Mosby's 2014 Nursing Drug Reference (292 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
(nye-taz-ox′a-nide)
Alinia
Func. class.:
Antiprotozoal
Interferes with DNA/RNA synthesis in protozoa
Diarrhea caused by
Cryptosporidium parvum
or
Giardia lamblia
Hypersensitivity
Precautions:
Pregnancy (B), breastfeeding, children <1 yr or >11 yr, renal/hepatic disease, diabetes mellitus (contains sucrose), HIV, immunocompromised patients
Calculator
• Adult:
PO
500 mg q12hr × 3 days
• Child 4-11 yr:
PO
10 ml (200 mg) q12hr × 3 days
• Child 12-47 mo:
PO
5 ml (100 mg) q12hr × 3 days
Available forms:
Powder for oral susp 100 mg/5 ml; tab 500 mg
•
With food
•
Shake oral suspension before giving, discard after 1 wk
CNS:
Dizziness, fever, headache
CV:
Hypotension
GI:
Nausea
, anorexia, flatulence, increased appetite, enlarged salivary glands, abdominal pain, diarrhea, vomiting
HEMA:
Anemia,
leukopenia,
neutropenia
INTEG:
Pruritus, sweating
MISC:
Increased creatinine, pale yellow eye discoloration, rhinitis, discolored urine, infection, malaise
Peak 1-4 hr; excreted in urine, bile, feces; hydrolyzed to active metabolite, which undergoes conjugation; metabolite protein binding >99%
•
Competes for binding sites: other highly protein-bound products; phenytoin, salicylates
Increase:
creatinine, GPT
•
Signs of infection
•
Bowel pattern before, during treatment
•
Therapeutic response: C&S negative for organism, decreased diarrhea
•
To take with food; shake susp well before each dose, discard susp after 7 days
Canada only Side effects:
italics
= common;
bold
= life-threatening Nurse Alert
(nye-troe-fyoor′an-toyn)
Furadantin, Macrobid, Macrodantin, Novo-Furantoin
Func. class.:
Urinary tract antiinfective
Chem. class.:
Synthetic nitrofuran derivative
Inhibits bacterial acetyl-CoA inteference with carbohydrate metabolism
Urinary tract infections caused by
Escherichia coli, Klebsiella, Pseudomonas, Proteus vulgaris, Proteus morganii, Serratia, Citrobacter, Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus, Salmonella, Shigella
Infants <1 mo, hypersensitivity, anuria, severe renal disease CCr <60 ml/min, at term pregnancy (38-42 wk), labor, delivery, cholestatic jaundice due to nitrofurantoin therapy
Precautions:
Pregnancy (B), breastfeeding, geriatric patients, G6PD deficiency, GI disease, diabetes
Calculator
• Adult:
PO
50-100 mg qid after meals
• Child:
PO
5-7 mg/kg/day in 4 divided doses
• Adult:
PO
50-100 mg q
PM
• Child:
PO
1-2 mg/kg/day in
PM
or 0.5-1 mg/kg q12hr if dose not well tolerated
Available forms:
Caps 25, 50, 100 mg; susp 25 mg/5 ml; macrocrystal caps (Macrodantin) 25, 50, 100 mg; Macrobid cap 100 mg (25 macrocrystals, 75 monohydrate)
•
Give with meals
•
Do not break, crush, chew, or open tabs, caps, store in original container
•
Two daily doses if urine output is high or if patient diabetic
•
Use calibrated device to measure liquid product; may mix water, fruit juice; rinse mouth after liquid product; staining of teeth may occur
CNS:
Dizziness, headache
, drowsiness, peripheral neuropathy, chills, confusion, vertigo
CV:
Bundle branch block,
chest pain
GI:
Nausea, vomiting, abdominal pain, diarrhea
,
cholestatic jaundice,
loss of appetite,
pseudomembranous colitis, hepatitis, pancreatitis
HEMA:
Anemia, agranulocytosis, hemolytic anemia, leukopenia, thrombocytopenia
INTEG:
Pruritus, rash, urticaria, angioedema, alopecia, tooth staining,
exfoliative dermatitis, Stevens-Johnson syndrome
MS:
Arthralgia, myalgia, numbness, peripheral neuropathy
RESP:
Cough, dyspnea,
pneumonitis, pulmonary fibrosis or infiltrate
SYST:
Superinfection,
SLE-like syndrome
PO:
Half-life 20-60 min; crosses blood-brain barrier, placenta; enters breast milk; excreted as inactive metabolites in liver, unchanged in urine; protein binding 60%-90%
Increase:
antagonistic effect—norfloxacin
Increase:
levels of nitrofurantoin—probenecid
Decrease:
absorption of magnesium trisilicate antacid
Increase:
BUN, alk phos, bilirubin, creatinine, blood glucose
•
Blood count during chronic therapy, LFTs, pulmonary function tests
•
Urinary tract infection:
burning, pain on urination; fever; cloudy, foul-smelling urine; I&O ratio: C&S before treatment, after completion; serum creatinine, BUN
•
Pseudomembraneous colitis:
diarrhea with mucus, abdominal pain, fever, fatigue, anorexia; may be treated with vancomycin or metroNIDAZOLE
•
CNS symptoms: insomnia, vertigo, headache, drowsiness, seizures
Hepatotoxicity:
yellowing of skin or eyes, dark urine, clay-colored stools; monitor AST, ALT
Pulmonary fibrosis, pneumonitis:
dyspnea, tachypnea, persistent cough
Serious skin disorders:
fever, flushing, rash, urticaria, pruritus
•
Peripheral neuropathy:
paresthesias (more common in diabetes mellitus, electrolyte imbalances, vit B deficiency, debilitated patients)
•
Therapeutic response: decreased dysuria, fever; negative C&S
•
To notify prescriber of continued symptoms of UTI, fever, myalgias, arthralgias, numbness or tingling of extremities
•
To take with food or milk; to avoid alcohol
•
To protect susp from freezing; shake well before taking
•
That product may cause drowsiness; to seek aid with walking, other activities; not to drive or operate machinery while taking medication
•
That diabetics should monitor blood glucose levels
•
That product may turn urine rust-yellow to brown
Pseudomembranous colitis:
fever; diarrhea with mucus, pus, or blood; report immediately
