Drug Names Mechanism of Action Indication Side Effects Nursing Responsibilities

Headache, nausea, abdominal Before :

PO, injection, nasal: Short-term
Inhibits prostaglandin (5 days or less) relief of mild to
Generic Name:
synthesis, reduces moderate pain.
Ketorolac prostaglandin levels in Ophthalmic: relief of ocular
aqueous humor. itching due to seasonal allergic
conjunctivitis. Treatment postop
Therapeutic Effect: for inflammation following
Brand Name:
Reduces intensity of pain cataract extraction, pain following
stimulus, reduces incisional refractive surgery.
intraocular inflammation. OFF-LABEL: prevention, treatment
of ocular inflammation
Classification: (ophthalmic form)
Analgesic
Dosage:
Contraindications
30 mg
Intracranial bleeding, hemorrhagic
diathesis, high risk of bleeding,
Route:
concomitant use of probenecid or
pentoxifylline, labor and delivery,
IVTT breatfeeding, advanced renal
impairment, active peptic ulcer
disease, chronic inflammation of
Frequency:
GI tract, GI bleeding/ulceration,
history of hypersensitivity to
Q8h
aspirin, NSAIDs. Perioperative
pain in setting of CABG surgery.
Timing:
8:00 AM- 4:00 PM
pain, dyspepsia, diarrhea, nasal
discomfort, rhinalgia, increased
lacrimation, throat irritation,
rhinitis, transient stinging,
burning, constipation, vomiting,
flatulence, stomatitis, ocular
irritation, allergic reactions,
superfacial ocular infection,
keratitis.
Adverse Effects
Peptic ulcer, GI bleeding,
gastritis, severe hepatic
reaction (cholestasis, jaundice)
occur rarely. Nephrotoxicity
( glomerular nephritis,
interstitial nephritis, nephritic
syndrome) may occur in
patients with pre-existing renal
impairment. Acture
hypersensitivity reaction
(fever, chills, joint pain) occurs
rarely.
 Asses onset, type, location,
duration of pain.
 Obtain baseline renal/hepatic
function tests.
During :
 Monitor renal function, LFT,
urinary output.
 Monitor daily pattern of bowel
activity, stool consistency.
 Observe for occult blood loss.
 Assess for therapeutic
response: relief of pain,
stiffness, swelling; increased
joint mobility; reduced join
tenderness; improved grip
strength.
 Monitor for bleeding ( may also
occur with ophthalmic route
due to systemic absorption)
After:
 Avoid aspirin, alcohol.
 Report abdominal pain, bloody
stools, or vomiting blood.
 If GI upset occur, take with
food, milk.
Ophthalmic :
 Transient stinging, burning
may occur upon instillation.
 Do not administer while
wearing soft contact lenses.
 Drug Names Mechanism of Action
Generic Name: Binds to mu-opioid
receptors in the central
Tramadol nervous system, causing
inhibition of ascending
pain pathways; increases
norpinephrine by
Brand Name: inhibiting its reabsorption
into nerve cells.
Thearapeutic effect:
Produces analgesia.
Classification:
Analgesic
Dosage:
50 mg
Indication
Nucynta: Relief of moderate to
severe acute pain in adult 18
years and older.
Nucynta ER: Management of
moderate to severe chronic pain
when around-the-clock analgesic
needed for extended period.
Treatment of diabetic neuropathy
pain.
Contraindications
Side Effects
Nausea, dizziness, vomiting,
sleeping, headache.
Adverse Effects
Nursing Responsibilities
Before :
 Assess onset, type, location,
and duration of pain.
 Obtain vital signs before giving
medication.
 If respirations are 12/min or
lower, withhold medication,
contact physician.
 Question history of hepatic
impairment.
During :
 Be alert for decreased
respiration or B/P.
 Initiate deep breathing and
coughing exercises, particularly
in patients with impaired
pulmonary function.
 Assess for clinical improvement
amd record onset of pain relief.
 Severe respiration depression,
acute or severe bronchial asthma,
hypercapnia in uncontrolled
setting, known or suspected
paralytic ileus, concurrent use or
ingestion within 14 days of MAOI
use.
Route:
IVTT
Frequency:
Drug Names Mechanism of Action Indication
Generic Name: Inhibits cell-wall
synthesis, promoting  Serious infections of
Cefazolin osmotic instability; respiratory, biliary And GU
usually bactericidal. tracts; skin soft tissues,
Brand Name: bone, and joint infections;
septecemia; endocarditis
Fazonil caused by E. Coli,
Enterobacteriaceae
gonococci, Haemophilus
Classification: influenza, Klebsiella,
Proteus mirabilis, S.
Antibiotic aureus, S. pneumonia, and
group of A beta-hemolytic
streptococci
Dosage:  Perioperative prophylaxis
2g
Contraindications
Respiratory depression,
serotonin syndrome have been
reported.
Side Effects
CNS:dizziness, headache, malaise,
paresthesia.
GI: abdominal cramps, anal
pruritus, anorexia, diarrhea,
dyspepsia, nausea, vomiting.
GU: genital pruritus, and
candidiasis, vaginitis
HEMATOLOGIC: anemia,
eosinophilia
RESPIRATORY: dyspnea
Adverse Effects
After:
 Avoid task that require
alertness, motor skills until
response to drug is
established.
 Avoid alcohol, CNS
depressants.
 Report nausea, vomiting,
shortness of breath, difficulty
breathing.
Nursing Responsibilities
Before :
 Assess patients injection before
therapy and regularly
thereafter
 Before giving first dose, obtain
specimen, culture for culture
and sensitivity test. Begin
therapy pending test results.
 Before giving first dose, ask
patient previous reactions to
cephalosporins or penicillin.
 Assess patients and familys
knowledge about drug therapy.
During :
 If adverse GI reactions occur,
monitor patients hydration.
After:
 Tell patient to report adverse
reactions.
Route:  Contraindicated in patients GI: pseudomembranous colitis
hypersensitive to
cephalosphorins. HEMATOLOGIC: leukopenia,
IVTT
thrombocytopenia, transient
neutropenia
Frequency:
SKIN: stevens-johnsons syndrome

