current pregnancy; fetus' head is too large to deliver through the vagina; prolonged contractions may injure the fetus or the uterus; have had a cesarean delivery or major uterine surgery; have given birth 6 or more times; are receiving an intravenous (IV) medicine to induce labor; PCM opposes cefazolin Indication(s) Treatment of the following infections: Skin and skin structure infections (including burn wounds); pneumonia; urinary tract infections; biliary tract infections; genital infections; bone and joint infections; septicemia, bacterial endocarditis prophylaxis for dental and upper respiratory procedures; perioperative prophylaxis; not for treatment of meningitis. Dosing IM: IV: (Adults) Moderate-to-severe infections– 500 mg-2 g every 6–8 hr; maximum 12 g/day. Mild infections with Gram-positive cocci– 250–500 mg every 8 hr. Uncomplicated urinary tract infection– 1 g every 12 hr. Pneumococcal pneumonia– 500 mg every 12 hr. Infective endocarditis or septicemia– 1–1.5 g every 6 hr. Perioperative prophylaxis– 1 g within 30–60 min prior to incision (an additional 500 mg–1 g should be given for surgeries ≥ 2 hr). 500 mg-1 g should then be given for all surgeries every 6–8 hr for 24 hr following the surgery. IM: IV: (Neonates ≤ 7 days): 40 mg/kg/day divided q 12 hr. IM: IV: (Neonates > 7 days and ≤ 2 kg): 40 mg/kg/day divided q 12 hr. 28
IM: IV: (Neonates > 7 days and > 2 kg): 60 mg/kg/day divided q 8 hr. Renal Impairment IM: IV: (Adults) CCr 10–30 mL/min– Administer dose every 12 hr; CCr ≤10 mL/min– Administer every 24 hr. Expected Reactions Resolves signs and symptoms of infection. Time for complete healing varies. Decreases incidence of infection when used for prophylaxis. Side Effects CNS: SEIZURES (HIGH DOSES) GI: PSEUDOMEMBRANOUS COLITIS, diarrhea , nausea , vomiting , cramps Derm: STEVENS-JOHNSON SYNDROME, rash , pruritus, urticaria Hemat: leukopenia, neutropenia, thrombocytopenia Local: pain at IM site , phlebitis at IV site Misc: allergic reactions including anaphylaxis and serum sickness, superinfection Nursing Implications Implement: IM: Reconstitute IM doses with 2 mL or 2.5 mL of with sterile water for injection to a achieve a final concentration of 225–330 mg/mL. o Inject deep into a well-developed muscle mass; massage well. Assess: Vital signs; appearance of wound, sputum, urine, and stool; WBC at beginning of and throughout therapy. Get a hx of sensitivities or allergic reactions. Obtain specimens for culture and sensitivity, may give before receiving results. for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Discontinue drug and notify HCP immediately if these problems occur. Keep epinephrine, an antihistamine, and resuscitation equipment close by in case of an anaphylactic reaction. bowel function- diarrhea, abdominal cramping, fever, and bloody stools-pseudomembranous colitis. May begin up to several weeks following cessation of therapy.
You've reached the end of your free preview.
Want to read all 39 pages?
- Fall '19
- Obstetrics, Blood sugar