Mosby's 2014 Nursing Drug Reference (140 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
(ophthalmic)
(dor-zole′ah-mide)
Trusopt
Func. class.:
Antiglaucoma
Chem. class.:
Carbonic anhydrase inhibitor
Decreases aqueous humor secretion by decreasing bicarbonate, thus decreasing IOP
For the treatment of elevated intraocular pressure in patients with ocular hypertension or open-angle glaucoma
Hypersensitivity
Precautions:
Hypersensitivity to sulfonamides, hepatic/renal disease, angle-closure glaucoma, electrolyte disturbances
Calculator
• Adult/adolescent/child/infant/neonate ≥1 wk: Ophthalmic
Instill 1 drop of a 2% solution into the affected eye(s) tid
Available forms:
Ophthalmic solution 2%
•
Wash hands before and after use, tilt the head back slightly and pull the lower eyelid down with the index finger to form a pouch, squeeze the prescribed number of drops into the pouch and gently close eyes for 1–2 min. Do not blink
•
Care should be taken to avoid contamination, do not touch the tip of the dropper to the eye, fingertips, or other surface
•
The sol may be used concomitantly with other topical ophthalmic drug products to lower IOP. If more than one topical ophthalmic drug is being used, administer ≥10 min apart
CNS:
Headache
EENT:
Blurred vision, tearing, allergy, burning/stinging, photophobia
GI:
Bitter taste
Onset 1-2 hr, peak 3 hr, duration 8 hr, half-life 4 mo
Increase:
effects—carbonic anhydrase inhibitors (PO), salicylates
•
Hypersensitivity
•
Monitor IOP during treatment
•
Decreasing IOP
•
How to use product
•
Not to share with others or use for other conditions
•
To notify prescriber immediately if vision changes or if condition worsens
•
To take as prescribed
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(dox′a-pram)
Dopram
Func. class.:
Analeptic
Respiratory stimulation through activation of peripheral carotid
chemoreceptor; with higher doses, medullary respiratory centers are stimulated; with progressive CNS stimulation
Chronic obstructive pulmonary disease (COPD), postanesthesia respiratory depression, prevention of acute hypercapnia, product-induced CNS depression
Unlabeled uses:
Neonatal apnea
Hypersensitivity, seizure disorders, severe hypertension, severe bronchial asthma, severe dyspnea, severe cardiac disorders, flail chest, pneumothorax, PE, severe respiratory disease
Precautions:
Pregnancy (B), breast-feeding, children, bronchial asthma, pheochromocytoma, severe tachycardia, dysrhythmias, hypertension, hyperthyroidism
Calculator
•
Adult: IV
inj 0.5-1 mg/kg, not to exceed 1.5 mg/kg total as a single inj;
IV INF
250 mg in 250 ml sol, not to exceed 4 mg/kg; run at 1-3 mg/min
•
Adult: IV
Priming dose of 2 mg/kg, repeated in 5 min; repeat q1-2hr until patient awakes;
IV INF
priming dose 2 mg/kg at 1-3 mg/min, not to exceed 3 g/day
•
Adult: IV INF
1-2 mg/min, not to exceed 3 mg/min for no longer than 2 hr
Available forms:
Inj 20 mg/ml
CNS:
Seizures (clonus/generalized),
headache
, restlessness, dizziness, confusion, paresthesias, flushing, sweating, bilateral Babinski’s sign, rigidity, depression
CV:
Chest pain, hypertension, change in heart rate
, lowered T waves, tachycardia,
dysrhythmias
EENT:
Pupil dilation, sneezing
GI:
Nausea, vomiting, diarrhea, desire to defecate
GU:
Retention, incontinence, elevation of BUN, albuminuria
INTEG:
Pruritus, irritation at inj site
RESP:
Laryngospasm, bronchospasm,
rebound hypoventilation, dyspnea, cough, tachypnea, hiccups
IV:
Onset 20-40 sec, peak 1-2 min, duration 5-10 min, metabolized by liver, excreted by kidneys (metabolites), half-life 2.5-4 hr
•
Synergistic pressor effect: MAOIs, sympathomimetics
•
Cardiac dysrhythmias: halothane, cyclopropane, enflurane; delay use of doxapram for at least 10 min after inhalation anesthetics
•
BP, heart rate, deep tendon reflexes, ABGs, LOC before administration, q30min
•
P
O
2
, P
CO
2
, O
2
saturation during treatment
•
Hypertension, dysrhythmias, tachycardia, dyspnea, skeletal muscle hyperactivity; may indicate overdosage; discontinue product
•
Respiratory stimulation: increased rate, abnormal rhythm
•
Extravasation; change IV site q48hr
•
Patient closely for ½-1 hr
•
Undiluted or diluted with equal parts of sterile water for inj; may be diluted 250 mg/250 ml of D
5
W, D
10
W and run as inf; rapid inf may cause hemolysis
•
IV undiluted over 5 min; IV inf at 1-3 mg/min; adjust for desired respiratory response, using inf pump IV; if an inf is
used after initial dose, start at 1-3 mg/min depending on patient response; D/C after 2 hr; wait 1-2 hr and repeat
•
Only after adequate airway is established
•
After O
2
, IV barbiturates, resuscitative equipment available
Syringe compatibilities:
Amikacin, bumetadine, chlorproMAZINE, cimetidine, CISplatin, cyclophosphamide, DOPamine, doxycycline, EPINEPHrine, hydrOXYzine, imipramine, isoniazid, lincomycin, methotrexate, netilmicin, phytonadione, pyridoxine, terbutaline, thiamine, tobramycin, vinCRIStine
•
Placing patient in Sims’ position to prevent aspiration of vomitus
•
Discontinue infusion if side effects occur; narrow margin of safety
•
Therapeutic response: increased breathing capacity
•
Purpose of medication
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert