Mosby's 2014 Nursing Drug Reference (317 page)

• Adult:
PO
400 mg tid with meals, may decrease to bid if side effects occur; must be taken for ≥8 wk for maximal effect

• Adult:
PO
300 mg bid × 2 wk then 300 mg/day

• Adult:
PO
400 mg tid

• Child:
PO
20 mg/kg/day in 3 divided doses with aspirin and IVIG

• 
Do not break, crush, or chew ext rel tabs

• 
With meals to prevent GI upset

Increase:
bleeding risk—warfarin, abciximab, eptifibatide, tirofiban, ticlopidine, clopidogrel, thrombin inhibitor

Increase:
theophylline level—theophylline

Increase:
hypotension—antihypertensives, nitrates

Increase:
pentoxifylline—cimetidine, ciprofloxacin

• 
B/P, respirations of patient also taking antihypertensives; intermittent claudication at baseline and throughout

• 
PT, Hgb, Hct in patients at risk for hemorrhage

• 
Serum creatinine/BUN

• 
Therapeutic response: decreased pain, cramping, increased ambulation

• 
That therapeutic response may take 2-4 wk, 8-12 wk to reach full benefit

• 
To observe feet for arterial insufficiency

• 
To wear cotton socks, well-fitted shoes; not to go barefoot

• 
To watch for bleeding, bruises, petechiae, epistaxis

• 
To avoid smoking to prevent blood vessel constriction

• 
That there are many drug, herb interactions

• Adult:
PO
4 mg/day, may increase or decrease to desired response, range 4-8 mg/day; may give in 2 divided doses or as single dose, max 16 mg/day

• Adult:
PO
2-4 mg/day in 1-2 divided doses, range 4-8 mg/day

• Adult:
PO
4 mg/day × 2 wk then increase as tolerated to 8 mg/day

• Adult:
PO
CCr 16-29 ml/min, 2 mg every other day; CCr 30-59 ml/min, 2 mg/day

• 
As single dose or in 2 divided doses, without regard to meals

Increase:
effects of neuromuscular blocking agents, antihypertensives, lithium

Increase:
antihypertensive effect—diuretics, NSAIDs

Increase:
hypersensitivity—allopurinol

Increase:
severe hypotension—diuretics, other antihypertensives

Increase:
hyperkalemia—salt substitutes, potassium-sparing diuretics, potassium supplements

Decrease:
effects of NSAIDs

Decrease:
antihypertensive effect—NSAIDs, salicylates

Increase:
antihypertensive effect—hawthorn

Decrease:
antihypertensive effect—ephedra

Interference:
glucose/insulin tolerance tests

• 
Hypertension:
B/P, pulse q4hr; note rate, rhythm, quality

• 
Electrolytes: K, Na, Cl during 1st 2 wk of therapy

• 
Baselines of renal, hepatic studies before therapy begins, 1 wk into therapy

• 
Skin turgor, dryness of mucous membranes for hydration status, dry mouth

• 
CHF:
edema, dyspnea, wet crackles

• 
Angioedema:
facial swelling, urticaria; product should be discontinued, may be more common in African Americans

• 
Therapeutic response: decreased B/P

• 
Not to use OTC (cough, cold, allergy) products unless directed by prescriber; to avoid salt substitutes

• 
To avoid sunlight or to wear sunscreen for photosensitivity

• 
To comply with dosage schedule, even if feeling better

• 
To notify prescriber of mouth sores, sore throat, fever, swelling of hands or feet, irregular heartbeat, chest pains, signs of angioedema

• 
That excessive perspiration, dehydration, vomiting, diarrhea may lead to fall in B/P; to consult prescriber if these occur

• 
That product may cause dizziness, fainting; that lightheadedness may occur during 1st few days of therapy

• 
That product may cause skin rash or impaired perspiration; that angioedema may occur and to discontinue product if it occurs

• 
Not to discontinue product abruptly

• 
To rise slowly to sitting or standing position to minimize orthostatic hypotension

Black Box Warning:

To notify prescriber if pregnancy is planned or suspected; pregnancy category (D)