Mosby's 2014 Nursing Drug Reference (196 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
(jen-ta-mye′sin)
Gentak, Garamycin
Func. class.:
Ophthalmic anti-infective
Chem. class.:
Aminoglycoside
Do not confuse:
clindamycin/tobramycin/erythromycin/vancomycin/GenTeal
Inhibits protein synthesis, thereby decreasing bacterial replication
External ocular infections
Hypersensitivity to this product or aminoglycosides
Precautions:
Pregnancy (C), breastfeeding
Calculator
• Adult/adolescent/child ≥1 mo:
SOL
1–2 drops in affected eye(s) every 4 hr while awake × 2 days, then every 4 hr; severe injections ≤2 drops every 1 hr
•
Ointment:
apply a small amount (1/2″) to lower conjunctival sac bid or tid
Available forms:
Ophthalmic ointment, ophthalmic solution 0.3%
•
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 to touch the tip of the dropper to the eye, fingertips, or other surface
•
Apply pressure to lacrimal sac for 1 min after instillation
•
To apply the ointment: pull down gently on lower eyelid, and apply a thin film of the ointment
EENT:
Burning, hypersensitivity, stinging, blurred vision, hyperemia, corneal ulcers
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 apply the ointment by pulling down gently on lower eyelid, and applying a thin film of the ointment
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(jen-ta-mye′sin)
Func. class.:
Topical anti-infective
Chem. class.:
Aminoglycoside
Do not confuse:
gentamicin/clindamycin
Antibacterial activity results from inhibition of protein synthesis; bactericidal
Superficial infections
Hypersensitivity to this product or other aminoglycosides
Precautions:
Infections
Calculator
• Adult/child >1 yr:
Apply to affected areas tid-qid
Available forms:
Topical cream, ointment 0.1%
•
For external use only; do not use skin products near the eyes, nose, or mouth
•
Wash hands before and after use; wash affected area and gently pat dry
•
Cream/Ointment:
Apply to the cleansed affected area, massage gently into affected areas
INTEG:
Rash, irritation
Unknown
•
Allergic reaction
: hypersensitivity, product may need to be discontinued
•
Infection
: skin infection
•
Decreased skin infection
•
To use for external use only; do not use skin products near the eyes, nose, or mouth
•
To wash hands before and after use, wash affected area and gently pat dry
•
Cream/Ointment:
To apply to the cleansed affected area and massage gently into affected areas
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(glah-tear′a-meer)
Copaxone
Func. class.:
Multiple sclerosis agent
Chem.. class.:
Biological response modifier
Unknown; may modify the immune responses responsible for multiple sclerosis (MS)
Reduction of the frequency of relapses in patients with relapsing or remitting MS after first clinical episode with MRI results consistent with MS
Hypersensitivity to this product or mannitol, IV use
Precautions:
Pregnancy (B), breastfeeding, children <18 yr, immune disorders, renal disease, infection, vaccinations, geriatric patients
Calculator
• Adult:
SUBCUT
20 mg/day
Available forms:
Inj, premixed 20 mg/ml and 40 mg mannitol in single use syringe
•
If refrigerated, allow to warm for 20 min; visually inspect for particulate or cloudiness, if present discard; prefilled syringe contents is for single use; administer SUBCUT into hip, thigh, arm; discard unused portion
•
Use SUBCUT route only; do not give IM or IV
CNS:
Anxiety, hypertonia, tremor, vertigo
, speech disorder,
agitation
, confusion, flushing
CV:
Migraine, palpitations, syncope, tachycardia, vasodilation
, chest pain, hypertension
EENT:
Ear pain, blurred vision
GI:
Nausea, vomiting, diarrhea, anorexia, gastroenteritis
GU:
Urinary urgency, dysmenorrhea, vaginal moniliasis
HEMA:
Ecchymosis, lymphadenopathy
INTEG:
Pruritus, rash, sweating, urticaria, erythema
, inj site reaction
META:
Edema, weight gain
MS:
Arthralgia, back pain, neck pain
, increased muscle tone
RESP:
Bronchitis, dyspnea, laryngismus, rhinitis
May be hydrolyzed locally, may reach regional lymph nodes
•
CNS symptoms: anxiety, confusion, vertigo
•
GI status: diarrhea, vomiting, abdominal pain, gastroenteritis
•
Cardiac status: tachycardia, palpitations, vasodilation, chest pain
•
Therapeutic response: decreased symptoms of MS
•
With written, detailed instructions about product; provide initial and return demonstrations on inj procedure; give information about use and disposal of product, inj site reaction (hives, rash, irritation, severe pain, flushing, chest pain)
•
To notify prescribers of allergic reactions including itching, trouble breathing; chest pain, dizziness, sweating
•
That irregular menses, dysmenorrhea, metrorrhagia, breast pain may occur; to use contraception during treatment
•
That if pregnancy is suspected or if nursing to notify prescriber
•
Not to change dosing or stop taking product without advice of prescriber
•
About
immediate postinjection reaction:
flushing, chest pain, palpitations, anxiety, dyspnea, laryngeal constriction, urticaria; does not usually require treatment, may occur months after beginning treatment
•
To take as directed, not to stop product or change schedule; teach on self-injection technique