Drug name Generic Name: Ketorolac tromethamine Brand Name: Acular

Mechanism of action Classification: Nonsteroidal antiinflammatory Action: Posseses antiinflammatoy, analgesic, and antipyretic effects

Administration Dosage: 30mg Route: IV Frequency: q6h

Indication Severe, acute pain in adults, itching causzed by seasonal allergic conjunctivitis, , post operative inflammation following cataract surgery, reduce ocular pain, burining and stinging after corneal refractive surgery, reduction of ocular pain and photophobia following incisional refractive surgery,

Contraindication Hypersenstivty to the drug or allergic symtpms to aspirin or other NSAIDs. Active peptic ulcer disease, recent GI bleeding or perforatin, history of peptic ulcer disease, advanced renal impairment and in those at risk for renal failure due to volume depletion, suspected or confirmed cerebrovaxcula bleeding, hemorrhagic diathesis, or incomplete hemostasis and in those with high risk of bleeding.

Adverse Effect Headache, dizziness, rdrowsiness, diarrhea, nausea, dyspepsia, indigestion, epigastric pain, edema, transient burning stinging upon administration, ocular irritation,

Nursing responsibilities 1. use as a part of a regular analgesic schedule rather than on an asneeded basis 2. if given p.r.n, basis, base size of repeat dose. If pain returns within 3-5 hr, the enxt dose can be increased by up to 50 percent 3. shortening the dosing intervals recommended will lead to an increased frequency and duation of side effects

Drug name Tramadol HCl (Dolcet)

Mechanism of action Inhibits prostaglandin sythetase to cause antipyretic and antiinflammatory effects: the exact mechanism is unknown.

Administration Indication Dosage: 50mg Route: oral Frequency: q6h Moderate to severe pain

Contraindication Acute intoxication with alcohol, hypnotics, narcotics, centrally-acting analgesics, opioids or psychotropic drugs. Hypersensitivity

Adverse effect CNS and GI disturbances. Nausea, dizziness. Fatigue, constipation, dry mouth.

Nursing responsibilities y Assess for level of pain relief and administer dose as needed but not to exceed the recommended total daily dose y Discontinue drug and notify the physician if s/sx of hypersensitivity occur y Take appropriate safety precautions. To be taken with food to y avoid GI upset.

Drug name Generic Name: Ranitidine Brand Name: Zantac/ Aciran

Mechanism of action Classification: H2 Receptor Blocker Antagonist Action: Competitively inhibits the action of histamine at the H2 receptors of the parietal cells of the stomach, inhibiting basal gastric acid secretion and gastric acid secretion that is stimulated by food, insulin, histamine, cholinergic agonists, gastrin and pentagastrin

Administration Dosage: 50mg Route: IVTT Frequency: Q8h

Indication y Short-term treatment of active duodenal ulcer and benign gastric ulcer y Maintenance therapy for duodenal ulcer at reduced dosage. y Short-term treatment for GERD. y Pathologic Hypersecretory conditions (Zollinger-Ellison syndrome) y Treatment of heartburn, acid indigestion, sour stomach

Contraindication y Contraindicated with allergy to ranitidine, lactation y Use cautiously with impaired renal or hepatic function, pregnancy

Adverse Effect y headache, malaise, dizziness, somnolence, insomnia, vertigo y tachycardia, bradycardia y rash, alopecia y constipation, diarrhea, y nausea and vomiting, abdominal pain, hepatitis

Nursing responsibilities 1. Administer oral drug with meals and at bedtime. 2. Decrease doses in renal and liver failure. 3. Provide concurrent antacid therapy to relieve pain. 4. Administer IM dose undiluted, deep into large muscle group. 5. Arrange for regular follow-up including blood test, to evaluate effects

Drug name Generic Name: Metoclopramide Brand Name: Maxolon

Mechanism of action Classification: Antiemetic, GI Stimulant Action: Stimulates motility of upper GI tract without stimulating gastric, biliary, or pancreatic secretions; appears to sensitize tissues to action of acetylcholine; relaxes pyloric sphincter, which, when combined with effects on motility, accelerates gastric emptying and intestinal transit; little effect on gallbladder or colon motility; increases lower esophageal sphincter pressure; has sedative properties; induces release of prolactin

Administration Dosage: 10mg Route: IV Frequency: PRN

Indication y Disturbances of GI motility y Relief of symptoms of acute and recurrent diabetic gastroparesis y Nausea and vomiting y Metabolic diseases y Short-term therapy for adults with symptomatic gastroesophageal reflux who fail to respond to conventional therapy. y

Contraindication Contraindicated with allergy to metoclopramide y GI hemorrhage y Mechanical obstruction or perforation y Epilepsy y Use cautiously with previously detected breast cancer, lactation, pregnancy, fluid overload, renal impairment

Adverse Effect y restlessness, drowsiness, fatigue, insomnia, dizziness, anxiety y transient hypertension nausea and diarrhea

Nursing responsibilities carefully during IV administration. >Monitor diabetic patients, arrange for alterations in insulin dose or timing if diabetic control is compromised by alterations in timing of food absorption.

Treatment y D5LR y

Description Hypertonic Solution

Indication Replacement therapy particularly in extracellular fluid deficit accompanied by acidosis

Nursing responsibilities 1. Never stop hypertonic solutions abruptly. 2. Don t give concentrated solutions I.M. or subcutaneously. 3. Monitor glucose level carefully. 4. Check vital signs frequently. Report adverse reactions. 5. Monitor fluid intake and output and weight carefully. Watch closely for signs and symptoms of fluid overload. 6. Monitor patient for signs of mental confusion

Treatment y PNSS y

Description for patients who cannot take y fluids orally and have developed or are in danger of developing dehydration or hypovolemia. NS is typically the first fluid used when hypovolemia is severe enough to threaten the adequacy of blood circulation and has long been believed to be the safest fluid to give quickly in large volumes.

Indication Replacement & maintenance of fluid & electrolytes.

Nursing responsibilities 1. Monitor pt. frequently for: a. Signs of infiltration / sluggish flow b. Signs of phlebitis / infection c. Dwell time of catheter and need to be replaced d. Condition of catheter dressing 2. Check the level of the IVF. 3. Correct solution, medication and volume. 4. Check and regulate the drop rate.

Treatment Blood transfusion

Description common procedure in which blood is given to you through an intravenous (IV) line in one of your blood vessels. Blood transfusions are done to replace blood lost during surgery or a serious injury. A transfusion also may be done if your body can't make blood properly because of an illness.

y y y y

Indication To replace blood loss To increase blood volume Restoring hemodynamic homeostasis of patient Maintaining the quality of life of patient

Nursing responsibilities insuring that the right unit of blood is to be administered to the right patient after typing and cross matching by the lab.