Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Mosby's 2014 Nursing Drug Reference (297 page)
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
(nye-stat′in)
Bio-Statin, Pediaderm AF, Nyamyc
Func. class.:
Antifungal
Chem. class.:
Amphoteric polyene
Interferes with fungal DNA replication; binds sterols in fungal cell membrane, which increases permeability, leaking of cell nutrients
Candida
species causing oral, intestinal infections
Hypersensitivity
Precautions:
Pregnancy (C)
Calculator
• Adult/adolescent/child:
SUSP
400,000-600,000 units qid, use 1/2 dose in each side of mouth, swish and swallow, use for at least 48 hr after symptoms resolved
• Infant:
SUSP
200,000 units qid (100,000 units in each side of mouth)
• Newborn and premature infant:
SUSP
100,000 units qid
• Adult/child:
TROCHES
200,000-400,000 units qid × ≤2 wk
• Adult:
PO
500,000-1,000,000 units tid
• Adult/child:
Top cream/ointment
apply to affected area bid;
powder
apply to affected area bid-tid
• Adult vag tab:
100,000 units daily at bedtime × 14 days
Available forms:
Tabs 500,000 units; powder for oral susp 50 million, 150 million, 500 million; susp 100,000 units per ml; oral caps 500,000, 1,000,000 units, bulk powder
•
Oral susp dose by placing 1/2 in each cheek, then swallow; do not mix with food
•
Topical dose after cleansing area; mouth may be swabbed; very moist lesions best treated with topical powder
GI:
Nausea, vomiting, anorexia, diarrhea, cramps
INTEG:
Rash, urticaria (rare)
PO:
Little absorption, excreted in feces
•
Allergic reaction:
rash, urticaria, irritated oral mucous membranes; product may have to be discontinued
•
Obtain culture, histologic tests to confirm organism
•
Predisposing factors: antibiotic therapy, pregnancy, diabetes mellitus, sexual partner infection (vaginal infections)
•
Storage at room temp for oral susp; tabs in tight, light-resistant containers at room temp
•
Therapeutic response: culture negative for
Candida
•
That long-term therapy may be needed to clear infection; to complete entire course of medication
•
To avoid commercial mouthwashes for mouth infection
•
To shake susp before measuring each dose
•
To notify prescriber of irritation; product may have to be discontinued
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
See
Appendix B
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(ok-tree′oh-tide)
SandoSTATIN, SandoSTATIN LAR Depot
Func. class.:
Growth hormone, antidiarrheal
Chem. class.:
Synthetic octapeptide
A potent growth hormone similar to somatostatin
SandoSTATIN:
acromegaly, improves symptoms of carcinoid tumors, vasoactive intestinal peptide tumors (VIPomas);
LAR Depot:
long-term maintenance of acromegaly, carcinoid tumors, VIPomas
Unlabeled uses:
GI fistula, variceal bleeding, diarrheal conditions, pancreatic fistula, irritable bowel syndrome, dumping syndrome, short bowel syndrome, insulinoma, hepatorenal syndrome
Hypersensitivity
Precautions:
Pregnancy (B), breastfeeding, children, geriatric patients, diabetes mellitus, hypothyroidism, renal disease
Calculator
• Adult:
SUBCUT/IV
(SandoSTATIN) 50-100 mcg bid-tid, adjust q2wk based on growth hormone levels or
IM
(SandoSTATIN LAR) 20 mg q4wk × 3 mo, adjust based on growth hormone levels
• Adult:
SUBCUT/IV
(SandoSTATIN) 200-300 mcg/day in 2-4 doses for 2 wk, or
IM
