,7GENERIC NAME:KetorolacBRAND NAME:ToradolCLASSIFICATION:Nonsteroidal anti-inflammatory agents, nonopioid analagesicsDOSAGE:30mg/amp1 amp IMMECHANISM OF ACTION:- Inhibits prostaglandin synthesis, producing peripherally mediated analgesia- Also has antipyretic and anti-inflammatory properties.- Therapeutic effect:Decreased painINDICATION:Short term management of pain (not to exceed 5 days total for all routes combined)CONTRAINDICATIONS:- Hypersensitivity- Cross-sensitivity with other NSAIDs may exist¨Pre- or perioperative use- Known alcohol intoleranceUse cautiously in:1) History of GI bleeding2) Renal impair-ment (dosage reduction may be required)3) Cardiovascular diseaseSIDE EFFECTS/ ADVERSE EFFECTS:- CNS:1) drowsiness2) abnormal thinking3) dizziness4) euphoria5) headache-- RESP:1) asthma2) dyspnea- CV:1) edema2) pallor3) vasodilation- GI:1) GI Bleeding

2) abnormal taste3) diarrhea4) dry mouth5) dyspepsia6) GI pain7) nausea- GU:1) oliguria2) renal toxicity3) urinary frequency- DERM:1) pruritis2) purpura3) sweating4) urticaria- HEMAT:1) prolonged bleeding time- LOCAL:1) injection site pain- NEURO:1) paresthesia- MISC:1) allergic reaction, anaphylaxisNURSING IMPLICATIONS/RESPONSIBILITIES:- Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reactions. Assess for rhinitis, asthma, and urticaria.- Assess pain (note type, location, and intensity) prior to and 1-2 hr following administration.- Ketorolac therapy should always be given initially by the IM or IV route. Oral therapy should be used only as a continuation of parenteral therapy.- Caution patient to avoid concurrent use of alcohol, aspirin, NSAIDs, acetaminophen, or other OTC medications without consulting health care professional.- Advise patient to consult if rash, itching, visual disturbances, tinnitus, weight gain, edema, black stools, persistent headche, or influenza-like syndromes (chills,fever,muscles aches, pain) occur.- Effectiveness of therapy can be demonstrated by decrease in severity of pain. Patients who do not respond to one NSAIDs may respond to another.

Serc (Betahistine Dihydrochloride) Drug StudyBrand Name: Serc

Generic Name: Betahistine Dihydrochloride

Classification: Antiemetic and Antivertigo

Availability: Tablet: 8mg, 16mg, 24mg

Action: It has a histamine-like action. It is readily absorbed from the gastrointestinal

tract. It is converted to two metabolites and peak concentrations in blood of the two

metabolites are achieved within 3 to 5 hours. Most of a dose is excreted in the urine, in

the form of the metabolites, in about 3 days.

The mechanism of action of betahistine is not known. Pharmacological testing in

animals has shown that the blood circulation in the striae vascularis of the inner ear

improves, probably by means of a relaxation of the precapillary sphincters of the

microcirculation of the inner ear.

In pharmacological studies, betahistine was found to have weak H1 receptor agonistic

and considerable H3 antagonistic properties in the central nervous system and

autonomic nervous system. Betahistine was also found to have a dose dependent

inhibiting effect on spike generation of neurons in lateral and medial vestibular nuclei.

The importance of this observation in the action against Meniere’s syndrome or

vestibular vertigo, however, remains unclear.

Indication:

1. Meniere’s Disease

2. Vertigo

3. Tinnitus

4. Sensorineural deafness.

Contraindications: Previous hypersensitive reaction to the drug components.

Cautious Use: Pheochromocytoma, bronchial asthma, peptic ulcer, pregnancy and

lactation.

Route & Dosage Adult: 8mg 1-2 tab; 16 mg ½-1 tab. To be taken TID. 24 mg 1 tab. To

be taken BID.

Adverse effects:

1. Urticaria

2. Pruritus

3. Mild gastric complaints

4. False heartbeat

5. Insomnia

Patient & Family Education

1. This drug should be taken with food.

2. Advise relatives to support patient’s ambulation.

3. Protect medication from moisture.

4. Do not give this medication to children.

5. Swallow tablet whole with one full glass of water.

6. Never take a double dose if you missed one medication. If you missed one,

take medication immediately.