Mosby's 2014 Nursing Drug Reference (443 page)

VAGINAL
ANTIFUNGALS

butoconazole (
OTC
)

(byoo-toh-kone′ah-zole)

Gynazol-1

miconazole (
OTC
)

(mye-kon′a-zole)

Monistat, Monistat 3, Monistat 7, Monistat Dual Pak

terconazole (
OTC
)

(ter-kone′ah-zole)

Terazol 7, Terazol 3, Zazole

tioconazole (
OTC
)

(tye-oh-kone′ah-zole)

Gyne-Trosyd
, Vagistat-1

ACTION:

Interferes with fungal DNA replication; binds sterols in fungal cell membranes, which increases permeability, leaking of nutrients

USES:

Vaginal, vulval, vulvovaginal candidiasis (moniliasis)

CONTRAINDICATIONS:

Hypersensitivity

Precautions:
Pregnancy, breastfeeding, children <2 yr

DOSAGE AND ROUTES
Calculator
Butoconazole

• Adult:
VAG
5 g (1 applicator) at bedtime × 3-6 days

Miconazole

• Adult:
200 mg supp at bedtime × 3 days or 100 mg supp × 1 wk

Terconazole

• Adult:
VAG 5 g (1 applicator) at bedtime

Tioconazole

• Adult:
1 applicator at bedtime

Administer:

Topical route

• 
One full applicator every night high into the vagina

• 
Store at room temperature in dry place

SIDE EFFECTS

GU:
Vulvovaginal burning, itching, pelvic cramps

INTEG:
Rash, urticaria, stinging, burning

MISC:
Headache, body pain

NURSING CONSIDERATIONS
Assess:

• 
For allergic reaction: burning, stinging, itching, discharge, soreness

Evaluate:

• 
Therapeutic outcome: decrease in itching or white discharge (vaginal)

Teach patient/family:

• 
About asepsis (hand washing) before, after each application

• 
To apply with applicator only; to avoid use of any other vaginal product unless directed by prescriber; sanitary napkin may prevent soiling of undergarments

• 
To abstain from sexual intercourse until treatment is completed; reinfection and irritation may occur

• 
To notify prescriber if symptoms persist

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

OTIC
ANTIINFECTIVES

ciprofloxacin (Rx)

Cetraxel

ACTION:

Inhibits protein synthesis in susceptible microorganisms

USES:

Ear infection (external), short-term use

CONTRAINDICATIONS:

Hypersensitivity, perforated eardrum

Precautions:
Pregnancy (C)

Administer:

• 
After removing impacted cerumen by irrigation

• 
After cleaning stopper with alcohol

• 
After restraining child if necessary

• 
After warming sol to body temp

SIDE EFFECTS

EENT:
Itching, irritation in ear

INTEG:
Rash, urticaria

NURSING CONSIDERATIONS
Assess:

• 
For redness, swelling, fever, pain in ear, which indicates superinfection

Evaluate:

• 
Therapeutic response: decreased ear pain

Teach patient/family:

• 
The correct method of instillation using aseptic technique, including not touching dropper to ear

• 
That dizziness may occur after instillation

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

Appendix C
Vaccines and toxoids

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

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