TRAMADOL HCl

Tramal
Classification: Analgesics (Opioid)

Route: Oral, Parenteral. (It can be taken with or
without food.)

Indication: Moderate to severe chronic & acute pain,
diagnostic procedure & surgery.

Common Side Effect(s): Dizziness, Sweating, N/V, Dry
Mouth & Fatigue, Headache.
Intervention(s): Provide safety environment

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).


Classification: Analgesic (Opioid)

Indication(s): Relief of moderate to severe pain. Pre-
op analgesia, as a supplement to balance
anesthesia, surgical anesthesia, for obstetric
analgesia during labor & relief of pain following MI.

Route: Parenteral (May be repeated after 3 6
hours).

Common Side Effect(s): Sedation, Dizziness ,
Headache, Allergic Reaction.
Interventions: Provide safety environment

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).


Classification: Antihypertensive

Route: Parenteral

Indication: Increased Blood Pressure

Common Side Effect(s): Hypotension

Intervention(s): BP Monitoring

Teaching Points: Lifestyle modification, Report any
unusualities. (Rash, Urinary Retention, Blurring of
Vision.)



Classification(s): Analgesic (Non-Opioid) &
Antipyretic

Indication(s): Relief of fever, minor aches & pains.

Route/Timing: Parenteral & Oral (Tablet & Syrup).
Given AS NEEDED every 4-6 hours.

Common Side Effects: Allergic Reactions & GI
disturbances.
Intervention(s): Assess patients fever or pain: type
of pain, location, intensity, duration, temperature,
and diaphoresis. Assess allergic reactions: rash,
urticaria; if these occur, drug may have to be
discontinued.

Teaching Points: Teach patient to recognize signs of
chronic overdose, bleeding, bruising, malaise,
fever, sore throat. Tell patient to notify prescriber
for pain/fever lasting for more than 3 days.


Classification(s): Brochodilator & Antiasthma

Indication(s): Symptomatic relief of bronchospasm
in obstructive airway disease.

Eg. Bronchial Asthma, Emphysema & Chronic
Bronchitis

Route: Via Nebulizer, Oral

Common Side Effects: Fine tremors, headache,
palpitations, restlessness, apprehension and
anxiety.
Intervention(s): Assess lung sounds, PR and BP
before drug administration and during peak of
medication. Administer PO medications with meals
to minimize gastric irritation.

Teaching Points: (Via Nebulizer) advise the patient
to rinse mouth with water after each inhalation to
minimize dry mouth. Back Tapping.


Classification: Brochodilator

Indication: Relief of dysnea and other symptoms
caused by respiratory obstructive disturbance in
following diseases: bronchial asthma, chronic
bronchitis and pulmonary emphysema.

Route: Oral (Tablet & Syrup)

Common Side Effects: Fine tremors, headache,
palpitations, restlessness, apprehension and
anxiety.

Intervention(s): Assess lung sounds, PR and BP
before drug administration and during peak of
medication. If the desired therapeutic effect of
Procaterol has not been achieved at the
recommend dose, the drug should be discontinued.

Teaching Points: Report if theres any signs of any
common side effects occurs.


Classification: Mucolytic Agent

Indication: Acute & chronic respiratory tract
affections with abundant mucus secretion.

Route: Oral (Dissolve in glass of water.)

Common Side Effect: The drug is well tolerated.
When it is use orally, in rare cases it can cause
nausea and vomiting, very seldom can be no
hypersensitivity reactions such as urticarial and
bronchospasm. In case of any side effects,
discontinue use of the drug.
Interventions: Monitor effectiveness of the
therapy and advent of adverse/allergic
effects.

Teaching Points: Instruct patient in
appropriate use and adverse effects to
report.

Classification: Antipasmodics

Indication: Treatment of spasm & hypermotility of
GIT, biliary & renal colic, spasmodic dysmenorrhea.
Parenterally, aid in diagnostic & therapeutic
procedures.

Route: Oral & Parenteral.

Common Side Effects: Dizziness, Hypotension, Dry
mouth, Constipation.
Intervention(s): Raise side rails as a precaution
because some patients become temporarily excited
or disoriented and some develop amnesia or
become drowsy.

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).


Classification: Drug Acting on the Uterus

Indication(s): Active management of the 3
rd
stage of
labor, Delivery under general anesthesia, Uterine
atony/hemorrhage.

Route: Oral & Parenteral.

Common Side Effect(s): The most common side
effect is hypertension associated in several cases
with seizure and/or headache.
Intervention: Methergine should be given slowly
over a period of no less than 60 seconds with
careful monitoring of blood pressure.

Teaching Points: Mothers should not breast-feed
during treatment with Methergine. Milk secreted
during this period should be discarded. Methergine
may produce adverse effects in the breast-feeding
infant. Methergine may also reduce the yield of
breast milk. Mothers should wait at least 12 hours
after administration of the last dose of Methergine
before initiating or resuming breast feeding.


Classification: Cephalosporins, Antibiotic

Indication: Treatment of Infections caused by
susceptible organisms.

Route: Parenteral, Oral.

Common Side Effect: Hypersensitivity. Diarrhea,
N/V.

Intervention: Assess for any allergic reaction, and
any signs of side effects.

Teaching Points: Inform for any sign of adverse
reactions to report.

FACT: The shelf-life of Cefuroxime is up to 3 years
or unopened dry powder has been set, however if
the solution is reconstituted it may be stored up to
24 hours when stored at 2 to 8 degree Celsius.



Classification: Hypnotics & Sedatives

Indication: Sedation in premed before surgical or
diagnostic procedures induction & maintenance of
anesthesia.

Route: Parenteral

Common Side Effects: N/V and Headache.
Intervention: Assess level of sedation and level of
consciousness throughout and for 2-6 hr following
administration.
Monitor BP, pulse and respiration continuously
during IV administration. Oxygen and resuscitative
equipment should be immediately available.
If overdose occurs, monitor pulse, respiration ,
and BP continuously. Maintain patent airway and
assist ventilation as needed. If hypotension occurs,
treatment includes IV fluids, repositioning and
vasopressors.


Classification: Central nervous system agent,
general anesthesia; sedative-hypnotic.

Indication: Induction and maintenance of general
anesthesia of ventilated adult patients receiving
intensive care. Conscious sedation for surgical &
diagnostic procedures.

Common Side Effect: Hypotension, transient apnea,
post-op fever.
Intervention(s):

Monitor hemodynamic status and assess for dose-related
hypotension.

Take seizure precautions. Tonic-clonic seizures have occurred
following general anesthesia with propofol.

Be alert to the potential for drug induced excitation (e.g.,
twitching, tremor, hyperclonus) and take appropriate safety
measures.

Provide comfort measures; pain at the injection site is quite
common especially when small veins are used.

Classification: Hemostatic Agent

Indication: This medication is a haemostatic agent,
prescribed for blood clotting and bone formation. It
is also used as an antidote.

Route: Parenteral

Common Side Effect: Anaphylaxis, difficulty in
breathing, cyanosis, pain, swelling, vein
inflammation at the injection site.
Interventions: Assess nutritional satus, assess for
bleeding or bruising: hematuria, black tarry stools,
hematemesis.

Teaching Points:
Teach patient not to take other supplements unless
directed by prescribe.

Teach patient necessary foods in Vit K to be
included in diet.

Advise patient to avoid IM inj., hard toothbrush,
flossing until treatment is terminated.


Classification: Anesthetics Local & General

Indication: For the production of local or regional
anesthesia or analgesia for surgery, for oral surgery
procedures, for diagnostic and therapeutic
procedures, and for obstetrical procedures.

Common Side Effect: Hypotension, bradycardia,
post lumbar puncture headache, vomiting, urinary
retention and incontinence.
Intervention: Monitor BP, pulse and respiration
continuously during IV administration. Oxygen and
resuscitative equipment should be immediately
available.

Teaching Point: When appropriate, patients should
be informed in advance that they may experience
temporary loss of sensation and motor activity,
usually in the lower half of the body following
proper administration of caudal or lumbar epidural
anesthesia.


Classification: Cardiac Drug

Indication: Cardiac stimulant in case of collapse,
shock, and anesthesia accidents.

Common Side Effects: Drowsiness, tremor, insomnia,
hallucinations, psychological disturbances,
convulsions, CNS depression, weakness, blurred
vision.
Intervention:

Monitor BP, pulse, respirations, and urinary output
and observe patient closely following IV
administration. Epinephrine may widen pulse
pressure. If disturbances in cardiac rhythm occur,
withhold epinephrine and notify physician
immediately.

Check BP repeatedly when epinephrine is
administered IV during first 5 min, then q35min
until stabilized.

Classification: General Anesthesia

Indication: Diagnostic and surgical procedures that
do not require skeletal muscle relaxation; induction
of anesthesia; supplementation of low-potency
agents, such as nitrous oxide.

Adverse Reaction: Confusion, delirium, excitement,
hallucinations, irrational behavior, pleasant dream-
like state, apnea after rapid injection,
laryngospasm, other airway obstruction,
respiratory stimulation, severe respiratory
depression.
Intervention: Monitor BP, pulse and respiration
continuously during IV administration. Oxygen and
resuscitative equipment should be immediately
available.

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).