Pediatric Drugs 5
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| Actemra (tocilizumab) | Over 2 years and 30 kg: IV 8mg/kg q 2wks.
Side effects: Headache, dizziness, rash.
Nursing implications: Monitor for S&S of serious allergic reactions, monitor for S&S of polyneuropathy.
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| Orencia (abatacept) | At least 6 yrs and under 75 kg: 10mg/kg at 2 and 4 wks, then monthly (max 1000mg).
Side effects: Cough, hypertension, nausea, rash.
Nursing implications: Screen for latent TB infection prior to initiating treatment, monitor for S&S of hypersensitivity.
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| Prednizone | 0.1-0.15mg/kg/day.
Side effects: Headache, N/V, peptic ulcer, growth suppression.
Nursing implications: Check and record BP during dose stabilization, monitor for S&S of hypocalcemia.
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| Ketoconazole | Over 2 yrs: 3.3-6.6mg/kg/day as a single dose.
Side effects: Urticaria, pruritus, N/V/D.
Nursing implications: Monitor baseline LFTs, monitor for S&S of hepatoxicity.
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| Cuvposa | 0.02 mg/kg orally three times daily.
Side effects: Dry mouth, vomiting, constipation, flushing.
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| Dexamethasone | 0.08-0.13 mg/kg/day.
Side effects: HTN, nausea, heartburn, impaired wound healing.
Nursing implications: Monitor for S&S of Cushing's syndrome, monitor for S&S of hypersensitivity reaction.
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| Lisinopril | 6-16 yrs: Start at 0.07mg/kg/day (max 5 mg) once a day.
Side effects: HA, dizziness, fatigue, N/V/D.
Nursing implications: Measure BP just prior to dosing, monitor for angioedema of face, lips, tongue.
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| Mebendazole | 100mg b.i.d for 3 days.
Side effects: Dizziness, fever, diarrhea.
Nursing implications: Initiate 2nd course of treatment if cure does not occur in 3 weeks, examine and treat all family members simultaneously.
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| Captopril (Capoten) | Adolescent: 12.5-25mg b.i.d. or t.i.d.
Side effects: Arthralgia, skin eruptions, altered taste.
Nursing implications: Monitor BP closely following first dose, advise bed rest, monitor therapeutic effectiveness.
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| Digoxin | 2-10 yrs: 6-7.5mcg/kg/day.
Side effects: fatigue, muscle weakness, headache.
Nursing implications: Take AP for 1 full minute prior to administration, withhold medication and notify prescriber if AP falls below ordered parameters.
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