Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Mosby's 2014 Nursing Drug Reference (433 page)
(lor-ca-ser′in)
Belviq
Func. class.:
Weight-control agent (anorexiant)
Chem. class.:
Serotonin 2C (5-HT
2C
) receptor agonist
Decreases food consumption and decreases hunger by selectively activating 5-HT
2C
receptors
Obesity management
Pregnancy (X), breastfeeding, hypersensitivity, severe renal impairment
Precautions:
Children, other organic causes of obesity, anemia, AV block, bradycardia, bundle branch block, depression, dialysis, liver/kidney disease, multiple myeloma, neutropenia, suicidal ideation, Peyronie’s disease, pulmonary hypertension, sick sinus syndrome
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•
PO
10 mg bid; do not exceed recommended dosage
Available forms:
Tabs, film-coated 10 mg
•
For obesity if patient is on weight reduction program that includes dietary changes, exercise
•
May give without regard to food
CNS:
Insomnia, depression, serotonin syndrome, anxiety,
suicidal ideation,
dizziness, headache, fatigue
CV:
Bradycardia, hypertension
GI:
Diarrhea, constipation, nausea
HEMA:
Neutropenia, leukopenia, lymphopenia
INTEG:
Rash
MS:
Back pain
70% protein binding, half-life 11 hr
Increase:
life-threatening serotonin syndrome or NMS—SSRIs, SNRIs, serotonin-receptor agonists, sibutramine, MAOIs, linezolid, tricyclic antidepressants, buPROPion, lithium, DOPamine antagonist, traMADol
Increase:
risk of hypoglycemia with sulfonylureas and insulin
Increase:
Serotonin syndrome—St. John’s wort
•
Weight weekly; oral hypoglycemic dosage might need to be reduced in diabetic patients
•
Monitor blood glucose, CBC with differential, Hct/Hgb, serum prolactin
Pregnancy (X): do not use in pregnancy
Use caution in psychiatric disorders with emotional lability; assess for depression, suicidal thoughts/behaviors
•
Therapeutic response: decrease in weight
•
To avoid hazardous activities until stabilized on medication
•
To discuss unpleasant side effects
To notify prescriber if pregnancy is planned or suspected, pregnancy X
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(loo′sin-ak′tant)
Surfaxin
Func. class.:
Synthetic lung surfactant
Prevention of respiratory distress syndrome in premature neonates (RDS)
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Intratracheal
5.8 ml/kg birth weight divided in 4 doses; give each dose with neonate in a different position; provide positive pressure ventilation when stable; dosage may be repeated 4 times in first 48 hr
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(mir′a-beg′ron)
Myrbetriq
Func. class.:
Bladder antispasmodic
Chem. class.:
β
3
Adrenergic receptor agonist
Relaxes smooth muscles in urinary tract
Overactive bladder (urinary frequency, urgency), urinary incontinence
Hypersensitivity
Precautions:
Pregnancy (C), breastfeeding, children, kidney/liver disease, bladder obstruction, dialysis, hypertension
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• Adult:
PO
25 mg/day, may increase to 50 mg/day if needed
PO
Child–Pugh B or (CCr 15-29 ml/min, max 25 mg/day; Child–Pugh C or CCr <15 ml/min, not recommended
Available forms:
Tabs ext rel 25, 50 mg
•
Give whole; take with liquids; do not crush, chew, or break ext rel product; use without regard to meals
CNS:
Fatigue, dizziness, headache
CV:
Hypertension
EENT:
Xerophthalmia, blurred vision
GI:
Nausea, vomiting, anorexia, abdominal pain, constipation, diarrhea, dyspepsia
GU:
Dysuria, urinary retention, frequency, UTI, bladder discomfort
INTEG:
Rash, pruritus
MISC:
Arthralgia, back pain
RESP:
Pharyngitis
SYST:
Stevens–Johnson syndrome
71% protein binding, excretion 25% unchanged in urine, terminal half-life 50 hr, peak 3.5 hr
Increase:
Effect of digoxin, warfarin, desipramine, thioridazine, flecainide, propafenone
Increase:
risk of urinary retention with antimuscarinic agents (eg, atropine, scopolamine)
•
Urinary patterns: distention, nocturia, frequency, urgency, incontinence
•
LFTs at baseline, periodically
•
Monitor B/P
•
Decreasing dysuria, frequency, nocturia, incontinence
•
To avoid hazardous activities; dizziness can occur
•
Not to drink liquids before bedtime
•
About the importance of bladder maintenance