Raritan Bay Medical Center

Transcription

1 Raritan Bay Medical Center For any question regarding Med of the Month. You may contact : Sherr Ann Arabit MSN, RN-BC, CCRN Professional Development Department Ext

2 Professional Development Presents IN2694/0.25/SA/September 2015 September 2015 Med of the Month Marinol (Dronabinol) Objective: To discuss the use/indication of Marinol in prevention of serious nausea and vomiting from chemotherapy, treatment of weight loss in AIDS patients, dosing, adverse reactions, contraindications and nursing implications.

3 MARINOL Brand Name: Marinol Generic Name: Dronabinol (droe- nab- i-nol) Class: Antiemetic (therapeutic), appetite stimulant Supplied as 2.5 mg, 5 mg, 10 mg capsules/capsule, liquid filled Controlled substance, C-III USES/INDICATIONS: Treats or prevents nausea and vomiting caused by cancer medicines when other medicines do not work Used to increase the appetite of people with Acquired Immunodeficiency Syndrome (AIDS) DOSAGE AND ADMINISTRATION: The dose of this medicine will be different for different patients. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depends on the medical problem for which you are using the medicine. For oral dosage forms (capsules): -for increasing appetite in patients with AIDS Adults and teenagers- at first, 2.5 mg twice a day, taken before lunch and supper. Usually not more than 20 mg a day. Increase dose gradually as tolerated; may also reduce dose to once daily if twice daily not tolerated. -For Nausea and vomiting caused by cancer medicines: Adults and teenagers- dose is based on body surface area, (5mg/meter squared) and must be determined by your doctor. Give one dose 1-3 hours before treatment, 1 dose 2-4 hours after treatment x 4 to 6 doses. Maximum 15mg/meter squared. *Swallow capsules whole. Do not chew, break or crush. *If the drug is for you to eat more, take drug before meals. *Do not take 2 doses at the same time or extra doses.

4 ADVERSE REACTIONS: This shouldn t be taken with Marijuana. It is possible to get too much dronabinol (an overdose), especially if Marinol is used. Signs of mild overdose: drowsiness, euphoria, heightened sensory awareness, altered time perception, red eyes, dry mouth, and rapid heart rate (tachycardia) Moderate over dosage: memory problems, depersonalization, mood alteration, urinary retention and constipation. Severe over dosage: decreased motor coordination, lethargy, slurred speech and postural hypotension. Common side effects: -clumsiness -confusion or forgetfulness -vomiting -drowsiness -nausea -change in sense of taste, smell, sound or touch -dizziness -trouble with thinking -constipation or trouble urinating - dry mouth -anxiety - red eyes or vision changes -hypotension -hypertension -syncope -tachycardia -CNS depression -vasodilation -palpitations -weakness CONTRAINDICATIONS: Marinol Capsules are contraindicated in any patient who has a known sensitivity to sesame oil, dronabinol, cannabinoids, or any of its ingredients. WARNINGS/PRECAUTIONS: Presence of the following medical problems will affect the use of this medicine: - alcohol/substance abuse or dependence -bipolar disorder -heart disease -severe mental illness -seizures -high blood pressure -bipolar disorder, depression and schizophrenia

5 Nursing Implications Assess nausea, vomiting, appetite, bowel sounds and abdominal pain prior to and following administration of this drug Monitor hydration, nutritional status and intake and output. Patient with severe nausea and vomiting may require IV fluids in addition to antiemetic Monitor BP and Heart rate periodically Patient/Family Teaching Instruct the patient/family on the following: *May experience withdrawal symptoms when stopping Marinol abruptly. Symptoms include irritability, trouble sleeping, restlessness, hot flashes and sweating. *Dronabinol will add to the effects of alcohol and other CNS depressants (medicines that will make you drowsy or less alert.) *Do not drive or operate machinery until you are sure how Marinol affects you. You can become drowsy, dizzy and lightheaded. *Use cautiously in elderly patients because they may be more sensitive to the neurological, psychoactive and postural hypotensive effects of the drug. *Avoid alcohol while taking this medicine. *Do not smoke Marijuana while on this drug. *Take extra precaution if taking Marinol with these meds that causes drowsiness such as antihistamines, narcotic pain medicines, sedatives, tranquilizers, muscle relaxants, medicines for seizures or tricyclic antidepressants such as Elavil (amitriptyline), Tofranil (imipramine) or Sinequan (doxepin). *Is excreted in breast milk. References: Lexicomp Online, 2015 Submitted by Arlene Malixi BSN, RN