Tramadol 50mg/tab

CLASSIFICATION INDICATION MECHANISM OF CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION

ACTION

CNS agent Management of Centrally acting Hypersensitivity to CNS: Assess for level of pain and
Opiate Agonist moderate to opiate receptor tramadol or other administer prn dose as
Narcotic moderately severe agonist that inhibits opioid analgesics. Drowsiness needed but not to exceed
Analgesics pain. the uptake of Patients on MAO Dizziness the recommended total
inhibitors. Headache daily dose.
norepinephrine and
Patients acutely Somnolence Monitor vital signs and
serotonin, suggesting intoxicated with Restlessness assess for orthostatic
both opioid and non- alcohol, hypnotics, CV: hypotension or signs of
opioid mechanisms centrally acting CNS depression.
of pain relief. May analgesics, opioids Palpitations Discontinue drug and notify
produce opioid-like or psychotropic Vasodilation physician if signs and
effects, but causes drugs. GI: symptoms of
less respiratory Patients on obstetric hypersensitivity occur.
preoperative Nausea Assess bowel and bladder
depression than
medication. Constipation function; report urinary
morphine. frequency or retention.
Lactation Vomiting
Diarrhea Use seizure precautions for
Abdominal pain patients who have a history
Anorexia of seizures or who have a
Flatulence history of seizures or who
are concurrently using
drugs that lower the seizure
threshold.
Monitor ambulation and
take appropriate safety
precautions.
 Nalbuphine Hydrochloride

10mg/ml, 20mg/ml injection

CLASSIFICATION INDICATION MECHANISM OF CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION

ACTION

CNS agent Symptomatic relief Synthetic narcotic History of CV: Assess respiratory rate
Analgesic of moderate to severe analgesic with sensitivity to the before drug administration.
Narcotic (Opiate) pain. Also agonist and weak drug. Hypertension Withhold drug and notify
Agonist- preoperative sedation antagonist properties. Pregnancy Hypotension physician if respiratory rate
antagonist Lactation Bradycardia falls below 12.
analgesia and as a Analgesics potency is
Tachycardia Watch for allergic response
supplement to about 3 to 4 times
Flushing in persons with sulfite
surgical anesthesia. greater than that of GI: sensitivity.
pentazocine and Administer with caution to
approximately equal Abdominal Cramps patients with hepatic or
to that produced by Bitter taste renal impairement.
equivalent doses of Nausea and Vomiting Monitor ambulatory
morphine. On a Dry mouth patients; nalbuphine may
CNS: produce drowsiness.
weight basis,
produces respiratory
Sedation
depression about Dizziness
equal to that of Nervousness
morphine. Headache
Respiratory:

Dyspnea
Respiratory Depression
 Ranitidine Hydrochloride

50mg/IM

CLASSIFICATION INDICATION MECHANISM OF CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION

ACTION

Gastrointestinal agent Short-term treatment of Potent anti-ulcer drug
Anti-secretory acute duodenal ulcer; that competitively and
maintenance therapy for reversibly inhibits
duodenal ulcer patient histamine action at H2-
after healing of acute receptor sites on parietal
ulcer; treatment of cells, thus blocking
gastroesophageal reflux gastric acid secretion.
disease; short-term use of Indirectly reduces pepsin
active, benign gastric secretion but appear to
ulcer; treatment of have minimal effect on
pathologic GI hyper fasting and postprandial
secretory conditions. serum gastrin
concentrations or
secretion of gastric
intrinsic factor or mucus.
Pregnancy CNS: Potential toxicity results
Lactation from decreased clearance
Headache and therefore prolonged
Malaise action; greatest in the older
Dizziness adult patients or those with
Somnolence hepatic or renal dysfunction.
Insomnia Be alert for signs of
Vertigo hepatotoxicity.
Mental confusion Long term therapy may lead
Agitation to vitamin B12 deficiency.
Depression Do not supplement therapy
Hallucinations in older with OTC remedies for
adult gastric distress or pain
CV: without physicians advice.
Do not smoke.
Do not breastfeed while
Bradycardia
taking this drug.
GI:

Constipation
Nausea
Abdominal pain
Diarrhea
SKIN:

Rashes
 Cefoxitin Sodium

1g, 2g injection

CLASSIFICATION INDICATION MECHANISM OF CONTRAINDICATION SIDE EFFECTS NURSING

ACTION CONSIDERATION

Anti-infective Infections caused by Semisynthetic, broad Hypersensitivity to Drug fever Determine previous
Antibiotic susceptible spectrum beta-lactam cephalosporins and Eosinophilia hypersensitivity to
Second organisms in the antibiotic derivative of related antibiotics. Superinfection cephalosporins,
generation lower respiratory cephamycin. Classified Pregnancy Local reaction penicillins and history of
cephalosporin tract, urinary tract, as second generation Lactation Pain allergies.
Tenderness Inspect injection site
skin and skin cephalosporin; regularly.
Thrombophlebitis
structures, bones and structurally and Monitor I&O and pattern.
Rash
joints; also intra- pharmacologically Reports onset of diarrhea.
Dermatitis
abdominal related to Pruritis Report severe vomiting.
endocarditis, cephalosporins and Urticaria Do not breast feed while
gynaecological penicillin. GI: taking this drug.
infection,
septicaemia etc. Diarrhea
Pseudomembranous colitis
 Hydroxyzine Hydrochloride

50mg/IM

CLASSIFICATION INDICATION MECHANISM OF CONTRAINDICATION SIDE EFFECTS NURSING CONSIDERATION

ACTION

Antihistamine Emotional or Piperazine derivative Known CNS: Evaluate alertness.

Antipruritic psychoneurotic states structurally and hypersensitivity to Drowsiness may occur and
characterized by anxiety, pharmacologically hydroxyzine. Drowsiness usually disappears with
tension, or psychomotor related to other Use as sole Sedation continued therapy or
treatment in Dizziness following reduction of
agitation. cyclizines. In common
psychoses or Headache dosage.
with such agents, causes depression. CV: Monitor condition of oral
CNS depression. Pregnancy membranes.
lactation Hypotension Do not drive or engage in
GI: other potentially hazardous
activities.
Dry mouth Do not take alcohol.
Notify physician
immediately if pregnant.
Relieve dry mouth by
frequent warm water rinse.
Give teeth scrupulous care.
Do not breast feed while
taking the drug.
 Metoclopramide Hydrochloride

5mg, 10mg/tab, 5mg/5ml solution, 5mg/5ml injection

CLASSIFICATION INDICATION MECHANISM OF CONTRAINDICATION SIDE EFFECTS NURSING

ACTION CONSIDERATION

Gastrointestinal agent Management of Potent central Sensitivity or CNS: Report immediately the
Prokinetic agent diabetic gastric dopamine receptor intolerance to onset of restlessness,
Autonomic nervous stasis; to prevent antagonist. metoclopramide. Mild sedatin involuntary movements,
system agent nausea and vomiting Allergy to sulfiting Fatigue facial grimacing, rigidity,
Direct-aging cholinergic agent. Restlessness or tremors.
associated with
Antiemetic History of seizure Agitation Be aware that during
ematogenic cancer disorders. Insomnia treatment period, serum
chemotherapy. Concurrent use of Headache aldosterone may be
drugs that can cause Disorientation elevated.
extrapyramidal Extrapyramidal Monitor for possible
symptoms. symptoms hypernatremia and
GI: hypokalemia.
Avoid driving and other
Nausea potentially hazardous
Constipation activities.
Diarrhea Avoid alcohol and other
Dry mouth CNS depressant.
Altered drug absorption Report signs and
CV: symptoms of acute
dystonia.
Hypertensive crisis Do not breast feed while
taking the drug.
 Oxacillin sodium

250 mg/5 mL, 1 g/50 mL IV

CLASSIFICATION INDICATION MECHANISM OF CONTRAINDICATION SIDE EFFECTS NURSING

ACTION CONSIDERATION

Antibiotic To treat bacteremia, bone
and joint infections (such
as osteomyelitis and
infectious arthritis), CNS
infections (such as
ventriculitis and
meningitis), endocarditis,
septicaemia, skin and soft-
tissue infections, upper and
lower tract infections and
UTIs caused by
penicillinase-producing
strains of Staphylococcus
or other susceptible
organisms.
Inhibits bacterial cell wall Hypersensitivity to oxacillin, CNS:
synthesis. In susceptible bacteria, penicillin or their components
the rigid, cross-linked cell wall is Anxiety,
depression,fatigue,
assembled in several steps.
hallucination,
Oxacillin exerts its effects in the headache,seizures
finbal stage of the cross-linking EENT:
process by binding with and
inactivating penicillin-binding Oral candidiasis
proteins (enzymes responsible GI:
for linking the cell wall strands).
Diarrhea, nausea,
This action causes bacterial cell pseudomembranous
lysis and death. colitis, vomiting
GU:
Instertitial nephritis,
vaginal candidiasis
SKIN:
Exfoliative dermatitis,
pruritis, rash and urticaria
Administer oxacillin at
least 1 hour before other
antibiotics.
Give oral forms on an
empty stomach,
preferably 1 hour before
or 2 hours after meal, to
prevent impaired
absorption
Before reconstituting
drug, loosen powder by
tapping bottle several
times. Reconstitute
powder for IM injection
with sterile water for
injection. Shake vial until
vial is clear.
For IV infusion,
reconstitute only with
NS or D5water.
 Nirmin 5-S Infusion
200ml

CLASSIFICATION INDICATION MECHANISM OF CONTRAINDICATION SIDE EFFECTS NURSING

ACTION CONSIDERATION

Amino acid injection Damage to the upper Nirmin 5-S

Acid-base imbalance or Metabolic imbalances Must be diluted
with sorbitol/electrolytes digestive tube, Infusion improves the
swallowing difficulties patient's condition by diabetes Hyperammonemia before
on the basis of performing the following Anuria High nitrogen in blood administration
neurological,
functions: 1. Promoting Fructose intolerance Stupor Instruct patient not
esophageal achalasia,
pyloric stenosis, sudden protein synthesis and
Hepatic coma Coma take additional
abdominal events, wound healing. 2.
especially the passage Retaining fluid in the Hypersensitivity Aluminum poisoning laxatives
impaired - and severe colon. Impaired nitrogen
gastrointestinal
infections infectious utilization
and non-infectious Severe heart or kidney
origin (ulcerative
colitis, Crohn's disease, problems
diverticulitis, ischemic Severe renal failure
damage, diversion
colitis, etc.);
acute and chronic,
pancreatitis,
malabsorption
syndrome type short
bowel, internal fistula,
short circuits and other
reasons for limiting
resorptive area, severe
exudative enteropathy
and gluten, enzyme
defects, and other
disorders of amino acid
 absorption;
preoperative
preparation in patients
with significant
malnutrition, post-
operative application in
the absence of income
per person more than 3
days after major
surgery and loss of
nitrogen; severe
anorexia nervosa,
cachexia in AIDS and
in indicated cases of
malignant tumors.
 Celecoxib

200mg/PO/day

CLASSIFICATION INDICATION MECHANISM OF CONTRAINDICATION SIDE EFFECTS NURSING

ACTION CONSIDERATION

>Anti-inflammatory To relieve pain Selectively inhibits the Allergic reaction (such as CNS: >Instruct patient to
from osteoarthritis enzymatic activity of anaphylaxis or swallow celecoxib capsule
>Antirheumatic To relieve pain cyclooxygenase-2, the angioedema) to aspirin, >Dizziness, headache, whole with a full glass of
from rheumatoid enzyme needed to convert other NSAIDs or insomnia water and to take drug with
arthritis
arachidonic acid to sulphonamide derivatives CV: food or milk to prevent
As adjunct to
reduce prostaglandin. or history of aspirin- stomach upset
adenomatous Prostaglandins are induced nasal polyps with >Peripheral edema
colorectal polyps in responsible for mediating bronchospasm;
patients with the inflammatory response hypersensitivity to EENT:
>Advise patient to avoid
familial and causing local celecocib or its
adenomatous >Pharyngitis, rhinitis, smoking and alcohol use
vasodilation, swelling and components.
polyposis sinusitis during celecoxib therapy
pain. Prostaglandins also because these activities
play a role in peripheral GI: may increase the risk of
transmission to the spinal adverse GI reaction.
cord. By inhibiting COX-2 >Abdominal pain, diarrhea,
activity and prostaglandin elevated liver function test
production, this NSAID results, flatulence,
reduces inflammatory indigestion, N/V >In patient who has bone
symptoms and relieves marrow suppression or is
SKIN: receiving antineoplastic
pain. Celecoxibs
mechanism of action in drug therapy, monitor
>Rash
reducing the number of laboratory results
colorectal polyps in (including WBC) and
unknown. assess for signs and
symptoms of infection
because celecoxib has anti-
inflammatory anf
antipyretic actions that may
mask signs and symptoms
such as fever and pain.

>Monitor intake and

output, especially in
patients with edema, heart
failure or hypertension
because drug may cause
fluid retention.