Ampicillin/Sulbactam (Unasyn)

Class/Action: Thera: Antibiotic, Pharm: Aminopenicillin and beta-lactamase inhibitor combo

Dose/Route: 1.5-3g IM or IV Q6Hrs. MAX dose of sulbactam is 4g daily(12g of combined drugs,
each 1.5g vial contains 1g ampicillin soduim and 0.5g sulbactam sodium)
Action: ANTIBIOTIC
Side effects: SEIZURES(high doses), PSEUDOMEMBRANOUS COLITIS
Interactions: Allopurinol, hormonal contraceptives, Probenecid renal excretion and blood
levels of ampicillin
Labs: CBC- WBC, Hgb, HCT. BMP- BUN, creatinine. LFT- ALT, AST, bilirubin, LDH, CK and
GGT
Concerns/Contra: hypersensitivity to penicillins or sulbactam. Epstein-Barr virus infection, acute
lymphocytic leukemia, Mononucleosis
Teaching: contact MD if rash, fever, chills occur. Women to use additional contraception with
hormonal contraceptives during use of this drug

Filgrastim (Neupogen, G-CSF)

Class/Action: Thera: Colony-stimulatin factors
Dose/Route: After Myelosuppressive Chemotherapy IV: SC: 5 mcg/kg/day as a single inj
daily for up to 2 wk. After Bone Marrow Transplantation IV: SC: 10 mcg/kg/day as a 4- or 24hr IV infusion or as a continuous SubQ infusion; Peripheral Blood Progenitor Cell Collection
and Therapy SC: 10 mcg/kg/day as a bolus or continuous infusion for at least 4 days before
first leukapheresis and continued until last leukapheresis Severe Chronic Neutropenia SC:
Congenital neutropenia6 mcg/kg twice daily. Idiopathic/cyclical neutropenia5 mcg/kg daily.
All dosages adjusted accroding to blood counts
Action: prevents and treats neutropenia in chemotherapy patients. Improved harvest of
progenitor cells for bone marrow transplantation
Side Effects: excessive leukocytosis,pain, redness at sq site, medullary bone pain
Interactions: Simultaneous use with antineoplastics may have adverse effects on rapidly
proliferating neutrophilsavoid use for 24 hr before and 24 hr after chemotherapy. Lithium may
potentiate the release of neutrophils; concurrent use should be undertaken cautiously.
Labs: CBC with differential
Concerns/Contra: Administer no earlier than 24 hr after cytotoxic chemotherapy, at least 24 hr
after bone marrow infusion, and not during the 24 hr before administration of chemotherapy.
Refrigerate; do not freeze. Do not shake. May warm to room temperature for up to 6 hr
before injection. Discard if left at room temperature for >6 hr. Vial is for 1-time use only.
Teaching: Instruct patient on correct technique and proper disposal for home administration.