[DRUG STUDY] VIRTUAL RLE / MDH PEDIA

Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES
College of Nursing
Tamag, Vigan City, 2700 Ilocos Sur

DRUG STUDY
In Partial Fulfillment

Of the Requirement For The

Virtual RLE

MDH Pedia

Presented by:

John Noeh D. Degracia

BSN II-E

Presented to:
Mrs. Winnie Ponce

University of Northern Philippines

College of Nursing
 [DRUG STUDY] VIRTUAL RLE / MDH PEDIA

AMPICILLIN DOSING CONSIDERATIONS

General Dosing Guidelines
Brand Name: Ampi, Omnipen, Penglobe, Principen
Adults:
Generic Name: Ampicillin
Orally: 250-500 mg every 6 hours
Drug Class: Penicillins, Amino
Intravenously/intramuscularly: 1-2 g every 4-6 hours or 50-250 mg/kg/day
divided every 4-6 hours, not to exceed 12 g/day
WHAT IS AMPICILLIN AND HOW DOES IT WORK?
Pediatric:
Ampicillin is a prescription penicillin-type antibiotic used to treat many 400 mg/kg/day intravenously/intramuscularly divided every 6 hours
different types of infections caused by bacteria, such as ear infections,
bladder infections, pneumonia, gonorrhea, and E. coli or salmonella 50-100 mg/kg/day orally divided every 4-6 hours, not to exceed 12 g/day
infection. Ampicillin is available under the following different brand  Severe infection: 200-400 mg/kg/day
names: Ampi, Omnipen, Penglobe, and Principen. intravenously/intramuscularly divided every 6 hours
WHAT ARE DOSAGES OF AMPICILLIN?  Potential toxic dose: Children under 6 years: 300 mg/kg
CAPSULES Neonates under 28 days:
250 mg 500 mg Under 7 days:
 Infants under 2 kg: 50-100 mg/kg/day
intravenously/intramuscularly divided every 12 hours
ORAL SUSPENSION
 Infants over 2 kg: 75-150 mg/kg/day intravenously/intramuscularly
125 mg/5 ml 250 mg/5 ml divided every 8 hours
 Infants under 1.2 kg: 50-100 mg/kg/day
intravenously/intramuscularly divided every 12 hours
POWDER FOR INJECTION
 Infants 1.2-2 kg: 75-150 mg/kg/day intravenously/intramuscularly
125 mg 250 mg 500 mg 1g 2g 10 g
divided every 8 hours
(adult
 Infants over 2 kg: 100-200 mg/kg/day
dosing
intravenously/intramuscularly divided every 6 hours
only
 [DRUG STUDY] VIRTUAL RLE / MDH PEDIA

Endocarditis Prophylaxis  Children over 40 kg: 500 mg intravenously/intramuscularly divided

every 6 hours
Adults:
Gastrointestinal Tract Infections
 2 g intravenously/intramuscularly (with or without gentamicin 1.5
mg/kg for gastrointestinal/genitourinary) within 30-60 minutes Adults:
before procedure
 500 mg intravenously every 6 hours; larger doses may be necessary
Dosing considerations for severe or chronic infection
American Heart Association guidelines recommend only for high-risk Pediatric:
patients
 Children under 20 kg: 50-100 mg/kg/day orally divided every 6
Pediatric: hours
 50 mg/kg intravenously/intramuscularly (with or without  Children over 20 kg: 500 mg orally every 6 hours
gentamicin 1.5 mg/kg for gastrointestinal/genitourinary) within
 Children under 40 kg: 50 mg/kg/day intravenously/intramuscularly
30-60 minutes before the procedure
divided every 6-8 hours
Dosing considerations:
 Children over 40 kg: 500 mg intravenously/intramuscularly every 6
American Heart Association guidelines recommended only for high-risk hours
patients
Gonorrhea
Endocarditis
Adults:
 12 g/day continuous intravenous infusion or divided every 4 hours
 3.5 g intravenously administered once simultaneously with 1 g of
Genitourinary Tract Infections (excluding Gonorrhea) probenecid
Adults: Pediatric:
 1-2 g intravenously every 6 hours with gentamicin if enterococcus  Children under 20 kg: safety and efficacy not established
suspected  Children over 20 kg: 3.5 g orally administered once simultaneously
Pediatric: with 1 g of probenecid
 Children under 40 kg: 50-100 mg/kg/day
intravenously/intramuscularly divided every 6 hours
 [DRUG STUDY] VIRTUAL RLE / MDH PEDIA

