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Name of Drug CEFAZOLIN

Dose Dosage Classification Route IV 500 Therapeutic: mg. Anti-infectives q 8 hr. Pharmacologic: First generation cephalosphorins

Action Inhibits bacterial cell wall synthesis by binding to one or more of the penicillinbinding proteins (PBPs) which in turn inhibit the final transpeptidati on step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein

Indication Cefazolin is mainly used to treat bacterial infections of the skin. It can also be used to treat moderately severe bacterial infections involving the lung, bone, joint, stomach, blood, heart valve, and urinary tract. It is clinically effective against infections caused by staphylococc i and streptococci of Grampositive

Side Effects Central nervous system: Fever, seizure Dermatologic: Rash, pruritus, StevensJohnson syndrome Gastrointestinal : Diarrhea, nausea, vomiting, abdominal cramps, anorexia, pseudomembra nous colitis, oral candidiasis Genitourinary: Vaginitis Hepatic: Transaminases increased, hepatitis Hematologic:

Drug to Drug Interaction BCG: Antibiotics may diminish the therapeutic effect of BCG. Risk X: Avoid combination

Nursing Consideration

Assess patient for infection (vital signs; appearance of surgical site, urine; WBC) at beginning and during therapy. Before initiating therapy, obtain a Typhoid history to Vaccine: Antibiotics may determine previous use of and diminish the reactions to therapeutic penicillins or effect of cephalosphorins. Typhoid Persons with a Vaccine. Only negative history of the live penicillin attenuated sensitivity may Ty21a strain is still have an affected. Risk allergic response. D: Consider Obtain specimens therapy for culture and modification sensitivity before initiating therapy. Uricosuric Observe patient Agents: May for signs and decrease the symptoms of excretion of Cephalosporins. anaphylaxis (rash, Risk C: Monitor pruritis, laryngeal

hydrolases) while cell wall assembly is arrested.

bacteria. These organisms are common on normal human skin. Resistance to cefazolin is seen in several species of bacteria.

Eosinophilia, neutropenia, leukopenia, thrombocytopen ia, thrombocytosis Local: Pain at injection site, phlebitis Renal: BUN increased, serum creatinine increased, renal failure Miscellaneous: Anaphylaxis

therapy

edema, wheezing). Discontinue drug and notify Vitamin K Antagonists (eg, physician or other health care warfarin): Cephalosporins professional immediately if may enhance these problems the occur. Keep anticoagulant epinephrine, an effect of antihistamine, and Vitamin K resuscitation Antagonists. Risk C: Monitor equipment close by in case of therapy anaphylactic reaction. Monitor site for thrombophlebitis (pain, redness, and swelling). Change sites every 48-72 hr to prevent phlebitis. Instruct patient to report signs of superinfection (furry overgrowth on the tongue, vaginal itching or discharge, loose or foul-smelling stools) and allergy. Instruct patient to

notify health care professional if fever and diarrhea develop, especially if diarrhea contains blood, mucus, or pus. Advise not to treat diarrhea without consulting healthcare professional.

Name of Drug PARACETAMOL (acetaminophen)

Dose Dosage Route IV 300 mg. x 6 doses q 4 hr.

Classificatio n Pharmacologi c class: Synthetic nonopioid paminophenol derivative Therapeutic class: Analgesic, antipyretic

Action
Pain relief may result from inhibition of prostaglandin synthesis in CNS, with subsequent blockage of pain impulses. Fever reduction may result from vasodilation and increased peripheral blood flow in hypothalamus , which dissipates heat and lowers body temperature.

Indication
Mild to moderate pain caused by headache, muscle ache, backache, minor arthritis, common cold, toothache, or menstrual cramps; fever

Side Effects Hematologic: thrombocytopenia, hemolytic anemia, neutropenia, leukopenia, pancytopenia Hepatic: jaundice, hepatotoxicity Metabolic: hypoglycemic coma Skin: rash, urticaria Other: hypersensitivity reactions (such as fever)

Drug to Drug Interaction Drug-drug. Activated charcoal, cholestyramine, colestipol: decreased acetaminophen absorption Barbiturates, carbamazepine, diflunisal, hydantoins, isoniazid, rifabutin, rifampin, sulfinpyrazone: increased risk of hepatotoxicity Hormonal contraceptives: decreased acetaminophen efficacy Oral anticoagulants: increased anticoagulant

Nursing Consideration
Caution parents or other caregivers not to give acetaminophen to children younger than age 2 without consulting prescriber first. Tell patient, parents, or other caregivers not to use drug concurrently with other acetaminophen -containing products. Advise patient, parents, or other caregivers to contact prescriber if fever or other symptoms persist despite taking recommended amount of drug.

effect Phenothiazines (such as chlorpromazine, fluphenazine, thioridazine): severe hypothermia Zidovudine: increased risk of granulocytopeni a

Inform patients with chronic alcoholism that drug may increase risk of severe liver damage. As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.