Nursing Implications for XYLOMETAZOLINE HYDROCHLORIDE Otrivin

XYLOMETAZOLINE HYDROCHLORIDE (zye-loe-met-az′oh-leen) 
Otrivin 
Classifications: NASAL DECONGESTANT; VASOCONSTRICTOR
Therapeutic: NASAL DECONGESTANT
Prototype: Naphazoline
Pregnancy Category: C

AVAILABILITY 
Nasal solution

ACTION & THERAPEUTIC EFFECT 
Markedly constricts dilated arterioles of nasal membrane. Decreases fluid exudate and mucosal engorgement associated with rhinitis and may open up obstructed eustachian tubes.

USES 
Temporary relief of nasal congestion associated with common cold, sinusitis, acute and chronic rhinitis, and hay fever and other allergies.

CONTRAINDICATIONS 
Sensitivity to adrenergic substances; angleclosure glaucoma; concurrent therapy with MAO inhibitors or tricyclic antidepressants; pregnancy (category C); lactation.

CAUTIOUS USE 
Hypertension; hyperthyroidism; heart disease, including angina; advanced arteriosclerosis, older adults, pregnancy (category C); children younger than 2 y and infants.

ROUTE & DOSAGE 
Nasal Congestion 
Adult/Child (12 y or older): Nasal 1–2 sprays or 1–2 drops of 0.1% solution in each nostril q8–10h (max: 3 doses/day)
Child (2 –12 y): Nasal 1 spray or 2–3 drops of 0.05% solution in each nostril q8–10h (max: 3 doses/day)

NURSING IMPLICATIONS Otrivin XYLOMETAZOLINE HYDROCHLORIDE

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ADMINISTRATION 
Instillation 

• Have patient clear each nostril gently before administering spray or drops. 
• Store at 15°–30° C (59°–86° F) in a tight, light-resistant container. 

ADVERSE EFFECTS (≥1%) 
All: Usually mild and infrequent; local stinging, burning, dryness and ulceration, sneezing, headache, insomnia, drowsiness. With Excessive Use: Rebound nasal congestion and vasodilation, tremulousness, hypertension, palpitations, tachycardia, arrhythmia, somnolence, sedation, coma.

INTERACTIONS 
Drug: May cause increase BP with guanethidine, methyldopa, MAO INHIBITORS; PHENOTHIAZINES may decrease effectiveness of nasal decongestant.

PHARMACOKINETICS 
Onset: 5–10 min. Duration: 5–6 h.

NURSING IMPLICATIONS 
Assessment & Drug Effects 

• Evaluate for development of rebound congestion (see ADVERSE EFFECTS). 

Patient & Family Education 

• Prevent contamination of nasal solution and spread of infection by rinsing dropper and tip of nasal spray in hot water after each use; restrict use to the individual patient. 
• Note: Prolonged use can cause rebound congestion and chemical rhinitis. Do NOT exceed prescribed dosage and report to prescriber if drug fails to provide relief within 3–4 days. 
• Do NOT self-medicate with OTC drugs, sprays, or drops without prescriber’s approval. 
• Note: Excessive use by a child may lead to CNS depression.

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Ditulis oleh Unknown pada tanggal Friday, July 3, 2015