Nursing 2007 Dangerous Drug Interactions

832 Pages·2006·2.542 MB·English

by  Springhouse

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Staff
Executive Publisher Editor
Judith A. Schilling McCann, RN, MSN Nancy Priff
Editorial Director Copy Editor
William J. Kelly Jenifer F. Walker
Clinical Director Digital Composition Services
Joan M. Robinson, RN, MSN Diane Paluba (manager),
Joyce Rossi Biletz, Donald G. Knauss
Senior Art Director
Arlene Putterman Manufacturing
Patricia K. Dorshaw (director),
Art Director Beth J. Welsh
Elaine Kasmer
Editorial Assistants
Clinical Manager Megan L. Aldinger, Karen Kirk, Linda
Eileen Cassin Gallen, RN, BSN K. Ruhf
Editorial Project Manager Indexer
Catherine E. Harold Barbara Hodgson
Clinical Editors
Carol A. Saunderson, RN, BA, BS;
Christine M. Damico, RN, MSN, CRNP;
Kimberly A. Zalewski, RN, MSN
The clinical procedures described and re- adopted its accompanying textbook. Printed
commended in this publication are based on in the United States of America. For informa-
research and consultation with medical and tion, write Lippincott Williams & Wilkins,
nursing authorities. To the best of our knowl- 323 Norristown Road, Suite 200, Ambler, PA
edge, these procedures reflect currently ac- 19002-2756.
cepted clinical practice; nevertheless, they
can’t be considered absolute and universal DDI010306—021006
recommendations. For individual application,
treatment recommendations must be consid- Library of Congress Cataloging-in-
ered in light of the patient’s clinical condition Publication Data
and, before administration of new or infre- Nursing2007 dangerous drug interactions.
quently used drugs, in light of the latest p. ; cm.
package-insert information. The authors and 1. Pharmacology—Handbooks, manuals,
the publisher disclaim responsibility for any etc. 2. Nursing—Handbooks, manuals, etc.
adverse effects resulting directly or indirectly 3. Drug interactions—Handbooks, manuals,
from the suggested procedures, from any etc. 4. Drugs—Safety measures—
undetected errors, or from the reader’s mis- Handbooks, manuals, etc. I. Lippincott
understanding of the text. Williams & Wilkins. II. Title: Dangerous drug
interactions. III. Title: Nursing 2007 danger-
© 2007 by Lippincott Williams & Wilkins. All
ous drug interactions.
rights reserved. This book is protected by
[DNLM: 1. Drug Interactions—Handbooks.
copyright. No part of it may be reproduced,
2. Nursing Process—Handbooks. 3.
stored in a retrieval system, or transmitted,
Pharmaceutical Preparations—adverse ef-
in any form or by any means—electronic,
fects—Handbooks. WY 49 N9765 2006]
mechanical, photocopy, recording, or other-
RM302.N87 2006
wise—without prior written permission of
615'.7045—dc22
the publisher, except for brief quotations em-
ISBN13 978-1-58255-615-4
bodied in clinical articles and reviews and
ISBN10 1-58255-615-6 (alk. paper)
test and evaluation materials provided by
2005034582
publisher to instructors whose schools have
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Contents
Contributors and consultants iv
How to use this book v
Guide to abbreviations vii
Drug interactions A to Z 1
Index 754
iii
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Contributors and consultants
Special thanks to David S. Tatro, PharmD, Editor, Drug
Interaction Facts.
Frances Davis Baldwin, RN, Caroline Kramer, RN
MSN Staff Nurse
Consultant North Hill Home Health
Charlotte, N.C. Needham, Mass.
Dana Bartlett, RN, MSN Phyllis Magaletto, RN, MSN, BC
Poison Information Specialist Instructor, Medical-Surgical
Philadelphia Poison Control Nursing
Center Cochran School of Nursing
Yonkers, N.Y.
Jennalie E. Blackwood,
PharmD Jeffrey B. Purcell, PharmD
Clinical Infusion Pharmacist Clinical Lead Pharmacist
Interlock Pharmacy Harborview Medical Center
Florissant, Mo. Clinical Associate Professor
University of Washington
Lisa Colodny, MBA, PharmD, School of Pharmacy
BCNSP Seattle, Wash.
Pharmacy Director
Coral Springs (Fla.) Medical
Center
Jennifer J. Gorrell, PharmD
Director of Pharmacy
Charleston (W.Va.) Area
Medical Center
Women & Childrens Hospital
Theresa R. Howard, RN
Trauma Nurse Coordinator
Limestone Medical Center
Groesbeck, Tex.
Julia N. Kleckner, PharmD
Clinical Coordinator
Mercy Fitzgerald Hospital
Darby, Pa.
iv
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How to use this book
Dangerous Drug Interactionsis the combined influence of the
an easy-to-use resource to help interaction’s severity, onset, and
you avoid thousands of unin- likelihood. Because this book
tended drug interactions as focuses only on potentially dan-
quickly and conveniently as pos- gerous interactions, you’ll find
sible. either a 1 or a 2 as the risk rat-
You can use this book in two ing.
ways. With its A-to-Z organiza- Severity.The severity of a
tion, you can flip quickly to the drug interaction may be major,
generic name of the drug you moderate, or minor. A major in-
plan to give. There you’ll find, teraction is one that may be life-
in alphabetical order, the drugs, threatening or cause permanent
drug classes, herbs, and foods damage. A moderate interaction
that may interact with it. Or you is one that may worsen the pa-
can turn first to the book’s com- tient’s condition. A minor inter-
prehensive index, find the drug action may be bothersome or
you plan to give, and scan the cause little effect. Because this
list of drugs and drug classes it book focuses on dangerous drug
may interact with. interactions, it includes only
those considered major or mod-
Format erate.
Each entry follows a standard Onset.A drug interaction
format, making it easy for you to with a rapid onset starts within
find key information fast. An 24 hours of combined use. An
entry starts with an interacting interaction with a delayed onset
pair. The pair may be drug- starts days to weeks after the
drug, drug-class, drug-herb, or start of combined use.
drug-food. Just below the inter- Likelihood.In this section
acting pair, as appropriate, you’ll get an idea of the likeli-
you’ll find a selection of com- hood that an interaction may
mon names. If the interacting occur. An established interac-
element is a generic drug, the tion is one that well-controlled
monograph typically provides clinical trials have proven can
common trade names. If the in- occur. A probable interaction is
teracting element is a drug a very likely possibility but not
class, the monograph provides proven clinically. And a suspect-
the generic names of applicable ed interaction is one that’s sup-
drugs in that class. ported by some reliable evi-
Risk rating.The risk rating dence but still needs more
gives you a quick idea of the study. Interactions that are
overall importance of an inter- merely possible or unlikely
action. The rating is based on aren’t included in this book.
v
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vi How to use this book
Cause.Next you’ll find a
brief description of the mecha-
nism by which the interaction
occurs.
Effect.This section reviews
the main clinical effect of the
interaction, usually in a single
quick-read sentence.
Nursing considerations.
Finally, each entry includes key
information about drug usage,
patient care, and patient teach-
ing. This section also includes a
special, in-text xALERT logo to
direct your attention to espe-
cially important information.
Index
The comprehensive index for
Dangerous Drug Interactions
includes generic drug names,
common trade names, and drug
classes. The index provides a
full, book-wide look at the po-
tentially dangerous interactions
for each drug included in this
handy volume.
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Guide to abbreviations
ACE angiotensin- D W dextrose 5% in
5
converting water
enzyme DIC disseminated
ADH antidiuretic intravascular
hormone coagulation
AIDS acquired dl deciliter
immunodeficiency DNA deoxyribonucleic
syndrome acid
ALT alanine ECG electrocardiogram
transaminase
EEG electroencephalo-
APTT activated partial gram
thromboplastin
EENT eyes, ears, nose,
time
throat
AST aspartate
FDA Food and Drug
transaminase
Administration
AV atrioventricular
g gram
b.i.d. twice daily
G gauge
BPH benign prostatic
GGT gamma-
hypertrophy
glutamyltransferase
BSA body surface area
GI gastrointestinal
BUN blood urea nitrogen
gtt drops
cAMP cyclic 3(cid:2), 5(cid:2)
GU genitourinary
adenosine
monophosphate G6PD glucose-6-
phosphate dehy-
CBC complete blood
drogenase
count
H histamine
CK creatine kinase 1 1
H histamine
CMV cytomegalovirus 2 2
HDL high-density
CNS central nervous
lipoprotein
system
HIV human immuno-
COPD chronic obstructive
deficiency virus
pulmonary disease
HMG-CoA 3-hydroxy-3-
CSF cerebrospinal fluid
