Mosby's 2014 Nursing Drug Reference (242 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
(lin′dane)
Hexit
Func. class.:
Scabicide, pediculicide
Chem. class.:
Chlorinated hydrocarbon (synthetic)
Stimulates nervous system of arthropods, resulting in seizures, death
Scabies, lice (head/pubic/body), nits in those intolerant to or who do not respond to other agents
Hypersensitivity, patients with known seizure disorders, Norwegian (crusted) scabies
Black Box Warning:
Premature neonate; inflammation of skin, abrasions, skin breaks; seizure disorder
Precautions:
Pregnancy (C), breastfeeding, infants, children <10 yr, avoid contact with eyes
Calculator
• Adult and child:
CREAM/LOTION
shampoo using 30 ml: work into lather, rub for 5 min, rinse, dry with towel; comb with fine-toothed comb to remove nits; most require 1 oz, max 2 oz
• Adult and child:
TOP
apply 1% cream/lotion to skin, from neck to bottom of feet, toes; wash area with soap, water; remove visible crusts; apply to skin surfaces; remove with soap, water in 8-12 hr; repeat after 1 wk prn; most require 1 oz, max 2 oz
Available forms:
Lotion, shampoo, cream (1%)
•
Caregivers should wear gloves less permeable to lindane, thoroughly clean hands after application; avoid natural latex gloves
•
Cream/ointment/lotion:
use for scabies only; skin should be clean without other products on it, wait 1 hr after bathing or showering before application, shake well, apply under fingernails after trimming; toothbrush can be used to apply; after application wrap toothbrush in paper and throw away; use only a single application, apply as thin layer over all skin from neck down, close bottle containing leftover lotion, throw away
•
Do not cover, wash off after 8-12 hr
•
Use warm, not hot, water; do not leave on >12hr
•
Shampoo:
for lice only; do not use other hair products before use; shake well; hair should be completely dry; use only enough shampoo to lightly coat hair and scalp, work into hair, do not use water; allow to remain only 4 min, rinse, lather away, towel briskly
•
To scalp only; do not apply to face, lips, mouth, eyes, any mucous membrane, anus, or meatus
•
Topical corticosteroids as ordered to decrease contact dermatitis; antihistamines
•
Lotions of menthol or phenol to control itching
•
Topical antibiotics for infection
CNS:
Seizures, CNS toxicity,
stimulation, dizziness
INTEG:
Pruritus, rash, irritation, contact dermatitis
Peak 6 hr, half-life 18-22 hr
•
Oils may increase absorption; if oil-based hair dressing used, shampoo, rinse, dry hair before applying lindane shampoo
Black Box Warning:
Skin for abrasions, breaks, inflammation; do not use on these areas
•
Infestation:
head, hair for lice, nits before and after treatment; if scabies present, check all skin surfaces; identify source of infection: school, family, sexual contacts
•
Isolation until areas on skin, scalp have cleared, treatment completed
•
Removal of nits with fine-toothed comb rinsed in vinegar after treatment; use gloves
•
Therapeutic response: decreased crusts, nits, brownish trails on skin, itching papules in skin folds, decreased itching after several weeks
•
To wash all inhabitants’ clothing using insecticide; that preventive treatment may be required of all persons living in same house using lotion or shampoo to decrease spread of infection; to use rubber gloves when applying product
•
That itching may continue for 4-6 wk
•
That product must be reapplied if accidently washed off or treatment will be ineffective
•
Not to apply to face; if accidental contact with eyes occurs, flush with water
•
To remove product after specified time to prevent toxicity
•
To treat sexual contacts simultaneously
•
To check for CNS toxicity: dizziness, cramps, anxiety, nausea, vomiting, seizures
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(line-zoe′lide)
Zyvox
Func. class.:
Broad-spectrum antiinfective
Chem. class.:
Oxazolidinone
Do not confuse:
Zyvox
/Ziox/Zosyn
Inhibits protein synthesis by interfering with translation; binds to bacterial 23S ribosomal RNA of the 50S subunit, thus preventing formation of the bacterial translation process in primarily gram-positive organisms
Vancomycin-resistant
Enterococcus faecium
infections, nosocomial pneumonia caused by
Staphylococcus aureus
or
Streptococcus
pneumonia, uncomplicated or complicated skin and skin-structure infections, community-acquired pneumonia,
Pasteurella multocida
, viridans streptococci
Hypersensitivity
Precautions:
