VIII.

DRUG STUDY Generic Name (Brand Name) Celecoxib Dose,Frequency,Route

200mg 1 cap BID PO 9-12-11

Classification
Nonsteroidal antiinflammatory drug (NSAID)

Indications
used to treat pain

Mechanism of Action
Blocks the enzyme that makes o prostaglandins o (cyclooxygenase 2), resulting in lower o concentrations of prostaglandins. As a consequence, o inflammation and its o accompanying pain, fever, swelling ando tenderness are o reduced. o o o

Side Effects
-Diarrhea -Dyspepsia -Headache o -Upper respiratory o tract infections -Abdominal pain -Flatulence -Nausea -Back pain -Peripheral edema -Dizziness -Rash o o o

Nursing Responsibilities
-May give without regard to food. Do not crush or break capsules. -Assess onset, type, location, and duration of pain or inflammation. -Inspect the appearance of affected joints for immobility, deformity, and skin condition. -Evaluate for therapeutic response: relief of pain, decreased stiffness, swelling, increased joint mobility, decreased tenderness, and improved grip strength

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Tramadol

500mg 1 cap TID PO PRN 9 -12- 11

Synthetic Analgesic

Severe pain

Its exact mechanism of action is unknown but similar morphine. Like morphine, tramadol binds to receptors in the brain (opioid receptors) that are important for transmitting the sensation of pain from throughout the body to. Tramadol, like other narcotics used for the treatment of pain, may be abused. Tramadol is not a nonsteroidal antiinflammatory drug (NSAID) and does not have the increased risk of stomach ulceration and internal bleeding that can occur with NSAIDs.

o - May increase central nervous system and respiratory depression when o combined with alcohol, anesthetics, narcotics, tranquilizers or sedative hypnotics. nausea, constipation, dizziness, headache, drowsiness, and vomiting. - Less commonly reported side effects include itching, sweating, dry mouth, diarrhea, rash, visual disturbances, and vertigo.

-Assess onset, type, location, and duration of pain or inflammation. -Inspect the appearance of affected joints for immobility, deformity, and skin condition. -Evaluate for therapeutic response: relief of pain, decreased stiffness, swelling, increased joint mobility, decreased tenderness

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Cefuroxime

500mg 1 cap BID PO 9-12- 11

Second-generation cephalosporin Antibiotic

To treat infections

Binds to bacterial membranes. It inhibits synthesis of bacterial cell wall.

-Oral candidiasis (mouth and/or tongue sores) -Mild diarrhea -Mild abdominal cramping -Nausea -Serum sickness reaction (joint pain, fever) Allergic reactions: Thrombophlebitis Colitis Superinfection Nephrotoxicity Severe hypersensitivity reactions

-Assess for history of allergies to cephalosporins and penicillins. -Give without regards to meals. If GI upset occurs give with food or milk. -Avoid crushing tablets due to bitter taste. -Suspension must be given with food. Assess mouth for white patches on mucous membranes and tongue. -Monitor bowel activity and stool consistency carefully. -Monitor input and output and renal function reports for nephrotoxicity.

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