Balido, John Emmanuel A. BSN223/Grp89 Drug Study Drug Data Classifi cation Mech anism of Acti on Indicat ion Contraindica tions Adverse Reacti on Nursing Responsibilities Generic Name Ampicillin Trade Name Principen Minimum Dose 8 g/day Maximum Dose 14 g/day Contents Ampicillin sodium Availability and colorCapsules: 250, 500 mg Powder for oral suspension: 125 mg/5 mL, 250 mg/5 mL Powder forinjection: 250, 500 mg, 1, 2 g Routes ofadministration Oral IntramuscularIntravenous Pharmacologic Class Penicillin Therapeutic Class Antibiotic Pregnancy Risk FactorB Bactericidal action against sensitive organisms; inhibits synthesis of bacterial cell wall, causing cell death. Pharmacokinetics D: Crosses placenta; enters breast milk M:Not known E: Urine, unchanged Drug Half Life 1-2 hours General Indications - Treatment ofinfections caused by susceptible strains of Shigella, Salmonella, Escherichia coli, Haemophilus influenzae, Proteus mirabilis, Neisseria gonnorhoeae, enterococci, gram- positive organisms (penicillin G- sensitive staphylococci, streptococci, pneumococci) - Meningitis caused by Neisseria meningitidis - Unlabeled use: Prophylaxis in cesarean section in certain high-risk patients Concentrations - Allergies to penicillins, cephalosporins, or otherallergens Precaution - Renal disorders Drug interaction Drug to drug - Increased ampicillin effect with probenecid - Increased risk of rash with allopurinol - Increased bleeding effect with heparin, oral anticoagulants - Decreased effect with tetracyclines, chloramphenicol - Decreased efficacy ofhormonal contraceptives, atenolol with ampicillin Drug to food - Oral ampicillin may be less effective with food; take on empty stomach Drug to lab test - False-positive Coombs' test if given IV - Decrease in plasma estrogen concentrations in pregnant women - False-positive urine glucose tests if Clinitest, Benedict's solution or Fehling's solution is used CNS: Lethargy, hallucinations, seizures CV: Heart failure GI: Glossitis, stomatitis, gastritis, sore mouth, furry tongue, black “hairy” tongue, nausea, vomiting, diarrhea, abdominal pain, bloody diarrhea, enterocolitis, pseudomembranous colitis, nonspecific hepatitis GU: Nephritis Hematologic: Anemia, thrombocytopenia, leukopenia, neutropenia, prolonged bleednig time Hypersensitivity: Rash, fever, wheezing, anaphylaxis Local: Pain, phlebitis, thrombosis at injection site Other: Superinfections – oral and rectal moniliasis, vaginitis Before - Observe 15 rights in drug administration. - Assess for allergies to penicillins, cephalosporins, or other allergens. - Assess for renal disorders or lactation. - Culture infected area before treatment. - If patient is a woman and she uses hormonal contraceptive, she should use a second form of birth control for 1-2 weeks while taking this drug. During - Administer oral drug on an empty stomach, 1 hour before or 2 hours aftermeals. - Administer with a full glass of water. Do not give with fruit juice or soft drinks. - Do not give IM injections in the same site; atrophy can occur. - For IV administration, give slowly over3-5 mins. - Use within 1 hour after preparation because potency may decrease significantly after that. After- Dispose of used materials properly. - Educate patient about side effects. - Instruct to report pain or discomfort at sites, unusual bleeding or bruising, mouth sores, rash, hives, fever, itching severe diarrhea, difficulty breathing. - Instruct patient not to use antibiotic to self-treat other infections. - Instruct to take the full course of drug therapy. - Do proper documentation.