Clinical Medications Worksheets
Generic Name Trade Name
Piperacillin/tazobactam Zosyn Anti-infectives
Peak Onset Duration
End of infusion rapid 4-6 hrs
Why is your patient getting this medication
Skin and skin structure infections
Mechanism of action and indications
(Why med ordered)
Piperacillin: Binds to bacterial cell wall membrane, causing
cell death. Spectrum is extended compared with other
penicillins.
Tazobactam: Inhibits beta-lactamase, an enzyme that can
destroy penicillins.
Interactions with other patient drugs, OTC or herbal
medicines (ask patient specifically)
None for this patient
Nursing Process- Assessment
(Pre-administration assessment)
Assess patient for infection (vital signs;
appearance of wound, sputum, urine, and stool;
WBC) at beginning of and during therapy, Obtain
a history before initiating therapy to determine
previous use of and reactions to penicillins or
cephalosporins. Persons with a negative history of an antihistamine, and resuscitation equipment
penicillin sensitivity may still have an allergic
response, Obtain specimens for culture and
sensitivity prior to initiating therapy. First dose
may be given before receiving results.
Classification Dose Route Time/frequency
2.25gm IVPB Q 6 hrs
Normal dosage range
3.375-4.5 g q 6 hr
Rate: Administer over at least 30 min
For IV meds, compatibility with IV drips and/or solutions
Reconstitute with 5 ml of 0.9% NaCl, sterile or bacteriostatic water for
injection, or D5W. Do not use LR--incompatible. Shake well until
dissolved. Dilute further in at least 50 ml of diluent. Discard any
unused solution after 24 hr at room temperature or 48 hr if refrigerated.
Nursing Implications (what to focus on)
Contraindications/warnings/interactions
Hypersensitivity to penicillins, betalactams, cephalosporins, or
tazobactam(cross-sensitivity may occur). Renal impairment (dosage
reduction or increased interval recommended if CCr <40 ml/min).
Common side effects
SEIZURES (HIGHER DOSES), PSEUDOMEMBRANOUS
COLITIS, rashes, hypokalemia, phlebitis at IV site,
HYPERSENSITIVITY REACTIONS, INCLUDING ANAPHYLAXIS
AND SERUM SICKNESS
Lab value alterations caused by medicine
Evaluate renal and hepatic function, CBC, serum potassium, and
bleeding times prior to and routinely during therapy, May cause
positive direct Coombs' test result, May cause ↑ BUN, creatinine, AST,
ALT, serum bilirubin, alkaline phosphatase, and LDH, May cause
leukopenia and neutropenia, especially with prolonged therapy or
hepatic impairment, May cause prolonged prothrombin and partial
thromboplastin time, Piperacillin may cause ↑ serum sodium and ↓
serum potassium concentrations, Piperacillin/tazobactam may also
cause ↓ hemoglobin and hematocrit and thrombocytopenia,
eosinophilia, leukopenia, and neutropenia. It also may cause
proteinuria; hematuria; pyuria; hyperglycemia; ↓ total protein or
albumin; and abnormalities in sodium, potassium, and calcium levels
Be sure to teach the patient the following about this medication
Advise patient to report signs of superinfection(black furry overgrowth
on tongue, vaginal itching or discharge, loose or foul-smelling stools)
and allergy. Caution patient to notify health care professional if fever
and diarrhea occur, especially if stool contains blood, pus, or mucus.
Advise patient not to treat diarrhea without consulting health care
professional. May occur up to several weeks after discontinuation of
medication.
Assessment Evaluation
Why would you hold or not give this med? Check after giving
Observe patient for signs and symptoms of Resolution of the signs and
anaphylaxis (rash, pruritus, laryngeal edema, symptoms of infection. Length of
wheezing). Discontinue the drug and notify time for complete resolution
the physician or other health care professional depends on the organism and site
immediately if these occur. Keep epinephrine, of infection.
close by in the event of an anaphylactic
reaction.