Mosby's 2014 Nursing Drug Reference (443 page)

BOOK: Mosby's 2014 Nursing Drug Reference
3.9Mb size Format: txt, pdf, ePub
VAGINAL
ANTIFUNGALS

butoconazole (
OTC
)

(byoo-toh-kone′ah-zole)

Gynazol-1

miconazole (
OTC
)

(mye-kon′a-zole)

Monistat, Monistat 3, Monistat 7, Monistat Dual Pak

terconazole (
OTC
)

(ter-kone′ah-zole)

Terazol 7, Terazol 3, Zazole

tioconazole (
OTC
)

(tye-oh-kone′ah-zole)

Gyne-Trosyd
, Vagistat-1

ACTION:

Interferes with fungal DNA replication; binds sterols in fungal cell membranes, which increases permeability, leaking of nutrients

USES:

Vaginal, vulval, vulvovaginal candidiasis (moniliasis)

CONTRAINDICATIONS:

Hypersensitivity

Precautions:
Pregnancy, breastfeeding, children <2 yr

DOSAGE AND ROUTES
Calculator
Butoconazole

• Adult:
VAG
5 g (1 applicator) at bedtime × 3-6 days

Miconazole

• Adult:
200 mg supp at bedtime × 3 days or 100 mg supp × 1 wk

Terconazole

• Adult:
VAG 5 g (1 applicator) at bedtime

Tioconazole

• Adult:
1 applicator at bedtime

Administer:

Topical route

• 
One full applicator every night high into the vagina

• 
Store at room temperature in dry place

SIDE EFFECTS

GU:
Vulvovaginal burning, itching, pelvic cramps

INTEG:
Rash, urticaria, stinging, burning

MISC:
Headache, body pain

NURSING CONSIDERATIONS
Assess:

• 
For allergic reaction: burning, stinging, itching, discharge, soreness

Evaluate:

• 
Therapeutic outcome: decrease in itching or white discharge (vaginal)

Teach patient/family:

• 
About asepsis (hand washing) before, after each application

• 
To apply with applicator only; to avoid use of any other vaginal product unless directed by prescriber; sanitary napkin may prevent soiling of undergarments

• 
To abstain from sexual intercourse until treatment is completed; reinfection and irritation may occur

• 
To notify prescriber if symptoms persist

Canada only   Side effects:
italics
= common;
bold
= life-threatening   
Nurse Alert

OTIC
ANTIINFECTIVES

ciprofloxacin (Rx)

Cetraxel

ACTION:

Inhibits protein synthesis in susceptible microorganisms

USES:

Ear infection (external), short-term use

CONTRAINDICATIONS:

Hypersensitivity, perforated eardrum

Precautions:
Pregnancy (C)

Administer:

• 
After removing impacted cerumen by irrigation

• 
After cleaning stopper with alcohol

• 
After restraining child if necessary

• 
After warming sol to body temp

SIDE EFFECTS

EENT:
Itching, irritation in ear

INTEG:
Rash, urticaria

NURSING CONSIDERATIONS
Assess:

• 
For redness, swelling, fever, pain in ear, which indicates superinfection

Evaluate:

• 
Therapeutic response: decreased ear pain

Teach patient/family:

• 
The correct method of instillation using aseptic technique, including not touching dropper to ear

• 
That dizziness may occur after instillation

Canada only   Side effects:
italics
= common;
bold
= life-threatening   
Nurse Alert

Appendix C
Vaccines and toxoids

Canada only   Side effects:
italics
= common;
bold
= life-threatening   
Nurse Alert

Other books

Rebekah by Jill Eileen Smith
The Hunted by Heather McAlendin
What Came After by Sam Winston
The Devil in Silver by Victor LaValle
Miss Merton's Last Hope by Heather Boyd
Wilde Ride by Moores, Maegan Lynn
The 22nd Secret by Lanser, Randal