drug study tramadol

DRUG STUDY

DRUG INDICATIONS CONTRAINDICATIONS ACTIONS SIDE EFFECTS

NURSING RESPONSIBILITIES

Generic Name:Tramadol

Brand Name:Ultram, Ultram ER

Carbamazepine (Tegretol, Tegretol XR , Equetro, Carbatrol) reduces the effect of tramadol by increasing its inactivation in the body. Quinidine (Quinaglute, Quinidex) reduces the inactivation of tramadol, thereby increasing the concentration of tramadol by 50%-60%. Combining tramadol with monoamine oxidase inhibitors (for example, Parnate) or

Tramadol may increase central nervous system and respiratory depression when combined with alcohol, anesthetics, narcotics, tranquilizers or sedative hypnotics.

Tramadol is used in the management of moderate to moderately severe pain. Extended release tablets are used for moderate to moderately severe chronic pain in adults who require continuous treatment for an extended period.

Tramadol is generally well tolerated, and side effects are usually transient. Commonly reported side effects include nausea, constipation, dizziness, headache, drowsiness, and vomiting. Less commonly reported side effects include itching, sweating, dry mouth, diarrhea, rash, visual disturbances, and vertigo. Some patients who received tramadol have reported

• Assess type, location, and intensity of pain before and 2-3 hr (peak) after administration.

• Assess BP & RR before and periodically during administration. Respiratory depression has not occurred with recommended doses.

• Assess bowel function routinely. Prevention of constipation should be instituted with increased intake of fluids and bulk and with laxatives to minimize constipating effects.

• Assess previous analgesic history. Tramadol is not recommended for patients dependent on opioids or who have previously received opioids for more than 1 wk; may cause opioid withdrawal symptoms.

• Prolonged use may lead to

selective serotonin inhibitors ((SSRIs, for example, fluoxetine Prozac]) may result in severe side effects such as seizures or a condition called serotonin syndrome.

seizures. Abrupt withdrawal of tramadol may result in anxiety, sweating, insomnia, rigors, pain, nausea, diarrhea, tremors, and hallucinations.

physical and psychological dependence and tolerance, although these may be milder than with opioids. This should not prevent patient from receiving adequate analgesia. Most patients who receive tramadol for pain d not develop psychological dependence. If tolerance develops, changing to an opioid agonist may be required to relieve pain.

• Tramadol is considered to provide more analgesia than codeine 60 mg but less than combined aspirin 650mg/codeine 60 mg for acute postoperative pain.

• Monitor patient for seizures. May occur within recommended dose range. Risk increased with higher doses and inpatients taking antidepressants (SSRIs, tricyclics, or Mao inhibitors), opioid analgesics, or other durgs that decrese the seizure threshold.

• Overdose may cause

respiratory depression and seizures. Naloxone (Narcan) may reverse some, but not all, of the symptoms of overdose. Treatment should be symptomatic and supportive. Maintain adequate respiratory exchange.

• Encourage patient to cough and breathe deeply every 2 hr to prevent atelactasis and pneumonia.

DRUG INDICATIONS CONTRAINDICATIONS

ACTIONS SIDE EFFECTS NURSING RESPONSIBILITIES

Generic

Name:

Fluconazole

Classification:

antifungal,

antibiotic

Fluconazole is a

drug indicated for

the treatment

and prophylaxis of

fungal infections

where

other antifungalshav

e failed or are not

tolerated (e.g., due

to adverse effects),

Have

known

hypersensiti

vity to other

azole

medicine

Are taking

terfenadine,

if 400 mg

per day

Like other imidazole- and triazole-class antifungals, fluconazole inhibits the fungal cytochrome P450 enzyme 14α-demethylase. Mammalian

Common

(≥1% of

patients):

rash,

headache,

dizziness,

nausea,

vomiting,

abdominal

pain,

1. Take this

medication

exactly as it was

prescribed for

you. Do not take

the medication in

larger amounts,

or take it for

longer than

recommended

including:[4]

Candidiasis ca

used by

susceptible

strains

of Candida

Tinea

corporis, tinea

cruris or tinea

pedis

Onychomycosi

s

Cryptococcal

meningitis

Fluconazole can be

used first-line for the

following indications:[4]

