DRUG STUDIES!

Brand Name: TRAMADOL

CLASSIFICATIONS
Therapeutic:
Analgesics (centrally acting)

ACTIONS
Physiologic Mechanism

• Decreased pain.

Pharmacologic Mechanism

• Binds to mu-opioid receptors.

• Inhibits reuptake of serotonin and norepinephrine in the CNS.

INDICATION
• Moderate to moderately severe pain

NURSING CONSIDERATIONS
• Assess type, location, and intensity of pain before and 2-3 hr (peak) after
administration.

• Assess BP & RR before and periodically during administration. Respiratory depression

has not occurred with recommended doses.

• Assess bowel function routinely. Prevention of constipation should be instituted with

increased intake of fluids and bulk and with laxatives to minimize constipating effects.

• Assess previous analgesic history. Tramadol is not recommended for patients dependent
on opioids or who have previously received opioids for more than 1 wk; may cause
opioid withdrawal symptoms.

• Prolonged use may lead to physical and psychological dependence and tolerance,
although these may be milder than with opioids. This should not prevent patient from
receiving adequate analgesia. Most patients who receivetramadol for pain d not develop
psychological dependence. If tolerance develops, changing to an opioid agonist may be
required to relieve pain.
• Tramadol is considered to provide more analgesia than codeine 60 mg but less than
combined aspirin 650mg/codeine 60 mg for acute postoperative pain.
• Monitor patient for seizures. May occur within recommended dose range. Risk
increased with higher doses and inpatients taking antidepressants (SSRIs, tricyclics, or
Mao inhibitors), opioid analgesics, or other durgs that decrese the seizure threshold.

• Overdose may cause respiratory depression and seizures. Naloxone (Narcan) may
reverse some, but not all, of the symptoms of overdose. Treatment should be
symptomatic and supportive. Maintain adequate respiratory exchange.

• Encourage patient to cough and breathe deeply every 2 hr to prevent atelactasis and
pneumonia.

GENERIC NAME: Ranitidine

BRAND NAME: Zantac

CLASSIFICATION
Therapeutic:
Anti-ulcer agents

Pharmacologic:
Histamine H2 antagonists

DOSAGE

20 mg
IV q8h

MECHANISM OF ACTION
• Inhibits the action of histamine at the H2 receptor site located primarily in gastric
parietal cells, resulting in inhibition of gastric acid secretion.

• In addition, ranitidine bismuth citrate has some antibacterial action against H. pylori.

INDICATION
•Treatment and prevention of heartburn, acid indigestion, and sour stomach.

CONTRA INDICATIONS
Contraindicated in:

•Hypersensitivity, Cross-sensitivity may occur; some oral liquids contain alcohol and
should be avoided in patients with known intolerance.

Use Cautiously in:

• Renal impair- ment
• Geriatric patients (more
susceptible to adverse CNS reactions)
• Pregnancy or Lactation

SIDE EFFECTS/ ADVERSE EFFECTS

• CNS:
Confusion, dizziness, drowsiness, hallucinations, headache

• CV:
Arrhythmias

• GI:
Altered taste, black tongue, constipation, dark stools, diarrhea, drug-induced hepatitis,
nausea

• GU:
Decreased sperm count, impotence

• ENDO:
Gynecomastia

• HEMAT:
Agranulocytosis, Aplastic Anemia, neutropenia, thrombocytopenia

• LOCAL:
Pain at IM site

• MISC:
Hypersensitivity reactions, vasculitis

NURSING IMPLICATIONS/RESPONSIBILITIES
• Assess patient for epigastric or abdominal pain and frank or occult blood in the stool,
emesis, or gastric aspirate.
• Nurse should know that it may cause false-positive results for urine protein; test with
sulfosalicylic acid.
• Inform patient that it may cause drowsiness or dizziness.
• Inform patient that increased fluid and fiber intake may minimize constipation.
• Advise patient to report onset of black, tarry stools; fever, sore throat; diarrhea;
dizziness; rash; confusion; or hallucinations to health car professional promptly.
• Inform patient that medication may temporarily cause stools and tongue to appear gray
black.