Generic Name Brand Name Classification Dosage & frequency Mechanism of actions

Metoclopramide  Biclomet amp Antiemitics Adult: PO Stimulates motility of upper GI

 Clometide amp  Diabetic gastric stasis 10 mg 4 tract, increases lower
 Clomitene amp times/day. Usual duration: 2-8 esophageal sphincter tone,

 Euro-Med wk. and blocks dopamine

Metoclopramide  Nausea and vomiting receptors at the

HCl amp associated w/ cancer chemoreceptor trigger zone.

 Metsil amp chemotherapy or radiotherapy

 Plasil amp 2 mg/kg 1 hr before start of

 Plasil syr treatment. Repeat dose 3 times

 Plasil tab at 2-hrly intervals. May repeat 2

 Reglomar syr additional doses at 3-hrly

intervals if needed. Max: 12
 Vitamet amp
mg/kg/day.
 Vomaine amp
 Gastro-oesophageal reflux
disease 10-15 mg up to 4
times/day, depending on severity
of symptoms.
 Delayed emesis following
chemotherapy 20-40 mg 2-4
 times/day for 3-4 days. IV
 Intubation of the small
intestine; Premed for
radiologic examination of the
upper GI tract 10 mg as a single
direct inj. IV/IM
 Diabetic gastric stasis 10 mg 4
times/day. Convert to PO when
possible. Usual duration: 2-8 wk.
IM
 Post-op nausea and vomiting
10 mg near the end of the
procedure. Repeat 4-6 hrly when
needed.
 Indications Contraindications
Side Effects Adverse Reactions Nursing Responsibilities

 Diabetic gastric  Contraindicated  CNS: restlessness, Extrapyramidal symptoms,  Monitor bowel sounds
with allergy to drowsiness,
restlessness, drowsiness, anxiety,  ALERT: use
stasis
metoclopramide fatigue, insomnia, diphenhydramine 25 mg
dizziness, anxiety diarrhoea, hypotension, I.V. to counteract
 GI hemorrhage extrapyramidal adverse
 Nausea and hypertension, headache,
 CV: transient effects from high
vomiting  Mechanical hypertension depression, blood disorders (e.g. metoclopramide doses
obstruction or aganulocytosis,  Tell patient to avoid
associated w/
perforation  GI: nausea and activities thet require
cancer methaemoglobinaemia), alertness for 2 hours after
diarrhea
chemotherapy  Epilepsy hypersensitivity reactions (e.g. doses
 Urge patient to report
or radiotherapy  Use cautiously bronchospasm, rash), persistenr or serious
with previously galactorrhoea or related disorders, adverse reactions promptly
detected breast  Advise patient to avoid
cancer, lactation, transient increase in plasma alcohol ingestion during
 Gastro- pregnancy, fluid aldosterone levels. theraphy
oesophageal overload, renal
impairment Potentially Fatal: Neuroleptic
reflux disease malignant syndrome; cardiac
conduction disorders may occur
 Delayed emesis with IV dosage form.
following
chemotherapy
 Intubation of the
small intestine;
Premed for
radiologic
examination of
the upper GI
tract

 Diabetic gastric
stasis

 Post-op nausea
and vomiting
 Generic Name Brand Name Classification Dosage & frequency Mechanism of actions

Furosemide  Diuspec amp Diuretics Adult: PO A potent loop diuretic that

 Diuspec tab  HTN 40-80 mg/day. inhibits sodium and chloride
 Edemann tab reabsorption at the proximal

 Flexamide tab  Edema Initial: 20 mg/day. Max: and distal tubules and the

 Fremid amp 600 mg/day in severe cases. IV ascending loop of Henle.

 Fretic amp
 Frusema amp
 Pulmonary Edema 40 mg, if
 Frusema tab
response is inadequate w/in 1 hr,
 Furide amp
a further dose of 80 mg may be
 Furolink amp
given.
 Furoscan inj
 Fusimex amp
 Oliguria in acute or chronic
 Lasix amp
renal failure For GFR: 5-20
 Lasix tab mL/min: Infuse 250 mg over 1 hr.
 Pisamor tab If urine output is insufficient w/in
 Rasitol amp the next hr, may follow by 500
 Rofunil amp mg infused over 2 hr. If urine
output is still unsatisfactory w/in 1
hr after the 2nd infusion, a 3rd
dose of 1 g may be infused over
4 hr. Rate of infusion: ≤4 mg/min.
If the response is satisfactory,
may repeat the effective dose (of
up to 1 g) every 24 hr. IM/IV
 Indications Contraindications
Side Effects Adverse Reactions Nursing Responsibilities