methylglutaryl
CV cardiovascular coenzyme A
CVA cerebrovascular h.s. at bedtime
accident
5-HT 5-hydroxytryp-
CYP cytochrome P-450 tamine
vii
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viii Guide to abbreviations
I.D. intradermal PTT partial thrombo-
I.M. intramuscular plastin time
INR International PVC premature ventric-
Normalized Ratio ular contraction
IPPB intermittent q every
positive-pressure q.i.d. four times daily
breathing RBC red blood cell
IU international unit RDA recommended daily
I.V. intravenous allowance
kg kilogram REM rapid eye
L liter movement
lb pound RNA ribonucleic acid
LDH lactate RSV respiratory syncytial
dehydrogenase virus
LDL low-density SA sinoatrial
lipoprotein S.C. subcutaneous
M molar sec second
m2 square meter SIADH syndrome of
MAO monoamine oxidase inappropriate
antidiuretic
mcg microgram
hormone
mEq milliequivalent
S.L. sublingual
mg milligram
SSRI selective serotonin
MI myocardial reuptake inhibitor
infarction
T triiodothyronine
3
min minute
T thyroxine
4
ml milliliter
t.i.d. three times daily
mm3 cubic millimeter
TSH thyroid-stimulating
NSAID nonsteroidal anti- hormone
inflammatory drug
tsp teaspoon
OTC over-the-counter
USP United States
PABA para-aminobenzoic Pharmacopeia
acid
UTI urinary tract
PCA patient-controlled infection
analgesia
WBC white blood cell
P.O. by mouth
wk week
P.R. by rectum
p.r.n. as needed
PT prothrombin time
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acebutolol–prazosin 1
acebutolol NSAIDs
Sectral ibuprofen, indomethacin,
naproxen, piroxicam
Risk rating: 2
Severity: Moderate Onset: Delayed Likelihood: Probable
Cause
NSAIDs may inhibit renal prostaglandin synthesis, allowing pressor
systems to be unopposed.
Effect
Acebutolol and other beta blockers may not be able to lower blood
pressure.
Nursing considerations
(cid:2)Avoid using these drugs together if possible.
(cid:2)Monitor blood pressure and other evidence of hypertension closely.
(cid:2)Talk with prescriber about ways to minimize or eliminate interac-
tion, such as adjusting beta blocker dosage or switching to sulindac as
the NSAID.
(cid:2)Explain the risks of using these drugs together, and teach patient
how to monitor his own blood pressure.
(cid:2)Other NSAIDs may interact with beta blockers. If you suspect an
interaction, consult prescriber or pharmacist.
acebutolol prazosin
Sectral Minipress
Risk rating: 2
Severity: Moderate Onset: Rapid Likelihood: Probable
Cause
The mechanism of this interaction is unknown.
Effect
Risk of orthostatic hypotension increases.
Nursing considerations
(cid:2)Assess patient’s lying, sitting, and standing blood pressures closely,
especially when combined therapy starts.
(cid:2)Adjust dosages of either drug, as needed.
(cid:2)To minimize effects of orthostatic hypotension, teach patient to
change positions slowly.
(cid:2)Interaction is confirmed only with propranolol but may occur with
other beta blockers as well.
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2 acebutolol–salicylates
acebutolol salicylates
Sectral aspirin, bismuth subsalicylate,
choline salicylate, magnesium
salicylate, salsalate, sodium
salicylate, sodium
thiosalicylate
Risk rating: 2
Severity: Moderate Onset: Rapid Likelihood: Suspected
Cause
Salicylates inhibit synthesis of prostaglandins, which acebutolol and
other beta blockers need to reduce blood pressure. In patients with
heart failure, the mechanism of this interaction is unknown.
Effect
Beta blocker effect decreases.
Nursing considerations
(cid:2)Watch closely for signs of heart failure and hypertension; notify pre-
scriber if they occur.
(cid:2)Talk with prescriber about switching patient to a different antihy-
pertensive or antiplatelet drug.
(cid:2)Other beta blockers may interact with salicylates. If you suspect an
interaction, consult prescriber or pharmacist.
(cid:2)Explain signs and symptoms of heart failure, and tell patient when
to contact prescriber.
acebutolol verapamil
Sectral Calan
Risk rating: 1
Severity: Major Onset: Rapid Likelihood: Probable
Cause
Verapamil may inhibit metabolism of acebutolol and other beta
blockers.
Effect
Effects of both drugs may increase.
Nursing considerations
(cid:2)Combined therapy is common in hypertension and unstable angina.
x ALERTCombined use increases risk of adverse effects, including
heart failure, conduction disturbances, arrhythmias, and hypotension.
(cid:2)Assess patient for adverse effects, including left ventricular dysfunc-
tion and AV conduction defects.