Generic /Brand Classification Dosage, Indication Mechanism of Adverse Nursing
name Timing, Route Action reaction responsibilities
nausea, vomiting,
TRAMADOL Analgesics 50mg IVTT q 8hrs Moderate to • Assess type,
sweating
(9/20/10) moderately severe • Binds to mu-opioid and constipation. location, and
pain Drowsiness is
receptors. intensity of pain
reported, although
• Inhibits reuptake of it is less of an before and 2-3 hr
serotonin and issue than for non- (peak) after
synthetic opioids.
norepinephrine in Patients administration.
Contraindication
the CNS prescribed • Assess bowel
tramadol for
function routinely.
general pain relief
with or without • Assess previous
other agents have analgesic history.
Health
reported
professionals have Tramadol is not
withdrawal
not yet fully symptoms recommended for
endorsed of its use including
on a large scale for uncontrollable patients dependent
these disorders, nervous tremors, on opioids or who
although it may be muscle
used when other have previously
contracture, and
treatments have 'thrashing' in bed received opioids for
failed (under the (similar to restless more than 1 wk; may
supervision of a leg syndrome.
psychiatrist). cause opioid
withdrawal
symptoms.
• • 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.
• Encourage patient
to cough and
breathe deeply
every 2 hr to prevent
atelactasis and
pneumonia.
DRUG STUDY
Generic Classification Dosage, Indication Mechanism of Adverse Nursing
/Brand name Timing, Route Action reaction responsibilities
sodium is the major hypernatremia, a.Monitor
Sodium Chloride Electrolytes 50ml vial slow IVTT prophylaxis of heat cation of the body hypopotassemia, electrolytes, ECG,
9/20/10 extracellular fluid. It acidosis. Fluid and liver and renal
prostration or
plays a crucial role in solute overload function studies
maintaining the fluid leading to dilution of b.Note level of
muscle cramps;
and electrolyte serum electrolyte consciousness
chloride deficiency balance. Excess level, CHF,
c.Assess the heart
retention of sodium overhydration, acute
and lung sounds
due to dieresis or pulmonary edem
results in d.Observe S&S of
overhydration(edema hypernatremia,
salt
, hypervolemia), flushed skin,
restrictions;
which is often treated elevated
prevention or
with diuretics. temperature, rough
treatment of
Abnormally low levels dry tongue, and
extracellular volume
of sodium result edema
depleti
indehydration. e.Monitor VS and
Contraindication Normally, the plasma I&O
congestive heart contains 136-145 f.Assess urine
failure, severely mEq/L and 98-1-6 specific gravity and
impaired renal mEq chloride/L. the serum sodium level
function, averagedaily
hypernatremia, fluid requirement of salt is
retention approximately 5g
DRUG STUDY
Generic Classification Dosage, Indication Mechanism of Adverse Nursing
/Brand name Timing, Route Action reaction responsibilities
diluted and GI irritation; soft-tissue Make sure
Calcium Gluconate Electrolytes 1 ampule IVTT administered as a replaces Calcium calcification, skin prescriber specifies
now in 30min and maintains
9/20/10 continuous IV sloughing or necrosis form of calcium to
Calcium level
infusion. Antidote in after IM/SC inj. be given; crash
severe Hypercalcaemia carts may contain
hypermagnesaemia; characterised by both calcium
Severe anorexia, nausea, gluconate and
hyperkalaemia 10 vomiting, constipation, calcium chloride.
abdominal pain,
mL of 10% soln, •
muscle
repeat every 10 mins Tell patient to take
weakness,mental
if needed oral calcium 1 to
disturbances,
11/2 hours after
polydipsia, polyuria,
meals if GI upset
nephrocalcinosis,
Patients with occurs.
renal calculi; chalky
calcium renal •
taste, hot flushes and
calculi or history of
Give I.M. injection in
Contraindicat
renal calculi. peripheralvasodilation
ion
Conditions . Potentially Fatal: gluteal region in
associated with adults and in lateral
Cardiac arrhythmias
hypercalcaemia
and coma thigh in infants. Use
and
hypercalciuria. I.M. route only in
emergencies
when no I.V. route is
available bec. of
irritation of tissue by
calcium salts.
Tell patient to take
oral calcium with a
full glass of water.
Monitor calcium
levels frequently.
Hypercalcemia may
result after large
doses in chronic
renal failure. Report
abnormalities
DRUG STUDY
Generic Classification Dosage, Indication Mechanism of Adverse Nursing
/Brand name Timing, Route Action reaction responsibilities
hypoprothrombine itamin K is Transient"flush
discussed in terms
Vitamine K Dose fat soluble 1 ampule IVTT q mia secondary to ing sensations"
of a new carbanion
vitamins 8hrs factors limiting model that mimics and "peculiar"
absorption or the proton sensations of
synthesis of abstraction from the taste have
gamma position of
vitamin K, e.g., been
protein-bound
obstructive glutamate. This is observed, as
jaundice, biliary the essential step well as rare
fistula, sprue, leading to instances of
ulcerative coilitis, carboxylation and dizziness,
activation of the
celiac disease, rapid and
blood-clotting
intestinal proteins. The model weak pulse,
resection, cystic comprises an profuse
fibrosis of the oxygenation that is sweating, brief
coupled to carbon-
pancreas, hypotension,
carbon bond
dyspnea, and
formation, as is the
oxygenation of cyanosis.
vitamin K Pain, swelling,
Contraindicat
hydroquinone to and
ion vitamin K oxide. The
tenderness at
model hypothesis is
Hypersensitivity to the injection
also supported by
any the mechanism of site may
component of this inhibition of the occur.
medication. carboxylase by The possibility
HCN, which acts as
of allergic
an acid-base
inhibitor rather than sensitivity
a metal-complexing including an
inhibitor. The new
model postulates a anaphylactoid
dioxetane
reaction
intermediate that
explains the
presence of a
second atom of 18O
(from 18O2)
incorporated into
vitamin K oxide in
the course of the
enzymatic
carboxylation.
Finally, the
chemistry developed
here has been used
to define the active
site of vitamin K
hydroquinone as the
carbon-carbon bond
adjacent to the
methyl group.
