Drug/

Frequency/ Action Indication Adverse Reaction Nursing Responsibilities

Dosage

Dexketoprofen + The most common side

Tramadol 25 effects during treatment
mg/75 mg; 1 tab with Skudexa are nausea
TID once IV pain Symptomatic and dizziness, which
meds consume; short term occur in more than 1 out
ORAL treatment of of 10 patients.
moderate to
severe acute ...
pain in adult
vomiting.
patients whose
pain is stomach pain.
considered to
diarrhoea.
require a
combination of digestive problems.
tramadol and
headaches.
dexketoprofen.
drowsiness, fatigue.

constipation. dry mouth.

Prazole Plus 1 cap  used to treat Management of GERD; Stomach and intestinal
OD; ORAL backflow of the gastritis, NUD, gastric disorders
stomach acid or duodenal ulcer,
Symptoms: diarrhea,
into the food dyspepsia, bloating,
constipation vomiting
pipe, fullness, belching,
inflammation of nonsteroidal anti- Blood disorders
the lining of inflammatory drug
food pipe, (NSAID)-induced Symptoms: low count of
stomach and dyspepsia. white blood cells
duodenal abnormally low level of
ulcers. platelets

Psychiatric disorders
 This medicine
contains Symptoms: hallucination,
Pantoprazole confusion, insomnia,
and sleepiness, anxiety
Domperidone. depression
 Pantoprazole Heart disorders
works by
preventing the Symptoms: abnormal
heartbeat loss of heart
 acid secretion in function
the stomach.
Urinary disorders
 Domperidone
Symptoms: an inability to
works by
empty the bladder
blocking the
brain cell Metabolic and
receptors and nutritional disorders
gives an
antiemetic Symptoms: increased
effect. level of creatine kinase
enzyme, swelling of the
 is also used to body, increased level of
relieve the triglycerides, increased
symptoms of level of liver enzymes,
nausea and increased level of
vomiting, upper bilirubin, decreased level
stomach of sodium decreased level
discomfort, of magnesium
indigestion with
Patients with low
the feeling of
magnesium level may
fullness and
require discontinuation of
backflow of
the proton pump
food from food
inhibitors and magnesium
pipe to mouth.
replacement.

Muscle disorders

Symptoms: fracture of
the hip fracture of the
spine

Eye disorders

Symptoms: blurred vision

Liver disorders

Symptoms: liver damage,

jaundice, liver failure an
inflammation of the liver
(hepatitis)

Kidney disorders

Symptoms: swelling in
between the kidney
tubules (interstitial
 nephritis)

cefuroxime axetil Cefuroxime binds to Oral Large doses can cause Assessment
- 500 mg 1 tab one or more of the cerebral irritation and
- Pharyngitis, tonsillitis History: Hepatic and renal
TID x 5days penicillin-binding convulsions; nausea,
caused by impairment, lactation,
proteins (PBPs) which vomiting, diarrhea, GI
cefuroxime Streptococcus pregnancy
inhibits the final disturbances; erythema
(Newxime) 750 pyogenes
transpeptidation step of multiforme, Stevens- Physical: Skin status, LFTs,
mg ANST x 2
peptidoglycan synthesis - Otitis media caused Johnson syndrome, renal function tests, culture
doses
in bacterial cell wall, by Streptococcus epidermal necrolysis. of affected area, sensitivity
thus inhibiting pneumoniae, S. tests
Potentially Fatal:
biosynthesis and pyogenes,
Anaphylaxis, Interventions
arresting cell wall Haemophilus
nephrotoxicity,
assembly resulting in influenzae, Moraxella  Culture infection,
pseudomembranous
bacterial cell death. catarrhalis and arrange for
colitis.
sensitivity tests
- Lower respiratory
before and during
infections caused by S.
therapy if expected
pneumoniae,
response is not
Haemophilus
seen.
parainfluenzae, H.
influenzae  Give oral drug with
food to decrease GI
- UTIs caused by
upset and enhance
Escherichia coli,
absorption.
Klebsiella pneumoniae
 Give oral drug to
- Uncomplicated
children who can
gonorrhea (urethral
swallow tablets;
and endocervical)
crushing the drug
- Dermatologic results in a bitter,
infections, including unpleasant taste.
impetigo caused by
Streptococcus aureus,  Have vitamin K
S. pyogenes available in case
hypoprothrombine
- Treatment of early mia occurs.
Lyme disease
 Discontinue if
Parenteral hypersensitivity
(cefuroxime sodium) reaction occurs.
Lower respiratory Teaching points
infections caused by S.
pneumoniae, S.  Take full course of
aureus, E. coli, therapy even if you
Klebsiella, H.
 influenzae, S. are feeling better.
pyogenes
 This drug is specific
Dermatologic for this infection
infections caused by S. and should not be
aureus, S. pyogenes, E. used to self-treat
coli, Klebsiella, other problems.
Enterobacter
 Swallow tablets
UTIs caused by E. coli, whole; do not
Klebsiella crush them. Take
the drug with food.
Uncomplicated and
disseminated  You may
gonorrhea caused by experience these
N. gonorrhoeae side effects:
Stomach upset or
Septicemia caused by
diarrhea.
S. pneumoniae, S.
aureus, E. coli,  Report severe
Klebsiella, H. diarrhea with
influenzae blood, pus, or
mucus; rash;
Meningitis caused by
difficulty breathing;
S. pneumoniae, H.
unusual tiredness,
influenzae, S. aureus,
fatigue; unusual
N. meningitidis
bleeding or
Bone and joint bruising; unusual
infections caused by S. itching or irritation.
aureus

