Mosby's 2014 Nursing Drug Reference (61 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
benzonatate (Rx)
(ben-zoe′na-tate)
Tessalon Perles, Zonatuss
Func. class.:
Antitussive, nonopioid
Nonproductive cough
Hypersensitivity
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(benz′troe-peen)
Cogentin
Func. class.:
Cholinergic blocker, antiparkinson’s agent
Chem. class.:
Tertiary amine
Blockade of central acetylcholine receptors, balances cholinergic activity
Parkinson’s symptoms, EPS associated with neuroleptic products, acute dystonic reactions, hypersalivation
Children <3 yr, hypersensitivity, closed-angle glaucoma, myasthenia gravis, GI/GU obstruction, peptic ulcer, megacolon, prostate hypertrophy, dementia, tardive dyskinesia
Precautions:
Pregnancy (C), breastfeeding, children, geriatric patients, tachycardia, renal/hepatic disease, substance abuse history, dysrhythmias, hypo/hypertension, psychiatric patients
Calculator
• Adult: IM/IV/PO
1-4 mg daily/bid; give
PO
dose as soon as possible
• Child >3 yr: IM/IV/PO
0.02-0.05 mg/kg/dose 1-2×/day
• Adult: PO/IM
0.5-1 mg at bedtime; increase by 0.5 mg q5-6days titrated to patient response, max 6 mg/day
• Adult: IM/IV
1-2 mg, may increase to 1-2 mg bid
(PO)
Available forms:
Tabs 0.5, 1, 2 mg; inj 1 mg/ml
•
With or after meals to prevent GI upset; may give with fluids other than water
•
At bedtime to avoid daytime drowsiness with parkinsonism
•
Inject deeply in muscle, use filtered needle to remove solution from ampule
•
Undiluted
IV (1 mg 5 1 ml):
give
1 mg/1 min (rarely used)
Syringe compatibilities:
Metoclopramide, perphenazine
Y-site compatibilities:
Fluconazole, tacrolimus
CNS:
Anxiety, restlessness, irritability, delusions, hallucinations, headache, se
dation, depression, incoherence, dizziness, memory loss;
confusion;
delirium (geriatric patients)
CV:
Palpitations, tachycardia, hypotension, bradycardia
EENT:
Blurred vision, photophobia, dilated pupils, difficulty swallowing
GI:
Dryness of mouth, constipation
, nausea, vomiting, abdominal distress,
paralytic ileus
GU:
Urinary hesitancy/retention, dysuria
INTEG:
Rash, urticaria, dermatoses
MISC:
Increased temperature, flushing, decreased sweating,
hyperthermia, heat stroke,
numbness of fingers
PO:
Onset 1 hr, duration 6-10 hr
IM/IV:
Onset 15 min, duration 6-10 hr
Increase:
anticholinergic effect—amantadine; antihistamines, phenothiazines, tricyclics, disopyramide, quiNIDine; reduce dose
Decrease:
absorption—antidiarrheals, antacids
Decrease:
anticholinergic effect of—cholinergic
•
Parkinsonism:
EPS, shuffling gait, muscle rigidity, involuntary movements, loss of balance
•
Paralytic ileus: abdominal pain, intermittent constipation/diarrhea
•
I&O ratio; commonly causes decreased urinary output; urinary hesitancy, retention; palpate bladder if retention occurs
•
Constipation: increase fluids, bulk, exercise if this occurs
•
Mental status: affect, mood, CNS depression, worsening of mental symptoms during early therapy
•
Use caution during hot weather; product may increase susceptibility to heat stroke by decreasing sweating
•
With benztropine “buzz” or “high,” patients may imitate EPS
•
Storage at room temp
•
Hard candy, gum, frequent drinks to relieve dry mouth
•
Therapeutic response: absence of involuntary movements after 2 days of treatment
•
To report urinary hesitancy/retention, dysuria
•
That tabs may be crushed, mixed with food, may take whole dose at bedtime if approved by prescriber
•
Not to discontinue product abruptly; to taper off over 1 wk or withdrawal symptoms may occur (EPS, tremors, insomnia, tachycardia, restlessness); to take as directed; not to double dose
•
To avoid driving, other hazardous activities; drowsiness/dizziness may occur
•
To avoid OTC medications: cough, cold preparations with alcohol, antihistamines, antacids, antidiarrheals within 2 hr unless directed by prescriber
•
To change positions slowly to prevent orthostatic hypotension
•
To use good oral hygiene, frequent sips of water, sugarless gum for dry mouth
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(beh-pot′uh-steen)
Bepreve
Func. class.:
Antihistamine (ophthalmic)
Chem. class.:
Histamine 1 receptor antagonist
A topically active, direct H
1
- receptor antagonist and mast cell stabilizer; by reducing these inflammatory mediators, relieves the ocular pruritus associated with allergic conjunctivitis
Ocular pruritus associated with signs and symptoms of allergic conjunctivitis
Hypersensitivity
Precautions:
Pregnancy (C), breastfeeding, children, contact lenses
Calculator
• Adult/child ≥2 yrs: OPHTH
Instill 1 drop in each eye bid, max 2 drops/day in each eye
Available forms:
Ophthalmic solution 1.5%
•
For topical ophthalmic use only
•
Wash hands before and after use. Tilt the head back slightly and pull the lower eyelid down with the index finger. Squeeze the prescribed number of drops into the conjunctival sac and gently close eyes for 1–2 min, do not blink
•
Do not touch the tip of the dropper to the eye, fingertips, or other surface
•
Wait ≥10 min after instilling the ophthalmic solution before inserting contact lenses; contact lenses should not be worn if eye is red. The preservative in this product may be absorbed by soft contact lenses
•
Do not share ophthalmic drops with others
CNS:
Headache
EENT:
Taste change, ocular irritation, pharyngitis
•
Eyes: for itching, redness, use of soft or hard contact lenses
•
Therapeutic response: absence of redness, itching in the eyes
•
Product is for topical ophthalmic use only
•
Wash hands before and after use. Tilt the head back slightly and pull the lower eyelid down with the index finger. Squeeze the prescribed number of drops into the conjunctival sac and gently close eyes for 1–2 min, do not blink
•
Do not touch the tip of the dropper to the eye, fingertips, or other surface
•
Wait ≥10 min after instilling the ophthalmic solution before inserting contact lenses; contact lenses should not be worn if eye is red
•
Do not share ophthalmic drops with others
•
Remove
contact lenses
before use because the preservative, benzalkonium chloride, may be absorbed by soft contact lenses; product should not be used to treat contact lens–related irritation