Anti-inflammatory Drug: CELECOXIB

GENERIC BRAND DRUG CLASS DOSAGE AND MECHANISM OF INDICATION CONTRAINDI SIDE - NURSING
NAME NAME FREQUENCY ACTION CATION EFFECTS RESPONSIBILITIES
celecoxib Celebrex Pharmacologic 400 mg OD Exhibits anti- Adjunctive ● CNS:
class: p.r.n inflammatory, treatment to Hypersensiti dizziness,
Nonsteroidal analgesic, decrease vity to drug, drowsines
cyclooxygenase- and antipyretic the number sulfonamide s,
2 (COX-2 ) action due to of s, headache,
inhibitor, inhibition adenomatous or other insomnia,
anti- of the enzyme colorectal NSAIDs fatigue
inflammatory COX-2 polyps in ● Severe CV:
drug (NSAID) familial hepatic peripheral
Therapeutic adenomatous impairment edema
class: polyposis ● History of EENT:
ophthalmi
Antirheumatic asthma or
c effects,
Pregnancy risk urticaria
tinnitus,
category C ● Advanced
pharyngiti
renal
s, rhinitis,
disease
sinusitis
● Late GI:
pregnancy nausea,
● diarrhea,
Breastfeedi constipati
ng on,
abdominal
pain,
dyspepsia,
flatulence,
dry
mouth, GI
bleeding
GU:
menorrha
gia
Hematolo
gic:
decreased
hemoglobi
n
or
hematocri
t,
eosinophili
a,
epistaxis,
bruising,
 DRUG STUDY opioid analgesic
DRUG INDICATIONS CONTRAINDICATIONS ACTIONS SIDE NURSING
EFFECTS RESPONSIBILITIES
Generic Carbamazepine Tramadol may increase Tramadol is Tramadol is • Assess type, location, and
Name: (Tegretol, central nervous system used in the generally well intensity of pain before and 2-
Tramadol Tegretol XR , and respiratory management tolerated, and 3 hr (peak) after
Equetro, depression when of moderate side effects are administration.
Brand Carbatrol) combined with alcohol, to usually
Name: reduces the anesthetics, narcotics, moderately transient. • Assess BP & RR before and
Ultram, effect of tranquilizers or sedative severe pain. Commonly periodically during
Ultram ER tramadol by hypnotics. Extended reported side administration. Respiratory
increasing its release effects include depression has not occurred
inactivation in tablets are nausea, with recommended doses.
the body. used for constipation,
Quinidine moderate to dizziness, • Assess bowel function
(Quinaglute, moderately headache, routinely. Prevention of
Quinidex) severe drowsiness, constipation should be
reduces the chronic pain and vomiting. instituted with increased intake
inactivation of in adults who Less commonly of fluids and bulk and with
tramadol, require reported side laxatives to minimize
thereby continuous effects include constipating effects.
increasing the treatment for itching,
concentration an extended sweating, dry • Assess previous analgesic
of tramadol by period. mouth, history. Tramadol is not
50%-60%. diarrhea, rash, recommended for patients
Combining visual dependent on opioids or who
tramadol with disturbances, have previously received
monoamine and vertigo. opioids for more than 1 wk;
oxidase Some patients may cause opioid withdrawal
inhibitors (for who received symptoms.
example, tramadol have
Parnate) or reported • Prolonged use may lead to
selective seizures. physical and psychological
serotonin Abrupt dependence and tolerance,
inhibitors withdrawal of although these may be milder
((SSRIs, for tramadol may than with opioids. This should
example, result in not prevent patient from
fluoxetine anxiety, receiving adequate analgesia.
Prozac]) may sweating, Most patients who receive
result in severe insomnia, tramadol for pain d not
side effects rigors, pain, develop psychological
such as nausea, dependence. If tolerance
seizures or a diarrhea, develops, changing to an
condition called tremors, and opioid agonist may be required
serotonin hallucinations. to relieve pain.
syndrome.
• Tramadol is considered to
provide more analgesia than
codeine 60 mg but less than
combined aspirin
650mg/codeine 60 mg for
acute postoperative pain.

• Monitor patient for seizures.

May occur within
recommended dose range.
Risk increased with higher
doses and inpatients taking
antidepressants (SSRIs,
tricyclics, or Mao inhibitors),
opioid analgesics, or other
durgs that decrese the seizure
threshold.

• Overdose may cause

respiratory depression and
 seizures. Naloxone (Narcan)
may reverse some, but not all,
of the symptoms of overdose.
Treatment should be
symptomatic and supportive.
Maintain adequate respiratory
exchange.

• Encourage patient to cough

and breathe deeply every 2 hr
to prevent atelactasis and
pneumonia.

DRUG STUDY anti hypertensive

 Mechanism of
Drug Data Classification
Action
Generic Name Pharmacologic Acts directly on vascular General Indications
Hydralazine Class smooth muscle to cause - Hypertension
Vasodilator vasodilation, primarily - Eclampsia
Trade Name arteriolar, decreasing
Apresoline, Novo- Therapeutic Class peripheral resistance;
Hylazin Antihypertensive maintains or increases
renal and cerebral flow.
Pharmacokinetics
A: Rapidly absorbed
from the GI tract after
oral administration.
D: About 90% bound to
plasma proteins.
M: Undergoes
considerable first-pass
metabolism by
acetylation in the GI
mucosa and liver.
E: Mainly excreted in
urine as metabolites.
Indication Contraindications
Concentrations
- Hypersensitivity
- CAD
- mitral valvular
rheumatic heart disease
Precaution
- with CAV’s
- increased intracranial
pressure
- severe hypertension
with uremia
- advanced renal
damage
- slow acetylators
- lactation
- pregnancy
- pulmonary hypertension
Drug interaction
Drug to drug
- Increased
pharmacologic effects of
beta-adrenergic blockers
and hydralazine when
given concomitantly
Drug to food
- Increased bioavailability
of oral hydralazine given
with food.
Adverse Reaction Nursing R
CNS: Headache, Before
peripheral neuritis, - Check blood pressure.
dizziness, tremors, - Arrange for CBC, LE cell
psychotic reactions, before therapy.
characterized by - Assess for contraindicate
depression, - Observe the 15 rights of
disorientation, anxiety - Assess bowel sounds.
- Assess voiding pattern.
CV: Palpitations,
tachycardia, angina During
pectoris, hypotension, - Give oral drug with food.
paradoxical pressor - Use parenteral drug imm
response, orthostatic - Discard discolored solutio
hypotension - Arrange for CBC, LE cell
during prolonged therapy.
GI: Anorexia, nausea, - Instruct to take drug exac
vomiting, diarrhea,
constipation, paralytic After
ileus - Withdraw drug gradually.
- Discontinue if blood dysc
GU: Difficult - Arrange for pyridoxine the
micturition, impotence symptoms of peripheral ne
- Monitor for orthostatic hy
Hematologic: Blood - Report persistent or seve
dyscrasias fever or malaise, muscle o
numbness, tingling.
Hypersensitivity: - Do proper documentation
Rash, urticaria,
pruritus, fever, chills,
arthralgia, eosinophilia;
rarely, hepatits,
obstructive jaundice
Other: Nasal
congestion, flushing,
edema, muscle
cramps,
lymphadenopathy,
splenomegaly,
dyspnea, lupus-like
syndrome, possible
carcinogenesis,
lacrimation,
conjunctivitis