XII.

Drug Study
Mechanism of Indication Contraindication Adverse Nursing Responsibilities Nursing Implication
Action Reactions
Generic Name: Dosage: Competitive Used to Hypersensitivity to ♣ Constipation C - Gastointestinal agent; ◙ Inform patient that the
Ranitidine 50mg inhibition of prevent ulcer ranitidine or any ♣ Diarrhea Antisecretory (H2-receptor medication may cause
Frequency: histamine at H2- while patient is component of the ♣ Fatigue antagonist) drowsiness, dizziness,
Brand name: Q8° receptors of the on NPO. formulation. H - Reduced amount of acid in or fatigue (use caution
♣ Headache
Zantac Route: gastric parietal the stomach that may result to when driving or
♣ Insomnia
IVTT while cells, which inhibits prevented ulcer incidence. engaging in tasks
♣ Muscle pain
Classification: on NPO gastric acid E - Every 8 hours while patient is requiring alertness).
♣ Nausea
Gastointestinal secretion, gastric on NPO.
♣ Vomiting
agent; volume, and C - Instruct client to report any ◙ Instruct patient to
Antisecretory hydrogen ion ♣ Agitation adverse reaction to the avoid taking any new
(H2-receptor concentration are ♣ Anemia physician or nurse. Tell patient medication during
antagonist) reduced. Does not ♣ Confusion that antacids may decrease the therapy without
affect pepsin ♣ Depression absorption of ranitidine. consulting prescriber.
Source: secretion, ♣ Easy bruising K - Ranitidine can interfere with
◙ Nursing 2007 pentagastrin- or bleeding the metabolism of alcohol. ◙ Instruct patient to
Drug Handbook stimulated intrinsic Patients taking ranitidine who avoid alcohol and
27th Edition, factor secretion, or drink alcohol may have follow diet as
Lippincot Williams serum gastrin. elevated blood alcohol levels. prescriber recommends.
& Wilkins

Mechanism of Indication Contraindication Adverse Nursing Responsibilities Nursing Implication

 Action Reactions
Generic Name: Dosage: Binds to -opiate Management Hypersensitivity to ♣ Dizziness C - Analgesic ◙ Tell patient that
Tramadol 50mg receptors in the of pain in the tramadol, opioids, or ♣ Nausea H - Relief of pain in the driving or operating
Frequency: CNS causing operation site. any component of the ♣ Drowsiness operation site. machinery should be
Brand name: Q6° inhibition of formulation; opioid- E - Every 6 hours x 6 doses. avoided until the effect
♣ Dry mouth
Ultram Route: ascending pain dependent patients; May be taken with or without of drug wears off.
♣ Constipation
IVTT x 6 pathways, altering acute intoxication food.
♣ Headache
Classification: doses the perception of with alcohol, C - Instruct client to report any ◙ Instruct patient to
♣ Sweating
Analgesic and response to hypnotics, centrally- adverse reaction to the repot cravings to
♣ Vomiting
pain; also inhibits acting analgesics, physician or nurse. Tell physician immediately.
Source: the reuptake of opioids, or ♣ Itching patient that tolerance or drug
◙ Nursing 2007 norepinephrine and psychotropic drugs ♣ Rash dependence may result from ◙ Inform client that
Drug Handbook serotonin, which ♣ Visual extended use (withdrawal medication may cause
27th Edition, also modifies the disturbances symptoms have been CNS depression and/or
Lippincot ascending pain ♣ Vertigo reported); abrupt respiratory depression,
Williams & pathway. discontinuation should be particularly when
Wilkins avoided. combined with other
K - You should not take CNS depressants
Ultram if you have ever been
addicted to drugs or alcohol.
Should be used only with
extreme caution in patients
receiving MAO inhibitors

Mechanism of Indication Contraindication Adverse Nursing Responsibilities Nursing Implication

Action Reactions
 Generic Name: Dosage: Inhibits Used for Hypersensitivity to ♣ Rash C - Nonsteroidal Anti- ◙ Instruct client to avoid
Ketorolac 30mg prostaglandin treating ketorolac, aspirin, other ♣ Ringing in Inflammatory Drugs alcohol and maintain
Frequency: synthesis by inflammation NSAIDs, or any component the ears (NSAIDs) adequate hydration (2-3
Brand name: Q6° decreasing the and pain in of the formulation; patients ♣ Headaches H - Pain as well as L/day of fluids) unless
Toradol Route: activity of the the operation who have developed nasal ♣ Dizziness inflammation and its instructed to restrict fluid
IVTT x 6 enzyme, site. polyps, angioedema, or signs and symptoms - intake.
♣ Drowsiness
Classification: doses cyclooxygenase, bronchospastic reactions to redness, swelling, fever,
♣ Abdominal
Nonsteroidal which results in other NSAIDs; active or and pain are reduced. ◙ Monitor for signs of
pain
Anti- decreased history of peptic ulcer E - Every 6 hours x 6 pain relief, such as an
♣ Nausea
Inflammatory formation of disease; recent or history of doses. increased appetite and
♣ Diarrhea
Drugs (NSAIDs) prostaglandin GI bleeding or perforation; C - Instruct client to report activity
♣ Constipation
precursors, patients with advanced renal any adverse reaction to
Source: chemicals that cells disease or risk of renal ♣ Heartburn the physician or nurse. ◙ Instruct client to avoid
◙ Nursing 2007 of the immune failure; labor and delivery; ♣ Fluid Tell patient that adverse taking ketorolac with
Drug Handbook system make that nursing mothers; prophylaxis retention reactions can occur with aspirin or other NSAIDs
27th Edition, cause the redness, before major surgery; overuse. such as ibuprofen
Lippincot fever, and pain of suspected or confirmed K - Do not drink alcohol (Motrin, Advil),
Williams & inflammation and cerebrovascular bleeding; while taking ketorolac. naproxen (Aleve,
Wilkins that also are hemorrhagic diathesis; Alcohol can increase the Naprosyn), piroxicam
believed to be concurrent ASA or other risk of stomach bleeding (Feldene), etc.
important in the NSAIDs; epidural or caused by ketorolac.
production of non- intrathecal administration;
inflammatory pain. concomitant probenecid;
pregnancy (3rd trimester
 Mechanism of Indication Contraindication Adverse Nursing Responsibilities Nursing Implication
Action Reactions
Generic Name: Dosage: Inhibits bacterial cell Used for treating Hypersensitivity ♣ Nausea C - Antibiotic ◙ Tell patient that
Ampicillin 500mg wall synthesis by bacterial infection. to ampicillin, any ♣ Vomiting H - Pain as well as medication may cause
Frequency: binding to one or component of the ♣ Loss of inflammation and its nausea or vomiting
Brand name: Q6° more of the penicillin formulation, or appetite signs and symptoms - (small, frequent
Omnipen, Route: binding proteins other penicillins ♣ Diarrhea redness, swelling, fever, meals, frequent
Polycillin, IVTT (PBPs); which in and pain are reduced. mouth care, sucking
♣ Abdominal
Principen turn inhibits the final E - Every 6 hours lozenges, or chewing
pain
transpeptidation step C - Instruct client to gum may help); or
♣ Rash
Classification: of peptidoglycan report any adverse diarrhea (buttermilk,
♣ Itching
Antibiotic synthesis in bacterial reaction to the physician boiled milk, or yogurt
♣ Headache
(penicillins) cell walls, thus or nurse. Tell patient may help).
♣ Confusion
inhibiting cell wall that Antibiotic
Source: biosynthesis. ♣ Dizziness medicines can cause ◙ Instruct client to
◙ Nursing 2007 Bacteria eventually diarrhea, which may be maintain adequate
Drug Handbook lyse due to ongoing a sign of a new hydration (2-3 L/day
27th Edition, activity of cell wall infection. of fluids) unless
Lippincot Williams autolytic enzymes K - Do not take the instructed to restrict
& Wilkins (autolysins and medication in larger fluid intake.
murein hydrolases) amounts, or take it for
while cell wall longer than recommended
assembly is arrested. by your doctor.

