DRUG NAME MECHANISM OF ACTION INDICATION / ADVERSE NURSING RESPONSIBILITIES

CONTRAINDICATION EFFECT

GENERIC: Interferes with prostaglandin INDICATIONs: CNS: BEFORE:

KETOROLAC biosynthesis by inhibiting Advanced renal impairment or drowsiness, Dx.
cyclooxygenase pathway of risk of headache, a) Assessed history of hypersensitivity to ketorolac.
BRAND: arachidonic acid metabolism; renal impairment due to volume dizziness b) Assessed onset, type, location and duration of pain.
ACULAR, ACULAR LS, also acts as potent inhibitor of depletion; CV: c) Obtained baseline renal/hepatic function tests.
APO-KETOROLAC platelet aggregation before or during surgery if hypertension Tx.
hemostasis is EENT: tinnitus a) Perform a thorough physical assessment to
CLASS:  To treat moderate to severe critical; breastfeeding; GI: nausea, establish baseline data before drug therapy begins,
pain cerebrovascular vomiting, to determine the effectiveness of therapy, and to
THERAPEUTIC bleeding; concurrent use of diarrhea, evaluate for the occurrence of any adverse effects
NONSTEROIDAL SOURCE: aspirin or constipation, associated with drug therapy.
ANTI-INFLAMMATORY DRUG Jones & Bartlett Learning., & other salicylates, other NSAIDs, flatulence, b) Periodically assess dose.
(NSAID) Jones & Bartlett Publishers. or dyspepsia,
(2000). Nurse's drug handbook. probenecid; hemorrhagic epigastric DURING:
PHARMACOLOGIC: Sudbury, MA: Jones and Bartlett diathesis; pain, stomatitis Dx:
ANALGESIC, ANTIPYRETIC, Publishers. Hematologic: a) Asses mental status for worsening of depression,
ANTI-INFLAMMATORY CONTRAINDICATION: thrombocytopeni suicidal ideation, anxiety, social functioning, and/or
Angiotensin-converting a panic attack(especially during initiation of therapy
DOSAGE: enzyme inhibitors, beta- Skin: rash, and when dosage is changed
30mg adrenergic pruritus, b) Monitor mood changes.
blockers: decreased diaphoresis c) Monitor for adverse effects (e.g. sedation,
ROUTE: antihypertensive Other: excessive dizziness, respiratory dysfunctions, GU problems,
INTRAVENOUS effect thirst, edema, etc).
Anticoagulants: prolonged injection
prothrombin time site pain Tx.
Aspirin: altered ketorolac a) Ensured that drug vial was protected from light.
distribution, metabolism, and b) Administered medication.
excretion; increased c) Notified physician of any significant changes.
risk of serious adverse reactions Edx.
Cholestyramine: decreased a) Educate client on drug therapy to promote
ketorolac
absorption
Corticosteroids, other NSAIDs:
additive adverse GI effects
Diuretics: decreased diuretic
effect Hydantoins, lithium:
increased blood
levels and greater risk of
toxicity of these drugs
Methotrexate: increased risk of
methotrexate
toxicity
Probenecid: increased risk of
ketorolac toxicity
DRUG TO DRUG
INTERACTION:
Aminoglycosides, loop
diuretics: increased risk of
nephrotoxicity
Calcium-containing solutions:
possibly fatal reactions caused
by ceftriaxone
calcium precipitates
Probenecid: decreased
excretion an
increased blood level of
ceftriaxone
DRUG TO FOOD
INTERACTION:
Angelica, anise, arnica,
asafetida, bogbean, boldo,
celery, chamomile, clove,
danshen, fenugreek,
understanding and compliance.
b) Instruct patient to verbalize feelings and concerns.
AFTER:
Dx.
a) Observed patient for side effects.
b) Assessed for therapeutic response: relief of pain,
stiffness, swelling; increased joint mobility;
reduced joint tenderness; and improved grip
strength.
c) Assessed for signs and symptoms of
hypersensitivity.
Tx.
a) In case of hypersensitivity, be sure that emergency
equipment is available.
b) Provide safety measures (e.g. adequate lighting,
raised side rails, etc.) to prevent injuries.
c) Provide comfort measures (e.g. voiding before
dosing, taking food with drug, etc.) to help patient
tolerate drug effects.
Edx.
a. Instructed to avoid tasks that require alertness, and
motor skills until response to drug is established.
b. Instructed patient to increase water intake.
c. Emphasized to report any signs of itching, swelling
in the ankles, sore throat, easy bruising, etc.
feverfew, garlic, ginger, ginkgo,
ginseng, horse chestnut,
horseradish, licorice,
meadowsweet, onion, papain,
passionflower,
poplar, prickly ash, quassia,
red clover, turmeric, wild
carrot, wild lettuce, willow:
increased risk of bleeding.