Post-operatively

Morphine

• 0.5-4 mg IV q4h prn in PACU
• 2-10 mg IM/SC q4h prn

• renally excreted, ½ life of 3-4 hrs. with normal renal function, ½ life of up to 89-136 hrs. in severe renal impairment
  
  

Dilaudid


(hydromorphone)

• 0.5-2 mg IV/M/SC q4h prn
• 2-4 mg po q4h prn

• used when pt.’s have nausea & vomiting rxn. to morphine/Percocet
• 5X as potent as morphine
  
  

Percocet

• I-II po q4h prn

• acetaminophen 325mg + oxycodone 5mg
  
  

Tramacet

• I-II po q4h prn

• tramadol 37.5mg + acetaminophen 325mg
• used when pt. allergy to codeine & Percocet
  
  

Tylenol #3

• I-II po q4h prn

• acetaminophen 325mg + codeine 30mg
• codeine metabolized ? morphine by CPY2D6 (10-15% of pop. lack enzyme)
  
  

Toradol


(ketorolac)

• 15-30 mg IV/IM q6h prn
• 10 mg po q6h prn

• NSAID available in IV acting as analgesic, antipyretic, and anti-inflammatory
  
  

Gravol


(dimenhydrinate)

• 25-50 mg po/IM/IV q4h prn

• antihistamine with anticholinergic properties
  
  

Maxeran


(metoclopramide)

• 10 mg po/IM/IV q6h prn

• dopamine receptor antagonist with antiemetic & prokinetic properties
  
  

Stemetil


(prochlorperazine)

• 10 mg IV q6h prn

• belongs to the phenothiazine class of antipsychotic agents
  
  

Ancef


(Cefazolin)

• 0.5-1.5 g IM/IV q8h

• 1st generation cephalosporin
• excellent gram coverage (Staph)
  
  

Vancomycin

• 500 mg IV q12h

• used when pt. has a serious penicillin or cephalosporin hypersensitivity
• order levels if pt. on > 3 days
  
  

Clindamycin

• 600 mg IV q8h

• used when pt. has a serious penicillin or cephalosporin hypersensitivity
  
  

Gentamicin

• 2 mg/kg IV q12h

• excellent gram coverage
  
  

Keflex

• 500 mg po qid

• oral form of Ancef
  
  

Fragmin

• 5000 IU SC od

• LMWH ? DVT prophylaxis
  
  

Fondaparinux

• 2.5 mg SC od

• LMWH ? DVT prophylaxis, given 6-8hrs. post-op
  
  

Heparin

• 5000 IU SC q12h

• monitor platelets, PTT should be 1.5-2x
  
  

Pantoloc

• 40 mg po od

• PPI used for tx. of GERD
  
  

Zantac


(ranitidine)

• 150 mg po bid
• 50 mg IV/IM q8h

• H2-receptor antagonist used for tx. of peptic ulcer disease & GERD
  
  

Senokot


(senna)

• I-II po bid prn

• cathartic laxative
  
  

Bisacodyl

• 10 mg PR qam prn

*stimulant laxative

MOM

• 30mL po prn

*saline osmotic (hydrating) laxative

Colace


(docusate)

• 100 mg po bid

• surfactant used as a laxative and stool softener
  
  

Ativan


(lorazepam)

• 1-2 mg po qhs prn

• medium ½ half benzodiazepine (10-15hrs)
  
  

Valium


(diazepam)

• 2-10 mg po bid prn

• long ½ life benzodiazepine (25-100hrs)