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,7GENERIC NAME:

Ketorolac
BRAND NAME:
Toradol
CLASSIFICATION:
Nonsteroidal anti-inflammatory agents, nonopioid analagesics
DOSAGE:
30mg/amp1 amp IM
MECHANISM OF ACTION:
- Inhibits prostaglandin synthesis, producing peripherally mediated analgesia
- Also has antipyretic and anti-inflammatory properties.
- Therapeutic effect:Decreased pain
INDICATION:
Short term management of pain (not to exceed 5 days total for all routes
combined)
CONTRAINDICATIONS:
- Hypersensitivity
- Cross-sensitivity with other NSAIDs may existPre- or perioperative use
- Known alcohol intolerance
Use cautiously in:
1) History of GI bleeding
2) Renal impair-ment (dosage reduction may be required)
3) Cardiovascular disease
SIDE EFFECTS/ ADVERSE EFFECTS:
- CNS:
1) drowsiness
2) abnormal thinking
3) dizziness
4) euphoria
5) headache- RESP:

1) asthma
2) dyspnea
- CV:
1) edema
2) pallor
3) vasodilation
- GI:
1) GI Bleeding
2) abnormal taste
3) diarrhea
4) dry mouth
5) dyspepsia
6) GI pain
7) nausea
- GU:
1) oliguria
2) renal toxicity
3) urinary frequency
- DERM:
1) pruritis
2) purpura
3) sweating
4) urticaria
- HEMAT:
1) prolonged bleeding time
- LOCAL:
1) injection site pain
- NEURO:
1) paresthesia
- MISC:
1) allergic reaction, anaphylaxis
NURSING 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 Study
Brand 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 H 1 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 Menieres syndrome or


vestibular vertigo, however, remains unclear.
Indication:
1. Menieres 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 -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 patients 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.

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