but is inactivated by penicillinase (beta-lactamase). Used parenterally only for moderately severe to severe infections. otitis media. Other: Severe pain (following IM). CONTRAINDICATION: Hypersensitivity to penicillin derivatives. interstitial nephritis. also gonococcal infections. infectious mononucleosis. aminopenicillin is highly bactericidal even at low concentrations. vomiting. and GI tracts and skin and soft tissues. urticaria. ADVERSE EFFECT: Body as a Whole: Similar to those for penicillin G. superinfections. CNS: Convulsive seizures with high doses. INDICATIONS: Infections of GU. bacterial meningitis. eosinophilia. phlebitis (following IV). AMINOPENICILLIN DOSAGE: 450mg IVTT every 6 hours ANST ( . pseudomembranous colitis. respiratory. hemolytic anemia. and septicemia and for prophylaxis of bacterial endocarditis. Hypersensitivity (pruritus. . anaphylactoid reaction). Skin: Rash. GI: Diarrhea.) ACTION: A broad-spectrum semisynthetic. sinusitis.DRUG NAME: AMPICILLIN CLASSIFICATIONS : ANTIINFECTIVE. nausea. ANTIBIOTIC.

and other allergens prior to therapy. or hyperuricemia or in patients taking allopurinol. lymphocytic leukemia. hepatic. and hematologic functions. Take medication around the clock. Report rash promptly to physician. particularly during prolonged or high-dose therapy. Lab tests: Baseline C&S tests prior to initiation of therapy. continue taking medication until it is all gone (usually 10 d) unless otherwise directed by physician or pharmacist. Inspect skin daily and instruct patient to do the same. start drug pending results. Note: Sodium content of drug must be considered in patients on sodium restriction. Baseline and periodic assessments of renal.NURSING CONSIDERATIONS Determine previous hypersensitivity reactions to penicillins. The appearance of a rash should be carefully evaluated to differentiate a nonallergenic ampicillin rash from a hypersensitivity reaction. cephalosporins. Note: Incidence of ampicillin rash is higher in patients with infectious mononucleosis or other viral infections. . Salmonella infections.

and infections involving Bacteroides fragilis and other anaerobic organisms. meningeal infections caused by H. Haemophilus influenzae) or when given in higher concentrations.DRUG NAME: CHLORAMPHENICOL CLASSIFICATIONS: ANTIINFECTIVE. Streptococcus pneumoniae. Particularly effective against Salmonella typhi and other Salmonella sp. . Rickettsia rickettsii (cause of Rocky Mountain spotted fever) and other rickettsiae. INDICATIONS: Severe infections when other antibiotics are ineffective or are contraindicated.) ACTION: Synthetic broad-spectrum antibiotic formerly derived from Streptomyces venezuelae. Principally bacteriostatic but may be bactericidal in certain species (e. and external auditory canal. eyes. and Mycoplasma. Neisseria. influenzae. the lymphogranulomapsittacosis group (Chlamydia).g. ANTIBIOTIC DOSAGE: 315mg IVTT every 8 hours ANST ( . Also used in cystic fibrosis antiinfective regimens and topically for infections of skin.. Believed to act by binding to the 50S ribosome of bacteria and thus interfering with protein synthesis.

leukemia. digital paresthesias. leukopenia. hypoplastic anemia. unpleasant taste. perianal irritation. stomatitis. hypoprothrombinemia. fever. fixed-drug eruptions. Skin: Urticaria. delirium. xerostomia. peripheral neuritis. thrombocytopenia. anaphylaxis. maculopapular and vesicular rashes. confusion. prophylactic use. agranulocytosis. vomiting. granulocytopenia. mental depression. reduced Hgb. lactation. dyspnea. diarrhea. increased plasma iron.CONTRAINDICATION: History of hypersensitivity or toxic reaction to chloramphenicol. treatment of minor infections. optic neuritis. GI: Nausea. CNS: Neurotoxicity: headache. Special Senses: Visual disturbances. paroxysmal nocturnal hemoglobinuria. history or family history of drug-induced bone marrow depression. Non-dose-related and irreversible pancytopenia. angioedema. enterocolitis. glossitis. pregnancy (category C). contact dermatitis. optic nerve atrophy. contact conjunctivitis. superinfections. aplastic anemia. Gray syndrome. concomitant therapy with drugs that produce bone marrow depression. typhoid carrier state. Hematologic: Bone marrow depression (dose-related and reversible): reticulocytosis. ADVERSE EFFECT: Body as a Whole: Hypersensitivity. .

