Mosby's 2014 Nursing Drug Reference (175 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
(fex-oh-fi′na-deen)
Allegra, Allegra ODT, GNP Allergy Relief, Premier Value Allergy Relief
Func. class.:
Antihistamine—2nd generation
Chem. class.:
Piperidine, peripherally selective
Do not confuse:
Allegra
/Viagra
Acts on blood vessels, GI, respiratory system by competing with histamine for H
1
-receptor site; decreases allergic response by blocking pharmacologic effects of histamine, less sedating
Rhinitis, allergy symptoms, chronic idiopathic urticaria
Breastfeeding, newborn or premature infants, hypersensitivity, severe hepatic disease
Precautions:
Pregnancy (C), children, geriatric patients, respiratory disease, closed-angle glaucoma, prostatic hypertrophy, bladder neck obstruction, asthma
Calculator
• Adult and child >12 yr:
PO
Rx only, 60 mg bid or 180 mg/day; PO OTC only, 60 mg bid or 180 mg/day (self-treatment of allergic rhinitis)
• Child 2-11 yr:
PO
30 mg bid;
ORALLY DISINTEGRATING TAB Child 6-11 yr:
30 mg bid dissolved on tongue
• Adult and child ≥12 yr:
PO
CCr <80 ml/min, 60 mg/day
• Child 2-11 yr:
PO
CCr <80 ml/min, 30 mg q day
• Child <2 yr:
PO
CCr <80 ml/min, 15 mg q day
Available forms:
Tabs 30, 60, 180 mg; oral susp 6 mg/ml, orally disintegrating tab 30 mg
•
Without regard to meals; caps/tabs should not be given with or right before grapefruit, orange, or apple juice
•
Orally disintegrating tab:
allow to dissolve, swallow; do not remove from blister pack until time of administration
•
Oral susp:
shake well, use calibrated measuring device
CNS:
Headache, stimulation, drowsiness, sedation, fatigue, confusion, blurred vision, tinnitus, restlessness, tremors, paradoxical excitation in children or geriatric patients
CV:
Hypotension, palpitations, bradycardia, tachycardia,
dysrhythmias
(rare)
GI:
Nausea, diarrhea, abdominal pain, vomiting, constipation
GU:
Frequency, dysuria, urinary retention, impotence
HEMA:
Hemolytic anemia, thrombocytopenia, leukopenia, agranulocytosis, pancytopenia
INTEG:
Rash, eczema, photosensitivity, urticaria
RESP:
Thickening of bronchial secretions, dry nose, throat
Well absorbed; onset 1 hr; peak 2-3 hr; duration 12-24 hr; 80% excreted in urine; half-life 14.5 hr, increased in renal disease
Decrease:
effect—magnesium-aluminum-containing antacids
Decrease:
absorption of product—apple, orange, grapefruit juice
False negative:
skin allergy tests
•
Allergy:
itchy, runny, watery eyes; congested nose; before and during treatment
•
I&O ratio: be alert for urinary retention, frequency, dysuria, especially among geriatric patients; product should be discontinued if these occur; serum creatinine/BUN at baseline and periodically during treatment
•
Respiratory status: rate, rhythm, increase in bronchial secretions, wheezing, chest tightness
•
Storage in tight, light-resistant container
•
Therapeutic response: absence of running or congested nose or rashes
•
About all aspects of product use; to notify prescriber if confusion, sedation, hypotension occur
•
To avoid driving, other hazardous activity if drowsiness occurs
•
To avoid alcohol, other CNS depressants
•
Not to exceed recommended dose; that dysrhythmias may occur
Lavage, diazepam, vasopressors, IV phenytoin
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(fye-dax′oh-mye′sin)
Dificid
Func. class.:
Antiinfective-macrolide
Bactericidal against
Clostridium difficile;
is a fermentation product obtained from
Dactylosporangium aurantiacum
; inhibits RNA synthesis by inhibiting transcription of bacterial RNA polymerases; may act at the early stages of transcription
Pseudomembraneous colitis
Clostridium difficile
-associated diarrhea
Hyper-sensitivity
Precautions:
Pregnancy (B), breastfeeding, children
Calculator
• Adult:
PO
200 mg bid × 10 days
Available forms:
Tab 200 mg
•
Without regard to food
•
Store at room temperature
GI:
Nausea, vomiting, abdominal pain,
GI bleeding
HEMA:
Anemia, neutropenia
META:
Metabolic acidosis,
hyperglycemia
Half-life 12 hr, onset 1 hr, peak 1-5 hr, excreted in feces 92%
Increase:
fidaxomicin action—cycloSPORINE
Increase:
Glucose, LFTs, alk phos
Decrease:
sodium bicarbonate
•
Pseudomembraneous colitis:
for diarrhea, abdominal pain, fever, fatigue, anorexia, anemia, elevated WBC and low serum albumin; product may be used in place of vancomycin; monitor CBC with differential and stool culture (
Clostridium difficile
), not to be used for systemic infection, obtain C&S before use, monitor glucose (diabetic patients)
•
Positive therapeutic response: resolution of
Clostridium difficile
•
To report GI bleeding, or severe abdominal pain
•
To report if pregnancy is planned or suspected or if breastfeeding
•
May take without regard to food
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(fill-grass′stim)
G-CSF, granulocyte colony stimulator, Neupogen
Func. class.:
Biologic modifier
Chem. class.:
Granulocyte colony-stimulating factor