 Hypertension  Contraindicated  Constipation or  CNS: vertigo, headache,  To prevent nocturia, give

diarrhea
in patients dizziness, paresthesia, P.O. and I.M. preparations
 Edema hypersensitive to  Vision changes weakness, restlessness, fever. in the morning. Give
drug and in those second dose in early
 Pulmonary with anuria.  Headaches  CV: orthostatic hypotension, afternoon.
Edema thrombophlebitis with I.V.  Alert: Monitor weight, blood
 Vertigo (a spinning
 Use cautiously in sensation) administration. pressure, and pulse rate
 Oliguria in acute patients with routinely with long-term use
or chronic renal hepatic cirrhosis  Anemia  EENT: transient deafness, and during rapid diuresis.
failure and in those blurred or yellowed vision. Furosemide can lead to
 Fever
allergic to profound water and
sulfonamides.  GI: abdominal discomfort and electrolyte depletion.
 Sensitivity to the
pain, diarrhea, anorexia, nausea,  If oliguria or azotemia
sun
 Furosemide vomiting, constipation, develops or increases, drug
should be used pancreatitis. may need to be stopped.
during pregnancy  Monitor fluid intake and
only if potential  GU: nocturia, polyuria, frequent output and electrolyte,
benefits clearly urination, azotemia, oliguria. BUN, and carbon dioxide
outweigh
possible risks to  Hematologic: agranulocytosis,
fetus. leukopenia, thrombocytopenia,
anemia, aplastic anemia.
 Hepatic: hepatic dysfunction.
 Metabolic: hypokalemia;
hypochloremic alkalosis; fluid and
electrolyte imbalances, including
dilutional hyponatremia,
hypocalcemia, hypomagnesemia;
hyperglycemia and impaired
glucose tolerance.
 Skin: dermatitis, purpura,
photosensitivity, volume
depletion, and dehydration.
 Musculoskeletal: muscle spasm.
levels frequently.
 Watch for signs of
hypokalemia, such as
muscle weakness and
cramps.
 Consult prescriber and
dietitian about a high-
potassium diet. Foods rich
in potassium include citrus
fruits, tomatoes, bananas,
and dates.
 Monitor glucose levels in
diabetic patients.
 In patient with severe heart
failure, oral forms of
furosemide may not be well
absorbed. Drug may need
to be given I.V. even if
patient is taking other oral
drugs.
 Monitor uric acid level,
especially in patients with a
 history of gout.
 Monitor geriatric patients,
who are especially
susceptible to excessive
diuresis, because
circulatory collapse and
thromboembolic
complications are possible.
 Store tablets in light-
resistant container to
prevent discoloration
(which doesn't affect
potency). Don't use
discolored (yellow)
injectable preparation.
Refrigerate oral furosemide
solution to ensure drug
stability.
 Alert: Don't confuse
furosemide with torsemide.
 Advise patient to take drug
with food to prevent GI
 distress, and to take drug in
morning to prevent
nocturia. If second dose is
needed, tell patient to take
second dose in early
afternoon, 6 to 8 hours
after morning dose.
 Inform patient of possible
need for potassium or
magnesium supplements.
 Instruct patient to stand
slowly to prevent dizziness
and to limit alcohol intake
and strenuous exercise in
hot weather to avoid
exacerbating orthostatic
hypotension.
 Advise patient to
immediately report ringing
in ears, severe abdominal
pain, or sore throat and
fever; these symptoms may
 indicate furosemide toxicity.
 Discourage patient taking
furosemide at home from
storing different types of
drugs in the same
container, increasing the
risk of drug errors. The
most popular strengths of
furosemide and digoxin
are white tablets about
equal in size.
 Tell patient to check with
prescriber or pharmacist
before taking OTC drugs.
 Teach patient to avoid
direct sunlight and to use
protective clothing and a
sunblock because of risk
of photosensitivity.
 Generic Name Brand Name Classification Dosage & frequency Mechanism of actions

Nifedipine  Adalat cap Antianginals Adult: PO Thought to inhibit calcium ion

 Adalat GITS tab  HTN Extended release 10-40 mg influx across cardiac and
 Adalat Retard twice daily or 20-90 mg once smooth-muscle cells,
tab daily. decreasing contractility and
 Calcibloc cap  Angina pectoris Extended oxygen demand. Also may

 Calcibloc OD release 10-40 mg twice daily or dilate coronary arteries and

coated tab arterioles.

