Published on March 11, 2014
U.S. Brand Name (Maxipime) Therapeutic Category: 1.Antibiotic 2.Cephalosporin(fourth generation)
Pregnancy Risk Factor (B) Prototype: Cefotaxime Sodium. Availability: 500mg,1g,2g vials
Lactation: Enters breast milkuse caution. Therapeutic Effects: 1.Treats pneumonia. 2.Skin and soft tissue .
Therapeutic Effects.cont. 3.Respiratory tract. 4.intra-abdominal infections. 5.Urinary tract infection by Eliminating SS of infection.
Use: 1.Treatment of respiratory tract infection including (brochitis and pneumonia). 2.Cellulitis, skin and soft tissue infections.
Use .Continued. 3.Urinary tract infection. Mechanism of Action: Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs).
Contraindications: Hypersensitivity to cefepime Any component ,or other Cephalosporins . Warnings /precaution: 1.Prolonged use may result in
Cont. Superinfection . 2.cross-sensitivity to penicillins exists (~10%). 3.Use in patients less than 2 months of age has not been established.
Drug Ineractions: 1.Increased Effect/ toxicity : High –dose probenecid decreases clearance and increases effect of cefepime.
Adverse Reaction: >10%: hematologic: Positive coombs‘test without hemolysis 1%to10%: 1.dermatologic:rash,pruritus. 2.GI:diarrhea,nausea,vomiting.
Cont. 3.C.N.S.:fever(1%)headache (1%). 4.Local:pain,erythema at injection site, phlebitis, inflammation, urticaria.
5.Urogenital: Vaginitis . Other reaction cephalosporins include:toxic epidermal necrolysis,erythema multiforme,renal Dysfunction,aplastic anemia, hemolytic anemia,hemorrhage…ect
Over dose: Include: 1.Neuromusclar hypersensitivity. 2.Convulsions. Pharmacodynamics: Protein binding:plasma:16%to19%.
Distribution : 20%protien bound,widely dist.,may Cross in flamed meninges ;crosses Placenta,secreted into breast milk. Absorption: After IM administration serum levels significantly lower than aftereqivalent IV dose.
Metabolism: It‘s very little and metabolized in the liver. Elimination: Excreted in urine . Half –life elimination:2hours
Formulation: Powder for injection as hydrochloride :500mg,1g,2g. Route and dosage: 1.Mild to moderate infections: Adult: IV/IM 0.5-1g q12h times 7-10d
2.Moderate to severe infections: Adult:IV 1-2g q12h time 10d. 3.Febrile neutropenia: Adult :IV 2g q8h for 7d or until resolu- Tion of neutropenia. Elderly :IV/IM should be based on renal function and severity of infection.
Administration: 1.(IM): Inject deep I.M. into large muscle mass. 2.(IV): Inject direct I.V. over 5min. Stability:
1.monitoring laboratory tests: Prothrombin time ;peform culture and sensitivity studies prior to initiating drug therapy. 2.compatibility: Discontinue other solution at the same site to avoid compatibility problems.
Cont. C.Monitor for S/S of hypersensitivity. D.Assess bowel function (severe diarrihea) E.Monitor urine output (if decreased,notify prescriber). F.Assess for opportunistic infection(fever, Malaise,rash,itching,redness,chills,or increased cough)
Additional Nursing lssues: 1.Physical assessment: A. Determine history of hypersensitivity reaction to cephalosporins, penicillins,or other drug before therapy is initiated. B.Lab tests perform culture and sensitivity tests before initiation of therapy. Dosage may be started pending test results.
2.Geriatric Consideration: Adjust dose for changes in renal function. 3.Patient and Family Education: A.Promptly report any S/S hypersensitivity ,superinfection and pseudomembranous colitis. B.Do not breast feed while taking this drug without consulting physician.
Additional Information: Each gram contain 2 mEq of Sodium. PH:4-6
THINK YOU FOR GIVING ME YOUR ATTANTION
References 1.Pharmacology,2nd edition-Mary J.Mycek, ph.D.and Richard.D.,Harvey ,ph.D. 2.Drug information hand book for nursing. Including assessment,administration,monitoring guidelines and patient education. 3.Prentice hall (nurses drug guide 2006)
WWW.antibiotic guide .com WWW.cefepime drug information.com كوم دوت طبيب–الحيوية المضادات WWW.drugs.com WWW.search.drug.com
Presented by: SAMIAH MASLUM AL- JAHANY. 2005
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