Drug Study Ranitidine Tramadol

XII.

Drug Study
Mechanism of

Indication

Contraindication

Adverse

Nursing Responsibilities

Nursing Implication

Dosage:

Action
Competitive

Used to

Reactions
Hypersensitivity to  Constipation

50mg

inhibition of

prevent ulcer

ranitidine or any

 Diarrhea

Antisecretory (H2-receptor

medication may cause

histamine at H2-

while patient is

component of the

antagonist)

drowsiness, dizziness,

Q8°

receptors of the

on NPO.

formulation.

 Fatigue

Route:

gastric parietal

IVTT while

cells, which inhibits

on NPO

gastric acid

 Muscle pain

Gastointestinal

secretion, gastric

 Nausea

agent;

volume, and

 Vomiting

Antisecretory

hydrogen ion

 Agitation

adverse reaction to the

avoid taking any new

(H2-receptor

concentration are

 Anemia

physician or nurse. Tell patient

medication during

antagonist)

reduced. Does not

that antacids may decrease the

therapy without

absorption of ranitidine.

consulting prescriber.

Generic Name:
Ranitidine

Frequency:
Brand name:
Zantac
Classification:

 Insomnia

 Confusion

affect pepsin
Source:

secretion,

◙ Nursing 2007

pentagastrin-

Drug Handbook

stimulated intrinsic

27th Edition,
Lippincot Williams

 Headache

 Depression
 Easy bruising

C - Gastointestinal agent;

H - Reduced amount of acid in

◙ Inform patient that the

or fatigue (use caution

the stomach that may result to

when driving or

prevented ulcer incidence.

engaging in tasks

E - Every 8 hours while patient is requiring alertness).
on NPO.
C - Instruct client to report any

◙ Instruct patient to

K - Ranitidine can interfere with
the metabolism of alcohol.

◙ Instruct patient to

Patients taking ranitidine who

avoid alcohol and

factor secretion, or

drink alcohol may have

follow diet as

serum gastrin.

elevated blood alcohol levels.

prescriber recommends.

or bleeding

& Wilkins

Mechanism of

Indication

Contraindication

Adverse

Nursing Responsibilities

Nursing Implication

Action
Generic Name:
Tramadol

Dosage:

Binds to -opiate

Management

Hypersensitivity to

 Dizziness

C - Analgesic

◙ Tell patient that

50mg

receptors in the

of pain in the

tramadol, opioids, or

 Nausea

H - Relief of pain in the

driving or operating

CNS causing

operation site.

any component of the

 Drowsiness

Frequency:
Brand name:

Reactions

formulation; opioid-

Route:

ascending pain

dependent patients;

IVTT x 6

pathways, altering

acute intoxication

doses

the perception of

with alcohol,

 Headache

and response to

hypnotics, centrally-

 Sweating

adverse reaction to the

repot cravings to

pain; also inhibits

acting analgesics,

 Vomiting

physician or nurse. Tell

physician immediately.

the reuptake of

opioids, or

 Itching

patient that tolerance or drug

◙ Nursing 2007

norepinephrine and

psychotropic drugs

 Rash

dependence may result from

◙ Inform client that

Drug Handbook

serotonin, which

extended use (withdrawal

medication may cause

27th Edition,

also modifies the

symptoms have been

CNS depression and/or

Lippincot

ascending pain

reported); abrupt

respiratory depression,

Williams &

pathway.

discontinuation should be

particularly when

avoided.

combined with other

K - You should not take

CNS depressants

Classification:
Analgesic
Source:

 Dry mouth
 Constipation

 Visual
disturbances
 Vertigo

Wilkins

E - Every 6 hours x 6 doses.

machinery should be

inhibition of

Ultram

Q6°

operation site.
May be taken with or without

avoided until the effect
of drug wears off.

food.
C - Instruct client to report any

◙ Instruct patient to

Ultram if you have ever been
addicted to drugs or alcohol.
Should be used only with
extreme caution in patients
receiving MAO inhibitors

Mechanism of
Action

Indication

Contraindication

Adverse
Reactions

Nursing Responsibilities

Nursing Implication

Generic Name:
Ketorolac

Inhibits

Used for

Hypersensitivity to

 Rash

C - Nonsteroidal Anti-

◙ Instruct client to avoid

prostaglandin

treating

ketorolac, aspirin, other

 Ringing in

Inflammatory Drugs

alcohol and maintain

synthesis by

inflammation

NSAIDs, or any component

the ears

(NSAIDs)

adequate hydration (2-3

Q6°

decreasing the

and pain in

of the formulation; patients

 Headaches

H - Pain as well as

L/day of fluids) unless

Route:

activity of the

the operation

who have developed nasal

IVTT x 6

enzyme,

site.

polyps, angioedema, or

doses

cyclooxygenase,

bronchospastic reactions to

which results in

other NSAIDs; active or

Dosage:
30mg
Frequency:

Brand name:
Toradol
Classification:
Nonsteroidal

 Dizziness
 Drowsiness
 Abdominal
pain

inflammation and its

instructed to restrict fluid

signs and symptoms -

intake.

redness, swelling, fever,
and pain are reduced.

Anti-

decreased

history of peptic ulcer

Inflammatory

formation of

disease; recent or history of

 Nausea

Drugs (NSAIDs)

prostaglandin

GI bleeding or perforation;

 Diarrhea

precursors,

patients with advanced renal

 Constipation

any adverse reaction to

chemicals that cells

disease or risk of renal

 Heartburn

the physician or nurse.

◙ Instruct client to avoid

◙ Nursing 2007

of the immune

failure; labor and delivery;

 Fluid

Tell patient that adverse

taking ketorolac with

Drug Handbook

system make that

nursing mothers; prophylaxis

reactions can occur with

aspirin or other NSAIDs

27th Edition,

cause the redness,

before major surgery;

overuse.

such as ibuprofen

Lippincot

fever, and pain of

suspected or confirmed

K - Do not drink alcohol

(Motrin, Advil), naproxen

Williams &

inflammation and

cerebrovascular bleeding;

while taking ketorolac.

(Aleve, Naprosyn),

Wilkins

that also are

hemorrhagic diathesis;

Alcohol can increase the

piroxicam (Feldene), etc.

believed to be

concurrent ASA or other

risk of stomach bleeding

important in the

NSAIDs; epidural or

caused by ketorolac.

production of non-

intrathecal administration;

inflammatory pain.

concomitant probenecid;

Source:

pregnancy (3rd trimester

retention

E - Every 6 hours x 6

◙ Monitor for signs of

doses.
C - Instruct client to report

pain relief, such as an
increased appetite and
activity

Mechanism of
Generic Name:
Ampicillin

Dosage:
500mg
Frequency:

Brand name:

Q6°

Contraindication

Nursing Responsibilities

Nursing Implication

Used for treating

Hypersensitivity

Reactions
 Nausea

C - Antibiotic

◙ Tell patient that

wall synthesis by

bacterial infection.

to ampicillin, any

 Vomiting

H - Pain as well as

medication may cause

binding to one or

component of the

more of the penicillin

formulation, or

 Loss of

other penicillins

Route:

binding proteins

Polycillin,

IVTT

(PBPs); which in
turn inhibits the final

Classification:

of peptidoglycan

Antibiotic

synthesis in bacterial

(penicillins)

appetite
 Diarrhea
 Abdominal
pain

transpeptidation step

Source:

Adverse

Action
Inhibits bacterial cell

Omnipen,
Principen

Indication

 Rash

inflammation and its

nausea or vomiting

signs and symptoms -

(small, frequent

redness, swelling, fever,

meals, frequent

and pain are reduced.

mouth care, sucking

E - Every 6 hours

lozenges, or chewing

C - Instruct client to

gum may help); or

report any adverse

diarrhea (buttermilk,

 Itching

reaction to the physician

boiled milk, or yogurt

cell walls, thus

 Headache

or nurse. Tell patient

may help).

inhibiting cell wall

 Confusion

that Antibiotic

biosynthesis.

 Dizziness

medicines can cause

◙ Instruct client to

◙ Nursing 2007

Bacteria eventually

diarrhea, which may be

maintain adequate

Drug Handbook

lyse due to ongoing

a sign of a new

hydration (2-3 L/day

27th Edition,

activity of cell wall

infection.

of fluids) unless

Lippincot Williams

autolytic enzymes

K - Do not take the

instructed to restrict

& Wilkins

(autolysins and

medication in larger

fluid intake.

murein hydrolases)

amounts, or take it for

while cell wall

longer than recommended

assembly is arrested.

by your doctor.

