Adalimumab HUMIRA
Nursing Considerations
• Use adalimumab cautiously in patients
with recurrent infection or increased risk
of infection, patients who live in regions
where tuberculosis and mycoses are
endemic, and patients with a history of
CNS demyelinating disorders because they
occur, rarely, during adalimumab therapy.
WARNING If patient has evidence of an
active infection when drug is prescribed,
therapy shouldn’t start until infection has
been treated.Monitor all patients for
infection during therapy, especially those
receiving immunosuppressants. If a serious
infection develops, expect prescriber
to stop drug.
•Make sure patient has a tuberculin skin
test before therapy starts. If skin test is
positive, treatment of latent tuberculosis
will start before adalimumab, as prescribed.
• Be aware that the needle cover of the
syringe contains dry rubber. Don’t handle
if you’re allergic to latex.
• To activate the protection device on needles
of prefilled syringes delivered to institutions,
hold the syringe in one hand and,
with the other hand, slide outer protective
shield over exposed needle until it locks
into place.
WARNING Stop adalimumab immediately
and tell prescriber if patient has an allergic
reaction. Expect to provide supportive
care.
•Watch closely for evidence of congestive
heart failure (sudden, unexplained weight
gain; dyspnea; crackles; anxiety), and notify
prescriber if they occur.
•Monitor patient’s CBC, as ordered,
because adalimumab may have adverse
hematologic effects. Notify prescriber
about persistent fever, bruising, bleeding,
or pallor.
• Be aware that adalimumab belongs to a
group of drugs called tumor necrosis factor
(TNF) blockers. Although rare, malignancies,
especially lymphomas and
leukemias, have occurred in patients receiving
TNF blockers, including children.
Patients with rheumatoid arthritis, especially
those with very active disease, are at
greatest risk.Monitor patients closely.
PATIENT TEACHING
vInform patient that the first injection of
adalimumab must take place with a health
care professional present.
• Teach patient or caregiver how to give
adalimumab as a subcutaneous injection
at home, if applicable. Emphasize importance
of injecting the full amount in the
syringe (0.8 ml) to obtain the correct dose
of 40 mg.
• If patient is allergic to latex, explain that
the needle cover contains rubber.
• Caution patient against reusing needles
and syringes. Provide patient or caregiver
with a puncture resistant container for
disposal of needles and syringes at home.
• Instruct patient or caregiver to rotate
injection sites and to avoid injecting in any
area that’s tender, bruised, red, or hard.
• Inform patient that prefilled syringes must
be refrigerated (not frozen), protected
from light, and stored in the original container.
• Urge patient to check expiration dates and
not to use outdated drug.
• Review signs and symptoms of an allergic
reaction (rash, swollen face, difficulty
breathing), and tell patient to seek emergency
care immediately if these occur.
• Inform patient that injection site reactions
(such as redness, rash, swelling, itching,
and bruising) may occur but are usually
mild and transient. Instruct him to apply a
towel soaked with cold water on the injection
site if it hurts or remains swollen. If
reaction does not disappear or seems to
worsen, tell patient to call prescriber
immediately.
• Inform patient that tuberculosis may
occur during adalimumab therapy.
Instruct him to report persistent cough,
wasting or weight loss, and low-grade
fever to prescriber.
• Teach patient to recognize evidence of
infection and bleeding disorders and to
tell prescriber if they occur; drug may
need to be stopped. Advise patient to
avoid people with infections and to have
all prescribed laboratory tests.
• Inform patient that the risk of certain
kinds of cancer, especially lymphomas, is
higher in patients taking adalimumab but
still rare. Emphasize the importance of
follow-up visits and reporting an unusual
or sudden onset of signs or symptoms.
• Caution patient against receiving livevirus
vaccines while taking adalimumab
because doing so may adversely effect the
immune system.
• Inform patient that blood samples may be
needed periodically, but especially around
week 24 of therapy, to check for autoantibody
development. Explain that adalimumab
therapy will need to be stopped if
they’re detected.
• Instruct patient to report lupus-like signs
and symptoms that, although rare, may
occur during therapy, such as chest pain
that doesn’t go away, shortness of breath,
joint pain, or a rash on cheeks or arms
that’s sensitive to the sun. Explain that
drug may be stopped if these occur.
• Advise patient to inform all health care
providers about adalimumab use and to
inform prescriber about any OTC medications
being taken, including herbal remedies
and vitamin and mineral supplements.
Thursday, April 7, 2011
Nursing Consideration Patient Teaching - Acitretin Soriatane
Acitretin Soriatane
Nursing Considerations
WARNING Don’t give acitretin to a pregnant
woman, a woman contemplating pregnancy,
or a woman who may not use reliable
contraception during drug therapy and for
at least 3 years afterward because acitretin
causes major fetal abnormalities.
•Make sure patient has had two negative
urine or serum pregnancy tests with a sensitivity
of at least 25 mIU/ml before
receiving acitretin. First test should be
obtained when decision is made to use
acitretin and second test during first
5 days of the menstrual period just before
acitretin therapy starts. For patients with
amenorrhea, second test should be done at
least 11 days after the last act of unprotected
sexual intercourse (which means
without using two effective forms of contraception
simultaneously).
• Check to make sure female patient of
childbearing age has signed the patient
agreement and informed consent form
before starting acitretin therapy.
•Obtain a lipid profile, as ordered, before
acitretin therapy starts and every 1 to
2 weeks for up to 8 weeks or until lipid
effects are known. In high-risk patients,
such as those with diabetes, obesity, or a
history of alcohol abuse and those taking
acitretin long-term, check lipid profile
periodically throughout therapy.
•Monitor liver function test results, as
ordered. If hepatotoxicity is suspected,
expect to stop drug and investigate cause.
• If patient takes acitretin long-term or she
develops a skeletal disorder, prepare her
for periodic bone radiography because
ossification abnormalities can occur, especially
of the vertebral column, knees, and
ankles.
•Monitor patient’s eyes for abnormalities
throughout therapy. Expect patient to stop
drug and have an ophthalmologic examination
if eye abnormalities occur.
•Monitor patient for evidence of increased
intracranial pressure, such as papilledema,
headache, nausea, vomiting, and visual
disturbances. If papilledema occurs, stop
drug therapy immediately and obtain a
neurologic evaluation, as ordered. Patient
should never receive a tetracycline while
taking acitretin because combined use can
increase intracranial pressure.
• Assess patient for suidical ideation because
depression and other psychiatric symptoms,
including thoughts of self-harm,
may occur with acitretin use. Expect drug
to be discontinued if psychiatric symptoms
develop.
• Significantly lower doses of phototherapy
are needed during acitretin therapy
because drug increases the risk of erythema.
PATIENT TEACHING
WARNING Warn women of childbearing age
that acitretin causes major fetal abnormalities.
• Inform woman of childbearing age that
she must have a pregnancy test before
acitretin therapy starts, every month during
acitretin therapy, and every 3 months
for 3 years after therapy stops.
• Stress to woman of childbearing age that
she must use two effective forms of contraception
simultaneously unless she has
chosen absolute abstinence or has had a
hysterectomy. This must begin at least 1
month before acitretin therapy starts and
continue throughout therapy and for at
least 3 years after therapy ends.
• Caution women taking oral contraceptives
that some prescribed and OTC drugs,
including herbal supplements such as St.
John’s wort, may interfere with oral contraceptives.
Urge her to tell prescriber
about all drugs she takes.
• Caution patient not to consume alcohol or
products that contain alcohol during
acitretin therapy and for 2 months after
therapy ends.
•Warn patient, male or female of any age,
not to donate blood during acitretin therapy
and for at least 3 years after it ends.
• Review acitretin medication guide with
patient, and answer the patient’s questions.
• Inform patient that psoriasis may worsen
during initial treatment and that full
effects of drug may not be seen for up to
3 months.
• Caution patient to avoid hazardous activities
until drug’s CNS and ophthalmic
effects are known.
• Inform patient that tolerance to contact
lenses may decrease during acitretin therapy
and for a period of time after treatment
ends.
• Advise patient not to take more than the
minimum recommended daily allowance
of vitamin A during acitretin therapy
because of the risk of vitamin A toxicity.
• Caution patient not to use sun lamps and
to avoid excessive exposure to sunlight
because the effects of UV light are
enhanced by retinoids such as acitretin.
Nursing Considerations
WARNING Don’t give acitretin to a pregnant
woman, a woman contemplating pregnancy,
or a woman who may not use reliable
contraception during drug therapy and for
at least 3 years afterward because acitretin
causes major fetal abnormalities.
•Make sure patient has had two negative
urine or serum pregnancy tests with a sensitivity
of at least 25 mIU/ml before
receiving acitretin. First test should be
obtained when decision is made to use
acitretin and second test during first
5 days of the menstrual period just before
acitretin therapy starts. For patients with
amenorrhea, second test should be done at
least 11 days after the last act of unprotected
sexual intercourse (which means
without using two effective forms of contraception
simultaneously).
• Check to make sure female patient of
childbearing age has signed the patient
agreement and informed consent form
before starting acitretin therapy.
•Obtain a lipid profile, as ordered, before
acitretin therapy starts and every 1 to
2 weeks for up to 8 weeks or until lipid
effects are known. In high-risk patients,
such as those with diabetes, obesity, or a
history of alcohol abuse and those taking
acitretin long-term, check lipid profile
periodically throughout therapy.
•Monitor liver function test results, as
ordered. If hepatotoxicity is suspected,
expect to stop drug and investigate cause.
• If patient takes acitretin long-term or she
develops a skeletal disorder, prepare her
for periodic bone radiography because
ossification abnormalities can occur, especially
of the vertebral column, knees, and
ankles.
•Monitor patient’s eyes for abnormalities
throughout therapy. Expect patient to stop
drug and have an ophthalmologic examination
if eye abnormalities occur.
•Monitor patient for evidence of increased
intracranial pressure, such as papilledema,
headache, nausea, vomiting, and visual
disturbances. If papilledema occurs, stop
drug therapy immediately and obtain a
neurologic evaluation, as ordered. Patient
should never receive a tetracycline while
taking acitretin because combined use can
increase intracranial pressure.
• Assess patient for suidical ideation because
depression and other psychiatric symptoms,
including thoughts of self-harm,
may occur with acitretin use. Expect drug
to be discontinued if psychiatric symptoms
develop.
• Significantly lower doses of phototherapy
are needed during acitretin therapy
because drug increases the risk of erythema.
PATIENT TEACHING
WARNING Warn women of childbearing age
that acitretin causes major fetal abnormalities.
• Inform woman of childbearing age that
she must have a pregnancy test before
acitretin therapy starts, every month during
acitretin therapy, and every 3 months
for 3 years after therapy stops.
• Stress to woman of childbearing age that
she must use two effective forms of contraception
simultaneously unless she has
chosen absolute abstinence or has had a
hysterectomy. This must begin at least 1
month before acitretin therapy starts and
continue throughout therapy and for at
least 3 years after therapy ends.
• Caution women taking oral contraceptives
that some prescribed and OTC drugs,
including herbal supplements such as St.
John’s wort, may interfere with oral contraceptives.
Urge her to tell prescriber
about all drugs she takes.
• Caution patient not to consume alcohol or
products that contain alcohol during
acitretin therapy and for 2 months after
therapy ends.
•Warn patient, male or female of any age,
not to donate blood during acitretin therapy
and for at least 3 years after it ends.
• Review acitretin medication guide with
patient, and answer the patient’s questions.
• Inform patient that psoriasis may worsen
during initial treatment and that full
effects of drug may not be seen for up to
3 months.
• Caution patient to avoid hazardous activities
until drug’s CNS and ophthalmic
effects are known.
• Inform patient that tolerance to contact
lenses may decrease during acitretin therapy
and for a period of time after treatment
ends.
