Drug Name Classification Ordered Dose Action

Ranitidine hydrochloride Zantac 150mg Competitively inhibits action of H at receptor sites of partial cells, decreasing gastric acid secretions.

Indication

Indicated to patient with intractable duodenal ulcer; pathologic hypersecretory conditions

Contraindication

Contraindicated to patients hypersensitive to the drug or any of its components

Drug interaction

May interfere with ranitidine absorption. CNS: vertigo, malaise

Adverse Effects/ Side Effects

EENT: blurred vision Hematologic: reversible leucopenia, pancytopenia, thrombovcytopenia Hepatic: jaundice Other: burning and itching at injection site

1. Do not use aluminum- based needles or equipment when mixing or Nursing Responsibilities giving drug parenterally because drug is incompatible with aluminum. 2. No dilution is needed when giving drug I.M. 3. The effervescent tablet may be dissolved in 5ml of water and given with an oral syringe or in a medicine cup 4. Do not confuse ranitidine with rimatadine 5. Do not confuse Zantac with Xanx or Zyrtec 6. Remind patient taking drug once daily to take it h.s 7. Instruct patient to take drug with or without food 8. Urge patient not to smoke cigarettes, smoking may increase gastric acid secretions and worsen the disease.

PICTURE

Drug Name Classification Ordered Dose Action

Acetaminophen Calpol 5ml May produce analgesic effect by blocking pain impulses, by inhibiting prostaglandin or pain receptor sensitizers. May relieve pain by acting in hypothalamic heat- regulating center

Indication Contraindication

Indicated to patient with mild pain or fever. Contraindicated to patients hypersensitive to drug. Use cautiously in patient with history of chronic alcohol abuse because hepatoxicity may occur after therapeutic doses.

Drug interaction

Barnbiturates, carbamazepine, hyperdantoins, isoniazid, rifampicin. With high doses or long- term use of these drugs, may reduce therapeutic effects and enhance hepatotoxicity effects acetaminophen. Acoid use together. Hematologic: hemolytic anemaia, neutropenia, leucopenia, pancytopenia,

Adverse Effects/ Side Effects

thrombocytopenia Hepatic; liver damage, jaundice Metabolic: hypoglycemia Skin: rash, urticaria

1. Tell patient that drug is for short- term use only. Prescriber should Nursing Responsibilities be consulted if child takes drug for longer than 5 days 2. Tell patient not to se drug for fever that is above 39. 5 degree Celsius lasts longer than 3 days or recurs. 3. Warn patient that high doses or unsupervised long term used can cause liver damage. Excessive alcohol use may increase risk of hepatotoxicity 4. Tell patient to keep track of daily acetaminophen intake, including OTC and prescription medications. 5. Warn patient not to exceed total recommended dose of acetaminophen per day because of risk of hepatoxicity

6. Instruct patient to take drug with or without food 7. Tell patient to consult physician before using the drug 8. Make sure not to overdose in drinking the medicine

PICTURE

Drug Name Classification Ordered Dose Action

Tramadol Analgesic, centrally acting 50mg TID for pain Binds to mu opioid receptors and inhibits the reuptake of norepinephrine and serotonin; causes many effects similar to opioids dizziness, somnolence, nausea, constipationbut Does not have the respiratory depressant effects.

Indication Contraindication

Relief of moderate to moderately severe pain Contraindicated with allergy to tramadol or opioids or acute intoxication with alcohol, opioids, or psychoactive drugs.

