Mosby's 2014 Nursing Drug Reference (337 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
(proe′ta-meen)
Func. class.:
Heparin antagonist
Chem. class.:
Low-molecular-weight protein
Binds heparin, thereby making it ineffective
Heparin, LMWH toxicity, hemorrhage
Hypersensitivity
Precautions:
Pregnancy (C), breastfeeding, fish allergy, diabetes, previous exposure to protamine, insulins, heparin rebound or bleeding
Calculator
• Adult and child:
IV
1 mg of protamine/100 units heparin given; administer slowly over 1-3 min; max 50 mg/10 min
• Adult:
IV
1 mg protamine/1 mg enoxaparin
• Adult:
IV
1 mg protamine/100 anti-Xa unit
Available forms:
Inj 10 mg/ml
•
After reconstituting 50 mg/5 ml sterile bacteriostatic water for inj; shake, give ≤20 mg over 1-3 min
Y-site compatibilities:
Alfentanil, amikacin, aminophylline, ascorbic acid, atracurium, atropine, azaTHIOprine, aztreonam, benztropine, bumetanide, buprenorphine, butorphanol, calcium chloride/gluconate, cefTAZidime, chlorproMAZINE, cimetidine, clindamycin, cyanocobalamin, cycloSPORINE, digoxin, diphenhydrAMINE, DOBUTamine, DOPamine, doxycycline, enalaprilat, ePHEDrine, EPINEPHrine, epoetin alfa, erythromycin, esmolol, famotidine, fentaNYL, fluconazole, ganciclovir, gentamicin, glycopyrrolate, hydrOXYzine, imipenem-cilastatin, inamrinone, iohexol, iopamidol, iothalamate, isoproterenol, labetalol, lidocaine, magnesium, mannitol, meperidine, metaraminol, methoxamine, methyldopate, metoclopramide, metoprolol, miconazole, midazolam, minocycline, morphine, multiple vitamins, nalbuphine, naloxone, netilmicin, nitroglycerin, nitroprusside, norepinephrine, ondansetron, oxytocin, papaverine, pentazocine, phenylephrine, polymyxin B, potassium chloride, procainamide, prochlorperazine, promethazine, proprano
lol, pyridoxine, quiNIDine, ranitidine, Ringer’s, ritodrine, sodium bicarbonate, succinylcholine, SUFentanil, theophylline, thiamine, tobramycin, tolazoline, trimetaphan, urokinase, vancomycin, vasopressin, verapamil
CNS:
Lassitude, flushing
CV:
Hypotension, bradycardia,
circulatory collapse,
capillary leak
GI:
Nausea, vomiting, anorexia
HEMA:
Bleeding
INTEG:
Rash
, dermatitis, urticaria
RESP:
Dyspnea,
pulmonary edema, severe respiratory distress,
bronchospasm
SYST:
Anaphylaxis, angioedema
IV:
Onset 5 min, duration 2 hr
Hypersensitivity:
urticaria, cough, wheezing, have emergency equipment nearby;
allergy to fish;
use with caution; men who have had vasectomies may be more prone to hypersensitivity
•
Blood studies (Hct, platelets, occult blood in stools) q3mo
•
Coagulation tests (aPTT, ACT) 15 min after dose then again after several hours
•
VS, B/P, pulse after 30 min then 3 hr after dose
•
Skin rash, urticaria, dermatitis
•
Storage at 36° F-46° F (2° C-8° C)
•
Therapeutic response: reversal of heparin overdose
•
Not to take if allergic to fish
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
OTC
, Rx)
(soo-doh-eh-fed′rin)
Elix Sure Cold, Eltor
, Nasofed, Sudafed, Sudafed 24 Hour, Sudogest
Func. class.:
Adrenergic
Chem. class.:
Substituted phenylethylamine
Primary activity through α-effects on respiratory mucosal membranes reducing congestion hyperemia, edema; minimal bronchodilation secondary to β-effects
Nasal decongestant, adjunct for otitis media; with antihistamines
Hypersensitivity to sympathomimetics, closed-angle glaucoma
Precautions:
Pregnancy (C), breastfeeding, cardiac disorders, hyperthyroidism, diabetes mellitus, prostatic hypertrophy, hypertension
Calculator
• Adult and child
>
12 yr:
PO
60 mg q6hr;
EXT REL
120 mg q12hr or 240 mg q24hr
• Geriatric:
PO
30-60 mg q6hr prn
• Child 6-12 yr:
PO
30 mg q6hr, max 120 mg/day
• Child 2-6 yr:
PO
15 mg q6hr, max 60 mg/day
Available forms:
Ext rel caps 120, 240 mg; oral sol 15 mg, 30 mg/5 ml; drops 7.5 mg/0.8 ml; tabs 30, 60 mg; caps 60 mg; ext rel tabs 120, 240 mg
•
Avoid taking at or near bedtime; stimulation can occur
CNS:
Tremors, anxiety
, stimulation, insomnia, headache, dizziness, hallucinations,
seizures
(geriatric patients)
CV:
Palpitations, tachycardia, hypertension, chest pain,
dysrhythmias, CV collapse
EENT:
Dry nose; irritation of nose and throat
GI:
Anorexia, nausea, vomiting
, dry mouth, ischemic colitis
GU:
Dysuria
PO:
Onset 15-30 min; duration 4-6 hr, 8-12 hr (ext rel); metabolized in liver; excreted in feces and breast milk; terminal half-life 9-16 hr
Do not use with MAOIs or tricyclics; hypertensive crisis may occur
Increase:
effect of this product—urinary alkalizers, adrenergics, β-blockers, phenothiazines, tricyclics
Decrease:
effect of this product—urinary acidifiers
•
Nasal congestion: auscultate lung sounds; check for tenacious bronchial secretions
•
B/P, pulse throughout treatment
•
CNS side effects in geriatric patients: excitation, seizures, hallucinations
•
Storage at room temperature
•
Therapeutic response: decreased nasal congestion
•
About the reason for product administration
•
Ext rel: do not divide, crush, chew, or dissolve
•
Do not use within 14 days of MAOIs
•
Not to use continuously or to take more than recommended dose because rebound congestion may occur
To notify prescriber immediately of anxiety; slow or fast heart rate; dyspnea; seizures
•
To check with prescriber before using other products because product interactions may occur
•
To avoid taking near bedtime because stimulation can occur
•
Not to use if stimulation, restlessness, tremors occur
•
That use in children may cause excessive agitation