Timing:

Drug Names Mechanism of Action Indication Side Effects Nursing Responsibilities

Generic Name: Competitively inhibits  Intractable duodenal ulcer;
action of h2 at receptor pathologic hypersecretory
Ranitidine sites of parietal cells, conditions, such as
decreasing gastric and Zollinger-Ellison syndrome;
secretion. short term therapy for
patients unable to tolerate
Brand Name: oral forms
 Duodenal and gastric ulcer
 Maintenance therapy for
duodenal ulcer
 Gastroesophageal reflux
Classification: disease
 Erosive esophagitis
Antiulcertive
CNS: malaise, vertigo
EENT: blurred vision
HEPATIC: jaundice
Other: burning and itching at
injection site
Before :
 Assess patients GI condition
before starting therapy and
regularly thereafter to monitor
drug effectiveness
 Don’t use aluminium based
needles or equipment when
mixing or giving drug
parenterally because drug is
incompatible with aluminium.
 Assess patients and familys
understanding about drug
therapy.

During :
Dosage:  be alert for adverse reaction
and drug interactions.

50 mg Contraindications Adverse Effects After:

  Contraindicated in patients
hypersensitivity to drug or
Route: any of its components
IVTT
HEMATOLOGIC: pancytopenia,
reversible leukopenia,
thrombocytopenia
Other: anaphylaxis,
angioedema
 warn patient about possible
complex sleep-related
bahaviors.
 Tell patient to consult
prescriber if insomnia worsens
or bahavior changes.

Frequency:  Urge

Timing:

Pre-operative

Drug Names Mechanism of Action Indication Side Effects Nursing Responsibilities

Generic Name: Inhibits prostaglandin PO, injection, nasal: Short-term Headache, nausea, abdominal Before :
synthesis, reduces (5 days or less) relief of mild to pain, dyspepsia, diarrhea, nasal  Asses onset, type, location,
Ketorolac prostaglandin levels in moderate pain. discomfort, rhinalgia, increased duration of pain.
 Obtain baseline renal/hepatic
aqueous humor. Ophthalmic: relief of ocular lacrimation, throat irritation,
function tests.
itching due to seasonal allergic rhinitis, transient stinging,
Brand Name: Therapeutic Effect: conjunctivitis. Treatment postop burning, constipation, vomiting, During :
Reduces intensity of pain for inflammation following flatulence, stomatitis, ocular  Monitor renal function, LFT,
stimulus, reduces cataract extraction, pain following irritation, allergic reactions, urinary output.
intraocular inflammation. incisional refractive surgery. superfacial ocular infection,  Monitor daily pattern of bowel
OFF-LABEL: prevention, treatment keratitis. activity, stool consistency.
Classification:  Observe for occult blood loss.
of ocular inflammation
 Assess for therapeutic
Analgesic (ophthalmic form) response: relief of pain,
stiffness, swelling; increased
joint mobility; reduced join
Dosage: tenderness; improved grip
strength.
 Monitor for bleeding ( may also
30 mg Contraindications Adverse Effects occur with ophthalmic route
due to systemic absorption)
 Intracranial bleeding, hemorrhagic
Route: diathesis, high risk of bleeding,
concomitant use of probenecid or
pentoxifylline, labor and delivery,
IVTT
breatfeeding, advanced renal
impairment, active peptic ulcer
Frequency: disease, chronic inflammation of
GI tract, GI bleeding/ulceration,
Q8h history of hypersensitivity to
aspirin, NSAIDs. Perioperative
pain in setting of CABG surgery.
Timing:
8:00 AM- 4:00 PM
Peptic ulcer, GI bleeding,
gastritis, severe hepatic
reaction (cholestasis, jaundice)
occur rarely. Nephrotoxicity
( glomerular nephritis,
interstitial nephritis, nephritic
syndrome) may occur in
patients with pre-existing renal
impairment. Acture
hypersensitivity reaction
(fever, chills, joint pain) occurs
rarely.
After:
 Avoid aspirin, alcohol.
 Report abdominal pain, bloody
stools, or vomiting blood.
 If GI upset occur, take with
food, milk.
Ophthalmic :
 Transient stinging, burning
may occur upon instillation.
 Do not administer while
wearing soft contact lenses.

Drug Names Mechanism of Action Indication Side Effects Nursing Responsibilities

Generic Name: Binds to mu-opioid
receptors in the central
Tramadol nervous system, causing
inhibition of ascending
pain pathways; increases
norpinephrine by
Brand Name: inhibiting its reabsorption
into nerve cells.
Thearapeutic effect:
Produces analgesia.
Classification:
Analgesic
Dosage:
Nucynta: Relief of moderate to
severe acute pain in adult 18
years and older.
Nucynta ER: Management of
moderate to severe chronic pain
when around-the-clock analgesic
needed for extended period.
Treatment of diabetic neuropathy
pain.
Nausea, dizziness, vomiting,
sleeping, headache.
Before :
 Assess onset, type, location,
and duration of pain.
 Obtain vital signs before giving
medication.
 If respirations are 12/min or
lower, withhold medication,
contact physician.
 Question history of hepatic
impairment.
During :
 Be alert for decreased
respiration or B/P.
 Initiate deep breathing and
coughing exercises, particularly
in patients with impaired
pulmonary function.
 Assess for clinical improvement
amd record onset of pain relief.
 50 mg Contraindications Adverse Effects
After:
Severe respiration depression, Respiratory depression,  Avoid task that require
Route: alertness, motor skills until
acute or severe bronchial asthma, serotonin syndrome have been response to drug is
hypercapnia in uncontrolled reported. established.
IVTT setting, known or suspected  Avoid alcohol, CNS
paralytic ileus, concurrent use or depressants.
ingestion within 14 days of MAOI  Report nausea, vomiting,
Frequency: use. shortness of breath, difficulty
breathing.
Q6h

Timing:

6:00 AM- 12:00 PM-

6:00 PM

Drug Names Mechanism of Action Indication Side Effects Nursing Responsibilities

Generic Name: Inhibits cell-wall CNS:dizziness, headache, malaise, Before :

synthesis, promoting  Serious infections of
Cefazolin osmotic instability; respiratory, biliary And GU
usually bactericidal. tracts; skin soft tissues,
Brand Name: bone, and joint infections;
septecemia; endocarditis
Fazonil caused by E. Coli,
Enterobacteriaceae
gonococci, Haemophilus
Classification: influenza, Klebsiella,
Proteus mirabilis, S.
Antibiotic aureus, S. pneumonia, and
group of A beta-hemolytic
streptococci
Dosage:  Perioperative prophylaxis
2g
paresthesia.  Assess patients injection before
therapy and regularly
GI: abdominal cramps, anal thereafter
pruritus, anorexia, diarrhea,  Before giving first dose, obtain
dyspepsia, nausea, vomiting. specimen, culture for culture
and sensitivity test. Begin
GU: genital pruritus, and therapy pending test results.
candidiasis, vaginitis  Before giving first dose, ask
patient previous reactions to
HEMATOLOGIC: anemia, cephalosporins or penicillin.
eosinophilia  Assess patients and familys
knowledge about drug therapy.
RESPIRATORY: dyspnea
During :
 If adverse GI reactions occur,
monitor patients hydration.
After:
 Tell patient to report adverse
 Contraindications
Route:
 Contraindicated in patients
hypersensitive to
IVTT
cephalosphorins.
Frequency:
Timing:
Drug Names Mechanism of Action Indication
Generic Name: Competitively inhibits  Intractable duodenal ulcer;
action of h2 at receptor pathologic hypersecretory
Ranitidine sites of parietal cells, conditions, such as
decreasing gastric and Zollinger-Ellison syndrome;
secretion. short term therapy for
patients unable to tolerate
Brand Name: oral forms
 Duodenal and gastric ulcer
 Maintenance therapy for
duodenal ulcer
 Gastroesophageal reflux
Classification: disease
 Erosive esophagitis
Antiulcertive
Dosage:
Adverse Effects
GI: pseudomembranous colitis
HEMATOLOGIC: leukopenia,
thrombocytopenia, transient
neutropenia
SKIN: stevens-johnsons syndrome
Side Effects
CNS: malaise, vertigo
EENT: blurred vision
HEPATIC: jaundice
Other: burning and itching at
injection site
reactions.
Nursing Responsibilities
Before :
 Assess patients GI condition
before starting therapy and
regularly thereafter to monitor
drug effectiveness
 Don’t use aluminium based
needles or equipment when
mixing or giving drug
parenterally because drug is
incompatible with aluminium.
 Assess patients and familys
understanding about drug
therapy.
During :
 be alert for adverse reaction
and drug interactions.
 50 mg Contraindications Adverse Effects After:
 warn patient about possible
 Contraindicated in patients HEMATOLOGIC: pancytopenia, complex sleep-related
Route: bahaviors.
hypersensitivity to drug or reversible leukopenia,
any of its components thrombocytopenia  Tell patient to consult
IVTT Other: anaphylaxis, prescriber if insomnia worsens
or bahavior changes.
angioedema
Frequency:  Urge

Timing:

Pre-operative

Drug Names Mechanism of Action Indication Side Effects Nursing Responsibilities

Generic Name: Inhibits prostaglandin PO, injection, nasal: Short-term Headache, nausea, abdominal Before :
synthesis, reduces (5 days or less) relief of mild to pain, dyspepsia, diarrhea, nasal  Asses onset, type, location,
Ketorolac prostaglandin levels in moderate pain. discomfort, rhinalgia, increased duration of pain.
 Obtain baseline renal/hepatic
aqueous humor. Ophthalmic: relief of ocular lacrimation, throat irritation,
function tests.
itching due to seasonal allergic rhinitis, transient stinging,
Brand Name: Therapeutic Effect: conjunctivitis. Treatment postop burning, constipation, vomiting, During :
Reduces intensity of pain for inflammation following flatulence, stomatitis, ocular  Monitor renal function, LFT,
stimulus, reduces cataract extraction, pain following irritation, allergic reactions, urinary output.
intraocular inflammation. incisional refractive surgery. superfacial ocular infection,  Monitor daily pattern of bowel
OFF-LABEL: prevention, treatment keratitis. activity, stool consistency.
Classification:  Observe for occult blood loss.
of ocular inflammation
 Assess for therapeutic
Analgesic (ophthalmic form) response: relief of pain,
stiffness, swelling; increased
joint mobility; reduced join
Dosage: tenderness; improved grip
strength.
 Contraindications
30 mg
Intracranial bleeding, hemorrhagic
diathesis, high risk of bleeding,
Route:
concomitant use of probenecid or
pentoxifylline, labor and delivery,
IVTT breatfeeding, advanced renal
impairment, active peptic ulcer
disease, chronic inflammation of
Frequency: GI tract, GI bleeding/ulceration,
history of hypersensitivity to
Q8h
aspirin, NSAIDs. Perioperative
pain in setting of CABG surgery.
Timing:
8:00 AM- 4:00 PM
Drug Names Mechanism of Action Indication
Adverse Effects
Peptic ulcer, GI bleeding,
gastritis, severe hepatic
After:
reaction (cholestasis, jaundice)
occur rarely. Nephrotoxicity
( glomerular nephritis,
interstitial nephritis, nephritic
syndrome) may occur in
patients with pre-existing renal
impairment. Acture
hypersensitivity reaction
(fever, chills, joint pain) occurs
rarely.
Side Effects
 Monitor for bleeding ( may also
occur with ophthalmic route
due to systemic absorption)
 Avoid aspirin, alcohol.
 Report abdominal pain, bloody
stools, or vomiting blood.
 If GI upset occur, take with
food, milk.
Ophthalmic :
 Transient stinging, burning
may occur upon instillation.
 Do not administer while
wearing soft contact lenses.
Nursing Responsibilities
Generic Name: Binds to mu-opioid Nucynta: Relief of moderate to Nausea, dizziness, vomiting, Before :
receptors in the central severe acute pain in adult 18 sleeping, headache.  Assess onset, type, location,
Tramadol nervous system, causing years and older. and duration of pain.
inhibition of ascending  Obtain vital signs before giving
pain pathways; increases Nucynta ER: Management of medication.
norpinephrine by moderate to severe chronic pain  If respirations are 12/min or
Brand Name: inhibiting its reabsorption when around-the-clock analgesic lower, withhold medication,
into nerve cells. needed for extended period. contact physician.
Treatment of diabetic neuropathy  Question history of hepatic
Thearapeutic effect: pain. impairment.
Produces analgesia. During :
Classification:  Be alert for decreased
respiration or B/P.
Analgesic  Initiate deep breathing and
coughing exercises, particularly
in patients with impaired
Dosage: pulmonary function.
 Assess for clinical improvement
amd record onset of pain relief.
50 mg Contraindications Adverse Effects
After:
 Avoid task that require
Route: Severe respiration depression, Respiratory depression, alertness, motor skills until
acute or severe bronchial asthma, serotonin syndrome have been response to drug is
hypercapnia in uncontrolled reported. established.
IVTT setting, known or suspected  Avoid alcohol, CNS
paralytic ileus, concurrent use or depressants.
ingestion within 14 days of MAOI  Report nausea, vomiting,
Frequency: shortness of breath, difficulty
use.
breathing.
Q6h

Timing:

