Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Mosby's 2014 Nursing Drug Reference (101 page)
(kloe-bay′ta-sol)
Clobex, Cormax, Olux, Olux-E, Temovate, Temovate-E
Func. class.:
Corticosteroid, topical
Crosses cell membrane to attach to receptors to decrease inflammation, itching
Inflammation/itching in corticosteroid-responsive dermatoses on the skin/scalp
Hypersensitivity, use of some preparations on face, axilla, groin; monotherapy for primary bacterial infections
Precautions:
Pregnancy (C), breastfeeding, children
Calculator
• Adult:
TOP
Apply to infected areas bid (shampoo: daily up to 4 times a week)
Available forms:
Gel, lotion, ointment, cream, shampoo, solution, spray, foam 0.05%
Do not use with occlusive dressings
Treatment should be limited to 2 wk
•
Cream/Ointment/Lotion:
Using gloves, apply sparingly in a thin film and rub gently into the cleansed, slightly moist affected area
•
Gel:
Using gloves, apply sparingly in a thin film and rub gently into the cleansed, slightly moist affected area
•
Scalp foam:
Invert can and dispense a small amount of foam onto a saucer or other cool surface. Do not dispense directly onto hands. Pick up small amounts of foam with fingers and gently massage into affected area until foam disappears. Repeat until entire affected scalp area is treated
•
Shampoo:
Apply onto dry scalp in thin film, leave lather on scalp for 15 min, rinse off
INTEG:
Burning, folliculitis, pruritus, dermatitis, irritation, erythema, hypertrichosis, acne
MISC:
Hyperglycemia
•
Skin reactions: burning, pruritus, folliculitis, dermatitis
•
Decreasing itching, inflammation on the skin, scalp
Do not use with occlusive dressings
Treatment should be limited to 2 wk
•
Cream/Ointment/Lotion:
To apply sparingly in a thin film and rub gently into the cleansed, affected area
•
Gel:
To apply sparingly in a thin film and rub gently into the cleansed, slightly moist affected area
•
Scalp foam:
To invert can and dispense a small amount of foam onto a saucer or other cool surface. Do not dispense directly onto hands. Pick up
small amounts of foam with fingers and gently massage into affected area until foam disappears. Repeat until entire affected scalp area is treated
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(kloe′mi-feen)
Clomid, Serophene
Func. class.:
Ovulation stimulant
Chem. class.:
Nonsteroidal antiestrogenic
Do not confuse:
clomiPHENE
/clomiPRAMINE
Serophen
/Sarafem
Increases LH, FSH release from the pituitary, which increases the maturation of the ovarian follicle, ovulation, and the development of the corpus luteum
Female infertility (ovulatory failure)
Unlabeled uses:
Oligospermia
Pregnancy (X), hypersensitivity, hepatic disease, undiagnosed uterine bleeding, uncontrolled thyroid or adrenal dysfunction, intracranial lesion, ovarian cysts, endometrial carcinoma
Precautions:
Hypertension, depression, seizures, diabetes mellitus, abnormal ovarian enlargement, ovarian hyperstimulation
Calculator
• Adult:
PO
50 mg/day × 5 days or 50 mg/day beginning on day 5 of menstrual cycle, may increase to 100 mg daily × 5 days with next cycle; may be repeated until conception occurs or max 6 cycles of therapy
• Adult (men):
PO
25 mg/day × 25 days then 5 days off cycle each mo
Available forms:
Tabs 50 mg
•
After discontinuing estrogen therapy
•
At same time daily to maintain product level, without regard to food
•
Avoid heat, moisture, light, store at room temperature
CNS:
Headache, depression
, restlessness, anxiety, nervousness, fatigue, insomnia, dizziness, flushing
CV:
Vasomotor flushing, phlebitis,
deep venous thrombosis
EENT:
Blurred vision, diplopia, photophobia
GI:
Nausea, vomiting, constipation
, abdominal pain, bloating,
hepatitis
GU:
Polyuria, urinary frequency,
birth defects, spontaneous abortions,
multiple ovulation, breast pain, oliguria, abnormal uterine bleeding, ovarian cyst, hypertrophy of ovary
INTEG:
Rash, dermatitis
, urticaria, alopecia
Metabolized in liver, excreted in feces
Decrease:
clomiPHENE effect—DHEA, black cohosh, chaste tree fruit
Decrease:
clomiPHENE effect—soy
Increase:
LFTs
•
LFTs before therapy: AST, ALT, alk phos
•
Serum progesterone, urinary excretion of pregnanediol to identify occurrence of ovulation
•
Ovarian size, cervical condition by pelvic examination
•
Rule out endometrial carcinoma in women >35 yr by endometrial biopsy
•
Therapeutic response: fertility
•
That multiple births are common
•
To notify prescriber immediately if low abdominal pain occurs; may indicate ovarian cyst, cyst rupture
•
To notify prescriber of photophobia, blurred vision, diplopia, abnormal bleeding
•
That, if dose is missed, to double it next time; if more than one dose is missed, to call prescriber
•
That response usually occurs 4-10 days after last day of treatment
•
About the method for taking, recording basal body temp to determine whether ovulation has occurred
•
If ovulation can be determined (there is a slight decrease in temp then a sharp increase with ovulation), to attempt coitus 3 days before and every other day until after ovulation
•
If pregnancy is suspected, to notify prescriber immediately (X)
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert