Mosby's 2014 Nursing Drug Reference (62 page)

BOOK: Mosby's 2014 Nursing Drug Reference
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Canada only   Side effects:
italics
= common;
bold
= life-threatening   
Nurse Alert

RARELY USED
beractant (Rx)

(ber-ak′tant)

Survanta

Func. class.:
Natural lung surfactant

USES:

Prevention and treatment (rescue) of respiratory distress syndrome in premature infants

DOSAGE AND ROUTES
Calculator

• Newborn: INTRATRACHEAL INSTILL
4 doses can be administered during the 1st 48 hr of life; give doses no more frequently than q6hr; each dose is 100 mg of phospholipids/kg birth weight

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

betamethasone (topical)

(bay-ta-meth′a-sone)

betamethasone
dipropionate

Diprolene, Diprolene AF

betamethasone
augmented dipropionate

 

 

betamethasone valerate

Beta-Val, Luxiq

Func. class.:
Corticosteroid, topical

ACTION:

Crosses cell membrane to attach to receptors to decrease inflammation, itching; inhibits multiple inflammatory cytokines

USES:

Inflammation/itching corticosteroid-responsive dermatoses on the skin/scalp

CONTRAINDICATIONS:

Hypersensitivity, use of some preparations on face, axilla, groin

Precautions:
Pregnancy (C), skin infections

DOSAGE AND ROUTES
Calculator

• Adult: TOP
1-2 times/day (dipropionate) or 1-3 times/day (valerate)

Available forms:
dipropionate: gel, lotion, ointment, cream 0.05%; valerate: cream, lotion, ointment 0.1%, foam 0.12%

SIDE EFFECTS

INTEG:
Burning, folliculitis, pruritus, dermatitis, maceration, erythema

MISC:
Hyperglycemia; glycosuria, Cushing syndrome, HPA axis suppression

PHARMACOKINETICS

Unknown

NURSING CONSIDERATIONS
Assess:

• 
Skin reactions: burning pruritus, folliculitis, dermatitis

Evaluate:

• 
Decreased itching, inflammation on the skin, scalp

Teach patient/family:
Topical route

• 
That betamethasone valerate may be used with occlusive dressings for psoriasis or recalcitrant conditions,
do not use dipropionate with occlusive dressings

Cream/ointment/lotion:

• 
To apply sparingly in a thin film, using gloves, and rub gently into the cleansed, slightly moist affected area

Gel:

• 
To apply sparingly in a thin film, using gloves, and rub gently into the cleansed, slightly moist affected area

Scalp foam:

• 
To invert can and dispense a small amount of foam onto a saucer or other cool surface. Do not dispense directly onto hands. Pick up small amounts of foam with fingers and gently massage into affected area until foam disappears. Repeat until entire affected scalp area is treated.

• 
That treatment should be limited to 2 wk

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

betamethasone
(augmented) topical

See
Appendix B

 

betaxolol (ophthalmic)

(beh-tax′oh-lol)

Betoptic-S

Func. class.:
Antiglaucoma

Chem. class.:
Beta blocker

ACTION:

Can decrease aqueous humor and increase outflows

USES:

Treatment of chronic open-angle glaucoma and ocular hypertension

CONTRAINDICATIONS:

Hypersensitivity, AV block, heart failure, bradycardia, sick sinus syndrome

Precautions:
Abrupt discontinuation, children, pregnancy, breastfeeding, asthma, COPD, depression, diabetes mellitus, myasthenia gravis, hyperthyroidism, pulmonary disease, angle-closure glaucoma

DOSAGE AND ROUTES
Calculator

• Adult: IV INF
Instill 1–2 drops in the affected eye(s) bid.

Available forms:
Ophthalmic sol 0.5%; ophthalmic susp 0.25%

SIDE EFFECTS

CNS:
Insomnia, headache, dizziness

CV:
Palpitations

EENT:
Eye stinging/burning, tearing, photophobia

MISC:
Bronchospasm

PHARMACOKINETICS

Onset 30 min, peak 2 hr, duration ≥12 hr

NURSING CONSIDERATIONS
Assess:

 
Systemic absorption:
When used in the eye, systemic absorption is common, with the same adverse reactions and interactions

• 
Glaucoma: Monitor intraocular pressure

Evaluate:

• 
Decreasing intraocular pressure

Teach patient/family:

• 
That strength is expressed in betaxolol base

• 
That drug is for ophthalmic use only. Shake the ophthalmic suspension well before use

• 
Not to touch the tip of the dropper to the eye, fingertips, or other surface to prevent contamination

• 
To wash hands before and after use. Tilt the head back slightly and pull the lower eyelid down with the index finger to form a pouch. Squeeze the prescribed number of drops into the pouch. Close eyes to spread drops. To avoid excessive systemic absorption, apply finger pressure on the lacrimal sac for 1–2 min following use

• 
That if more than one topical ophthalmic drug product is being used, the drugs should be administered at least 5 min apart

• 
To avoid contamination or the spread of infection, do not use dropper for more than one person

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

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