Cipro (Ciprofloxacin hydrochloride) Contraindication/Precautions:

500 mg tablet - Hypersensitivity to cipro & quinolones

- Use caution if pt is pregnant, breastfeeding,
Alternate name: Ciprofloxacin Hydrochloride have a history of seizure, renal and hepatic
disease, stroke, CV disease, geriatric, QT
Frequency: 1 tab Q12H prolongation, hypokalemia, colitis
Class: fluoroquinolone antibiotics Medication Interaction:
Action: Stop bacterial growth by inhibiting DNA - Metformin/sulfonylurea: lower & control blood
gyrase sugar level
- Warfarin: ↑ risk of bleeding & bruising
Use: treat bacterial infections (typhoid fever, - Dairy product: ↓ cipro absorption
plague, infectious diarrhea, UTI, nosocomial - Magnesium, aluminum, calcium, iron, zinc: ↓
pneumonia, inhalation of anthrax, gonorrhea) cipro absorption (antacids)
- Painkillers
Common Side Effects: - Medication affects heart rhythm: side effect ↑
- Nausea
Nurse Consideration:
- Vomiting
- Assess pt for S/S of infection (including
- Stomach pain
characteristics of wound, sputum, urine stool,
- Heartburn
WBC> 10.000/ mm, fever, obtain baseline
- Diarrhea
(before & during)
- Vaginal itching and/or discharge
- Assess for Stevens Johnson syndrome,
- Pale skin
anaphylaxis: rash, dyspnea, pruritus, chills,
- Unusual tiredness and sleepiness
fever, joint pain. Have emergency equipment
Serious Side Effects: (epinephrine & resuscitation)
- Serious skin reaction: rash, swelling of face, - Monitor QT Prolongation
lips) - Check for CNS symptoms: headache,
- Severe diarrhea (watery- CDAD- [Link]), dizziness, fatigue, insomnia, depression,
nausea, vomit, excessive sweat seizure
- Heart rhythm change: fast or irregular - Check for overgrowth of infection: fever,
heartbeat, severe dizziness, feeling faint, redness, pain, swelling, draining, rash,
lightheaded, chest pain, trouble breathing diarrhea, change in cough, sputum
- Seizure - Monitor: AST, ALT, CBC, Hct, bilirubin, LDH,
- Pseudotumor cerebri alkaline phosphate
- Toxic epidermal necrolysis
Times:
- Anaphylaxis
- Onset: begins working rapidly
- Stevens- Johnson syndrome
- Peaks: 1-4 hrs.
- QT prolongation
- Durations: up to 24 hrs.
- Yellow skin or eyes

Dosage Safety: Patient Education:

- Usual dose depends on infection - Do not skip doses and finish treatment even if
- UTI: 250 mg Q12H for 3 days pt feels better; when missed, do not double
- Other infection: usually 500 mg- 750 mg and dose
days depends on the infection - Do not crush or chew the extended release
- Comes in tablet of 100mg, 250 mg, 500 mg, - Can cause skin sensitivity so protect skin and
and 750 mg avoid sun exposure
- Extended-release form (Cipro XR) in 500 mg - Drink plenty of water to prevent
& 1000mg doses crystalluria
24 HR Nicotine 0.292 mg/hr. Contraindication/ Precaution:
transdermal patch - Hypersensitivity
- Pregnancy & breastfeeding
Alternate name: Habitrol
- Diabetes mellitus
Dose: 1 patch - Dysrhythmias & coronary disease
- Impaired kidney and liver function
Class: ganglionic deterrent - Continued smoking
Action: release nicotine through skin, helps - Peripheral vascular disease
reduce cravings and withdrawal symptoms - Hyperthyroidism
- Peptic ulcer disease
Use: provide source of nicotine during controlled
withdrawal from cigarette smoking. Medication Interactions:
- Bromocriptine, cabergoline: ↑ vasoconstriction
- Adenosine: ↑ effects
Common Side Effects - BuPROPion: ↑ B/P
- Dizziness, headache, nausea, vomiting - Insulin: ↓ effect
- Diarrhea - Cimetidine: ↓ nicotine clearance
- Redness or swelling at the patch side - Adrenergic antagonists, beta blockers: ↑ effect
after smoking discontinuation
Serious side effects - Ergots: ↑ vasoconstriction
- Severe rash or swelling
- Seizures
- Heart palpitation- rapid, pounding, irregular Nursing Consideration:
heartbeat (tachycardia, dysrhythmia)
- Assess for withdrawal symptoms: headache,
- Difficulty breathing
fatigue, drowsiness, restlessness, irritability,
- Hypertension
severe cravings for nicotine products before,
- Difficult breathing, wheezing
during, and after treatment
- Assess for nicotine toxicity: GI symptoms
Administration: (nausea, vomiting, diarrhea), cardiopulmonary
symptoms (decreased B/P, dyspnea, change
- Wear gloves and wipe with alcohol pad and in pulse), weakness, abdominal cramping,
place in upper chest, upper arm, shoulder, headache, blurred vision, tinnitus,
back or inner arm. hypotension; product should be discontinued
- Avoid putting patch on areas of irritated, oily,
scarred, or damaged skin
- Press firmly place for ~10 secs. Patient Education:
- Choose new spot on the body every new
- Instruct patient to apply once a day to a
patch
nonhairy, clean, dry area of skin on upper
- Don’t wear two patches at same time
body or upper outer arm; to rotate sites to
Times: prevent skin irritation
- Onset: Rapid - Instruct patient to stop smoking immediately
- Peak: 30 mins. when beginning patch treatment
Preparation & Dosage Safety: - Teach patient signs of toxicity: nausea,
vomiting, diarrhea, headache, dizziness,
- If smoke more than 10 cigar a day: week 1- 4: dyspnea, hypotension
21 mg patch; week 5-6: 14 mg patch; week 7- - Caution patient not to exceed the prescribed
8: 7 mg patch. dose
- If smoke less than 10 cigar a day: week 1-6: - Discontinue if patient is unable to stop
14 mg patch; week 7-8: 7 mg patch smoking after fourth week of therapy
Warfarin Sodium 4 mg oral tab Contraindication/Precaution:

Alternate name: Coumadin - Pregnant & breastfeeding

- Hypersensitivity
Dose: 1 tab - Pt w/ liver disease
- Pt undergo surgery (brain, eye, spine)
Frequency: Daily
- Use caution if pt is Asian, have diabetes,
Class: anticoagulant; coumarins indwelling catheters
- Hypertension
Action: decrease ability to clot by preventing
synthesis of coagulation factors Medication Interaction:
Use: prevent clotting (blood thinner); prevent - Antibiotics: ↑ warfarin level
venous thrombosis, pulmonary embolism. - Antifungal: ↑ risk of bleeding
Reduce risk of stroke and heart attack - Anti-seizure: clear warfarin faster and ↓ INR
(especially in pt w/ heart condition) - Phenytoin: ↑ toxicity and ↑ warfarin effect
- Statin and propranolol: ↑ warfarin level and
risk of bleeding
Common side effects: - Blood thinner (Plavix): ↑ risk of bleeding
- Vit K: ↑ vit K= ↑ warfarin
- Bleeding, bruising, rash, nausea, vomit,
- Alcohol: (binge: ↑ warfarin & ↑ risk of
diarrhea, chills, itching, change in taste
bleeding); (everyday drink: ↓ warfarin level)
Serious Side effects:
- Severe bleeding: feeling faint, lightheaded,
-Nursing Consideration:
dizziness, vomiting blood, bloody or dark-
colored stools, severe pain or discomfort - Monitor blood studies: hct, PT, INR (make
- Calciphylaxis (Ca build-up in blood sure blood is not too thin/thick)
vessels): skin discoloration, skin sores, - Monitor B/P
painful lumps in skin, skin infection - Monitor for fever (TEMP) & skin rashes
- Hematuria & Hemorrhage - Ask the patient for abdominal or back pain,
- Anaphylaxis severe headache, confusion, seizures,
- Purple toe syndrome hemiparesis, and aphasia because they
- Liver damage indicate hemorrhage.
- Check the patient for excessive bleeding
from minor cuts and scratches. Assess their
Administration: gums for erythema and gingival bleeding.

