Drug Study Rani Ti Dine Metoclopramide Ketorolac and Omeprazole (1)

8/14/2019 Drug Study Rani Ti Dine Metoclopramide Ketorolac and Omeprazole (1)

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DRUG DOSE

ROUTE

INDICATIONS

CONTRAINDICATION ACTION SIDEEFFECT

NURSINGCONSIDERATION

SGeneric

Name:Ranitidine

Hydrochloride

Brand Name:Zantac

Class:

Histamine 2antagonists

50 mg

q 8hrs

IV Short-term

treatment of active duodenal

ulcer

Short-termtreatment of

active, benigngastric ulcer

Maintenancetherapy for

duodenal ulcer at reduced

dosage.

Short-termtreatment for

GERD.

Pathologichypersecretory

conditions(Zollinger-

Ellisonsyndrome)

Contraindicated with

allergy to ranitidine,lactation

Use cautiously withimpaired renal or hepatic

function, pregnancy

Competitively

inhibits theaction of

histamine atthe H 2

receptors of the parietalcells of thestomach,inhibiting

basal gastricacid secretion

and gastricacid secretion

that isstimulated byfood, insulin,

histamine,cholinergic

agonists,gastrin and pentagastrin.

CNS:

headache,malaise,

dizziness,somnolence,

insomnia,vertigo

CV:tachycardia,

bradycardia

Dermatologic:rash, alopecia

GI:constipation,

diarrhea,nausea and

vomiting,abdominal pain, hepatitis

GU:impotence or

decreasedlibido

Assessment:

1. History: allergy toranitidine, impaired

renal or hepaticfunction, lactation,

pregnancy.2. Physical: skin

lesions, orientation,affect, liver evaluation,

abdominalexamination, normal

output, renalfunction tests, CBC

Interventions:1. Administer oral

drug with meals andat bedtime.

2. Decrease doses inrenal and liver failure.

3. Provideconcurrent antacidtherapy to relieve

pain.4. Administer IM


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Treatment of erosive

esophagitis

Treatment of heartburn, acid

indigestion,sour stomach

Hematologic:leucopenia,

granulocytope

nia,thrombocytop

enia, pancytopenia

dose undiluted, deepinto large muscle

group.5. Arrange for

regular follow-upincluding blood test,to evaluate effects.


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DRUG DOSE ROUTE INDICATIONS CONTRAINDICATIONS ACTION SIDE

EFFECT

NURSING

CONSIDERATIONSGeneric Name:

Metoclopramide

Brand Name:Maxolon

Class:Antiemetic, GI

stimulant

1 ampq 8 hrs

IV Disturbances of GI motility

Relief of symptoms of

acute andrecurrentdiabetic

gastroparesis

Nausea andvomiting

Metabolicdiseases

Short-term

therapy for adults withsymptomatic

gastroesophageal reflux whofail to respondto conventional

therapy.

Contraindicated withallergy to metoclopramide

GI hemorrhage

Mechanical obstruction or perforation

Epilepsy

Use cautiously with previously detected breast

cancer, lactation, pregnancy, fluid overload,

renal impairment

Stimulatesmotility of upper GI

tract withoutstimulating

gastric, biliary, or pancreatic

secretions;appears tosensitizetissues toaction of

acetylcholine; relaxes pyloric

sphincter,

which,whencombined

with effectson motility,accelerates

gastricemptying

CNS:restlessness,drowsiness,

fatigue,insomnia,dizziness,

anxiety

CV:transient

hypertension

GI: nauseaand diarrhea

Assessment:1. History: allergy tometoclopramide, GI

hemorrhage,mechanical

obstruction or perforation,

depression, epilepsy,

lactation, previouslydetected breast cancer

2. Physical:orientation, reflexes,affect, bowel sounds,normal output, EEG

Interventions:1. Monitor BP

carefully during IVadministration.2. Monitor diabetic

patients, arrange for alterations in insulin

dose or timing if diabetic control iscompromised by


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Prophylaxis of postoperative

nausea and

vomiting whennasogastricsuction is

undesirable.

andintestinal

transit; littleeffect on

gallbladder or colonmotility;increases

lower esophagealsphincter pressure;

has sedative

properties;induces

release of prolactin

alterations in timingof food absorption.


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DRUG DOSE

ROUTE

INDICATIONS

CONTRAINDICATIONS

ACTION SIDE EFFECT NURSINGCONSIDERATION

SGeneric Name:

KetorolacTromethamin

e

Brand Name:Toradol

Class:Antipyretic

NSAID

1AMPq 6hrs

andPRNfor

pain

IV Short-termmanagement of pain (up to 5

days)

Ophthalmic:relief of ocular itching due to

seasonalconjunctivitisand relief of

post-operativeinflammation

after cataractsurgery.

Contraindicated withsignificant renal

impairment, during labor and delivery, lactation,

aspirin allergy, recent GI bleed or perforation

Use cautiously withimpaired hearing;allergies; hepatic

conditions

Anti-inflammatoryand analgesic

activity;

inhibits prostaglandin

s andleukotrienesynthesis

CNS:headache,dizziness,

somnolence,

insomnia,fatigue,

dizziness,tinnitus,

ophthalmologic effects

Assessment:1. History: renal

impairment,impaired hearing,

allergies, hepatic,lactation, pregnancy

2. Physical: skincolor and lesions,

orientation, reflexes, peripheral sensation,clotting times, CBC,adventitious sounds

Interventions:1. Be aware that patient may be atrisk for CV events,GI bleeding, renaltoxicity, monitor

accordingly.2. Do not use during


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DRUG DOSE ROUTE INDICATIONS CONTRAINDICATIONS ACTION SIDEEFFECT

NURSINGCONSIDERATIONS

Generic Name:

Omeprazole

Brand Name:Tansinel

Class:Antisecretory

drug

20 mg1 cap

for twoweeks

Oral Short-termtreatment of

active duodenalcancer

Short-termtreatment of

active benigngastric ulcer

Eradication of

Helicobacter Pylori

First-linetherapy for

treatment of heartburn or symptoms of

Contraindicated withhypersensitivity to

omeprazole or itscomponents.

Use cautiously with pregnancy, lactation.

Gastric-acid pump

inhibitor:suppressesgastric acidsecretion by

specificinhibition of

thehydrogen- potassium

ATPaseenzymesystem at

thesecretorysurface of the gastric parietal

CNS;headache,

dizziness,asthenia,vertigo,

insomnia,apathy,anxiety,

paresthesias,dream

abnormalities

Dermatologic:rash,

inflammation,urticaria, pruritus,

alopecia, dryskin

Assessment:1. History

:hypersensitivity toomeprazole or any of its components;

pregnancy, lactation2. Physical: skinlesions; reflexes;urinary output;

abdominalexamination;

respiratoryauscultation

Interventions:1. Administer before

meals.2. Administer

antacids with, if


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GERD. cells; blocksthe final

step of acid production.

GI: diarrhea,abdominal

pain, nausea,

vomiting,constipation,dry mouth,

tongueatrophy

Respiratory:URI

symptoms,

cough,epistaxis

needed.3. Have regular

medical follow-upvisits.

4. Report severeheadache, worseningof symptoms, fever,

chills.

Documents

Drug Study Rani Ti Dine Metoclopramide Ketorolac and Omeprazole (1)