Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Mosby's 2014 Nursing Drug Reference (170 page)
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
OTC
, Rx)
(fa-moe′ti-deen)
Pepcid, Pepcid AC
Func. class.:
H
2
-histamine receptor antagonist
Competitively inhibits histamine at histamine H
2
-receptor site, thus decreasing gastric secretion while pepsin remains at a stable level
Short-term treatment of active duodenal ulcer, maintenance therapy for duodenal ulcer, Zollinger-Ellison syndrome, multiple endocrine adenomas, gastric ulcers; gastroesophageal reflux disease, heartburn
Unlabeled uses:
GI disorders in those taking NSAIDs; urticaria; prevention of stress ulcers, aspiration pneumonitis, inactivation of oral pancreatic enzymes in pancreatic disorders
Hypersensitivity
Precautions:
Pregnancy (B), breastfeeding, children <12 yr, geriatric patients, severe renal/hepatic disease
Calculator
• Adult:
PO
40 mg/day at bedtime × 4-8 wk then 20 mg/day at bedtime if needed (maintenance);
IV
20 mg q12hr if unable to take
PO
• Child 1-16 yr:
PO
0.5 mg/kg/day at bedtime or divided bid, max 40 mg/day
• Adult:
PO
20 mg q6hr; may give 160 mg q6hr if needed;
IV
20 mg q6hr if unable to take
PO
• Adult:
PO
10 mg with water or 15 min-1 hr before eating
• Adult:
PO
CCr <50 ml/min, decrease dose by 50% or extend interval to 36-48 hr
Available forms:
Tabs 10, 20, 40 mg; gel cap 10 mg; powder for oral susp 40 mg/5 ml; inj 10 mg/ml, 20 mg/50 ml; chew tabs 10 mg
•
Antacids 1 hr before or 2 hr after famotidine; may be given with foods or liquids
•
After shaking oral suspension
•
After diluting 2 ml of product (10 mg/ml) in 0.9% NaCl to total volume of 5-10
ml; inject over 2 min to prevent hypotension
•
After diluting 20 mg (2 ml) of product in 100 ml of LR, 0.9% NaCl, D
5
W, D
10
W; run over 15-30 min
•
Adults:
Dilute 40 mg of product in 250 ml D
5
W, NS; infuse over 24 hr, run at 11 ml/hr, use inf device
Y-site compatibilities:
Acyclovir, alfentanil, allopurinol, amifostine, amikacin, aminocaproic acid, aminophylline, amiodarone, amphotericin B lipid complex, amphotericin B liposome, amsacrine, anakinra, anidulafungin, ascorbic acid injection, atenolol, atracurium, atropine, aztreonam, benztropine, bivalirudin, bleomycin, bumetanide, buprenorphine, butorphanol, calcium chloride/gluconate, CARBOplatin, caspofungin, cefonicid, cefotaxime, cefTAZidime, cefuroxime, chlorproMAZINE, cimetidine, cisatracurium, CISplatin, cladribine, clindamycin, codeine, cyanocobalamin, cyclophosphamide, cycloSPORINE, cytarabine, DACTINomycin, DAPTOmycin, dexamethasone, dexmedetomidine, digoxin, diltiazem, diphenhydrAMINE, DOBUTamine, DOCEtaxel, DOPamine, doripenem, doxacurium, DOXOrubicin, DOXOrubicin liposomal, doxycycline, droperidol, enalaprilat, ePHEDrine, EPINEPHrine, epirubicin, epoetin alfa, eptifibatide, ertapenem, erythromycin, esmolol, etoposide, fenoldopam, fentaNYL, filgrastim, fluconazole, fludarabine, fluorouracil, folic acid, gatifloxacin, gemcitabine, gentamicin, glycopyrrolate, granisetron, heparin, hydrocortisone, HYDROmorphone, hydrOXYzine, IDArubicin, ifosfamide, imipenem-cilastatin, irinotecan, isoproterenol, ketorolac, labetalol, levofloxacin, lidocaine, linezolid, LORazepam, LR, magnesium sulfate, mannitol, mechlorethamine, melphalan, meperidine, metaraminol, methicillin, methotrexate, methoxamine, methyldopate, methylPREDNISolone, metoclopramide, metoprolol, metroNIDAZOLE, miconazole, midazolam, milrinone, mitoXANtrone, morphine, moxalactam, multiple vitamins injection, mycophenolate, nafcillin, nalbuphine, naloxone, nesiritide, netilmicin, niCARdipine, nitroglycerin, nitroprusside, norepinephrine, 0.9% NaCl, octreotide, ondansetron, oxacillin, oxaliplatin, oxytocin, PACLitaxel, palonosetron, pamidronate, pancuronium, papaverine, PEMEtrexed, penicillin G potassium/sodium, pentamidine, pentazocine, PENTobarbital, perphenazine, PHENobarbital, phenylephrine, phytonadione, polymyxin B, potassium chloride/phosphates, procainamide, prochlorperazine, promethazine, propofol, propranolol, protamine, pyridoxine, quiNIDine, ranitidine, remifentanil, Ringer’s, ritodrine, riTUXimab, sargramostim, sodium acetate/bicarbonate, succinylcholine, SUFentanil, tacrolimus, teniposide, theophylline, thiamine, thiotepa, ticarcillin, ticarcillin-clavulanate, tigecycline, tirofiban, TNA, tobramycin, tolazoline, TPN, trastuzumab, trimetaphan, urokinase, vancomycin, vasopressin, vecuronium, verapamil, vinCRIStine, vinorelbine, voriconazole, zoledronic acid
CNS:
Headache, dizziness
, paresthesia, depression, anxiety, somnolence, insomnia, fever,
seizures in renal disease
CV:
Dysrhythmias, QT prolongation (impaired renal functioning)
EENT:
Taste change, tinnitus, orbital edema
GI:
Constipation
, nausea, vomiting, anorexia, cramps, abnormal hepatic enzymes, diarrhea
INTEG:
Rash,
toxic epidermal necrolysis, Stevens-Johnson syndrome
MS:
Myalgia, arthralgia
RESP:
Pneumonia
Plasma protein binding 15%-20%, metabolized in liver 30% (active metabo
lites), 70% excreted by kidneys, half-life 2½-3½ hr
PO:
Onset 30-60 min, duration 6-12 hr, peak 1-3 hr, absorption 50%
IV:
Onset immediate, peak 30-60 min, duration 8-15 hr
Decrease:
absorption—ketoconazole, itraconazole, cefpodoxime, cefditoren
Decrease:
famotidine absorption—antacids
Decrease:
effect of—atazanavir, delavirdine
•
Ulcers:
epigastric pain, adominal pain, frank or occult blood in emesis, stools
•
Intragastric pH, serum creatinine/BUN baseline and periodically
•
For bleeding, hematuria, hematuresis, occult blood in stools; abdominal pain
•
Storage in cool environment (oral); IV sol stable for 48 hr at room temp; do not use discolored sol; discard unused oral sol after 1 mo
•
Increase in bulk and fluids in diet to prevent constipation
•
Therapeutic response: decreased abdominal pain
•
That product must be continued for prescribed time in prescribed method to be effective; not to double dose
•
About possibility of decreased libido; that this is reversible after discontinuing therapy
•
To avoid irritating foods, alcohol, aspirin, extreme-temp foods that may irritate GI system
•
That smoking should be avoided because it diminishes effectiveness of product
•
To avoid tasks requiring alertness because dizziness, drowsiness may occur
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
Intralipid 10%, Intralipid 20%, Liposyn II 10%, Liposyn II 20%, Liposyn III 10%, Liposyn III 20%
Func. class.:
Caloric
Chem. class.:
Fatty acid, long chain; nutritional supplement
Needed for energy, heat production; consist of neutral triglycerides, primarily unsaturated fatty acids
Increase calorie intake, fatty acid deficiency, prevention
Hypersensitivity to this product or eggs, soybeans, legumes; hyperlipemia, lipid necrosis, acute pancreatitis accompanied by hyperlipemia, hyperbilirubinemia of the newborn; renal insufficiency, hepatic damage
Precautions:
Pregnancy (C), premature/term newborns, severe hepatic disease, diabetes mellitus, thrombocytopenia, gastric ulcers, sepsis
Black Box Warning:
Preterm infants
Calculator
• Adult and child:
IV
8%-10% of required calorie intake (intralipid)
• Adult:
IV
1 ml/min over 15-30 min (10%) or 0.5 ml/min over 15-30 min (20%); may increase to 500 ml over 4-8 hr if no adverse reactions occur; max 2.5 g/kg
• Child:
IV
0.1 ml/min over 10-15 min (10%) or 0.05 ml/min over 10-15 min (20%); may increase to 1 g/kg over 4 hr if no adverse reactions occur; max 4 g/kg
• Adult:
IV
500 ml 2×/wk (10%), given 1 ml/min for 30 min, max 500 ml over 6 hr
• Child:
IV
5-10 ml/kg/day (10%), given 0.1 ml/min for 30 min, max 100 ml/hr
Available forms:
Inj 10% (50, 100, 200, 250, 500 ml), 20% (50, 100, 200, 250, 500 ml)
•
At 10% (1 ml/min) or 20% (0.5 ml/min) initially × 15-30 min, may increase 10% (120 ml/hr) or 20% (62.5 ml/hr) if no adverse reaction; do not give more than 500 ml on 1st day
•
After changing IV tubing at each inf; infection may occur with old tubing
•
With inf pump at prescribed rate; do not use in-line filter sized for lipid emulsion; clogging will occur
CNS:
Dizziness, headache, drowsiness,
focal seizures
CV:
Shock
GI:
Nausea, vomiting,
hepatomegaly
HEMA:
Hyperlipemia, hypercoagulation, thrombocytopenia, leukopenia, leukocytosis
RESP:
Dyspnea,
fat in lung tissue
Completely absorbed, distributed to intravascular space, converted to triglycerides then to free fatty acids
•
Triglycerides, free fatty acid levels, platelet counts daily to prevent fat overload, thrombocytopenia
•
Hepatic studies: AST, ALT, Hct, Hgb; notify prescriber if abnormal
•
Nutritional status: calorie count by dietitian; monitor weight daily
•
Do not use mixed sol if separated or oily looking
•
Therapeutic response: increased weight
•
About the reason for use of lipids