Coccidioidomy

cosis

Cryptococcosis

Histoplasmosis

Prophylaxis

of candidiasis i

n immunocomp

multidose

of fluconaz

ole is

administere

d

Concomitan

t

administrati

on

of fluconaz

ole and

quinidine,

especially

when flucon

azole is

administere

d in high

dosages

Are

pregnant.

demethylase activity is much less sensitive to fluconazole than fungal demethylase. This inhibition prevents the conversion of lanosterol toergosterol, an essential component of the fungal cytoplasmic membrane, and subsequent accumulation of 14α-methyl sterols. Fluconazole is primarily fungistatic;

diarrhea,

and/or

elevated

liver

enzymes

Infrequent

(0.1–1% of

patients): a

norexia,

fatigue,

constipatio

n

Rare

(<0.1% of

patients): o

liguria, hyp

okalaemia,

paraesthes

ia,

seizures, a

lopecia, St

evens-

Johnson

syndrome,

thrombocyt

by your doctor.

Follow the

directions on

your prescription

label.

2. Your dose will

depend on the

infection you are

treating. Vaginal

infections are

often treated

with only one pill.

For other

infections, your

first dose may be

a double dose.

Carefully follow

your doctors

instructions. Tell

your doctor if

your symptoms

do not improve.

3. Take this

medicine with a

full glass of

romised people openia,

other bloo

d dyscrasi

as,

serious he

patotoxicit

y including

hepatic

failure, ana

phylactic/a

naphylacto

id

reactions

Very rare:

prolonged

QT

interval, tor

sades de

pointes

water. Shake the

oral suspension

(liquid) well just

before you

measure a dose.

To be sure you

get the correct

dose, measure

the liquid with a

marked

measuring

spoon or

medicine cup,

not with a

regular table

spoon. If you do

not have a dose-

measuring

device, ask your

pharmacist for

one.

4. Take this

medication for

the entire length

of time

prescribed by

your doctor.

Your symptoms

may get better

before the

infection is

completely

treated. Diflucan

will not treat a

viral infection

such as the

common cold or

flu.



Generic

Name:

Calcium

Carbonate

Classification:Antacid, electrolyte

Dietary

supplement wh

en calcium

intake is

inadequate.

Treatment of

Contraindic

ated in

patients

with

ventricular

fibrillation,

Essential

element of the

body; helps

maintain the

functional

integrity of the

nervous and

CV:

Slowed

heart rate,

tingling,

“heat

waves”

1. do not give if

calcium levels is

more than

normal

2. may take in with

food

calcium

deficiency

in tetany of the

newborn, acute

and chronic

hypoparathyroi

dism,

pseudohypopa

rathyroidism,

postmenopaus

al and senile

osteoporosis,

rickets,

osteomalacia.

Prevention of

hypocalcemia

during

exchange

transfusions.

Adjunctive

therapy for

insect bites or

stings, such as

black widow

spider bites;

hypercalce

mia,

hypophaste

mia, or

renal

calculi.Use all calcium products caustiously in patients taking digitalis and in patients with sarcidosis and renal or cardiac disease

muscular

systems;

helps

maintain cardi

ac

function, blood

coagulation; is

an enzyme co-

factor and

affects the

secretory

activity of

endocine

and exocrine

glands;

neutralizes or

reduces gastri

c acidity (oral

use).

(rapid IV

administrat

ion);

peripheral

vasodilatio

n, local

burning,

drop in BP

(calcium

chloride

injection)

Local:

Local

irritation,

severe

necrosis,

sloughing

and

abscess

formation )

IM,

subcutane

ous use of

calcium

chloride)

3. increase fluid

intake if

constipation

occurs

4. eat small

frequent

feedings if

nausea occurs

5. take with a large

glass of water

sensitivity

reactions,

particularly

when

characterized

by urticaria;

depression due

to overdose of

magnesium

sulfate; acute

symptoms of

lead colic.

Improves weak

or ineffective

myocardial

contractions

when

epinephrine

falls in cardiac

resuscitation ,

particularly

after open

heart surgery.

Symptomatic

relief of upset

Metabolic:

Hypercalc

emia

(anorexia,

nausea,

vomiting

constipatio

n,

abdominal

pain, dry

mouth,

thirst,

polyuria),

rebound

hyperacidit

y and milk-

alkali

syndrome

(hypercalc

emia,

alkalosis,

renal

damage

withcalciu

m

stomach

associated with

hyperacidity;

hyperacidity

associated with

peptic ulcer,

gastritis, peptic

esophagitis,

gastric

hyperacidity,

hiatal hernia.

Prophylaxis of

GI bleeding,

stress ulcers,

and aspiration

pneumonia;

possibly useful.

carbonate

used as an

antacid.



Generic

Name:

Ketosteril

Classification:

Prevention &

therapy of damages

due to faulty or

deficient protein

metabolism in

Allergy and

hypersensitivity

to any content of

this drug

Normalizes

metabolic

process,

promotes

recycling

hyperkalemia

1. Evaluate for any

contraindications

2. Take drug as

prescribed

Essential Amino Acid

chronic renal

insufficiency

together w/ a protein

restricted (40 g/day)

diet.

Protein

energy malnutrition

Prevention and

treatment of

conditions caused

by modified or

insufficient protein

metabolism in

chronic renal failure

Hypercalcaemia

Disturbed amino

acid metabolism

Caution use for

patietn with

phenylketonuria

product

exchange.

REduces

ionconcentrati

on

of potassium,

magnesium

and

phosphate.

3. Warn the patient

about possible

side effects and

how to recognize

them

4. Give with food if

GI upset occurs

5. Frequently

assess for

hypercalcemia



After topical application on the Contraindicated i

After topica lapplication on

Burning

Generic

Name:

Zinc Oxide

Topical

Classification:Antibacterial

skin, Zinc Oxide has an adstringent and antiseptic action.

n patients hypersensitive todrug/ointment.•Not applied ondischarging wound surface.

•The ointment should never be used whilepregnant or nursing a baby, and should never be used on the breast area.

the skin, Zinc Oxide has an adstringent and antiseptic action.

Stinging

Itching

Tingling

Dark discoloration of skin

Asses allergic reactions: rash.

Make sure to completely cover the area that needs to be treated.

Don’t let the patient rub theointment on the affected area.



Generic

Name: Methotrexate

Classification:Antineoplastic, antirheumatic, immunosuppressant, antimetabolite

Trophoblastic neoplasms (choriocarcinoma, Hydatidiform Mole)

Leukemia Breast, head and

neck carcinoma Severe

psoriasis and rheumatoid

Known allergic hypersensitivity to the drug

PregnancyMethotrexate has caused fetal death and/or congenital anomalies,

Methotrexate works against folic acid metabolism which leads to the inhibition of DNA synthesis and cell production. The drug’s

1. Dizziness2. Drowsiness3. Headaches4. Malaise5. Anorexia6. Nausea and

vomiting7. Hepatoxicity8. Alopecia9. Ulcerative

stomatitis

1. Solutions for injection must be prepared in a biologic cabinet. Gloves, gown and mask are worn while preparing and handling the medication.

2. Administer

arthritis unresponsive to conventional therapy

Ectopic pregnancy

Lymphosarcoma Mycosis

fungoides

therefore, it is not recommended in women of childbearing potential unless there is imperative medical evidence that the benefits can be expected to outweigh the considered risks. Pregnant psoriatic patients should not receive this drug. Concomitant

use of other drugs that has a hepatotoxic potential (including alcohol) should be avoided.

principal mechanism is through competitive inhibition of the enzyme folic acid reductase. For the cells to proliferate and replicate, folic acid must be reduced to tetrahydrofolic acid by this enzyme (folic acid reductase) in the process of DNA synthesis and cellular replication. With the dministration of Methotrexate, the reduction of folic acid to

10.Leukopenia11.Chills and

fever12.Photosensivi

ty13.Thrombocyto

penia14.Hyperurece

mia

Allopurinol per doctor’s order to decrease uric acid levels.

3. Instruct patient to avoid caffeine as it may decrease the efficacy of the drug.

4. To prevent hematologic toxicity (platelet levels are decreased) salicylates, NSAIDs, phenytoin, tetracycline and chlorampenicol should be avoided.

http://nursingcrib.com/nursing-notes-reviewer/ectopic-pregnancy/

http://nursingcrib.com/nursing-notes-reviewer/ectopic-pregnancy/

tetrahydrofolic acid is inhibited thus, interfering with the tissue cell reproduction.Because of this function, death of rapidly replicating cells (e.g. cancer cells, choriocarcinoma, leukemia, carcinoma in different body parts and ectopic pregnancy) specifically the malignant ones is made possible. It also has an immunosuppressive activity.