PHARMACOLOGY DRUG CARD ASSIGNMENT

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1301 Pharmacology Drug Cards Drug: __Penicillin G&V____ General Classification: _Penicillins/ Beta-lactam antibacterial Prototype Ampicillin (Principen) Pharmacokinetics After absorption is widely ... distributed. Penetration into the CSF occurs only w inflamed meninges. Kidneys rapidly excrete ampicillin, produces high drug concentration in the urine. It is present in breast milk, and the volume of distribution increases during pregnancy, when the half-life, generally 1- 2hrs is decreased. Mode of Action (list 3-4 main ones) Inhibits bacterial cell wall synthesis by binding to one or multiple penicillinbinding proteins. Indications/Uses Bacterial infection caused by susceptible microorganisms, prophylaxis/treatment of ineffective endocarditis, skin/soft tissue/respiratory/GI/GU infections. Effective on Gr- bacilli. Contraindications Hypersensitivity or allergic reactions to any penicillin formulation. Crosssensitivity is the allergy to a drug of another class with a similar chemical structure. Adverse Reactions/Side Effects Hypersensitivity (rash/anaphylactoid reactions), abdominal pain, diarrhea, diarrhea, gastritis, N/V, interstitial nephritis, irritate the CNS (confusion, lethargy, twitching, dysphagia, coma, seizures), hepatotoxicity, hypokalemia and hypernatremia. Preventing Interactions Often given concomitantly with aminoglycosides for serious infections such as those caused by Pseudomonas aeruginosa. These drugs should not be admixed in a syringe, given in an IV solution, or administered via Y-site, because the penicillin inactivates the aminoglycoside. If feasible, dose separation is ideal. Effects on Labs (if any) BUN, Creatinine, ALT/AST Nursing Implications Make sure the patient finishes the course of the antibiotic, know that there are medications and herbs that can increase or decrease effects of medication. Patient Teaching Guidelines Do not take if allergic to penicillin, complete the full course of drug treatment, follow instructions carefully about how much of the drug to take, take on empty stomach 1hr before or 2hrs after meals. Penicillin V can be taken with food. Take medication with a glass of water, do not take with orange juice, report skin rash, itching, severe diarrhea, SOB. Toxicity & Antidote Renal and hepatic. Administration Of Medication Oral on empty stomach with a full glass of water. 1hr before and 2 hrs after meals. IV penicillin’s need to be given full, prescribed course, of treatment to prevent complications. PO, IV, IM The Nursing Process (state main points) in all categories, assess, outcome, nursing intervention, eval. Obtain c/s test to determine that the right antibiotic is being used, assess for allergic reaction, teach patient how to administer PO medication, draw labs to monitor renal function, monitor for adverse effects. QSEN Perform culture and susceptibility studies for Streptococcal infections. Be aware of local patterns of streptococcal susceptibility and resistance. Penicillin G&V are narrow spectrum that are penicillinase sensitive. Black Box Inadvertent IV administration of penicillin G benzathine may result in cardiopulmonary arrest and death. Long acting repository forms have additives that decrease their solubility in tissue fluids and delay their absorpt. 1 Drug: _Ampicillin (Principen)_ General Classification_ Penicillins/ Beta-lactam antibacterial Prof. Katherine Daniels MSN RN 1st day Handout Prototype Ampicillin (Principen) Pharmacokinetics After absorption is widely distributed. Penetration into the CSF occurs only w inflamed meninges. Kidneys rapidly excrete ampicillin, produces high drug concentration in the urine. It is present in breast milk, and the volume of distribution increases during pregnancy, when the half-life, generally 1- 2hrs is decreased. Mode of Action (list 3-4 main ones) Inhibits bacterial cell wall synthesis by binding to one or multiple penicillinbinding proteins. Indications/Uses Bacterial infection caused by susceptible microorganisms, prophylaxis/treatment of ineffective endocarditis, skin/soft tissue/respiratory/GI/GU infections. Effective on Gr- bacilli. Contraindications Hypersensitivity or allergic reactions to any penicillin formulation. Crosssensitivity is the allergy to a drug of another class with a similar chemical structure. Adverse Reactions/Side Effects Hypersensitivity (rash/anaphylactoid reactions), abdominal pain, diarrhea, diarrhea, gastritis, N/V, interstitial nephritis, irritate the CNS (confusion, lethargy, twitching, dysphagia, coma, seizures), hepatotoxicity, hypokalemia and hypernatremia. Preventing Interactions Ampicillin inhibits the renal tubular secretion of methotrexate, which may lead to prolonged and higher drug concentrations of methotrexate. Effects on Labs (if any) BUN, Creatinine, AST/ALT Nursing Implications Khat and food decreases the effects of Ampicillin so make sure to administer 1hr before meals, or 2hrs after. Patient Teaching Guidelines Take at even intervals, preferably around the clock, discard liquid penicillin after 1 week if it is stored at room temperature or after 2 weeks if it is refrigerated. Liquid forms deteriorate and should not be taken after their expiration dates. Toxicity & Antidote Renal and hepatic. Administration Of Medication Oral on empty stomach with a full glass of water. 1hr before and 2 hrs after meals. IV penicillin need to be given full, prescribed course, of treatment to prevent complications. PO, IM, IV The Nursing Process (state main points) in all categories, assess, outcome, nursing intervention, eval. Obtain c/s test to determine that the right antibiotic is being used, assess for allergic reaction, teach patient how to administer PO medication, draw labs to monitor renal function, monitor for adverse effects. QSEN Perform culture and susceptibility studies for Streptococcal infections. Be aware of local patterns of streptococcal susceptibility and resistance. Black Box Caution in neonates because immature kidney function slows drug elimination. Dosage should be based on age, weight and severity of the infection being treated, and renal function. [Show More]

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