GENERIC NAME: Cefuroxime BRAND NAME: Ceftin, Zinacef Doctors Postoperative order: 750 mg/ IV ANST bid CLASSIFICATI

MECHANISM INDICATION DRUG ON OF ACTION INTERACTION >Antibiotic >Route: IV Parenteral: Drug-drug: >Cephalospor >Onset: >Lower >increased in (second Rapid respiratory nephrotoxicity generation) >Peak: infections with Immediate caused by aminoglycosides >Duration:18 Streptococcus >increased -24 hours pneumonia, S. bleeding effects >Metabolism: aureus, E. with oral Half-life: 1-2 coli, Klebsiella anticoagulants hours pnemoniae, >Distribution: H.influenzae, Drug-Lab test: Crosses the S. pyogenes >possibility of placenta, >Dermatologi false results of enters breast c infections tests urine milk caused by S. glucose using aureus, S. Benedicts pyogenes, E. solution, Fehlings coli, K. solution, Clinitest pneumonia, tablets, urinary Enterobacter 17-ketosteroids, >UTIs caused direct Coombs by E. coli, K. test pneumonia >Uncomplicat ed and disseminated gonorrhea caused by N. gonorrheae >Septicemia caused by S.

ADVERSE EFFECTS >CNS: headache, dizziness, lethargy, paresthesia >GI: nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence,pseudome mbranous colitis, hapatoxicity >GU: nephrotoxicity >Hematologic: Bone marrow depression >Hypersensitivity: ranging from rash to fever to anaphylaxis, serum sickness reaction >Local: pain, abscess at injection site, phlebitis, inflammation at I.V. site

NURSING RESPONSIBILITIES Assessment: >Hepatic and renal impairment, lactation, pregnancy >Physical: Skin status, liver function tests, renal function tests, culture of affected area, sensitivity tests Interventions: >Culture infection, and arrange for sensitivity tests before and during therapy if expected response is not seen >Give oral drug with food to decrease with G.I. upset and enhance absorption >Give oral drug to children who can swallow tablets, crushing the drug results in a bitter unpleasant taste >Have vitamin K available in ease hypothrombinemia >Discontinue if hypersensitivity reaction

pneumonia, S. aureus, E. coli, K. pneumonia, H. influenza >Meningitis caused by S. pneumonia, H influenza, S. aureus, N. meningitidis >Bone and joint infections due to S. aureus >Perioperativ e prophylaxis GENERIC NAME: Tramadol hydrochloride BRAND NAME: Ultram Doctors Postoperative order: 110 mg / IV/ q6hrs CLASSIFICATION MECHANISM OF INDICATION ACTION >Analgesic >Route: Oral >Relief to >Onset: 1 hour moderate to >Peak: 2 hour moderately > Metabolism: severe pain Hepatic, Half-life: 6-7 hours >Distribution: crosses placenta, enters breastmilk >Excretion: Urine

occurs

DRUG INTERACTION Drug-drug: >decreased effectiveness with carbamazepine >Increased risk of tramadol toxicity with monoamine oxidase inhibitor

ADVERSE EFFECTS >CNS: sedation, dizziness or vertigo, headache, confusion, dreaming, sweating anxiety, seizures >CV: hypotension, tachycardia, bradycardia

NURSING RESPONSIBILITIES Assessment: >History: Hypersensitivity to tramadol, pregnancy, acute intoxication with alcohol, opioids, psychotropic drugs or other centrally acting analgesics, lactation,

>Dermatologic: sweating, pruritus, rash, pallor, urticaria >GI: nausea, vomiting, dry mouth, constipation, flatulence

seizures, concomitant use of CNS depressant or monoamine oxidase inhibitor, renal or hepatic impairment >Physical: Skin colour, texture, lesions; orientation, reflexes , bilateral grip strength, affect; p, auscultation, BP; bowel sounds, normal output; LFTs, renal function test Interventions: >Control environment (temperature, lighting) if sweating or CNS effects occur. WARNING: limit use in patient with past present history of addiction to or dependence on opiods.

