Ampicillin Unit 2 PDF

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Ampicillin Drug Card ...

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Student Name: Samantha Mendoza Classification: Antibiotics, Aminopenicillins Generic Name: Ampicillin Expected Pharmacological Action: Ampicillin, like all penicillins, inhibits bacterial cell wall synthesis by binding to one or multiple penicillin-binding proteins./Stops the full development of bacteria by inhibiting the production of its cell wall, thereby treating infection. Usual Dose: PO, IM, IV 250–500 mg every 6 h. In severe infections, doses up to 2 g every 4 h may be given IV Usual routes: PO, IV, IM Therapeutic Uses: Adverse Effects:

Expected Common

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Clinical indications for use of ampicillin include bacterial infections caused by susceptible microorganisms.

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Health care providers use the drug in the treatment or prophylaxis of infective endocarditis.

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The drug’s broad spectrum is often useful in skin, soft tissue, respiratory, gastrointestinal (GI), and genitourinary infections.

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The broad-spectrum coverage of ampicillin extends its activity against gram-negative bacilli. Note that the incidence of resistance among streptococci, staphylococci, and other microorganisms continues to increase.

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Hypersensitivity reactions, including rash and/or anaphylactoid reactions.

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Commonly reported GI adverse effects include abdominal pain, diarrhea, gastritis, and nausea and vomiting.

Adverse Effects Requiring Nursing Action: Adverse Effects

Action: Prevention/Assessment/Intervention

Nephropathy (e.g., interstitial nephritis) happens with all PCNs

Assess patient’s urine along with I&O; do renal function tests (BUN & creatinine).

(rare occurrence) Hypersensitivity reactions, including rash and/or anaphylactoid reactions

Carefully assesses the characteristics of a rash, if present. It is necessary to distinguish, if possible, a hypersensitivity reaction from a nonallergic ampicillin rash.

Likely Medication/Food Interactions: Herbs and Foods That Decrease the Effects of Ampicillin  Food- Decreases absorption  Khat- Decreases absorption Drugs That Increase the Effects of Ampicillin  Allopurinol- Increases the incidence of skin rash 

Clavulanic acid- Overcomes resistance in bacteria that secrete beta-lactamase

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Probenecid- Inhibits the renal tubular secretion Uricosuric drugs Block renal excretion

Drugs That Decrease the Effects of Ampicillin  Chloroquine- Decreases the serum concentration 

Fusidic acid- Diminishes the therapeutic effect

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Tetracycline derivatives- Diminish the therapeutic effect

In addition, ampicillin inhibits the renal tubular secretion of methotrexate, which may lead to prolonged and higher drug concentrations of methotrexate. Administration/Interventions/Evaluation of Effectiveness/Laboratory Work 

It is necessary to give oral ampicillin, like most oral penicillins, on an empty stomach, approximately 1 hour before or 2 hours after a meal. Patients should take the oral drug with a full glass of water, preferably to promote absorption and decrease inactivation, which may occur in an acidic environment. If need be, they may take it with food; however, the absorption rate decreases with food.

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Oral suspensions of the drug are stable for 7 days at room temperature and 14 days when refrigerated.

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When diluted with 0.9% sodium chloride, ampicillin is stable for 8

hours for concentrations up to 30 mg/mL. It is stable for only 1 hour when diluted with dextrose-containing solutions for concentrations of 10 to 20 mg/mL. 

It is necessary to give IV penicillins for the full, prescribed course of treatment to prevent complications such as rheumatic fever, endocarditis, and glomerulonephritis. IV concentrations should not exceed 30 mg/mL.

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It is not necessary to obtain drug levels when administering ampicillin or any of the antimicrobials in the penicillin class. When administering ampicillin, it is recommended that serum creatinine and blood urea nitrogen (BUN) be monitored.

Patient Education: What will the safe nurse teach the client to DO or expect or report? 

Do not take any penicillin if you have ever had an allergic reaction to penicillin in which you had difficulty breathing, swelling, or skin rash. However, some people call a minor stomach upset an allergic reaction, which is incorrect, and they are not given penicillin when that is the best antibiotic in a given situation.

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Complete the full course of drug treatment for greater effectiveness and prevention of secondary infection with drug-resistant bacteria.

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Follow instructions carefully about how much of the drug you are supposed to take and how often you are supposed to take it. Drug effectiveness depends on maintaining adequate blood levels. Penicillins often need more frequent administration than some other antibiotics, because they are rapidly excreted by the kidneys.

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Take most penicillins on an empty stomach, 1 hour before or 2 hours after a meal. Penicillin V, amoxicillin, and Augmentin can be taken with food. (Take Augmentin with meals to increase absorption and decrease GI upset.)

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Take each dose with a full glass of water; do not take with orange juice or with other acidic fluids (they may destroy the drug).

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Take at even intervals, preferably around the clock.

Shake liquid penicillins well, so they are mixed thoroughly, and measure the dose accurately. 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.

Report skin rash, hives, itching, severe diarrhea, shortness of breath, fever, sore throat, black tongue, or any unusual bleeding to your health care provider. These symptoms may indicate an allergy to penicillin.

Citations: Frandsen & Pennington: Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, Eleventh Edition...