Drug Name: ampicillin ; ampicillin sodium

Oral: Ampicin (CAN), Apo-Ampi (CAN), Novo-Ampicillin (CAN), Nu-Ampi (CAN), Penbritin (CAN), Principen
Pregnancy Category B
Drug classes
Antibiotic
Penicillin
Therapeutic actions
Bactericidal action against sensitive organisms; inhibits synthesis of bacterial cell wall, causing cell death.
Indications
Treatment of infections caused by susceptible strains of Shigella, Salmonella, Escherichia coli, Haemophilus
influenzae, Proteus mirabilis, Neisseria gonorrhoeae, enterococci, gram-positive organisms (penicillin G
sensitive staphylococci, streptococci, pneumococci)
Meningitis caused by Neisseria meningitidis
Unlabeled use: Prophylaxis in cesarean section in certain high-risk patients
Dosage & route
Maximum recommended dosage, 814 g/day (reserve 14 g for serious infections, such
asmeningitis, septicemia); may be given IV, IM, or PO. Use parenteral routes for severe infections; switch to
oral route as soon as possible.
ADULTS AND PEDIATRIC PATIENTS
Respiratory and soft-tissue infections:
> 40 kg: 250500 mg IV or IM q 6 hr.
< 40 kg: 2550 mg/kg/day IM or IV in equally divided doses at 68 hr intervals.
> 20 kg: 250 mg PO q 6 hr.
< 20 kg: 50 mg/kg/day PO in equally divided doses q 68 hr.
GI and GU infections, including women with N. gonorrhoeae:
> 40 kg: 500 mg IM or IV q 6 hr.
< 40 kg: 50100 mg/kg/day IM or IV in equally divided doses q 68 hr.
> 20 kg: 500 mg PO q 6 hr.
< 20 kg: 100 mg/kg/day PO in equally divided doses q 68 hr.
Gonococcal infections: 500 mg q 6 hr for penicillin-sensitive organism or for patients > 45 kg, single dose of
3.5 g PO with 1 g probenecid.
Bacterial meningitis: 150200 mg/kg/day by continuous IV drip and then IM injections in equally divided
doses q 34 hr.
Septicemia: 150200 mg/kg/day IV for at least 3 days, then IM q 34 hr.
PEDIATRIC PATIENTS
Prevention of bacterial endocarditis for GI or GU surgery or instrumentation: 50 mg/kg ampicillin IM or IV
with 1.5 mg/kg gentamicin IM or IV within 30 minutes of procedure. Six hours later give 25 mg/kg ampicillin
IM or IV or 25 mg/kg amoxicillin PO.
Prevention of bacterial endocarditis for dental, oral, or upper respiratory procedures: 50 mg/kg ampicillin IM
or IV within 30 minutes of procedure.

Adverse effects
CNS: Lethargy, hallucinations, seizures
CV: CHF
GI: Glossitis, stomatitis, gastritis, sore mouth, furry tongue, black hairy tongue, nausea, vomiting, diarrhea,
abdominal pain, bloody diarrhea, enterocolitis, pseudomembranous colitis, nonspecific hepatitis
GU: Nephritis
Hematologic: Anemia, thrombocytopenia, leukopenia, neutropenia, prolonged bleeding time
Hypersensitivity: Rash, fever, wheezing, anaphylaxis
Local: Pain, phlebitis, thrombosis at injection site (parenteral)
Other: Superinfectionsoral and rectal moniliasis, vaginitis
Contraindications and cautions
Contraindicated with allergies to penicillins, cephalosporins, or other allergens.
Use cautiously with renal disorders.
Nursing considerations
Assessment
History: Allergies to penicillins, cephalosporins, or other allergens; renal disorders; lactation
Physical: Culture infected area; skin color, lesion; R, adventitious sounds; bowel sounds; CBC, LFTs, renal
function tests, serum electrolytes, Hct, urinalysis
Interventions
Culture infected area before treatment; reculture area if response is not as expected.
Check IV site carefully for signs of thrombosis or drug reaction.
Do not give IM injections in the same site; atrophy can occur. Monitor injection sites.
Administer oral drug on an empty stomach, 1 hr before or 2 hr after meals with a full glass of water; do not
give with fruit juice or soft drinks.
Teaching points
Take this drug around-the-clock.
Take the full course of therapy; do not stop taking the drug if you feel better.
Take the oral drug on an empty stomach, 1 hour before or 2 hours after meals; do not take with fruit juice or
soft drinks; the oral solution is stable for 7 days at room temperature or 14 days refrigerated.
This antibiotic is specific to your problem and should not be used to self-treat other infections.
You may experience these side effects: Nausea, vomiting, GI upset (eat frequent small meals),diarrhea.
Report pain or discomfort at sites, unusual bleeding or bruising, mouth sores, rash, hives, fever, itching, severe
diarrhea, difficulty breathing