Pregnancy (C), breastfeeding, children, thrombocytopenia, bone marrow suppression, hypertension, hyperthyroidism, pheochromocytoma, seizure disorder, ulcerative colitis, MI, PKU, renal/GI disease
Calculator
enterococcus faecium
infections
• Adult/adolescent/child ≥12 yr:
IV/PO
600 mg q12hr × 14-28 days; max 1200 mg/day
• Child <12 yr/infant/term neonate:
IV/PO
10 mg/kg q8hr × 14-28 days
• Adult:
IV/PO
600 mg q12hr × 10-14 days; max 1200 mg/day
• Child: Birth-11 yr:
PO
10 mg/kg q8hr × 10-14 days
• Adult:
PO
400 mg q12hr × 10-14 days; max 1200 mg/day
• Adolescent:
PO
600 mg q12hr × 10-14 days; max 1200 mg/day
• Infant preterm <7 days old:
PO
10 mg/kg q12hr × 10-14 days
Available forms:
Tabs 600 mg; oral sus 100 mg/5 ml; inj 2 mg/ml
•
With/without food
•
Store reconstituted oral susp at room temp, use within 3 wk
•
Do not use if particulate is present, yellow color is normal
•
Premixed sol ready to use (2 mg/ml), give over 30-120 min; do not use IV inf bag in series connections; do not use with additives in sol; do not use with another product, administer separately, flush line before and after use
Y-site compatibilities:
Acyclovir, alfen-tanil, amikacin, aminophylline, ampicillin, aztreonam, buprenorphine, butorphanol, calcium gluconate, CARBOplatin, ceFAZolin, cefoperazone, cefoTEtan, cefOXitin, cefTAZidime, ceftizoxime, cefuroxime, cimetidine, ciprofloxacin, cisatracurium, CISplatin, clindamycin, cyclophosphamide, cycloSPORINE, cytarabine, digoxin, furosemide, ganciclovir, gemcitabine, gentamicin, heparin, HYDROmorphone, ifosfamide, labetalol, leucovorin, levofloxacin, lidocaine, LORazepam, magnesium sulfate, mannitol, meperidine, meropenem, mesna, methotrexate, methylPREDNISolone, metoclopramide, metroNIDAZOLE, midazolam, minocycline, mitoXANtrone, morphine, nalbuphine, naloxone, nitroglycerin, ofloxacin, ondansetron, PACLitaxel, PENTobarbital, PHENobarbital, piperacillin, potassium chloride, prochlorperazine, promethazine, propranolol, ranitidine, remifentanil, SUFentanil, theophylline, ticarcillin,
tobramycin, vancomycin, vecuronium, verapamil, vinCRIStine, zidovudine
Solution compatibilities:
D
5
, 0.9% NaCl, LR
CNS:
Headache
, dizziness, insomnia
GI:
Nausea, diarrhea
,
pseudomembranous colitis,
increased ALT/AST,
vomiting
, taste change, tongue-color change
HEMA:
Myelosuppression
MISC:
Vaginal moniliasis, fungal infection, oral moniliasis,
lactic acidosis, anaphylaxis, angioedema, Stevens-Johnson syndrome
Peak 1-2 hr, terminal half-life 4-5 hr, rapidly and extensively absorbed, protein binding 31%, metabolized by oxidation of the morpholine ring
Do not use with MAOIs (or within 2 wk) or with products that possess MAOI-like action (furazolidone, isoniazid, INH, procarbazine); hypertensive crisis may occur
Increase:
hypertensive crisis, seizures, coma—amoxapine, maprotiline, mirtazapine, traZODone, cyclobenzaprine, tricyclics, methyldopa
Increase:
serotonin syndrome—SSRIs, SNRIs, serotonin receptor agonists
Increase:
effects of adrenergic agents (DOPamine, EPINEPHrine, pseudoephedrine)
•
Avoid use with green tea, valerian, ginseng, yohimbine, kava, guarana, St. John’s wort
•
Tyramine foods: avoid; increased pressor response
•
CBC with differential weekly, assess for myelosuppression (anemias, leukopenia, pancytopenia, thrombocytopenia)
•
Serotonin syndrome:
at least 2 wk should elapse between discontinuing linezolid and starting serotonergic agents; assess for increased heart rate, shivering, sweating, dilated pupils, tremor, high B/P, hyperthermia, headache, confusion; if these occur, stop linezolid, administer a serotonin antagonist if needed
•
Lactic acidosis:
repeated nausea/vomiting, unexplained acidosis, low bicarbonate level; notify prescriber immediately
•
Anaphylaxis/angioedema/Stevens-Johnson syndrome:
rash, pruritus, difficulty breathing, fever; have emergency equipment nearby
•
CNS symptoms: headache, dizziness
•
Hepatic studies: AST, ALT
•
Diabetes mellitus:
monitor those receiving insulin or oral antidiabetics for increased hypoglycemia
Pseudomembranous colitis:
diarrhea, abdominal pain, fever, fatigue, anorexia, possible anemia, elevated WBC, low serum albumin; stop product, usually either vancomycin or IV metroNIDAZOLE given
•
Therapeutic response: decreased symptoms of infection, blood cultures negative
•
If dizziness occurs, to ambulate, perform activities with assistance
•
To complete full course of product therapy
•
To contact prescriber if adverse reaction occurs
•
To inform prescriber if SSRIs or cold products, decongestants being used
•
To inform prescriber of history of hypertension
•
To avoid large amounts of high-tyramine foods, drinks; provide list