 Pharmacokinetics:
    

Route: oral; peak: 60 mins.; duration: 8-10 hours Metabolism: T 1/2: 50-80 mins Distribution: crosses the placenta; enters the breast milk Excretion: urine Cephalexin belongs to a class of antibiotic called cephalosporins. They are similar to penicillin in action and side effects. They stop or slow the growth of bacterial cells by preventing bacteria from forming the cell wall that surrounds each cell. The cell wall protects the bacteria from

 Pharmacodynamics:

Cephalexin is approved by the FDA in January 1971  Indications:   Respiratory tract infections. skin and skin structure infection caused by staphylococcus/streptococcus Otitis media. bone infection. and several others. GU infections  Contraindication   Allergy to cephalosporins or penicillin Use cautiously with renal failure. Without a cell wall . bacteria are not able to survive. E. streptococcus pnuemoneae. haemophilus influenza. pregnancy or lactation .the external environment and keeps the contents of the cell together. Bacteria that are susceptible to cephalexin includes staphylococcus aureus. Coli.

mucus. culture and sensitivity test on infected area. skin status. Teach to avoid alcohol while taking this drug. pus. arrange for small frequent meals if GU complication occur complete drug in full course. pregnancy. difficulty in breathing. respiratory status. unusual bleeding or bruising. . fatigue. Give drug with meals. Teach that drug prescribed for this type of infection. do not self-medicate Report severe diarrhea with blood. unusual tiredness. lactation Physical: Renal function tests. rash or hives. Nursing   Responsibilities:     History: cephalosporins or penicillin allergy.

Peak: 2 hours. Pharmacokinetics: Route: oral.  Excretion: urine   Pharmacodynamics  Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs) which in return inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls. therapeutic concentrations achieved in CSF even with meninges are not inflammed. Duration: 18-24 hours  Metabolism: T 1/2: 1-2 hours  Distribution: crosses the placenta. crosse blood-brain barrier. . Onset: varies. enters breast milk. widely to body tissues and fluid.

 Indications Pharyngitis. haemophilus influenzae. E.gonorrhoeae. bone & joint infections  Perioperative prophylaxis. and many others. skin & skin structure infection for early Lyme disease  Septicimia. otitis media. It is effective against a wide variety of bacteria organisms.  Cefuroxime is a semisynthetic cephalosporin antibiotic. lower respiratory infections. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins & murein hydrolases) while cell wall assembly is arrested. such as staphylococcus aureus. N. treatment for acute bacterial maxillary sinusitis in patients 3 months to 12 years  .coli. chemically similar to penicillin.thus inhibiting cell wall biosynthesis. tonsilitis. streptococcus pneumoniae. UTIs  Uncomplicated gonorrhoea. meningitis.

difficulty breathing. LFTs. Contraindications   Allergy to cephalosporins or penicillin Use cautiously w/ renal failure. unusual tiredness or fatigue. sensitivity test Give oral drug w/ food to decrease GI upset & enhance absorption Have Vit. renal function test. lactation & pregnancy Physical: Skin status. K available in case hypoprothrombinemia occurs Teach to avoid alcohol while taking this drug Ask to report severe diarrhea. lactation & pregnancy  Nursing     Responsibilities   History: Hepatic & renal impairment. pain in injection site if parenteral . culture of affected area.

Duration: 6-8 hrs Route: IV. Onset: 30 mins. Onset: 15 mins. Peak: 5mins. Duration: 6-8 hrs Route: IM. Duration: 6-8 hrs Metabolism: T 1/2 : 1-2 hrs Distribution: Crosses placenta & enters breastmilk Excretion: Urine. Peak: 1 hr. Pharmacokinetics       Route: Oral. unchanged . Peak: 2hrs. Onset: stat.

It differs from penicillin only by the presence of an amino acid group. which lead to cell lysis  Indication Treatment of infections caused by susceptible strains of shigella. etc.  Meningitis  Unlabeled use: Prophylaxis in CS in certain high-risk patients  . That amino acid group helps the drug penetrate the outer membrane of the Gram-negative bacteria Ampicillin acts as a competitive inhibitor of the enzyme transpeptidase. Coli. It inhibits the third & final stage of bacterial cell wall synthesis in binary fission. Pharmacodynamics    Ampicillin is able to penetrate Gram-positive & some Gram-negative bacteria. which is needed by bacteria to make their cell walls. salmonella. E.

serum electrolytes. cephalosporins or other allergens Use cautiously with renal disorders  Nursing Responsibilities    History: Allergy to this drug. atrophy can occur. renal function test. renal disorder. monitor site . lactation Physical: Culture infected area. respiration adventitious sounds. bowel sounds. Contraindications     Allergy to penicillin. UA Culture infected are before treatment Check IV site carefully for signs of thrombosis or drug reaction Do not give IM injections in the same site. HCT. skin color/lesions. LFTs. CBC.

no fruit juice or soft drinks The oral drug is stable for 7 days at room temperature. itching. mouth sores. rash. hives. severe diarrhea. 1 hr before or 2 hrs after meals w/ a full glass of water.      Administer oral drug on an empty stomach. fever. . ask to use a second form of birth control for 1-2 weeks while taking this drug Report pain or discomfort at site usually bleeding or bruising. difficulty breathing. take full course of treatment This drug is specific to your problem. do not self medicate If a woman using this is using hormonal contraceptive. And 14 days if refrigerated Teach to take drug around the clock..

many are susceptible to amikacin in vitro  . Onset: stat. & kanamycin. Proteus sp (indole-positive-&negative). enters breastmilk  Excretion: urine. E. including gentamicin. Peak: 30 mins Route: IM. Peak: 45-120 mins Metabolism: T 1/2 : 2-3 hrs  Distribution: Crosses placenta. & Citrobacter freundii  When strains of the previously mentioned organism are found to be resistant to other aminoglycosides. Klebsiella-Enterobacter-Serratia sp. Onset: varies. unchanged     Pharmcodynamics Gram-negative: Amikacin if active in vitro against Pseudomonas sp. tobramycin. Providencia sp. coli. Acinobacter (formerly Mima-Herellea) sp. Pharmacokinetics Route: IV.

