Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Mosby's 2014 Nursing Drug Reference (233 page)
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
OTC
)
(lan-so-prey′zole)
Prevacid, Prevacid SoluTab
Func. class.:
Antiulcer, proton pump inhibitor
Chem. class.:
Benzimidazole
Do not confuse:
Prevacid
/Pravachol/Prinivil
Suppresses gastric secretion by inhibiting hydrogen/potassium ATPase enzyme system in gastric parietal cell; characterized as gastric acid pump inhibitor because it blocks the final step of acid production
Gastroesophageal reflux disease (GERD), severe erosive esophagitis, poorly responsive systemic GERD, pathologic hypersecretory conditions (Zollinger-Ellison syndrome, systemic mastocytosis, multiple endocrine adenomas); possibly effective for treatment of duodenal, gastric ulcers, maintenance of healed duodenal ulcers
Unlabeled uses:
GERD (infants/neonates)
Hypersensitivity
Precautions:
Pregnancy (B), breastfeeding, children
Calculator
• Adult:
PO (OTC)
15 mg daily up to 14 days
• Adult:
PO
15 mg/day before eating for 4 wk then 15 mg/day to maintain healing of ulcers; associated with
Helicobacter pylori
: 30 mg lansoprazole, 500 mg clarithromycin, 1 g amoxicillin bid × 14 days or 30 mg lansoprazole, 1 g amoxicillin tid × 14 days
• Adult:
PO
60 mg/day, may give up to 90 mg bid, administer doses of >120 mg/day in divided doses
• Adult and adolescent:
PO
15-30 mg/day × 8 wk
• Child 1-11 yr (>30 kg):
PO
30 mg/day ≤12 wk
• Child 1-11 yr (≤30 kg):
PO
15 mg/day ≤12 wk
• Infant (unlabeled):
PO
1-1.74 mg/kg/day; limited data available
• Neonate (unlabeled):
PO
0.5-1 mg/kg/day
• Adult:
NG
Use 30 mg oral cap or 30 mg disintegrating tab
Available forms:
Del rel caps 15, 30 mg; orally disintegrating tabs 15, 30 mg
•
Swallow caps whole 30 min before eating; do not crush or chew caps; caps may be opened and contents sprinkled on food
•
Oral cap:
open cap and pour 1/4 of granules into NG feeding syringe with plunger removed, slowly add water and depress plunger, repeat until all granules used; flush tube with 15 ml water
•
Place on tongue, allow to dissolve, use without regard to water
•
Oral syringe:
dissolve 15 mg/4 ml or 30 mg/10 ml water, use extra water in syringe to remove all of the product
•
Oral disintegrating tab:
mix 30 mg tab in 10 ml water, give via NG tube, flush tube with 10 ml sterile water, clamp for 60 min
CNS:
Headache
GI:
Diarrhea, abdominal pain, vomiting, nausea,
constipation
, flatulence, acid regurgitation, anorexia, irritable colon, microscopic colitis
GU:
Hematuria,
glycosuria, impotence, kidney calculus, breast enlargement
Absorption after granules leave stomach 80%; plasma half-life 1½-2 hr; protein binding 97%; extensively metabolized in liver; excreted in urine, feces; clearance decreased in geriatric patients, renal/hepatic impairment
Decrease:
antiplatelets, effect of—clopidogrel
Increase:
lansoprazole, toxicity—fluvoxaMINE, voriconazole
Decrease:
lansoprazole absorption—sucralfate
Decrease:
absorption of ketoconazole, itraconazole, iron salts, calcium carbonate, atazanavir, ampicillin
Increase:
hypomagnesemia—loop/thiazide diuretics
Decrease:
lansoprazole effect—antimuscarinics, octreotide, H
2
-blockers, misoprostol
Decrease:
release of ext rel amphetamine/dextroamphetamine
•
Avoid use with dasatinib, delavirdine
•
Avoid use with red yeast rice, St. John’s wort
•
GI system:
bowel sounds q8hr, abdomen for pain, swelling, anorexia, blood in stool, emesis
•
Hepatic studies:
AST, ALT, alk phos during treatment
•
INR and prothrombin time when taking warfarin
•
Magnesium: low magnesium may occur
•
Therapeutic response: absence of epigastric pain, swelling, fullness
•
To report severe diarrhea; product may have to be discontinued
•
That hypoglycemia may occur if diabetic
•
To avoid hazardous activities; that dizziness may occur
•
To avoid alcohol, salicylates, ibuprofen; may cause GI irritation
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
lanthanum (Rx)
(lan′-tha-num)
Fosrenol
Func. class.:
Phosphate binder
End-stage renal disease
Hypophosphatemia, hypersensitivity
Calculator
• Adult:
PO
750-1500 mg/day in divided doses with meals; titrate dose q2-3wk until an acceptable phosphate level is reached; tabs should be chewed completely before swallowing; intact tabs should not be swallowed; maintenance dose 1500-3000 mg/day divided with meals
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
HIGH ALERTlapatinib (Rx)
(la-pa′tin-ib)
Tykerb
Func. class.:
Antineoplastic—miscellaneous
Chem. class.:
Biologic response modifier, signal transduction inhibitor (STIs)