30-90 mg once daily. Liquid-filled
 Darat soft-gelatin cap: 5-20 mg 3 times/day.
caps  Raynaud's syndrome Liquid-
 Hartigard SR filled cap: 5-20 mg 3 times/day.
Sustained-release
tab
 Heblopin cap
 Hyperten soft-
gelatin caps
 Nelapine cap
 Nelapine Retard
tab
 Nifestad
Sustained-release
tab
 Odipin tab
 Indications Contraindications
Side Effects Adverse Reactions Nursing Responsibilities

 HTN  Contraindicated in  Constipation  CNS: dizziness, light-headedness,  When a rapid response to

 Dizziness
 Angina pectoris patients headache, weakness, syncope, drug is desired, have
 Flushing
 Raynaud's hypersensitive to  Giddiness nervousness. patient bite and swallow the
syndrome drug.  Headache  CV: peripheral edema, capsule. If he can't chew
 heat sensation
 Use cautiously in  heartburn hypotension, palpitations, heart capsules, the liquid can be
patients with heart  lightheadedness failure, MI, pulmonary edema, withdrawn by puncturing
 nausea
failure or flushing. the capsule with a needle
 weakness
hypotension and in  EENT: nasal congestion. and squeezing the contents
geriatric patients.  GI: nausea, diarrhea, constipation, into the mouth. When these
 Use extended- abdominal discomfort. methods are used,
release tablets  Metabolic: hypokalemia. continuous blood pressure
cautiously in  Musculoskeletal: muscle cramps. and ECG monitoring is
patients with  Respiratory: dyspnea, cough. recommended. These
severe GI  Skin: rash, pruritus. methods aren't
narrowing. recommended for the
treatment of hypertension.
 Despite widespread S.L.
use of nifedipine capsules,
 avoid this route of
administration. Peak serum
levels are lower and take
longer to occur than when
capsules are bitten and
swallowed.
 Monitor blood pressure
regularly, especially in
patients who are taking
beta blockers or
antihypertensives.
 Although rebound effect
hasn't been observed when
drug is stopped, dosage
should be reduced slowly
under prescriber's
supervision.
 Alert: Don't confuse
nifedipine with nimodipine
or nicardipine.
 If patient is kept on nitrate
therapy while nifedipine
 dosage is being adjusted,
urge continued compliance.
S.L. nitroglycerin especially
may be taken as needed
when angina symptoms are
acute.
 Tell patient he may briefly
develop angina
exacerbation when
beginning drug therapy or
when dosage is increased.
 Instruct patient to swallow
extended-release tablets
without breaking, crushing,
or chewing.
 Instruct patient to avoid
taking drug with grapefruit
juice.
 Reassure patient who is
taking the extended-
release form that a wax-
matrix "ghost" from the
 tablet may be passed in the
stools. Drug is completely
absorbed before this
occurs.
 Warn patient not to switch
brands. Procardia XL and
Adalat CC aren't
therapeutically equivalent
because of major
differences in their
pharmacokinetics.
 Tell patient to protect
capsules from direct light
and moisture and to store
at room temperature.
 Generic Name Brand Name Classification Dosage & frequency Mechanism of actions

Metoprolol  Apo-Metoprolol Antihypertensives  Hypertension: initially, 100 mg/ A beta blocker that decreases
 Betaloc day PO in single or divided myocardial contractility, heart
 Lopressor doses gradually increase rate, cardiac output, and

 Novometoprol dosage at weekly intervals. blood pressure and reduces

 Nu-Metop Usual maintenance dose is 100- myocardial oxygen use. Also

450 mg/day. depresses renin secretion.
 Angina pectoris: initially, 100
mg/day PO in two divided
doses; maybe increased
gradually, effective range, 100-
400 mg/day.
 MI early treatment: three IV bolus
doses of 5 mg each at 2-min
intervals with careful monitoring.
If these are tolerated, give 50
mg PO 15 min after the last IV
dose and q 6 hr for 48 hr.
thereafter, give maintenance
dose of 100 mg PO Bid. Reduce
 initial PO doses to 25 mg, or
discontinue in patients who do
not tolerate the IV doses.
 MI, late treatment: 100 mg PO bid
as soon as possible after infarct,
continuing for at least 3 mo and
possibly for 1-3 yrs.
 Indications Contraindications Side Effects Adverse Reactions Nursing Responsibilities