(SandoSTATIN LAR) 20 mg q4wk × 2 mo, adjust dose
• Adult:
SUBCUT/IV
(SandoSTATIN) 100-600 mcg/day in 2-4 doses for 2 wk, titrated to patient response or
IM
(SandoSTATIN LAR) 20 mg q4wk × 2 mo, adjust dose
• Adult:
SUBCUT
(SandoSTATIN) 50-200 mcg q8hr
• Adult:
SUBCUT
(SandoSTATIN) 50 mcg q8hr prn, increase to 500 mcg q8hr
• Adult:
SUBCUT
(SandoSTATIN) 100 mcg in single dose, up to 125 mcg bid
• Adult:
SUBCUT
(SandoSTATIN) 50-150 mcg/day
• Adult:
IV
(SandoSTATIN) 25-50 mcg/hr
CONT IV INF
for 18 hr-5 days
Available forms:
Inj (SandoSTATIN) 0.05, 0.1, 0.2, 0.5, 1 mg/ml; inj powder for susp (LAR depot) 10, 20, 30 mg/5 ml
•
Reconstitute with diluent provided; give in gluteal region
•
Rotate inj site; use hip, thigh, abdomen
•
Avoid using medication that is cold; allow to reach room temp; do not use LAR depot
•
IV direct:
give over 3 min; during an emergency carcinoid crisis, give rapid bolus
•
Intermittent IV inf:
dilute in 50-200 ml D
5
W, 0.9% NaCl; give over 15-30 min
Y-site compatibilities:
Acyclovir, alfentanil, allopurinol, amifostine, amikacin, aminocaproic acid, aminophylline, amiodarone, amphotericin B colloidal, amphotericin B lipid complex, amphotericin B liposome, ampicillin, ampicillin-sulbactam, anidulafungin, argatroban, arsenic trioxide, atenolol, atra
curium, azithromycin, aztreonam, bivalirudin, bleomycin, bumetanide, buprenorphine, busulfan, butorphanol, calcium chloride/gluconate, capreomycin, CARBOplatin, carmustine, caspofungin, ceFAZolin, cefepime, cefotaxime, cefoTEtan, cefOXitin, cefTAZidime, ceftizoxime, cefTRIAXone, cefuroxime, chloramphenicol, chlorproMAZINE, cimetidine, ciprofloxacin, cisatracurium, CISplatin, clindamycin, cyclophosphamide, cycloSPORINE, cytarabine, dacarbazine, DACTINomycin, DAPTOmycin, DAUNOrubicin, DAUNOrubicin liposome, dexamethasone, digoxin, diltiazem, diphenhydrAMINE, DOBUTamine, DOCEtaxel, dolasetron, DOPamine, DOXOrubicin, DOXOrubicin liposomal, doxycycline, droperidol, enalaprilat, ePHEDrine, EPINEPHrine, epirubicin, eptifibatide, ertapenem, erythromycin, esmolol, etoposide, famotidine, fenoldopam, fentaNYL, fluconazole, fludarabine, fluorouracil, foscarnet, fosphenytoin, furosemide, gallium nitrate, ganciclovir, gatifloxacin, gemcitabine, gentamicin, glycopyrrolate, granisetron, haloperidol, heparin, hydrALAZINE, hydrocortisone, HYDROmorphone, hydrOXYzine, IDArubicin, ifosfamide, imipenem-cilastatin, insulin (regular), irinotecan, isoproterenol, ketorolac, labetalol, lansoprazole, leucovorin, levofloxacin, lidocaine, linezolid, LORazepam, magnesium sulfate, mannitol, mechlorethamine, melphalan, meperidine, meropenem, mesna, methohexital, methotrexate, methyldopate, methylPREDNISolone, metoclopramide, metoprolol, metroNIDAZOLE, midazolam, milrinone, minocycline, mitoMYcin, mitoXANtrone, mivacurium, morphine, moxifloxacin, mycophenolate, nafcillin, nalbuphine, naloxone, nesiritide, niCARdipine, nitroglycerin, nitroprusside, norepinephrine, ondansetron, oxaliplatin, PACLitaxel, palonosetron, pamidronate, pancuronium, PEMEtrexed, pentamidine, pentazocine, PENTobarbital, PHENobarbital, phenylephrine, piperacillin, piperacillin-tazobactam, polymyxin B, potassium acetate/chloride/phosphates, procainamide, prochlorperazine, promethazine, propranolol, quiNIDine, quinupristin-dalfopristin, ranitidine, remifentanil, rocuronium, sodium acetate/bicarbonate/phosphates, streptozocin, succinylcholine, SUFentanil, sulfamethoxazole-trimethoprim, tacrolimus, teniposide, thiopental, thiotepa, ticarcillin, ticarcillin-clavulanate, tigecycline, tirofiban, tobramycin, topotecan, vancomycin, vasopressin, vecuronium, verapamil, vinBLAStine, vinCRIStine, vinorelbine, voriconazole, zidovudine, zoledronic acid