NURSING CONSIDERATIONS Lab tests: Perform bacterial culture and susceptibility tests prior to first dose and periodically thereafter. at 48 h intervals during therapy. platelets. fever. Baseline CBC. and periodically. serum iron. bleeding gums. Avoid prolonged or frequent intermittent use of topical preparations because systemic absorption and toxicity can occur. . or any other suspicious sign of symptom. Drug therapy should be discontinued if abnormal bleeding occurs. Watch for S&S of superinfection. Follow dosage and duration of therapy as prescribed by physician. Do not breast feed while taking this drug. or other unusual bleeding or bruising. Desired concentrations: peak 10²20 mg/mL. through 5² 10 mg/mL. Usually chloramphenicol is discontinued if temperature remains normal for 48 h. fatigue. or other adverse reactions appear. Check temperature at least q4h. Monitor I&O ratio or pattern: Report any appreciable change. irritation. petechiae. and reticulocyte cell counts before initiation of therapy. nose bleeds. superinfection. Report immediately sore throat. Monitor chloramphenicol blood levels weekly or more frequently with hepatic dysfunction and in patients receiving therapy for longer than 2 wk. Withhold medication and check with physician immediately if signs of hypersensitivity reaction.

phlebitis (IV site). INDICATIONS: Infections caused by susceptible organisms in lower respiratory tract. GI: Diarrhea. bones and joints. induration at IM injection site. and surgical prophylaxis. ADVERSE EFFECT: Body as a Whole: Pruritus.) ACTION: Semisynthetic third-generation cephalosporin antibiotic. urinary tract. . thus killing the bacterium.D. pelvic inflammatory disease. Preferentially binds to one or more of the penicillin-binding proteins (PBP) located on cell walls of susceptible organisms. also intra-abdominal infections. ANTIBIOTIC. CONTRAINDICATION: Hypersensitivity to cephalosporins and related antibiotics. pregnancy (category B). THIRDGENERATION CEPHALOSPORIN DOSAGE: 1 gram IV drip O. moniliasis. This inhibits third and final stage of bacterial cell wall synthesis. pseudomembranous colitis. meningitis. pain. Urogenital: Genital pruritus. biliary sludge. uncomplicated gonorrhea. abdominal cramps. chills. ANST ( .DRUG NAME: CEFTRIAXONE CLASSIFICATIONS: ANTIINFECTIVE. fever. skin and skin structures.

Watch for and report signs: petechiae.NURSING CONSIDERATIONS Determine history of hypersensitivity reactions to cephalosporins and penicillins and history of other allergies. hypoprothrombinemic bleeding may occur. . Note IV injection sites for signs of phlebitis (redness. Dosage may be started pending test results. Monitor for manifestations of hypersensitivity. Report loose stools or diarrhea promptly. pain). before therapy is initiated. therefore. ecchymotic areas. Most vulnerable patients: chronically ill or debilitated older adult patients undergoing abdominal surgery. swelling. Rotate sites. Report any signs of bleeding. Ceftriaxone appears to alter vitamin K-producing gut bacteria. epistaxis. Report their appearance promptly and discontinue drug. Lab tests: Perform culture and sensitivity tests before initiation of therapy and periodically during therapy. or any unexplained bleeding. particularly to drugs. Check for fever if diarrhea occurs: Report both promptly. Do not breast feed while taking this drug without consulting physician. The incidence of antibiotic-produced pseudomembranous colitis is higher than with most cephalosporins. Inspect injection sites for induration and inflammation.

INDICATIONS: Fever reduction. perhaps by action on peripheral nervous system. CONTRAINDICATION: Hypersensitivity to acetaminophen or phenacetin. sweating. and dissipation of heat. Temporary relief of mild to moderate pain. PRN ACTION: Produces analgesia by unknown mechanism. Generally as substitute for aspirin when the latter is not tolerated or is contraindicated.DRUG NAME: PARACETAMOL CLASSIFICATIONS: CENTRAL NERVOUS SYSTEM AGENT. ANTIPYRETIC DOSAGE: 1. acetaminophen has little effect on platelet aggregation. Unlike aspirin. Reduces fever by direct action on hypothalamus heat-regulating center with consequent peripheral vasodilation. use with alcohol. does not affect bleeding time. . and generally produces no gastric bleeding.O. NONNARCOTIC ANALGESIC.4ml drops P.

pancytopenia. diaphoresis. Do not breast feed while taking this drug without consulting physician. hypoglycemia. cold preparations) containing acetaminophen without medical advice. fever over 39. lethargy. acute renal failure (rare). vomiting. Do not give children more than 5 doses in 24 h unless prescribed by physician. thrombocytopenic purpura. Chronic ingestion: Neutropenia.5° C (103° F). usually from accidental ingestion or suicide attempts. chills. even with moderate acetaminophen doses. or recurrent fever. . hepatic coma.ADVERSE EFFECT: Body as a Whole: Negligible with recommended dosage. poisoning.. Do not take other medications (e. overdosing and chronic use can cause liver damage and other toxic effects. leukopenia. especially in individuals with poor nutrition or who have ingested alcohol over prolonged periods. nausea. hepatotoxicity in alcoholics. NURSING CONSIDERATIONS: Monitor for S&S of: hepatotoxicity. dizziness. Do not self-medicate adults for pain more than 10 d (5 d in children) without consulting a physician. rash. epigastric or abdominal pain. renal damage. onset of hepatotoxicity³elevation of serum transaminases (ALT. diarrhea. AST) and bilirubin.g. Acute poisoning: Anorexia. potential abuse from psychological dependence (withdrawal has been associated with restless and excited responses). Do not use this medication without medical direction for: fever persisting longer than 3 d.

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