GENERIC NAME: Ketorolac tromethamine BRAND NAME: Acular, Acular LS, Acular PF (ophthalmic), Toradol Doctors Postoperative order: 30 mg / IV q8hrs CLASSIFICATION MECHANISM OF INDICATION DRUG ACTION INTERACTION >NSAID >Route: IV,IM >Short-term Drug-Drug: >Nonopioid >Onset: 30mins management of >increased risk analgesic >Peak: 1-2 hours pain (up to 5 of nephrotoxicity >Antipyretic >Duration 6 days) with other hours >Ophthalmic: nephrotoxins >Metabolism: Relief of ocular (aminiglycosides, Crosses placenta, itching due to cyclosporine) enters breast seasonal >increased risk milk conjunctivitis and of bleeding with Excretion: Urine relief of anticoagulants postoperative (warfarin), aspirin inflammation after cataract surgery

ADVERSE EFFECTS >CNS: headache, dizziness, somnolence, insomnia >Dermatologic: rash, pruritus, sweating, dry mucous membranes >GI: nausea, dyspepsia, GI pain, diarrhea, vomiting, constipation, flatulence, gastric or duodenal ulcer GU: dysuria, renal impairment Hematologic: bleeding, platelet inhibition with higher doses, neutropenia, eosinophilia, leucopenia, pancytopenia, thrombocytopeni a, argranulocytosis, granulocytopenia , aplastic anemia,

NURSING RESPONSIBILITIES Assessment: >History: Renal impairment, impaired hearing, allergies, hepatic, CV, and GI conditions, lactation, pregnancy >Physical: Skin color and lesions, orientation, reflexes, ophthalmologic and audiometric evaluation, peripheral sensation, peripheral edema, BP, respiratory adventitious sounds, CBC, clotting time, liver function tests, renal function test, serum electrolytes, stool guaiac Interventions: >Be aware that

decreased Hgb oc Hct, bone marrow depression, menorrhagia Respiratory: dyspnea, hemoptysis, bronchospasm, rhinitis Other: peripheral edema, anaphylactoid reactions to anaphylactic shock, local burning, stinging (ophthalmic)

the patient may be at risk for CV events, GI bleeding, renal toxicity, monitor accordingly >Do not use during labor, delivery or while nursing >keep emergency equipment readily available at time of initial dose in case of severe hypersensitivity reactions >Protect drug vials from light >Administer every 6 hours to maintain serum levels and control pain

GENERIC NAME: Ranitidine hydrochoride BRAND NAME: Apo-Ranitidine (CAN), CO Ranitidine (CAN), Gen- Ranitidine, Zantac Doctors Postoperative order: 50mg/ IV q8hrs while in NPO CLASSIFICATION MECHANISM OF INDICATION DRUG ADVERSE ACTION INTERACTION EFFECTS .>Histamine2 >Route: IV >Short-term Drug-Drug: >CNS: headache, antagonist >Onset: treatment of >increased malaise, Immediate duodenal ulcer effects of dizziness, >Peak: 5-10mins >Maintenance warfarin, tricyclic somnolence,

NURSING RESPONSIBILITIES Assessment: >History: Allergy to ranitidine, impaired renalor

>Duration: 8-12 hours >Metabolism: Hepatic, Half-life: 2-3 hours >Distribution: Cross placenta, enters breast milk >Excretion: Urine

therapy for duodenal ulcer at reduced dose >Short-term treatment of active, benign, gastric ulcer >Short-term treatment of GERD >Pathologic hypersecretory conditions >Treatment of erosive esophagitis >Treatment of heartburn, acid indigestion, sour stomach

antidepressants

insomnia, vertigo >CV: tachycardia, bradycardia, premature ventricular contractions >Dermatologic: Rash, alopecia >GI: constipation, diarrhea, vomiting, abdominal pain, hepatitis, increased alanine transaminase levels >GU: gynecomastia, impotence or decreased libido >Hematologic: leucopenia, granulocytopenia , thrombocytopeni a, pancytopenia >Local: pain at IM site, local burning or itching at IV site >Other: anthralgias

hepatic function, lactation, pregnancy >Physical: Skin lesions, orientation, affect pulse, baseline ECG, liver evaluation, abdominal examination, normal output, CBC, liver function test, renal function test Interventions: >Administer oral drug with meals and at bedtime >Decrease doses in renal and liver failure >Provide concurrent antacid therapy to relieve pain >Administer IM dose undiluted, deep into large muscle groups >Arrange for regular folow-up, including blood tests to evaluate effects

Feso4 GENERIC NAME: ferrous sulfate BRAND NAME: fer-iron, feosol, iberet Doctors Postoperative order: CLASSIFICATION MECHANISM OF ACTION Anti anemic > Elevates the serum iron concentration which then helps to form High or trapped in the reticuloendotheli al cells for storage and eventual conversion to a usable form of iron.

INDICATION >Prevention and treatment of iron deficiency anemias. > Dietary supplement for iron.

DRUG INTERACTION >The following medications may reduce the absorption of ferrous sulfate: ACE Inhibitors Bile Acid Sequestrants Birth Control Medications Carbidopa, levadopa Cimetidine Famotidine Levothyroxine Nizatidine Proton-pump Inhibitors Quinolones Tetracycline

ADVERSE EFFECTS >Dizziness N&V Nasal Congestion Dyspnea Hypotension CHF MI Muscle cramps Flushing

NURSING RESPONSIBILITIES Assessment: >Advise patient to take medicine as prescribed. Caution patient to make position changes slowly to minimize orhtostatic hypotension. Instruct patient to avoid concurrent use of alcohol or OTC medicine without consulting the physician. Advise patient to consult physician if irregular heartbeat, dyspnea, swelling of hands and feet and hypotension occurs. Inform patient that angina

attacks may occur 30 min. after administration due reflex tachycardia. Encourage patient to comply with additional intervention for hypertension like proper diet, regular exercise, lifestyle changes and stress management.

ascorbic ACID GENERIC NAME: BRAND NAME: Doctors Postoperative order: CLASSIFICATION MECHANISM OF ACTION >vitamins > Ascorbic acid is a functional and principal in vivo form of vitamin C, an essential water-soluble vitamin which is fundamental in the synthesis of collagen and intercellular

INDICATION > Prophylaxis and treatment of scurvy and as a dietary supplement. >Increases protection mechanism of the immune system, thus supporting

DRUG INTERACTION Deferroxamine, hormonal contraceptives, flufenazine,eleme ntal iron, salicylates, warfarin, fluphenazine, disulfiram, mexiletine,

ADVERSE EFFECTS >GI: Nausea, vomiting, heartburn, diarrhea. >Hematologic: Acute hemolytic anemia (patients with deficiency of G6PD); sickle cell crisis. >CNS: Headache

NURSING RESPONSIBILITIES Assessment: >

materials.

wound healing. Necessary for wound healing and resistance to infection.

vitamin B12.

(high doses). Urogenital: Urethritis, dysuria, crystalluria (high doses) > Other: Mild soreness at injection site; dizziness and temporary faintness with rapid IV administration.

mefenamic acid GENERIC NAME: BRAND NAME: ponstel Doctors Postoperative order: CLASSIFICATION MECHANISM OF ACTION Non steroidal anti >aspirin like drug inflammatory that has analgesic, anti pyretic and anti inflammatory activities.

INDICATION > relief of pain including muscular, rheumatic, traumatic, dental, post op and post partum pain, headache, migraine, fever

DRUG INTERACTION Anticoagulants Increased risk of gastric erosion and bleeding. Cyclosporine Nephrotoxicity of both agents may

ADVERSE EFFECTS >Cardiovascular Edema; weight gain; CHF; altered BP; palpitations; chest pain; bradycardia;

NURSING RESPONSIBILITIES Assessment: >

and dysmenorrhea

be increased. CYP-450 Exercise caution when coadministering mefenamic acid with drugs known to inhibit the isoenzyme 2C9. Lithium Serum lithium levels may be increased. Methotrexate Increased methotrexate levels. Salicylates Additive GI toxicity.

tachycardia.

>CNS Headache; vertigo; drowsiness; dizziness; insomnia. >Dermatologic Rash; urticaria; purpura. >EENT Blurred vision; tinnitus; salivation; glossitis. >GI Diarrhea; dry mouth; vomiting; abdominal pain; dyspepsia; GI bleeding; nausea; constipation; flatulence.

>Genitourinary Hematuria; proteinuria; dysuria; renal failure. >Hematologic Decreased hematocrit; bleeding; neutropenia; leukopenia; pancytopenia; eosinophilia; thrombocytopeni a. >Hepatic Mild elevations in LFT results. >Respiratory Bronchospasm; laryngeal edema; rhinitis; dyspnea; pharyngitis; hemoptysis; shortness of

breath. >Miscellaneous Autoimmune hemolytic anemia may occur if used long term.

Diphenhydramine GENERIC NAME: BRAND NAME: benadryl Doctors Postoperative order: CLASSIFICATION MECHANISM OF ACTION Anti histamine >Antagonizes the effect of histamine at H1 receptor sites; does not bind or inactivate histamine

INDICATION > Allergic diseases such as hay fever, allergic rhinitis, urticaria, angioedema, atopic dermatitis, contact dermatitis, gastrointestinal allergy, pruritus, physical allergies, reactions to injection of contrast media,

DRUG INTERACTION Masks ototoxicity produced by aminoglycosides. Increases gastric degradation of levodopa and decreases its absorption by reduction of gastric emptying. Antagonises

ADVERSE EFFECTS >CNS: headache, fatigue, anxiety, tremors, vertigo, confusion, depression, seizures, hallucinations CV: tachycardia, palpitations, orthostaic hypotension,

NURSING RESPONSIBILITIES Assessment: >

reactions to therapeutic preparations and allergic transfusion reactions; also postoperative nausea and vomiting, motion sickness, and quieting emotionally disturbed children.

therapeutic effects of cholinergic agents e.g. tacrine, donezepil and neuroleptics. Valerian, St. John's wort, Kava Kava and gotu kola may increase CNS depression. Potentially Fatal: Potentiates CNS depression with alcohol, barbiturates, analgesics, sedatives and neuroleptics. Additive antimuscarinic action with MAOIs, atropine and TCAs.

heart failure EENT: blurred vision GI: dry mouth, nausea, vomiting, constipation, flatulence GU: urinary hesitancy or frequency, urine retention Hematologic: leukopenia Skin: photosensitivity, dermatitis

calcium gluconate GENERIC NAME: BRAND NAME: Doctors Postoperative order: CLASSIFICATION MECHANISM OF ACTION >Calcium gluconate is
used to prevent or treat negative calcium balance. It also helps

INDICATION >

DRUG INTERACTION
Co-admin of high calcium doses with thiazide diuretics may result in milk-alkali

ADVERSE EFFECTS >GI irritation; softtissue calcification, skin sloughing or necrosis after IM/SC inj.

NURSING RESPONSIBILITIES Assessment: >

facilitate nerve and muscle performance as well as normal cardiac function. Absorption: Soluble calcium is predominantly absorbed from the small intestine by active transport and passive diffusion. Small intestines by active transport and passive diffusion. There is increased absorption in calcium deficiency and during childhood, pregnancy and lactation. Distribution: Crosses the placenta and enters breast milk. Excretion: Excreted mainly in the kidneys (as excess calcium), faeces (as unabsorbed calcium) with traces found in sweat, skin, hair and nails.

syndrome and hypercalcaemia. May potentiate digoxin toxicit y. Decreases effects of calcium-channel blockers. Enhanced absorption with calcitriol (a vitamin D metabolite).

Hypercalcaemia characterised by anorexia, nausea, vomiting, constipation, abdominal pain, muscle weakness, mental disturbances, polydipsia, polyuria, nephrocalcinosis, renal calculi; chalky taste, hot flushes and peripheral vasodilation. Potentially Fatal: Cardiac arrhythmias and coma.