 Essential  Contraindicated in  Slow heart rate  CNS: fatigue, dizziness,  Always check patient's
hypertension patients  Tiredness depression. apical pulse rate before
 Tachycardia hypersensitive to  Dizziness  CV: bradycardia, hypotension, giving drug. If it's slower
 Coronary heart drug or other beta  Diarrhea heart failure, AV block. than 60 beats/minute,
disease blockers.  Itching or  GI: nausea, diarrhea. withhold drug and call
(prevention of  Contraindicated in unexplained rash  Respiratory: dyspnea. prescriber immediately.
angina attacks) patients with sinus  Shortness of  Skin: rash.  Monitor glucose levels
 Secondary bradycardia, heart breath closely in diabetic
prevention after block greater than patients because drug
a myocardial first-degree, masks common signs
infarction cardiogenic and symptoms of
 Treatment of shock, or overt hypoglycemia.
heart failure. cardiac failure  Monitor blood pressure
 Migraine when used to frequently; metoprolol
prophylaxis treat hypertension masks common signs
or angina. and symptoms of shock.
 When used to
treat MI, drug is
contraindicated in
 patients with heart  Beta blockers may mask
rate less than 45 tachycardia associated
beats/minute, with hyperthyroidism. In
second- or third- patients with suspected
degree heart thyrotoxicosis, withdraw
block, PR interval beta blocker gradually to
of 0.24 seconds avoid thyroid storm.
or longer with  Store drug at room
first-degree heart temperature and protect
block, systolic from light. Discard
blood pressure solution if it's discolored
below 100 mm or contains particles.
Hg, or moderate  Beta1 selectivity is lost at
to severe cardiac higher doses. Monitor for
failure. peripheral adverse
 Use cautiously in effects.
patients with heart  Alert: Don't confuse
failure, diabetes, metoprolol with
or respiratory or metaproterenol or
hepatic disease. metolazone. Don't
confuse Toprol-XL with
Topamax (topiramate).
 Instruct patient to take
drug exactly as
prescribed and to take it
with meals.
 Tell patient not to stop
drug suddenly but to
notify prescriber about
unpleasant adverse
reactions. Inform him that
drug must be withdrawn
gradually over 1 to 2
weeks.
Generic Name Brand Name Classification Dosage & frequency Mechanism of actions

Hydrazaline  Alazine Antihypertensive Adult: PO A direct-acting vasodilator

Hydrochloride
 Apresoline  HTN 40-50 mg/day in divided that primarily relaxes
 Novohylazin doses. Max: 200 mg/day. IV arteriolar smooth muscle.

 Supres  Hypertensive crisis 5-10 mg,

repeat after 20-30 mins if needed.
 Indications Contraindications
Side Effects Adverse Reactions Nursing Responsibilities

 Essential  Contraindicated in  Diarrhea  CNS: peripheral neuritis,  Monitor patient's blood

Hypertension patients  fast heartbeat headache, dizziness. pressure, pulse rate, and
(oral, alone or in hypersensitive to  headache  CV: orthostatic hypotension, body weight frequently.
combination drug.  loss of appetite tachycardia, edema, angina, Hydralazine may be given
with other  Contraindicated in  nausea or vomiting palpitations. with diuretics and beta
antihypertensive patients with  pounding heartbeat  EENT: nasal congestion. blockers to decrease
); to reduce after coronary artery  GI: nausea, vomiting, diarrhea, sodium retention and
load in severe disease or mitral anorexia, constipation. tachycardia and to prevent
CHF ( with valvular rheumatic  Hematologic: neutropenia, angina attacks.
nitrates); and heart disease. leukopenia, agranulocytopenia,  Geriatric patients may be
severe essential  Use cautiously in agranulocytosis, more sensitive than younger
hypertension patients with thrombocytopenia with or without patients to drug's
(parenteral to suspected cardiac purpura. hypotensive effects.
lower blood disease, CVA, or  Skin: rash.  Monitor CBC, lupus
pressure severe renal  Other: lupus-like syndrome. erythematosus cell
quickly) impairment and in preparation, and antinuclear
those taking other antibody titer determination
antihypertensives. before therapy and
 periodically during long-term
therapy.
 Alert: Watch patient closely
for signs and symptoms of
lupus-like syndrome (sore
throat, fever, muscle and
joint aches, rash). Notify
prescriber immediately if
these develop.
 Compliance may be
improved by giving drug
twice daily. Check with
prescriber.
 Alert: Don't confuse
hydralazine with
hydroxyzine or Apresoline
with Apresazide.
 Alert: Apresoline may
contain tartrazine.
 Instruct patient to take oral
form with meals to increase
absorption.
 Inform patient that
orthostatic hypotension can
be minimized by rising
slowly and avoiding sudden
position changes.
 Tell woman to notify
prescriber if she suspects
pregnancy; drug should be
stopped.
 Generic Name Brand Name Classification Dosage & frequency Mechanism of actions

