Generic Name

DRUG STUDY Generic Name Classification /Brand Name Generic Name: GI stimulant, Metoclopramide antiemetic, dopaminergic Brand Name: blocker Octamide PFS, Reglan

Dosage

Mechanism of Action

Metoclopramide > Stimulates the muscles of 1amp IVTT @ the gastrointestinal tract 6am including the muscles of the lower esophageal sphincter, stomach, and small intestine by interacting with receptors for acetylcholine and dopamine on gastrointestinal muscles and nerves; > Decreases the reflux of stomach acid by strengthening the muscle of the lower esophageal sphincter; > Stimulates the muscles of the stomach and thereby hastens emptying of solid and liquid meals from the stomach and into the intestines; > Interacts with the dopamine receptors in the brain and can be effective in treating nausea.

Indication

Contraindication

> Stimulation of gastric emptying prior to surgery

> Hypersensitivity to metoclopramide, GI hemorrhage, mechanical obstruction or perforation;

Side Effects > Drowsiness > Restlessness > Fatigue > Anxiety > Insomnia

> > Depression Pheochromocytom a (may cause > Sedation hypertensive crisis); > Nausea > Epilepsy

> Diarrhea > Urinary frequency

Nursing Responsibility 1. Assess patient for contraindication. 2. Assess for baseline data. 3. Give direct IV dose slowly (over 1 to 2 minutes). 4. Monitor BP carefully during IV administration. 5. Monitor for extrapyramidal reactions, and consult physician if they occur. 6. Keep diphenhydramine injection readily available incase of extrapyramidal reactions. 7. Have phentolamine readily available in case of hypertensive crisis (most likely to occur with undiagnosed pheochromocytoma). 8. Tell patient that he may experience side effects brought upon by the drug. 9. Instruct patient to report involuntary movement of the face, eyes or limbs, severe depression, severe diarrhea. 10. Provide a safe environment if restlessness, involuntary muscle movement occur.

Generic Name: Tramadol HCl

Analgesic, centrally acting

Tramadol 50mg q 6° IVTT

Brand Name: Ultram

> Binds to mu-opioid receptors and inhibits the reuptake of norepinephrine and serotonin; > Causes many effects similar to opioids – dizziness, somnolence, nausea, constipation – but does not have the respiratory effects.

Generic Name: Ketorolac tromethamine Brand Name: Toradol

NSAID, Nonopioid analgesic

Ketorolac 30mg q 8 IVTT

> Reduces the production of prostaglandins, chemicals that cells of the immune system make that cause the redness, fever, and pain of inflammation and that also are believed to be important in the production of noninflammatory pain.

> Relief of moderate to moderately severe pain;

> Hypersensitivity to tramadol or opioids or acute intoxication with alcohol, opioids, or > Post surgery psychoactive drugs analgesia

> For shortterm management (up to 5 days) of moderately severe acute pain that otherwise would require narcotics. It most often is > It blocks the enzymes that used after cells use to make surgery. prostaglandins (cyclooxygenase 1 and 2).

> Hypersensitivity to ketorolac, renal Impairment, aspirin allergy

> Nausea > Constipation > Dizziness > Headache > Drowsiness > Vomiting > Somnolence > Sedation > Headache > Dry mouth > Sweating > Diarrhea > Rash > Visual disturbances > Vertigo

1. Assess for contraindications. 2. Assess for baseline data. 3. Tell patient that he may experience side effects brought upon by the drug. 4. Instruct him to report side effects that are intolerable. 5. Control environment (temperature, lighting) if sweating or CNS effects occur. 6. Encouraged small frequent meals if vomiting occurs. 7. Oral care for dry mouth and vomiting. 8. Encourage him to increase oral fluid intake. 9. Instruct patient to report adverse effects that he may experience.

> Rash > Ringing in the ears > Headaches > Dizziness > Drowsiness > Abdominal pain > Nausea > Diarrhea > Constipation > Heartburn > Fluid retention > Somnolence > Insomnia

1. Assess patient for contraindication. 2. Assess for baseline data. 3. Infuse slowly as a bolus over no less than 15 seconds. 4. Administer with ranitidine to avoid ulceration. 5. Tell patient that he may experience side effects brought upon by the drug. 6. Encouraged oral fluid intake to avoid dry mucous membrane. 7. Provide comfort measures if headache occurs. 8. Instruct to report intolerable

As a result, pain as well as inflammation and its signs and symptoms - redness, swelling, fever, and pain are reduced.

Generic Name: Bupivacaine

Anesthesia

Bupivacaine 0.25% 10cc + 0.25MSO4 OD

Brand Name: Bupican

Generic Name: Ciprofloxacin

Fluoroquinolone s

Ciprofloxacin 500mg/cap BIDx5days

> Block the generation and the conduction of nerve impulses, presumably by increasing the threshold for electrical excitation in the nerve, by slowing the propagation of the nerve impulse, and by reducing the rate of rise of the action potential. > The analgesic effects of Bupivacaine are thought to be due to its binding to the prostaglandin E2 receptors, subtype EP1 (PGE2EP1), which inhibits the production of prostaglandins, thereby reducing fever, inflammation, and hyperalgesia > Inhibits bacterial DNA synthesis, mainly by blocking DNA gyrase, bactericidal

> Dyspepsia > Dry mucous membrane > Sweating > Peripheral edema > GI pain

side effects for prompt intervention. 9. Instruct to report signs of bleeding such as black tarry stool, weakness and dizziness upon standing. 10. Instruct to report if he experiences adverse effects.

> Nervousness > Tingling around the mouth > Tinnitus > Tremor > Dizziness > Blurred vision > Ringing of the ears > Feeling of disorientation > Nausea > Vomiting > Drowsiness > Numbness of tongue > Lightheadedness

1. Assess for contraindication. 2. Assess for baseline data. 3. Monitor vital signs carefully, drug depresses the pulmonary and cardiac system. 4. Monitor for side effects. 5. Tell patient that he may experience side effects brought about by the drug and if such is/are intolerable he must report them so as prompt interventions be done. 6. Oral care if vomiting occurs. 7. Monitor for occurrence of adverse effects, report to the anesthesiologist any signs and symptoms of adverse effects. 8. Continue to monitor patient following discontinuation of anesthesia.

> Local or regional anesthesia > Analgesia for surgery

> Hypersensitivity to bupivacaine or other local anesthesia e.g. lignocaine, blood clotting disorder, low blood pressure,

> Severe or complicated bone or joint infections

> Contraindicated > Headache to patients sensitive > Restlessness to fluoroquinolone > Fatigue > Drowsiness

1. Use cautiously in patients with CNS disorders, such as severe cerebral arteriosclerosis or seizure

Brand Name: Ciprobay

> Complicated intraabdomina l infections

> Edema > Chest pain > Nausea > Diarrhea > Leucopenia > Crystalluria

disorders, and in those with risk for seizures. 2. Monitor patients intake and output and observe for signs of crystalluria 3. Obtain specimen for culture and sensitivity before giving first-dose