- Check hct, PT, platelets, INR Patient Education

- Avoid alcohol
Preparation & Dosage Safety:
- Withhold med during active bleeding (mens)
- Initial: 2-5 mg PO per day; then adjust - Instruct to carry/wear emergency ID
based on INR level identifying product taken
- Inform pt about limit intake vit K food
Time: - Take warfarin (Coumadin) exactly as your
- Onset: 12-24 hrs. provider tells you.
- Be careful with high-impact activities or
- Peak: 1/2 – 4 days
sports while taking this medication. Advise to
- Duration: 3-5 days use soft toothbrush. Avoid IM injection.
Pilocarpine hydrochloride 2% Administration:
Ophthalmic solution - Tilt head back, pull lower eyelid, place drop
in conjunctival sac
Alternate name: Salagen - Gently close eye and apply gentle pressure
inner corner of eye (1-2 mins). Try not to
Dose: 2 drops OU
blink or rub eyes
Frequency: Q6H
Class: cholinergic agonists
Action: ↑ smooth muscle tone, contracts Contraindication/ Precaution:
pupillary and iris sphincter muscles, & induce - Hypersensitivity
miosis - Caution if pt is pregnant, breastfeeding,
Use: kidney and/or liver disease.

- treat glaucoma and ocular hypertension Times

by allowing excess fluid to drain from eye (↓ - Onset: 10-30 mins
fluid in eye= ↓ eye pressure). - Peak: 1 hr.
- Treats presbyopia by reducing size of pupil - Duration: 4-8 hrs.
which helps see objects up close. Nursing Consideration:
- Check for contact lenses, discharge
- Assess for redness and pain
- Long term use: CBC test (to check kidney,
liver function, and electrolytes)
Common Side effects:
- Temporary blurred vision
- Chills
- Diarrhea Client Education:
- Excessive swelling
- Flushing - Inform pt about S/S like temporary mild
- Headache burning, stinging and blurred vision
- Mild burning, stinging - Teach pt about proper use of solution
- Bitter taste in mouth - Advise pt to use caution with night driving
and when performing dangerous activities in
Serious side effect: low lighting
- Inform pt about possible hypotension
- Allergic reaction: skin rash, itching, swelling
of face, lips, tongue, throat
- Changes in vision Medication Interaction:
- Fast or slow heartbeat
- Decrease B/P - Carbonic anhydrase inhibitors
- Sulfonamides
- Thiazide
- Tegafur
- Medication for B/P and heart problems
Ondansetron 4 mg Disintegrating Oral tab Contraindication/Precautions:
- Hypersensitivity
Alternate name: Zofran - Pregnancy & breastfeeding
- Children
Dose: disintegrating tablet - Pt w/ phenylketonuria
Frequency: Zofran - QT prolongation
- Torsades de pointes
Class: antiemetics; 5-HT receptor antagonists Medication Interactions:
Action: block serotonin at 5-HT3 receptor site to - Apomorphine: increased unconsciousness,
hypotension: do not use together
prevent nausea and vomiting
- CarBAMazepine, phenytoin, rifampin:
Use: prevent severity of nausea and vomiting decreased ondansetron effect
after chemotherapy or surgery - Increased QT prolongation with other products
that prolong QT
- Serotonin- increasing medication (SSRIs,
SSNRIs), MAOIs, tricyclic antidepressants:
Common side effects: Increased serotonin syndrome, monitor for
- Headache symptoms
- Constipation
- Weakness
- Tiredness Nursing Considerations:
- Chills - Assess for absence of nausea, vomiting
- Drowsiness - Assess for hypersensitivity reaction: rash,
bronchospasm
Serious side effects - QT prolongation: monitor ECG in those with
hypokalemia, hypomagnesemia, cardiac
- Allergy: Rash
disease and those receiving other products
- Severe dizziness
that increase QT
- Hypoxia
- Serotonin syndrome: occurs when other
- Fast, slow, or irregular heartbeat
products are given that increase CNS or
- Change in heart rhythm (QT prolongation) peripheral serotonin levels; agitation,
- Serotonin syndrome (↑ serotonin, agitation, confusion, dizziness, diaphoresis, flushing,
confusion, sweating, shaking) tremor, seizures, nausea, vomiting, diarrhea,
product should be discontinued
Patient Education:
Administration: - Instruct patient to report diarrhea, constipation,
rash, changes in respirations, or discomfort at
- Oral disintegrating tab: Remove strip from insertion site, serotonin syndrome
pouch, place on tongue, and allow to - Teach patient reason for medication and
dissolve, drink water expected results
- Avoid alcohol ( ↑ drowsiness)
Dosage Safety - Monitor improvements in GI symptoms
- 4 mg = 1 disintegrating tablet (decreased nausea and vomiting, increased
- Chemotherapy induced nausea: 8 mg PO appetite)
- Monitor EKG, potassium, and magnesium
Times: levels due to the potential for dose-dependent
QT interval prolongation
- Onset: 30 mins- 1 hr.
- Peak: 1.5- 2 hrs.
APAP (Acetaminophen) 650 mg Rectal Medication Interactions:
- Alcohol, carBAMazepine: increased
Suppository
hepatotoxicity
Alternate name: Tylenol - Nitric oxide, pilocarpine: increased
methoglobinemia, avoid concurrent use
Dose: 1 suppository
- Warfarin: hypoprothrombinemia; long-term use,
Frequency: Q4h PRN high doses of acetaminophen
- Barbiturates, hydantoins: decreased effect;
Class: Nonopioid Analgesics (pain relievers) and increased hepatotoxicity, monitor for
anti-pyrectics (fever reducers) hepatotoxicity
Action: inhibit the synthesis of prostaglandins - NSAIDs, salicylates: increased renal adverse
which are mediators in the CNS for fever & pain reactions

Use: treat mild to moderate pain and fever.