Entecocci & Streptococcus pneumoniae(formerly Diplococcus pneumoniae). & kanamycin In vitro studies have shown that amikacin combined w/ a β-lactam antibiotic acts synergistically against many clinically significant gram-negative organism . Amikacin resists degrafation by most aminoglycoside inactivating enzymes known to affect gentamicin. However.   Gram-positive: Amikacin is active in vitro against penicillinase & nonpenicillinase produce streptococcus including methicillin-resistant strains. Streptococcus pygenes. tobramycin. aminoglycosides in general have a low order of activity against other grampositive organisms eg.

 Indications Short term treatment for serious infection caused by susceptible strains of Pseudomonas sp. etc  Suspected gram-negative infections before results of susceptibility studies are known  Initial treatment of Streptococcal infections when penicillin is contraindicated or infection may be caused by mixed organisms  Neonatal sepsis when other antibiotics cannot be used  Unlabeled uses: Intrathecal or intraventricular administration at 8 mg/24 hrs part of a multidrug regimen for treatment of Mycobacterium avium complex. myathenia gravis. parkinsonism. E. Coli. lactation  Use cautiously w/ elderly patients. Proteus sp. renal or hepatic disease. a common infection of AIDS patients   Contraindications Allergy to any aminoglycosides. pre-existing hearing loss. neuromuscular disorders. infant botulism. any patient w/ diminished hearing. dehydration. pregnancy  . decrease renal function.

CBC. diminished hearing. stop therapy because prolonged use increases risk for toxicity. decreased renal function. renal function test. & after therapy. dehydration. skin color & lesions. orientation & affect. lactation. during. LFTs. parkinsonism. bilateral grip strength. ototoxicity w/ baseline & periodic renal function & neurologic examination. 8th cranial nerve function. pre-existing hearing loss. risk for serious toxicity Arranged for culture & sensitivity testing of infected area before treatment Monitor duration & treatment: usually 7-10 days. If drug is used longer than 10 days. & state of hydration prior to. reflexes. If there is no clinical response w/in 3-5 days. Nursing Responsibilities       History: Allergy to any aminoglycosides. monitor auditory & renal function daily Ensure patient is well-hydrated before & during therapy . weight & bowel sounds Monitor patient for nephrotoxicity. renal or hepatic disease. myasthenia gravis. infant botulism. neuromuscular disorders Physical: Arranged culture & sensitivity test on infection prior to therapy.

 Pharmacokinetics  Absorption: the 2 components of co-amoxiclav. amoxicillin & clavulanic acid. Absorption of co-amoxiclav is optomized when taken at the start of a meal . are fully dissociated in aqueous solution at physiological pH. Both components are rapidly & well absorb by the oral route of administration.

susceptible by degradation by β-lactamases & therefore the spectrum of activity of amoxicillin alone does not include organism w/c produce this enzymes . preventing crosslinking of bacterial cell wall & leading to cell death. however. Amoxicillin is. Pharmacodynamics   It inhibits transpeptydase. Addition of clavulanic( a beta-lactam) increases drug resistance to beta-lactanase (an enzyme produced by bacteria that may inactivate amoxicillin) Amoxicillin is a semisynthetic antibiotic w/ a broad spectrum of antibacterial activity against many gram-positive & gram-negative microorganisms.

Haemophilus influenzae. otitis media. sinusitis. skin & skin-structure infections. or Moraxella catarrhalis in children ages 2 & younger & in children who have receive antibiotic therapy w/in last 3 months Use cautiously: severe renal insufficiency. pregnant patient  Contraindications Hypersensitivity to drug or any penicillin  Phenylketonuria (some products)  History of cholestatic jaundice or hepatic dysfunction associated w/ this drug  . Indications     Lower respiratory tract infections. infectious mononucleosis. & UTIs caused by susceptible strains of gram-negative & gram-positive organism Serious infections & community-acquired pneumonia Recurrent or persistent acute otitis media caused by Streptococcus pneumoniae.

specially oral or rectal candidiasis  Instruct patient to immediately report s/s of hypersensitivity reaction such as rash. fever & chills  Tell patient he may take drug w/ or w/o food  Inform patient that drug lowers resistance to some types of infections  Instruct him to report s/s of infection (specially of mouth & rectum)  Advice patient to minimize GI upset by eating small. Suggest she use alternative birth control method  Inform parents that they may give liquid form of drug directly to child or may mix it w/ foods or beverages  . frequent servings of food & drinking plenty of fluids  Tell patients taking hormonal contraceptives that drug may reduce contraceptive efficacy. Nursing Resposibilities Monitor patient carefully for signs & symptoms of hypersensitivity reaction  Monitor for seizure when giving high doses  Check patient’s temperature & watch for other s/s of superinfections.

Amy M. . 2010 Lippincott’s Nursing Drug Guide.(2010). 323 Norristown Road. Suite 200: Lippincott Williams & Wilkins. Karch.

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