Mosby's 2014 Nursing Drug Reference (350 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
2
) (
OTC
)
(rye′boh-flay-vin)
Func. class.:
Vit B
2
, water soluble
Needed for respiratory reactions by catalyzing proteins
Vit B
2
deficiency or polyneuritis; cheilosis adjunct with thiamine
Unlabeled uses:
Migraine prophylaxis
Calculator
• Adult:
PO
5-30 mg/day
• Child ≥12 yr:
PO
3-10 mg/day then 0.6 mg/1000 calories ingested
• Adult:
PO
(males) 1.3 mg, (females) 1.1 mg
• Adult:
PO
400 mg/day × 3 mo
Available forms:
Tabs 5, 10, 25, 50, 100, 250 mg
•
With food for better absorption
GU:
Yellow discoloration of urine
Precautions:
Pregnancy (A)
Half-life 65-85 min, 60% protein bound, unused amounts excreted in urine (unchanged)
Increase:
riboflavin need—alcohol, probenecid, tricyclics, phenothiazines
Decrease:
action of tetracyclines
•
May cause false elevations of urinary catecholamines
•
Nutritional status: liver, eggs, dairy products, yeast, whole grains, green vegetables
•
Storage in airtight, light-resistant container
•
Therapeutic response: absence of headache, GI problems, cheilosis, skin lesions, depression; burning, itchy eyes; anemia
•
That urine may turn bright yellow
•
About the addition of needed foods rich in riboflavin
•
To avoid alcohol
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(riff′a-byoo-ten)
Mycobutin
Func. class.:
Antimycobacterial agent
Chem. class.:
Rifamycin S derivative
Do not confuse:
rifabutin
/rifampin/rifapentine
Inhibits DNA-dependent RNA polymerase in susceptible strains of
Escherichia coli
and
Bacillus subtilis;
mechanism of action against
Mycobacterium avium
unknown
Prevention of
M. avium
complex (MAC) in patients with advanced HIV infection
Unlabeled uses:
Helicobacter pylori
that has not responded to other treatment
Hypersensitivity, active TB, WBC <1000/mm
3
or platelet count <50,000/mm
3
Precautions:
Pregnancy (B), breastfeeding, children, hepatic disease, blood dyscrasias
Calculator
• Adult:
PO
300 mg/day (may take as 150 mg bid); max 600 mg/day
• Adult:
PO
CCr <30 ml/min, reduce by 50%
Available forms:
Caps 150 mg
•
With food if GI upset occurs; better to take on empty stomach 1 hr before or 2 hr after meals; high-fat foods slow absorption; may take in 2 divided doses, may open capsule, mix with applesauce if unable to swallow whole cap
•
Antiemetic if vomiting occurs
•
After C&S completed; monthly to detect resistance
CNS:
Headache
, fatigue, anxiety, confusion, insomnia
GI:
Nausea, vomiting, anorexia, diarrhea
, heartburn,
hepatitis,
discolored saliva, pseudomembranous colitis
GU:
Discolored urine
HEMA:
Hemolytic anemia, eosinophilia, thrombocytopenia, leukopenia
INTEG:
Rash
MISC:
Flulike symptoms, shortness of breath, chest pressure
MS:
Asthenia, arthralgia, myalgia
53% absorbed, peak 2-3 hr, duration >24 hr, half-life 45 hr, metabolized in liver (active/inactive metabolites), excreted in urine primarily as metabolites
Increase:
levels of rifabutin: ritonavir
Decrease:
action of amprenavir, anticoagulants, β-blockers, barbiturates, busPIRone, clofibrate, corticosteroids, cycloSPORINE, dapsone, delavirdine, disopyramide, doxycycline, efavirenz, estrogens, fluconazole, indinavir, ketoconazole, losartan, nelfinavir, nevirapine, oral contraceptives, phenytoin, quiNIDine, saquinavir, sulfonylureas, theophylline, tricyclic antidepressants, zidovudine, zolpidem
•
High-fat diet decreases absorption
Interference:
folate level, vit B
12
, BSP, gallbladder studies
Acute TB:
chest x-ray, sputum culture, blood culture, biopsy of lymph nodes, PPD; product should not be given for active TB
•
CBC for neutropenia, thrombocytopenia, eosinophilia
Pseudomembranous colitis:
diarrhea, abdominal pain/cramping, fever, bloody stools
•
Signs of anemia: Hct, Hgb, fatigue
•
Hepatic studies weekly: ALT, AST, bilirubin
•
Renal status before, each mo: BUN, creatinine, output, specific gravity, urinalysis
•
Hepatic status: decreased appetite, jaundice, dark urine, fatigue
•
Therapeutic response: not used for active TB because of risk for development of resistance to rifampin; culture negative
That patients using oral contraceptives should consider using nonhormonal methods of birth control, may decrease effect; to notify prescriber if pregnancy planned, suspected
•
That compliance with dosage schedule, duration necessary
•
That scheduled appointments must be kept because relapse may occur
•
That urine, feces, saliva, sputum, sweat, tears may be colored red-orange; soft contact lenses may be permanently stained
To report flulike symptoms: excessive fatigue, anorexia, vomiting, sore throat; unusual bleeding, yellowish discoloration of skin, eyes; myositis: muscle or bone pain; diarrhea, fever, abdominal cramping, bloody stools