• Advise patient not to take more than the
minimum recommended daily allowance
of vitamin A during acitretin therapy
because of the risk of vitamin A toxicity.
• Caution patient not to use sun lamps and
to avoid excessive exposure to sunlight
because the effects of UV light are
enhanced by retinoids such as acitretin.
Nursing Consideration Patient Teaching - Acetylcysteine Acetadote Mucomyst Mucosil
Acetylcysteine, Acetadote, Mucomyst, Mucosil
Nursing Considerations
• Acetylcysteine should be used cautiously
in patients with asthma or a history of
bronchospasm because drug may adversely
affect respiratory function.
WARNING To avoid fluid overload and possibly
fatal hyponatremia or seizures, adjust
total administered volume, as ordered, for
patients weighing less than 40 kg (88 lb)
and for those who need fluid restriction.
• If needed, dilute 20% instillation or
inhalation solution with normal saline
solution or sterile water. The 10% solution
may be used undiluted.
•When treating acetaminophen overdose,
dilute 20% oral solution with cola or other
soft drink to a concentration of 5%, and
use within 1 hour. Dilute parenteral solution
with D5W or half-normal saline
(0.45% sodium chloride) solution for
injection following manufacturer guidelines
because dilution is based on dosage.
Acetadote may turn from colorless to
slight pink or purple once the stopper is
punctured, but color change has no effect
on product quality.
• Acetylcysteine is most effective if given
within 24 hours of acetaminophen ingestion.
For specific instructions, contact a
regional poison center at 1-800-222-1222
or a special health professional assistance
hotline at 1-800-525-6115.
• If patient vomits loading dose or any
maintenance dose within 1 hour of
administration, repeat dose as prescribed.
• Keep in mind that suicidal patient may
not provide reliable information about
vomiting.Watch such a patient to ensure
that he ingests all of prescribed dosage.
• During treatment for acetaminophen
overdose, watch for signs of hepatotoxicity,
such as prolonged bleeding time,
altered coagulation, and easy bruising.
• Be aware that acetylcysteine may have a
disagreeable odor, which disappears as
treatment progresses.
• Because nebulization causes sticky residue
on face and in mouth, have patient wash
his face and rinse his mouth at the end of
each treatment.
• Be aware that an open vial of solution may
turn light purple but that this doesn’t alter
its effectiveness.
• Refrigerate opened vials and discard after
96 hours.
• Assess type, frequency, and characteristics
of patient’s cough. Particularly note sputum.
If cough doesn’t clear secretions, prepare
to perform mechanical suctioning.
•Monitor patient for tachycardia.
PATIENT TEACHING
• Instruct patient to notify prescriber immediately
about nausea, rash, or vomiting.
•Warn patient about acetylcysteine’s
unpleasant smell; reassure him that it subsides
as treatment progresses.
• To decrease mucus viscosity, urge patient
to consume 2 to 3 L of fluid daily unless
contraindicated by another condition.
Nursing Considerations
• Acetylcysteine should be used cautiously
in patients with asthma or a history of
bronchospasm because drug may adversely
affect respiratory function.
WARNING To avoid fluid overload and possibly
fatal hyponatremia or seizures, adjust
total administered volume, as ordered, for
patients weighing less than 40 kg (88 lb)
and for those who need fluid restriction.
• If needed, dilute 20% instillation or
inhalation solution with normal saline
solution or sterile water. The 10% solution
may be used undiluted.
•When treating acetaminophen overdose,
dilute 20% oral solution with cola or other
soft drink to a concentration of 5%, and
use within 1 hour. Dilute parenteral solution
with D5W or half-normal saline
(0.45% sodium chloride) solution for
injection following manufacturer guidelines
because dilution is based on dosage.
Acetadote may turn from colorless to
slight pink or purple once the stopper is
punctured, but color change has no effect
on product quality.
• Acetylcysteine is most effective if given
within 24 hours of acetaminophen ingestion.
