Generic Name: Ceftriaxone Trade name: Rocephin

Pharmacologic Class: Antibiotic, 3rd generation Usual dose: 1-2g/50mL IV (or IM) or divided q12hrs, max: 4g
Cephalosporin

Action (What does it do? How long does it take to work?): Uses for this medication:
Bactericidal - weakens bacterial cell wall, causing cell death. - Infections  gonorrhea, pelvic inflammatory disease,
Active against many gram-positive pathogens. meningitis, pneumonia, septicemia, otitis media
- Perioperative prophylaxis
Onset: 5 minutes (IV), 1 hour (IM) Duration: 5-8 hrs
Common side effects:
- pain/tenderness/hardness/warmth @ injection site
- pale skin, weakness, SOB when exercising
- diarrhea (incl. C-diff associated diarrhea)

Serious complications
- rash, bloody/watery stools, cramps, N/V
- chest pain, heartburn, painful urination, decreased urination, foul smelling urine, edema in legs and feet,
peeling/blistering/shedding skin
- seizures

Clinical Judgment
Pre-administration assessment: What should the nurse assess before administering the medication?
- Hx of hypersensitivity reactions to cephalosporins/penicillin (beta-lactam Abx) or other drug allergies
- Bowel functions – N/V/D
- Hx of colitis, hyperbilirubinemia, gallbladder disease, pancreatitis, renal/liver disease, seizure disorders
- Dx of anemia or coagulation disorders – PTT alterations
- Lab tests: CBC, renal and hepatic function, electrolytes
- Culture & sensitivity
- Vitals (RR, pulse, BP, temp)
- IV site – redness, edema, pain, temperature, infection, leakage, embolism

How will the nurse know if it is appropriate to administer?

- No N/V/D, no Hx of hypersensitivity to cephalosporins/penicillin, no complications at IV site, no GI disease, anemia,
coagulation disorders

Post- administration assessment: What should the nurse assess after administering the medication? How will you know if the
medication is effective?
- Monitor S&S of allergic reactions and anaphylaxis: pulmonary symptoms (tightness in throat and chest, wheezing, cough,
dyspnea) or skin reactions (rash, pruritis, urticaria)
- Monitor for hypersensitivity reaction, urine output

Nursing considerations:
- Precipitation of ceftriaxone-calcium can also occur when Rocephin is mixed with calcium-containing solutions in the
same IV administration line  DO NOT admin Ca-containing IV solutions simultaneously (e.g. parenteral nutrition)
- Drug-drug interactions: aminoglycosides – increased risk for nephrotoxicity, oral anticoagulants – increased bleeding
- Avoid alcohol for 72 hours after discontinuation of the drug to prevent disulfiram-like reaction (e.g. flushing, throbbing
headache, N/V, chest pain, palpitations, dyspnea, syncope, vertigo, convulsions)