Cefotaxime, Nursing Sapiens Drug Diary, Part - 1

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CEFOTAXIM - Nursing Sapien's Drug Diary - I

CLASSIFICATION 
  • Its a broad spectrum antibiotic against various gram positive and gram negative bacteria. 
  • Cephalosporin, Third generation Cephalosporin.
PHARMACOKINETICS  
  •  Half life is 1 Hr. 
  •  Widely distributed to CSF. Protein binding: 30%–50%. 
  •  Partially metabolized in liver to active metabolite. 
  •  Primarily excreted in urine. 
MECHANISM OF ACTION 
  • Bactericidal
  • Binds to bacterial cell membranes, inhibits cell wall synthesis.
INDICATION 
  • Treatment of susceptible infections (active vs. most gram-negative [not Pseudomonas] and gram positive cocci   
  • Treatment of bone, joint, GU, gynecologic, intra-abdominal, lower respiratory tract, skin/skin structure infections, septicemia, meningitis.
  • Perioperative prophylaxis.
CONTRAINDICATIONS 
  • Hyper sensitivity to cephalosporins, infants <1 mo 

PRECAUTIONS
  • Pregnancy, breastfeeding, children, hypersensitivity to penicillins, GI/renal disease, geriatric patients, pseudomembranous colitis, viral infection, vit K deficiencies, diabetes
ADMINISTRATION 
  • IV after diluting 1 g/10 mL D5W, NS, sterile water for inj, give over 3-5 min by Y-tube or 3-way stopcock; may be diluted further with 50100 mL NS or D5W; run over ½-1 hr; discontinue primary infusion during administration; may be diluted in larger vol of sol, given as a continuous infusion 
  •  For 1014 days to ensure organism death, prevent superinfection 
  • Thaw frozen container at room temperature or refrigeration; do not force thaw by immersion or microwave; visually inspect container for leaks

SIDE EFFECTS 
  • CNS: Headache, dizziness, seizures 
  • GI: Nausea, vomiting, diarrhea, anorexia, abdominal pain, 
  • CDAD; cholestasis 
  • GU: renal failure 
  • HEMA: Thrombocytopenia, agranulocytosis, neutropenia, lymphocytosis, eosinophilia, pancytopenia, hemolytic anemia 
  • INTEG: Rash, urticaria, dermatitis, injection site reaction 
  • MS: Arthralgia 
  • SYST: Anaphylaxis, serum sickness, Stevens-Johnson syndrome, toxic epidermal necrolysis

NURSING CONSIDERATIONS 
  • Infection: characteristics of wounds, sputum, urine, stool, WBC >10,000/ mm3, fever; obtain baseline and periodically during treatment 
  • Crosssensitivity to penicillin, other cephalosporins; hypersensitivity reaction may occur • Obtain C&S prior to treatment, may start treatment before results are received
  • Blood studies: AST, ALT, CBC, Hct, bilirubin, LDH, alkphos, Coombs’ test monthly if patient is on long-term therapy
  • Electrolytes: potassium, sodium, chloride monthly if patient is on long-term therapy CDAD: bowel pattern daily; if severe diarrhea occurs, product should be dis continued
  • If diabetic, to check blood glucose
  • To report sore throat, bruising, bleeding, joint pain, may indicate blood dyscrasias (rare); diarrhea with mucus, blood, may indicate CDAD
  • To complete full course of treatment, to take missed dose as soon as remembered unless close to next dose, do not double dose; to use calibrated device for suspension




 

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