Mechanism of Indication Contraindication Adverse Nursing Nursing

 Action Reactions Responsibilities Implication

Generic Name: Dosage: Reduces fever Used for the relief of Contraindicated with ♣ Chest pain C - Analgesic and ◙ Warn patient that
Paracetamol 500mg by acting on the fever, headaches, and allergy to acetaminophen ♣ Dyspnea Antipyretic acute overdoses
hypothalamus other and pains or any component. ♣ Rash H - Relief of fever, (above 1000 mg per
Classification: Frequency: to cause regarding surgical headaches, and other single dose and
♣ Fever
Analgesic and PRN vasodilatation wound. Use cautiously with minor aches and pains. above 4000 mg per
♣ Acute
Antipyretic & sweating. impaired hepatic E - as necessary or when day for adults,
kidney
Route: function, chronis temperature is more above 2000 mg per
failure
Source: IVTT alcoholism, and than 37.80C day if drinking
♣ Jaundice
◙ Nursing 2007 pregnancy lactation. C- Instruct client to report alcohol) of
♣ Acute
Drug Handbook any adverse reaction paracetamol can
kidney
27th Edition, like allergies to the cause potentially
failure
Lippincot Williams physician or nurse. fatal liver damage
♣ Hepatic
& Wilkins Warn patient that high and, in rare
toxicity and
doses or unsupervised individuals, a
failure
long –term use can normal dose can do
cause liver damage. the same; the risk is
K - Do not exceed the heightened by
recommended dosage. alcohol .
Not to use for marked
fever (temperature
higher than 39.50C).
Fever persisting longer
than 3 days.
XIII. Health Teaching Plan
Medication Exercise Treatment Hygiene Outpatient Diet
Ranitidine •The extended period of •Pain relievers •Make sure you have enough •Instruct patient to have follow •Try eating smaller meals than
C - Gastointestinal agent; bed rest after a prescribed by the sanitary pads for vaginal up check up consultation and normal and have healthy
Antisecretory (H2- hysterectomy can weaken doctor bleeding and discharge. You regular check ups. snacks in between .Eat healthy,
receptor antagonist) the muscles in the lower may have some discharge because the patient’s body
H - Reduced amount of back and stomach. •Indwelling and bloody drainage for •Instruct patient to follow good needs nutrients to heal (even if
acid in the stomach that Following exercises catheter several days after your compliance to medication she doesn’t feel like it). Eat
may result to prevented should be held for five to hysterectomy. cold-water fish as well as
ulcer incidence. 10 seconds and repeated •Instruct patient to limit her turkey, chicken, organic bread,
E - Every 8 hours while 10 times on a daily basis. •Keep sanitary environment movement at the beginning or soups, salads, vegetables and
patient is on NPO. one that would not allow if her doctor authorizes it take broths.
C - Instruct client to report •The chin tuck can be microorganisms to multiply some short walks to keep her
any adverse reaction to performed while sitting and cause infection. blood circulating and prevent • Take the best daily multiple
the physician or nurse. in a chair or on the side blood clots from forming in premium vitamins recommend
Tell patient that antacids of your bed. Keep your •Provide catheter care: Keep her legs. and vitamin C as well. These
may decrease the arms relaxed and by your the catheter coiled by the vitamins will help improve
absorption of ranitidine. side. Look straight ahead client’s side to prevent the •Avoid all lifting after the sleep, will make less
K - Ranitidine can and pull your chin as tubing to hang in a loop that surgery and during the post susceptibility to colds, flu’s
interfere with the though you are allow the urine to sit in the hysterectomy period (ask for and viruses less, will increase
metabolism of alcohol. attempting to create a tubing; maintain external assistance). energy levels and provide the
Patients taking ranitidine double chin. cleanliness around the patient with sharper and clearer
who drink alcohol may catheter. Keep the drainage •Instruct patient avoid mind.
have elevated blood •The upper back and bag off the floor to prevent climbing stairs or driving a car
alcohol levels. shoulder stretch is done microorganisms from during this recuperation period
while lying in bed or on a moving up from outside the (ask family and friends for
Tramadol mat. Bring your hands bag and into the catheter; help). • Instruct patient to drink
