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NURS 2516 Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name

Trade Name ketorolac toradol Classification Dose Route Time/frequency nonsteroidal anti- 15mg IV 1000, 1600, 2200, 0400; q 6hr inflammatory agents, nonopioid analgesics Duration For IV meds, compatibility with IV drips and /or solutions 6 hr or Administer undiluted longer Nursing Implications (what to focus on) Contraindications/warnings/interactions Concurrent use with aspirin may ↓ effectiveness, ↑ adverse GI effects with aspirin , other NSAIDs , potassium supplements , corticosteroids , or alcohol, Chronic use with acetaminophen may ↑ risk of adverse renal reactions, ↑ bleeding risk with arnica, chamomile, clove, dong quai, feverfew, garlic, ginger, ginkgo, Panax ginseng Common side effects Drowsiness, GI BLEEDING, EXFOLIATIVE DERMATITIS, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, anaphylaxis Lab value alterations caused by medicine Evaluate liver function tests, especially AST and ALT, periodically in patients receiving prolonged therapy. May cause ↑ levels ○ May cause prolonged bleeding time that may persist for 24-48 hr following discontinuation of therapy ○ May cause ↑ BUN, serum creatinine, or potassium concentrations Be sure to teach the patient the following about this medication Instruct patient on how and when to ask for pain medication, Instruct patient to take medication exactly as directed. Take missed doses as soon as remembered if not almost time for next dose. Do not double doses, May cause drowsiness or dizziness. Advise patient to avoid driving or other activities requiring alertness until response to the medication is known, Caution patient to avoid the concurrent use of alcohol, aspirin, NSAIDs, acetaminophen, or other OTC medications without consulting health care professional, Advise patient to inform health care professional of medication regimen prior to treatment or surgery, Advise patient to consult health care professional if rash,

Peak 1-2 hr

Onset 10 min

Mechanism of action and indications (Why med ordered) Inhibits prostaglandin synthesis, producing peripherally mediated analgesia, Also has antipyretic and antiinflammatory properties. Anti-inflammatory, pain relief

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) Chronic use with acetaminophen may ↑ risk of adverse renal reactions

itching, visual disturbances, tinnitus, weight gain, edema, black stools, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain) occurs

Nursing Process- Assessment (Pre-administration assessment) Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reactions. Assess for rhinitis, asthma, and urticaria, Assess pain (note type, location, and intensity) prior to and 1-2 hr following administration

Assessment Why would you hold or not give this med? Occurrence of unwanted or dangerous side effects

Evaluation Check after giving Decrease in severity of pain. Patients who do not respond to one NSAID may respond to another