DRUG

DOSAGE

MECHANISM OF ACTION The exact mechanism of action is not entirely known, but the primary mechanism responsible for its anti-inflammatory, antipyretic, and analgesic action is thought to be inhibition of prostaglandin synthesis by inhibition of cyclooxygenase (COX).

INDICATION AND CONTRAINDICATION Indication: Acute or long-term treatment of mild to moderate pain

SIDE AND ADVERSE EFFECTS

Side Effects: Headache Dizziness Insomnia Fatigue Tinnitus, Ohthamologic effects Rash Stomatitis Diarrhea Nausea &Vomiting Adverse Effects: Bleeding Peripheral edema Anaphylactoid reactions to fatal anaphylactic shock

NURSING CONSIDERATION
Assess pain and limitation of movement; note type, location and intensity before annd 30-60 mins after administration Observe and report signs of bleeding (e.g, bleeding gums, bloody or black stools, cloudy or bloody urine) Monitor for signs and symptoms of GI irritation and ulceration. Monitor for increased serum sodium and potassium in patients receiving potassiumsparing diuretics Monitor weight and report gains greater than 1 kg (2 lb)/24 h

Generic Name: Diclofenac Brand Name: Cataflam Therapeutic Class: Analgesic and Antiinflammatory Functional Class: NSAIDs

Dose: 75mg Route: TIV Frequency: q12o (x4 doses)

Contraindication Contraindicated with allergy to NSAIDs, significant renal impairment

Why client is receiving the drug based on the history of present illness? Patient is having pain (Post OP)

DRUG Generic Name: Pantoprazole Brand Name: Protonix IV Therapeutic Class: Antiulcer Agents Functional Class: Proton Pump Inhibitor Why client is receiving the drug based on the history of present illness? Patient was placed on NPO. (Pre-Op)

DOSAGE Dose: 40mg *While on NPO Route: TIV Frequency: Once a day

MECHANISM OF ACTION Binds to an enzyme in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen. Therapeutic Effects: Diminished accumulation of acid in the gastric lumen, with lessened acid reflux.

INDICATION AND CONTRAINDICATION Indication: Prevent serious problems caused by acid damage to your digestive system (Ulcers, CA of Esophagus)

Contraindication: Hypersensitivity

SIDE AND ADVERSE EFFECTS Side Effects: CNS: Headache, Nausea GI: Abdominal Pain, Diarrhea, Eructation, Flatulence, Constipation Skin: Pain/Redness/Swelling of the injection site, Rash, Pruritus, Urticaria Adverse Effects: Hematologic: Thrombophlebitis Leukopenia Musculoskeletal: Myalgia, Rhabdomyolysis Zollinger-Ellison Syndrome Immune System Disorder: Anaphylaxis Renal and Urinary Disorder: Interstitial Nephritis Psychiatric Disorder: Somnolence Endo: Hyperglycemia

NURSING CONSIDERATION Asses for any hypersensitivity to any proton pump inhibitor or any drug component Switch patients on IV therapy to oral dosage as soon as possible Monitor for immediately report S of S angioedema or a severe skin reaction Urea breath test 46 weeks after completion of therapy Provide additional comfort measures to alleviate discomfort from GI effects and headache

DRUG

DOSAGE

MECHANISM OF ACTION It inhibits the synthesis of bacterial cell wall, causing cell death. Therapeutic Actions: Bactericidal Action

INDICATION AND CONTRAINDICATION Indication: Surgical Prophylaxis/Reducing or eliminating infections Contraindication: Hypersensitivity to cephalosporins and other related antibiotics

Generic Name: Cefuroxime Brand Name: Zinacef Therapeutic Class: Antibacterial Antibiotic Functional Class: 2nd Generation Cephalosporins Why client is receiving the drug based on the history of present illness? Surgical prophylaxis(PreOP)

Dose: 750mg Route: TIV Frequency: q8o

SIDE AND ADVERSE EFFECTS Side Effects: Vomiting Abdominal Pain Diarrhea Rash Pruritus Urticaria Colitis Increased Serum Creatinine Decreased creatinine clearance Adverse Effects: Thrombophlebitis Pseudomonas Colitis Hemolytic Anemia Aplastic Anemia Haemorrhage Seizures Angioedema Cutaneous Vasculitis Anaphylaxis Nephrotoxicity

NURSING CONSIDERATION Determine history of hypersensitivity reactions to cephalosophorins, penicillins and history of allergies particularly to drugs before therapy is initiated. Perform culture and sensitivity before initiation of therapy. Monitor periodically BUN and creatinine clearance. Inspect IM/IV sites for signs of phlebitis Report onset of loose stools or diarrhea, though pseudomonas colitis rarely occurs, this potentially lifethreatening

complication should be ruled out. Monitor for manifestations of hypersensitivity. Discontinue drug and report their appearance promptly. Monitor I and O rates and patterns. Report any significant changes.

DRUG

DOSAGE

MECHANISM OF ACTION Binds to mu-opioid receptors and inhibits reuptake of serotonin and norepinephrine in the CNS. Tramadol works primarily by acting directly on the brain. The primary mode of action is to decrease the brain's perception of pain. Therapeutic Effects: Decreased pain

INDICATION AND CONTRAINDICATION Indication: Moderate to moderately severe pain

Generic Name: Tramadol Brand Name: Ultram Therapeutic Class: Analgesic Why client is receiving the drug based on the history of present illness? The patient is having pain

Dose: 300mg Route: TIV (side drip)

Contraindication: Known hypersensitivity to tramadol, any other component of this product, or opioids

SIDE AND ADVERSE EFFECTS Side Effects: Fever Diarrhea Nausea and Vomiting Fainting Tachycardia Drowsiness Headache Dizziness Upset Stomach

NURSING CONSIDERATION Assess type, location, and intensity of pain before and 2-3 hr (peak) after administration. Assess BP & RR before and periodically during administration. Assess bowel function routinely. Monitor patient for seizures Overdose may cause respiratory depression and seizures Encourage patient to cough and breathe deeply every 2 hr to prevent atelactasis and pneumonia.

Adverse Effects: Angioedema Seizures Loss of coordination Overactive reflexes Shallow breathing