Nursing Intervention:
- Pain/fever: Assess for location, duration, type,
Common Side Effects: aggravating/alleviating factors, intensity;
- Stomach pain, nausea, vomiting assess for diaphoresis, fever; baseline and
Serious Effect: periodically
- Skin rashes & severe skin condition - Monitor liver function studies: AST, ALT,
- Bloody or black, tarry stools bilirubin, creatinine before therapy if long-term
- Liver damage (jaundice, dark urine, extreme
therapy is anticipated; may cause hepatic
tiredness, delirium)
toxicity at doses >4 g/day with chronic use
- Coma & Death
- Monitor renal function studies: BUN, urine
- Swelling, pain or tenderness in abdomen
creatinine, occult blood; albumin indicates
- Hepatoxicity
- Hepatic seizure (overdose) nephritis, check I&O ratio; decreasing output
- Renal failure may indicate renal failure (long-term therapy)
- Monitor blood studies: CBC, PT if patient is
on long-term therapy
Administration: - Assess for chronic poisoning: rapid, weak
- Ask pt to lie left side w/ right knee bent pulse; dyspnea; cold, clammy extremities;
- Lubricate and insert suppository into rectum report immediately to prescriber
(1-3 inches)
- Remain lying down a few minutes
Patient Education:
Dosage Safety:
- Inform patient that toxicity may occur when
- 325-650 mg Q4-6 hrs. as needed
- Max 4,000 mg per day used with other combination products
- Child: depend on body weight (10-15 mg per - Advise patient not to use with alcohol, OTC
kilo Q4-6 hrs) products, or herbals without prescriber
Times: approval
- Onset: 30 mins- 1 hr. - Teach patient to recognize signs of chronic
- Peak: 1-3 hrs. overdose: bleeding, bruising, malaise, fever,
- Duration: 3-4 hrs. sore throat
Contraindication/Caution: - Inform patient that urine may become dark
- Hypersensitivity to APAP, aspartame, brown as a result of phenacetin (metabolite of
saccharin, tartrazine, phenacetin acetaminophen)
- Caution for pt who is pregnant, - Tell patient to notify prescriber for pain or
breastfeeding, geriatric, with anemia, renal/ fever lasting more than 3 days, not to be used
hepatic disease, and chronic alcoholism in <2 yr unless approved by prescriber
Phenobarbital 20 mg per 5 ml Oral Nursing Consideration:
Solution - Assess mental status: mood, sensorium,
affect, memory (long, short), especially
Alternate name: Luminal, Solfoton
geriatric; if using as a hypnotic, assess sleep
Dose: 5 mL patterns during therapy; product suppresses
Frequency: Q8H REM sleep with dreaming
Class: barbiturates - Withdrawal insomnia may occur after short-
Action: Depresses sensory cortex, decreases term use; do not start using product again;
motor activity and alters cerebellar function. insomnia improves in 1-3 nights; may
Raises seizure threshold and inhibits experience increased dreaming
transmission in the NS. - Assess respiratory dysfunction: respiratory
Use: control seizures, relieve anxiety, prevent depression, character, rate, rhythm when
withdrawal symptoms using IV; hold product if respirations are
<10/min or if pupils are dilated; also check VS
Common Effects: q30min after parenteral route for 2 hr
- Drowsiness, dizziness, upset stomach, - Assess for barbiturate toxicity: hypotension;
constipation, feeling hungover pulmonary constriction; cold, clammy skin;
cyanosis of lips; CNS depression; nausea;
Serious Effect:
vomiting; hallucinations; delirium; weakness;
- Serotonin syndrome, headache, dizziness,
coma; pupillary constriction; mild symptoms
drowsiness, fatigue, occur in 8-12 hr without product
- weakness, torsades de pointes, Steven - Assess for pain in post-op patients; pain
Johnson syndrome, toxic epidermal threshold is lowered in patients taking this
necrolysis medication
- Coma - Assess for blood dyscrasias: fever, sore throat,
- Angioedema bruising, rash, jaundice, epistaxis (long-term
- anemia treatment only)
- Assess seizure activity, including type,
Dosage Safety: location, duration, character; provide seizure
- Seizures: 1-3mg/kg per day (adults) precaution
- Sleep prob: 100-200 mg at bedtime
Contraindication/Precautions:
- Pregnancy, breastfeeding, geriatric, Patient Education:
hypersensitivity to barbiturates, porphyria, - Teach patient that hangover is common
hepatic/respiratory disease, nephritis, - Inform patient that physical dependency may
hyperthyroidism, diabetes mellitus result when used for extended time
- Anemia, renal disease - Teach patient to avoid driving and other
activities requiring alertness
- Caution patient to avoid alcohol ingestion
Medication Interactions: and CNS depressants; serious CNS
- Alcohol: ↑ CNS depression depression may result
- Chloramphenicol, disulfiram: ↑ effects - Instruct patient not to discontinue medication
- Doxycycline, metroNIDAZOLE, quiNIDine, quickly after long-term use; may cause
theophylline: ↓ effectiveness seizures; product should be tapered over 1
- Furosemide: ↑ orthostatic hypotension wk;
- Emphasize the need to tell all prescribers
- Valproic acid: ↑ sedation
that a barbiturate is being taken
- Anticoagulants, glucocorticoids, estrogens, - Teach the patient to make position changes
hormonal contraceptives: ↓ effectiveness slowly; orthostatic hypotension may occur
- CNS depressants: ↑ effects - Instruct patient to notify prescriber
- MAOIs, skeletal muscle relaxants immediately if bruising, bleeding occur,
(nondepolarizing), sulfonamides: ↑ effects which may indicate blood dyscrasias
Glucophage 500mg Oral tablet Contraindication/precaution:

