Name : Sophia Angela Famor BSN12E

Drug Name

Generic Name : cefuroxime, cefuroxime axetil, cefuroxime sodium

Brand Name: Ceftin , Zinacef

Classification: Antibiotic, Cephalosporin (second generation)

Pregnancy Category B

Dosage & Route

 PO Uncomplicated UTI 125 mg twice daily. Respiratory tract

infections 250-500 mg twice daily. Uncomplicated gonorrhea W/ oral
probenecid: 1 g as a single dose. IV Meningitis 3 g 8 hrly. IM
Gonorrhea W/ oral probenecid: 1.5 g as a single dose. IV/IM Surgical
prophylaxis 1.5 g IV per-op, then 750 mg IM 8 hrly for up to 24-48 hr.
Susceptible infections750 mg 8 hrly, up to 1.5 g 6-8 hrly for severe
infections.
 Therapeutic actions

 Cefuroxime binds to one or more of the penicillin-binding proteins
(PBPs) which inhibits the final transpeptidation step of
peptidoglycan synthesis in bacterial cell wall, thus inhibiting
biosynthesis and arresting cell wall assembly resulting in bacterial
cell death.

 Absorption: Absorbed from the GI tract with peak plasma
concentrations after 2-3 hr (oral); may be enhanced by the presence
of food.
 Distribution: Pleural and synovial fluid, sputum, bone and aqueous
fluids; CSF (therapeutic concentrations). Crosses the placenta and
enters breast milk. Protein-binding: Up to 50%.

 Metabolism: Rapidly hydrolysed (intestinal mucosa and blood).
 Excretion: Via the urine by glomerular filtration and renal tubular
secretion (as unchanged); via bile (small amounts); 70 min
(elimination half-life); prolonged in neonates and renal impairment.

Adverse effects
 Large doses can cause cerebral irritation and convulsions; nausea,
vomiting, diarrhea, GI disturbances; erythema multiforme, Stevens-
Johnson syndrome, epidermal necrolysis.
 Potentially Fatal: Anaphylaxis, nephrotoxicity, pseudomembranous
colitis.

Contraindications
  Hypersensitivity to cephalosporins

Mechanism of Action:
 Cefuroxime axetil is a bactericidal agent that acts by inhibition of
bacterial cell wall synthesis. Cefuroxime axetil has activity in the
presence of some β-lactamases, both penicillinases and
cephalosporinases, of gram-negative and gram-positive bacteria.

Nursing considerations :
 Culture infection, and arrange for sensitivity tests before and during
therapy if expected response is not seen.
 Give oral drug with food to decrease GI upset and enhance
absorption.
 Give oral drug to children who can swallow tablets; crushing the
drug results in a bitter, unpleasant taste.
 Have vitamin K available in case hypoprothrombinemia occurs.
 Discontinue if hypersensitivity reaction occurs.

Reference:
rnpedia.com
Erythromycin ophthalmic (Rx)

Brand and Other Names: lotycin Ophthalmic

Classes: Macrolides, Ophthalmic

Dosage Forms & Strengths

 ophthalmic ointment : 0.5%

Adverse Effects :

 Frequency Not Defined


 Hypersensitivity reactions
 Minor ocular reactions
 Redness

Contraindications
 Minor ocular irritation; hypersensitivity

Mechanism of Action

 Inhibits protein synthesis in susceptible organisms by binding to

50S ribosomal subunits, thereby inhibiting translocation of
aminoacyl transfer-RNA and inhibiting polypeptide synthesis
 Exerts effect only against multiplying organisms; penetrates cell
wall of gram-positive bacteria more readily than that of gram-
negative bacteria, and thus, gram-positive organisms may
accumulate 100 times more erythromycin than gram-negative
organisms do

Nursing Considerations :

 Culture site of infection before therapy.

 Administer oral erythromycin base or stearate on an empty
stomach, 1 hr before or 2–3 hr after meals, with a full glass of water
(oral erythromycin estolate, ethylsuccinate, and certain enteric-
coated tablets [see manufacturer’s instructions] may be given
without regard to meals).
 Administer around the clock to maximize effect; adjust schedule to
minimize sleep disruption.
 Monitor liver function in patients on prolonged therapy.
  Give some preparations with meals, as directed, or substitute one
of these preparations, if GI upset occurs with oral therapy.

Reference : rnpedia.com/ medscape.com