For specific instructions, contact a
regional poison center at 1-800-222-1222
or a special health professional assistance
hotline at 1-800-525-6115.
• If patient vomits loading dose or any
maintenance dose within 1 hour of
administration, repeat dose as prescribed.
• Keep in mind that suicidal patient may
not provide reliable information about
vomiting.Watch such a patient to ensure
that he ingests all of prescribed dosage.
• During treatment for acetaminophen
overdose, watch for signs of hepatotoxicity,
such as prolonged bleeding time,
altered coagulation, and easy bruising.
• Be aware that acetylcysteine may have a
disagreeable odor, which disappears as
treatment progresses.
• Because nebulization causes sticky residue
on face and in mouth, have patient wash
his face and rinse his mouth at the end of
each treatment.
• Be aware that an open vial of solution may
turn light purple but that this doesn’t alter
its effectiveness.
• Refrigerate opened vials and discard after
96 hours.
• Assess type, frequency, and characteristics
of patient’s cough. Particularly note sputum.
If cough doesn’t clear secretions, prepare
to perform mechanical suctioning.
•Monitor patient for tachycardia.
PATIENT TEACHING
• Instruct patient to notify prescriber immediately
about nausea, rash, or vomiting.
•Warn patient about acetylcysteine’s
unpleasant smell; reassure him that it subsides
as treatment progresses.
• To decrease mucus viscosity, urge patient
to consume 2 to 3 L of fluid daily unless
contraindicated by another condition.
Nursing Consideration Patient Teaching - Acetohydroxamic acid Lithostat
Acetohydroxamic acid, Lithostat
Nursing Considerations
• Use acetohydroxamic acid cautiously in
patients with severe chronic renal disease
or anemia and those who’ve had phlebitis
or thrombophlebitis.
• Be aware that risk of adverse psychomotor
effects increases if patient drinks alcohol
or takes drugs that affect alertness and
reflexes, such as antihistamines, tranquilizers,
sedatives, analgesics, and narcotics.
• Administer tablets with food or liquid,
crushing them if needed.
WARNING Acetohydroxamic acid chelates
with dietary iron. If patient has iron deficiency
anemia, expect to administer I.M.
iron as needed during acetohydroxamic
acid therapy.
•Monitor follow-up laboratory tests to
check renal and hepatic function and
urine pH, as ordered.
PATIENT TEACHING
• Instruct patient to take drug at same time
each day, as prescribed.
• Tell patient to take a missed dose up to
2 hours after scheduled time. If more than
2 hours have passed, he should wait for
next scheduled dose and shouldn’t double
that dose.
•Warn patient not to take drug with alcohol
or iron and to consult prescriber
before taking it with any other drug.
• Instruct patient to avoid hazardous activities
during therapy.
Nursing Considerations
• Use acetohydroxamic acid cautiously in
patients with severe chronic renal disease
or anemia and those who’ve had phlebitis
or thrombophlebitis.
• Be aware that risk of adverse psychomotor
effects increases if patient drinks alcohol
or takes drugs that affect alertness and
reflexes, such as antihistamines, tranquilizers,
sedatives, analgesics, and narcotics.
• Administer tablets with food or liquid,
crushing them if needed.
WARNING Acetohydroxamic acid chelates
with dietary iron. If patient has iron deficiency
anemia, expect to administer I.M.
iron as needed during acetohydroxamic
acid therapy.
•Monitor follow-up laboratory tests to
check renal and hepatic function and
urine pH, as ordered.
PATIENT TEACHING
• Instruct patient to take drug at same time
each day, as prescribed.
• Tell patient to take a missed dose up to
2 hours after scheduled time. If more than
2 hours have passed, he should wait for
next scheduled dose and shouldn’t double
that dose.
•Warn patient not to take drug with alcohol
or iron and to consult prescriber
before taking it with any other drug.
• Instruct patient to avoid hazardous activities
during therapy.
Nursing Consideration Patient Teaching - Acetohexamide Dimelor Dymelor
Acetohexamide Dimelor Dymelor
Nursing Considerations
• Use acetohexamide cautiously in elderly
patients and in those with cardiac, hepatic,
or renal disease or thyroid dysfunction.
