Pre-op medications

Generic name
Cefazolin

Brand
Name
Ancef

Classification
Therapeutic: Antiinefectives

1g/IVTT/OD
Pharmacologic: First
generation
cephalosphorins

Ranitidine
50mg IVTT

Zanta
c

Therapeutic:
Anti-ulcer agents
Pharmacologic:

Mechanism of
action
Bind to bacterial
cell wall
membrane,
causing cell death.
Active against
many grampositive cocci
including:
Streptococcus
pneumoniae,
Group A betahemolytic
streptococci;
Penicillinasproducing
staphylococci.

Inhibits the
action of
histamine at the
H2 receptor site

Indication

Skin & skin structure

infections; bone & joint
infections

Treatment and
prevention of heartburn,
acid indigestion, and
sour stomach.

Adverse effects
CNS:
Seizures (high doses)
GI:
Pseudomembranous colitis,
diarrhea, nausea, vomiting,
cramps
GU:
Interstitial nephritis
DERM:
Rashes, urticaria
HEMAT:
Blood dyscrasias, hemolytic
anemia
LOCAL:
Pain at IM site, phlebitis at IV
site
MISC:
Allergic reactions including
Anaphylaxis and Serum
sickness, superinfection

CNS:
Confusion, dizziness,
drowsiness, hallucinations,
headache

Nursing consideration
Assess patient for infection (vital
signs; appearance of surgical site,
urine; WBC) at beginning and during
therapy.
Before initiating therapy, obtain a
history to determine previous use of
and reactions to penicillins or
cephalosphorins. Persons with a
negative history of penicillin
sensitivity may still have an allergic
response.
Obtain specimens for culture and
sensitivity before initiating therapy.
Observe patient for signs and
symptoms of anaphylaxis (rash,
pruritis, laryngeal edema, wheezing).
Discontinue drug and notify physician
or other health care professional
immediately if these problems occur.
Keep epinephrine, an antihistamine,
and resuscitation equipment close by in
case of anaphylactic reaction.
Assess patient for epigastric or
abdominal pain and frank or occult
blood in the stool, emesis, or gastric
aspirate.

Metoclopromide

Clopr
a

Histamine H2
antagonists

located primarily
in gastric parietal
cells, resulting in
inhibition of
gastric acid
secretion.
In addition,
ranitidine bismuth
citrate has some
antibacterial
action against H.
pylori.

Therapeutic:
Antiemetic

Potent central
dopamine receptor
antagonist.
Structurally
related to
procainamide but
has little

10mg IVTT
Pharmacologic:
direct-acting
cholinergic
(parasympathomimetic

CV:
Arrhythmias
GI:
Altered taste, black tongue,
constipation, dark stools,
diarrhea, drug-induced hepatitis,
nausea
GU:
Decreased sperm count,
impotence
ENDO:
Gynecomastia
HEMAT:
Agranulocytosis, Aplastic
Anemia, neutropenia,
thrombocytopenia
LOCAL:
Pain at IM site
MISC:
Hypersensitivity reactions,
vasculitis
To facilitate intubation of
small bowel;
symptomatic treatment
of gastroesophageal
reflux.

CNS: restlessness,
drowsiness,
fatigue,insomia,
dizziness,anxiety
CV: tansient hypertension
GI: nausea and diarrhea

Nurse should know that it may cause

false-positive results for urine protein;
test with sulfosalicylic acid.
Inform patient that it may cause
drowsiness or dizziness.
Inform patient that increased fluid
and fiber intake may minimize
constipation.

Be aware that during early

treatment period, serum
aldosterone may be elevated;
after prolonged administration
periods, it returns to
pretreatment level.
Lab tests: Periodic serum

Midazolam
15mg tab

Therapeutic:
Anti-anxiety agents,
sedative/hypnotics
Pharmacologic:
benzodiazepines

antiarrhythmic or
anesthetic activity.
Exact mechanism
of action not clear
but appears to
sensitize GI
smooth muscle to
effects of
acetylcholine by
direct action.
Physiologic
Mechanism
Short-term
sedation
Postoperative
amnesia
Pharmacologic
Mechanism
Acts at many
levels of the CNS
to produce
generalized CNS
depression.
Effects may be
mediated by
GABA, an
inhibitory
neurotransmitter.

Preprocedural sedation.
Aids in the induction of
anesthesia and as part of
balanced anesthesia.

drowsiness

confusion

problems with balance

and movement

slowed reflexes

slowed breathing and

heartbeat

coma (loss of
consciousness for a
period of time)

electrolyte.
Monitor for possible
hypernatremia and
hypokalemia, especially if
patient has CHF or cirrhosis.

Assess level of sedation and level of

consciousness throughout and for 2-6
hr following administration.
Monitor BP, pulse and respiration
continuously during IV administration.
Oxygen and resuscitative equipment
should be immediately available.
If overdose occurs, monitor pulse,
respiration , and BP continuously.
Maintain patent airway and assist
ventilation as needed. If hypotension
occurs, treatment includes IV fluids,
repositioning and vasopressors.