Drug interaction

Alcohol/ increase respiratory depression Anesthetics general/ increase respiratory depression Carbamazepine/ decrease tramadol effect R/T increase metabolism CNS depressants/ additive CNS depression CNS: Sedation, dizziness or vertigo, headache, confusion, dreaming,

Adverse Effects/ Side Effects

sweating, anxiety, seizures. CV: hypotension, tachycardia, bradycardia Derm: Sweating, pruritus, rash, pallor, urticaria GI: nausea, vomiting, dry mouth, constipation, flatulence Other: Potential for abuse, anaphylactoid reactions

1. Identify patient by name badge or bracelet. Nursing 2. Check record for name of drug and compare with drug on hand.

Responsibilities

3. Check medication record for how to administer the drug and check labeling of drug to ensure it matches prescribed route. 4. Compare ordered dose to dose on hand. At times, calculations may need to be performed to ascertain the correct dose. 5. Verify that frequency or time ordered matches current time. 6. All medications should be handled to ensure that they do not come into contact with potentially contaminated objects or surfaces. 7. The patient should be monitored to make sure the medication has had the desired effect. 8. Take as directed with or immediately following meals. Wait 1 hour before taking an antacid. 9. Report any evidence of yellow discoloration of skin or eyes, or diarrhea. Maintain adequate hydration. Report any confusion or disorientation. 10. Symptoms of breast tenderness will usually disappear after several weeks; report if persistent and evaluate need to stoop drug. 11. Report as scheduled to determine extent of healing and expected length of therapy. 1. 12. Do not give to patients with pre existing CNS

PICTURE

Drug Name Classification Ordered Dose Action

Cefuroxime axetil Zinacef 500 mg q 12h Inhibits cell- wall synthesis, promoting osmotic instability; usually bactericidal.

Indication

Indicated to patient with pharygngitis, tonsillitis, infections or urinary and

lower respiratory tracts, and skim and skin structure infections. Contraindication Contraindicated to patients hypersensitive to drug or other cephalosporins. Use cautiously in patients with history of sensitivity to penicillin and in patients with renal impairment. Drug interaction Diuretics: may increase risk of adverse renal reactions. Monitor renal function closely. Probenecid: may inhibit excretion and increase leve of cefuroxie. Sometimes used for this effect. CNS: dizziness, headache, malaise, paresthesia Adverse Effects/ Side Effects GI: abdominal cramps, anal pruritis, anorexia, diarrhea, dyspepesoa, glossitis, nausea GU: genital pruritus, candidiasis Hematologic: eosinophilia, hemolytic anemia, Respiratory: dyspnea

1. Instruct patient to take drug exactly as prescribed, even after he Nursing Responsibilities feels better 2. Advise patient to take oral drug with food to enhance absorption. 3. Explain to the patient that tablets may be crushed, but drug has bitter taste that is difficult to mask, even with food. 4. Tell patient to report adverse reactions 5. Be alert with adverse reactions and drug interactions 6. If adverse Gi reactions occur, monitor patients hydration 7. Do not confuse the drug with cephalosporins with similar- sounding names. 8. Monitor for any unusualities.

PICTURE

Drug Name Classification Ordered Dose Action

Cefazolin sodium Ancef 250mg PO Inhibits cell- wall synthesis, promoting osmotic instability; usually bactericidal

Indication

Indicated to patients with serious infections of respiratory, billiary, and Gu tracts ; skin, soft- tissue, bone and joint infections; septicemia; endocarditis.

Contraindication

Contraindicated to patients hypersensitive to other cephalosporins. Use cautiously in patients with a history of sensitivity to penicillin because of cross- allergic reaction

Drug interaction

Probenecid: may inhibit excretion and increase level of cefazolin. CNS: dizziness, headache, malaise, paresthesia

Adverse Effects/ Side Effects

GI: abdominal cramps , anal pruritis, anorexia, diarrhea, dyspepsia, glossitis, nausea, oral candidiasis, vomiting, tenesmus GU: genital pruritus, and candidiasis, vaginitis HEMATOLOGIC: anemia, eosinophili RESPIRATORY: dyspnea

1. Monitor patients GI reaction occurs, monitor patients hydration Nursing Responsibilities 2. Dont confuse the drug with other cephalosporins with similarsounding names 3. Explain to the patient that tablets may be crushed, but drug has bitter taste that is difficult to mask, even with food. 4. Tell patient to report adverse reactions 5. Be alert with adverse reactions and drug interactions 6. Do not confuse the drug with cephalosporins with similar- sounding names. 7. Monitor for any unusualities.

PICTURE