Perioperative
prophylaxis

Treatment of acute
bacterial maxillary
sinusitis in patients 3
mo–12 yr

Dynastat 40 mg The active substance in Short-term treatment Nausea. Abdominal pain, - Must not be given
then 20 mg TIM q Dynastat, parecoxib, is a of acute pain & post- constipation, dyspepsia, Dynastat if had an attack of
6 x 4 doses ‘prodrug’ of valdecoxib. op pain ie, oral vomiting; peripheral asthma, hives, itching, skin
This means that it is surgery, abdominal edema; alveolar osteitis; rash or a runny nose after
converted to valdecoxib hysterectomy, dizziness; insomnia; taking aspirin or
in the body. Valdecoxib myomectomy, total oliguria; increased nonsteroidal anti-
is a non-steroidal knee replacement, sweating, pruritus; inflammatory drugs
anti-inflammatory drug total hip arthroplasty, hypotension. (NSAIDs, medicines used to
(NSAID) that belongs to laparoscopic treat pain and
the group of medicines cholecystectomy, inflammation), including
called inguinal hernia repair other coxib medicines.
‘cyclo-oxygenase-2 & other general
Must not be given Dynastat
(COX-2) inhibitors’. It surgery eg, diagnostic
if about to undergo heart
blocks the COX-2 laparoscopy,
or blood vessel surgery.
enzyme, resulting in a gastrectomy,
reduction in the hernioplasty, - It should not be given if
production of appendectomy, had any of the following
prostaglandins, hemithyroidectomy & medical conditions. The
substances that are splenectomy. Pre-op doctor or nurse need to
involved in the to prevent or reduce know if you have ever had:
inflammation process. post-op pain & reduce
By reducing the opioid requirements
production of when used  Heart disease;
prostaglandins, concomitantly
Dynastat helps to  A heart attack;
reduce the symptoms of
 A stroke;
inflammation, including
pain.  Severe liver
problems.

The nurse need to know if

have any allergies to:

 Any other
medicines
including aspirin or
other NSAID
medicines,
including other
coxib medicines;

 Any other
substances, such as
foods,
preservatives or
dyes.

- The nurse need to know

about all the medical
conditions, especially if
have ever had any of the
following:
  Kidney or liver
problems;

 Heart problems,
heart surgery,
heart failure, heart
attack or other
blood vessel
disease;

 Stroke;

 Diabetes;

 High cholesterol
levels;

 High blood
pressure;

 Fluid retention or if
you are receiving
diuretic treatment;

 Dehydration;

 Asthma or other
allergic conditions;

 Skin problems with

symptoms such as
swelling, blistering,
peeling, itching,
reddening or some
other abnormality;

 Peptic ulcer i.e.

stomach or
duodenal ulcer.

