Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Mosby's 2014 Nursing Drug Reference (345 page)
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
(ran-ih-biz′oo-mab)
Lucentis
Func. class.:
Ophthalmic
Chem. class.:
Selective vascular endothelial growth factor antagonist
Binds to receptor-binding site of active forms of vascular endothelial growth factor A (VEGF-A) that causes angiogenesis and cell proliferation
Macular degeneration (neovascular) (wet), macular edema after retinal vein occlusion (RVO), diabetic macular edema
Hypersensitivity, ocular infections
Precautions:
Pregnancy (C), breastfeeding, children, retinal detachment, increased intraocular pressure
Calculator
• Adult:
INTRAVITREAL
0.5 mg (0.05 ml) monthly
• Adults:
INTRAVITREAL
0.5 mg then prompt (within 1 wk) or deferred (≥24 wk) laser
Available forms:
Sol for inj 0.5 mg/0.05 ml
•
By ophthalmologist via intravitreal injection using adequate anesthesia; use 19-gauge filter
CNS:
Dizziness, headache
EENT:
Blepharitis, cataract, conjunctival hemorrhage/hyperemia, detachment of retinal pigment epithelium, dry/irritation/pain in eye, visual impairment, vitreous floaters, ocular infection
GI:
Constipation, nausea
MISC:
Hypertension, UTI,
thromboembolism, nonocular bleeding
RESP:
Bronchitis, cough, sinusitis, URI
Elimination half-life 9 days
Increase:
severe inflammation—verteporfin photodynamic therapy (PDT)
•
Eye changes:
redness; sensitivity to light, vision change; increased intraocular pressure change; report infection to ophthalmologist immediately
•
Storage in refrigerator; do not freeze
•
Protect from light
•
Therapeutic response: prevention of increasing macular degeneration
• That, if eye becomes red, sensitive to light, painful, or if there is a change in vision, to seek immediate care from ophthalmologist
•
About reason for treatment, expected results
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
OTC
)
(ra-nit′i-deen)
Equaline Heartburn Relief, Nu-Ranit
, Top Care Heartburn Relief, Wal-zan, Zantac, Zantac C
citrate
Tritec
Func. class.:
H
2
-Histamine receptor antagonist
Do not confuse:
ranitidine
/amantadine/rimantadine
Zantac
/Xanax/Zofran/ZyrTEC
Inhibits histamine at H
2
-receptor site in parietal cells, which inhibits gastric acid secretion
Duodenal ulcer, Zollinger-Ellison syndrome, gastric ulcers, hypersecretory conditions, gastroesophageal reflux disease, stress ulcers, erosive esophagitis (maintenance), active duodenal ulcers with
Helicobacter pylori
in combination with clarithromycin, systemic mastocytosis, multiple endocrine adenoma syndrome, heartburn
Unlabeled uses:
Prevention of aspiration pneumonitis, upper GI bleeding, angioedema, gastritis, urticaria, NSAID-induced ulcer prophylaxis
Hypersensitivity
Precautions:
Pregnancy (B), breastfeeding, child <12 yr, renal/hepatic disease
Calculator
• Adult:
PO
150 mg bid or 300 mg/day after
PM
meal or at bedtime; maintenance 150 mg at bedtime
• Infant and child:
PO
2-4 mg/kg bid, max 300 mg/day
• Adult:
PO
150 mg bid, may increase if needed
• Adult:
PO
150 mg bid × 6 wk then 150 mg at bedtime
• Infant and child:
PO
2-4 mg/kg bid, max 300 mg/day
• Adult:
PO
150 mg bid
• Adult:
PO
150 mg qid for up to 12 wk
• Child ≥1 mo:
PO
5-10 mg/kg/day in 2-3 divided doses
• Adult:
CCr <50 ml/min, give 50% of dose or extend dosing interval
• Adult:
PO
150 mg bid
• Adult:
IM/INT IV INF
50 mg q6-8hr
• Adult:
INT IV INF
50 mg with H
1
-blocker
• Adult:
PO
400 mg bid × 4 wk with clarithromycin 500 mg tid × 1st 2 wk
Available forms:
Ranitidine:
tabs 75, 150, 300 mg; sol for inj 25 mg/ml; caps 150, 300 mg; syr 15 mg/ml;
ranitidine bismuth citrate:
tabs 400 mg
•
Antacids 1 hr before or 1 hr after ranitidine
•
Without regard to meals;
EFFERdose tab:
dissolve 25 mg/≥5 ml, give after dissolved; swallow whole or dissolve on tongue, do not chew
•
No dilution needed; inject in large muscle mass, aspirate
•
Dilute to max 2.5 mg/ml (50 mg/20 ml) using 0.9% NaCl (nonpreserved) or D
5
W, give dose over ≥5 min (max 4 mg/ml)
•
Dilute to max 0.5 mg/ml with D
5
W, NS, give over 15-20 min (5-7 ml/min); premixed ready-to-use bags as 1 mg/ml (50 mg/50 ml), inf over 15-20 min
• dilute 150 mg/250 ml of D
Adult:
5
W or NS, run over 24 hr (6.25 mg/hr or as directed); use inf device, use within 48 hr;
Zollinger-Ellison Syndrome:
dilute in D
5
W, NS; max conc 2.5 mg/ml, use inf device
Y-site:
Acyclovir, aldesleukin, alemtuzumab, alfentanil, allopurinol, amifostine, amikacin, aminophylline, amphotericin B liposome, amsacrine, anikinra, anidulafungin, ascorbic acid, atracurium, atropine, aztreonam, bivalirudin, bumetanide, buprenorphine, butorphanol, calcium chloride/gluconate, CARBOplatin, ceFAZolin, cefepime, cefonicid, cefoperazone, cefotaxime, cefoTEtan, cefOXitin, cefTAZidime, ceftizoxime, cefTRIAXone, cefuroxime, chloramphenicol, chlorproMAZINE, cimetidine, ciprofloxacin, cisatracurium, CISplatin, clindamycin, cyanocobalamin, cyclophosphamide, cycloSPORINE, cytarabine, DACTINomycin, DAPTOmycin, dexamethasone, dexmedetomidine, digoxin, diltiazem, DOBUTamine, DOCEtaxel, DOPamine, doripenem, doxacurium, doxapram, DOXOrubicin, DOXOrubicin liposome, doxycycline, enalaprilat, ePHEDrine, EPINEPHrine, epirubicin, epoetin alfa, ertapenem, erythromycin, esmolol, etoposide, etoposide phosphate, famotidine, fenoldopam, fentaNYL, filgrastim, fluconazole, fludarabine, fluorouracil, folic acid, foscarnet, furosemide, ganciclovir, gemcitabine, gentamicin, glycopyrrolate, granisetron, heparin, hydrocortisone, HYDROmorphone, IDArubicin, ifosfamide, imipenem/cilastatin, inamrinone, indomethacin, isoproterenol, ketorolac, labetalol, levofloxacin, lidocaine, linezolid, LORazepam, magnesium sulfate, mannitol, mechlorethamine, melphalan, meperidine, metaraminol, methotrexate, methoxamine, methyldopate, methylPREDNISolone, metoclopramide, metoprolol, metroNIDAZOLE, midazolam, milrinone, mitoXANtrone, morphine, multivitamin, nalbuphine, naloxone, nesiritide, niCARdipine, nitroglycerin, nitroprusside, norepinephrine, octreotide, ondansetron, oxacillin, oxaliplatin, oxytocin, PACLitaxel, palonosetron, pancuronium, papaverine, PEMEtrexed, penicillin G, pentamidine, pentazocine, PENTobarbital, PHENobarbital, phentolamine, phenylephrine, phytonadione, piperacillin/tazobactam, potassium chloride, procainamide, prochlorperazine, promethazine, propofol, propranolol, protamine, pyrdoxime, remifentanil, riTUXimab, rocuronium, sargramostim, sodium
acetate/bicarbonate, succinylcholine, SUFentanil, tacrolimus, teniposide, theophylline, thiamine, thiopental, thiotepa, ticarcillin/clavulanate, tigecycline, tirofiban, tobramycin, tolazoline, trastuzumab, trimethaphan, urokinase, vancomycin, vecuronium, vinCRIStine, vinorelbine, warfarin, zidovudine, zoledronic acid
CNS:
Headache, sleeplessness, dizziness, confusion, agitation, depression, hallucination (geriatric patients)
CV:
Tachycardia, bradycardia, PVCs
EENT:
Blurred vision, increased ocular pressure
GI:
Constipation, abdominal pain, diarrhea, nausea, vomiting,
hepatotoxicity
GU:
Impotence,
acute interstitial nephritis (rare)
INTEG:
Urticaria, rash, fever
RESP:
Pneumonia
SYST:
Anaphylaxis (rare)
PO:
Peak 2-3 hr; duration 8-12 hr; metabolized by liver; excreted in urine (30% unchanged, PO), breast milk; half-life 2-3 hr; protein binding 15%
Increase:
effect of pramipexole, procainamide, trospium, triazolam, calcium channel blockers, memantine, saquinavir, adefovir
Increase:
GI obstruction risk—NIFEdipine ext rel products
Increase:
toxicity—sulfonylureas, procainamide, benzodiazepines, calcium channel blockers
Decrease:
absorption of ranitidine—antacids, anticholinergics
Decrease:
effects of cephalosporins, iron salts, ketoconazole, itraconazole
Increase:
GI obstruction risk—NIFEdipine ext rel products
Increase:
AST, ALT, creatinine
False positive:
urine protein (Multistix)
•
GI complaints:
nausea, vomiting, diarrhea, cramps, abdominal discomfort, jaundice; report immediately
•
I&O ratio, BUN, creatinine, LFTs, serum, stool guaiac before, periodically during therapy
•
Storage at room temp
•
Therapeutic response: decreased abdominal pain, heartburn
•
To avoid driving, other hazardous activities until stabilized on product
•
That product must be continued for prescribed time to be effective
•
To notify prescriber if pregnancy planned, suspected; to avoid breastfeeding
•
Not to take maximum OTC daily dose for >2 wk
•
To take once daily dose before bedtime