AMBULATORY SURGERY CENTER OF SPARTANBURG, LLC SIDE EFFECT MEDICATION INFORMATION – ORIGINAL COPY TO PATIENT
Below you will find information regarding medications you have received during your procedure today. Side effects and special instructions are listed. It is important that you understand the effects of these drugs may last up to 24 hours following their administration. During such time, you should not operate a vehicle or other machinery, sign important papers or decide legal matters. You should not drink any alcoholic beverages.
IF CHECKED IN THE LEFT-HAND COLUMN, YOU RECEIVED THESE MEDICATIONS.
ANCEF - An antibiotic used to treat or prevent infections caused by bacteria. Side effects include: mild diarrhea; skin rash; itching; redness or swelling; sore mouth or tongue; stomach cramps or upset (mild). ZOFRAN/ONDANSETRON - Used for the prevention of nausea and vomiting. Common side effects include: diarrhea; constipation. Less com- mon side effects include: headache; rash. BENADRYL - Used to prevent or relieve allergic symptoms, nausea or vomiting and dizziness. Side effects include: drowsiness; thickening of mucus; sore throat and fever; unusual bleeding or bruising (uncommon with one dose); unusual tiredness or weakness. CLEOCIN - An antibiotic used to treat or prevent infections caused by bacteria. Side effects include: difficulty in breathing (rarely); light- headedness; skin rash; itching. More common are nausea, vomiting; abdominal pain. DECADRON/DEXAMETHASONE - Used to help with swelling and inflammation. Side effects include: acne, bruising, headache, seizures (rarely), diarrhea, nausea. Steroids may or may not effect blood sugar levels. Contact your physician for recommendations regarding monitoring of blood sugars. DEMEROL - Used to relieve or prevent pain or as sedation during a procedure. Side effects include: drowsiness; dizziness; light-headedness; false sense of well-being. Less common side effects include: hallucinations; hives; itching; skin rash; redness or flushing of face; increased sweating; ring- ing or buzzing in ears; unusual excitement or restlessness; unusual fast or pounding heartbeat. DIPRIVAN/PROPOFAL - Used for sedation in the induction and maintenance of anesthesia. Side effects include: nausea or vomiting; headache; dry mouth; dizziness or light-headedness. Less common side effects include: depression; hypersalivation; tingling or numbness at the injection site; muscle weakness; insomnia; hallucination; diarrhea; sweating of skin or difficulty in urination. FENTANYL/SUBLIMAZE - Used for sedation and maintenance of anesthesia. Side effects include: dizziness; nausea or vomiting; blurred vision; sweating of skin. Less common side effects include; difficulty in urination. MORPHINE - Used to prevent or relieve pain or as sedation during a procedure. Side effects include: drowsiness; dizziness; light-headedness; slowed respirations; nausea or vomiting. Less common side effects include: hallucinations; hives; itching; skin rash; increased sweating; redness or flushing of face; ringing or buzzing in ears; facial swelling; unusual excitement or restlessness; unusually fast or pounding heartbeat. PHENERGAN - Used to prevent pain or treat nausea and or vomiting and to produce sedation. Side effects include: drowsiness; dry mouth; sensi- tivity of skin to sun; nightmares; sore throat and fever; unusual excitement; nervousness; restlessness or irritability. REGLAN - Used for prevention or postoperative nausea and vomiting, to decrease gastroesophageal reflux. Side effects include: restlessness; drowsiness; fatigue; insomnia; headache. TORADOL - Used to relieve or prevent pain. Side effects include: drowsiness; dizziness; nausea; dry mouth; diarrhea; headache; sweating; and pain at injection site. Less common side effects include: vomiting; rash; lowered blood pressure; asthma; frequent urination; depression; euphoria; nervousness; abnormal taste or vision; muscle ache; convulsions. VANCOMYCIN - An antibiotic used to treat or prevent infections caused by bacteria. Common side effects include: nausea; rash on face, neck, trunk and extremities. VERSED - Used to produce sleepiness or drowsiness and to relieve anxiety before surgery or certain procedures. Side effects include: drowsiness; dizziness; light-headedness. Less common side effects include: blurred vision or other changes in vision; feeling faint; nausea or vomiting; headache; numbness; tingling; pain or weakness in hands or feet; redness, pain, lump, hardness, or muscle stiffness at place of injection. ZANTAC - Inhibits gastric secretion. Side effects include: dizziness; insomnia. Less common side effects include: blurred vision; irregular heart- beat. NOTE: You may experience the symptoms listed as “Side Effects” following the descriptions of the drug’s usage. However, the “less com- mon or rare side effects” listed are rare, particularly without prolonged or repeated usage. If you experience any of theses “less common or rare side effects”, you should contact your physician immediately.
Your state may require any pharmacy/pharmacist who fills a prescription for you to explain its usage and side effects when you receive your medication. Be certain that he or she provides you with this information.
Received by: ____________________________________________________________________________ ___________________________ Signature of Patient and Responsible Adult Date
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