Drug’s duration of action is prolonged in
patients with renal disease.
• Give acetohexamide 30 minutes before
meals, crushing tablets if desired. If GI
upset occurs, give in divided doses, as prescribed.
•Watch for evidence of hypoglycemia and
hyperglycemia, especially after meals.
• Check blood glucose level often, as ordered.
Provide additional insulin if needed during
stressful periods, as prescribed.
•Monitor liver enzyme levels during therapy;
acetohexamide may increase AST, ALT,
and alkaline phosphatase levels.
• Store acetohexamide in tightly sealed container
in a cool environment.
PATIENT TEACHING
• Stress need to adhere to prescribed drug
regimen, diet, and exercise program.
• Advise patient to take acetohexamide with
food to avoid GI upset.
• Teach patient how to self-monitor blood
glucose level and check urine for glucose
and ketones, as appropriate.
• Teach patient to recognize and report
signs of hypoglycemia and hyperglycemia.
Nursing Considerations
• Use acetohexamide cautiously in elderly
patients and in those with cardiac, hepatic,
or renal disease or thyroid dysfunction.
Drug’s duration of action is prolonged in
patients with renal disease.
• Give acetohexamide 30 minutes before
meals, crushing tablets if desired. If GI
upset occurs, give in divided doses, as prescribed.
•Watch for evidence of hypoglycemia and
hyperglycemia, especially after meals.
• Check blood glucose level often, as ordered.
Provide additional insulin if needed during
stressful periods, as prescribed.
•Monitor liver enzyme levels during therapy;
acetohexamide may increase AST, ALT,
and alkaline phosphatase levels.
• Store acetohexamide in tightly sealed container
in a cool environment.
PATIENT TEACHING
• Stress need to adhere to prescribed drug
regimen, diet, and exercise program.
• Advise patient to take acetohexamide with
food to avoid GI upset.
• Teach patient how to self-monitor blood
glucose level and check urine for glucose
and ketones, as appropriate.
• Teach patient to recognize and report
signs of hypoglycemia and hyperglycemia.
Nursing Consideration Patient Teaching - Acetazolamide Acetazolam Ak-Zol Apo-Acetazolamide Dazamide Diamox Diamox Sequels Storzolamide
Acetazolamide Acetazolam Ak-Zol Apo-Acetazolamide Dazamide Diamox Diamox Sequels Storzolamide
Nursing Considerations
• Use acetazolamide cautiously in patients
with calcium-based renal calculi, diabetes
mellitus, gout, or respiratory impairment.
• Know that acetazolamide may increase
risk of hepatic encephalopathy in patients
with hepatic cirrhosis.
• To avoid painful I.M. injections (caused by
alkaline solution), give acetazolamide by
mouth or I.V. injection if possible.
• Reconstitute each 500-mg vial with at least
5 ml sterile water for injection. Use within
24 hours because drug has no preservative.
•Monitor blood tests during acetazolamide
therapy to detect electrolyte imbalances.
•Monitor fluid intake and output every
8 hours and body weight daily to detect
excessive fluid and weight loss.
PATIENT TEACHING
• Inform patient that acetazolamide tablets
may be crushed and suspended in chocolate
or another sweet syrup. Or, one tablet
may be dissolved in 10 ml hot water and
added to 10 ml honey or syrup.
• Advise patient to avoid hazardous activities
if dizziness or drowsiness occurs.
• Instruct patient who takes high doses of
salicylates to notify prescriber immediately
about evidence of salicylate toxicity, such
as anorexia, tachypnea, and lethargy.
• If patient plans to mountain climb, urge
her to descend mountain gradually and to
seek immediate medical care if symptoms
of mountain sickness occur.
Nursing Considerations
• Use acetazolamide cautiously in patients
with calcium-based renal calculi, diabetes
mellitus, gout, or respiratory impairment.
