A Drug Study on

Ciprofloxacin

In partial Fulfillment of the

Requirements in NCM 212 RLE

OXYGENATION/FLUIDS & ELECTROLYTES NURSING ROTATION

Submitted to:
MRS. CLAUDETTE ADVINCULA, RN, MN
Clinical Instructor

Submitted by:
Aleeza Mae M. Salenga, St. N
BSN 3B Group 1 Subgroup 3

December 3, 2020
Generic name: Ciprofloxacin

Brand name: Apo-Ciproflox, Cetraxal, Ciloxan, Cipro, Cipro XR,

Proquin XR
Drug Classification:

 PHARMACOTHERAPEUTIC: Fluoroquinolone
 CLINICAL: Antibiotic

Mode of Action:

 Inhibits enzyme, DNA gyrase, in susceptible bacteria, interfering with bacterial cell
replication.
 Therapeutic Effect: Bactericidal

Dosage and Route:

Usual Dosage Range

PO:
 ADULTS, ELDERLY: 250–750 mg q12h.
 CHILDREN:
 (Mild to moderate infections): 10 mg/kg twice daily. Maximum: 500 mg/dose.

 (Severe infections): 15-20 mg/kg twice daily. Maximum: 750 mg/dose.

IV:
 ADULTS, ELDERLY: 200–400 mg q12h.
 CHILDREN: 10 mg/kg q8–12h. Maximum: 400 mg/dose.
Usual Ophthalmic Dosage
 ADULTS, ELDERLY, CHILDREN:
 (Solution): 1–2 drops q2h while awake for 2 days, then 1–2 drops q4h while
awake for 5 days.
 (Ointment): Apply 3 times/day for 2 days, then 2 times/day for 5 days.
Usual Otic Dosage
 ADULTS, ELDERLY, CHILDREN: Otic solution 0.2%. Instill 0.25 mL (0.5 mg) 2
times/ day for 7 days.
Dosage in Renal Impairment
Dosage and frequency are modified based on creatinine clearance and the severity of
the infection.
Dosage in Hepatic Impairment
No dose adjustment.

Indications:

 Skin and Skin Structure Infections

 Bone and Joint Infections

 Complicated Intra-Abdominal Infections

 Infectious Diarrhea

 Typhoid Fever (Enteric Fever)

 Uncomplicated Cervical and Urethral Gonorrhea

 Inhalational Anthrax (Post-Exposure)

 Plague (pneumonic and septicemic) due to Yersinia pestis

 Chronic Bacterial Prostatitis

 Lower Respiratory Tract Infections

 Urinary Tract Infections

 Urinary Tract Infections in Adults
 Acute Uncomplicated Cystitis
 Complicated Urinary Tract Infection and Pyelonephritis in Pediatric Patients

 Acute Sinusitis

Contraindications:

 Hypersensitivity to ciprofloxacin, other quinolones. Concurrent use of Tizanidine.

 Cautions: Renal impairment, CNS disorders, seizures, rheumatoid arthritis, history
of QT prolongation, uncorrected hypokalemia, hypomagnesemia, myasthenia gravis.
 Suspension not used through feeding or gastric tubes. Use in children (due to
adverse events to joints/surrounding tissue).
Side effects:

 Frequent (5%–2%): Nausea, diarrhea, dyspepsia, vomiting, constipation, flatulence,

confusion, crystalluria.
 Occasional (less than 2%): Abdominal pain/discomfort, headache, rash.
 Rare (less than 1%): Dizziness, confusion, tremors, hallucinations, hypersensitivity
reaction, insomnia, dry mouth, paresthesia.

Adverse effects:

 Superinfection (esp. enterococcal, fungal), nephropathy, cardiopulmonary arrest,

cerebral thrombosis may occur. Hypersensitivity reaction (rash, pruritus, blisters,
edema, burning skin), photosensitivity have occurred. Sensitization to ophthalmic
form may contraindicate later systemic use of ciprofloxacin. May exacerbate muscle
weakness in pts with myasthenia gravis. Dermatologic conditions such as toxic
epidermal necrolysis, Stevens-Johnson syndrome have been reported. Cases of
severe hepatotoxicity have occurred. May increase risk of tendonitis, tendon rupture.
Drug interactions:

 DRUG: Antacids, calcium, magnesium, zinc, iron preparations, sucralfate may

decrease absorption. May increase effects of caffeine, oral anticoagulants (e.g.,
warfarin). May decrease concentration of fosphenytoin, phenytoin. May increase
concentration, toxicity of theophylline.
 HERBAL: Dong quai, St. John’s wort may increase photosensitization.
 FOOD: None known.
 LAB VALUES: May increase serum alkaline phosphatase, creatine kinase (CK),
LDH, ALT, AST.

Nursing Responsibilities:

1. Encourage patient to maintain adequate hydration.

R: To prevent the risk of crystalluria. Diarrhea can also cause a tremendous loss of
water and electrolytes in a short amount of time, leading to dehydration.
2. Avoid exposure to sunlight/artificial light.
R: May cause photosensitivity reaction.
3. Do not give antacids within 2 hours of administration of Ciprofloxacin.
R: Antacids reduces the effectiveness of Ciprofloxacin.
4. Monitor daily pattern of bowel activity, stool consistency.
R: Antibiotics often cause diarrhea since it upsets the balance of the good and bad
bacteria in the gastrointestinal tract.
5. It is essential to complete drug therapy despite symptom improvement.
R: Early discontinuation may result in antibacterial resistance or increase risk of
recurrent infection.
6. Provide sugarless gum or hard candy
R: To relieve bad taste from the medication.
7. Advice patient to report tendon pain or swelling.
R: Taking ciprofloxacin increases the risk of tendonitis (swelling of a fibrous tissue
that connects a bone to a muscle) and tendon rupture (tearing of a fibrous tissue that
connects a bone to a muscle) 
8. Advice to eat small frequent meals.
R: To prevent nausea and vomiting.
9. Advice patient to observe caution if driving or using dangerous equipment.
R: Possible side effects such as drowsiness, blurry vision, and dizziness may pose
as a threat to patient’s safety.
10. Ensure that the patient swallows ER tablets whole; do not cut, crush, or chew.
R: It allows the patient to experience the full extent of the medication.

Reference:

Cipro (Ciprofloxacin): Uses, Dosage, Side Effects, Interactions, Warning. (2020).

Retrieved November 26, 2020, from https://www.rxlist.com/cipro-drug.htm

Durbin, K. (2020). Ciprofloxacin: Uses, Dosage, Side Effects, Warnings. Retrieved

November 26, 2020, from https://www.drugs.com/ciprofloxacin.html

Kizior, R. J., Hodgson, B. B., Hodgson, K. J., & Witmer, J. B. (2019). Saunders nursing
drug handbook 2019. St. Louis, Mo: Elsevier.

Skidmore-Roth, L. (2019). Mosby’s Drug Guide for Nursing Students (13 th ed.). St.
Louis, Missouri: Elsevier