Drug Name Aeknil

Classificatio n Analgesic (Non Opiod) & Antipyretic

Action Antipyretic, analgesic. Paracetamol produces analgesia by raising the threshold of the pain center in the brain and by obstructing impulses at the painmediating chemoreceptors. The drug produces antipyresis by an action on the hypothalamus; heat dissipation is increased as a result of vasodilation and increased peripheral blood flow.

Contraindication Nephropathy. o

Nursing Considerations If to be given as analgesia, assess onset, type, location, duration of pain. Can be given without regards to meals. Tablets can be crushed. Assess temperature directly before and 1 hour after giving medication. If respirations are <12/min (<20/min in children), withhold the medication and contact the physician. Evaluate for therapeutic response: relief of pain, stiffness, swelling; increasing in joint mobility; reduced joint tenderness; improve grip strength. Therapeutic blood serum level: 10-30 mcg/mL; toxic serum level: >200 mcg/mL.

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Ephedr ine

Bronchodila tor, sympathomi metic, vasopressor

Ephedrine sulfate is a potent sympathomimetic that stimulates both and receptors and has clinical uses related to both actions. Its peripheral actions , which it owes in part to the release of norepinephrine, simulate responses that are obtained when adrenergic nerves are stimulated. These

Allergic reactions to ephedrine sulfate are rare. The hypersensitivity, if known, is a specific contrain dication. Patients hypersensitive to other sympathomimeti cs may also be hypersensitive to ephedrine sulfate.

Supervise continuously patients receiving ephedrine IV. Take baseline BP and other vital signs. Check BP repeatedly during first 5 min, then q35min until stabilized. Monitor I&O ratio and pattern, especially in older male patients. Encourage patient to void before taking medication (see ADVERSE

include an increase in blood pressure, stimulation of heart muscle, constriction of arterioles, relaxation of the smooth muscle of the bronchi and gastr ointestinal tract, anddilation of the pupils. In the bladder, relaxation of the detrusor muscle is not prominent, but the tone of the trigone and vesicle sphincter is increased. Ephedrine sulfate also has a potent effect on the CNS. It stimulates the cerebral cortex and subcortical centers, which accounts for its use in narcolepsy. The cardiovascular r esponses reported in man include moderate tachycardia , unchanged or augmented stroke volume, enhanced cardiac output, variable alterations in peripheral resistance and usually a rise in blood pressure. The action of ephedrine is more prominent on the heart than on the blood vessels.

EFFECTS). Monitor for systemic effects of nose drops that can occur because of excessive dosage from rapid absorption of drug solution through nasal mucosa. This is most likely to occur in older adults.

Do not exceed recommended dose. Avoid OTC meds. Pt may experience the following side effects: dizziness, weakness, restlessness,tremors,l ight headedness,urinary retention. Report nervousness,palpitati ons,sleeplessness, sweating. Avoid driving or operating dangerous equipments Empty bladder before taking the drug

Ephedrine sulfate increases the flow of coronary, cerebral an d muscle blood. Fentan yl Opiod agonist analgesic The principal actions of therapeutic value are analgesia and sedation. Alterations in respiratory rate and alveolar ventilation, associated with narcotic analgesics, may last longer than the analgesic effect. As the dose of narcotic is increased, the decrease in pulmonary exchange becomes greater. Large doses may produce apnea. Fentanyl appears to have less emetic activity than either morphine or meperidine. Histamine assays and skin wheal testing in man indicate that clinically significant histamine release rarely occurs with fentanyl. Recent assays in man show no clinically significant histamine release in dosages up to 50 mcg/kg (0.05 mg/kg) (1 mL/kg). Fentanyl preserves cardiac stability, and blunts stress-related hormonal changes at Fentanyl citrate injection is contraindicated in patients with known intolerance to the drug.
Repeated intraoperative doses can cause respiratory depression to persist into the postoperative period. - Fentanyl interferes with respiratory function and pupil reaction, both of which are essential parts of neurological assessment. - Assess the therapeutic response and in breakthrough cancer pain consider adjustment of background analgesia where this is appropriate. - Excessive heat may increase absorption from patches so local heat should not be applied and patients with fever should be carefully monitored.

Do not drink grape fruit juice while using this drug Pt may exp. The ff. side effects: Dizziness, sedation, drowsiness,impaired visual acuity,nausea, loss of appetite,constipation Report severe nausea, vomiting, palpitations,shortness of breath, or DOB Pt. must ask for assistance if there is a need to move Laxative may help in

Mether gin

Ergot Alkaloid and Derivative

higher doses. Methergin Stimulates uterine smooth muscles producing sustained contractions thereby shortens the third stage of labor

case of constipation contraindicated in patients hypersensitive to methylergonovin e or any component of the formulation. >ergot alkaloids are contraindicated with potent inhibitors of CYP3A4 (includes protease inhibitors, azole antifungals, and some macrolide antibiotics); hypertension; toxemia; pregnancy Be alert for adverse reactions and drug interactions. >This drug should be used extremely carefully because of it's potent vasoconstrictor action. I.V. use may induce sudden hypertension and cerebrovascular accidents. As a last resort, give I.V. slowly over several minutes and monitor blood pressure closely. Monitor BP, notify physician if BP suddenly increases or frequent periods of uterine relaxation, Excretion in breast milk unknown/not recommended Causes uterine cramping so medicate as needed for pain. Should not be routinely administered I.V. because of possibility of inducing sudden hypertension and

Syntoci Hormone, non oxytocic

Syntocinon (oxytoc in) exerts a selective action on the smooth musculature of the uterus, particularly toward the end of pregnancy, during labor and immediately following delivery. Oxytocin stimulates rhythmic contractions of the uterus, increases the frequency of existing contractions, and raises the tone of the uterine musculature. Syntocinon (oxytoc in), when given in appropriate doses during pregnancy, is capable of eliciting graded increases in uterine motility from a moderate increase in the rate and force of spontaneous motor activity to sustained tetanic contraction.

Syntocinon (ox ytocin) injection is contraindicated in any of the following conditions: Significant cephalopelvic disproportion; unfavorable fetal positions or presentations which are undeliverable without conversion prior to delivery (transverse lies); i.e., in obstetrical emergencies where the benefit-to-risk ratio for either the fetus or the mother favors surgical intervention; in cases of fetal distress where delivery is not imminent; prolonged use in uterine inertia or severe toxemia; hypertonic uterine patterns; patients with hypersensitivity to the drug; induction or augmentation of labor in those cases where

cerebrovascular accident Drug teaching should be incorporated into the teaching about delivery The pt needs to know the name of the drug and what she can expect after it is administered Be aware of purpose and anticipated effect of oxytocin. Monitor blood pressure, fluid intake and output, and labor closely if using oxytocin for induction; fetal monitoring is strongly recommended Pregnancy risk factor X. Note breast-feeding caution. Must be given with infusion pump for induction of labor and uterine contractions observed for hyperstimulation and/or fetal distress. Turn off medication if this occurs and notify health care provider. Report sudden, severe HA immediately to healthcare providers.

vaginal delivery is contraindicated, such as cord presentation or prolapse, total placental previa, and vasa previa.