Mosby's 2014 Nursing Drug Reference (127 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
OTC
)
(dex-troe-meth-or′fan)
Balminil
, Benylin, Buckley’s DM, Buckley’s Mixture, Delsym 12-Hour, ElixSure Cough, Koffex, Robitussin, Robitussin Cough with honey, Robitussin Long Acting Strength, Scot-Tussin Diabetes CF, Silphen-DM, Top Care Day Time Cough, Top Care Tussin Cough Suppressant Long-Acting, Triaminic Long Acting Cough, Tylenol Children’s Simply Cough, Vicks DayQuil Cough, Vicks Formula 44, Wal-Tussin
Func. class.:
Antitussive, nonopioid
Chem. class.:
Levorphanol derivative
Depresses cough center in medulla by direct effect
Nonproductive cough caused by colds or inhaled irritants
Hypersensitivity
Precautions:
Pregnancy (C), fever, hepatic disease, asthma/emphysema, chronic cough
Calculator
• Adult and child ≥12 yr: PO
10-20 mg q4hr or 30 mg q6-8hr, max 120 mg/day;
SUS-REL LIQ
60 mg q12hr, max 120 mg/day
• Child 6-12 yr: PO
5-10 mg q4hr;
SUS REL LIQ
30 mg bid,
LOZ
5-10 mg q1-4hr; max 60 mg/day
• Child 4-6 yr: PO
2.5-7.5 mg q4-8hr, max 30 mg/day;
SUS REL LIQ
15 mg bid
•
Child <2-5 yr:
2.5-5 mg q4hr or 7.5 mg q6-8hr, max 30 mg/day;
EXT REL
not recommended
Available forms:
Liq 7.5, 15 mg/5 ml; syr 10 mg/5 ml, 15 mg/5 ml, 30 mg/15
ml; gel caps 15 mg; caps 15 mg; ext rel susp: 30 mg/5 ml
•
Chew tabs:
chew well;
syrup:
use calibrated measuring device;
ext rel susp:
shake well, use calibrated measuring device
•
Decreased dose for geriatric patients; metabolism may be slowed
CNS:
Dizziness
, sedation, confusion, ataxia, fatigue
GI:
Nausea
PO:
Onset 15-30 min, duration 3-6 hr
SUS:
Duration 12 hr, terminal half-life 11 hr, metabolized by the liver, excreted via kidneys
•
Do not give with MAOIs or within 2 wk of MAOIs; avoid furazolidone, linezolid, procarbazine (MAOI activity)
Increase:
CNS depression—alcohol, antidepressants, antihistamines, opioids, sedative/hypnotics
Increase:
adverse reactions—amiodarone, quiNIDine, serotonin receptor agonist, sibutramine, SSRI
•
Cough:
type, frequency, character, including sputum
•
Increase fluids to liquify secretions
•
Therapeutic response: absence of cough
•
To avoid driving, other hazardous activities until stabilized on medication
•
To avoid smoking, smoke-filled rooms, perfumes, dust, environmental pollutants, cleaners that increase cough
•
To avoid alcohol, CNS depressants
•
To notify prescriber if cough persists over a few days
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
D
-glucose) (Rx)
Func. class.:
Caloric, parenteral solution
Needed for adequate utilization of amino acids; decreases protein, nitrogen loss; prevents ketosis
Increases intake of calories; increases fluids in patients unable to take adequate fluids, calories orally; acute hypoglycemia
Hyperglycemia, delirium tremens, hemorrhage (cranial/spinal), CHF, anuria, allergy to corn products (concentrated products)
Precautions:
Cardiac/renal/hepatic disease, diabetes mellitus, carbohydrate intolerance
Calculator
•
Adult: PO/IV
10-25 mg g/dose (20-50 ml of a 50% sol), may need subsequent continuous IV infusion of 10% dextrose
• Neonate/infant: IV
250-500 mg/kg/dose (25% sol)
Available forms:
Inj 2.5%, 5%, 10%, 20%, 25%, 30%, 38.5%, 40%, 50%, 60%, 70%; oral gel 40%; chew tab 5 g
• Do not use concentrated solutions IM/IV; 25%, 50% may be used IV
•
Only (4%) protein and dextrose (up to 12.5%) via peripheral vein; stronger sol: central IV administration
•
May be given undiluted via prepared sol; give 10% sol, 5 ml/15 sec; 10% sol, 1000 ml/3 hr or more; 20% sol, 500 ml/1/2-1 hr; 50% sol, 10 ml/min; control rate, rapid inf may cause fluid shifts, do not use same inf set as used for blood,
never discontinue hypertonic products abruptly
•
To reduce contamination, all IV sets should be replaced ≤24 hr
•
Oral glucose preparations (gel, chew tabs) to be used in conscious patients only; check serum blood glucose 10 min after 1st dose
CNS:
Confusion,
loss of consciousness,
dizziness
CV:
Hypertension,
CHF, pulmonary edema, intracranial hemorrhage
ENDO:
Hyperglycemia, rebound hypoglycemia, hyperosmolar syndrome, hyperglycemic nonketotic syndrome, aluminum toxicity, hypokalemia, hypomagnesium
GI:
Nausea
GU:
Glycosuria, osmotic diuresis
INTEG:
Chills, flushing, warm feeling, rash, urticaria, extravasation necrosis
RESP:
Pulmonary edema
Increase:
fluid retention/electrolyte excretion—corticosteroids
Increase:
glucose
•
Electrolytes (potassium, sodium, calcium, chlorine, magnesium), blood glucose, ammonia, phosphate
•
Inj site for extravasation: redness along vein, edema at site, necrosis, pain; hard, tender area; site should be changed immediately
•
Monitor temp for increased fever, indicating infection; if infection suspected, discontinue inf, culture tubing, bottle, catheter tip cultured
•
Monitor glucose level, I&O, weight, fluid overload
•
Nutritional status: calorie count by dietitian
•
Therapeutic response: increased weight
•
About the reason for dextrose inf
•
To review hypoglycemia/hyperglycemia symptoms
•
To review blood glucose monitoring procedures