DE CASTRO, Lady Charlene E.
BSN 3C – 2b
DRUG DRUG MECHANISM OF ACTION CONTRAINDICATIONS/
CLASSFICATION INDICATIONS
Ketorolac tromethamine NSAID, ANALGESIC It inhibits synthesis of Contraindications:
prostaglandins and is a ▪ Hypersensitivity to ketorolac;
Brand name: peripherally acting analgesic. individuals with complete or
Toradol, Acular, Acular LS Ketorolac does not have any partial syndrome of nasal polyps,
known effects on opiate angioedema, and bronchospastic
Dosage: receptors reaction to aspirin or other
10 mg tablets; 15 mg/mL, NSAIDs; during labor and
30 mg/mL injection; 0.4%, delivery; patients with severe
0.5% ophthalmic solution renal impairment or at risk for
renal failure due to volume
depletion; patients with risk of
bleeding; active peptic ulcer
disease; pre- or intraoperatively;
intrathecal or epidural
administration; in combination
with other NSAIDs; lactation.
Indications:
▪ Short-term management of pain
▪ reduction of post-operative pain
ADVERSE EFFECTS NURSING RESPONSIBILITIES
CV: Drowsiness, dizziness, ▪ Correct hypovolemia prior to administration of
headache ketorolac.
▪ Lab tests: Periodic serum electrolytes and liver
GI: Nausea, dyspepsia, GI functions; urinalysis (for hematuria and
pain, hemorrhage proteinuria) with long-term use.
▪ Monitor urine output in older adults and patients
Other: Edema, sweating, pain with a history of cardiac decompensation, renal
at injection site. impairment, heart failure, or liver dysfunction as
well as those taking diuretics. Discontinuation of
drug will return urine output to pretreatment
level.
▪ Monitor for S&S of GI distress or bleeding
including nausea, GI pain, diarrhea, melena, or
hematemesis. GI ulceration with perforation can
occur anytime during treatment. Drug decreases
platelet aggregation and thus may prolong
bleeding time.
▪ Monitor for fluid retention and edema in patients
with a history of CHF.Avoid taking calcium
carbonate with cereals or other foods high in
oxalates. Oxalates combine with calcium
carbonate to form insoluble, nonabsorbable
compounds.
▪ Watch for S&S of GI ulceration and bleeding
(e.g., bloody emesis, black tarry stools) during
long-term therapy.
▪ Note: Possible CNS adverse effects (e.g., light-
headedness, dizziness, drowsiness).
▪ Do not drive or engage in potentially hazardous
activities until response to drug is known.
▪ Do not use other NSAIDs while taking this drug.
▪ Do not breast feed while taking this drug. Give
with food to reduce GI effects.
 DRUG DRUG MECHANISM OF ACTION CONTRAINDICATIONS/ ADVERSE EFFECTS NURSING RESPONSIBILITIES
CLASSFICATION INDICATIONS
PENICILLIN G ANTIINFECTIVE; Acid-stable, penicillinase-Contraindications: Body as a Whole: Local ▪ Do not confuse penicillin G benzathine
BENZATHINE BETA-LACTAM sensitive, long-acting form of ▪ Hypersensitivity to penicillins or pain, tenderness, and fever with preparations containing procaine
ANTIBIOTIC; penicillin G. Absorbed slowly cephalosporins; lactation; associated with IM penicillin G (e.g., Bicillin C-R).
Brand name: NATURAL in body because of extremely pregnancy (category B). injection, chills, fever, ▪ Make IM injection deep into upper outer
Bicillin, Bicillin L-A, PENICILLIN low water solubility. wheezing, anaphylaxis, quadrant of buttock. In infants and small
Permapen Produces lower blood Indications: neuropathy, children, the preferred site is the midlateral
concentrations than other ▪ Infections highly susceptible to nephrotoxicity; aspect of the thigh.
penicillin G compounds but penicillin G, such as Streptococcal, superinfections, Jarisch- ▪ Shake multiple-dose vial vigorously before
Dosage: has the longest duration of Pneumococcal, and Staphylococcal Herxheimer reaction in withdrawing desired IM dose. Shake
300,000 units/mL, 600,000 antimicrobial activity of all infections, venereal disease such as patients with syphilis. prepared cartridge unit vigorously before
units/mL, 1,200,000 units/2 other available parenteral or syphilis (including early, late, and injecting drug.
mL, 2,400,000 units/4 mL repository penicillins. congenital forms), and Skin: Pruritus, urticaria ▪ Select IM site with care. Injection into or
injection nonvenereal diseases (e.g., yaws, and other skin eruptions. near a major peripheral nerve can result in
bejel, and pinta). Also used in nerve damage. Inadvertent IV administration
prophylaxis of rheumatic fever. Hematologic: has resulted in arterial occlusion and cardiac
Eosinophilia, hemolytic arrest.
anemia and other blood ▪ Make injections at a slow steady rate to
abnormalities prevent needle blockage.
▪ Store at 15°–30° C (59°–86° F)
▪ Determine history of hypersensitivity
reactions to penicillins, cephalosporins, or
other allergens prior to initiation of drug
therapy.
▪ Lab tests: Perform C&S tests prior to
initiation of therapy and periodically
thereafter. Perform periodic renal function
tests.
▪ Report immediately to physician the onset of
an allergic reaction. There is great risk of
severe and prolonged reactions because drug
is absorbed so slowly.
▪ Do not breast feed while taking this drug.
 DRUG DRUG MECHANISM OF ACTION CONTRAINDICATIONS/ ADVERSE EFFECTS NURSING RESPONSIBILITIES
CLASSFICATION INDICATIONS
CEFTRIAXONE ANTIBIOTICS Semisynthetic third-
Contraindications: Body as a Whole: Pruritus, ▪ Determine history of hypersensitivity
SODIUM generation cephalosporin ▪ Hypersensitivity to fever, chills, pain, reactions to cephalosporins and penicillins
antibiotic. Preferentially cephalosporins and related induration at IM injection and history of other allergies, particularly to
Brand name: binds to one or more of the antibiotics site; phlebitis (IV site). drugs, before therapy is initiated.
Rocephin penicillin-binding proteins ▪ Lab tests: Perform culture and sensitivity
(PBP) located on cell walls of Indications: GI: Diarrhea, abdominal tests before initiation of therapy and
susceptible organisms. This ▪ Infections caused by susceptible cramps, periodically during therapy. Dosage may be
Dosage: inhibits third and final stage organisms in lower respiratory pseudomembranous colitis, started pending test results. Periodic
250 mg, 500 mg, 1 g, 2 g of bacterial cell wall tract, skin and skin structures, biliary sludge. coagulation studies (PT and INR) should be
injection synthesis, thus killing the urinary tract, bones and joints; also done.
bacterium. intra-abdominal infections, pelvic Urogenital: Genital ▪ Inspect injection sites for induration and
inflammatory disease, pruritus; moniliasis inflammation. Rotate sites. Note IV injection
uncomplicated gonorrhea, sites for signs of phlebitis (redness, swelling,
meningitis, and surgical pain).
prophylaxis. ▪ Monitor for manifestations of
hypersensitivity (see Appendix F). Report
their appearance promptly and discontinue
drug.
▪ Watch for and report signs: petechiae,
ecchymotic areas, epistaxis, or any
unexplained bleeding. Ceftriaxone appears to
alter vitamin K–producing gut bacteria;
therefore, hypoprothrombinemic bleeding
may occur.
▪ Check for fever if diarrhea occurs: Report
both promptly. The incidence of antibiotic-
produced pseudomembranous colitis (see
Appendix F) is higher than with most
cephalosporins. Most vulnerable patients:
chronically ill or debilitated older adult
patients undergoing abdominal surgery.

• Report any signs of bleeding.

• Report loose stools or diarrhea promptly.
• Do not breast feed while taking this drug
without consulting physician