Drug Name

GENERIC NAME: Ketorolac BRAND NAME: Toradol CLASSIFICA TION: Nonsteroidal antiinflammatory agents, nonopioid analagesics

Dosa ge
DOSAG E: 30mg IV q6

Mechanis m of Action
- Inhibits prostaglandin synthesis, producing peripherally mediated analgesia - Also has antipyretic and antiinflammatory properties. - Therapeutic effect:Decreas ed pain

Indicatio n

Contraindic ation

Adverse/Side Effects

Nursing interventions

Short term managemen t of pain (not to exceed 5 days total for all routes combined)

- Hypersensitivity - Crosssensitivity with other NSAIDs may exist pre- or perioperative use - Known alcohol intolerance Use cautiously in: 1) History of GI bleeding 2) Renal impairment (dosage reduction may be required) 3) Cardiovascular disease

- CNS: 1) drowsiness 2) abnormal thinking 3) dizziness 4) euphoria 5) headache - RESP: 1) asthma 2) dyspnea - CV: 1) edema 2) pallor 3) vasodilation - GI: 1) GI Bleeding 2) abnormal taste 3) diarrhea 4) dry mouth 5) dyspepsia 6) GI pain 7) nausea - GU: 1) oliguria 2) renal toxicity 3) urinary frequency - DERM: 1) pruritis 2) purpura 3) sweating

- Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reactions. Assess for rhinitis, asthma, and urticaria. - Assess pain (note type, location, and intensity) prior to and 1-2 hr following administration. - Ketorolac therapy should always be given initially by the IM or IV route. Oral therapy should be used only as a continuation of parenteral therapy. - Caution patient to avoid concurrent use of alcohol, aspirin, NSAIDs, acetaminophen, or other OTC medications without consulting health care professional. - Advise patient to consult if rash, itching, visual disturbances, tinnitus, weight gain, edema, black stools, persistent headche, or influenza-like syndromes (chills,fever,muscles aches,

- LOCAL: 1) injection site pain - NEURO: 1) paresthesia - MISC: 1) allergic reaction, anaphylaxis

pain) occur. - Effectiveness of therapy can be demonstrated by decrease in severity of pain. Patients who do not respond to one NSAIDs may respond to another.

Drug Name

Dosa ge

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Generic name: bisacodyl Brand name: Dulcolax Classificatio n: Laxative

5mg 2 tab HS

The laxative effect of Bisacodyl (Dulcolax) occurs upon contact with the colonic mucosa where it stimulates the sensory nerve endings that results to increased peristaltic contracting of the large intestine to produce soft well-formed stools. This results in a stimulation of defecation, reduction of transit time, and a softening of the stool. It is a reversible reaction wherein colonic function would return to its normal

> Short term relief of constipation . Constipation , either chronic or of recent onset, whenever a stimulant laxative is required. Bowel clearance before surgery or radiological investigatio n. Replacemen t of the evacuant enema in all its indications.

> patients with ileus, intestinal obstruction, acute abdominal conditions including appendicitis, acute inflammatory bowel diseases, and severe abdominal pain associated with nausea and vomiting which may be indicative of the aforementioned severe conditions. >severe dehydration and in patients with known hypersensitivity to bisacodyl or any other component of the product.

IS -anaphylactic reactions, angioneurotic edema and other hypersensitivity. GI -vomiting , Abdominal discomfort, abdominal pain, abdominal cramps, nausea and diarrhea.

>Avoid use within one hour of ingestion of milk or milk products or antacids (may breakdown enteric coating of tablet and result in gastric irritation) > monitor frequency & character of stool >monitor occurrence of adverse rxn >advice pt not to chew tablet because it may cause gastric irritation

condition after defecation occurs..

Drug Name
GENERIC NAME: Ketorolac BRAND NAME: Toradol CLASSIFICA TION: Nonsteroidal antiinflammatory agents, nonopioid analagesics

Dosag e
DOSAG E: 30mg IV q6

Mechanis Indicatio m of n Action

- Inhibits prostaglandin synthesis, producing peripherally mediated analgesia - Also has antipyretic and antiinflammatory properties. - Therapeutic effect:Decrea sed pain Short term managemen t of pain (not to exceed 5 days total for all routes combined)

Contraindic ation

Adverse/Side Effects

Nursing interventions

- Hypersensitivity - Crosssensitivity with other NSAIDs may existPre- or perioperative use - Known alcohol intoleranceUse cautiously in: 1) History of GI bleeding 2) Renal impairment (dosage reduction may be required) 3) Cardiovascular disease

- CNS: 1) drowsiness 2) abnormal thinking 3) dizziness 4) euphoria 5) headache- RESP: 1) asthma 2) dyspnea - CV: 1) edema 2) pallor 3) vasodilation - GI: 1) GI Bleeding 2) abnormal taste 3) diarrhea 4) dry mouth 5) dyspepsia 6) GI pain 7) nausea - GU: 1) oliguria 2) renal toxicity 3) urinary frequency - DERM: 1) pruritis 2) purpura 3) sweating

- Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reactions. Assess for rhinitis, asthma, and urticaria. - Assess pain (note type, location, and intensity) prior to and 1-2 hr following administration. - Ketorolac therapy should always be given initially by the IM or IV route. Oral therapy should be used only as a continuation of parenteral therapy. - Caution patient to avoid concurrent use of alcohol, aspirin, NSAIDs, acetaminophen, or other OTC medications without consulting health care professional. - Advise patient to consult if rash, itching, visual disturbances, tinnitus, weight gain, edema, black stools, persistent headche, or influenza-like syndromes (chills,fever,muscles aches,

- LOCAL: 1) injection site pain - NEURO: 1) paresthesia - MISC: 1) allergic reaction, anaphylaxis

pain) occur. - Effectiveness of therapy can be demonstrated by decrease in severity of pain. Patients who do not respond to one NSAIDs may respond to another.

Drug Name

Dosag e

Mechanis Indicatio m of n Action

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Castor Oil Classificatio n: Laxative

30cc

increases peristalsis

Constipation

>hypersens. to drug >suspected appendicitis >fecal impaction >GI obstruction >menstruation >caution if rectal bleeding

>painful cramps, fecal incontinence and explosive diarrhea > involuntary bowel movement at inconvenient locations and during sleep >dizziness >electrolyte disorders >abdominal pain >nausea >diarrhea

>do not admin. at bedtime because of rapid onset; give chilled w/ other liquids

Drug Name

Dosag e

Mechanis Indicatio m of n Action

After diffusing into the organism, interacts with DNA to cause a loss of helical DNA structure and strand breakage resulting in inhibition of protein synthesis and cell death in susceptible organisms Systemic metronidazo le is indicated for the treatment of: Vaginitis due to Trichomona s vaginalis (protozoal) infection in both symptomati c patients as well as their asymptomat ic sexual contacts; and due to bacterial Gardnerella or Mycoplasma hominis infection in

Contraindic ation

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Generic name: metronidazol e Brand name: Flagyl CLASSIFICAT ION: Antiinfectives, Antiprotozoals

500 mg HAB TID

In cases of hypersensitivity to metronidazole or other nitroimidazole derivatives (which are, however, very rare), Metronidazole intravenous infusion 500mg should only be given for lifethreatening infections when other antibiotic treatment is ineffective

CNS: seizures, dizziness, headache GI: abdominal pain, anorexia, nausea, diarrhea, dry mouth, furry tongue, glossitis, unpleasant taste, vomiting Hematologic: leukopenia Skin: rashes, urticaria

Administer with food or milk to minimize GI irritation. Tablets may be crushed for patients with difficulty swallowing. Instruct patient to take medication exactly as directed evenly spaced times between dose, even if feeling better. Do not skip doses or double up on missed doses. If a dose is missed, take as soon as remembered if not almost time for next dose. May cause dizziness or light-headedness. Caution patient or other activities requiring alertness until response to medication is known. Inform patient that medication may cause an unpleasant metallic taste. Inform patient that medication may cause urine to turn dark. Advise patient to consult health care professional if no improvement in a few days or if signs and symptoms of superinfection (black furry overgrowth on tongue; loose

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Drug Name

Dosag e

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Drug Name

Dosag e

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