Drug Study (ranitidine, Metoclopramide, Ketorolac, And Omeprazole)

DRUG

DOS E

ROUT E

INDICATION S

CONTRAINDICATION

ACTION

SIDE EFFECT

Generic Name: Ranitidine Hydrochlorid e

50 mg q8 hrs

IV

Short-term treatment of active duodenal ulcer

Contraindicated with allergy to ranitidine, lactation

Competitively inhibits the action of histamine at the H2 receptors of the parietal cells of the stomach, inhibiting basal gastric acid secretion and gastric acid secretion that is stimulated by food, insulin, histamine, cholinergic agonists, gastrin and pentagastrin.

CNS: headache, malaise, dizziness, somnolence, insomnia, vertigo

Brand Name: Zantac Class: Histamine2 antagonists

Short-term treatment of active, benign gastric ulcer Maintenance therapy for duodenal ulcer at reduced dosage. Short-term treatment for GERD. Pathologic hypersecretory conditions (ZollingerEllison syndrome)

Use cautiously with impaired renal or hepatic function, pregnancy

CV: tachycardia, bradycardia Dermatologic: rash, alopecia GI: constipation, diarrhea, nausea and vomiting, abdominal pain, hepatitis GU: impotence or decreased libido

NURSING CONSIDERATION S Assessment: 1. History: allergy to ranitidine, impaired renal or hepatic function, lactation, pregnancy. 2. Physical: skin lesions, orientation, affect, liver evaluation, abdominal examination, normal output, renal function tests, CBC Interventions: 1. Administer oral drug with meals and at bedtime. 2. Decrease doses in renal and liver failure. 3. Provide concurrent antacid therapy to relieve pain. 4. Administer IM

Treatment of erosive esophagitis Treatment of heartburn, acid indigestion, sour stomach

Hematologic: leucopenia, granulocytope nia, thrombocytop enia, pancytopenia

dose undiluted, deep into large muscle group. 5. Arrange for regular follow-up including blood test, to evaluate effects.

DRUG

DOSE

ROUTE

INDICATIONS

CONTRAINDICATIONS

Generic Name: Metoclopramide

1 amp q 8 hrs

IV

Disturbances of GI motility

Contraindicated with allergy to metoclopramide

Brand Name: Maxolon Class: Antiemetic, GI stimulant

Relief of symptoms of acute and recurrent diabetic gastroparesis Nausea and vomiting Metabolic diseases Short-term therapy for adults with symptomatic gastroesophage al reflux who fail to respond to conventional therapy.

ACTION

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

Stimulates motility of upper GI GI hemorrhage tract without stimulating Mechanical obstruction or gastric, perforation biliary, or pancreatic Epilepsy secretions; CV: appears to transient Use cautiously with sensitize hypertensio previously detected breast tissues to n cancer, lactation, action of pregnancy, fluid overload, acetylcholin GI: nausea renal impairment e; relaxes and diarrhea pyloric sphincter, which, when combined with effects on motility, accelerates gastric emptying

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 alterations in insulin dose or timing if diabetic control is compromised by

Prophylaxis of postoperative nausea and vomiting when nasogastric suction is undesirable.

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

alterations in timing of food absorption.

DRUG

DOS E

ROUT E

INDICATION S

CONTRAINDICATION S

ACTION

SIDE EFFECT

Generic Name: Ketorolac Tromethamin e

1 AMP q6 hrs and PRN for pain

IV

Short-term management of pain (up to 5 days)

Contraindicated with significant renal impairment, during labor and delivery, lactation, aspirin allergy, recent GI bleed or perforation

Antiinflammatory and analgesic activity; inhibits prostaglandin s and leukotriene synthesis

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

Brand Name: Toradol Class: Antipyretic NSAID

Ophthalmic: relief of ocular itching due to seasonal conjunctivitis and relief of post-operative inflammation after cataract surgery.

Use cautiously with impaired hearing; allergies; hepatic conditions

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

Contraindicated with hypersensitivity to omeprazole or its components.

Short-term treatment of active benign gastric ulcer

Use cautiously with pregnancy, lactation.

Eradication of Helicobacter Pylori First-line therapy for treatment of heartburn or symptoms of

ACTION

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

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

GERD.

cells; blocks the final step of acid production.

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

needed. 3. Have regular medical follow-up visits. 4. Report severe headache, worsening of symptoms, fever, chills.