Alternate name: Metformin - Contraindication:

Hypersensitivity, Metabolic acidosis
Dose: 1 tab including diabetic ketoacidosis w/ or w/o
Frequency: BID coma, impaired kidney function
- Caution:
Class: Biguanides Pregnancy, Impaired renal and hepatic
function, heart failure
Action:
- Reduce the amount of glucose the liver
produces
- Lessen absorption of glucose in intestine Medication Interactions:
- Raise tissue sensitivity to insulin - Digoxin: ↑ metformin level and digoxin
level
Use - Beta-blocker: ↑ hyperglycemia
- Dofetilide: ↑lactic acidosis, don’t use
- To control blood glucose level of pt w/ type 2 together
diabetes mellitus - Morphine, vancomycin, cimetidine: ↑
metformin level
Nursing Consideration:
- Check pt’ blood glucose
Common: - Monitor S/S of hypoglycemia or
- Diarrhea, Gas, Indigestion hyperglycemia (confusion, lethargy,
- Nausea or vomiting shallow rapid breathing, tachycardia,
- Stomach pain hypotension, nausea & vomiting)
- Headache - Monitor: Liver function (AST, LDH), renal
- Anorexia, change in taste (BUN, creatinine), Blood glucose, A1C,
- Low vitamin B12 level liver enzymes, and vit B12 levels.
Serious Evaluation:
- Lactic acidosis (buildup of lactic acid) Lower glucose level, normal lab result for
- Hyperventilation blood glucose and A1C levels

Dosage Safety: Client Education:

