TRAMADOL HYDROCHLORIDE

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(tra’ma-dol)
Ultram, Zydol 
Classifications: central nervous system (cns) agent; analgesic; narcotic (opiate) agonist
Prototype: Morphine sulfate
Pregnancy Category: C

NURSING IMPLICATIONS

Assessment & Drug Effects

• Assess for level of pain relief and administer prn dose as needed but not to exceed the recommended total daily dose.
• Monitor vital signs and assess for orthostatic hypotension or signs of CNS depression.
• Discontinue drug and notify physician if S&S of hypersensitivity occur.
• Assess bowel and bladder function; report urinary frequency or retention.
• Use seizure precautions for patients who have a history of seizures or who are concurrently using drugs that lower the seizure threshold.
• Monitor ambulation and take appropriate safety precautions.

Patient & Family Education

• Exercise caution with potentially hazardous activities until response to drug is known.
• Understand potential adverse effects and report problems with bowel and bladder function, CNS impairment, and any other bothersome adverse effects to physician.
• Do not breast feed while taking this drug.

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• ESOMEPRAZOLE MAGNESIUM (e-so-me’pra-zole) Nexium Classifications: gastrointestinal agent; proton pump inhibitor Prototype: Omeprazole Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Monitor for S&S of adverse CNS effects (vertigo, agitation, depression) especially in severely ill patients. Monitor phenytoin levels with concurrent use. Monitor INR/PT with concurrent
• MOXIFLOXACIN HYDROCHLORIDE (mox-i-flox’a-sin) Avelox, Vigamox Classifications: antiinfective; antibiotic; quinolone Prototype: Ciprofloxacin Pregnancy Category: C NURSING IMPLICATIONS Assessment & Drug Effects Monitor therapeutic effectiveness indicated by clinical improvement of infection. Monitor for and notify physician immediately of adverse CNS effects. Notify physician immediately for S&S of hypersensitivity (see Appendix F). Lab tests: C&S
• CIPROFLOXACIN HYDROCHLORIDE (ci-pro-flox’a-cin) Cipro, Cipro IV, Cipro XR CIPROFLOXACIN OPHTHALMIC Ciloxan Classifications: antiinfective; quinolone antibiotic Pregnancy Category: C NURSING IMPLICATIONS Assessment & Drug Effects Report tendon inflammation or pain. Cipro needs to be discontinued. Lab tests: Culture and sensitivity tests should be done prior to initial dose. Treatment may be implemented
• PROPOFOL (pro’po-fol) Diprivan Classifications: central nervous system agent, general anesthesia; sedative-hypnotic Prototype: Thiopental Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Monitor hemodynamic status and assess for dose-related hypotension. Take seizure precautions. Tonic-clonic seizures have occurred following general anesthesia with propafol. Be alert to the potential for
• CLOXACILLIN, SODIUM (klox-a-sill’in) Apo-Cloxi , Cloxapen, Cloxilean, Novocloxin , Orbenin, Tegopen Classifications: antiinfective; antibiotic, natural penicillin; beta-lactam Prototype: Penicillin G Pregnancy Category: B NURSING IMPLICATIONS Assessment & Drug Effects Determine previous exposure and sensitivity to penicillins and cephalosporins and other allergic reactions of any kind before treatment is initiated. Monitor for S&S of