- The nurse need to know if

pregnant or intend to
become pregnant. Related
medicines, NSAIDs, have
been associated with
reversible infertility in
some women. Use of
 NSAIDs in early pregnancy
can increase the risk of
spontaneous abortion. Use
of Dynastat during
pregnancy is not
recommended as it may
affect your developing
baby.

- Discuss the benefits and

risks of using it.

- Must know if
breastfeeding or intend to
breastfeed. Dynastat
passes into breast milk,
therefore, breastfeeding
should be discontinued
during treatment with
Dynastat.

- Must know if a smoker or

drink alcohol.

- Should know if currently

have an infection.

Nalbuphine 10 Synthetic narcotic For the relief of Sedation, dizziness, Assessment & Drug Effects
mg IV q 6 hrs analgesic with agonist moderate to severe vertigo, miosis, headache;
 Assess respiratory
and weak antagonist pain. depression, restlessness,
rate before drug
properties. Analgesic nervousness, crying,
Symptomatic relief of administration.
potency is about 3 or 4 drunkenness, euphoria,
moderate to severe Withhold drug and
times greater than that floating, hostility,
pain. Also notify physician if
of pentazocine and confusion, unusual
preoperative sedation respiratory rate
approximately equal to dreams, faintness, feeling
analgesia and as a falls below 12.
that produced by of heaviness, tingling,
supplement to surgical
equivalent doses of numbness; nausea,  Watch for allergic
anesthesia.
morphine. On a weight vomiting, dry mouth; response in
basis, produces bradycardia, tachycardia, persons with sulfite
respiratory depression HTN, hypotension, sensitivity.
about equal to that of pulmonary oedema;
 Administer with
morphine; however, in itching, burning, urticaria;
contrast to morphine, resp depression, caution to patients
doses >30 mg produce dyspnoea, asthma; with hepatic or
no further respiratory speech difficulty, urinary renal impairment.
depression. urgency, blurred vision,  Monitor
Antagonistic potency is flushing, warmth, ambulatory
approximately one sweatiness, clamminess. patients;
fourth that of naloxone nalbuphine may
Potentially Fatal:
and about 10 times produce
Anaphylactic or
greater than that of drowsiness.
anaphylactoid and other
pentazocine.
serious hypersensitivity  Watch for
reactions (e.g. shock, resp respiratory
distress or arrest, depression of
bradycardia, cardiac newborn if drug is
arrest, hypotension, used during labor
laryngeal oedema). and delivery.

 Avoid abrupt
termination of
nalbuphine
following
prolonged use,
which may result in
symptoms similar
to narcotic
withdrawal:
nausea, vomiting,
abdominal cramps,
lacrimation, nasal
congestion,
piloerection, fever,
restlessness,
anxiety.

Patient & Family Education

 Do not drive or
engage in
potentially
hazardous
activities until
response to drug is
known.

 Avoid alcohol and

other CNS
depressants.

Do not breast feed while

taking this drug without
 consulting physician.

Omeprazole 40 An antisecretory Suppresses gastric CNS: Headache, dizziness, Assessment & Drug Effects
mg IV OD compound that is a acid secretion fatigue. GI: Diarrhea,
Lab tests: Monitor
gastric acid pump relieving abdominal pain, nausea,
urinalysis for hematuria
inhibitor. Suppresses gastrointestinal mild transient increases
and proteinuria. Periodic
gastric acid secretion by distress and in liver function tests.
liver function tests with
inhibiting the H+, K+- promoting ulcer Urogenital: Hematuria,
prolonged use.
ATPase enzyme system healing. proteinuria. Skin: Rash
[the acid (proton H+) Patient & Family Education
Duodenal and gastric
pump] in the parietal
ulcer. Report any changes in
cells.
Gastroesophageal urinary elimination such as
reflux disease pain or discomfort
including severe associated with urination,
erosive esophagitis (4 or blood in urine.
to 8 wk treatment).
Long-term treatment Report severe diarrhea;
of pathologic drug may need to be
hypersecretory discontinued.
conditions such as Do not breast feed while
Zollinger-Ellison taking this drug.
syndrome, multiple
endocrine adenomas,
and systemic
mastocytosis. In
combination with
clarithromycin to treat
duodenal ulcers
associated
with Helicobacter
pylori.
Tramadol 50 mg Tramadol inhibits Relief of Moderate to Sweating, dizziness, Assessment
reuptake of Severe pain nausea, vomiting, dry
History: Hypersensitivity to
norepinephrine, mouth, fatigue, asthenia,
tramadol; pregnancy; acute
serotonin and enhances somnolence, confusion,
intoxication with alcohol,
serotonin release. It constipation, flushing,
opioids, psychotropic drugs
alters perception and headache, vertigo,
or other centrally acting
response to pain by tachycardia, palpitations,
analgesics; lactation;
binding to mu-opiate miosis, insomnia,
seizures; concomitant use
receptors in the CNS. orthostatic hypotension,
of CNS depressants or
seizures, CNS stimulation
MAOIs; renal or hepatic
e.g. hallucinations.
impairment; past or
Potentially Fatal: present history of opioid
Respiratory depression. addiction