Mechanism of

Indication

Contraindication

Adverse

Nursing

Nursing

Action
Generic Name:
Paracetamol
Classification:
Analgesic and

Dosage:
500mg
Frequency:
PRN

Antipyretic
Source:
◙ Nursing 2007
Drug Handbook

Reactions

Responsibilities

Implication

Reduces fever

Used for the relief of

Contraindicated with

 Chest pain

C - Analgesic and

◙ Warn patient that

by acting on the

fever, headaches, and

allergy to acetaminophen

 Dyspnea

Antipyretic

acute overdoses

hypothalamus

other and pains

or any component.

H - Relief of fever,

(above 1000 mg per

to cause

regarding surgical

 Rash

vasodilatation

wound.

& sweating.

Use cautiously with
impaired hepatic

Route:

function, chronis

IVTT

alcoholism, and
pregnancy lactation.

 Fever
 Acute
kidney
failure
 Jaundice
 Acute

headaches, and other

single dose and

minor aches and pains.

above 4000 mg per

E - as necessary or when

day for adults,

temperature is more

above 2000 mg per

than 37.80C

day if drinking

C- Instruct client to report alcohol) of
any adverse reaction

paracetamol can

27th Edition,

kidney

like allergies to the

cause potentially

Lippincot Williams

failure

physician or nurse.

fatal liver damage

Warn patient that high

and, in rare

toxicity and

doses or unsupervised

individuals, a

failure

long –term use can

normal dose can do

cause liver damage.

the same; the risk is

& Wilkins

 Hepatic

K - Do not exceed the
recommended dosage.
Not to use for marked
fever (temperature
higher than 39.50C).
Fever persisting longer
than 3 days.

heightened by
alcohol .

XIII. Health Teaching Plan
Medication
Ranitidine
C - Gastointestinal agent;

Exercise
•The extended period of

Treatment
•Pain relievers

Hygiene
•Make sure you have enough

Outpatient
•Instruct patient to have follow

Diet
•Try eating smaller meals than

bed rest after a

prescribed by the

sanitary pads for vaginal

up check up consultation and

normal and have healthy

regular check ups.

snacks in between .Eat healthy,

Antisecretory (H2-

hysterectomy can weaken doctor

bleeding and discharge. You

receptor antagonist)

the muscles in the lower

may have some discharge

H - Reduced amount of

because the patient’s body

back and stomach.

•Indwelling

and bloody drainage for

•Instruct patient to follow good needs nutrients to heal (even if

acid in the stomach that

Following exercises

catheter

several days after your

compliance to medication

may result to prevented

should be held for five to

ulcer incidence.

10 seconds and repeated

hysterectomy.

she doesn’t feel like it). Eat
cold-water fish as well as

•Instruct patient to limit her

turkey, chicken, organic bread,

•Keep sanitary environment

movement at the beginning or

soups, salads, vegetables and

one that would not allow

if her doctor authorizes it take

broths.

•The chin tuck can be

microorganisms to multiply

some short walks to keep her

any adverse reaction to

performed while sitting

and cause infection.

blood circulating and prevent

• Take the best daily multiple

the physician or nurse.

in a chair or on the side

blood clots from forming in

premium vitamins recommend

Tell patient that antacids

of your bed. Keep your

•Provide catheter care: Keep

her legs.

and vitamin C as well. These

may decrease the

arms relaxed and by your

the catheter coiled by the

absorption of ranitidine.

side. Look straight ahead

client’s side to prevent the

•Avoid all lifting after the

sleep, will make less

K - Ranitidine can

and pull your chin as

tubing to hang in a loop that

surgery and during the post

susceptibility to colds, flu’s

interfere with the

though you are

allow the urine to sit in the

hysterectomy period (ask for

and viruses less, will increase

metabolism of alcohol.

attempting to create a

tubing; maintain external

assistance).

energy levels and provide the

Patients taking ranitidine

double chin.

cleanliness around the

E - Every 8 hours while

10 times on a daily basis.

patient is on NPO.
C - Instruct client to report

who drink alcohol may

vitamins will help improve

patient with sharper and clearer

catheter. Keep the drainage

•Instruct patient avoid

have elevated blood

•The upper back and

bag off the floor to prevent

climbing stairs or driving a car

alcohol levels.

shoulder stretch is done

microorganisms from

during this recuperation period

while lying in bed or on a

moving up from outside the

(ask family and friends for

mind.

