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DOSAGE Adult: 3-5 mg/kg/day, given in divided doses every 8 hr for 7-10 days. Child: 2 wk: 3 mg/kg every 12 hr; 2 wk-12 yr: 2 mg/kg every 8 hr.
MECHANISM OF ACTION Inhibits bacterial cell wall synthesis, most effective against rapidly growing organism
SIDE EFFCETS/ADVERSE EFFECT CNS: headache, lethargy, dizziness, seizure, vertigo, ataxia CV: hypotension EENT: blurred vision, tinnitus GI: vomiting, nausea Hematologic: anemia, eosinophilia Muskuloskeletal: muscle twitching Resp.: apnea Skin: rash, pruritus Other: fever, anaphylaxis
NURSING IMPLICATION RESPONSIBILITIES - Assess for hypersensitivity. - Use cautiously in neonates, infants and Elderly - Monitor urine output, specific gravity, urinalysis, BUN and creatinine levels. - Notify physician for signs of decreasing renal function - Watch for super infections - Repeat C&S if improvement does not occur in 35 d; reevaluate therapy
Drug acts directly and by the release of norepinephrine from sympathetic nerve terminals; dopaminergic receptors mediate dilation of vessels in the renal and splanchnic beds, which maintains renal perfusion and function; alpha receptors, which are activated by higher doses of dopamine, mediate vasoconstriction, which can override the vasodilating effects; beta1 receptors mediate a positive inotropic effect on the heart.
- To correct hemodynamic imbalance in shock syndrome due to MI (cardiogenic shock), trauma, endotoxic septicemia (septic shock), open heart surgery, and CHF - Poor perfusion of vital organs - Low cardiac output - Hypotension - Unlabeled Uses: COPD, heart failure, RDS in infants
- Pheochromocytoma - Tachyarrhytmias - Ventricular fibrillation - Hypovolemia - General anesthesia with halogenated hydrocarbons or cyclopropane, which sentisize the myocardium with catecholamines Precaution - Atherosclerosis - Arterial embolism - Raynaud's disease - Cold injury
CV: Hypotension, ectopic beats, tachycardia, angina pain, palpitation, vasoconstriction cold extremities; less frequent: bradycardia, widening of QRS complex, elevated blood pressure. GI: Nausea, vomiting. CNS:Headache. Skin: Necrosis, tissue sloughing with extravasation, gangrene, piloerection. Other: Azotemia, dyspnea, dilated pupils (high doses).
- Monitor blood pressure, pulse, peripheral pulses, and urinary output at intervals prescribed by physician. - Report the following indicators promptly to physician for use in decreasing or temporarily suspending dose: Reduced urine flow rate in absence of hypotension; ascending tachycardia; dysrhythmias; disproportionate rise in diastolic pressure (marked decrease in pulse pressure); signs of peripheral ischemia (pallor, cyanosis, mottling, coldness, complaints of tenderness, pain, numbness, or burning sensation). - Monitor improvement in vital signs and urine flow.
Penicillin, Antibiotic
Bactericidal action against sensitive organisms; inhibits synthesis of bacterial cell wall, causing cell death
- to treat bacterimia, CNS, bone and joint infection - Endocarditis - Septicimia - skin and soft tissue infections - Respi infections - UTI caused by penicillinase producing strains of Staphylococcus or other susceptible organisms
- Contraindicated with allergies to penicillins, cephalosporins, or other allergens - Use cautiously with renal disorder
GI upset, nausea, vomiting, diarrhoea; blood dyscrasias; urticaria, exfoliative dermatitis, rash; fever, seizures; interstitial nephritis. Potentially Fatal: Anaphylactic shock; Pseudomembranous colitis; neuromuscular hypersensitivity; electrolyte imbalance
- Assess for hypersensitivity. - Administer the drug 1 hour before other antibiotics - Before reconstitution, tap bottle several times to loosen powder. For injection, 0.45 NS or D5rW. Shake until the solution is clear. - Notify prescriber immediately if rash developed - take it on empty diet