Physical: Skin color,

texture, lesions;
orientation, reflexes,
bilateral grip strength,
affect; P, auscultation, BP;
bowel sounds, normal
output; LFTs, renal function
tests

Interventions

Control environment
(temperature, lighting) if
sweating or CNS effects
occur.

WARNING: Limit use in

patients with past or
present history of addiction
to or dependence on
opioids.

Teaching points

You may experience these

side effects: Dizziness,
sedation, drowsiness,
impaired visual acuity
(avoid driving or
performing tasks that
require alertness); nausea,
loss of appetite (lie quietly,
eat frequent small meals).
Butorphanol 6 mg Butorphanol tartrate is CNS: confusion, Assessment
IV indicated for the nervousness, lethargy,
History: Hypersensitivity to
management of pain headache, somnolence,
butorphanol, physical
when the use of an dizziness, insomnia,
dependence on a narcotic
opioid analgesic is anxiety, paresthesia,
analgesic, pregnancy,
appropriate. euphoria, hallucinations,
lactation, bronchial
increased intracranial
Narcotic agonist- asthma, COPD, increased
pressure.
analgesic of kappa intracranial pressure, acute
opiate receptors and CV: palpitations, flushing, MI, ventricular failure,
partial agonist of mu vasodilation, coronary insufficiency,
opiate receptors; hypotension. hypertension, biliary tract
inhibits ascending pain surgery, renal or hepatic
EENT: blurred vision,
pathways, which causes impairment
nasal congestion (with
alteration in response
nasal spray), tinnitus. Physical: Orientation,
to pain; produces
reflexes, bilateral grip
analgesia, respiratory GI: taste perversion,
strength, affect; pupil size,
depression, and nausea, vomiting,
vision; pulse, auscultation,
sedation constipation, anorexia.
BP; R, adventitious sounds;
Respiratory: respiratory bowel sounds, normal
depression. output; LFTs, renal function
tests
Skin: rash, hives,
excessive diaphoresis. Interventions

Other: clamminess, Ensure that opioid

sensation of heat. antagonist facilities for
assisted or controlled
respiration is readily
available during parenteral
administration.

Teaching points

You may experience these

side effects: Dizziness,
sedation, drowsiness,
impaired visual acuity
(avoid driving, performing
other tasks that require
alertness); nausea, loss of
appetite (lie quietly, eat
frequent small meals).

Report severe nausea,

vomiting, palpitations,
 shortness of breath or
difficulty breathing, nasal
lesions or discomfort (nasal
spray).

Algesia 1 tab TID; It works by blocking It is used for short  Nausea, vomiting
ORAL chemical messengers term relief of pain, (with or without
that are responsible for inflammation, and blood)
causing the pain swelling in conditions
 Stomach pain
sensation. It can help that affect joints and
relieve pain in muscles  Indigestion
conditions like
rheumatoid arthritis  Constipation
and osteoarthritis.  Mouth ulcers

 Black stools

 Loose motions

 Skin rashes

 Dizziness

 Excess sleepiness

Elevated levels of liver

enzymes & creatinine