Tramadol

mat. Bring your hands

bag and into the catheter;

over your head and rest

change catheter every 2

C - Analgesic

with your palms up.

weeks to prevent infection.

H - Relief of pain in the

Press your arms back into

operation site.

the bed.

•Maintain good oral hygiene

E - Every 6 hours x 6

help).

• Instruct patient to drink
filtered water. And since most

•Tell patient to avoid drinking

of life is "consumption and

alcoholic beverages for a few

elimination", the patient needs

weeks (especially while taking

to consume 8-10 glasses of

medication).

water daily to adequately

doses. May be taken with

•The pelvic tilt can also

•Provide good perineal care.

or without food.

be achieved in a lying-

Change off perineal pad at

•Instruct patient to avoid

which would otherwise build

down position. You can

least twice a day. Wiping

aspirin and dairy foods during

up and cause some level of

any adverse reaction to

place your hands on your

from front to back.

the post hysterectomy time

discomfort or illness.

the physician or nurse.

stomach or put one hand

because dairy products will not

Tell patient that tolerance

under your lower back

help you with constipation.

• Taking omega-3 and fatty

or drug dependence may

and keep the remaining

The pain medicine you will be

acids should be taken daily

result from extended use

hand on your stomach.

taking during the post

because it has shown that it

(withdrawal symptoms

Lightly tighten your

hysterectomy time will tend to

reduces inflammation, reduces

have been reported);

buttocks and stomach

make you constipated.

the risk of strokes and heart

abrupt discontinuation

muscles to pull your

should be avoided.

lower back down. You

C - Instruct client to report

K - You should not take

will notice your pelvis or

Ultram if you have ever

hip bones roll backward.

been addicted to drugs or
alcohol. Should be used
only with extreme caution
in patients receiving MAO
inhibitors

"flush" her system of toxins

attacks, help lower cholesterol
• Instruct patient to change the
dressing over her incision once
a day or sooner if it gets dirty
or wet.


Keep the wound area
clean by washing it with
mild soap and water.

and thin the blood.

Ketorolac

•You will have to get on
your hands and knees to

C - Nonsteroidal Anti-

carry out the stomach-

Inflammatory Drugs

strengthening movement.

(NSAIDs)

Start by taking a deep

H - Pain as well as

breath. As you slowly

inflammation and its

exhale, keep the rest of

signs and symptoms -

your body still while

redness, swelling, fever,

tightening your stomach

and pain are reduced.

muscles.

E - Every 6 hours x 6

•Tell patient that she may
remove her wound dressings
(bandages) and take showers if
sutures (stitches), staples, or
glue were used to close her
skin. Instruct her not to soak in
a bathtub or hot tub, or go
swimming, until her doctor
tells her it is okay.

doses.
C - Instruct client to report

•If tape strips (Steri-Strips)

any adverse reaction to

•Exercise as soon as the

were used to close her incision,

the physician or nurse.

doctor authorizes it.

cover them with plastic wrap

Tell patient that adverse

Moderate exercise will

before showering for the first

reactions can occur with

improve immune

week. Do not try to wash off

overuse.

defenses and antioxidant

the Steri-Strips or glue. They

levels.

should fall off in about a week.

K - Do not drink alcohol
while taking ketorolac.

If they are still there after 10

Alcohol can increase the

days, she can remove them,

risk of stomach bleeding

unless her doctor tells her not

caused by ketorolac

to.

Ampicillin
C - Antibiotic
H - Pain as well as
inflammation and its
signs and symptoms redness, swelling, fever,
and pain are reduced.
E - Every 6 hours
C - Instruct client to report
any adverse reaction to
the physician or nurse.
Tell patient that Antibiotic
medicines can cause
diarrhea, which may be a
sign of a new infection.
K - Do not take the
medication in larger
amounts, or take it for
longer than recommended
by your doctor.

Paracetamol

C - Analgesic and
Antipyretic
H - Relief of fever,
headaches, and other
minor aches and pains.
E - as necessary or when
temperature is more than
37.80C
C- Instruct client to report
any adverse reaction like
allergies to the physician
or nurse. Warn patient
that high doses or
unsupervised long –term
use can cause liver
damage.
K - Do not exceed the
recommended dosage.
Not to use for marked
fever (temperature higher
than 39.50C). Fever
persisting longer than 3
days.