Active Learning Template for medication: Fluticasone Propionate.
Active Learning Template for medication: Fluticasone Propionate.
Homework Answers
Ans) Generic Name: Fluticasone (Rx)
Trade Name: Arnuity Ellipta, FLONASE, Flovent HFA, Flovent Diskus, Veramyst (nasal spray)
Classification: corticosteroid
Dose
Flovent diskus- 100 mcg bid
Flonase 2 sprays initially then 1 spray per nostril
Route
Oral INH
Intranasal
Time/Frequency
Flovent- bid
Daily
Peak
several days
Onset
oral INH- 24 hr
Intranasal 12 hr
Duration
1-2 weeks
Normal dosage range
100-500 mcg bid
Lab alterations caused by this med
unknown
Uses
Prevention of chronic asthma during maintenance treatment in those
requiring oral corticosteroids; nasal symptoms of
seasonal/perennial, allergic/nonallergic rhinitis
UNLABELED USES; COPD
Action
Decreases inflammation by inhibiting mast cells, macrophages, and
leukotrienes; anti-inflammatory and vaso-constrictor
properties.
Nursing Implications
corticosteroid use, adrenal insufficiency, Anaphalxsis
Pre-administration assessment
RESPIRATORY STATUS- lung sounds, pulmonary function tests during,
for several mo after change from systemic to inhalation
corticosteroids
ADRENAL INSUFFICIENCY: NAS, WEAKNESS, FATIGUE, HYPOTENSION,
HYPOGLYCEMIA, ANOREXIA, MAY OCCUR WHEN CHANGING FORM SYSTEMIC TO
INHALATION CORTICOSTERIODS; MAY BE LIFE THREATENING; ADRENAL
FUNCTION TEST PERIDODICALLY: HYPTHALAMIC-PITUITARY-ADRENAL AXIS
SUPRESSION IN LONG-TERM TREATMENT
Growth rate in children; blood glucose, serum K for all
Patients
AVOID BEERS may worsen delirium
Reasons to hold
corticosteroid use
Post- administration (Evaluate)
Therapeutic response; decreased severity of asthma, COPD,
allergies
Side effects/adverse reactions
CNS; Fatigue, fever, headache, nervousness, dizziness,
migraines
EENT; Pharyngitis, sinusitis, rhinitis, laryngitis, hoarseness, dry
eyes, cataracts, nasal discharge, epitaxis, blurred vision
GI; Dia, abd pain, nas, vom, oral candidiasis
INTEG; urticaria, dermatitis
META: Hyperglycemia, growth retardation in children, cushingoid
features
MISC: INFLUENZA, EOSINPHILIC CONDITIONS, ANGIOEDEMA, CHRUG-STRAUSS
SYNDROME< ANAPHYAXIC, ADRENAL INSUFFICIENCY (HIGH DOSES) bone
mineral density reduction
MS; osteoporosis, muscle soreness, joint pain, arthralgia
RESP: Upper respiratory infections, dyspnea, cough, bronchitis,
BRONCHOSPASM
Contraindications
Hypersensitivity to this product or milk protein, primary treatment
in status asthmaticus, acute bronchospasm
PRECAUTIONS; pregnancy (C), breast feeding, active infections,
glaucoma, diabetes, immunocompromised pt, Cushing syndrome
Nursing considerations (administer)
Give at 1-min intervals; if a bronchodilator aerosol spray is used,
use bronchodilator first, wait 5-15 min, then use fluticasone
- decrease dose to lowest effective does after desired effect;
decrease dose at 2-4 wk intervals
INHALATION ROUTE
-shake well, prime before 1st use, release 4 sprays into air away
from face, Clean mouth piece daily in warm water, dry ; don't
share; child requires face mask with spacer/ DONT USE SPACER FOR
FLOVENT DISKUS
INTRANASAL
prime before 1st use, shake bottle gently before each use, rinse
tip after use, dry with tissue, blow nose before use
Teach pt
-to use bronchodilator first, before using inhalation, if taking
both
-not to use for acute asthmatic attack; acute asthma may require
oral corticosteroids
-to avoid smoking, smoke-filled rooms, those with URIs, those not
immunized against chicken pox or measles
-to rinse mouth after inhaled product to decrease risk of oral
candidiasis,
- TO REPORT IMMEDIATELY CUSHINGOID SYMPTOMS; NO APPETITE, NAS,
WEAKNESS, FAT, DECREASED BP
-how to use, and when it may be empty
-to use medical id identifying corticosteroid use
Interactions w/ other drugs/otc/herbal meds
Increase: fluticasone levels-CYP3A4 inhibitors(ketoconazole,
itraconazole), darunavir, nelfinavir, ritonavir, amprenavir,
fosamprenavir, atazanavir, delavirdine, saquinavir
Increase; Cardiac Toxicity- isoproterenol (asthma pt)
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