DRUG STUDY

Generic

Brand
Name

Classification

Dosage

Indications

Contra
indications

Adverse Effect

Mechanism of
Action

Nursing
Responsibility

ranitidine

zantac

Ranitidine is an
oral drug that
blocks the
production of
acid by acidproducing cells
in the stomach.
It belongs to a
class of drugs
called H2
(histamine-2)
blockers that
also includes
cimetidine
(Tagamet),
nizatidine
(Axid), and
famotidine

>150 mg PO
q6hr or 50
mg IM/IV
q6-8hr
intermitent
bolus or
infusion;
alternatively,
6.25 mg/hr
IV by
continuous
infusion

>Treatment and
prevention of
heartburn, acid
indigestion, and
sour stomach.

>.Hypersensitivity,
Cross-sensitivity
may occur; some
oralliquids contain
alcohol andshould
be avoided in
patientswith known
intolerance

.>eadache (may
be severe);
>drowsiness,
dizziness;
>sleep problems
(insomnia);

inhibits the
action of
histamine at
theH2 receptor
site located
primarily
ingastric parietal
cells, resulting
ininhibition of
gastric acid
secretion
has some
antibacterial
action againstH.
pylori

>Usual: 1-2g
IV/IM qdor
in equally

>symptomatic
precipitation of
ceftriaxone

>pain,Induratio
Phlebitis,Rash
Diarrhea

>Works
byinhibiting the
Mucopeptidesynt

>Instruct patient
not to take new
medicationw/
consulting
physician
>Instruct patient
to take as
directed and
donot increase
dose
>Allow 1 hour
between any
other antacidand
ranitidine
>Inform patient
that medication
may temporarily
cause stools and
tongue toappear
gray
blackInstruct
patients to
monitor for
andreport
occurrence of
druginducedadverse
reaction
>.Assess
patients
Previoussensitivi

cefriazone

forgram

>3 generationc
rd

ephalospori

>Prophylaxis of
GI hemorrhage
fromstress ulcer

>Maintenanc
e of healing:
150 mg PO
q12hr

>Indicated
inpatients
withneurologic

divided doses
bid
depending on
the type and
severity of
infection
Max: 4g/day
>Usual
Duration of
Therapy: 414 days;
complicated
infections
may require
longer
therapy
Continue for
2 days after
signs and
symptoms of
infection
have
disappeared

tramadol

Ultram,
ultram ER

>Applies to
the following
strength(s):
50 mg ; 100
mg/24 hours ;
200 mg/24
hours ; 300
mg/24 hours ;
150 mg/24

Complications
Carditisandarthr
itis.
it is also
effective in
Gramnegativein
fections;
Meningitis
,Gorrhea. It
isalso for Bone
and joint
infections,
Lower
respiratorytract
infections,middl
e earinfection,
PID,Septicemia
andUrinary
Tractinfections.

calcium salt in the

gallbladder,
kernicterus,
oliguria, and
anaphylactic or
anaphylactoid
reactions.

Thrombocytosis
Leucopenia
Glossitis
Respiratorysuper
infections

.
>Carbamazepin
e(Tegretol,
Tegretol XR
,Equetro,
Carbatrol)
reduces the
effect of
tramadol by

>Tramadol may
increase central
nervous system
and respiratory
depression when
combined with
alcohol,
anesthetics,
narcotics,tranquiliz

>Tramadol
isgenerally
welltolerated,
andside effects
arusuallytransien
t.Commonlyrepo
rted sideeffects
includenausea,co
nstipation,dizzin

hesis in
thebacterial
cellwall. The
beta-lactam
moietyof
Ceftriaxone
binds
tocarboxypeptida
ses,endopeptidas
es,andtranspeptid
asesin the
bacterialcytoplas
micmembrane.
Theseenzymes
in cell-wall
synthesisand cell
division.By
binding
totheseenzymes,
Ceftriaxoneresult
s in theformation
of of defective
cellwalls and
celldeath

tyreaction to
penicillin
orothercephalosp
horins.

>.Tramadol
isused in
themanagemento
f
moderatetomode
ratelysevere
pain.Extendedrel
easetablets
areused for

> Assess type,

location, and
intensity of pain
before and 2-3 hr
(peak) after
administration
.> Assess BP &
RR before and
periodicallydurin

>Assess patient
forsigns
andsymptoms of
infection before
and during the
treatment
>Obtain C&S
beforebeginning
drugtherapy
toidentifyif
correcttreatment
has beeninitiated.

hours

increasing its in
activation in the
body.Quinidine
(Quinaglute,
Quinidex)
reduces the in
activation of
tramadol,there
by increasing
the
concentration of
tramadol
by50%60%.Combinin
gtramadol with
monoamineoxid
aseinhibitors
(for example,
Parnate)

ers or sedative
hypnotics.

ess,headache,dro
wsiness,andvomi
ting.Less
commonlyreport
ed sideeffects
includeitching,s
weating,
drymouth,diarrhe
a,
rash,visualdistur
bances,and
vertigo.Some
patientswho
receivedtramadol
havereported

moderate
tomoderatelysev
erechronic painin
adults
whorequireconti
nuoustreatment
for an
extendedperiod.

gadministration.
Respiratorydepre
ssion has not
occurredwith
recommended
doses.
>Assess bowel
function
routinely.
Prevention of
constipation
should
beinstituted with
increased
intakeof fluids
and bulk and
withlaxatives to
minimizeconstip
ating effects.
>Assess previous
analgesic
history.
Tramadol is
notrecommended
for
patientsdependen
t on opioids or
whohave
previously
receivedopioids
for more than 1
wk;may cause
opioid
withdrawalsympt
oms

