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DRUG: ceftrioxone
DOSAGE: _______________ ROUTE: ________________ FREQUENCY: _______________OTHERS:
___________
PHARMACOLOGIC ACTION: interferes with bacterial cell- wall synthesis and division by binding to cell wall, causing cell to die.
DRUG CLASS: Anti-infective
INDICATIONS: moderate to severe infections; gonorrhoea; bacterial meningitis; otitis media; pharyngittis, tonsillitis
CONTRAINDICATIONS: hypersensitivity to cephalosporins or penicillins; carnitine deficiency
ADVERSE EFFECTS:
● CNS: headache, hyperactivity, hypertonia, seizures
● CV: hypotension, phlebitis, palpitations, heart failure, cardiac arrest, myocardial infarction
● GI: nausea, vomiting diarrhea, abdominal pain, dyspepsia, pseudomembranous colitis
● GU: hematuria, vaginal candidiasis, renal dysfunction, acute renal failure
● Hematologic: haemolytic anemia, aplastic anemia, hemorrhage
● Metabolic: hyperglycemia
● Respiratory: chest discomfort, dyspnea, hyperventilation
● Skin: toxic epidermal necrolysis, erythema multiforme, Stevens- Johnson syndrome
● Other: allergic reaction, drug fever, superinfection, anaphylaxis
NURSING RESPONSIBITIES:
ADMINISTRATION:
● Obtain specimens for culture and sensitivity testing as necessary before starting therapy
● Be aware that drug should not be given with or within 48 hours of calcium- containing IV solutions, including calcium- containing
continuous infusions such as parenteral nutrition, because of risk of precipitation of ceftriaxone calcium salt
● Know that the drug for IV injection is compatible with sterile water, dextrose 5% in water (D5W), half- normal saline solution and
D5W and normal saline solution
● After reconstituting, dilute further for desired concentration for intermittent IV infusion. Infuse over 30 minutes.
● For IM use, reconstitute powder for injection with compatible solution by adding 0.9 ml of diluent to 250- mg vial, 1,8 ml to 500 mg
vial, 3,6 ml to 1 g vial, or 7.2 ml to 2 g vial, to yield a concentrating averaging 250 mg/ml
● Divide high IM doses equally and administer in two separate sites. Inject deep into large muscle mass.
MONITORING:
● Monitor for extreme confusion, tonic- clonic seizures, and mild hemiparesis when giving high doses.
● Monitor coagulation studies.
● Assess CBC and kidney and liver function test results.
● Monitor for signs and symptoms of superinfection and other serious adverse reactions.
● Be aware that cross- sensitivity to penicillins and cephalosporins may occur.
TEACHING:
● Instruct patient to report persistent diarrhea, bruising or bleeding
● Caution patient not to use herbs unless prescriber approves
● As appropriate, review all other significant and life- threatening adverse reactions and interactions, especially those related to the
drugs, tests, and herbs mentioned above.