Respiratory Tract Infections Dosing Modifications

Adults: Renal Impairment
 250 mg intravenously every 6 hours  Creatinine Clearance less than 10 ml/min: administer every 12-24
hours
Pediatric:
 Creatinine Clearance 10-50 ml/min: administer every 6-12 hours
 Children under 20 kg: 50 mg/kg/day orally divided every 6-8 hours
 Creatinine Clearance over 50 ml/min: administer every 6 hours
 Children over 20 kg: 250 mg orally every 6 hours
Hepatic Impairment
 Children under 40 kg: 25-50 mg/kg/day
intravenously/intramuscularly divided every 6-8 hours  Not studied
 Children over 40 kg: 250-500 mg intravenously/intramuscularly WHAT ARE SIDE EFFECTS ASSOCIATED WITH USING
every 6 hours AMPICILLIN?
Bacterial Meningitis Common Side effects of Ampicillin include:
 150-200 mg/kg/day intravenously every 6-8 hours  acute inflammatory skin eruption (erythema multiforme)
 Group B Streptococcus  redness and peeling of the skin (exfoliative dermatitis)
Neonatal prophylaxis  rash
 2 g intravenously initially, followed by every 4 hours until delivery  hives
Listeria Infection  fever

 2 g intravenously every 4 hours  seizure

Cholera  black hairy tongue

 diarrhea
Pediatric:
 inflammation of the small intestine and colon
 50 mg/kg/day orally divided every 6 hours for 3 days; not to exceed
2 g/day  inflammation of the tongue
Administration  nausea
Take oral dosage form on an empty stomach  yeast infection in the mouth (oral candidiasis/thrush)
 [DRUG STUDY] VIRTUAL RLE / MDH PEDIA

 swelling or inflammation of the large intestine/colon pharmacist first. Ampicillin has no known severe interactions with other
drugs.
 inflammation of the mouth
Serious Interactions of ampicillin include:
 vomiting
 BCG vaccine live
 low white blood cell count (agranulocytosis)
 cholera vaccine
 anemia
 demeclocycline
 low red blood cell count (anemia)
 doxycycline
 high white blood cell count (eosinophilia)
 lymecycline
 reduction of white blood cells (leukopenia)
 minocycline
 acute allergic reaction (anaphylaxis)
 mycophenolate
 elevated aspartate aminotransferase (AST)
 oxytetracycline
 inflammation in the kidney
 tetracycline
 noisy breathing
 typhoid vaccine live
 allergic reaction
 Ampicillin has moderate interactions with at least 29 different
 headache
drugs.
 vaginal itching or discharge
Mild interactions of ampicillin include:
 dark urine
 allopurinol
 easy bruising or bleeding
 atenolol
 persistent sore throat or fever
 azithromycin
WHAT OTHER DRUGS INTERACT WITH AMPICILLIN?
 bendroflumethiazide
If your doctor has directed you to use this medication, your doctor or
 chloramphenicol
pharmacist may already be aware of any possible drug interactions and may
be monitoring you for them. Do not start, stop, or change the dosage of any  chlorothiazide
medicine before checking with your doctor, health care provider or
 clarithromycin
 [DRUG STUDY] VIRTUAL RLE / MDH PEDIA

 colestipol
 didanosine
 entacapone
 erythromycin base
 erythromycin ethylsuccinate
 erythromycin lactobionate
 erythromycin stearate
 hydrochlorothiazide
 methyclothiazide
 metolazone
 rifampin
 roxithromycin

This information does not contain all possible interactions or adverse

effects. Therefore, before using this product, tell your doctor or pharmacist
of all the products you use. Keep a list of all your medications with you, and
share this information with your doctor and pharmacist. Check with your
health care professional or doctor for additional medical advice, or if you
have health questions, concerns or for more information about this
medicine.

