Name of Patient Diagnosis Doctor Drug Data Generic Name amoxicillin trihydrate (amoxycillin) Trade Name Amoxil, Apo-Amoxi

(CAN), DisperMox, Moxatag, Novamoxin (CAN), Nu-Amoxi (CAN), Polymox, Trimox, Wymox Patients Dose Suspension for 7 days Minimum Dose Children age 12 wk and over weighing less than 20 kg. 20 mg/kg daily in divided doses every 8 hr Maximum Dose 500 mg every 8 hr or 875 mg every 12 hr Availability and color

Anding, Jessica Donaire R/O conjunctivitis secondary to trauma Dr. Tipgos Classification Therapeutic: Antibiotic Pharmacologic aminopenicillins

Age Sex Date of Admission Indication General Indications To treat ear, nose, throat, GU tract, skin, and soft-tissue infections caused by susceptible grampositive and gramnegative organisms, To treat tonsillitis or pharyngitis caused by Streptococcus pyogenes, To treat lower respiratory tract infec tions caused by susceptible gram-positive and gramnegative organisms,

5 yrs. 5 months Female Not yet admitted Contraindications Hypersensitivity to amoxicillin or its components Precaution Severe renal insufficiency ( dose if CCr <30 mL/min) Infectious mononucleosis, acute lymphocytic leukemia, or cytomegaloviru s infection ( risk of rash) OB: Lactation: Has been used safely Drug interaction -drug to drug allopurinol: Increased risk of rash

Height Weight Body Build Adverse Reaction CNS: Agitation, anxiety, behavior changes, confusion, dizziness, insomnia, reversible hyperactivity, seizures CV: Hypersensitivity vasculitis EENT: Black, hairy tongue; mucocutaneous candididasis; tooth discoloration GI: Diarrhea, diarrhea related to Clostridium difficile, elevated liver enzymes, hemorrhag- ic or pseudomembrano us colitis, jaundice, hepatic dysfunction,

105.5 cm 17 kg sthenic Nursing Responsibilities Before Patients with mononucleosis shouldnt receive amoxicillin because this class of drugs may cause an erythematous rash. Use drug cautiously in patients with hepatic impairment. Monitor hepatic and renal function and CBC, as ordered, in patients on prolonged therapy. use cautiously in breastfeeding and elderly patients. Expect to start therapy before culture and sensitivity test results are known. as ordered. PATIENT TEACHING Tell patient to refrigerate reconstituted suspension and to shake well before each use.

Mechanism of Action Pharmacokinetics A Well absorbed from duodenum (7590%). More resistant to acid inactivation than other penicillins D Diffuses readily into most body tissues and fluids. CSF penetration increased when meninges are inflamed. Crosses placenta; enters breast milk in small amounts M&E 70% excreted unchanged in the urine; 30% metabolized by the liver Onset Unknown Peak Unknown

CAPSULES, CHEWABLE TABLETS, ORAL SUSPENSION, PEDIATRIC DROPS, POWDER OR TABLETS FOR ORAL SUSPENSION, TABLETS Routes of administration P.O.

Duration\ 68 hr Drug Half Life Neonates: 3.7 hr; Infants and Children: 12 hr; Adults: 0.7 1.4 hr

Treatment of Skin and skin structure infections Patients Actual Indication Treatment of Skin and skin structure infections

chloramphenicol, erythromycins, sulfon- amides, tetracyclines: Reduced bactericidal effect of amoxicillin methotrexate: Increased risk of methotrex- ate toxicity oral contraceptives with estrogen: Possibly 76 amphetamine sulfate reduced effectiveness of contraceptive probenecid: Increased amoxicillin effects

nausea, vomiting When amoxicillin GU: Crystalluria, suspension is prescribed vaginal mycosis for a child, instruct HEME: parents to place it Agranulocytosis, directly on childs anemia (including tongue to swallow. If hemolytic this doesnt work, tell anemia), parents to mix dose of eosinophilia, suspension with formula granulo- cytosis, or cold drink (milk, fruit leukopenia, juice, ginger ale, water) thrombocytopenia and have child drink it , immediately. thrombocytopenic Instruct patient using purpura DisperMox tablets to SKIN: Erythema place one tablet and multiforme, about 2 teaspoonfuls of erythematous water in a glass, drink maculopapular entire mix ture, add rash, generalized more water to the glass, exanthe- matous and drink again to pustulosis, ensure delivery of full Stevens-Johnson dose. syn- drome, toxic During Be aware that chewable epidermal tablets and tablets for necrolysis, oral suspension contain urticaria Other: phenylalanine. Allergic reaction, Tell patient to chew or anaphylaxis, crush chewable tablets serum and not to swallow them sicknesslike whole. reaction (such as Dont confuse arthralgia, amoxicillin tablets with arthritis, fever, amoxicillin tablets for myalgia, rash, and

urticaria)

oral suspension (DisperMox). Theyre not interchangeable. If allergic reaction occurs, stop amoxicillin immediately and provide emergency care as indicated and ordered. Monitor patient for superinfection. If it occurs, expect to discontinue drug and provide treatment After Teach patient to report adverse reactions notify prescriber if infection worsens or doesnt improve after 72 hours. To prevent infection from recurring, urge patient to take amoxicillin for full length of time prescribed, even if he feels better. Urge patient to tell prescriber about diarrhea thats severe or lasts longer than 3 days. Remind patient that watery or bloody

stools can occur 2 or more months after antibiotic therapy and may be serious, requiring prompt treatment. Monitor patient closely for diarrhea, which may indicate pseudomembranous colitis Expect treatment that lasts at least 10 days for hemolytic streptococci infections. Source: Deglin, Vallerand, Sanoski, D aviss Drug Guide for Nurses F.A. Davis Company. 2010 Source: Deglin, Vallerand, Sanos ki, Daviss Drug Guide for Nurses F.A. Davis Company. 2010 Source: http://www.drugguide .com/ddo/ub/view/Da vis-DrugGuide/51047/3/amoxi cillin?q=amoxicillin Source: Deglin, Vallerand, Sanos ki, Daviss Drug Guide for Nurses F.A. Davis Company. 2010 Source: Deglin, Vallerand, Sanosk i, Daviss Drug Guide for Nurses F.A. Davis Company. 2010 Source: http://www.drugg uide.com/ddo/ub/ view/Davis-DrugGuide/51047/4/a moxicillin?q=amo xicillin Source: Deglin, Vallerand, Sanoski, Davis s Drug Guide for Nurses F.A. Davis Company. 2010