Ampicillin  Aldribid vial penicillins  Susceptible infections 0.25-0.5 Inhibits cell-wall synthesis
 Ampicin cap g 6 hrly. during bacterial multiplication
 Ampicin vial
 Ampiclin vial  Typhoid and paratyphoid fever
 Ampico cap 1-2 g 6 hrly. Duration: 2 wk
 Ampico vial
 Ampinex vial (acute infections); 4-12 wk
 Ampisan vial (carriers).
 Ampitrex vial
 Uncomplicated gonorrhoea W/
 Ampizef vial
 Cilisod vial probenecid: 2 g as single dose.
 Clovillin vial IV
 Dincil vial
 Dinpen vial  Intrapartum prophylaxis
 Eurocin vial against group B streptococcal
 Excillin vial
 Famacin cap infections Initial, 2 g, then 1 g 4
 Gramcil vial hrly until delivery.
 Mapciril inj
 Septicaemia 150-200
 Microcilin vial
 Obocil vial mg/kg/day. Start with IV admin
 Obocil-100 vial
for 3 days, then IM inj 3-4 hrly.
 Panacta vial
 Penbritin cap Continue treatment for at least
 Penbritin drops 48-72 hr after patient has
 Penbritin Forte
syr become asymptomatic or when
 Penbritin syr there is evidence of bacterial
 Pentrexyl cap eradication. IV/IM
 Pentrexyl DS
susp  Susceptible infections 250-500
 Pentrexyl Ped mg 6 hrly.
drops
 Pentrexyl susp  Meningitis 2-3 g 4-6 hrly, may
 Pentrexyl vial start w/ IV admin, then continue
 Pharmawealth
Lab Ampicillin w/ IM inj. Inj
vial  Supplement to systemic
 Phil
Pharmawealth/Ka therapy for
rnataka Ampicillin intrapleural/intraperitoneal/intra-
vial
 Picaplin cap articular admin: 500 mg/day.
 Polypen vial
 RiteMED
Ampicillin cap
 Rotocin vial
 Shinapen vial
 Sodampen vial
 Trumepen vial
 Vatacil vial
 Indications Contraindications
Side Effects Adverse Reactions Nursing Responsibilities

 Susceptible  Hypersensitivity Severe allergic GI upset, nausea, vomiting,  Before giving drug, ask
reactions (rash;
infections diarrhoea; blood dyscrasias; patient aboutallergic
 Infectious hives; itching;
 Typhoid and mononucleosis.
difficulty breathing; urticaria, exfoliative dermatitis, rash; reactions tio penicillin. A
tightness in the
paratyphoid fever, seizures; interstitial nephritis. negative history of penicillin
chest; swelling of the
fever mouth, face, lips, or Potentially Fatal: Anaphylactic allergy is no guarantee
tongue); bloody
 Uncomplicated stools; severe
shock; pseudomembranous colitis; against future allergic
gonorrhoea diarrhea; stomach neuromuscular hypersensitivity; reaction.
pain/cramps; vaginal
 Intrapartum irritation or
electrolyte imbalance.  Tell patient to take entire
prophylaxis discharge. quantity of drug exactly as
against group B prescribed even after he
streptococcal feels better
infections  Instruct patient to take oral
 Septicaemia form on an empty stomach
 Susceptible 1 hour before o 2 hours
infections after.

