Inhalation route (nebulizer) • Use Lamira Nebulizer System • May pretreat with short-acting beta 2 agonists • Allow to warm to room temperature • Shake well, pour medication into reservoir • Press and hold on/off button, mist will fl ow • Insert mouthpiece, take slow deep breaths, when done a beep will be heard • Clean after each use Intermittent IV INF route • Dilute 500 mg of product/100-200 ml of IV D 5 W, 0.9% NaCl and give over ½-1 hr; dilute insuffi cient volume to allow inf over 1-2 hr (infants); fl ush after administration with D 5 W or 0.9% NaCl; solution is clear or pale yellow; discard if precipitate or dark color develops • In children, amount of fl uid depends on ordered dose; in infants infuse over 1-2 hr • Give in evenly spaced doses to maintain blood level Y-site compatibilities: Acyclovir, alatrofl oxacin, aldesleukin, alemtuzumab, alfentanil, amifostine, aminophylline, amiodarone, amsacrine, anidulafungin, argatroban, ascorbic acid, atracurium, atropine, aztreonam, benztropine, bivalirudin, bumetanide, buprenorphine, butorphanol, calcium chloride/gluconate, CARBOplatin, caspofungin, ceFAZolin, cefepime, cefonicid, cefotaxime, cefoTEtan, cefOXitin, cefTAZidime, ceftizoxime, cefTRIAXone, cefuroxime, chloramphenicol, chlorproMAZINE, cimetidine, cisatracurium, CISplatin, clindamycin, codeine, cyanocobalamin, cyclophosphamide, cycloSPORINE, cytarabine, DACTINomycin, DAPTOmycin, dexamethasone, dexmedetomidine, digoxin, diltiazem, diphenhydrAMINE, DOBUTamine, DOCEtaxel, DOPamine, doripenem, doxacurium, DOXOrubicin, doxycycline, enalaprilat, ePHEDrine, EPINEPHrine, epirubicin, epoetin alfa, eptifi batide, ertapenem, erythromycin, esmolol, etoposide, famotidine, fentaNYL, fi lgrastim, fl uconazole, fl udarabine, fl uorouracil, foscarnet, furosemide, gemcitabine, gentamicin, glycopyrrolate, granisetron, hydrocortisone, HYDROmorphone, IDArubicin, ifosfamide, IL-2, imipenem-cilastatin, isoproterenol, ketorolac, labetalol, levofl oxacin, lidocaine, linezolid, LORazepam, magnesium sulfate, mannitol, mechlorethamine, melphalan, meperidine, metaraminol, methotrexate, methoxamine, methyldopate, methylPREDNISolone, metoclopramide, metoprolol, metroNIDAZOLE, midazolam, milrinone, mitoXANtrone, morphine, multivitamins, nafcillin, nalbuphine, naloxone, niCARdipine, nitroglycerin, nitroprusside, norepinephrine, octreotide, ondansetron, oxaliplatin, oxytocin, PACLitaxel, palonosetron, pantoprazole, papaverine, PEMEtrexed, penicillin G, pentazocine, perphenazine, PHENobarbital, phenylephrine, phytonadione, piperacillintazobactam, potassium chloride, procainamide, prochlorperazine, promethazine, propranolol, protamine, pyridoxime, quinupristin-dalfopristin, ranitidine, remifentanil, riTUXimab, rocuronium, sargramostim, sodium acetate, sodium bicarbonate, succinylcholine, SUFentanil, tacrolimus, teniposide, theophylline, thiamine, thiotepa, ticarcillin/ clavulanate, tigecycline, tirofi ban, tobramycin, tolazoline, trimetaphan, urokinase, vancomycin, vasopressin, vecuronium, verapamil, vinCRIStine, vinorelbine, voriconazole, warfarin, zidovudine, zoledronic acid Patient/family education • Advise patient to contact prescriber if vaginal itching, loose foul-smelling stools, furry tongue occur; may indicate superinfection • Advise patient to report hypersensitivity: rash, itching, trouble breathing, facial edema and notify prescriber BLACK BOX WARNING: Monitor for hyperkalemia: MS: fatigue, muscle weakness; CARDIAC: dysrhythmias, hypotension; NEURO: paresthesias, confusion; RESP: dyspnea, monitor potassium level baseline and each dosage change, hyperkalemia is more common in renal disease, geriatrics, diabetes, if potassium 5.5 mEq/L immediately notify prescriber Evaluation Positive therapeutic outcome • Absence of signs/symptoms of infection: WBC 10,000/mm 3 , temp WNL; absence of red draining wounds; absence of earache • Reported improvement in symptoms of infection TREATMENT OF OVERDOSE: Withdraw product; administer EPINEPHrine, O 2 , hemodialysis, exchange transfusion in the newborn; monitor serum levels of product; may give ticarcillin or carbenicillin aMILoride (Rx) (a-milloh-ride) Midamor Func. class.: Potassium-sparing diuretic Chem. class.: Pyrazine Do not confuse: aMILoride /amLODIPine/ amiodarone ACTION: Inhibits sodium, potassium ATPase ion exchange in the distal tubule, cortical collecting duct resulting in inhibition of sodium reabsorption