D.

INDICATION AND CONTRAINDICATIONS OF MEDICATIONS

DRUG ORDER

MECHANISM OF
ACTION

INDICATION

CONTRAINDICATION
S

ADVERSE
EFFECT

Generic name
Tramadol

the exact mechanism

of action is unknown
but similar morphine.
Like morphine,
tramadol binds to
receptors in the brain
(opioid receptors) that
are important for
transmitting the
sensation of pain from
throughout the body t

moderate to
moderately
severe pain

Contraindicated in
patients
hypersensitive to drug
or other opioids
Use cautiously in
patients at risk for
seizures or respiratory
depression

nausea,
vomiting,
sweating,
itching and
constipation

Brand name
Ultracep,
Ultram
Classification
Analgesics

Route
IV
Dosage
50 mg

Frequency
Q 8 hours

Source:
http://www.nlm.nih.go
v/medlineplus/druginf
o/meds/a695011.html

NURSING RESPONSIBILITIES
Do not take tramadol while you are:
alcohol or street drugs;
narcotic pain medicine;
sedatives or tranquilizers (such as
Valium);
medicine for depression or anxiety; or
medicine for mental illness (such as
bipolar disorder, schizophrenia).
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.
Encourage patient to cough and

breathe deeply every 2 hr to prevent

atelactasis and pneumonia
Monitor patient for drug dependence

DRUG ORDER

Generic name
Tranexamic
ketorolac
Acid
Brand Name
Brand
toradol Name
Cyklokapron,
Lysteda
Classification
Nonsteroidal
antiClassification
inflammatoryage
Antifibrinolytic,
nts,
antihemorrhagi
nonopioidanalage
c
sics

Route
IV

Dosage
500
30 mg
mg

Frequency
q
Every
8 Hours
6 hours

MECHANISM OF
ACTION
-Tranexamic
Inhibits prostaglandin
acid is a
synthesis,
synthetic producing
derivative pe
of
ripherally
the aminomediated
acid lysine
analgesiathat exerts
Also
itshas
antipyretic
antifibrinolytic
and antieffect
inflammatory
through the reversible
propertie
s.blockade
Therapeutic
of lysine
effect:
Decreased
binding sites
pain
on
plasminogen
molecules
http://www.scribd.com
/doc/174028890/ketor
olac-drug-study

Source:
http://www.patient.co.
uk/medicine/Tranexa
mic-acid.htm

INDICATION

bleeding
Activedue
duodenal
to trauma,
ulcer
control
unwanted
GERD
bleeding
Active being
gastric ulcer

CONTRAINDICATION
S
allergy
Sensitivity
to tranexamic
to NSAIDS
acid
kidney
GI bleeding
problems
(kidney failure),
patients
Renal Impairment
who have or
have had a blood clot
Cardiovascular
in their blood vessels
disease
(thrombosis)
particularly in the leg
or lung, patients in
whom a blood clot has
caused a stroke,
severebruising,
patients with family
members who have
had a blood clot in
their blood
vessels, irregular
periods

ADVERSE
EFFECT
Nausea,
Headache
vomiting,
Dizziness
diarrhea,
fatigue or
dizziness

NURSING RESPONSIBILITIES
Advice pt not to to drive or
Observe
operate10
machinery
rights
for safety
Wash handspurposes
Provide
safety
Never
take more than the
Evaluate pt pain
prescribed dose.
Keep patient IV site sterile
Unusual
change
in bleeding
Watched
out
for signs
of allergic
pattern
should
be
immediately
reactions during drug reaction
reported
to the physician.
Record
and document
the time
The medication
reaction
after drugcan be taken
with or without meals.
administration
Do notrest
break,
or chew
Provide
and crush,
comfort
Discardbefore
sharp swallowing.
to container
Inform the client that he/she
should inform the physician
immediately if the following
severe side effects occur:
Severe allergic reactions such as
rash, hives, itching, dyspnea,
tightness in the chest, swelling
of the mouth, face, lips or
tongue
Calf pain, swelling or tenderness
Chest pain
Confusion

DRUG ORDER

MECHANISM OF
ACTION

INDICATION

Generic name
RANITIDINE

Inhibits the action of

anti-histamine in the
H2 receptor site
located in the gastric
parietal cells resulting
in inhibition on gastric
acid secretion

Treatment and
prevention of
heart burn,
ingestion and
sour stomache

Brand Name
ZANTAC

Classification
ANTI-ULCER

Has anti bacterial

action against H pylori

Route
IV

Dosage
50 MG

Frequency
Every 8 hours

DRUG ORDER

Read
more: http://www.netd
octor.co.uk/digestivehealth/medicines/zant
ac.html#ixzz2hGLykX
ND
Follow
us: @NetDoctor on
Twitter | NetDoctorUK
on Facebook

