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Drug Name ciprofloxacin (si proe flox' a sin) Ciloxan, Cipro, Cipro HC Otic, Cipro I.V., Cipro XR, Co Ciprofloxacin (CAN), Proquin XR Pregnancy Category C Drug classes Antibacterial Fluoroquinolo ne Adults

Dosages

Uncomplicated UTIs: 100 250 mg PO q 12 hr for 3 days or 500 mg PO daily (ER tablets) for 3 days. Proquin XR500 mg PO as a single dose. Mild to moderate UTIs: 250 mg PO q 12 hr for 714 days or 200 mg IV q 12 hr for 714 days. Complicated UTIs: 500 mg PO q 12 hr for 714 days or 400 mg IV q 12 hr or 1,000 mg (ER tablets) PO daily for 714 days. Chronic bacterial prostatitis: 500 mg PO q 12 hr for 28 days or 400 mg IV q 12 hr for 28 days. Infectious diarrhea: 500 mg q 12 hr PO for 57 days. Anthrax postexposure: 500 mg PO q 12 hr for 60 days or 400 mg IV q 12 hr for 60 days. Respiratory infections 500750 mg PO q 12 hr or 400 mg IV q 812 hr for 7 14 days. Acute sinusitis: 500 mg PO q 12 hr or 400 mg IV q 12 hr for 10 days. Acute uncomplicated pyelonephritis: 1,000 mg ER tablets PO daily for 7 14 days. Bone, joint, skin infections: 500750 mg PO q 12 hr or

Therapeutic Actions Ciprofloxacin promotes breakage of doublestranded DNA in susceptible organisms and inhibits DNA gyrase, which is essential in reproduction of bacterial DNA.

Indications For the treatment of infections caused by susceptible gram-negative bacteria, including Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, Enterobacter cloacae, Proteus vulgaris, Proteus rettgeri, Morganella morganii, Pseudomonas aeruginosa, Citrobacter freundii, Staphylococcus aureus, Staphylococcus epidermidis, group D streptococci Treatment of uncomplicated UTIs caused by E. coli, K. pneumoniae as a one-time dose in patients at low risk of nausea, diarrhea (Proquin XR) Otic: Treatment of acute otitis externa

Adverse effects GI disturbances; headache, tremor, confusion, convulsions; rashes; joint pain; phototoxicity. Transient increases in serum creatinine. Hematological, hepatic and renal disturbances. Vasculitis, pseudomembra nous colitis and tachycardia. Phototoxicity. Potentially Fatal: Anaphylactoid reaction; cardiopulmonar y arrest.

Contraindications Hypersensitivity. Not to be used concurrently with tizanidine. Avoid exposure to strong sunlight or sun lamps during treatment.

Nursing considerations Assessment History: Allergy to ciprofloxacin, norfloxacin or other quinolones; renal dysfunction; seizures; lactation Physical: Skin color, lesions; T; orientation, reflexes, affect; mucous membranes, bowel sounds; LFTs, renal function tests Interventions Arrange for culture and sensitivity tests before beginning therapy. Continue therapy for 2 days after signs and symptoms of infection are gone. Be aware that Proquin XR is not interchangeable with other forms. Ensure that the patient swallows ER tablets whole; do not cut, crush, or chew. Ensure that patient is well hydrated. Give antacids at least 2 hr after dosing. Monitor clinical response; if no improvement is seen or a relapse occurs,

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400 mg IV q 812 hr for 4 6 wk. Nosocomial pneumonia: 400 mg IV q 8 hr for 1014 days. Ophthalmic infections caused by susceptible organisms not responsive to other therapy: 1 or 2 drops per eye daily or bid or 1/2 inch ribbon of ointment into conjunctival sac tid on first 2 days, then apply 1/2 inch ribbon bid for next 5 days. Acute otitis externa: 4 drops in infected ear, tid qid. Pediatric Patients Not recommended; produced lesions of joint cartilage in immature experimental animals. Inhalational anthrax: 15 mg/kg/dose PO q 12 hr for 60 days or 10 mg/kg/dose IV q 12 hr for 60 days; do not exceed 500 mg/dose PO or 400 mg/dose IV. Geriatric Patients or Patients with Impaired Renal Function For creatinine clearance of 3050 mL/min, give 250 500 mg PO q 12 hr. For creatinine clearance of 5 29 mL/min, give 250500 mg PO q 18 hr or 200400 mg IV q 1824 hr. For

Treatment of chronic bacterial prostatitis IV: Treatment of nosocomial pneumonia caused by Haemophilus influenza, K. pneumoniae Oral: Typhoid fever Oral: STDs caused by Neisseria gonorrhea Prevention of anthrax following exposure to anthrax bacilla (prophylactic use in regions suspected of using germ warfare) Acute sinusitis caused by H. influenzae, Streptococcus pneumoniae, or Moraxella catarrhalis Lower respiratory tract infections: Caused by E. Coli, Klebsiella, Enterobacter species, P. mirabilis, P. aeruginosa, H. influenzae, Haemophilia parainfluenza, S.

repeat culture and sensitivity. Encourage patient to complete full course of therapy. Teaching points If an antacid is needed, take it at least 2 hours before or after dose. Take Proquin XR with the main meal of the day. Do not touch tip of eye ointment or solution for this may contaminate the product. Drink plenty of fluids while you are taking this drug. You may experience these side effects: Nausea, vomiting, abdominal pain (eat frequent small meals); diarrhea or constipation; drowsiness, blurring of vision, dizziness (observe caution if driving or using dangerous equipment). Report rash, visual changes, severe GI problems, weakness, tremors.

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patients on hemodialysis, give 250500 mg q 24 hr, after dialysis.

pneumoniae Unlabeled use: Effective in patients with cystic fibrosis who have pulmonary exacerbations

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