Generic Name : gentamicin sulfate

Brand Name:
Parenteral, intrathecal: Alcomicin (CAN), Garamycin, Pediatric Gentamicin Sulfate
Topical dermatologic cream, ointment: Garamycin
Ophthalmic: Garamycin, Gentacidin, Gentak, Genoptic, Genoptic S.O.P.
Gentamicin impregnated PMMA beads: Septopal
Gentamicin Liposome injection: Maitec
Classification:
Aminoglycoside
Pregnancy Category D
Dosage & Route
Available forms :Injection10, 40 mg/mL; ophthalmic solution3 mg/mL; ophthalmic ointment3 mg/g;
topical ointment0.1%; topical cream0.1%; ointment1 mg; cream1 mg
Parenteral
PEDIATRIC PATIENTS
22.5 mg/kg q 8 hr IM or IV.
Infants and neonates: 2.5 mg/kg q 8 hr.
Premature or full-term neonates: 2.5 mg/kg q 12 hr.
Therapeutic actions
Gentamicin is an aminoglycoside that binds to 30s and 50s ribosomal subunits of susceptible bacteria disrupting
protein synthesis, thus rendering the bacterial cell membrane defective.
Adverse 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).
Contraindications
History of hypersensitivity to aminoglycoside; pregnancy; hepatic impairment, perforated ear drum.
Nursing considerations
Assessment
 History: Allergy to any aminoglycosides; renal or hepatic disease; preexisting hearing loss; active infection with
herpes, vaccinia, varicella, fungal infections, myobacterial infections (ophthalmic preparations); myasthenia
gravis; parkinsonism; infant botulism; lactation, pregnancy
Physical: Site of infection; skin color, lesions; orientation, reflexes, eighth cranial nerve function; P, BP; R,
adventitious sounds; bowel sounds, liver evaluation; urinalysis, BUN, serum creatinine, serum electrolytes, LFTs,
CBC
Interventions
Give by IM route if at all possible; give by deep IM injection.
Culture infected area before therapy.
Use 2 mg/mL intrathecal preparation without preservatives, for intrathecal use.
Avoid long-term therapies because of increased risk of toxicities. Reduction in dose may be clinically indicated.
Patients with edema or ascites may have lower peak concentrations due to expanded extracellular fluid volume.
Cleanse area before application of dermatologic preparations.
Ensure adequate hydration of patient before and during therapy.
BLACK BOX WARNING: Monitor hearing with long-term therapy; ototoxicity can occur.
BLACK BOX WARNING: Monitor renal function tests, CBCs, serum drug levels during long-term therapy.
Consult with prescriber to adjust dosage.
Teaching points
Apply ophthalmic preparations by tilting head back; place medications into conjunctival sac and close eye; apply
light pressure on lacrimal sac for 1 minute. Cleanse area before applying dermatologic preparations; area may be
covered if necessary.
You may experience these side effects: Ringing in the ears, headache, dizziness (reversible; use safety measures if
severe); nausea, vomiting, loss of appetite (eat frequent small meals, perform frequent mouth care); burning,
blurring of vision with ophthalmic preparations (avoid driving or performing dangerous activities if visual effects
occur); photosensitization with dermatologic preparations (wear sunscreen and protective clothing).
Report pain at injection site, severe headache, dizziness, loss of hearing, changes in urine pattern, difficulty
breathing, rash or skin lesions; itching or irritation (ophthalmic preparations); worsening of the condition, rash,
irritation (dermatologic preparation).