 Meningitis  Inform patient to notify

prescriber if rash, fever, or
chills develop. A rash is the
 most common allergic
reaction, especially if
allopurinol is also being
taken.
 Advise patient to report
discomfort at I.V. injrction
site.
 Generic Name Brand Name Classification Dosage & frequency Mechanism of actions

Oxytocin  Comxytocin Oxitocics  Adjunct in abortion 10-20 Oxytocin induces rhythmic

uterine contraction which
amp milliunits/min. Max total dose: 30 increases throughout the
 Estima amp u in a 12-hr period. pregnancy, reaching the max
at term by proliferating
 Evatocin amp  Postpartum hemorrhage 10-40 oxytocin receptors. It
 Lavoxin amp u by infusion at a rate to control increases the tone and
amplitude of the uterine
 NeOxyn amp uterine atony. contractions at small doses.
 Obcin inj  Labour induction 1-2

 Otoxin amp milliunits/min, may increase at

 Oxitone amp intervals of at least 30 mins till a

 Oxtimon amp max of 3-4 contractions every 10

 Oxymed soln mins. Max: 32 milliunits/min and

≤5 u/day. Not to be given w/in 6
 Oxyten amp
hr after administration of vag
 Roxipan amp
prostaglandins.
 Solvoxine amp
 Oxytocin challenge test for
 Syntocinon amp
evaluating of fetal distress
 Syntox amp
Dilute 5-10 u in 1 L of 5%
 Tocinox amp
dextrose inj. Initial: Drug infused
 Tranoxy amp
in the mother via infusion at a
 rate of 0.5 milliunits/min. May
gradually increase infusion rate.
Max: 20 milliunits/min.
Discontinue infusion when 3
moderate uterine contractions
occur w/in one 10-minute
interval. Compare baseline and
oxytocin-induced foetal heart
rates. Nasal
 Facilitate lactation per spray
contains 4 u: 1 spray into 1 nostril
5 mins before suckling.
 Indications Contraindications
Side Effects Adverse Reactions Nursing Responsibilities

 Adjunct in  Cephalopelvic Nausea; vomiting; Foetus or neonate: Jaundice;  Drug isn’t recommended
abortion more intense or
disproportion; arrhythmias, bradycardia; brain, for routine I.M. use, but 10
abrupt contractions
 Postpartum  abnormal of the uterus. CNS damage; seizure; retinal units may be given I.M.
hemorrhage haemorrhage; low Apgar score.
presentation of the after delivery of placents to
 Labour induction foetus Mother: transient hypotension, control uterine bleeding
 hydraminios reflex tachycardia; nasal irritation,  Never give oxytocin
 multiparae rhinorrhoea, lachrymation (following simultaneously by more
 previous caesarian nasal admin); uterine bleeding, than one route
section or other violent contractions, hypertonicity;  Explain use and
uterine surgery spasm; nausea, vomiting. adminisstration of drug to
 hyperactive or Potentially Fatal: Maternal water patient and family
hypertonic uterus, intoxication (especially with slow  Instruct patient to report
uterine rupture infusion over 24 hr); prolonged adverse reactions promtly
 Contraindicated uterine contractions causing foetal

vaginal delivery hypoxia and death; rupture of

(invasive cervical gravid uterus; afibrinogenaemia;

cancer, active subarachnoid haemorrhage

genital herpes,
 prolapse of the
cord, cord
presentation, total
placenta previa or
vasa previa)
 Fetal distress
where delivery is
not imminent;
 Severe pre-
eclamptic toxemia.
 Generic Name Brand Name Classification Dosage & frequency Mechanism of actions

Tramadol Ultram Analgesic  Moderate to severe pain 50-100 A centrally acting synthetic
hydrochloride mg 4-6 hrly. Max: 400 mg/day. analgesic compound not
Extended-release 50-100 mg 1-2 chemically related to opiates.
times/day. Max: 300 mg/day. Drug is thought to bind to
IV/IM opioid receptors and inhibit
 Moderate to severe pain 50-100 reuptake of norepinephrine
mg 4-6 hrly. and serotonin.
 Post-op pain Initial: 100 mg,
then 50 mg every 10-20 mins if
needed, up to 250 mg for the 1st
hr. Maintenance: 50-100 mg 4-6
hrly. Max: 600 mg/day. Rectal
 Moderate to severe pain As 100
mg supp: 1 supp up to 4
times/day.
 Indications Contraindications
Side Effects Adverse Reactions Nursing Responsibilities

 Moderate to  Contraindicated in dizziness, weakness,  CNS: dizziness, vertigo,  Monitor CV and respiratory
severe pain patients incoordination, headache, somnolence, CNS status. Withhold dose and
 Post-op pain hypersensitive to nausea or vomiting, stimulation, asthenia, anxiety, notify prescriber if
 Moderate to drug. stomach upset, confusion, coordination respiration rate decreases
severe pain  Contraindicated in constipation, disturbance, euphoria, or rate is below 12
those with acute headache, nervousness, sleep disorder, breaths/minute.
intoxication from drowsiness, anxiety, seizures, malaise.  Monitor bowel and bladder
alcohol, irritability, dry mouth,  CV: vasodilation. function. Anticipate need
hypnotics, increased sweating  EENT: visual disturbances. for a laxative.
centrally acting  GI: nausea, constipation,  For better analgesic effect,
analgesics, vomiting, dyspepsia, dry mouth, give drug before onset of
opioids, or diarrhea, abdominal pain, intense pain.
psychotropic anorexia, flatulence.  Monitor patients at risk for
drugs.  GU: urine retention, urinary seizures. Drug may reduce
 Use cautiously in frequency, menopausal seizure threshold.
patients at risk for symptoms, proteinuria.  Monitor patient for drug
seizures or  Musculoskeletal: hypertonia. dependence. Drug can
respiratory  Respiratory: respiratory produce dependence
 depression. depression. similar to that of codeine or
 Use cautiously in  Skin: pruritus, diaphoresis, rash. dextropropoxyphene and
patients with thus has potential for
increased abuse.
intracranial  Alert: Don't confuse
pressure or head tramadol HCl with
injury, acute trazodone HCl (Desyrel).
abdominal  Tell patient to take drug as
conditions, renal prescribed and not to
or hepatic increase dose or dosage
impairment, or interval unless ordered by
physical prescriber.
dependence on  Caution ambulatory patient
opioids. to be careful when rising
and walking. Warn
outpatient to avoid driving
and other potentially
hazardous activities that
require mental alertness
until drug's CNS effects are
known.
 Advise patient to check
with prescriber before
taking OTC drugs; drug
interactions can occur.
 Generic Name Brand Name Classification Dosage & frequency Mechanism of actions

ketoralac Toradol Nonsteroidal anti- Reduces pain from both

inflammatory drugs, inflammatory and non-
nonopioid inflammatory causes.
analagesics Ketorolac reduces the
production of prostaglandins,
chemicals that cells of the
immune system make that
cause the redness, fever, and
pain of inflammation and that
also are believed to be
important in the production of
non-inflammatory pain. It
does this by blocking the
enzymes that cells use to
make prostaglandins
(cyclooxygenase 1 and 2). As
a result, pain as well as
inflammation and its signs
and symptoms - redness,
swelling, fever, and pain - are
reduced.
 Indications Contraindications
Side Effects Adverse Reactions Nursing Responsibilities

Ketorolac is used Hypersensitivity  Headache  CNS:  Patients who have asthma,

for short-term - Cross-sensitivity drowsiness aspirin-induced allergy, and
 Abdominal pain (or abnormal thinking
management (up with other NSAIDs stomach pain) nasal polyps are at
dizziness
to 5 days) of may exist ¨Pre- or euphoria increased risk for
 Nausea
moderately severe perioperative use headache- developing hypersensitivity
acute pain that - Known alcohol  Heartburn or reactions. Assess for
indigestion  RESP:
otherwise would intolerance Use asthma rhinitis, asthma, and
require narcotics. cautiously in:  Diarrhea dyspnea urticaria.
It most often is 1) History of GI  Dizziness
 CV:
used after surgery. bleeding
edema  Assess pain (note type,
 Drowsiness
2) Renal impairment pallor location, and intensity) prior
(dosage reduction  Swelling vasodilation to and 1-2 hr following
may be required) administration.
 GI:
3) Cardiovascular GI Bleeding
disease abnormal taste  Ketorolac therapy should
diarrhea
always be given initially by
dry mouth
dyspepsia the IM or IV route. Oral
GI pain therapy should be used
 nausea only as a continuation of
parenteral therapy.
 GU:
oliguria
renal toxicity  Caution patient to avoid
urinary frequency concurrent use of alcohol,
aspirin, NSAIDs,
acetaminophen, or other
OTC medications without
consulting health care
professional.

