Impaired Ventilation

Premixed containers: 750 mg/50ml, 1. g/50ml

Source: Davis Drug Guide for Nurses 10th Edition

Therapeutic: Anti-infectives

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Pharmacologic: Second-generation Cephalosporins Pregnancy Category B Bind to bacterial cell wall membrane, causing cell death

Therapeutic Effects: Bactericidal action

Treatment: It is effective for the treatment of penicillinase-producing Neisseria gonorrhea (PPNG).

Effectively treats bone and joint infections, bronchitis, meningitis, gonorrhea, otitis media, pharyngitis/tonsillitis, sinusitis, lower respiratory tract infections, skin and soft tissue infections, urinary tract infections, and is used for surgical prophylaxis, reducing or eliminating the infection. Hypersensitivity to cephalosporins and related antibiotics; pregnancy (category B), lactation.

GI: Diarrhea, nausea, antibiotic-associated colitis.

Skin: Rash, pruritus, urticaria.

Urogenital: Increased serum creatinine and BUN, decreased creatinine clearance.

Hemat: Hemolytic anemia

MISC: Anaphylaxis

Before: Determine history of hypersensitivity reactions to cephalosporins, penicillins, and history of allergies, particularly to drugs, before therapy is initiated. Lab tests: Perform culture and sensitivity tests before initiation of therapy and periodically during therapy if indicated. Therapy may be instituted pending test results. Monitor periodically BUN and creatinine clearance.

During: Inspect IM and IV injection sites frequently for signs of phlebitis. Monitor for manifestations of hypersensitivity Tramadol 50mg

Therapeutic: Analgesics (centrally acting)

Actions:

• Physiologic Mechanism
• Decreased pain
• Pharmacologic Mechanism
• Binds to mu-opioid receptors
• Inhibits reuptake of serotonin and norepinephrine in the CNS.

Indication:

• Moderate to moderately severe pain
• Nursing Care
• Assess type, location, and intensity of pain before and 2-3 hr (peak) after administration.
• Assess BP & RR before and periodically during administration. Respiratory depression has not occurred with recommended doses.
• Assess bowel function routinely.

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 the patient from receiving adequate 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 patients for seizures. May occur within the recommended dose range. Risk increased with higher doses and in patients taking antidepressants (SSRIs, tricyclics, or Mao inhibitors), opioid analgesics, or other drugs that decrease 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 the patient to cough and breathe deeply every 2 hr to prevent atelectasis and pneumonia.

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