Mosby's 2014 Nursing Drug Reference (432 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
(eye-koe′sa-pent)
Vascepa
Func. class.:
Antilipidemic
Chem. class.:
Omega-3 fatty acid ethylester
Inhibits hepatic very low density lipoprotein (VLDL) and triglyceride synthesis; enhances clearance of triglycerides from circulating VLDL particles
As adjunct to diet in adults with severe hypertriglyceridemia (≥500 mg/dl)
Hypersensitivity to icosapent ethyl
Precautions:
Hepatic disease, bleeding, breastfeeding, children, fish/shellfish hypersensitivity, thrombolytic/anticoagulation therapy, pregnancy C
Calculator
• Adult:
PO
2 g bid
Available forms:
Soft gel cap 1 g
•
Give with food, swallow whole
•
Store at room temperature
HEMA:
Ecchymosis, epistaxis
MS:
Arthralgia
Peak 5 hr, protein binding 99%, half-life 89 hr
Increase:
effects of anticoagulants, platelet inhibitors, thrombolytics
Increase:
bleeding time
•
Obtain diet history including fat, cholesterol in diet; cholesterol, triglyceride levels periodically during treatment
•
Monitor LFTs baseline, periodically in those with liver disease
•
Monitor ecchymosis, epistaxis, bleeding time; use cautiously in anticoagulant/thrombolytic therapy
•
Identify fish hypersensitivity, use cautiously
•
Therapeutic response: decrease in triglycerides
•
That blood work may be necessary during treatment
•
To report bleeding if anticoagulants or thrombolytics are used
•
Not to break, crush, open, or dissolve caps
•
That previously prescribed regimen will continue: low-cholesterol diet, exercise program, smoking cessation
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
ivacaftor
(eye′va-kaf′tor)
Kalydeco
Func. class.:
Respiratory agent
Cystic fibrosis in those with G551D mutation in the
CFTR
gene
Calculator
• Adult/adolescent/child
≥
6 yr:
PO
150 mg every 12 hr with fat-containing food
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(lin′a-kloe′tide)
Linzess
Func. class.:
Functional GI disorder agent
Chem. class.:
Selective guanylate cyclase C agonist
Acts locally on the luminal surface of the intestinal epithelium; stimulates secretion of chloride and bicarbonate into the intestinal lumen; this action results in increased intestinal fluid and accelerated GI transit
Irritable bowel syndrome (IBS) with constipation, chronic constipation not associated with IBS
Hypersensitivity, urticaria, infection, sinusitis, GI obstruction
Black Box Warning:
Children <6 yr, infants, neonates
Precautions:
Pregnancy C, breastfeeding, diarrhea, abdominal pain, cholelithiasis, Crohn’s disease, diverticulitis, fecal impaction, gastric cancer, GI disease, IBS
Calculator
• Adult:
PO
145 mcg/day on empty stomach,
AM
• Adult:
PO
290 mcg/day on empty stomach,
AM
Available forms:
Caps 145, 290 mcg
•
Give on empty stomach, ≥30 min before first meal of day, swallow whole
•
Store at room temperature
CNS:
Headache, fatigue
GI:
Nausea, abdominal pain, diarrhea, flatulence, fecal incontinence, vomiting, GERD,
GI bleeding
Minimally absorbed, metabolized within the GI tract
Do not use with antidiarrheals
Decrease:
linaclotide effect—antimuscarinics
Black Box Warning:
Neonates/infants/children <6 yr: Can cause serious effects, including death
•
GI symptoms: nausea, abdominal pain, evidence of mechanical GI obstruction; check for other sources of constipation, determine stool quality and frequency
•
Decreased constipation in IBS
•
To notify prescriber of GI symptoms, avoid antidiarrheals, if severe diarrhea occurs, stop product
•
Do not crush, break, chew
•
Pregnancy C: Avoid use in pregnancy, breastfeeding
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert