DRUG STUDY

Name of Patient:: Mr. Dale Address: Impression: Invasive Ductal Carcinoma

Date of Visit / Admission: November 23, 1993 Ward: Surgical Room: 2 Status: Single Age: 67 y.o Sex: Male
CLASSIFICATION:
Date Brand Generic Route & CONTRA NURSING
DOSAGE MECHANISM OF INDICATIONS EVALUATION
Ordered Name Name Frequency INDICATIONS RESPONSIBILITIES
ACTION
November Apo- ranitidine 50 mg IVTT q8hrs Chemical class: -To prevent -Acute -Be aware that Signs of acid
23, 1993 Ranitidine Aminoalkyl-substituted duodenal and porphyria,hyper ranitidine must be reflux is not
(CAN), furan derivative gastric ulcers. sensitivity to diluted for I.V. use if noted.
GenRanitidi Therapeutic class: Anti- -To prevent ranitidine or its not using premixed
ne (CAN), ulcer agent, gastric acid components solution. For I.V.
Novo- Mechanism of Action: indigestion, injection, dilute to
Ranitidine Mechanism of Action heartburn, and total of 20 ml with
(CAN), Nu- Inhibits basal and sour stomach normal saline
Ranit nocturnal secretion of caused by solution, D5W,
(CAN), gastric acid and pepsin eating certain D10W, lactated
Zantac by competitively foods or Ringer’s solution, or
inhibiting the action of drinking certain 5% sodium
histamine at H2 beverages. bicarbonate. For I.V.
receptors on gastric -To treat acid infusion, dilute to
parietal cells. This action indigestion, total volume of 100
reduces total volume of heartburn, and ml of same
gastric juices and, thus, sour stomach. solutions.
irritation of GI mucosa. -Tell patient to stop
taking ranitidine and
contact prescriber if
she has trouble
swallowing, vomits
blood, or passes
black or bloody
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stools.
-Don’t add additives
to premixed
solution.
November Zinacef cefuroxime 1.5 gms ANSTT Chemical class: -To treat acute Hypersensitivity -Give I.V. injection No infection is
23, 1993 prior to ORSecond-generation bacterial to over 3 to 5 minutes noted.
cephalosporin, 7- exacerbations cephalosporins through tubing of a
750 mg IVTT q8hrs aminocephalosporanic of chronic or their flowing compatible
acid bronchitis and components I.V. fluid.
Therapeutic class: uncomplicated -Monitor I.V. site for
Antibiotic skin and soft- extravasation and
Mechanism of Action: tissue phlebitis.
Interferes with bacterial infections. -Monitor BUN and
cell wall synthesis by -To treat serum creatinine
inhibiting the final step in severe or levels and fluid
the cross-linking of complicated intake and output to
peptidoglycan strands. infections. detect signs of
Peptidoglycan makes the nephrotoxicity.
cell membrane rigid and Monitor patients with
protective. Without it, renal impairment
bacterial cells rupture closely because
and die. they may have
greater toxic
reactions to
cefuroxime.
November Allerdryl diphenhydr 1 amp prior to OR Chemical class: -To treat -Bladder neck -Keep elixir No allergic
23, 1993 (can), amine Ethanolamine derivative hypersensitivity obstruction container tightly symptoms is
Banophen, hydrochlori Therapeutic class: reactions, such -hypersensitivity closed. Protect elixir noted.
Benadryl, de Antianaphylactic adjunct, as perennial to and parenteral
Benadryl antidyskinetic, and seasonal diphenhydramin forms from light.
Allergy, antiemetic, allergic rhinitis, e or its -Expect to
Diphenhist antihistamine, antitussive vasomotor components discontinue drug at
CapTabs, (syrup), antivertigo, rhinitis, allergic -lower least 72 hours
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Genahist, sedative-hypnotic conjunctivitis, respiratory tract before skin tests for
Hyrexin Mechanism of uncomplicated symptoms allergies because
Action:Diphenhydramin allergic skin (including drug may inhibit
e produces eruptions, and asthma), MAO cutaneous histamine
antidyskinetic effects, transfusion inhibitor response, thus
possibly by inhibiting reactions therapy, narrow producing false
acetylcholine in the CNS. angle negative results.
