Effects: Dry mouth. Central Nervous System Effects: Drowsiness is usually transitory and may disappear in a few days of continued therapy or upon reduction of the dose. Involuntary motor activity including rare instances of tremor and convulsions have been reported, usually with doses considerably higher than those recommended.
Nursing responsibilities:

tramadol
Brand Name:
y y y y y y y y y y

Amaryll Clomadol Dolmal Dolotral Dolpaz Doltrahex Gesidol Indol Mardol Milador

CLASSIFICATIONS Therapeutic: Analgesics (centrally acting)

ACTIONS Physiologic Mechanism Decreased pain. Pharmacologic Mechanism Binds to mu-opioid receptors. Inhibits reuptake of serotonin and norepinephrine in the CNS. INDICATION Moderate to moderately severe pain NURSING CONSIDERATIONS Assess type, location, and intensity of pain before and 2-3 hr (peak) after administration. Assess BP & RR before and periodically during administration. Respiratory depression has not occurred with recommended doses. Assess bowel function routinely. Prevention of constipation should be instituted with increased intake of fluids and bulk and with laxatives to minimize constipating effects.

 Assess previous analgesic history. Tramadol is not recommended for patients dependent on opioids or who have previously received opioids for more than 1 wk; may cause opioid withdrawal symptoms. Prolonged use may lead to physical and psychological dependence and tolerance, although these may be milder than with opioids. This should not prevent patient from receiving adequate analgesia. Most patients who receive tramadol for pain d not develop psychological dependence. If tolerance develops, changing to an opioid agonist may be required to relieve pain. Tramadol is considered to provide more analgesia than codeine 60 mg but less than combined aspirin 650mg/codeine 60 mg for acute postoperative pain. Monitor patient for seizures. May occur within recommended dose range. Risk increased with higher doses and inpatients taking antidepressants (SSRIs, tricyclics, or Mao inhibitors), opioid analgesics, or other durgs that decrese the seizure threshold. Overdose may cause respiratory depression and seizures. Naloxone (Narcan) may reverse some, but not all, of the symptoms of overdose. Treatment should be symptomatic and supportive. Maintain adequate respiratory exchange. Encourage patient to cough and breathe deeply every 2 hr to prevent atelactasis and pneumonia.

256=Rocephin X=Lexotan (bromacepam) X=Hidrasec X=simulect 602=Iterax X=Dolcet (tramadol) 71=paracetamol 784=Metronidazole Relestal Salinase Fluimidal