Metronidazole
Classification: Antibiotic, Antibacterial, Antiprotizoal
Indication: Acute infection with susceptible anaerobic bacteria
Contraindication: Active organic disease of CNS, Drug Allergy, Blood Dyscracia
MOA: Disturbs DNA Synthesis resulting in loss of structure, strand breakage,
inhibition of nucleic acid synthesis and cell death
Side effects: Headache, Nausea, Dry mouth, Vomiting, Diarrhea
Nsg Responsibilities:
 Instruct pt to take with food/milk to decrease GI reaction
 Inform pt that drug may turn urine into brown
Carboprost
Classification: Abortifacient, Prostaglandins
Indication: Termination of pregnancy 13-20 weeks from LMP,
Evacuation of uterus in instance of missed abortion or
intrauterine fetal death in 2nd trimester
Post-partum hemorrhage due to uterine atony
Contraindication: Hypersensitivity, Acute PID, Active cardiac,
pulmonary & renal disease.
MOA: Stimulates the myometrium of the pregnant uterus to contract,
similar to labor contractions, eliminating the contents of the uterus
Side Effects: Headache, Weakness, Hypotension, Chest pain, Nausea & Vomiting
Nsg Responsibilities:
 Assess allergy to drug
 Monitor uterine tone and vaginal discharge during procedure and after
 Ensure adequate hydration
Keterolac
Classification: Non-steroidal anti inflammatory agents (NSAIDs) , Non opioid analgesics
Indication: Short term management of pain
Contraindication: Hypersensitivity, cross sensitivity with other NSAIDs may exist
pre or perioperative use.
MOA: Inhibits prostaglandin synthesis, producing peripherally mediated analgesia
Also has an antipyretic and anti-inflammatory property
Side Effects: Drowsiness, Headache, Fatigue
Nsg Responsibilities:
 Monitor BP upon admin, lower than 90/80: never administer.
 Assess pain prior and 1-2 hrs following
 Caution patient to avoid concurrent use of alcohol, aspirin and NSAIDs
Tranexamic Acid
Classification: Anti-hemophilic agent
Indication: Anti hemorrhagic and antifibrinolytic for effective homeostasis in
various surgical cases
Contraindication: Patients predisposed to thrombosis, prophylaxis before
and during delivery
MOA: Forms a reversible comlex that displaces plasminogen from fribrin resulting
In inhibition of fibrinolysis, also inhibits the proteolytic activity of plasmin
Side Effects:
Nsg Responsibilities:
 Dosage modification required
 Watch out for any signs of bleeding
Mefenamic Acid
Classification: NSAIDs, Analgesic, Anti pyretic
Indication: Short term relief of mild to moderate pain
Contraindication: Hypersensitivity to drug, GI Inflammation, Use cautiously in
Children, pregnant & lactating women
MOA: Binds the prostaglandin synthetase receptors, inhibiting the action of
Prostaglandin synthetase making the symptoms of pain temporarily reduced
Side Effects: Headache, dizziness, N/V, Diarrhea, Bleeding, GI pain
Nsg Responsibilities:
 Assess pain prior to and 1-2 hrs following
 Assess history of allergies to NSAIDs
 Give drug with food, milk or antacids
Metoclopramide (reclomide)
Classification: Dopaminergic Blocker, Anti emetic, GI Stimulant
Indication: Relief of symptoms of acute and recurrent diabetic gastroparesis,
Short term therapy for adults with symptomatic GERD who fail to
Respond to continuous therapy
Prophylaxis of post-op N/V when nasogastric suction is undesirable
Stimulation of gastric emptying and intestinal transit of barium when
delayed emptying interferes with radiologic exam of the stomach/SI
Contraindication: Allergy, GI hemorrhage, Mechanical obstruction/perforation, Epilepsy
MOA: Blocks dopamine receptors by disrupting CNS chemoreceptor trigger zone, increasing
Peristalsis and promoting gastric emptying
Side Effects: Drowsiness, N/V, Diarrhea, Dry mouth,
Nsg Responsibilities:
 Inform pt to take medication 30 minutes before meals
 Instruct pt to report any involuntary movement of face, eyes or limbs
Cefuroxime
Classification: Cephalosporin, Anti-infective
Indication: Pharyngitis, Tonsillitis, Infections of the urinary & lower respiratory tracts, skin
Structure infections caused by streptococcus pneumoniae and pyogenes,
Contraindication: Hypersensitivity to drug, use cautiously with hypersensitive pts to
Penicillin, BF women w/ history of renal sufficiency
MOA: Interferes with bacterial cell wall synthesis and division by binding to cell wall,
causing cell to die.
Side Effects: Thrombophlebitis, pain, N/V, seizures, hematuria, renal dysfunction
Nsg Responsibilities:
 Instruct pt to take drug with food every 12 hrs as prescribed
 Determine history of hypersensitivity rx to cephalosporins, penicillins and
allergies particularly to drugs before therapy is initiated
 Advise pt to immediately report rash/bleeding tendency
 Report episodes of loose stools
Amoxicillin
Classification: Anti infective
Indication: Treatment of infection of respi tract, skin and skin structures, urinary tract,otitis
media, meningitis, sinusitis
Contraindication: Hypersensitivity to penicillin, cephalosporins or imipenen. Not used to
treat severe pneumonia, bacteremia, pericarditis, meningitis and septic
arthritis during acute stage
MOA: Prevents bacterial cell wall synthesis during replication
Side Effects: N/V, Abdominal pain, diarrhea, rash
Nsg Responsibilities:
 Advise pt to take medication with meals for better absorption
 Instruct pt to take medication as prescribed even after feeling better
 Instruct pt to report any s/e that may occur
Tramadol hydrochloride
Classification: Analgesics
Indication: Moderate to severe pain in pts who require around the clock treatment of pain
Contraindication: Hypersensitivity to drug, Acute intoxication with alcohol, sedative
hypnotics, Significant respiratory depression, acute asthma
MOA: Inhibits reuptake of serotonin and norepinephrine in CNS
Side Effects: Headache, Vertigo, Dizziness, N/V, Diarrhea, Bronchospasm
Nsg Responsibilities:
 Assess pt’s response to drugs 30 mins after administration
 Monitor respiratory status
 Instruct pt to report any allergic reaction
Bisacodyl
Classification: Laxative
Indication: Constipation, bowel cleansing for childbirth, surgery and endoscopic exam
Contraindication: Hypersensitivity to drug, intestinal obstruction, gastroenteritis &
Appendicitis
MOA: Thought to stimulate colonic mucosa, producing parasympathetic reflexes that
enhance peristalsis and increase water and electrolyte secretions
Side Effects: N/V, Diarrhea, Abdominal pain, burning sensation in rectum
Nsg Responsibilities:
 Assess stools for frequency and consistency
 Monitor pt for electrolyte imbalances & dehydration
Naproxen
Classification: NSAIDs, Non-opioid analgesic, anti pyretic, anti inflammatory
Indication: Pain, Dysmenorrhea
Contraindication: Hypersensitivity to NSAIDs, Asthma
MOA: Thought to inhibit prostaglandin synthesis
Side Effects: Drowsiness, Headache, Palpitations, N/V, Diarrhea, GI Bleeding
Nsg Responsibilities:
 Tell pt to take medication with food and stay upright for 30 minutes