Mosby's 2014 Nursing Drug Reference (238 page)

• Adult:
Instill 1-2 drops in the affected eyes once or twice a day (0.5% solution), bid (0.25% solution)

• 
For ophthalmic use only

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

• 
Wash hands before and after use; tilt 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 after use

• 
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

• 
Decreased intraocular pressure can take several weeks, monitor IOP after a month

Increase:
β-blocking effect—oral β-blockers

Increase:
Intraocular pressure reduction—topical miotics, dipivefrin, EPINEPHrine, carbonic anhydrase inhibitors; this may be beneficial

Increase:
B/P, severe—when abruptly stopping cloNIDine

Increase:
Depression of AV nodal conduction, bradycardia, or hypotension—adenosine, cardiac glycosides, disopyramide, other antiarrhythmics, class 1C antiarrhythmic drugs (flecainide, propafenone, moricizine, encainide, quiNIDine, or drugs that significantly depress AV nodal conduction

Increase:
AV block nodal conduction, induce AV block—high doses of procainamide

Increase:
Antihypertensive effect—other antihypertensives

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

• 
Glaucoma:
Monitor intraocular pressure

• 
Decreasing intraocular pressure

• 
That product is for ophthalmic use only

• 
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 by applying 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 by not using dropper for more than one person

• Adult and child ≥12 yr:
PO
2.5-5 mg/day in the evening

• Child 6-11 yr:
PO
(oral solution) 2.5 mg/day in the evening

• Child 2-5 yr:
PO
(oral solution) 1.25 mg/day in the evening

• Geriatric:
PO
2.5-5 mg/day in the evening

• Adult:
PO
CCr 50-80 ml/min, 2.5 mg/day; CCr 30-50 ml/min, 2.5 mg every other day; CCr 10-30 ml/min, 2.5 mg 2×/wk; CCr <10 ml/min, do not use

• 
Without regard to meals in the evening; tabs scored, may be broken in half

Increase:
CNS depression—alcohol, other CNS depressants

Increase:
anticholinergic/sedative effect—MAOIs, phenothiazines, tricyclics

Decrease:
clearance of levocetirizine—ritonavir

False negative:
Skin allergy tests

• 
Allergy symptoms:
pruritus, urticaria, watering eyes at baseline, during treatment

• 
Respiratory status:
rate, rhythm, increase in bronchial secretions, wheezing, chest tightness

• 
Liver function tests, serum creatinine, BUN

• 
Storage in tight, light-resistant container

• 
Therapeutic response: absence of running or congested nose or rashes

• 
About all aspects of product use; to notify prescriber if confusion, sedation, hypotension occur, not to exceed recommended dose

• 
To avoid driving, other hazardous activities if drowsiness occurs

• 
To avoid alcohol, other CNS depressants

• 
That product not recommended while breastfeeding