Ciprofloxacin PDF

Preview

Summary

Ciprofloxacin...

Description

INSTRUCTIONS: 1. For each chapter that teaches about medications, fill in the following table regarding the chosen meds. CLASS: fluoroquinolones GENERIC NAME: ciprofloxacin TRADE NAMES: Cipro, Cipro XR MOA: Inhibits bacterial DNA synthesis by inhibiting DNA gyrase enzyme INDICATIONS: Treatment of the following infections: PO, IV: skin, bone, joint, UTIs, chronic bacterial prostatitis, lower respiratory tract infections*, acute bacterial sinusitis*, Post-exposure prophylaxis of inhalational anthrax, treatment and prophylaxis of plague. PO: Infectious diarrhea, typhoid fever, uncomplicated cervical and urethral gonorrhea. IV: Nosocomial pneumonia, febrile neutropenia (with piperacillin/tazobactam) CONTRAINDICATIONS/PRECAUTIONS: Hypersensitivity, concurrent use with tizanidine, Lactation: avoid breastfeeding during treatment and for 2 days after final dose, Pedi: use only if no alternatives in children 1-17 years due to possible arthropathy INTERACTIONS with other Drugs/Substances: D-D: tizanidine (risk of hypotension and sedation), theophylline (risk of CNS toxicity), may increase levels and risk of toxicity of CYP1A2 substrates, increase effects and risk of bleeding from warfarin, increase risk of hypoglycemia when used with antidiabetic agents, alter levels and effects of phenytoin. D-N: Fennel (decrease of bioavailability). D-F: Absorption is impaired by concurrent enteral feeding (because of metal cations). Absorption is decreased by food and/or dairy products (take 1 hr before or 2 hr after). PATIENT RESPONSE / REACTIONS: DESIRED OUTCOME: Death of susceptible bacteria

COMMON SIDE EFFECTS: Agitation, confusion, depression, dizziness, drowsiness, hallucinations, headache, insomnia, nightmares, paranoia, toxic psychosis, tremor, photosensitivity, rash, hyperglycemia, hypoglycemia, abdominal pain, diarrhea, nausea

NURSING ACTIONS:

ASSESS: Assess for infection, obtain specimens for culture and sensitivity before initiating therapy. First dose may be given before receiving results, observe for S/S of anaphylaxis, and monitor bowel function.

ADVERSE REACTIONS: ELEVATED INTRACRANIAL PRESSURE (INCLUDING PSEUDOTUMOR CEREBRI), SEIZURES, SUICIDAL THOUGHTS, AORTIC ANEURYSM/DISSECTION, HEPATOTOXICITY, CLOSTRIDIOIDES DIFFICILE-ASSOCIATED DIARRHEA (CDAD) & HYPERSENSITIVITY REACTIONS

S/S TOXICITY: The toxic effects of quinolones on connective tissue structures are tendopathies. Tendinitis and tendon ruptures have occurred as late as several months after quinolone treatment

CARE/IMPLEMENT: TEACH: PO: Administer w/o food with a Instruct pt to take full glass of water, at the same medication at evenly time each day. Shake oral spaced times and to suspension vigorously for 15 sec finish drug completely, be administering. even if they feel better. IV: Dilute with 0.9% of NaCl or Take missed doses asap, D5W, concentration: 1-2mg/mL, unless within 6 hrs of rate: Admin. Over 60 min into a next dose. Teach pts large vein to minimize venous about the side effects irritation. and interactions. SPECIAL CONSIDERATIONS/NOTES: * should be used only when there are no other alternative treatment options

TOXICITY/OVERDOSE TX: Cause long-lasting, disabling and potentially permanent side effects involving tendons, muscles, joints and the nervous system.

EVALUATE: Resolution of the signs and symptoms of bacterial infection.

D-D: Drug-Drug D-N: Drug-Natural D-F: Drug-Food FDA adds “black box” warning label to fluoroquinolone antibiotics. The US Food and Drug Administration has told manufacturers of fluoroquinolones to warn doctors and patients of the raised risk of tendinitis and tendon rupture. Increased risk of worsening symptoms for those with myasthenia grarvis, potential for irreversible peripheral neuropathy (serious nerve damage), disabling and potentially permanent side effects involving tendons, muscles, joints, nerves and the central nervous system....