Look inside the book: Nursing 2025-2026 Drug Handbook

cabotegravir 203

• When tapering opioids, watch closely for signs and symptoms of opioid withdrawal. Such symptoms may indicate a need to taper more slowly. Monitor patient for suicidality, use of other substances, and mood changes. Alert: Monitor patient for signs and symp toms of adrenal insufficiency. Perform diag nostic testing if adrenal insufficiency is sus pected. If adrenal insufficiency is confirmed, treat with corticosteroids and wean patient off opioids, if appropriate. Discontinue corticos teroids when clinically appropriate. Alert: Monitor patient for signs and symp toms of decreased sex hormone levels. If signs and symptoms occur, evaluate patient and obtain specimens for lab testing. • Drug may cause constipation. Assess bowel function and need for stool softener and stim ulant laxatives. • Periodically monitor postoperative vital signs and bladder function. Because drug de creases both rate and depth of respirations, monitor arterial oxygen saturation to help as sess respiratory depression. Alert: Drug may cause opioid-induced hyperalgesia (OIH). Symptoms include in creased pain level with opioid dose increase, decreased pain level with opioid dose reduc tion, pain from ordinarily nonpainful stimuli without underlying disease progression, opi oid tolerance or withdrawal, and addictive be havior. For suspected OIH, decrease opioid dose or switch patient to alternative opioid. PATIENT TEACHING Boxed Warning Counsel patient and care giver on serious risks, safe use, and impor tance of reading the medication guide with each prescription. • Advise patient to take drug exactly as pre scribed and to use lowest dose possible for shortest time needed. • Inform patient that, for acute pain, drug may only be needed for a few days. Teach pa tient about safe disposal of unused drug. • Instruct patient to contact health care provider if prescribed dosage isn’t controlling pain. Alert: Encourage patient to report all med ications being taken, including prescription and OTC drugs and supplements. • Advise patient to avoid alcohol during ther apy. Alert: Counsel patient who has been regu larly taking drug not to discontinue without

first discussing the need for gradual tapering with prescriber. Alert: Caution patient to immediately re port signs and symptoms of serotonin syn drome, adrenal insufficiency, and decreased sex hormone levels. Alert: Warn patient to withhold drug and inform prescriber if pain level worsens, pain sensitivity increases, or new pain occurs after taking drug. • Teach patient who is ambulatory to use care when getting out of bed or walking due to possible dizziness or light-headedness. • Warn outpatient to avoid driving and other hazardous activities that require mental alert ness until drug’s effects on the CNS are clear. Boxed Warning Accidental ingestion of even one dose of an opioid, especially by chil dren, can result in a fatal overdose. • Tell patient how to take nasal spray and how to store it in child-resistant container. • Teach patient that naloxone may be pre scribed with the opioid when beginning and renewing therapy to reduce risk of opioid overdose and death. • Caution patient to report to prescriber preg nancy or plan to become pregnant. cabotegravir ka-boe-TEG-ra-vir Apretude, Vocabria Therapeutic class: Antiretrovirals Pharmacologic class: HIV-1 integrase strand transfer inhibitors AVAILABLE FORMS Injection (extended-release): 600mg/3mL single-dose vial Tablets: 30mg INDICATIONS & DOSAGES ➤ Short-term treatment of HIV-1 infection in combination with rilpivirine in patients who are virologically suppressed (HIV-1 RNA less than 50 copies/mL) while on a stable antiretroviral regimen with no history of treatment failure and with no known or suspected resistance to either cabotegravir or rilpivirine Adults and adolescents ages 12 and older weighing at least 35 kg (lead-in therapy): 30 mg PO daily in combination with oral rilpivirine for at least 28 days as lead-in


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