Mosby's 2014 Nursing Drug Reference (286 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
neomycin (Rx)
(nee-oh-mye′sin)
Func. class.:
Antiinfective
Severe systemic infections of CNS, respiratory, GI, urinary tract, eye, bone, skin, soft tissues caused by
Pseudomonas aeruginosa, Escherichia coli, Enterobacter, Klebsiella pneumoniae, Proteus vulgaris;
hepatic coma, preoperatively to sterilize bowel, infectious diarrhea caused by enteropathogenic
E. coli
Infants, children, bowel obstruction (oral use), severe renal disease, hypersensitivity, GI disease
Black Box Warning:
Dehydration, geriatric patients, hearing impairment, neuromuscular disease, renal disease, respiratory insufficiency
Calculator
• Adult:
PO
4-12 g/day in divided doses q6hr × 5-6 days
• Child:
PO
50-100 mg/kg/day in divided doses q6hr × 5-6 days
• Adult:
PO
1 g/hr × 4 hr then 1 g q4hr for remaining 24 hr
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
See
Appendix B
See
Appendix B
HIGH ALERT(neh-seer′ih-tide)
Natrecor
Func. class.:
Vasodilator
Chem. class.:
Human B-type natriuretic peptide
Uses DNA technology; human B-type natriuretic peptide binds to the receptor in vascular smooth muscle and endothelial cells, thereby leading to smooth muscle relaxation
Acutely decompensated CHF
Hypersensitivity to this product or
Escherichia coli
protein; cardiogenic shock or B/P <90 mm Hg as primary therapy
Precautions:
Pregnancy (C); breastfeeding; children; mitral stenosis; significant valvular stenosis, restriction, or obstructive cardiomyopathy, or any condition dependent on venous return; renal disease; constrictive pericarditis
Calculator
• Adult:
IV BOL
2 mcg/kg then
CONT IV INF
0.01 mcg/kg/min
Available forms:
Powder for inj, 1.5-mg single-use vial
•
Do not give through a central catheter containing other products; administer other products through separate catheter or central line heparin-coated catheter because nesiritide binds to heparin
•
Reconstitute one 1.5-mg vial/5 ml of diluent from prefilled 250-ml plastic IV bag with diluent of choice (preservative free D
5
, 0.9% NaCl, D
5
/1/2 NaCl, D
5
/0.2% NaCl); do not shake vial, roll gently; use only clear sol
•
Withdraw all contents of reconstituted vial and add to 250-ml plastic IV bag (6 mcg/ml), invert bag several times
•
Use within 24 hr of reconstituting
•
Prime IV fluid with inf of 5 ml before connecting to patient’s vascular access port and before bolus dose or IV inf
•
Prime tubing with 5 ml inf sol; calculate dose based on patient’s weight, 0.33 × patient weight (kg) = bolus vol (ml) (6 mcg/ml); withdraw prescribed bolus dose (volume) from prepared inf bag; give over 1 min through IV port
•
After bolus dose, use inf, give at 0.1 ml/kg/hr (0.01 mcg/kg/min)
Y-site compatibilities:
Acyclovir, alfen-tanil, allopurinol, amifostine, aminocaproic acid, aminophylline, amiodarone, amphotericin B colloidal, amphotericin B lipid complex, amphotericin B liposome, anidulafungin, argatroban, atenolol, atracurium, azithromycin, aztreonam, bivalirudin, bleomycin, buprenorphine, busulfan, butorphanol, calcium acetate/chloride/gluconate, CARBOplatin, carmustine, ceFAZolin, cefotaxime, cefoTEtan, cefOXitin, cefTAZidime, ceftizoxime, cefTRIAXone, cefuroxime, chloramphenicol, cimetidine, ciprofloxacin, cisatracurium, CISplatin, clindamycin, cyclophosphamide, cycloSPORINE, cytarabine, dacarbazine, DACTINomycin, DAUNOrubicin, digoxin, diltiazem, diphenhydrAMINE, DOCEtaxel, dolasetron, doxacurium, DOXOrubicin, doxycycline, droperidol, ePHEDrine, epirubicin, ertapenem, erythromycin, esmolol, etoposide, etoposide phosphate, famotidine, fenoldopam, fentaNYL, filgrastim, fluconazole, fludarabine, fluorouracil, foscarnet, fosphenytoin, ganciclovir, gatifloxacin, gemcitabine, gemtuzumab, glycopyrrolate, granisetron, haloperidol, hydrocortisone, HYDROmorphone, hydrOXYzine, IDArubicin, ifosfamide, imipenem-cilastatin, irinotecan, ketorolac, leucovorin, levofloxacin, lidocaine, linezolid, LORazepam, magnesium sulfate, mannitol, mechlorethamine, melphalan, meropenem, mesna, metaraminol, methohexital, methotrexate, methylPREDNISolone, metoclopramide, metroNIDAZOLE, midazolam, milrinone, minocycline, mitoMYcin, mitoXANtrone, mivacurium, moxifloxacin, mycophenolate, nalbuphine, naloxone, niCARdipine, nitroglycerin, nitroprusside, octreotide, ondansetron, oxaliplatin, oxytocin, PACLitaxel, palonosetron, pamidronate, pancuronium, PEMEtrexed, pentamidine, PENTobarbital, PHENobarbital, phentolamine, phenylephrine, polymyxin B sulfate, potassium chloride/phosphates, prochlorperazine, propranolol, quiNIDine, quinupristin-dalfopristin, ranitidine, remifentanil, rocuronium, sodium acetate/bicarbonate/phosphates, streptozocin, succinylcholine, SUFentanil, tacrolimus, teniposide, theophylline, thiotepa, ticarcillin, tigecycline, tirofiban, tolazoline, topotecan, torsemide, trimethobenzamide, vancomycin, vasopressin, vecuronium, verap-amil, vinBLAStine, vinCRIStine, vinorelbine, zidovudine, zoledronic acid
CNS:
Headache, insomnia, dizziness, anxiety, confusion, paresthesia, tremor
CV:
Hypotension
,
tachycardia,
dysrhythmias, bradycardia,
ventricular tachycardia, ventricular extrasystoles, atrial fibrillation
GI:
Vomiting, nausea
INTEG:
Rash, sweating, pruritus, inj site reaction
MISC:
Abdominal pain, back pain
RESP:
Increased cough, hemoptysis,
apnea
Half-life 18 min
Increase:
hypotension—ACE inhibitors, antihypertensives, inotropes, IV nitrates
•
PCWP, RAP, cardiac index, MPAP, B/P, pulse during treatment until stable
•
Daily serum creatinine, BUN
•
CHF:
weight gain, dyspnea, crackles, I&O ratios, peripheral edema
•
Therapeutic response: improvement in CHF with improved PCWP, RAP, MPAP
•
About purpose of medication, expected results, to report pain at IV site
•
To report dizziness, blurred vision, lightheadedness, sweating
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert