Jordan Gonzales

Nur81- Rabe
7-9-16

Name

Action

Generic name:
Metronidazole
Brand name: Flagyl

-Treats bacterial
infections of the
vagina, stomach,
skin, joints, &
respiratory tract (not
used for vaginal
yeast infection)
-Treats bacterial
vaginosis, pelvic
inflammatory
disease (PID),
pseudomembranous
colitis, aspiration
pneumonia, rosacea,
fungating (topical)
wounds, intraabdominal
infections, lung
abscess,
periodontitis,
amoebiasis, oral
infections,
giardiasis,
trichomoniasis, H.
pylori, & anaerobic
bact infections
(Bacteroides,
Clostridium,
Fusobacterium,
Prevotella)

Dosage:
Adult
A) Bacterial Infection
(Anaerobic): -Loading
dose: 15mg/kg IV,
Maintenance dose:
7.5mg/kg IV q6h
-Oral: 7.5mg/kg q6h
-Max dose: 4g/dy;
therapy duration: 7-10
dys
B) Endocarditis:
-Loading dose:
15mg/kg IV,
Maintenance dose:
7.5mg/kg IV q6h
-Oral: 7.5mg/kg q6h
-Max dose: 4g/dy;
therapy duration: 7-10
dys
C) Jt Infection:
-Loading dose:
15mg/kg IV,
Maintenance dose:
7.5mg/kg IV q6h
-Oral: 7.5mg/kg q6h
-Max dose: 4g/dy;
therapy duration: 7-10
dys

Drug class: antibiotic

(antibacterial);
antiprotozoal

Nur81: Drug Study- Metronidazole

Indication
Contraindication Interactions
Susceptible
anaerobic
infections
(intraabdominal,
skin,
gynecologic,
bacterial
septicemia, bone
& jt, CNS, lower
resp tract,
endocarditis)

Hypersensitivity
to metronidazole
Disulfiram
(taken in the past
2 wks):
metronidazole w/
disulfiram causes
psychotic
reactions
Alcohol:
metronidazole w/
alcohol causes
abdominal
cramps, nausea,
vomiting,
headaches, &
flushing

-Disulfiram:
psychotic reactions
-Alcoholic
beverages:
abdominal cramps,
nausea, vomiting,
headaches, &
flushing
-Lithium: elevated
serum lithium;
lithium toxicity
-Busulfan:
increased busulfan
plasma conc;
busulfan toxicity
-Drugs that Inhibit
CYP450 Enzymes
(ex: cimetidine):
may prolong halflife, & decrease
metronidazole in
plasma
-Drugs that Induce
CYP450 Enzymes
(phenytoin,
phenobarbital):
may accelerate
elimination of
metronidazole

Side Effects

Nursing
Considerations

CNS
-Seizure
-Encephalopathy
-Aseptic meningitis
-Optic & peripheral
neuropathy
GI
-Nausea
(occasionally w/
vomiting)
-Diarrhea
-Epigastric distress
-Abdominal
cramping
-Constipation
Mouth
-Metallic taste
-Furry tongue,
glossitis, &
stomatitis
Skin
-Rash
-Pruritis
Hypersensitivity
-Urticaria
-Rash
Renal
-Dysuria
-Cystitis
-Polyuria
-Incontinence

-Assess pain
before & 2-3 hr
after
administration
-Assess BP & RR
before & during
administration;
respiratory
depression has not
occurred w/ doses
-Assess bowel
function routinely;
prevent
constipation w/
increased fluid
intake, increase
fiber intake, &
laxatives
-Assess analgesic
history; Tramadol
not recommended
for patients who
receiving opioids
-Monitor for
seizures

Jordan Gonzales
Nur81- Rabe
7-9-16
Nur81: Drug Study- Cefuroxime
Contraindication Interactions

Name

Action

Indication

Generic name:
Cefuroxime
Brand name: Ceftin;
Zinacef

-Treats certain
bacterial
infections
(bronchitis;
gonorrhea; Lyme
disease;
infections of the
ear, throat, sinus,
urinary tract, &
skin); stops
bacterial growth

-Pharyngitis/
Tonsillitis (S.
pyogenes)
-Acute bacterial
otitis media (S.
pneumoniae; H.
influenzae; S.
pyogenes)
-Acute bacterial
maxillary sinusitis
(S. pneumoniae; H.
influenzae)
-Acute bacterial
exacerbations of
chronic bronchitis;
secondary bact
infections of acute
bronchitis (S.
pneumoniae; H.
influenzae)
-Uncomplicated
skin & skinstructure infections
-Uncomplicated
UTI's
-Gonorrhea
-Early lyme disease
-Impetigo

Dosage
A) Pharyngitis/
Tonsillitis:
Adult: 250mg PO q12
for 10 dys
Pediatric (3mo-12yr):
30mg/kg/dy PO
divided q12 for 10 dys
Pediatric (>12):
250mg PO q12 for 10
dys
B) Acute Bacterial
Maxillary Sinusitis
Adult: 250mg PO q12
for 10 dys
Pediatric (3mo-12yr):
30mg/kg/dy divided
q12 for 10 dys
C) Acute Bacterial
Exacerbations of
Chronic Bronchitis:
Adult: 250-500mg PO
q12 for 10 dys
D) Uncomplicated
UTI: 125-250mg PO
q12 for 7-10 dys
Drug class:
cephalosporin
antobiotic (2nd gen)

-Hypersensitivity to
cefuroxime (or other
-lactam
antibacterial drugs)

-Oral
contraceptives:
lower estrogen
reabsorption in
intestines; reduced
efficacy of
combined oral
contraceptives
-Drugs that Reduce
Gastric Acidity
(Histamine-2
antagonists; proton
pump inhibitors):
may lower
cefuroxime
absorption
-Probenecid:
increases serum
cefuroxime conc

Side Effects
>10%
-Diarrhea
1-10%
-Decreased
hemoglobin/
hematocrit
-Eosinophilia
-Nausea; voiting
-Vaginitis
-Rise in hepatic
transaminase
-Diaper rash
-Rise in alkaline
phosphatase
-Thrombophlebitis
-Increase in lactate
dehydrogenase
<1%
-Anemia
-Cholestasis
-Colitis
-Dyspnea
-Increase in BUN &
creatinine
-Jaundice
-Nephritis
-Rash
-Stomach cramps
-Urticaria

Nursing
Considerations
-Determine
history of
hypersensitivity
reactions to
cephalosporin &
penicillin
-Determine
history of drug
allergies
-Inspect IM &
IV injections for
phlebitis
-Report for loose
stool or diarrhea
-Monitor for
hypersensitivity
signs
(discontinue
drug & report
appearance)
-Monitor I&O;
report signifant
changes