6:00 AM- 12:00 PM-

6:00 PM

Drug Names Mechanism of Action Indication Side Effects Nursing Responsibilities

Generic Name: Inhibits cell-wall
synthesis, promoting  Serious infections of
Cefazolin osmotic instability; respiratory, biliary And GU
usually bactericidal. tracts; skin soft tissues,
Brand Name: bone, and joint infections;
septecemia; endocarditis
Fazonil caused by E. Coli,
Enterobacteriaceae
gonococci, Haemophilus
Classification: influenza, Klebsiella,
Proteus mirabilis, S.
Antibiotic aureus, S. pneumonia, and
group of A beta-hemolytic
streptococci
Dosage:  Perioperative prophylaxis
2g
Contraindications
Route:
 Contraindicated in patients
IVTT hypersensitive to
cephalosphorins.
Frequency:
Timing:
Drug Names Mechanism of Action Indication
CNS:dizziness, headache, malaise,
paresthesia.
GI: abdominal cramps, anal
pruritus, anorexia, diarrhea,
dyspepsia, nausea, vomiting.
GU: genital pruritus, and
candidiasis, vaginitis
HEMATOLOGIC: anemia,
eosinophilia
RESPIRATORY: dyspnea
During :
After:
Adverse Effects
GI: pseudomembranous colitis
HEMATOLOGIC: leukopenia,
thrombocytopenia, transient
neutropenia
SKIN: stevens-johnsons syndrome
Side Effects
Before :
 Assess patients injection before
therapy and regularly
thereafter
 Before giving first dose, obtain
specimen, culture for culture
and sensitivity test. Begin
therapy pending test results.
 Before giving first dose, ask
patient previous reactions to
cephalosporins or penicillin.
 Assess patients and familys
knowledge about drug therapy.
 If adverse GI reactions occur,
monitor patients hydration.
 Tell patient to report adverse
reactions.
Nursing Responsibilities
Generic Name: Unclear, pain relief may Mild to moderate pain caused by Hematologic: haemolytic anemia Before :
acetaminophen result from inhibition of headache, muscle ache, backache, Hepatic: jaundice  assess patients pain or
prostaglandin synthesis in minor arthritis, common cold, Skin: rash temperature before and during
CNS, with subsequent toothache or menstrual cramps or Other: hypersensitivity reaction therapy
blockage , pain impulses fever such as fever  assess patients drug history
from vasodilation and and calculate total daily dosage
Brand Name: increased peripheral accordingly. Many OTC
blood flow in products and combination
Paracetamol, tylenol hypothalamus, which prescription pain products
dissipates heat and lower contain acetaminophen
body temperature. During :
Classification:  be alert for adverse reaction
and drug interactions.
Analgesic, antipyretic  Give liquid form to children and
other patient who have trouble
swallowing
Dosage:
After:
 evaluate patient report of pain
325-600mg Contraindications Adverse Effects relief with drug
 patient’s liver function test
result remain normal
Hypersensitivity to drugs, caloric Hematologic:  patient and family states
Route:
under nutrition, acute liver failure, thrombocytopenin, understanding of drug therapy.
liver problems; severe renal neutropenia, leukopenia,
PO impairment, shock.
pancytopenia
Hepatic: hepatoxicity
Frequency: Metabolic: hypoglycemic coma
Skin: urticaria
Q4

Timing:

8AM 12PM 4PM 8PM

Drug Names Mechanism of Action Indication Side Effects Nursing Responsibilities

Generic Name: Direct-acting  To prevent post operative CNS: ataxia, confusion, Before :
trichomonacide and infection in contaminated depression, drowsiness, fatigue,  Assess patients infection before
metronodazole amebicide that works at or potentially contaminated fever, headache, insomnia, therapy and regularly
both intestinal and colorectal surgery. vertigo, weakness thereafter to monitor drug
Brand Name: extraintestinal sites.  Pelvic inflammatory CV: edema, flushing, effectiviness
disease. thrombophlebitis  Watch carefully for edema,
 Active Crohn disease GI: abdominal cramping,v especially on patients receiving
 Giardiasis anorexia, constipation, dry mouth, corticosteroids because it may
Classification: nausea, vomiting cause retention
GU: cystitis, darkened urine,  Record number and character
Antibacterial, dysuria, pyuria, polyuria. of stools when used inn
antiprotozoal SKIN: burning and stinging, amebiasis
contact dermatitis, dry skin,  Assess patients and familys
Dosage: pruritus, irritation, rash. knowledge about drug therapy
During :
500mg  Be alert for adverse reactions
and drug interactions
Route:  I. V. Infusion may cause
thrombophlebitis at site,
P. O. Contraindications Adverse Effects observe closely
 Assess skin for severity, areas
Frequency: or resocea before and after
 Contraindicated to patients CNS: seizures therapy, and any local adverse
T. I. D. hypersensitive to the drug reaction.
or other nitroimidazole HEMATOLOGIC: neutropenia, After:
Timing: derivatives. thrombocytopenia, transient  Tell patient not to use alcohol
leukopenia or drugs that contain alcohol
during therapy for at least 8
hours after therapy is
completed.
 Urge patient to take full course
of therapy even he/she feels
better.
 Instruct patient in proper
hygiene.