DRUG STUDY

GENERIC
NAME
(BRAND
NAME)

DOSAGE,
TIMING &
ROUTE
(ACTUAL)

CLASSIFICAT
ION

Vancomycin
(Vancocin)

Capsule
125mg
250mg

Anti-infectives

Injectable
solution
5mg/mL
Powder for
injection
500mg
750mg
1g
5g
10g
(ACTUAL:
625mg q6 IV
September 515, 2016;
500mg q6

INDICATIONS

MECHANISM
OF ACTION

SIDE EFECTS

NURSING
CONSIDERATIONS

Treatment of
potentially lifethreatening
infections when
less toxic antiinfectives are
contraindicated.
Particularly useful
in staphylococcal
infections,
including
Endocarditis,
meningitis,
osteomyelitis,
pneumonia
septicicemia,
soft0tissue
infections in
patients who
have allergies to
penicillin or its
derivatives or

Inhibits the
second stage
of cell wall
synthesis of
susceptible
bacteria.
There is also
evidence that
vancomycin
alters the
permeability
of the cell
membrane
and
selectively
inhibits
ribonucleic
acid synthesis

Common side
effects ototoxicity;
hypotension;
nausea; vomiting;
nephrotoxicity;
rashes;
eosinophilia;
leukopenia;
phlebitis; back and
neck
pain;
hypersensitivity
reactions including
anaphylaxis; chills;
fever;
red-man syndrome
(with rapid
infusion);
superinfection

Be sure to teach the

patient the following
about this
medication:
Report signs of
hypersensitivity,
tinnitus, vertigo, or
hearing loss. Report
iFs
there is no
improvement in a few
days. Heart patients
need to be taught
importance of using
antimicrobial
prophylaxis prior to
invasive dental or
medical procedures.

IVTT
September
16-18 , 2016)

when sensitivity
testing
demonstrates
resistance to
methicillin.

GENERIC
NAME
(BRAND
NAME)

DOSAGE,
TIMING &
ROUTE
(ACTUAL)

CLASSIFICAT
ION

INDICATIONS

MECHANISM
OF ACTION

SIDE EFECTS

NURSING
CONSIDERATIONS

Tramadol
(Ultram,
Zydol)

Immediate
release: 50 to
100 mg orally
every 4 to 6
hours as
needed for
pain

Central
nervous
system (cns)
agent;

Effective agent
for control of
moderate to
moderately
severe pain.

Centrally
acting opiate
receptor
agonist that
inhibits the
uptake of
norepinephrin
e and
serotonin,
suggesting
both opioid
and nonopioid
mechanisms
of pain relief.
May produce
opioid-like
effects, but
causes less

Tramadol is
generally well
tolerated, and side
effects are usually
transient.

Assess type,
location, and
intensity of pain
before and 2-3 hr
(peak) after
administration.

Maximum
dose: 400 mg
per day
Pain
Adult: PO 50
100 mg q46h
prn (max: 400
mg/d), may

Analgesic
Narcotic
(opiate)
agonist

Tramadol inhibits
reuptake of
norepinephrine,
serotonin and
enhances
serotonin release.
It alters
perception and
response to pain
by binding to muopiate receptors
in the CNS.

Commonly reported
side effects include
nausea,
constipation,
dizziness,
headache,
drowsiness, and
vomiting. Less
commonly reported
side effects include
itching, sweating,
dry mouth,

Assess BP & RR
before and
periodically during
administration.
Respiratory
depression has not
occurred with
recommended doses.
Assess bowel
function routinely.

start with 25
mg/d if not
well tolerated,
and increase
by 25 mg q3d
up to 200
mg/d
Geriatric: PO
50100 mg
q46h prn
(max: 300
mg/d), may
start with 25
mg/d if not
well tolerated,
and increase
by 25 mg q3d
up to 200
mg/d
Renal
Impairment
Clcr <30
mL/min:
decrease to
50100 mg
q12h
Hepatic
Impairment
Cirrhosis
decrease to

Management of
moderate to
moderately
severe pain.

respiratory
depression
than
morphine.

diarrhea, rash,
visual disturbances,
and vertigo. Some
patients who
received tramadol
have reported
seizures. Abrupt
withdrawal of
tramadol may
result in anxiety,
sweating, insomnia,
rigors, pain,
nausea, diarrhea,
tremors, and
hallucinations.

Prevention of
constipation should
be instituted with
increased intake of
fluids and bulk and
with laxatives to
minimize
constipating effects.
Assess previous
analgesic history.
Tramadol is not
recommended for
patients dependent
on opioids or who
have previously
received opioids for
more than 1 wk; may
cause opioid
withdrawal
symptoms.
Prolonged use may
lead to physical and
psychological
dependence and
tolerance, although
these may be milder
than with opioids.
This should not
prevent patient from
receiving adequate

50100 mg
q12h
(ACTUAL:
50mg q6 x 4
doses IV
September
15-16, 2016)

analgesia. Most
patients who receive
tramadol for pain d
not develop
psychological
dependence. If
tolerance develops,
changing to an opioid
agonist may be
required to relieve
pain.
Tramadol is
considered to provide
more analgesia than
codeine 60 mg but
less than combined
aspirin
650mg/codeine 60
mg for acute
postoperative pain.
Monitor patient for
seizures. May occur
within recommended
dose range. Risk
increased with higher
doses and inpatients
taking
antidepressants
(SSRIs, tricyclics, or
Mao inhibitors),

opioid analgesics, or
other durgs that
decrese the seizure
threshold.
Overdose may
cause respiratory
depression and
seizures. Naloxone
(Narcan) may reverse
some, but not all, of
the symptoms of
overdose. Treatment
should be
symptomatic and
supportive. Maintain
adequate respiratory
exchange.
Encourage patient
to cough and breathe
deeply every 2 hr to
prevent atelactasis
and pneumonia.

REFERENCES:
Vancomycin
https://www.drugs.com/vancomycin.html
http://www.webmd.com/drugs/2/drug-939/vancomycin-intravenous/details
https://medlineplus.gov/druginfo/meds/a604038.html
http://reference.medscape.com/drug/vancocin-vancomycin-342573
https://www.scribd.com/doc/6774377/Drug-Study
Tramadol
http://www.webmd.com/drugs/2/drug-4398-5239/tramadol-oral/tramadol---oral/details
https://www.drugs.com/tramadol.html
http://nurseslabs.com/tramadol-hcl-ultram-drug-study/
https://www.scribd.com/doc/126654029/Drug-Study-Tramadol