Mosby's 2014 Nursing Drug Reference (349 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
(re-te-pam′you-lin)
Altabax
Func. class.:
Topical anti-infective
Chem. class.:
Pleuromutilin
Antibacterial activity results from inhibition of protein synthesis
For the treatment of impetigo
Hypersensitivity to this product
Precautions:
Children
Calculator
• Adult/child ≥9 mo:
TOP
apply to affected area bid × 5 days
Available forms:
Topical ointment 1%
•
Do not use skin products near the eyes, nose, or mouth
•
Wash hands before and after use
•
Ointment:
Apply a thin film to the cleansed affected area and massage gently into affected areas
INTEG:
Pruritus, irritation, headache, diarrhea, nausea
•
Hypersensitivity, product may need to be discontinued
•
Number of lesions, severity of impetigo
•
Decreased lesions, infection in impetigo
•
Not to use skin products near the eyes, nose, or mouth
•
To wash hands before and after use
•
Ointment:
To apply a thin film to the cleansed affected area
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
o
(D) immune globulin standard dose IM (Rx)
BayRho-D, HyperRHO SD, RhoGAM Ultra-Filtered Plus
o
(D) immune globulin microdose IM (Rx)
MICRhoGAM Ultra-Filtered Plus
o
(D) immune globulin IV (Rx)
Rhophylac, WinRho SDF
Func. class.:
Immune globulins
Suppresses immune response of nonsensitized Rh
o
(D or D
u
)-negative patients who are exposed to Rh
o
(D or D
u
)-positive blood
Prevention of isoimmunization in Rh-negative women given Rh-positive blood after abortions, miscarriages, amniocentesis; chronic idiopathic thrombocytopenia purpura (Rhophylac)
Previous immunization with this product, Rh
o
(O)-positive/D
u
-positive patient
Black Box Warning:
Hemolysis
Precautions:
Pregnancy (C)
Black Box Warning:
Requires a specialized setting
Calculator
• Adult and adolescent ≥16 yr:
IM
(BayRho-D [HyperRHO SD] full dose only) 300 mcg (1500 international units) at 28 wk gestation, repeat within 72 hr of delivery of confirmed Rho(D)-positive infant; dose not needed after delivery if delivery within 3 wk of last dose and no fetal maternal hemorrhage of >15 ml of RBC;
IM
(RhoGam only) 300 mcg (1500 international units) at 26-28 wk gestation, repeat within 72 hr even if status of Rho unknown or if 72 hr have passed;
IM/IV
(WinRho SDF only) 300 mcg (1500 international units) at 28 wk gestation; if given earlier during pregnancy, give at 12-wk intervals during pregnancy, 120-mcg (600 international units) dose; IM/IV should be given as soon as possible and preferably within 72 hr of delivery of confirmed Rho(D)-positive infant and even if status unknown; give ≤ 28 days after delivery
• Adult and adolescent ≥16 yr:
IM
(BayRho-D [HyperRHO SD] full dose only) 300 mcg (1500 international units) per every 15 ml of fetal blood cells or 30 ml of whole blood; multiple syringes may be injected IM at same time in different sites, give within 72 hr of exposure, repeat dose within 72 hr of delivery;
IM
(RhoGAM only) 300 mcg (1500 international units) for every 15 ml of fetal blood cells or 30 ml of whole blood, give total dose within 72 hr of exposure;
IM/IV
(WinRho SDF only) if large fetomaternal hemorrhage suspected, give
IV
9 mcg (45 international units) or
IM
12 mcg (60 international units) for every ml of fetal whole blood, give
IV
600 mcg (3000 international units) q8hr or
IM
1200 mcg (6000 international units) q12hr until total dose given, total dose should be given within 72 hr of exposure
• Adult and adolescent ≥16 yr:
IM
(BayRho-D [HyperRHO SD] full dose only) 300 mcg (1500 international units) as soon as possible; if given at 13-18 wk gestation, give another 300 mcg (1500 international units) at 26-28 wk gestation; repeat dose within 72 hr of delivery;
IM
(RhoGam only) 300 mcg (1500 international units) as soon as
possible and within 72 hr of exposure;
IM/IV
(Rhophylac only) 300 mcg (1500 international units) as soon as possible and within 72 hr;
IM/IV
(WinRho SDF only) 300 mcg (1500 international units) as soon as possible and within 72 hr, repeat dose at 12-wk intervals during pregnancy and give 120 mcg (600 international units) as soon as possible after delivery and within 72 hr
• Adult and adolescent ≥16 yr:
IM
(BayRho-D Minidose, HyperRHO Minidose, MICRhoGAM only) 50 mcg (250 international units) as soon as possible, give within 3 hr of spontaneous or surgical removal, if possible within 72 hr
• Adult and adolescent ≥16 yr:
IM
(BayRho-D [HyperRHO SD] full dose, RhoGAM only) 300 mcg (1500 international units) as soon as possible and within 72 hr of event
• Adult and adolescent ≥16 yr:
IM/IV
(WinRho SDF only) 300 mcg (1500 international units) within 72 hr, repeat at 12-wk intervals during pregnancy, give 120 mcg (600 international units) as soon as possible and preferably within 72 hr of delivery
Available forms:
BayRho-D sol for inj 300 mcg/ml (HyperRHO SD sol for inj), MICRhoGAM Ultra Filtered Plus Solution for inj 50 mcg/ml; RhoGam Ultra Filtered Plus Solution for inj 50 mcg; Rhophylac Pre-Filled Syringes Solution for inj 300 mcg/2 ml; WinRho SDF liquid for inj; WinRho powder for inj
•
BayRho-D (HyperRHO SD), MICRhoGAM, RhoGAM given by IM only; do not give IV
•
WinRho SDF and Rhophylac can be given IM or IV
•
Inspect for particulate matter; do not use if particulate matter present
•
Reconstitute/dilution: no reconstitution or dilution needed for BayRho-D (HyperRHO SD); Rhophylac, MICRhoGAM, RhoGAM, or liquid formulation of WinRho SDF
•
WinRho SDF powder for IV use: if giving IV, reconstitute 600 international units or 1500 international units immediately before use with 2.5 ml of sterile diluent; reconstitute 5000 international units with 8.5 ml sterile diluent; add diluent to vial slowly down wall of vial; gently swirl until powder dissolved; do not shake
•
WinRho SDF powder for IM use: IV giving IM, reconstitute 600 international units or 1500 international units immediately before use with 1.25 ml of sterile diluent; 5000 international units with 8.5 ml of sterile diluent; add diluent to vial slowly down wall of vial; gently swirl until powder dissolved; do not shake
•
Use aseptic technique, observe for 20 min after administration
•
Bring Rhophylac to room temp before use
•
Inject into deltoid muscle of upper arm or anterolateral portion of upper thigh; do not inject into gluteal muscle
•
If dose calculated requires multiple vials or syringes, use different sites at same time
•
Use aseptic technique
•
WinRho SDF: remove entire contents of vial to obtain calculated dose; if partial vial required for dosage calculation, withdraw entire vial contents to ensure correct calculation; infuse correct calculated dose over 3-5 min; do not infuse with other fluids, products
•
Rhophylac: bring to room temp; infuse by slow IV; observe for 20 min
CNS:
Lethargy
CV:
Hypo/hypertension
INTEG:
Irritation at inj site, fever
MISC:
Infection,
ARDs, anaphylaxis, pulmonary edema, DIC
MS:
Myalgia, arthralgia
Decrease:
antibody response—live virus vaccines (measles, mumps, rubella)
Allergies, reactions to immunizations; previous immunization with product
Intravascular hemolysis:
back pain, chills, hemoglobinuria, renal insufficiency; usually when WinRho SDF is given in those with immune thrombocytopenia purpura
•
Type, crossmatch mother and newborn’s cord blood; if mother Rh
o
(D)-negative, D
u
-negative and newborn Rh
o
(D)-positive, product should be given
•
Storage in refrigerator
•
Rh
o
(D) sensitivity in transfusion error, prevention of erythroblastosis fetalis for normal vision
•
How product works; that product must be given after subsequent deliveries if subsequent babies are Rh-positive
To report immediately: shaking, fever, chills, dark urine, swelling of hands or feet, back pain, SOB (intravascular hemolysis)