CHLORAMPHENICOL
Brand Name: Chloramphenicol IV, Chloromyectin
Generic Name: Chloramphenicol
Drug Class: Antibiotics, Other
WHAT IS CHLORAMPHENICOL AND HOW DOE S IT WORK?
 Chloramphenicol is prescription intravenous antibiotic for
treatment of serious infections and systemic infections.
 Chloramphenicol is available under the following different brand
names: Chloramphenicol IV and Chloromyectin. These brand
names are discontinued in the U.S.
WHAT ARE DOSAGES OF CHLORAMPHENICOL?
Injectable solution
1,000 mg/vial
Dosage Considerations – Should be Given as Follows:
Serious Infections Caused by Susceptible Strains
Adults:
 50 mg/kg/day intravenously divided every 6 hours; in exceptional
cases, patients with moderately resistant organisms or severe
infections may require increased dosage up to 100 mg/kg/day;
decrease these high doses as soon as possible
[DRUG STUDY] VIRTUAL RLE / MDH PEDIA
Systemic Infections
Pediatric:
Infants and children: As in adults; when adequate cerebrospinal fluid
concentrations are desired, may require up to 100 mg/kg/day; however,
should reduce dose to 50 mg/kg/day as soon as possible
Infants and children with suspected immature metabolic functions: 25
mg/kg/day divided every 6 hours will usually produce therapeutic
concentrations of the drug in the blood
Neonates (Infants younger than 28 days)
Pediatric:
 Loading dose (LD): 20 mg/kg intravenously once; give
maintenance dose 12 hours after loading dose
Maintenance Dose
 Infants younger than 7 days old: 25 mg/kg/day intravenously every
24 hours
 Infants over 7 days old, less than 2000 g: 25 mg/kg/day
intravenously every 24 hours
 Infants over 7 days old, over 2000 g: 50 mg/kg/day intravenously
every 12 hours
 [DRUG STUDY] VIRTUAL RLE / MDH PEDIA

Pediatric:  inflammation of the optic nerve

 Peaks 10-20 mg/l, troughs 5-10 mg/l  weakness and numbness in your hands and feet

Other Indications and Uses  rash

Adults:  inflamed and sore mouth

 Use only as an alternative for treatment of meningitis, typhoid, or  vomiting

rickettsial infection
WHAT OTHER DRUGS INTERACT WITH
WHAT ARE SIDE EFFECTS ASSOCIATED WITH USING CHLORAMPHENICOL?
CHLORAMPHENICOL?
If your doctor has directed you to use this medication, your doctor or
Common side effects of chloramphenicol include: pharmacist may already be aware of any possible drug interactions and may
be monitoring you for them. Do not start, stop, or change the dosage of any
 not enough red blood cells produced (aplastic anemia) medicine before checking with your doctor, health care provider, or
pharmacist first. Chloramphenicol has no known severe interactions with
 bone marrow suppression
other drugs.
 diarrhea
Serious interactions of chloramphenicol include:
 inflammation of the small intestine and the colon (enterocolitis)
 lurasidone
 accumulation of chloramphenicol especially in newborns (gray
Serious interactions of chloramphenicol include:
syndrome)
 BCG vaccine live
 headache
 cefoxitin
 nausea
 cholera vaccine
 nightmares
 [DRUG STUDY] VIRTUAL RLE / MDH PEDIA

 mefloquine  lomitapide

 red yeast rice  maraviroc

 typhoid vaccine live  mestranol

 vilazodone  ospemifene

 warfarin  phenytoin

 Moderate interactions of chloramphenicol include:  piperacillin

 axitinib  sodium picosulfate/magnesium oxide/anhydrous citric acid

 bazedoxifene/conjugated estrogens WHAT ARE WARNINGS AND PRECAUTIONS FOR

CHLORAMPHENICOL?
 ceftriaxone
Warnings
 conjugated estrogens, vaginal
 Serious and fatal blood dyscrasias, including aplastic anemia,
 eluxadoline hypoplastic anemia, thrombocytopenia, and granulocytopenia, have
 estradiol occurred after short-term and prolonged therapy.

 estrogens conjugated synthetic  Monitor complete blood count (CBC) frequently in all patients. Use
only in serious infections.
 estrogens esterified
 This medication contains chloramphenicol. Do not take
 estropipate Chloramphenicol IV and Chloromyectin if you are allergic to
chloramphenicol or any ingredients contained in this drug.
 fosphenytoin

 ivacoftor
 [DRUG STUDY] VIRTUAL RLE / MDH PEDIA

Keep out of reach of children. In case of overdose, get medical help or

contact a Poison Control Center immediately.

