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Kryssel D.

Java
Name of Drug
Generic Name:
tramadol hydrochloride
Brand Name: Ultram;
Tramadol
Classifications:
Analgesic

BSAN4A
Dosage/ Route/ Mechanism of
Frequency
action
Dosage:
Inhibits
50 mg
reuptake of
serotonin and
Route: IVTT
norepinephrine
in CNS
Frequency:
Q8h, PRN

September 4, 2014
Indications
Moderate to
moderately
severe pain in
adults (16 and
older)

Contraindications

Adverse Reaction

Hypersensitivity
to drug, its
components or
opioids

CNS: Dizziness,
vertigo, headache,
drowsiness, anxiety,
stimulation, confusion,
incoordination,
euphoria, nervousness,
sleep disorder,
asthenia, hypertonia,
seizures
EENT: Visual
disturbances
CV: Vasodilation
Respiratory:
Respiratory depression
GI: Nausea, vomiting,
diarrhea, constipation,
abdominal discomfort,
dyspepsia, flatulence,
dry mouth, anorexia
Metabolic: Increased
hepatic enzyme and
creatinine levels
GUT: Urinary
retention and
frequency, proteinuria,
menopausal symptoms
Hematologic:
Decreased hemoglobin

Acute
intoxication with
alcohol,
sedativehypnotics,
centrally acting
analgesics,
opioids
analgesics, or
psychotropic
agents
Physical opioids
dependence

Nursing Responsibility

Assess patients
response to drug 30
minutes after
administration
Monitor respiratory
status; withhold drug if
respiratory rate is less
than 12 breaths/minute
Monitor for physical
and psychological drug
dependence
Teach patient that drug
may cause respiratory
depression of used with
alcohol; advise patient
to avoid alcohol
Instruct patient to
immediately report
seizure
Tell patient that drug
interacts with many
common over-the
counter drugs and
herbal remedies
Inform patient that drug
can cause physical or
psychological

Kryssel D. Java

BSAN4A

September 4, 2014
Integumentary:
Pruritus, sweating
Others: Physical or
psychological drug
dependence, drug
tolerance

dependence
Caution patient to
avoid driving and other
hazardous activities
until she knows drug
affects concentration
and alertness
Review all other
significant and lifethreatening adverse
reactions and
interactions, especially
those related to the
drug, tests, herbs, and
behaviors mentioned

Kryssel D. Java
Name of Drug
Generic Name:
Paracetamol

BSAN4A
Dosage/ Route/
Frequency
Dosage: 300g
Route: IVTT

Brand Name:
Sinomol
Classifications:
Analgesic/
Antipyretic
(Non-opioid)

Frequency: Q4
PRN (as needed)

September 4, 2014

Mechanism of action

Indications

Indication:
Temporary relief of
pain and discomfort
from headache, fever,
cold, flu, minor
muscular aches,
overexertion, menstrual
cramps, toothache,
minor arthritic pain.

Hematologic:
hemolytic
anemia,
leukopenia,
neutropenia,
pancytopenia,
thrombocytopenia
.
Hepatic:
liver damage,
jaundice
Metabolic:
hypoglycemia
Skin: rash,
urticuri

Mechanism of Action:
Paracetamol may cause
analgesia by inhibiting
CNS prostaglandin
synthesis. The
mechanism of
morphine is believed to
involve decreased
permeability of the cell
membrane to sodium,
which results in
diminished
transmission of pain
impulses therefore
analgesia.

Contraindications
Hypersensitivity
Fulminant hepatic
failure
Note: The antidote
acetylcysteine (e.g.
fluimucil) must be
administered within 8
to 10 hours when there
is intoxication: i.v.
infusion of 150 mg/kg
in 15 minutes, then 50
mg/kg for 4 hours, and
then 100 mg/kg for 16
hours in a 5% glucose
solution.

Adverse
Reaction
Hematologic:
hemolyticanemi
a, neutropenia,
leukopenia,
pancytopenia
Hepatic: liver
damage,
jaundice

Nursing Responsibility

If there is fever, assess


patients fever or pain: type
of pain, location, intensity,
duration, temperature, and
diaphoresis.

Tell patient not to use for


marked fever (higher than
39.5 C). Fever persisting
longer than 3 days, or
recurrent fever unless
directed by prescriber.

Avoid giving patient aspirin


or aspirin-like analgesics
because it inhibits platelet
aggregation.

Teach client warning signs


that needs immediate
attention of the physician.

Evaluate therapeutic effects.

Metabolic:hypo
glycemia
Skin: rash,
urticaria

Kryssel D. Java

BSAN4A

September 4, 2014

Kryssel D. Java
Name of Drug
Generic Name:
Mefenamic Acid
Brand Name:
Ponstan
Classifications:
NSAID (Non
Steroidal AntiInflammatory
Drug)

BSAN4A
Dosage/ Route/
Frequency
Dosage:
500mg/capsule
Route: per orem
Frequency: Q8

September 4, 2014

Mechanism of action

Indications

Contraindications

Mefenamic acid binds


the prostaglandin
synthetase receptors
COX-1 and COX-2,
inhibiting the action of
prostaglandin
synthetase. As these
receptors have a role as
a major mediator of
inflammation and/or a
role for prostanoid
signaling in activitydependent plasticity,
the symptoms of pain
are temporarily
reduced.

For the treatment


of rheumatoid
arthritis,
osteoarthritis,
dysmenorrhea,
and mild to
moderate pain,
inflammation,
and fever.

Hypersensitivity to
mefenamic acid;
patients who have
experienced asthma,
urticaria, or allergictype reactions after
taking aspirin or other
NSAIDs; treatment of
perioperative pain in
the setting of coronary
artery bypass graft
(CABG) surgery;
active ulceration or
chronic inflammation
of either the upper or
lower GI tract;
preexisting renal
disease.

Adverse
Reaction
Cardiovascular:
CHF;
hypertension;
syncope;
tachycardia.
CNS
Dizziness,
headache (up to
10%).
Dermatologic
Pruritus, rashes
(up to 10%).
GI
Abdominal
pain,
constipation,
diarrhea,
dyspepsia,
flatulence, GI
ulcers
(gastric/duoden
al), gross
bleeding/perfor
ation,
heartburn,
nausea,
vomiting (up to

Nursing Responsibility

Instruct patients to
promptly report signs or
symptoms of unexplained
weight gain or edema to
their health care provider.
Inform patients of the
warning signs and
symptoms of hepatotoxicity
(eg, nausea, fatigue,
lethargy, pruritus, jaundice,
right upper quadrant
tenderness, flu-like
symptoms). If these occur,
instruct patients to stop
taking mefenamic acid and
seek immediate medical
therapy.
Inform patients of the signs
of an anaphylactoid
reaction (eg, difficulty
breathing, swelling of the
face or throat). If these
occur, instruct patients to
seek immediate emergency
help.
Advise patients that
mefenamic acid, like other

Kryssel D. Java

BSAN4A

September 4, 2014

10%).
Hematologic
Anemia,
increased
bleeding time
(up to 10%).
Hepatic
Elevated liver
enzymes (up to
10%).
Miscellaneous
Abnormal renal
function,
edema, tinnitus
(up to 10%).

NSAIDs, can cause GI


discomfort and, rarely,
serious GI adverse effects,
such as ulcers and bleeding,
which may result in
hospitalization and even
death. Although serious GI
tract ulcerations and
bleeding can occur without
warning symptoms, instruct
patients to be alert for the
signs and symptoms of
ulcerations and bleeding,
and instruct patients to ask
for medical advice when
observing any indicative
signs or symptoms,
including epigastric pain,
dyspepsia, melena, and
hematemesis.