MECHANISM OF
ACTION

Read
more: http://www.
netdoctor.co.uk/di
gestivehealth/medicines/
zantac.html#ixzz
2hGLqiT9u
Follow
us: @NetDoctor
on
Twitter | NetDocto
rUK on Facebook

INDICATION

CONTRAINDIC
ATIONS

Elderly
people.
People
with
decrease
d kidney
function.
Zantac
syrup
contains
ethanol
(alcohol)
and as a
result
may not
be
suitable
for
children,
pregnant
or
breastfee
ding
women,
or those
suffering
from
alcoholis
m, liver
disease,
epilepsy,
or brain
injury or
disease.

CONTRAINDIC
ATIONS

ADVERSE
EFFECT

NURSING RESPONSIBILITIES

headache

constipation

diarrhea

nausea

vomiting

stomach
pain

ADVERSE
EFFECT

observe 10 rights of drug

administration
wash hands
instruct patient not to take new
medicationw/o consulting physician
Instruct patient to take as directed
and donot increase dose
Allow 1 hour between any other
antacidand ranitidine
Avoid excessive alcohol
Assess patient for epigastric or
abdominalpain and frank or occult
blood in the stool,emesis, or gastric
aspirate
Nurse should know that it may
cause false-positive results for urine
protein; test withsulfosalicylic
acid
Inform patient that it may cause
drowsinessor dizziness
Inform patient that increased fluid
and fiber intake may minimize
constipation
Advise patient to report onset of
black, tarrystools; fever, sore throat;
diarrhea;dizziness; rash; confusion;
or hallucinationsto health car
professional promptly
Inform patient that medication
maytemporarily cause stools and
tongue toappear gray blackInstruct
patients to monitor for andreport
occurrence of drug-inducedadverse
reaction
Record the drug given and watch
out for signs of adverse effect

NURSING RESPONSIBILITIES

DRUG ORDER

Generic name
ceftriaxone

Classification
Antibiotics/Cep
halosporin.

Route
Deep IM

Dosage
250 mg

Frequency
Single dose

MECHANISM OF
ACTION

INDICATION

Treatment
Works by inhibiting
for
the mucopeptide
bacterial
synthesis in the
infection To
bacterial cell wall. The
reduce the
beta-lactam
developme
moietyof Ceftriaxon
nt of druge binds to
resistant
carboxypeptidases,
bacteria
endopeptidases, an
and
d
maintain
Transpeptidases in
the
the
effectivene
bacterial cytoplasmic
ss
of
membrane. The
Rocephin
s e enzymes are
(ceftriaxon
involved in cell-wall
e)
and
synthesis and cell
other
division. By binding
antibacteri
to these enzymes
al
drugs,
, Ceftriaxone results
ceftriaxone
in the formation of
should be
of defective cell
used only
walls and cell death
to treat or
prevent
infections
Source:
that
are
http://www.rxlist.com/
proven or
rocephinstrongly
drug/consumer-sidesuspected
effectsto
be
precautions.htm
caused by
http://www.scribd.com
bacteria.
/doc/53039442/DRUGSTUDY-ceftriaxoneForgram

CONTRAINDI
CATIONS

Hyperbilirubin
emic neonates
(esp.
prematures).
Concomitant
calciumcontaining
solutions
or
products
in
newborns

ADVERSE
EFFECT

Inj site
reactions,
hematologi
c effects
(eg,
eosinophilia
), rash,
diarrhea,
elevated
liver
enzymes;
rare:
allergic
pneumoniti
s, seizures,
anaphylaxis
.

NURSING RESPONSIBILITIES

Before using this medication, tell

your doctor or pharmacist your
medical history, especially of:
gallbladder disease, kidney disease,
liver disease, stomach/intestinal
diseases (e.g., colitis).

Skin test should be done

Apply aseptic technique

Locate the site

Observe 10 rights of the patient

Avoid giving any products by vein

that contain calcium (including
solutions such as Ringer's solution,
Hartmann's solution, parenteral
nutrition-TPN/PPN) to a newborn less
than 1 month old who is receiving
this medication. Doing so can cause
serious problems in the vital organs.

Ceftriaxone is not recommended for

use in newborns with high blood
bilirubin levels.

Tell your doctor if you are pregnant

before using this medication.

This medication passes into breast

milk and may have undesirable
effects on a nursing infant. Consult
your doctor before breast-feeding