It also produces glaucoma, -Advise patient to
antitussive effects by pyloroduodenal avoid taking other
directly suppressing the obstruction, OTC drugs that
cough center in the stenosing peptic contain
medulla oblongata in the ulcer, diphenhydramine to
brain. symptomatic prevent additive
Diphenhydramine’s benign prostatic effects.
antiemetic and hyperplasia
antivertigo effects may
be related to its ability to
bind to CNS muscarinic
receptors and depress
vestibular stimulation
and labyrinthine function.
Its sedative effects are
related to its CNS
depressant action.
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November ConZip, tramadol 50 mg IV q8hrs Chemical class: -To relieve -Alcohol -After patient Pain is
23, 1993 Rybix ODT, PRN Cyclohexanol moderate to intoxication receives first relieved.
Ryzolt, Therapeutic class: moderately -excessive use tramadol dose,
Ultram, Analgesic severe pain. of central-acting watch for allergic
Ultram ER Mechanism of Action: analgesics, reactions, including
Binds with mu receptors hypnotics, angioedema,
and inhibits the reuptake opioids, or other bronchospasm,
of norepinephrine and psychotropic pruritus, Stevens-
serotonin, which may drugs Johnson syndrome,
account for tramadol’s -hypersensitivity toxic epidermal
analgesic effect. to tramadol or necrolysis, and
its components; urticaria. Also watch
use within 14 for signs and
days of MAO symptoms of
inhibitor therapy anaphylaxis, such
as dyspnea and
hypotension.
-Tell patient to notify
prescriber
immediately if he
develops any
sudden onset,
unusual, persistent,
or severe adverse
reactions.
-Instruct patient to
inform all
prescribers of
tramadol therapy
because of potential
drug interactions.
November Toradol ketorolac 30 mg IVTT q8hrs Chemical class: Acetic -To treat -Advanced -Give I.V. injection Pain is
23, 1993 acid derivative moderate to renal over at least 15 relieved.
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Therapeutic class: severe pain impairment or seconds.
Analgesic, anti- risk of renal -Notify prescriber if
inflammatory impairment due pain relief is
Mechanism of Action: to volume inadequate or if
Blocks cyclooxygenase, depletion breakthrough pain
an enzyme needed to hemophilia or occurs between
synthesize other bleeding doses because
prostaglandins. problems, supplemental doses
Prostaglandins mediate including of an opioid
inflammatory response coagulation or analgesic may be
and cause local platelet function required.
vasodilation, swelling, disorders -Monitor liver
and pain. They also -hypersensitivity function test results
promote pain to ketorolac because rarely,
transmission from tromethamine, elevations may
periphery to spinal cord. aspirin, other progress to severe
By blocking NSAIDs, or their hepatic reactions,
cyclooxygenase and components including fatal
inhibiting prostaglandins, -incomplete hepatitis, liver
this NSAID reduces hemostasis necrosis, and
inflammation and -labor and hepatic failure.
relieves pain. delivery
-treatment of
perioperative
pain during
coronary artery
bypass graft
surgery
November Tylenol paracetamo 300 mg IVTT q4hrs Chemical Class: -To relieve mild - -Tell patient that Fever is
23, 1993 l/ PRN Nonsalicylate, para- to moderate Hypersensitivity tablets may be reduced.
acetaminop aminophenol derivative pain from to crushed or
hen Therapeutic Class: headache, acetaminophen swallowed whole.
Antipyretic, nonopioid muscle ache, or its -Caution patient not
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analgesic backache, components, to exceed
Mechanism of Action: minor arthritis, severe hepatic recommended
Inhibits the enzyme common cold, impairment, dosage or take other
cyclooxygenase, Toothache, or severe active drugs containing
blocking prostaglandin menstrual liver disease. acetaminophen at
production and cramps the same time
interfering with pain -To reduce because of risk of
impulse generation in the fever liver damage.
peripheral nervous Advise patient to
system. Acetaminophen contact prescriber
also acts directly on before taking other
temperature regulating prescription or OTC
center in the products because
hypothalamus by they may contain
inhibiting synthesis of acetaminophen.
prostaglandins E2. -Teach patient to
recognize signs of
hepatotoxicity, such
as bleeding, easy
bruising and
malaise, which
commonly occurs
with chronic
overdose.