DRUG STUDY Drug Name Generic name: Cefotaxime Brand name: Claforan Classification: Antibiotis: Cephalosporin Third generation Dosage: Adult: I.V/I.M 1g, 2g/4-12 hour max. 12g/day.
Mechanism of action It inhibits the bacterial cell wall synthesis by binding to one or more of the penicillin binding proteins (PBP’s). This inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis.
Indicatio ns Treatment for lower respiratory tract infection. Treatment for pelvic inflammatory. Treatment for endometritis. Treatment skin and skin structure infections.
contraindicat ions Hypersensitivity to penicillin, and cephalosporin.
Side/Adverse Effects Local – injection site inflammation, pain and tenderness. Allergy – Rash, itching, fever, eosinophilia, hives and shock. G.I – nausea and vomiting HEENT – hearing loss.
Nursing considerati ons Avoid excess dosage. Use cefotaxime cautiously in patients with renal function. For I.V use, reconstitute each 0.5g, 1g or 2g vial with 10 ml of sterile water for injection. Shake to dissolve. For I.M use, reconstitute each 500mg vial with 2 ml of sterile water for injection or bacteriostatic water injection; 1g vial with 3ml of diluents; and each 2g vial with 5ml of diluents. Shake
DRUG STUDY Drug Name Generic name: Dexamethasone Brand name: Decadron Classification: Corticosteroid Glucocorticoid Hormone Dosage: 1.8mg TIV q6
Mechanism of action The patient was given dexamethasone 1.8mg TIV q 6 hours to decreases inflammatory, mainly by stabilizing leukocyte lysosomal membranes; suppress immune response; stimulates bone marrow; and influences proteins, fats and carbohydrates metabolism.
Indications Hyperglycemia associated with cancer. Short-term management of various inflammatory and allergic disorders Hematologic disorders. Cerebral edema associated with brain tumor, craniotomy, or head injury.
contraindi cations Hypersensitivity: active untreated infection; ophthalmic use in viral, fungal disease of the eye.
Side/Advers e Effects CNS: euphoria, insomnia, psychotic behavior, pseudotumor cerebri, vertigo,headache, paresthesia,seizures, depression.
Nursing considerati ons Do not give drug to nursing mother; drug is secreted breast milk. Give daily doses before 9 AM to mimic normal peak corticosteroid blood levels. Do not give liver virus vaccines with immunenosuppres sive doses of corticostiroids. Avoid prolonged use near the eyes, in genital and rectal areas, and in skin creases.
CV: hypertension, edema,arrythmias,thromboembolism. EENT: cataracts, glaucoma.
GI: peptic ulceration, GIirritation, increased appetite, pancreatitis, nausea,vomiting. GU: increase urine glucose,and calcium levels Metabolic: hypokalemia,hyperglycemia Musculoskeletal: muscleweakness Skin: Delayed wound healing Other: Susceptibility toinfections
DRUG STUDY
Drug Name Generic name: Ceftriaxone Brand name: Forgram Classification: Cephalosporin Dosage: 1g dissolves in 1 vial in 1.75 distilled water + 1.75ml 2% Lidocaine. OD
Mechanism of action Works by inhibiting the mucopeptide synthesis in the bacterial cell wall. The betalactam moietyof Ceftriaxone binds to carboxypeptidases, endopeptidases, and transpeptidases in the bacterial cytoplasmic membrane. These enzymes are involved in cell-wall synthesis and cell division. By binding to these enzymes, Ceftriaxone results in the formation of of defective cell walls and cell death.
Indicatio ns Treatment of infections of the lower resp tract, acute bacterial otitis media, skin & skin structure infection, UTI, uncomplicated gonorrhe a, pelvic inflammatory disease, bacterial septicemia, bone & joint infections, intra-abdominal infections, meningitis.
contraindicat ions Hypersensitivity to penicillin, and cephalosporin. Hypersensitivity to lidocaine soln (in case of IM inj). Hyperbilirubinemic neonates esp prematures. Concurrent administration w/ Cacontaining soln or products in newborns.
Side/Advers e Effects •Pain •Induration •Phlebitis •Rash •Diarrhea •Thrombocytosis •Leucopenia •Glossitis •Respiratory superinfections
Nursing considerati ons Assess patient’s previous sensitivity reaction to penicillin or other cephalosphorins. •Assess patient for signs and symptoms of infection before and during the treatment •Obtain C&S before beginning drug therapy to identify if correct treatment has been initiated. •Assess for allergic reaction. •Monitor hematologic, electrolytes, renal and hepatic function. •Assess for possible superinfection: itching fever, malaise, redness, diarrhea.
DRUG STUDY
Drug Name Generic name: Gentamicin Brand name: Gentacidin
Mechanism of action Broad-spectrum aminoglycoside antibiotic derived from Micromonospora purpurea. Action is usually bacteriocidal.
Classification: Antibiotis: Cephalosporin Third generation Dosage: Adult: IV/IM 2 mg/kg followed by 1.5 mg/kg q8h Prophylaxis of Bacterial Endocarditis Adult: IV/IM 1.5 mg/kg 30 min before procedure, may repeat in 8 h Child: IV/IM < 27 kg, 2 mg/kg 30 min before procedure, may repeat in 8h
Indicatio ns Parenteral use restricted to treatment of serious infections of GI, respiratory, and urinary tracts, CNS, bone, skin, and soft tissue (including burns) when other less toxic antimicrobial agents are ineffective or are contraindicated. Has been used in combination with other antibiotics. Also used topically for primary and secondary skin infections and for superficial infections of external eye and its adnexa.
contraindi cations History of hypersensitivity to or toxic reaction with any aminoglycoside antibiotic.
Side/Advers e Effects
Dizziness or vertigo; acute renal failure, interstitial nephritis, acute tubular necrosis; electrolyte imbalances; transient elevation of serum bilirubin and aminotransferases; purpura; nausea, vomiting; convulsions, mental depression, hallucinations. Atrophy or rat necrosis at inj sites.
Potentially Fatal: Nephrotoxicity, ototoxicity and neuromuscular blockade (may unmask or aggravate myasthaenia gravis).
Nursing considerati ons Dosages are generally adjusted to maintain peak serum gentamicin concentrations of 4 – 10 g/mL, and trough concentrations of 1 –2 g/mL. Peak concentrations above 12 g/mL and trough concentrations above 2 g/mL are associated with toxicity.
