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Nursing Notes and Community

Drug Name cephalexin (sef a lex' in) Apo-Cephalex (CAN), Biocef, Keflex, NovoLexin (CAN), Nu-Cephalex (CAN) Pregnancy Category B Drug classes Antibiotic Cephalospori n (first generation)

Dosages Adults 14 g/day in divided doses; 250 mg PO q 6 hr usual dose. Skin and skin structure infections: 500 mg PO q 12 hr. Larger doses may be needed in severe cases; do not exceed 4 g/day. Pediatric Patients 2550 mg/kg/day PO in divided doses. Skin and skin structure infections: Divide total daily dose, and give q 12 hr. Dosage may be doubled in severe cases. Otitis media: 75 100 mg/kg/day PO in four divided doses.

Therapeutic Actions Bactericidal: Inhibits synthesis of bacterial cell wall, causing cell death.

Indications Respiratory tract infections caused by Streptococcus pneumoniae, group A beta-hemolytic streptococci Skin and skin structure infections caused by staphylococcus, streptococcus Otitis media caused by S. pneumoniae, Haemophilus influenzae, streptococcus, staphylococcus, Moraxella catarrhalis Bone infections caused by staphylococcus, Proteus mirabilis GU infections caused by Escherichia coli, P. mirabilis, Klebsiella

Adverse effects CNS: Headache, dizziness, lethargy, paresthesias GI: Nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence, pseudomembr anous colitis, hepatotoxicity GU: Nephrotoxicity Hematologic: Bone marrow depression Hypersensitiv ity: Ranging from rash to fever to anaphylaxis; serum sickness reaction Other: Superinfection s

Contraindicat ions Contraindic ated with allergy to cephalospo rins or penicillins. Use cautiously with renal failure, lactation, pregnancy.

Nursing considerations Assessment History: Penicillin or cephalosporin allergy, pregnancy, or lactation Physical: Renal function tests, respiratory status, skin status; culture and sensitivity tests of infected area Interventions Arrange for culture and sensitivity tests of infection before and during therapy if infection does not resolve. Give drug with meals; arrange for small, frequent meals if GI complications occur. Refrigerate suspension, discard after 14 days. Teaching points Take this drug with food. Refrigerate suspension; discard any drug after 14 days. Complete the full course of this drug even if you feel better. This drug is prescribed for this particular infection; do not self-treat any other infection. You may experience these side effects: Stomach upset, loss of appetite, nausea (take drug with food); diarrhea; headache, dizziness. Report severe diarrhea with

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Nursing Notes and Community

blood, pus, or mucus; rash or hives; difficulty breathing; unusual tiredness, fatigue; unusual bleeding or bruising. Avoid alcohol while taking cephalexin.

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