Mosby's 2014 Nursing Drug Reference (442 page)

Canada only   Side effects:
italics
= common;
bold
= life-threatening   
Nurse Alert

TOPICAL
ANTIVIRALS

acyclovir (Rx)

(ay-sye′kloe-ver)

Zovirax

penciclovir (Rx)

(pen-sye′kloe-ver)

Denavir

ACTION:

Interferes with viral DNA replication

USES:

Simple mucocutaneous herpes simplex, in immunocompromised clients with initial herpes genitalis

CONTRAINDICATIONS:

Hypersensitivity

Precautions:
Pregnancy (C), breastfeeding

Administer:

• 
Using finger cot or rubber glove to prevent further infection

• 
Enough medication to cover lesions completely

• 
After cleansing with soap, water before each application; dry well

SIDE EFFECTS

INTEG:
Rash, urticaria, stinging, burning, pruritus, vulvitis

NURSING CONSIDERATIONS
Assess:

• 
Allergic reaction: burning, stinging, swelling, redness, rash, vulvitis, pruritus

Perform/provide:

• 
Storage at room temperature in dry place

Evaluate:

• 
Therapeutic response: decrease in size, number of lesions

Teach patient/family:

• 
Not to use in eyes or when there is no evidence of infection

• 
To apply with glove to prevent further infection

• 
To avoid use of OTC creams, ointments, lotions unless directed by prescriber

• 
To use medical asepsis (hand washing) before, after each application and avoid contact with eyes

• 
To adhere strictly to prescribed regimen to maximize successful treatment outcome

• 
To begin taking product when symptoms arise

Canada only   Side effects:
italics
= common;
bold
= life-threatening   
Nurse Alert

TOPICAL
ANESTHETICS

benzocaine (
OTC
)

(ben′zoe-kane)

Americaine Anesthetic, Anbesol Maximum Strength, Baby Anbesol, Biozene, Boil-Ease, Comfort Caine, Ora-Jel

dibucaine (
OTC
)

(dye′byoo-kane)

Nupercainal

lidocaine (Rx,
OTC
)

(lye′doe-kane)

LMX, Solarcaine, Xylocaine, Xylocaine 10% oral, Xylocaine Viscous, Zilactin-L

pramoxine (
OTC
)

(pra-mox′een)

Pramox, Prax, Sarna

tetracaine (Rx,
OTC
)

(tet′ra-cane)

Pontocaine, Viractin

ACTION:

Inhibits conduction of nerve impulses from sensory nerves

USES:

Oral irritation, sore throat, toothache, cold sore, canker sore, sunburn, minor cuts, insect bites, pain, itching

CONTRAINDICATIONS:

Hypersensitivity, infants <1 yr, application to large areas

Precautions:
Pregnancy (C), children <6 yr, sepsis, denuded skin

DOSAGE AND ROUTES
Calculator

• Adult and child:
TOP
apply qid as needed;
RECT
insert tid and after each BM

SIDE EFFECTS

INTEG:
Rash, irritation, sensitization

NURSING CONSIDERATIONS
Assess:

• 
Pain: location, duration, characteristics before and after administration

• 
For infection: redness, drainage, inflammation; this product should not be used until infection is treated

Perform/provide:

• 
Storage in tight, light-resistant container; do not freeze, puncture, or incinerate aerosol container

Evaluate:

• 
Therapeutic response: decreased redness, swelling, pain

Teach patient/family:

• 
To avoid contact with eyes

• 
Not to use for prolonged periods: use for <1 wk; if condition remains, prescriber should be contacted

Canada only   Side effects:
italics
= common;
bold
= life-threatening   
Nurse Alert

TOPICAL
MISCELLANEOUS

docosanol (
OTC
)

(doe-koe′san-ole)

Abreva

pimecrolimus (Rx)

(pim-eh-croh′lim-us)

Elidel

ACTION:

Docosanol unknown; pimecrolimus may bind with macrophilin and inhibit calcium-dependent phosphatase

USES:

Docosanol applied to fever blisters to promote more rapid healing; pimecrolimus used to treat mild to moderate atopic dermatitis in nonimmunocompromised patients ≥2 yr who are unresponsive to other treatment

CONTRAINDICATIONS:

Hypersensitivity

Precautions:
Pregnancy (C), breastfeeding, dermal infections

DOSAGE AND ROUTES
Calculator
Docosanol

• Adult:
TOP
Rub into blisters 5×/day until healing occurs

Pimecrolimus

• Adult and child

2 yr:
TOP
Apply thin layer 2×/day and rub in, use as long as needed

Administer:

• 
To skin, rub in gently

SIDE EFFECTS
Pimecrolimus

INTEG:
Burning

NURSING CONSIDERATIONS
Assess:

• 
Skin condition (color, pain, inflammation) before and after administration

• 
For signs and symptoms of skin infections (redness, draining lesions); if present, avoid use of product (pimecrolimus)

Evaluate:

• 
Therapeutic response: decreased inflammation, redness

Teach patient/family:

• 
To avoid contact between medication and eyes

• 
To discontinue use of product when condition clears

Canada only   Side effects:
italics
= common;
bold
= life-threatening   
Nurse Alert

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