Mosby's 2014 Nursing Drug Reference (88 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
OTC
)
(se-teer′i-zeen)
All Day Allergy, All Day Allergy Children’s, GNP All Day Allergy, GNP Children’s All Day Allergy, Good Sense All Day Allergy, Good Sense Children’s All Day Allergy, Publix Allergy Children’s, Reactine
, Top Care Children’s All Day Allergy, Zyrtec, Zyrtec Children’s
Func. class.:
Antihistamine (2nd generation, peripherally selective)
Chem. class.:
Piperazine, H
1
-histamine antagonist
Do not confuse:
ZyrTEC
/Xanax/Zantac
Acts on blood vessels, GI, respiratory system by competing with histamine for H
1
-receptor site; decreases allergic response by blocking pharmacologic effects of histamine; minimal anticholinergic, sedative action
Rhinitis, allergy symptoms, chronic idiopathic urticaria
Unlabeled uses:
Asthma, atopic dermatitis
Breastfeeding, newborn or premature infants, hypersensitivity to this product or hydrOXYzine, severe hepatic disease
Precautions:
Pregnancy (B), children, geriatric patients, respiratory disease, angle-closure glaucoma, prostatic hypertrophy, bladder neck obstruction, asthma
Calculator
• Adult and child ≥6 yr:
PO
5-10 mg/day
• Child 2-5 yr:
PO
2.5 mg/day, may increase to 5 mg/day or 2.5 mg bid
• Child 1-2 yr:
PO
2.5 mg/day, may increase to 2.5 mg q12hr
• Geriatric:
PO
5 mg/day, may increase to 10 mg/day
• Adult/adolescent/child ≥6 yr:
PO
10 mg/day;
ORAL SOL
5-10 mg/day
• Adult:
PO
CCr 11-31 ml/min, 5 mg/day
• Child 6-12 yr:
PO
5-10 mg/day
• Child 1-2 yr:
PO
0.25 mg/kg bid
Available forms:
Tabs 5, 10 mg; syr 5 mg/5 ml, prefilled spoons 1 mg/ml; oral sol 5 mg/ml; liquid-filled caps 10 mg; chew tabs 5, 10 mg
•
Without regard to meals
•
Caps:
swallow whole, do not break, cut, chew, crush
•
Chew tabs:
chew before swallowing, may use with or without water
•
Oral liquid:
use calibrated measuring device
CNS:
Headache
, stimulation,
drowsiness
, sedation,
fatigue
, confusion,
blurred vision, tinnitus, restlessness, tremors; paradoxical excitation in children, geriatric patients
GI:
Dry mouth
, increased LFTs, constipation
INTEG:
Rash, eczema, photosensitivity, urticaria
RESP:
Thickening of bronchial secretions
, dry nose, throat
Absorption rapid; onset 1/2 hr; peak 1-2 hr; duration 24 hr; protein binding 93%; half-life decreased in children, increased in renal/hepatic disease
Increase:
CNS depression—alcohol, opiates, sedative/hypnotics, other CNS depressants
Increase:
anticholinergic/sedative effect—MAOIs
Increase:
cetirizine effect—ritonavir
•
Food prolongs absorption by 1.7 hr
False negative:
skin allergy tests
•
Allergy symptoms:
pruritus, urticaria, watering eyes at baseline and during treatment
•
Respiratory status: rate, rhythm, increase in bronchial secretions, wheezing, chest tightness
•
Blood studies: LFTs, BUN, creatinine at baseline, periodically
•
Hard candy, gum, frequent rinsing of mouth for dryness
•
Storage in tight, light-resistant container
•
Therapeutic response: absence of running or congested nose, rashes
•
About all aspects of product use; to notify prescriber if confusion, sedation, hypotension occur
•
To avoid driving, other hazardous activity if drowsiness occurs
•
To avoid alcohol, other CNS depressants, OTC antihistamines
•
To avoid exposure to sunlight; burns may occur
•
To use sugarless gum, candy, frequent sips of water to minimize dry mouth
•
Not to breastfeed
Administer diazepam, vasopressors, phenytoin IV
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(set-roe-ree′lix)
Cetrotide
Func. class.:
Gonadotropin-releasing hormone antagonist
Chem. class.:
Synthetic decapeptide
Inhibitor of pituitary gonadotropin secretion; initially increases LH and FSH, induces a rapid suppression of gonadotropin secretion
For inhibition of premature LH surges in women undergoing controlled ovarian hyperstimulation
Unlabeled uses:
Benign prostatic hyperplasia (BPH), endometriosis
Pregnancy (X), breastfeeding, hypersensitivity, latex allergy, renal disease
Precautions:
Geriatric patients
Calculator
• Adult:
SUBCUT
3 mg when serum estradiol level at appropriate stimulation response, usually on stimulation day 7; if hCG not given within 4 days after inj of 3 mg cetrorelix, give 0.25 mg daily until day of hCG administration
• Adult:
SUBCUT
0.25 mg given on stimulation day 5 (either morning or
evening) or 6 (morning) and continued daily until day hCG is given
• Adult (male):
SUBCUT
5 mg bid × 2 days then 1 mg/day
• Adult (female):
SUBCUT
3 mg weekly
Available forms:
Inj 0.25, 3 mg
•
Attach yellow-marked needle to dilutent syringe, dilute powder by injecting liquid from syringe into vial, leaving syringe on vial; gently swirl until clear, avoid bubbles; withdraw contents of vial back into syringe, replace yellow-marked needle with gray-marked needle
•
SUBCUT using abdomen, 1 inch away from navel or upper thigh; swab inj area with disinfectant; clean a 2-inch circle and allow to dry; pinch up area between thumb and finger; insert needle 45-90 degrees to surface; if positioned correctly, no blood will be drawn back into syringe; reposition needle without removing it; rotate inj sites
•
Protect from light
CNS:
Headache
CV:
Edema
ENDO:
Ovarian hyperstimulation syndrome, abdominal pain (gyn)
GI:
Nausea, vomiting, diarrhea
INTEG:
Pain on inj; local site reactions, bruising, pruritus
OTHER:
Rapid weight gain
RESP:
Shortness of breath
SYST:
Fetal death, anaphylaxis
Excreted in feces/urine, half-life depends on dosage, metabolized to metabolites, protein binding 86%
•
Serum progesterone, LH; ovarian ultrasound day 7-14; pelvic exam, serum estradiol/gonadotropin; weight
•
For suspected pregnancy; product should not be used, pregnancy (X)
•
For latex allergy, product should not be used
For anaphylaxis during first inf
•
Therapeutic response: pregnancy
•
To report abdominal pain, vaginal bleeding, nausea, vomiting, diarrhea, SOB, peripheral edema
•
How to perform self-administration technique if needed