Fluticasone Propionate MEDICATION SHEET

Name &
Administration Mechanism of Action Side Effects Nursing Rationale for Use with
(Generic & brand (Classification, physiologic Responsibilities This Patient
name, dosage, actions) & Patient
safe dose range, Teaching
route, frequency,
rate of admin. of
IV meds)

fluticasone Action Contraindication/Precautions Assessment Indications

(nasal) Potent, locally acting anti-
inflammatory and immune modifier. Contraindicated in: Monitor degree Seasonal or perennial
Trade Name(s) Therapeutic Effect(s): of nasal stuffiness, allergic rhinitis.
Avamys [Canada] Decrease in symptoms of allergic and Hypersensitivity (Flonase contains amount and color Seasonal or perennial
Flonase nonallergic rhinitis. alcohol). of nasal discharge, nonallergic rhinitis
Veramyst Pharmacokinetics and frequency of (Flonase only)
Absorption: <2%; action is Use Cautiously in: sneezing.
Pregnancy primarily local following nasal use. Patients on
Category Distribution: Crosses the placenta Active untreated infections long-term therapy
Category C and enters breast milk in small Diabetes or glaucoma should have
amounts. Underlying immunosuppression periodic
Ther. Class. Metabolism and Excretion: (due to disease or concurrent therapy) otolaryngologic
anti-inflammatories Rapidly and extensively metabolized Systemic corticosteroid therapy examinations to
(steroidal) by the liver; primarily excreted in (should not be abruptly discontinued monitor nasal
feces; <5% excreted in urine. when intranasal therapy is started) mucosa and
Route/Dosage Half-life: 7.8 hr. Concurrent use of ritonavir passages for
Intranasal: TIME/ACTION PROFILE Recent nasal trauma, septal ulcers, infection or
(Children ≥4 yr): (improvement in symptoms) or surgery (wound healing may be ulceration.
Flonase –1 spray in ROUTE ONSET PEAK DURATION impaired by nasal corticosteroids) Monitor
each nostril once OB: Lactation: Pedi: Pregnancy, growth rate in
daily (not to exceed few up to lactation, or children <4 yr (for children receiving
Intranasal unknown
2 sprays in each days 3 wk Flonase) or <2 yr (for Veramyst) chronic therapy;
nostril/day). (safety not established; prolonged or use lowest
Intranasal: high-dose therapy may lead to possible dose.
(Children 2–11 complications). Monitor for
yrs): Veramyst –1 signs and
spray in each nostril Adverse Reactions/Side Effects symptoms of
daily; may ↑ to 2 hypersensitivity
sprays if no CNS: headache reactions (rash,
response; once pruritis, swelling of
symptoms EENT: epistaxis, nasal burning, nasal face and neck,
controlled, attempt irritation, nasopharyngeal fungal dyspnea)
to ↓ dose to 1 infection, pharyngitis periodically during
spray/day. therapy.
GI: nausea, vomiting
Availability Lab Test
(generic Endo: adrenal suppression (↑ dose, Considerations:
available) long-term therapy only), ↓ growth
Nasal spray (children) Periodic adrenal
(Flonase): 50 function tests may
mcg/metered spray Derm: rash, urticaria be ordered to
in 16-g bottle assess degree of
(delivers 120 Resp: cough hypothalamic-
metered sprays) pituitary-adrenal
Nasal spray Misc: ANAPHYLAXIS, ANGIOEDEMA (HPA) axis
(Veramyst): 27.5 suppression in
mcg/spray in a 10-g * CAPITALS indicate life-threatening. chronic therapy.
bottle (delivers 120 Italics indicate most frequent. Children and
sprays) patients using
In Combination higher than
with: azelastine recommended
(Dymista); see doses are at
combination drugs). highest risk for
HPA suppression.

Patient/Family
Teaching

Advise patient
to take medication
exactly as
directed. Take
missed doses as
soon as
remembered
unless almost time
for next dose.
 Instruct patient
in correct
technique for
administering
nasal spray (see
medication
administration
techniques). Shake
well before use.
Before first-time
use, prime unit by
spraying 6 times.
If not used for at
least 7 days or if
cap left off for
more than 5 days,
reprime unit. Warn
patient that
temporary nasal
stinging may
occur.
Instruct patient
to stop fluticasone
and notify health
care professional
immediately if
signs of
anaphylaxis (rash,
hives, difficulty
breathing, swollen
lips or throat)
occur.
Instruct patient
to notify health
care professional
of all Rx or OTC
medications,
vitamins, or herbal
products being
taken and consult
health care
professional before
taking other Rx,
OTC, or herbal
products.
Advise female
patients to notify
health care
professional if
pregnancy is
planned or
suspected or if
breastfeeding.
Instruct patient
to notify health
care professional if
symptoms do not
improve within 1
mo or if symptoms
worsen.