Diazepam

Valium

>Pharmacologic
Class
Benzodiazepine
Therapeutic
Class
Antiepileptic,A
nxiolytic,
Skeletalmuscle
relaxant
Pregnancy
RiskFacto

> Tablets-2,
5, 10mg- Oral
solution1mg/mL,
5mg/mLRectal
pediatricgel2.5, 5, 10mgInjection5mg/m

>Shorttermmanageme
nt of anxietyInsomnia
associatedwith
anxietySleepwalkingNight terrorsPremedication
beforeanaesthes
ia- Adjunctoin
themanagement
of seizuresMuscle spasmsAcute
symptoms of
alcohol
withdrawalPremedication
before
Anaesthesia

>Concentrations
- HypersensitivityPreexisting
CNSdepression or
coma- Respiratory
depression- Acute
pulmonaryinsuffici
ency or
sleepapnea- Severe
hepaticimpairmentAcute narrow
angleglaucomaChildren < 6 mthPregnancy and
lactation.
Precaution
- Impaired renal
andhepatic
function- Chronic
pulmonaryinsuffici
ency- Organic
cerebralchanges;
elderly- History of
alcohol or
drugaddiction.
Drug interaction
Drug to drugIncreased
CNSdepression
with
alcohol,omeperazol
e- Increased
pharmacologiceffe
cts of diazepam if

>CNS:
Transient,
milddrowsiness
initially;
sedation,depressi
on, lethargy,
apathy,fatigue,
disorientation,res
tlessness,
confusion,deliriu
m, headache,
slurredspeech,
dysarthria,
stupor,rigidity,
tremor,
mildparadoxical
excitatoryreactio
ns,
extrapyramidalsy
mptoms, visual
andauditory
disturbances
CV:Bradycardia,
tachycardia,
CVcollapsehyper
tension
andhypotension,
edema
Dependence:
Drugdependence
with
withdrawalsyndr
ome
Dermatologic:

> it increases
neuronal
membrane
permeability to
chloride ions
bybinding to
stereospecificben
zodiazepine
receptors on
thepostsynaptic
GABA neuron
within theCNS
and enhancing
the
GABAinhibitory
effects resulting
inhyperpolarisati
on and
stabilization.

> Do not
administer
intrarterially;
mayproduce
arteriospasm,
gangrene.Carefully
monitor P. BP,
respirationduring
IV
administration.Change from IV
therapy to oral
therapyas soon
as possible.- Do
not use small
veins for IV
injection.Instruct to take
drug exactly
asprescribed.
After
- Maintain
patients
receiving
parenteralbenzod
iazepines in bed
for 3 hours.- Do
not permit
ambulatory
patients
tooperate a
vehicle
following an

combined with
cimetidine,disulfira
m,
hormonalcontracep
tives- Decreased
effects of diazepam
withtheophyllines,
ranitidineDrug to
food- none
reported

Urticaria,pruritus
, skin rash,
dermatitis
GI:Constipation,
diarrhea,dry
mouth,
salivation,nausea
, anorexia,
vomiting,
difficulty in
swallowing,eleva
tion in blood
enzymes,hepatic
impairment
GU:
Incontinence,
urinaryretention,
changes in
libido,menstrual
irregularities
Hematologic:
DecreasedHct,
blood dyscrasias
Other:
Phlebitis,
thrombosis,hiccu
ps, fever,
diaphoresis,pares
thesias, muscular
disturbances,
gynecomastia,pai
n, burning,
redness after IM
injection

injection.Instruct patient
to report
adversereactions.
- Monitor EEG
in patients
treated for status
epilepticus,
seizures may
recur after initial
control.- Monitor
liver and renal
function,
CBCduring long
term therapy.Taper dosage
gradually after
longtermtherapy.Document that
drug has been
given.

> Ultra short

INTERMEDIAT
E INSULIN

VARIOUS

acting
Immediate
onset Duration
up to 4 hours
Peak action 60
minutes

It has
anonset
of action
starting
about 2
>

>Treatment

>Contraindicated

of type 1
(insulindependent)
diabetes

with allergy
to pork
products(varies
with preparations
;human
insulinnotcontrai
ndicatedwith
pork allergy).
>Use cautiously
with
pregnancy( keep
patient sunder
close
supervision;rigid
control is
desired;following
delivery,requirem
entsmay drop
for 2472 hr, rising to
normal levels
during next 6wk);
lactation(monitor
mother caref
ully;insulin
require
mentsmay
decreaseduringla
ctation)

>Treatment
of type 2 (non
Insulin
dependent)
diabetes that
cannot be
controlled by
diet or oral
agents
>Regular
insulin
injection:
Treatment of
severe
ketoacidosis
or diabetic
comA
>Treatmentof
hyperkalemia
with infusion
of glucose
to produce a
shift of
potassium into
the cellS
>Highly

>

> Insulin is a

naturallyoccurring
hormone
secreted by the
pancreas.
Insulin is
required by the
cells of the
body in order
for them to
remove and
use
glucose from
the blood.
> Cells use
glucose to
produce energy
that they need
to carry out
their functions

>

purified and
human
insulins
promoted
for short
courses
of therapy
(surgery,
intercurrent
disease),newly
diagnosed
patients,
with poor
metabolic
control,
and patients
with
gestational
iabeteS
>Insulin
injection
concentrated