Adverse Effects o Pseudomembranous colitis, Clostridium difficile diarrhea, and nausea and vomiting can lead to serious dehydration and electrolyte imbalances, as well as to new serious infections/Superinfections - Drug-to-drug interactions o Valproic acid and Meropenem Nursing Considerations for Patients Receiving Carbapenems
- Assess: o For possible contraindications or cautions : allergy to any Carbapenem or beta-lactam o Perform physical assessment o Perform culture and sensitivity tests o Conduct orientation and reflex assessment o VS and renal function tests Prototype Summary: Ertapenem Cephalosporin's - Similar to penicillin in structure and activity - Common medications o First generation: cefadroxil (generic) and cephalexin ( Keflex ) o Second : cefaclor ( Ceclor ), cefoxitin (generic), cefprozil (generic), and cefuroxime ( Zinacef ) o Third: cefdinir ( Omnicef ), cefotaxime ( Claforan ), cefpodoxime (generic), ceftazidime ( Ceptaz,Tazicef ), ceftibuten ( Cedax ), and ceftriaxone ( Rocephin ) o Fourth: cefditoren ( Spectracef ) and ceftaroline ( Teflaro ) - Bactericidal and bacteriostatic - Indications- o Treatment of infections caused by susceptible bacteria - Action- o Interfere with the cell wall–building ability of bacteria when they divide - Pharmacokinetics- o Well absorbed from the GI tract o Metabolized in the liver, excreted in the urine o Cross the placenta and enter breast milk (see Contraindications - Contraindications o Allergies to cephalosporins or penicillin, hepatic or renal impairment - Adverse Effects o Most significant -GI track - Drug-to-Drug Interactions o Aminoglycosides, oral anticoagulants, ETOH Nursing Considerations for Patients Receiving Cephalosporins
- Assess: o For possible contraindications or cautions: known allergy to any cephalosporin or penicillin o Perform physical assessment o Skin for any rash or lesions o Culture and sensitivity tests o Renal function tests o Prototype Summary: Cefaclor Fluoroquinolones - Relatively new class of antibiotics with a broad spectrum of activity - Common medications- o ciprofloxacin ( Cipro ), which is the most widely used o fluoroquinolone, gemifloxacin ( Factive ), levofloxacin ( Levaquin ), moxifloxacin ( Avelox ),norfloxacin ( Noroxin ), ofloxacin ( Floxin, Ocuflox ), and finafloxacin ( Xtoro ) - Bactericidal - Indications o Treating infections caused by susceptible strains of gram-negative bacteria. Includes: urinary track, respiratory track, and skin infections - Actions o Interferes with DNA replication in susceptible gram-negative bacteria, preventing cell reproduction - Pharmacokinetics o Absorbed in GI tract, metabolized in the liver, excreted in urine and feces and cross the placenta and enter breast milk - Contraindications o Known allergy, pregnancy, or lactating women and renal disfuntion - Adverse Effects o Most common: Headache, dizziness, insomnia and depression - Drug-to-Drug Interactions o Antacids, quinidine, theophylline
Nursing Considerations for Patients Receiving Fluoroquinolones - Assess: o Known allergy to any fluoroquinolone o Perform physical assessment o Examine the skin for any rash or lesions o
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