 Advise patient to consult if

rash, itching, visual
disturbances, tinnitus,
weight gain, edema, black
stools, persistent headche,
or influenza-like syndromes
(chills,fever,muscles aches,
pain) 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.

 Control environment (
temperature, lighting) if
sweating or CNS effects
occur.
Generic Name Brand Name Classification Dosage & frequency Mechanism of actions

Ranitidine Zantac, Zantac 150, Antiulcer drugs Duodenal Ulcer (Active) Competitively inhibits action
Zantac 300, Zantac Adults of H2 at receptor sites of the
75, Zantac PO 150 mg twice daily or 300 mg at parietal cells, decreasing
EFFERdose bedtime. Maintenance dose is 150 gastric acid secretion.
mg at bedtime. IM/IV/Intermittent IV
50 mg every 6 to 8 h.
Treatment of Duodenal and
Gastric Ulcers
Children 1 mo to 16 yr of age
PO 2 to 4 mg/kg twice daily (max,
300 mg/day).
Maintenance of Healing of
Duodenal and Gastric Ulcers
Children 1 mo to 16 yr of age
PO 2 to 4 mg/kg daily (max, 150
mg/day).
Acute Benign Gastric Ulcer and
GERD
Adults
PO 150 mg twice daily.
IM/IV/Intermittent IV 50 mg every 6
to 8 h.
Treatment of GERD and Erosive
Esophagitis
Children 1 mo to 16 yr of age
PO 5 to 10 mg/kg daily usually
given in 2 divided doses.
Pathologic Hypersecretory
Conditions
Adults
PO 150 mg twice daily.
Individualize.
Erosive Esophagitis
Adults
PO 150 mg 4 times daily.
IM/IV/Intermittent IV 50 mg every 6
to 8 h. Continuous IV 6.25 mg/h.
For patients with Zollinger-Ellison,
start infusion at rate of 1 mg/kg/h
and adjust upward in 0.5 mg/kg/h
increments according to gastric acid
output (max, 2.5 mg/kg/h; infusion
rate 220mg/h).
 Indications Contraindications
Side Effects Adverse Reactions Nursing Responsibilities

 Duodenal Ulcer  Contraindicated in chest pain, fever,  CNS: vertigo, malaise.  Assess patient for
feeling short of
patients breath, coughing up  CV: angioneurotic edema. abdominal pain. Note
 Treatment of hypersensitive to green or yellow  EENT: blurred vision. presence of blood in
mucus;
Duodenal and drug. easy bruising or  Hematologic: reversible emesis, stool, or gastric
Gastric Ulcers  Contraindicated in bleeding, unusual leukopenia, pancytopenia. aspirate.
weakness;
patients with fast or slow heart  Hepatic: jaundice.  Ranitidine may be added to
 Maintenance of acute porphyria. rate;  Skin: burning and itching at total parenteral nutrition
problems with your
Healing of  Use cautiously in vision; injection site. solutions.
Duodenal and patients with fever, sore throat,  Other: anaphylaxis.  Alert: Don't confuse
and headache with a
Gastric Ulcers hepatic severe blistering, ranitidine with rimantadine;
dysfunction. peeling, and red skin or Zantac with Xanax or
rash; or
 Acute Benign Adjust dosage in nausea, stomach Zyrtec.
Gastric Ulcer patients with pain, low fever, loss  Instruct patient on proper
of appetite, dark
and GERD impaired renal urine, clay-colored use of OTC preparation, as
function. stools, jaundice indicated.
(yellowing of the skin
or eyes).  Remind patient taking
prescription drug once daily
to take it at bedtime for
 Treatment of best results.
GERD and  Instruct patient to take
Erosive without regard to meals
Esophagitis because absorption isn't
affected by food.
 Pathologic  Tell patient taking
Hypersecretory EFFERdose to dissolve
Conditions drug in 6 to 8 ounces of
Adults water before taking.
 Urge patient to avoid
 Erosive cigarette smoking because
Esophagitis it may increase gastric acid
Adults secretion and worsen
disease.
 Advise patient to report
abdominal pain and blood
in stool or emesis.
 Warn patient with
phenylketonuria that
EFFERdose granules and
tablets contain aspartame.