Mosby's 2014 Nursing Drug Reference (109 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
OTC
, Rx)
(kroe′moe-lin)
Gastrocrom, Nasalcrom
Func. class.:
Antiasthmatic
Chem. class.:
Mast cell stabilizer
Do not confuse:
Nasalcrom
/Nasalide
Stabilizes the membrane of the sensitized mast cell, thus preventing the release of chemical mediators after an antigen-IgE interaction
Severe perennial bronchial asthma; prevention of exercise-induced bronchospasm; acute bronchospasm induced by environmental pollutants, mastocytosis, allergic rhinitis
Unlabeled uses:
Food allergy, ulcerative colitis
Hypersensitivity to this product or lactose; status asthmaticus, acute asthma
Precautions:
Pregnancy (B), breastfeeding, children <5 yr (aerosol); <2 yr (nebulizer); <2 yr (nasal sol); oral <2 yr; renal/hepatic disease, safety not established; cardiac dysrhythmias, CAD
Calculator
• Adult and child >2 yr:
NASAL SOL
1 spray in each nostril tid-qid, max 6 doses/day
• Adult and child >5 yr:
INH
2 metered sprays inhaled ≤1 hr prior to exercise
• Adult and child >5 yr:
INH
2 metered sprays using inhaler qid;
NEB
20 mg qid by nebulization
• Adult and child >12 yr:
PO
200 mg qid 1/2 hr before meals and at bedtime
• Child 2-12 yr:
PO
100 mg qid 1/2 before meals and at bedtime
• Adult:
PO
(Gastrocrom) 200 mg qid 20 min before meals and at bedtime, may double dose after 2 wk
• Child 2-14 yr:
PO
(Gastrocrom) 100 mg qid 20 min before meals and at bedtime, may double dose after 2-3 wk
Available forms:
Nasal sol 5.2 mg/metered spray (40 mg/ml); neb sol 20 mg/2 ml; aerosol 800 mcg/actuation; oral conc 100 mg/5 ml
•
For oral conc: break open ampule, squeeze contents into glass of water, stir, drink
CNS:
Headache, dizziness
, neuritis, confusion, drowsiness
EENT:
Throat irritation, cough, nasal congestion, burning eyes, nasal stinging/irritation, sneezing
GI:
Nausea, vomiting, anorexia, dry mouth, bitter taste
GU:
Urinary frequency, dysuria
INTEG:
Rash, urticaria, angioedema
MS:
Joint pain/swelling
CNS:
Dizziness, headache, paresthesia, migraine,
seizures,
psychosis, anxiety, depression, hallucinations, insomnia
CV:
Tachycardia, PVCs, palpitations
GI:
Diarrhea, nausea, abdominal pain, constipation, dyspepsia, stomatitis, vomiting
HEMA:
Polycythemia, neutropenia, pancytopenia
INTEG:
Pruritus, rash, flushing, photosensitivity
Excreted unchanged in feces, half-life 80 min, 63%-76% protein binding
•
Eosinophil count during treatment
•
Respiratory status: rate, rhythm, characteristics, cough, wheezing, dyspnea
•
Gargle, sip of water to decrease irritation in throat (INH/Neb)
•
Therapeutic response: decrease in asthmatic symptoms; congested, runny nose
Nasal sol:
Blow nose, hold pump between fingers; if 1st use, spray in air until fine mist occurs, insert nozzle in nostril, spray and breathe in through nose, repeat in other nostril
Aerosol (not for acute asthma):
Take cover off mouthpiece, shake gently, breathe out slowly, place mouthpiece in mouth, close mouth around it, tilt head back, breathe in as the inhaler is depressed, remove, hold breath, then breathe out slowly
Inhalation:
Do not swallow sol, empty ampule into power-driven nebulizer as directed; do not combine different meds
Oral:
Take 1/2 hr before meals and at bedtime
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(kroe-tam′-ih-tuhn)
Eurax
Func. class.:
Scabicide/pediculicide
Scabicidal and antipruritic properties; the mechanisms of these actions are not known, but the drug is toxic to the scabies mite; antipruritic effect may be due to counterirritation mechanisms
Infestations of scabies, lice
Hypersensitivity; raw, inflamed skin
Precautions:
Pregnancy (C), children
Calculator
• Adult:
TOP
After routine bath, apply over the entire body from the chin to the soles; do not apply to the face or head; repeat in 24 hr. Patient may take a cleansing bath 48 hr after the second dose
• Adult:
TOP
Apply topically by massaging gently into affected area until medication is completely absorbed; repeat if needed
Available forms:
Lotion, cream 10%
•
The cream and lotion are for topical use only to the skin; shake lotion well before use; do not apply in the eyes or mouth; do not apply to raw, weeping, or inflamed skin until acute inflammation has subsided
Scabies:
After taking a bath or shower, apply by massaging into the skin from the chin to the toes, including folds and creases; ensure use under fingernails (they should be trimmed short), because scabies are likely to remain under nails; a toothbrush may be used to apply under fingernails; if a toothbrush is used to apply, wrap it in paper and discard immediately after use; accidental use of the same toothbrush in the mouth could cause poisoning; a second application 24 hr later is recommended; a 60-g tube of cream or bottle of lotion is sufficient for 2 applications for most patients; clothing and bed linen should be changed the next morning. Contaminated clothing and bed linen may be washed in the hot cycle of the washing machine or dry cleaned; a cleansing bath should be taken 48 hours after the last application
Pruritus:
Massage cream or lotion into affected areas until the medication is absorbed; repeat as needed
INTEG:
Irritation, rash
Scabies/Lice:
Area of infestation, irritation, scales; itching, raw, peeling, in
flamed skin; contamination of other family members
•
Decreasing infestation, itching
•
To stop using if irritation, rash occurs, wash off completely; not to use on raw, inflamed skin
•
How to use (see dosage and routes)
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert