Mosby's 2014 Nursing Drug Reference (193 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
See
Appendix B
(ga-ti-floks′a-sin)
Zymar, Zymaxid
Func. class.:
Ophthalmic anti-infective
Chem. class.:
Fluoroquinolone
Do not confuse:
gatifloxacin/levofloxacin/moxifloxacin
Inhibits DNA gyrase, thereby decreasing bacterial replication
Bacterial conjunctivitis
Hypersensitivity to this product or fluoroquinolones, infants <1 yr
Precautions:
Pregnancy (C), breastfeeding
Calculator
• Adult/adolescent/child ≥1 yr:
OPHTH SOL
Instill 1 drop in affected eye(s) every 2 hr while awake × 2 days, then 1 drop up to qid × 5 more days or
Zymaxid 1 drop every 2 hr while awake first day, then bid to qid while awake days 2 to 7
Available forms:
Ophthalmic solution 0.3%, 0.5%
•
Commercially available ophthalmic solutions are not for injection subconjunctivally or into the anterior chamber of the eye
•
Apply topically to the eye, taking care to avoid contamination
•
Do not touch the tip of the dropper to the eye, fingertips, or other surface
•
Apply pressure to lacrimal sac for 1 min after instillation
•
Avoid wearing contact lenses during treatment
EENT:
Hypersensitivity, irritation, redness, tearing, keratitis, blepharitis, taste changes
Unknown
•
Allergic reaction
: hypersensitivity, discontinue product
•
Decreased ophthalmic infection
•
To apply topically to the eye, taking care to avoid contamination; for ophthalmic use only
•
Not to touch the tip of the dropper to the eye, fingertips, or other surface
•
To apply pressure to lacrimal sac for 1 min after instillation
•
To avoid wearing contact lenses during treatment
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(ge-fi′tye-nib)
Iressa
Func. class.:
Antineoplastic—miscellaneous
Chem. class.:
Epidermal growth factor receptor inhibitor
Not fully understood; inhibits intracellular phosphorylation of cell surface receptors associated with epidermal growth factor receptors
Advanced/metastatic non–small cell lung cancer (NSCLC) in those who have not responded to platinum or DOCEtaxel products
Pregnancy (D), breastfeeding, children, hypersensitivity
Precautions:
Geriatric patients, ocular/pulmonary/renal/hepatic disorders
EENT:
Amblyopia, conjunctivitis, eye pain, corneal erosion/ulcer
GI:
Nausea, diarrhea, vomiting
, anorexia,
pancreatitis,
mouth ulceration,
hepatotoxicity
INTEG:
Rash
, pruritus,
acne, dry skin
,
toxic epidermal necrolysis, angioedema
MISC:
Peripheral edema,
hemorrhage
RESP:
Interstitial lung disease,
cough, dyspnea, pneumonia
Slowly absorbed; excreted in feces (86%), urine (<4%); elimination halflife 48 hr; metabolism by CYP3A4
Increase:
gefitinib concentrations—ketoconazole, itraconazole, erythromycin, clarithromycin
Increase:
bone marrow suppression—cloZAPine
Increase:
plasma concentration of warfarin, metoprolol
Decrease:
gefitinib levels—phenytoin, rifampin, cimetidine, ranitidine, sodium bicarbonate
Decrease:
gefitinib levels—St. John’s wort
Pulmonary changes: lung sounds, cough, dyspnea; interstitial lung disease may occur, may be fatal; discontinue therapy if confirmed
•
Ocular changes: eye irritation, corneal erosion/ulcer, aberrant eyelash growth
Pancreatitis: abdominal pain, levels of amylase, lipase
Toxic epidermal necrolysis, angioedema
•
GI symptoms: frequency of stools, if diarrhea is poorly tolerated, therapy may be discontinued for up to 14 days; LFTs baseline and periodically
•
Without regard to food; avoid grapefruit juice
•
May be dispersed in half-glass of water (noncarbonated), rinse glass and drink liquid, may be given through NG tube
•
Therapeutic response: decreased NSCLC
To report adverse reactions immediately: shortness of breath, severe abdominal pain, ocular changes, skin eruptions
•
Reason for treatment, expected results
•
Use contraception during treatment; avoid breastfeeding
•
Avoid persons with infections