• Know that acetazolamide may increase
risk of hepatic encephalopathy in patients
with hepatic cirrhosis.
• To avoid painful I.M. injections (caused by
alkaline solution), give acetazolamide by
mouth or I.V. injection if possible.
• Reconstitute each 500-mg vial with at least
5 ml sterile water for injection. Use within
24 hours because drug has no preservative.
•Monitor blood tests during acetazolamide
therapy to detect electrolyte imbalances.
•Monitor fluid intake and output every
8 hours and body weight daily to detect
excessive fluid and weight loss.
PATIENT TEACHING
• Inform patient that acetazolamide tablets
may be crushed and suspended in chocolate
or another sweet syrup. Or, one tablet
may be dissolved in 10 ml hot water and
added to 10 ml honey or syrup.
• Advise patient to avoid hazardous activities
if dizziness or drowsiness occurs.
• Instruct patient who takes high doses of
salicylates to notify prescriber immediately
about evidence of salicylate toxicity, such
as anorexia, tachypnea, and lethargy.
• If patient plans to mountain climb, urge
her to descend mountain gradually and to
seek immediate medical care if symptoms
of mountain sickness occur.
Nursing Consideration Patient Teaching - Acebutolol hydrochloride Monitan Sectral
Acebutolol hydrochloride Monitan Sectral
Nursing Considerations
• Before therapy begins, obtain baseline
renal function tests, as ordered.
• Check apical and radial pulses before giving
acebutolol. Also, frequently monitor
blood pressure and pulse rate, rhythm,
and quality during treatment.
• Give drug with food to prevent GI upset.
• Acebutolol may elevate uric acid, potassium,
triglyceride, lipoprotein, and antinuclear
antibody levels; it also may interfere
with accuracy of glucose tolerance tests.
•Monitor diabetic patient’s blood glucose
level to spot alterations.
• Notify prescriber if you detect a heart rate
below 50 beats/min or signs of heart failure,
such as dyspnea, crackles, unexplained
weight gain, and jugular vein distention.
•Monitor patient for peripheral edema, and
evaluate fluid intake and output.
PATIENT TEACHING
• Tell patient that tablets may be crushed or
swallowed whole.
•Warn against stopping acebutolol abruptly
because doing so could cause angina or
dangerously high blood pressure.
• Instruct patient to take a missed dose as
soon as possible up to 6 hours before next
scheduled dose but not to double the next
dose.
• Advise patient to consult prescriber before
taking OTC drugs that contain alpha agonists,
such as nasal decongestants and cold
preparations.
• Instruct patient to report dizziness, confusion,
and fever immediately.
• Urge patient to maintain diet and lifestyle
changes to help control blood pressure.
Nursing Considerations
• Before therapy begins, obtain baseline
renal function tests, as ordered.
• Check apical and radial pulses before giving
acebutolol. Also, frequently monitor
blood pressure and pulse rate, rhythm,
and quality during treatment.
• Give drug with food to prevent GI upset.
• Acebutolol may elevate uric acid, potassium,
triglyceride, lipoprotein, and antinuclear
antibody levels; it also may interfere
with accuracy of glucose tolerance tests.
•Monitor diabetic patient’s blood glucose
level to spot alterations.
• Notify prescriber if you detect a heart rate
below 50 beats/min or signs of heart failure,
such as dyspnea, crackles, unexplained
weight gain, and jugular vein distention.
•Monitor patient for peripheral edema, and
evaluate fluid intake and output.
PATIENT TEACHING
• Tell patient that tablets may be crushed or
swallowed whole.
•Warn against stopping acebutolol abruptly
because doing so could cause angina or
dangerously high blood pressure.
• Instruct patient to take a missed dose as
soon as possible up to 6 hours before next
scheduled dose but not to double the next
dose.
• Advise patient to consult prescriber before
taking OTC drugs that contain alpha agonists,
such as nasal decongestants and cold
preparations.
• Instruct patient to report dizziness, confusion,
and fever immediately.
• Urge patient to maintain diet and lifestyle
changes to help control blood pressure.
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