Contraindications

Hypersensitivity

 Do not use oral or topical; not for use in trivial infections or for
prophylaxis

 Avoid during breastfeeding

Effects of Drug Abuse

Cautions

Kidney or liver impairment (not studied in these conditions) Carotenoderma

(yellowing of the skin) was reported 4-6 weeks after initiating high doses
When antioxidant vitamins, including beta-carotene, are used together, they
might interfere with healing following angioplasty May increase
cardiovascular risk (coronary artery disease, cardiovascular mortality),
especially in current smokers. Increased incidence of lung cancer following
chloramphenicol supplementation has been reported in clinical trials of
adult smokers and those exposed to asbestos

Pregnancy and Lactation

Use chloramphenicol with caution during pregnancy if the benefits

outweigh the risks. Animal studies show risk and human studies are not
available or neither animal nor human studies were done. Chloramphenicol
enters breast milk; discontinue the drug or do not breastfeed
 [DRUG STUDY] VIRTUAL RLE / MDH PEDIA

CETIRIZINE Tablet

Brand Names: Zyrtec 5 mg

Generic Name: Cetirizine 10 mg

Drug Class: Antihistamines Tablet, oral-disintegrating

WHAT IS CETIRIZINE AND HOW DOES IT WORK? 10 mg

Cetirizine is a prescription approved by the U.S. Food and Drug Tablet, chewable
Administration (FDA), and over-the-counter antihistamine medication.
5 mg
This drug may be used as a treatment for annual or seasonal allergic and
vasomotor rhinitis (inflammation of the membranes of the nose not caused 10 mg
by an allergy). This medication is also used as a treatment to provide relief
of cold symptoms and other conditions such as urticaria (hives), Syrup
angioedema, anaphylactic reactions, pruritus, and allergic conjunctivitis.
Cetirizine works by blocking a certain natural substance (called histamine) 5 mg/5 ml
that your body makes during an allergic reaction. It works against the
production of histamine, and belongs to as class of medications called Solution
antihistamines. Cetirizine is available under the following different brand
5 mg/5 ml
names: Zyrtec, Zyrtec Allergy, Children's Zyrtec Allergy, Children's Zyrtec
Hives Relief, PediaCare Children's 24 Hour Allergy, Aller-Tec, and Geriatric
Wal-Zyr.
 5 mg orally once per day, may increase to 10 mg per day maximum,
WHAT ARE DOSAGES OF CETIRIZINE? depending on the severity of the symptoms, not to exceed 5 mg per
day in patients over 77 years old
Dosages of Cetirizine:

Adult and pediatric dosages

 [DRUG STUDY] VIRTUAL RLE / MDH PEDIA

Dosage Considerations – Should be Given as Follows: Renal impairment, pediatric

Allergic Conditions, Including Hay Fever and Hives  GFR equal to 30 mL/min/1.73 m²: Dose adjustment not necessary

Perennial and seasonal allergic rhinitis and vasomotor rhinitis; relief of  GFR 10-29 mL/min/1.73 m²: Decrease dose by 50%
symptoms from colds, hives, rapid swelling, acute allergic reactions,
pruritus, and allergic conjunctivitis  GFR lower than 10 mL/min/1.73 m²: Not recommended

Adults  Peritoneal dialysis: 5 mg orally each day

 5 mg to 10 mg orally each day, depending on the severity of Adult

symptoms; not to exceed 10 mg each day.
 Intermittent hemodialysis: 5 mg orally each day; may also
Children administer 3 times weekly

Children under 2 years: Safety and efficacy not established Pediatric

Children 2-6 years old  Intermittent hemodialysis or peritoneal dialysis: Decrease dose by
50%
 2.5 mg (0.5 teaspoons) oral solution orally once daily; can increase
to 5 mg orally once per day or 2.5 mg twice daily; not to exceed 5 Hepatic impairment
mg per day
 Dose adjustment not provided by manufacturer's label
Children over 6 years:
Administration
 5-10 mg orally each day, depending on the severity of symptoms;
not to exceed 10 mg per day  It May be taken with or without food

Dosing Modifications WHAT ARE SIDE EFFECTS ASSOCIATED WITH USING

CETIRIZINE?
Renal impairment, adult
Common side effects include:
 GFR greater than 50 mL/min: Dose adjustment not necessary
 sleepiness
 GFR less than 50 mL/min: 5 mg orally each day
 headache
 [DRUG STUDY] VIRTUAL RLE / MDH PEDIA

 fatigue

 dry mouth  There are no severe Interactions of Cetirizine.

 diarrhea Serious Interactions of Cetirizine include:

 malaise Isocarboxazid

 difficulty breathing tranylcypromine

 vomiting Moderate Interactions of Cetirizine include:

 nose bleed bosutinib

 stomach pain clobazam

 drowsiness crizotinib

 rapid swelling daclatasvir

 hallucinations eliglustat

 low blood pressure hyaluronidase

 tremor lomitapide

 tongue discoloration lurasidone

WHAT OTHER DRUGS INTERACT WITH CETIRIZINE? ombitasvir/paritaprevir/ritonavir

If your doctor has directed you to use this medication, your doctor or phenelzine
pharmacist may already be aware of any possible drug interactions and may
be monitoring you for them. Do not start, stop, or change the dosage of any ponatinib
medicine before checking with your doctor, health care provider, or
ritonavir
pharmacist first.
 [DRUG STUDY] VIRTUAL RLE / MDH PEDIA

Mild Interactions of Cetirizine include: Short-Term Effects

 dyphylline Avoid the use of alcohol, sedatives, and tranquilizers as cetirizine can
increase the risk of drowsiness. Cetirizine may cause central nervous system
 theophylline depression; avoid activities requiring mental alertness until accustomed to
the medication.
WHAT ARE WARNINGS AND PRECAUTIONS FOR
CETIRIZINE? See "What Are Side Effects Associated with Using Cetirizine?"
Warnings Long-Term Effects
Documented hypersensitivity to cetirizine or hydroxyzine See "What Are Side Effects Associated with Using Cetirizine?"
 This medication contains cetirizine. Do not take Zyrtec, Zyrtec Cautions
Allergy, Children's Zyrtec Allergy, Children's Zyrtec Hives Relief,
PediaCare Children's 24 Hour Allergy, Aller-Tec, or Wal-Zyr if  Avoid the use of alcohol, sedatives, and tranquilizers as cetirizine
you are allergic to cetirizine or any ingredients contained in this can increase the risk of drowsiness
drug
 Cetirizine may cause central nervous system depression; avoid
 Keep out of reach of children. In case of overdose, get medical help activities requiring mental alertness until accustomed to medication
or contact a Poison Control Center immediately Use caution in hepatic and renal impairment The elderly may be
more sensitive to adverse effects
Contraindications
Pregnancy and Lactation
 Avoid use if there is hypersensitivity to cetirizine or hydroxyzine.
 The use of cetirizine in pregnancy may be acceptable. Either animal
Effects of Drug Abuse studies show no risk but human studies are not available, or animal
studies showed minor risks, and human studies were done and
None showed no risk

 Zyrtec-D 12-hour use with caution in pregnancy if benefits

outweigh risks. Animal studies show risk and human studies are not
available or neither animal nor human studies were done
 [DRUG STUDY] VIRTUAL RLE / MDH PEDIA

REFERENCES

Cetirizine

https://www.rxlist.com/consumer_cetirizine_zyrtec/drugs-condition.htm

Ampicillin

https://www.rxlist.com/consumer_ampicillin_penicillin/drugs-condition.ht

Chloramphenicol

https://www.rxlist.com/consumer_chloramphenicol_chloramphenicol/drug
s-condition.htm