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Clinical Medications Worksheets

Generic Name Trade Name Classification Dose Route Time/frequency
Piperacillin/tazobactam Zosyn Anti-infectives 2.25gm IVPB Q 6 hrs
Peak Onset Duration Normal dosage range
End of infusion rapid 4-6 hrs 3.375-4.5 g q 6 hr
Rate: Administer over at least 30 min
Why is your patient getting this medication For IV meds, compatibility with IV drips and/or solutions
Skin and skin structure infections Reconstitute with 5 ml of 0.9% NaCl, sterile or bacteriostatic water for
injection, or D5W. Do not use LR--incompatible. Shake well until
dissolved. Dilute further in at least 50 ml of diluent. Discard any
unused solution after 24 hr at room temperature or 48 hr if refrigerated.
Mechanism of action and indications Nursing Implications (what to focus on)
(Why med ordered) Contraindications/warnings/interactions
Piperacillin: Binds to bacterial cell wall membrane, causing Hypersensitivity to penicillins, betalactams, cephalosporins, or
cell death. Spectrum is extended compared with other tazobactam(cross-sensitivity may occur). Renal impairment (dosage
penicillins. reduction or increased interval recommended if CCr <40 ml/min).
Tazobactam: Inhibits beta-lactamase, an enzyme that can Common side effects
destroy penicillins. SEIZURES (HIGHER DOSES), PSEUDOMEMBRANOUS
COLITIS, rashes, hypokalemia, phlebitis at IV site,
HYPERSENSITIVITY REACTIONS, INCLUDING ANAPHYLAXIS
AND SERUM SICKNESS
Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine
medicines (ask patient specifically) Evaluate renal and hepatic function, CBC, serum potassium, and
None for this patient bleeding times prior to and routinely during therapy, May cause
positive direct Coombs' test result, May cause ↑ BUN, creatinine, AST,
ALT, serum bilirubin, alkaline phosphatase, and LDH, May cause
leukopenia and neutropenia, especially with prolonged therapy or
hepatic impairment, May cause prolonged prothrombin and partial
thromboplastin time, Piperacillin may cause ↑ serum sodium and ↓
serum potassium concentrations, Piperacillin/tazobactam may also
cause ↓ hemoglobin and hematocrit and thrombocytopenia,
eosinophilia, leukopenia, and neutropenia. It also may cause
proteinuria; hematuria; pyuria; hyperglycemia; ↓ total protein or
albumin; and abnormalities in sodium, potassium, and calcium levels
Be sure to teach the patient the following about this medication
Advise patient to report signs of superinfection(black furry overgrowth
on tongue, vaginal itching or discharge, loose or foul-smelling stools)
and allergy. Caution patient to notify health care professional if fever
and diarrhea occur, especially if stool contains blood, pus, or mucus.
Advise patient not to treat diarrhea without consulting health care
professional. May occur up to several weeks after discontinuation of
medication.
Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this med? Check after giving
Assess patient for infection (vital signs; Observe patient for signs and symptoms of Resolution of the signs and
appearance of wound, sputum, urine, and stool; anaphylaxis (rash, pruritus, laryngeal edema, symptoms of infection. Length of
WBC) at beginning of and during therapy, Obtain wheezing). Discontinue the drug and notify time for complete resolution
a history before initiating therapy to determine the physician or other health care professional depends on the organism and site
previous use of and reactions to penicillins or immediately if these occur. Keep epinephrine, of infection.
cephalosporins. Persons with a negative history of an antihistamine, and resuscitation equipment
penicillin sensitivity may still have an allergic close by in the event of an anaphylactic
response, Obtain specimens for culture and reaction.
sensitivity prior to initiating therapy. First dose
may be given before receiving results.