over your head and rest change catheter every 2 filtered water. And since most
C - Analgesic with your palms up. weeks to prevent infection. •Tell patient to avoid drinking of life is "consumption and
H - Relief of pain in the Press your arms back into alcoholic beverages for a few elimination", the patient needs
operation site. the bed. •Maintain good oral hygiene weeks (especially while taking to consume 8-10 glasses of
E - Every 6 hours x 6 medication). water daily to adequately
doses. May be taken with •The pelvic tilt can also •Provide good perineal care. "flush" her system of toxins
or without food. be achieved in a lying- Change off perineal pad at •Instruct patient to avoid which would otherwise build
C - Instruct client to report down position. You can least twice a day. Wiping aspirin and dairy foods during up and cause some level of
any adverse reaction to place your hands on your from front to back. the post hysterectomy time discomfort or illness.
the physician or nurse. stomach or put one hand because dairy products will not
Tell patient that tolerance under your lower back help you with constipation. • Taking omega-3 and fatty
or drug dependence may and keep the remaining The pain medicine you will be acids should be taken daily
result from extended use hand on your stomach. taking during the post because it has shown that it
(withdrawal symptoms Lightly tighten your hysterectomy time will tend to reduces inflammation, reduces
have been reported); buttocks and stomach make you constipated. the risk of strokes and heart
abrupt discontinuation muscles to pull your attacks, help lower cholesterol
• Instruct patient to change the
should be avoided. lower back down. You and thin the blood.
dressing over her incision once
K - You should not take will notice your pelvis or
a day or sooner if it gets dirty
Ultram if you have ever hip bones roll backward.
or wet.
been addicted to drugs or
alcohol. Should be used
• Keep the wound area
only with extreme caution
clean by washing it with
in patients receiving MAO
mild soap and water.
inhibitors
Ketorolac •You will have to get on
your hands and knees to
C - Nonsteroidal Anti- carry out the stomach-
•Tell patient that she may
Inflammatory Drugs strengthening movement.
remove her wound dressings
(NSAIDs) Start by taking a deep
(bandages) and take showers if
H - Pain as well as breath. As you slowly
sutures (stitches), staples, or
inflammation and its exhale, keep the rest of
glue were used to close her
signs and symptoms - your body still while
skin. Instruct her not to soak in
redness, swelling, fever, tightening your stomach
a bathtub or hot tub, or go
and pain are reduced. muscles.
swimming, until her doctor
E - Every 6 hours x 6
tells her it is okay.
doses.
C - Instruct client to report •If tape strips (Steri-Strips)
any adverse reaction to •Exercise as soon as the were used to close her incision,
the physician or nurse. doctor authorizes it. cover them with plastic wrap
Tell patient that adverse Moderate exercise will before showering for the first
reactions can occur with improve immune week. Do not try to wash off
overuse. defenses and antioxidant the Steri-Strips or glue. They
K - Do not drink alcohol levels. should fall off in about a week.
while taking ketorolac. If they are still there after 10
Alcohol can increase the days, she can remove them,
risk of stomach bleeding unless her doctor tells her not
caused by ketorolac to.
Ampicillin

C - Antibiotic
H - Pain as well as
inflammation and its
signs and symptoms -
redness, swelling, fever,
and pain are reduced.
E - Every 6 hours
C - Instruct client to report
any adverse reaction to
the physician or nurse.
Tell patient that
Antibiotic medicines can
cause diarrhea, which
may be a sign of a new
infection.
K - Do not take the
medication in larger
amounts, or take it for
longer than recommended
by your doctor.
Paracetamol

C - Analgesic and
Antipyretic
H - Relief of fever,
headaches, and other
minor aches and pains.
E - as necessary or when
temperature is more than
37.80C
C- Instruct client to report
any adverse reaction like
allergies to the physician
or nurse. Warn patient
that high doses or
unsupervised long –term
use can cause liver
damage.
K - Do not exceed the
recommended dosage.
Not to use for marked
fever (temperature higher
than 39.50C). Fever
persisting longer than 3
days.