Mosby's 2014 Nursing Drug Reference (54 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Black Box Warning:
Bone marrow suppression: severe leukopenia, pancytopenia, thrombocytopenia; Hgb, WBC, platelets during treatment monthly; if leukocytes are <3000/mm
3
or platelets <100,000/mm
3
, product should be discontinued, CBC
Hepatotoxicity:
if dark urine, jaundice, itching, light-colored stools, increased LFTs, product should be discontinued; hepatic studies: alk phos, AST, ALT, bilirubin
•
Arthritis:
pain, ROM, swelling, mobility before, during treatment
•
Therapeutic response: absence of graft rejection, immunosuppression in autoimmune disorders
•
To take as prescribed; not to miss doses; if dose is missed on daily regimen, to skip dose; if taking multiple doses/day, to take as soon as remembered
•
That therapeutic response may take 3-4 mo with RA; to continue with prescribed exercise, rest, other medications
•
To report fever, rash, severe diarrhea, chills, sore throat, fatigue because
serious infections
may occur; report unusual bleeding, bruising; signs/symptoms of
renal/hepatic toxicity
•
To use contraceptive measures during treatment, for 16 wk after ending therapy (pregnancy [D]); to avoid vaccinations
•
To avoid crowds to reduce risk for infection
•
To take with food to decrease GI intolerance
•
On multiple significant drug-drug interactions
•
To use soft-bristled toothbrush to prevent bleeding
•
That treatment is ongoing to prevent transplant rejection
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(aze-eh-lay′ik)
Azelex, Finacea
Func. class.:
Antiacne agent
Chem. class.:
Dicarboxylic acid
Active for
Staphylococcus epidermidis, Propionibacterium acnes
by inhibiting microbial protein synthesis in the cell
Mild to moderate inflammatory acne vulgaris, rosacea
Hypersensitivity
Precautions:
Pregnancy (B), breastfeeding; patients with dark complexions should be monitored for early signs of hypopigmentation
Calculator
•
Apply a thin film and massage into affected areas bid am and pm
Available forms:
Cream 20%, Gel 15%
•
Before applying, the affected areas should be thoroughly washed and patted dry. Then apply cream or gel and massage gently into the affected areas. Occlusive dressings or wrappings should not be used. Wash hands after applying.
•
Do not apply to the eye; avoid contact with the mouth, eyes, and other mucous membranes. If contact with the eye(s) occur, the eye(s) should be washed with large amounts of water; contact prescriber if ocular irritation persists.
•
Avoid concurrent use of alcoholic cleansers, astringents, abrasives, and peeling agents.
•
Store at room temperature, do not freeze.
MISC:
Allergic reaction
SKIN:
Itching, burning, stinging, dermatitis, peeling, erythema, edema, acne
Onset, peak, duration unknown; half-life 12 hr
•
Skin: assess for redness, irritation, stinging; if severe, product might need to be discontinued
•
Hypopigmentation: In patients with dark complexion
•
Therapeutic response: Decreased acne lesions
•
To thoroughly wash and pat dry the affected areas before applying product. Apply cream or gel and massage gently into the affected areas. Occlusive dressings or wrappings should not be used. Wash hands after applying.
•
Not to apply to the eye; avoid contact with the mouth, eyes, and other mucous membranes. If contact with the eyes occurs, wash with large amounts of water; contact prescriber if ocular irritation persists.
•
To avoid concurrent use of alcoholic cleansers, astringents, abrasives, and peeling agents.
•
To store at room temperature, not to freeze
•
To use for prescribed amount of time
•
To report burning, stinging, irritation
•
To report change in skin color
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(ah-zell′ah-steen)
Optivar
Func. class.:
Antihistamine (ophthalmic)
Chem. class.:
H
1
receptor antagonist
Decreases the allergic response by inhibiting histamine release
Pruritus from allergic conjunctivitis
Hypersensitivity
Precautions:
Pregnancy (C), breastfeeding, child <3 yr
Available forms:
Ophthalmic sol: 0.05%
•
Tip of dropper should not touch the eye
•
Store upright and tightly closed at room temperature
CNS:
Headache
EENT:
Eye burning/stinging/irritation, blurred vision, rhinitis, bitter taste
INTEG:
Pruritus
RESP:
Asthma, dyspnea, wheezing
Onset 3 min, duration 8 hr, half-life 22 hr, protein binding 88%
•
Eyes: for itching, redness, use of soft or hard contact lenses
•
Therapeutic response: Absence of redness, itching in the eyes
•
To use in the eyes only; not to touch dropper to eye/eyelid
•
Not to wear contact lenses if eyes are red and itching
•
To wait at least 10 min before inserting contact lenses, soft contact lenses can absorb preservative
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert