Mosby's 2014 Nursing Drug Reference (64 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
HIGH ALERTbicalutamide (Rx)
(bye-kal-u′ta-mide)
Casodex
Func. class.:
Antineoplastic hormone
Chem. class.:
Nonsteroidal antiandrogen
Do not confuse:
Casodex
/Kapidex
Binds to cytosolic androgen in target tissue, which competitively inhibits the action to androgens
Stage D-2 metastatic prostate cancer in combination with luteinizing-hormone releasing hormone (LHRH) analog
Unlabeled uses:
Recurrent priapism
Pregnancy (X), women, hypersensitivity
Precautions:
Breastfeeding, geriatric patients, renal/hepatic disease, diabetes mellitus
Calculator
• Adult: PO
50 mg/day with LHRH analog
• Adult: PO
50 mg every other day
Available forms:
Tabs 50 mg
•
At same time each day, either
AM
or
PM
, with/without food
•
With LHRH treatment; start both products at same time
CNS:
Dizziness, paresthesia, insomnia, anxiety, neuropathy, headache
CV:
CHF,
edema, hot flashes
, hypertension, chest pain,
MI
GI:
Diarrhea, constipation, nausea
, vomiting, increased hepatic enzymes, anorexia, dry mouth, melena,
abdominal pain
,
hepatitis, hepatotoxicity
GU:
Nocturia, hematuria
, UTI, impotence, gynecomastia; urinary incontinence, frequency, dysuria, retention, urgency; breast tenderness, decreased libido
INTEG:
Rash, sweating, dry skin, pruritus, alopecia
MISC:
Infection
, anemia, dyspnea, bone pain, headache,
asthenia, back pain
, flulike symptoms
Well absorbed; peak 31½ hr; metabolized by liver; excreted in urine, feces; half-life 5.8 days; 96% protein binding
Increase:
anticoagulation—anticoagulants
Increase:
bicalutamide effects—CYP3A4 inhibitors (amiodarone, antiretrovirals, protease inhibitors, clarithromycin, dalfopristin, quinupristin, delavirdine, efavirenz, erythromycin, FLUoxetine, fluvoxaMINE, imatinib, mifepristone, RU-486, nefazodone, some azole antifungals)
Decrease:
bicalutamide effects—CYP3A4 inducers (barbiturates, bosentan, carBAMazepine, dexamethasone, nevirapine, OXcarbazepine, phenytoins, rifabutin, rifampin, rifapentine)
•
May require dosage change when used with St. John’s wort
•
Do not use with grapefruit juice
Increase:
AST, ALT, bilirubin, BUN, creatinine
Decrease:
Hgb, WBC
•
For diarrhea, constipation, nausea, vomiting
•
For hot flashes, gynecomastia; assure patient that these are common side effects
•
Prostate-specific antigen, LFTs
•
Therapeutic response: decreased tumor size, decreased spread of malignancy
•
To recognize, report signs of anemia, hepatoxicity, renal toxicity
•
That hair may be lost but this is reversible after therapy is completed
•
Not to use other products unless approved by prescriber
•
To report severe diarrhea
•
To use contraception while taking this product
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(ophthalmic/topical)
(by-mat′oh-prost)
Latisse, Lumigan
Func. class.:
Antiglaucoma agent
Chem. class.:
Prostaglandin agonist
Do not confuse:
latanoprost/
travoprost
Promotion of eyelash growth, thickness, and darkness
: unknown; possible increase in the percent of hairs and an increase in the duration of the hair growth (anagen) phase
Reduction of intraocular pressure (IOP) in patients with ocular hypertension or open-angle glaucoma;
selectively mimics endogenous prostamides to produce ocular hypotension
Increased intraocular pressure in those with open-angle glaucoma/ocular hypertension (Lumigan); eyelash hypotrichosis (Latisse)
Hypersensitivity to this product, benzalkonium chloride
Precautions:
Children, intraocular inflammation, closed-angle glaucoma, macular edema, contact lenses
Calculator
• Adult: OPHTH Instill
1 drop in each affected eye (conjunctival sac) every night
• Adult: Apply
1 drop to skin of upper eyelid margin at base of eyelashes every night using a new supplied disposable sterile applicator
Available forms:
Ophthalmic solution 0.01%, 0.03%; topical solution 0.03%
Conjunctival hyperemia, growth of eyelashes (hypertrichosis), ocular pigment changes ocular pruritus
, xerophthalmia, visual disturbance, ocular irritation/burning, foreign body sensation, ocular pain, blepharitis, cataracts, superficial punctate keratitis
INTEG:
Hyperpigmentation of the periocular skin, eyelash darkening, lacrimation, photophobia, conjunctivitis, asthenopia, iritis, macular edema
MISC:
Influenza, upper respiratory tract infections, asthenia, headache, hirsutism
Ophthalmic: Onset 4 hr, peak 8-12 hr; half-life 45 min
Decrease:
Intraocular pressure lowering effect—latanoprost, travoprost (no longer available in the US)
Increase:
LFTs
•
Intraocular pressure:
in those with ongoing increased IOP or those using latanoprost, travoprost (no longer available in the US)
•
Decreasing IOP or increased growth of eyelashes
•
To wash hands before and after use; remove contact lenses before use and reinsert 15 min after use; Lumigan contains benzalkonium chloride, which can be absorbed by soft contact lenses
•
To tilt the head back slightly and pull the lower eyelid down with the index finger to form a pouch. Squeeze the prescribed number of drops into the pouch and gently close the eyes for 1–2 min; do not blink; to avoid contamination, do not touch the tip of the dropper to the eye, fingertips, or other surface
•
That the solution may be used concomitantly with other topical ophthalmic drug products to lower IOP. If more than one topical ophthalmic drug is being used, the drugs should be administered at least 5 min apart
•
To ensure the patient’s face is clean and makeup is removed before using Latisse; the disposable sterile applicator is the only applicator that should be used. Each applicator should be used for 1 eye only; dispose of the applicator after each use; after applying 1 drop of solution to the applicator, apply evenly along the skin of the upper eyelid margin at the base of the eyelashes; blot excess solution runoff outside the upper eyelid margin with a tissue or other absorbent cloth; do not apply to the lower eyelash line