Mosby's 2014 Nursing Drug Reference (382 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
(tel-a-van′sin)
Vibativ
Func. class.:
Antiinfective, miscellaneous
Chem. class.:
Lipoglycopeptide
Inhibits bacterial cell wall synthesis, blocks glycopeptides
Skin/skin-structure infections caused by
Enterococcus faecalis, E. faecium, Staphylococcus aureus
(MSRA),
S. aureus
(MSSA),
S. epidermidis, S. haemolyticus, Streptococcus agalactiae
(group B),
S. dysgalactiae, S. pyogenes
(group A β-tremolytic),
S. anginosus, S. intermedius, S. constellates
Unlabeled uses:
Nosocomial pneumonia caused by susceptible gram-positive bacteria
Hypersensitivity
Precautions:
Breastfeeding, children, geriatric patients, renal disease, antimicrobial resistance, diabetes mellitus, diarrhea, GI disease, heart failure, hypertension, pseudomembranous colitis, QT prolongation, vancomycin hypersensitivity
Black Box Warning:
Pregnancy (C), females
Calculator
• Adult:
IV INF
10 mg/kg over 60 min q24hr × 7-14 days
• Adult:
IV INF
10 mg/kg q24hr × 7-21 days
Available forms:
Lyophilized powder for inj 250, 750 mg
•
Use only for susceptible organisms to prevent drug-resistant bacteria
•
Antihistamine if red-man syndrome occurs: decreased B/P; flushing of neck, face
•
After reconstitution with 15 ml D
5
W sterile water for inj; 0.9% NaCl (15 mg/ml) 250-mg vial; add 45 ml to 750-mg vial (15 mg/ml) for dose of 150-800 mg; further dilute with 100-250 ml of compatible sol; for dose <150 mg or >800 mg, further dilute to conc of 0.6-8 mg/ml with compatible sol; give over 60 min; reconstituted or diluted sol is stable for 4 hr room temperature, 7 hr refrigerated
CNS:
Anxiety, chills, flushing, headache, insomnia
CV:
QT prolongation,
irregular heartbeat
EENT:
Hearing loss
GI:
Nausea,
vomiting,
pseudomembranous colitis,
abdominal pain, constipation, diarrhea, metallic taste
GU:
Nephrotoxicity,
increased BUN, creatinine
,
renal failure,
foamy urine
HEMA:
Leukopenia, eosinophilia, anemia, thrombocytopenia
INTEG:
Chills, fever, rash, thrombophlebitis at inj site; urticaria, pruritus, necrosis (red-man syndrome)
SYST:
Anaphylaxis, superinfection
Onset rapid, half-life 8-9 hr, excreted in urine (76%), protein binding 90%
Increase:
otoxicity or nephrotoxicity—aminoglycosides, cephalosporins, colistin, polymyxin, bacitracin, CISplatin, amphotericin B, nondepolarizing muscle relaxants, cidofovir
Increase:
QT prolongation—class IA, III antidysrhythmics; some phenothiazines; chloroquine, clarithromycin, droperidol, dronedarone, erythromycin, haloperidol, levomethadye, methadone, pimozide, ziprasidone
False increase:
INR, PT, PTT
•
Infection:
WBC, urine, stools, sputum, characteristics of wound throughout treatment C&S
•
I&O ratio; report hematuria, oliguria; nephrotoxicity may occur
Black Box Warning:
Obtain a pregnancy test before use; if a woman has taken this product during pregnancy, the national registry should be notified at 866-658-4228
•
Auditory function during, after treatment; hearing loss; ringing, roaring in ears; product should be discontinued
•
B/P during administration; sudden drop may indicate red-man syndrome; also flushing, pruritus, rash
•
Respiratory status: rate, character, wheezing, tightness in chest
•
Allergies before treatment, reaction to each medication
•
EPINEPHrine, suction, tracheostomy set, endotracheal intubation equipment on unit; anaphylaxis may occur
•
Adequate intake of fluids (2 L/day) to prevent nephrotoxicity
•
Therapeutic response: negative culture
•
About all aspects of product therapy; that culture may be taken after completed course of medication
•
To report sore throat, fever, fatigue; could indicate superinfection; diarrhea
(pseudomembranous colitis)
•
To use contraception while taking this product, do not breastfeed
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(tel-bi′vyoo-deen)
Sebivo
, Tyzeka
Func. class.:
Antiretroviral
Chem. class.:
Nucleoside reverse transcriptase inhibitor (NRTI)
Inhibits replication of HBV DNA polymerase, which inhibits HBV replication
Treatment of chronic hepatitis B
Hypersensitivity, breastfeeding
Precautions:
Pregnancy (B), children, severe renal disease, anemia, organ transplant, dialysis, HIV, obesity, alcoholism; Hispanic or African descendents (safety not established)
Black Box Warning:
Impaired hepatic function, lactic acidosis
Calculator
• Adult and adolescent >16 yr:
PO
600 mg/day; max 600 mg/day
• Adult:
PO
CCr 30-49 ml/min, 600 mg tab q48hr or 400 mg oral sol daily; CCr <30 ml/min (not requiring dialysis), 600 mg tab q72hr or 200 mg oral sol daily
Available forms:
Tabs 600 mg
•
With/without food with a full glass of water
CNS:
Fever, headache, malaise
, weakness,
dizziness, insomnia
EENT:
Taste change, hearing loss, photophobia
GI:
Nausea, vomiting, diarrhea, anorexia
, abdominal pain, hepatomegaly
INTEG:
Rash
MISC:
Lactic acidosis
MS:
Myalgia, arthralgia, muscle cramps
RESP:
Cough
Excreted by kidneys (unchanged), steady state 5-7 days, protein binding 3.3%, terminal half-life 40-49 hr, peak 1-4 hr
•
Altered telbivudine levels: any agent altering renal function
•
Do not use with pegylated interferon α-2a
Increase:
myopathy risk possible—HMG-CoA reductase inhibitors, fibric acid derivatives, penicillamine, zidovudine, ZDV, cycloSPORINE, erythromycin, niacin, azole antifungals, corticosteroids, hydrochloroquine
Black Box Warning:
LFTs, hepatitis B serology, creatine kinase, periodically, monitor HBV DNA after 24 wk; if viral suppression incomplete (≥300 copies/ml), start alternate therapy; monitor HBV DNA q6mo
Black Box Warning:
Lactic acidosis: obtain baseline liver function tests; if elevated, discontinue treatment; discontinue even if liver function tests normal but lactic acidosis, hepatomegaly present, may be fatal
•
Storage at room temp
•
Therapeutic response: decreasing hepatitis B serology
•
That GI complaints and insomnia may resolve after 3-4 wk of treatment
•
That product does not cure hepatitis B and does not stop its spread to others
•
That follow-up visits must be continued
•
That serious product interactions may occur if OTC products are ingested; to check with prescriber before taking
•
That product may cause dizziness; to avoid hazardous activities until response is known
•
To report symptoms of cough, difficulty sleeping, excessive headache, muscle pain/weakness