INDICATION DRUG GENERIC NAME: Ranitidine BRAND NAME: Zantac DRUG CLASS:Histamine2 Antagonist II.

THERAPEUTICACTIONS: 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, gastric, and penta gastrin III. DOSAGE: 12.5 mg TIV q 12hrs Short-term treatment of active duodenal ulcer Maintenance therapy for duodenal ulcer at reduced dosage Short-term treatment of active, benign gastric ulcer Short-term treatment of GERD Treatment of heartburn, acid indigestion, sour stomach

CONTRAINDICATIONS& CAUTIONS Contraindicated with allergy to ranitidine, lactation Use cautiously with impaired renal or hepatic function, pregnancy

ADVERSE EFFECTS CNS: headache ,malaise, dizziness, somnolence, insomnia, vertigo CV: tachycardia, bradycardia GI: constipation, diarrhea, nausea, vomiting, abdominal pain LOCAL: pain at IM site, local burning or itching at IV site

INTERACTIONS Increased effects of warfarin; monitor patient closely and adjust dosage as needed

NURSINGCONSIDERATIONS 1. Administer oral drug with meals and at bedtime. 2. Decrease dose sin renal and liver failure. 3. Provide concurrent antacid therapy to relieve pain. 4. Administer IM dose undiluted, deep into large muscle group. 5. Arrange for regular follow-up, including blood tests to evaluate effects. 6. Report sore throat, fever, unusual bleeding or bruising, severe headache and etc

DRUGS Generic Name: Ketorolac Tromethamine Brand Name: Toradol Class: Antipyretic NSAID DOSE: 1 AMP q 6hrs and PRN for pain

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

CONTRAINDICATION 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 Anti-inflammatory and analgesic activity; inhibits prostaglandins and leukotrienesynthesis

SIDE EFFECTS CNS: headache, dizziness, somnolence, insomnia, fatigue, dizziness, tinnitus, ophthalmologic effects

NURSINGCONSIDERATIONS 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: Metoclopramide Brand Name: Maxolon Class: Antiemetic, GIstimulant DOSE: 1 amp q 8 hrs

INDICATION Disturbances of GI motility Relief of symptoms of acute and recurrent diabetic gastro paresis Nausea and vomiting Metabolic diseases Short-term therapy for adults with symptomatic gastro esophageal reflux who fail to respond to conventional therapy. Prophylaxis of post operative nausea and vomiting when nasogastric suction is undesirable

CONTRAINDICATION 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; appears to sensitize tissues to action of acetylcholine; relaxes pyloric sphincter, which, when combined with effects 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 pro lactin

SIDE EFFECTS CNS: restlessness, drowsiness, fatigue, insomnia, dizziness, anxiety CV: transient hypertension GI: nausea and diarrhea

NURSING CONSIDERATIONS 1. Monitor BP carefully during IVadministration.2. Monitor diabetic patients; arrange for alterations in insulin dose or timing if diabetic control is compromised by alterations in timing of food absorption.