Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Mosby's 2014 Nursing Drug Reference (347 page)
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
(rass-burr′i-case)
Elitek, Fasturtec
Func. class.:
Enzyme
Chem. class.:
Recombinant urate-oxidase enzyme
Catalyzes enzymatic oxidation of uric acid into an inactive and soluble metabolite (allantoin)
To reduce uric acid levels in children with leukemia, lymphoma, solid tumor malignancies who are receiving chemotherapy
Hypersensitivity
Black Box Warning:
G6PD deficiency (Mediterranean, African descendants), hemolytic reactions, methemoglobinemia reactions to product
Precautions:
Pregnancy (C), breastfeeding, children <2 yr, anemia
Black Box Warning:
Acute bronchospasm, angina, angioedema, atony, African-American and Mediterranean patients, hypotension, urticaria
Calculator
• Adult/adolescent/infant:
IV INF
0.2 mg/kg as single daily dose given as
IV INF
over 1/2 hr × 5 days
Available forms:
Powder for inj 1.5, 7.5 mg/vial
•
Reconstitute with diluent provided, add 1 ml of diluent/each vial, swirl, withdraw amount needed, mix with NS to final volume of 50 ml, use within 24 hr, give over 30 min, do not use filter, use different line; if not possible, flush with ≥15 ml of saline before, after use
•
Chemotherapy started 4-24 hr after 1st dose
CNS:
Headache
, fever
CV:
Chest pain, hypotension
GI:
Nausea, vomiting, anorexia, diarrhea, abdominal pain, constipation, dyspepsia, mucositis
HEMA:
Neutropenia with fever, hemolysis, methemoglobinemia
INTEG:
Rash
MISC:
Edema
RESP:
Bronchospasm,
wheezing, dyspnea
SYST:
Anaphylaxis, hemolysis, methemoglobinemia, sepsis
Elimination half-life 16-21 hr
Increase:
toxicity—allopurinol
•
Blood studies: BUN, serum uric acid, urine creatinine clearance, electrolytes, CBC with differential before, during therapy
•
Monitor temp; fever may indicate beginning infection; no rectal temps
Anaphylaxis:
dyspnea, urticaria, flushing, wheezing, swelling of lips, tongue, throat; have emergency equipment nearby
G6PD deficiency, hemolytic reactions, methemoglobinemia;
these patients should not be given this product; screen patients who are at higher risk for these disorders
•
GI symptoms: frequency of stools, cramping; if severe diarrhea occurs, fluid, electrolytes may need to be given
•
Therapeutic response: decreased uric acid levels in children when antineoplastics causing high uric acid levels used
•
About the reason for therapy, expected results
To report trouble breathing, jaundice, chest pain
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
HIGH ALERTremifentanil (Rx)
(rem-ih-fin′ta-nill)
Ultiva
Func. class.:
Opiate agonist analgesic
Chem. class.:
μ-Opioid agonist