- Tab: max 2550 mg/day (can be crushed) - Advise pt monitor blood sugar
- Ext Rel Tabs: max 2000mg/day (DO NOT - Inform pt to take medication as directed
CRUSH/CHEW) and do not stop abruptly
- Oral sol 500mg/ml - Teach about S/S of lactic acidosis
Times: (hyperventilation, fatigue, chills, severe
- Onset: Unknown abdominal pain, confusion & vomiting)
- Peak: - Inform pt to avoid alcohol
o Immediate rel: 1-2 hr. - Instruct pt to do not intake medication
o Ext Rel: 7 hrs. (over the counter) w/o consulting HCP
o Sol: 2.5 hr. - Discuss to pt about their diet and
- Duration: unknown encourage them to stick to it as much as
possible
Administration: immediate (take w/ meals); ext
rel (take w/ evening meals)
120 ACTUAT Albuterol 0.1mg/ Dosage Safety:
Ipratropium Bromide 0.02/ MDI - Dose: 2 puff every 4-6 hrs. Do not exceed
12 puffs in 24 hrs
Alternate name: Ipratropium Bromide Inhaler Contraindication/Precaution:
- Hypersensitivity to sympathomimetics
Dose: 4 puff
- Precautions: Pregnancy, breastfeeding,
Frequency: Once a day exercise-induced bronchospasm (aerosol) in
children <12 yr, cardiac/renal disease,
Class: Bronchodilator hyperthyroidism, diabetes mellitus,
Action: relaxes smooth muscle; produces hypertension, seizures, hypoglycemia, severe
bronchodilatation; CNS, cardiac stimulation, cardiac disease
increased diuresis, and increased gastric acid
secretion; longer acting than isoproterenol
Medication Interaction:
Use - Digoxin: ↑digoxin level
- Adrenergics: ↑ action of albuterol; do not use
- To open up the airways and treat breathing together
problems like wheezing or shortness of breath - β-Adrenergic blockers: block therapeutic effect
- Treat asthma, bronchitis, emphysema, or other - Bronchodilators (aerosol): ↑ action of
lung disease bronchodilator
- CNS stimulants: ↑CNS stimulation
- Diuretics (potassium-losing): ↑ECG
Common Side effects: changes/hypokalemia
- Shakiness - MAOIs, tricyclics: increased chance of
- Dizziness, headache, nausea hypertensive crisis; do not use together
- Sudden change in mood& increase or decrease Nursing Consideration:
- Oxytocics: severe hypotension; do not use
in appetite - Assess
togetherrespiratory function: pulse oximetry,
- Muscle cramps
- ABGs, lung sounds;
Theophylline: toxicityheart rate, rhythm; B/P,
- Pale skin
- sputum (baseline and during therapy)
Serious side effect - Assess for paradoxial bronchospasm, trouble
- Fast, pounding, or irregular heartbeat breathing with wheezing, notify health care
- Chest pain professional immediately
- Fever, rash, itching, swelling of face - Monitor for S/S of heart problem and serious
- Difficulty breathing or swallowing
side effect like worsening after using the
- Overdose: chest pain, ↓ K level cause muscle
inhaler.
weakness or cramps
Client education:
- Tell patient not to use OTC medications before
Administration: consulting prescribe
- Shake the inhaler than exhale full, place in - Teach patient to use inhaler
mouth and take a deep breath while pressing - Teach patient that if paradoxic bronchospasm
down to release puff occurs to stop product immediately and notify
- Hold breath 5-10 secs then exhale pursed lip prescriber
- Wait 1 min. between puff and rinse mouth after - Instruct patient on administration of dose, not
Times: (INH) to use more than prescribed; serious side
- Onset: 5-15 mins effects may occur; notify HCP immediately if
- Peak: 1 ½- 2 hrs. product does not relieve symptoms
- Duration: 4-6 hrs.
Carbamide peroxide 6.5% Otic Solution Contraindication/Precautions:
- Do not use if you have hole in your eardrum
Alternate name: Debrox
(ruptured eardrum)
Frequency: BID, do not exceed more than QID - Do not use if there’s any sign of ear infection
(pain, swelling, drainage, bleeding)
Class: Astringents
- Pregnancy and lactation
Action: helps soften by releasing hydrogen
Medication Interaction:
peroxide and oxygen in air.
- No significant medication but always inform
Use: helps soften, loosen, and remove built-up
the Healthcare provider about all medication
earwax
you use.
Dosage Safety:
Common Side Effects: 5- 10 drops of the solution instilled into the
- Foaming or crackling sound in the ear affected ear(s) 2 times daily for up to 4 days.
- Temporary decrease in hearing Nurse Consideration:
- Mild feeling of fullness
- Mild itching inside the ear - Assess for ear pain
- Asses for S/S of irritation, allergic reaction.
Serious Side Effects:
Times:
- Severe dizziness
- Worsening ear pain - Onset: immediately
- Trouble breathing - Peaks: softening
- Allergic reactions (skin, rash, itching, hives, - Durations: 4 days
swelling of face, lips, tongue, throat)

Preparation:
- Warm the eardrops prior to use
Administration: Patient Education:
- Lie down or tilt your head with your ear - Do not use for longer than 4 days without
facing upward. Open the ear canal by gently consulting your doctor
pulling your ear back or pulling downward on - If your ear becomes painful, irritated, or if
the earlobe when giving this medicine to a there’s no improvement after few days, stop
child. using the drops and contact HCP.
- You may hear a bubbling sound inside your
- Store the bottle at room temperature.
ear. This is caused by the foaming action of
- Avoid using cotton swabs as they can push
carbamide peroxide, which helps break up
the wax inside your ear. wax further in.
- Stay lying down or with your head tilted for - Teach proper medicine administration
at least 5 minutes. You may use a small
piece of cotton to plug the ear and keep the
medicine from draining out.
- Do not touch the dropper tip or place it
directly in your ear. Wipe the tip with a clean
tissue but do not wash with water or soap.