CNS:
Headache, dizziness, fatigue, weakness
, depression, anxiety, tremors,
seizure,
paranoia
CV:
Sinus bradycardia, conduction abnormalities
,
dysrhythmias,
chest pain, SOB, thrombophlebitis, ischemia,
CHF,
hypertension, palpitations,
QT prolongation, ST- or T-wave changes
ENDO:
Hypo/hyperglycemia, ketosis, hypothyroidism
, galactorrhea, diabetes insipidus
GI:
Diarrhea, nausea, abdominal pain, vomiting, flatulence, distention, constipation
,
hepatitis,
increased LFTs,
GI bleeding, pancreatitis,
cholelithiasis, ileus
GU:
UTI
HEMA:
Hematoma of inj site, bruise
INTEG:
Rash, urticaria, pain; inflammation at inj site
MS:
Joint and muscle pain
Absorbed rapidly, completely; peak 1/2 hr (subcut/IV), 2-3 wk (IM); half-life 1.7 hr, duration 12 hr, excreted unchanged in urine
Increase:
QT prolongation—class IA/III antidysrhythmics, some phenothiazines, β agonists, local anesthetics, tricyclics, haloperidol, chloroquine, droperidol, pentamidine; CYP3A4 inhibitors
(amiodarone, clarithromycin, erythromycin, telithromycin, troleandomycin), arsenic trioxide, levomethadyl; CYP3A4 substrates (methadone, pimozide, QUEtiapine, quiNIDine, risperiDONE, ziprasidone)
Decrease:
effect of—cycloSPORINE
Decrease:
absorption of dietary fat, vit B
12
levels
Increase:
glucose
Decrease:
T
4
, thyroid function tests, vit B12, glucose
•
Growth hormone antibodies, IGF-1 at 1- to 4-hr intervals for 8-12 hr after dose
(acromegaly)
; 5-HIAA, plasma serotonin; blood glucose, serotonin levels
(carcinoid tumors)
, plasma substance P, plasma vasoactive intestinal peptide
(VIP) (VIPoma)
•
Thyroid function tests: T
3
, T
4
, T
7
, TSH to identify hypothyroidism
•
Fecal fat, serum carotene, somatomedin-C q 14 days, glucose; plasma serotonin levels (carcinoid tumors); plasma vasoactive intestinal peptide levels (VIPoma); serum growth hormone, serum IGF-1 baseline and periodically, diabetes to monitor blood glucose
•
Allergic reaction:
rash, itching, fever, nausea, wheezing
Cardiac status:
bradycardia, conduction abnormalities, dysrhythmias; monitor ECG for QT prolongation, low voltage, axis shifts, early repolarization, R/S transition, early wave progression
•
Gall bladder disease, pancreatitis: monitor closely
•
Storage in refrigerator for unopened amps, vials or at room temp for 2 wk; protect from light; do not use discolored or cloudy sol
•
Therapeutic response: relief of diarrhea in patients with AIDS, improves symptoms of carcinoid or VIP tumors; data is insufficient regarding whether products decrease size/rate of tumor growth; decreasing symptoms of acromegaly
•
That regular assessments are required, diabetics to monitor blood glucose
•
About SUBCUT inj if patient or other persons will be giving inj
That product may cause dizziness, drowsiness, weakness; to avoid hazardous activities if these occur; to report abdominal pain immediately
•
That pregnancy may occur in acromegaly because fertility may be restored
•
That in diabetes, to monitor glucose regularly