CLASS DOSAGE IFICAT ION Therap 20 mg GENERIC NAME: Ranit eutic: IV q8h idine AntiBRAND ulcer NAME: Zanta

agents c Pharma cologic: Histami ne H2 antago nists

DRUG

INDICATIONS

CONTRAINDICA TION Contraindicated in: Hypersensitivity, Cross-sensitivity may occur; some oral liquids contain alcohol and should be avoided in patients with known intolerance. Use Cautiously in:
Renal impair- ment Geriatric patients (more susceptible to adverse CNS reactions) Pregnancy or Lactation

ACTION

Treatment and prevention of heartburn, acid indigestion, and sour stomach.

Inhibits the action of histamine at the H2 receptor site located primarily in gastric parietal cells, resulting in inhibition of gastric acid secretion. In addition, ranitidine bismuth citrate has some antibacterial action against H. pylori.

NURSING CONSIDERATION S CNS: Assess patient for Confusion, epigastric or dizziness, abdominal pain and drowsiness, frank or occult blood hallucinations in the stool, emesis, , headache or gastric aspirate. CV: Nurse should know Arrhythmias that it may cause GI: false-positive results Altered taste, for urine protein; black tongue, test with constipation, sulfosalicylic acid. dark stools, Inform patient that diarrhea, it may cause drug-induced drowsiness or hepatitis, dizziness. nausea Inform patient that GU: increased fluid and Decreased fiber intake may sperm count, minimize impotence constipation. ENDO: Advise patient to Gynecomastia report onset of HEMAT: black, tarry stools; Agranulocytos fever, sore throat;

SIDE EFFECT

is, Aplastic Anemia, neutropenia, thrombocyto penia LOCAL: Pain at IM site MISC: Hypersensitivi ty reactions, vasculitis

diarrhea; dizziness; rash; confusion; or hallucinations to health car professional promptly. Inform patient that medication may temporarily cause stools and tongue to appear gray black.

DRUG Generic Name: Metoclopramide Brand Name: Maxolon Class: Antiemetic, GI stimulant

DOSE 1 amp q 8 hrs

ROUTE IV

INDICATIONS Disturbances of GI motility Relief of symptoms of acute and recurrent diabetic gastroparesis Nausea and vomiting Metabolic diseases Short-term therapy for adults with symptomatic gastroesophage

CONTRAINDICATIONS Contraindicated with allergy to metoclopramide GI hemorrhage Mechanical obstruction or perforation Epilepsy Use cautiously with previously detected breast cancer, lactation, pregnancy, fluid overload, renal impairment

ACTION

Stimulates motility of upper GI tract without stimulating gastric, biliary, or pancreatic secretions; CV: appears to transient sensitize hypertensio tissues to n action of acetylcholin GI: nausea e; relaxes and diarrhea pyloric sphincter, which, when combined with effects

SIDE EFFECT CNS: restlessness, drowsiness, fatigue, insomnia, dizziness, anxiety

NURSING CONSIDERATIONS Assessment: 1. History: allergy to metoclopramide, GI hemorrhage, mechanical obstruction or perforation, depression, epilepsy, lactation, previously detected breast cancer 2. Physical: orientation, reflexes, affect, bowel sounds, normal output, EEG Interventions: 1. Monitor BP carefully during IV administration. 2. Monitor diabetic patients, arrange for

al reflux who fail to respond to conventional therapy. Prophylaxis of postoperative nausea and vomiting when nasogastric suction is undesirable.

on motility, accelerates gastric emptying and intestinal transit; little effect on gallbladder or colon motility; increases lower esophageal sphincter pressure; has sedative properties; induces release of prolactin

alterations in insulin dose or timing if diabetic control is compromised by alterations in timing of food absorption.

DRUG

DOS E 1 AMP q6 hrs and PRN for pain

ROUT E IV

INDICATION S Short-term management of pain (up to 5 days) Ophthalmic: relief of ocular itching due to seasonal conjunctivitis and relief of post-operative inflammation after cataract surgery.

CONTRAINDICATION S Contraindicated with significant renal impairment, during labor and delivery, lactation, aspirin allergy, recent GI bleed or perforation Use cautiously with impaired hearing; allergies; hepatic conditions

ACTION

SIDE EFFECT

Generic Name: Ketorolac Tromethamin e Brand Name: Toradol Class: Antipyretic NSAID

Antiinflammatory and analgesic activity; inhibits prostaglandin s and leukotriene synthesis

CNS: headache, dizziness, somnolence, insomnia, fatigue, dizziness, tinnitus, ophthalmologi c effects

NURSING CONSIDERATION S Assessment: 1. History: renal impairment, impaired hearing, allergies, hepatic, lactation, pregnancy 2. Physical: skin color and lesions, orientation, reflexes, peripheral sensation, clotting times, CBC, adventitious sounds Interventions: 1. Be aware that patient may be at risk for CV events, GI bleeding, renal toxicity, monitor accordingly. 2. Do not use during

labor, delivery, or while nursing. 3. Keep emergency equipment readily available at time of initial dose, in case of severe hypersensitivity reaction. 4. Protect drug vials from light. 5. Administer every 6 hrs to maintain serum levels and control pain.

DRUG Generic Name: Omeprazole Brand Name: Tansinel Class: Antisecretory drug

DOSE ROUTE INDICATIONS CONTRAINDICATIONS 20 mg 1 cap for two weeks Oral Short-term treatment of active duodenal cancer Short-term treatment of active benign gastric ulcer Eradication of Helicobacter Pylori First-line therapy for treatment of heartburn or symptoms of GERD. Contraindicated with hypersensitivity to omeprazole or its components. Use cautiously with pregnancy, lactation.

NURSING CONSIDERATIONS Gastric-acid Assessment: pump 1. History inhibitor: :hypersensitivity to suppresses omeprazole or any of gastric acid its components; secretion by pregnancy, lactation specific 2. Physical: skin inhibition of lesions; reflexes; the urinary output; hydrogenabdominal potassium examination; ATPase respiratory enzyme Dermatologic: auscultation system at rash, the inflammation, Interventions: secretory urticaria, 1. Administer before surface of pruritus, meals. the gastric alopecia, dry 2. Administer parietal skin antacids with, if cells; blocks needed. the final GI: diarrhea, 3. Have regular step of acid abdominal medical follow-up

ACTION

SIDE EFFECT CNS; headache, dizziness, asthenia, vertigo, insomnia, apathy, anxiety, paresthesias, dream abnormalities

production.

pain, nausea, vomiting, constipation, dry mouth, tongue atrophy Respiratory: URI symptoms, cough, epistaxis

visits. 4. Report severe headache, worsening of symptoms, fever, chills.