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CHAPTER VIII

DRUG STUDY

Generic Name: Tramadol Hydrochloride

CLASSIFICATION DOSAGE AND PHARMACOLOGIC INDICATIONS SIDE EFFECTS NURSING


ADMINISTRATION ACTION CONSIDERATIONS
• Analgesic Dosage: 50 mg Binds to mu-opioid • Relief of • Dizziness • Assess type,
(centrally acting) Route: IV receptors and inhibits moderate to • sedation location, and
• Opioid analgesic Frequency: q6h the reuptake of severe pain • drowsines intensity of pain
norepinephrine and s before and 2-3 hr
serotonin; causes • Relief of • headache (peak) after
many effects similar moderate to • confusion administration.
to the opioids- severe • dreaming •Assess BP & RR
dizziness, chronic pain • sweating before and
somnolence, nausea, in adults who • anxiety periodically during
constipation, but does need around- • seizures administration.
not have the the-clock • hypotensi • Assess bowel
respiratory depressant treatment for on function routinely.
effects. extended • tachycard • Assess previous
periods ia analgesic history.
• bradycard
• Prolonged use may
ia lead to physical and
• pruritus
psychological
• rash
dependence and
• pallor
tolerance, although
• urticaria
these may be milder
• dry
than with opioids.
mouth
• Monitor patient for
• constipati seizures. May occur
on within
• flatulence recommended dose
• impaired range. Risk
visual acuity increased with
• Nausea higher doses and
• vomiting inpatients taking
• loss of antidepressants,
appetite analgesics, or other
drugs that decreses
• anaphylactoid the seizure
reaction threshold.
• Overdose may
cause respiratory
depression and
seizures.
• Encourage patient
to cough and
breathe deeply
every 2 hr to
prevent atelectasis
and pneumonia.
Generic Name: Ketorolac tromethamine

CLASSIFICATION DOSAGE AND PHARMACOLOGIC INDICATIONS SIDE NURSING


ADMINISTRATION ACTION EFFECTS CONSIDERATIONS
• Antipyretic Dosage: 30 mg Anti-inflammatory and Short term • drowsiness • Patients who have
• Nonopioid Route: IV analgesic activity; management for • abnormal asthma, aspirin-
analgesic Frequency: q6h inhibits prostaglandins pain (up to 5 thinking induced allergy,
• NSAID and leukotriene days) • dizziness and nasal polyps
synthesis • euphoria are at increased
• headache risk for developing
• asthma hypersensitivity
• dyspnea reactions
• edema • Assess pain prior to
• pallor and 1-2 hr
• vasodilation following
• GI Bleeding administration.
• abnormal • Ketorolac therapy
taste should always be
• diarrhea given initially by
• dry mouth the IM or IV route.
• dyspepsia Oral therapy should
• GI pain be used only as a
• nausea continuation of
• oliguria parenteral therapy.
• renal • Caution patient to
toxicity avoid concurrent
• urinary use of alcohol,
frequency aspirin, NSAIDs,
• pruritis acetaminophen, or
• purpura other OTC
• sweating medications
• urticaria without consulting
• prolonged health care
bleeding professional
time • Advise patient to
• injection consult if rash,
site pain itching, visual
• paresthesia disturbances,
tinnitus, weight
• allergic gain, edema, black
reaction stools, persistent
headache, or
influenza-like
syndromes 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.
Generic Name: Ranitidine hydrochloride

CLASSIFICATION DOSAGE AND PHARMACOLOGIC INDICATION SIDE NURSING


ADMINISTRATION ACTION EFFECTS CONSIDERATIONS
• Histamine-2 Dosage: 50 mg Competitively inhibits • short term • Headache • Assess patient for
antagonist Route: IV the action of histamine treatment • Malaise epigastric or
Frequency: q8h at the H2 receptors of of active • dizziness abdominal pain and
the parietal cells of the duodenal • somnolence frank or occult
stomach, inhibits basal ulcer • insomia blood in the stool,
gastric secretion and • maintenance • vertigo emesis, or gastric
gastric acid secretion therapy for • tachycardia aspirate.
that stimulated by duodenal • bradycardia • Nurse should
food, insulin, ulcer at • rash know that it may
histamine, cholinergic reduced • alopecia cause false-positive
agonists, gastrin and dosage • constipation results for urine
pentagastrin. • short term • diarrhea protein; test with
treatment • nausea sulfosalicylic acid.
and • vomitting • Inform patient that
maintenance • abdominal it may cause
therapy of pain drowsiness or
active, • hepatitis dizziness
benign • impotence • Inform patient that
gastric ulcer or decrease increased fluid and
• Short term libido fiber intake may
treatment of minimize
GERD • local constipation.
• Pathologic burning or • Advise patient to
hypersecreto itching on report onset of
ry condition IV site black, tarry stools;
• treatment of fever, sore throat;
erosive diarrhea; dizziness;
esophagitis rash; confusion; or
hallucinations to
• treatment for health care
heartburn, professional
acid promptly.
indigestion,
sour stomach • Inform patient that
medication may
temporarily cause
stools and tongue
to appear gray
black.

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