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one drug card for each medication. Write the rationale for why this patient is getting the prescribed medication. Drug Trade Name: Physiological Action: Common Side Effects: Entocort EC, pulmicort (How drug works in the body) Back pain; dizziness; dry mouth; flexhaler, pulmicort respules, Exhibits wide range of inhibitory headache; nausea; nervousness; activities against multiple cell types and rhinocort aqua. stomach pain or upset; stuffy nose; mediators involved in allergic-mediated throat irritation; tiredness; tremor; inflammation. trouble sleeping; vomiting Generic Name: budesonide Uses: Adverse Side Effects: Intranasal Hypertension, migraine, palpitations, Management of seasonal and perennial Classification: syncope, tachycardia, dizziness, allergic rhinitis symptoms in adults and Corticosteroid, glucocorticoid, children. fatigue, amnesia, hypokalemia, intranasal steroid. anxiety, depression, nervousness. Usual Ranges: Adult: Pediatric:
Nasal Spray Adults and Children 12 y and older Spray Start with 64 mcg/day administered as 1 spray in each nostril daily. Maintenance Spray Titrate to minimum effective dose (max, 256 mcg/day administered as 4 sprays in each nostril daily). Adults and Children 6 to younger than 12 y Spray Start with 64 mcg/day administered as 1 spray in each nostril daily. Maintenance Spray Titrate to minimum effective dose (max, 128 mcg/day administered as 2 sprays in each nostril daily). Powder for inhalation Adults Inhalation 360 mcg twice daily (max, 720 mcg twice daily). Children 6 to 17 y of age Inhalation 180 mcg twice daily (max, 360 mcg twice daily). Inhalation suspension Children 12 mo to 8 y of age Patients

Powder for inhalation For the maintenance treatment of asthma as prophylactic therapy in adults and children 6 y and older. Inhalation suspension For the maintenance treatment of asthma and as prophylactic therapy in children 12 mo to 8 y of age. Oral capsule Crohn disease. Unlabeled Uses Inhalation suspension Eosinophilic esophagitis.

Contraindications with food or other drugs:

Untreated localized infections involving the nasal mucosa; relief of acute bronchospasm; primary treatment of status asthmaticus or other acute episodes of asthma when intensive measures are required; hypersensitivity to the drug or any component of the product; severe hypersensitivity to milk proteins (powder for inhalation). Not recommended for treatment of nonallergic rhinitis because of lack of data. Aspirin, warfarin, barbiturates, hormonal contraceptives.

Grapefruit. Pregnancy Category: C

receiving bronchodilators alone Inhalation 0.5 mg/day administered daily or twice daily in divided doses (max, 0.5 mg/day). Patients receiving inhaled corticosteroids Inhalation 0.5 mg/day administered daily or twice daily in divided doses (max, 1 mg/day). Patients receiving oral corticosteroids Inhalation 1 mg/day administered as 0.5 mg twice daily or 1 mg daily (max, 1 mg/day). For patients who are maintained on long-term oral corticosteroids, the usual maintenance dose should be used concurrently with the initial budesonide therapy. After approximately 1 week, gradual withdrawal of the systemic corticosteroid is started by reducing the daily or alternate daily dose. The next reduction is made after 1 or 2 weeks, depending on the response of the patient. Generally, these decrements should not exceed 25% of the prednisone dose or its equivalent. A slow rate of withdrawal is strongly recommended. Oral Capsules Adults PO 9 mg daily in the morning for up to 8 wk (Crohn disease); can be tapered to 6 mg daily for up to 3 mo for maintenance of clinical remission.

Recommended Frequency of Administration: Twice daily Recommended Route of Administration: Oral, inhalation, intranasal

NURSING CONSIDERATIONS (Before, during or after administration): History: untreated local nasal infections, nasal trauma, septal ulcers, recent nasal surgery, lactation. Vitals Avoid grapefruit. Make sure patient does not crush or chew capsules.

RATIONALE for this PATIENT: (Why prescribed for patient)




RT Reviewed June 1985/LAB Reviewed June 1989/LAB Reviewed June 1990/KAC Revised July 1991/ HPO Revised May 2002/LAC Revised January 2003