Mosby's 2014 Nursing Drug Reference (56 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
• Child 2-15 yr: PO
10 mg/kg on day 1 then 5 mg/kg × 4 days
• Adult: PO
600 mg/day with ethambutol 15 mg/kg/day
• Adult: PO/IV
500 mg
IV
q24hr × 2 doses then 500 mg
PO
q24hr × 7-10 days
• Adult: PO
1 g single dose
• Adult: PO
2 g single dose
• Adult: PO
500 mg day 1, then 250 mg × 4 days
• Child: PO
5-12 mg/kg/day × 5 days
• Child >6 mo: PO
30 mg/kg as a single dose or 10 mg/kg/day × 3 days or 10 mg/kg as a single dose on day 1 (max 500 mg/day) then 5 mg/kg on days 2-5 (max 250 mg/day)
• Child: PO
10 mg/kg q wk × 6 mo
• Adult/adolescent/child ≥1 yr: OPHTHALMIC
1 drop in affected eye BID ×2 days, then 1 drop × next 5 days
• Adult: PO
500 mg/day
• Adult: PO
500 mg on day 1 then 250 mg/day for 2-5 days
• Infant <6 mo: PO
10 mg/kg/day × 5 days
Available forms:
Tabs 250, 500, 600 mg; powder for inj 500 mg; susp 100, 200 mg/5 ml 1 g single-dose powder for susp; ext rel powder for susp 2 g; ophthalmic drops 1% solution
•
Susp
1 hr before meal or 2 hr after meal; reconstitute 1 g packet for susp with 60 ml water, mix, rinse glass with more water and have patient drink to consume all medication; packets not for pediatric use
•
Reconstitute
500 mg of product with 4.8 ml sterile water for inj (100 mg/ml); shake,
dilute
with 250 or 500 ml 0.9% NaCl, 0.45% NaCl, or LR to 1-2 mg/ml; diluted sol stable for 24 hr or 7 days if refrigerated
•
Give
1 mg/ml sol over 3 hr or 2 mg/ml sol over 1 hr; never give IM or as bolus
Y-site compatibilities:
Aminocaproic acid, amphotericin B liposome, anidulafungin, atenolol, bivalirudin, bleomycin, CARBOplatin, CISplatin, cytarabine, DAPTOmycin, dexmedetomidine, diphenhydrAMINE, docetaxel, dolasetron, doripenem, doxacurium, droperidol, epirubicin, eptifibatide, ertapenem, fenoldopam, fluorouracil, IDArubicin, irinotecan, methochlorethamine, meperidine, nesiritide, octreotide, ondansetron, oxaliplatin, palonosetron, pamidronate, pantoprazole, pemetrexed, rocuronium, sodium acetate, tigecycline, tirofiban, TPN, vasopressin, vinCRIStine, voriconazole
CNS:
Dizziness, headache, vertigo, somnolence, myasthenia gravis
CV:
Palpitations, chest pain
EENT:
Hearing loss, tinnitus, loss of smell (anosmia)
GI:
Nausea, vomiting, diarrhea
,
hepatotoxicity,
abdominal pain, stomatitis, heartburn, dyspepsia, flatulence, melena,
cholestatic jaundice, pseudomembranous colitis,
tongue discoloration
GU:
Vaginitis, moniliasis, nephritis
HEMA:
Anemia
INTEG:
Rash, urticaria, pruritus, photosensitivity
SYST:
Angioedema, Stevens-Johnson syndrome, toxic epidermal necrolysis
PO:
Peak 2-4 hr, duration 24 hr
IV:
Peak end of inf; duration 24 hr; half-life 11-57 hr; excreted in bile, feces, urine primarily as unchanged product; may be inhibitor of P-glycoprotein
Increase:
ergot toxicity—ergotamine
Increase:
Dysrhythmias—pimozide: fatal reaction, do not use concurrently
Increase:
effects of oral anticoagulants, digoxin, theophylline, methylPREDNISolone, cycloSPORINE, bromocriptine, disopyramide, triazolam, carBAMazepine, phenytoin, tacrolimus, nelfinavir
Decrease:
clearance of triazolam
Decrease:
absorption of azithromycin—aluminum, magnesium antacids, separate by ≥2 hr
Increase:
CPK, ALT, AST, bilirubin, BUN, creatinine, alk phos
Decrease:
absorption—food (susp)
•
I&O ratio; report hematuria, oliguria with renal disease
•
Hepatic studies: AST, ALT, CBC with differential
•
Renal studies: urinalysis, protein, blood
•
C&S before product therapy; product may be taken as soon as culture is taken; C&S may be repeated after treatment
•
Serious skin reactions:
Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema; discontinue if rash develops, treat symptomatically
•
Superinfection:
sore throat, mouth, tongue; fever, fatigue, diarrhea, anogenital pruritus
•
Pseudomembranous colitis:
diarrhea, abdominal pain, fever, fatigue, anorexia; obtain CBC, serum albumin
•
Bowel pattern before, during treatment
•
Respiratory status: rate, character; wheezing, tightness in chest: discontinue product
•
Cardiovascular death has occurred in those with serious bradycardia or ongoing hypokalemia, hypomagnesemia, avoid use
•
Storage at room temperature
•
Therapeutic response: C&S negative for infection; decreased signs of infection
To report sore throat, fever, fatigue, severe diarrhea, anal/genital itching (may indicate superinfection)
•
Not to take aluminum-magnesium–containing antacids simultaneously with this product (PO)
To notify nurse of diarrhea, dark urine, pale stools; yellow discoloration of eyes, skin; severe abdominal pain
•
To complete dosage regimen
•
To take ZMAX 1 hr before or 2 hr after a meal; shake well before use
•
To use protective clothing or stay out of the sun, photosensitivity may occur
Withdraw product, maintain airway; administer EPINEPHrine, aminophylline, O
2
, IV corticosteroids
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
aztreonam (Rx)
(az-tree′oh-nam)
Azactam, Cayston
Func. class.:
Antibiotic—miscellaneous
Urinary tract infection; septicemia; skin, muscle, bone infection; lower respiratory tract, intraabdominal infections; other infections caused by gram-negative organisms
Hypersensitivity to product, penicillins, cephalosporins, severe renal disease
Calculator
• Adult: IM/IV
500 mg-1 g q8-12hr
• Adult: IM/IV
1-2 g q8-12hr
• Child: IM/IV
90-120 mg/kg/day in divided doses q6-8hr; max 8 g/day
IV
• Adult: IM/IV
2 g q6-8hr; max 8 g/day; continue treatment for 48 hr after negative culture or until patient is asymptomatic
Pseudomonas aeruginosa
• Adult, adolescent, child ≥7 yr: NEB
75 mg tid × 28 days, then 28 days off; give q4hr or more; give bronchodilator before aztreonam