DRUG DATA

CLASSIFICATION

MECHANISM OF ACTION > second-generation cephalosporin that inhibits cell-wall synthesis, promoting osmotic instability; usually bactericidal. Pharmacokinetics: Absorption: well absorbed Distribution: Crosses the placenta, enters breat milk Metabolism: T 1-2 hr Excretion: urine Half-life: 1-2 hours Onset: varies Peak: 2 hours Duration: 18-24 hours

INDICATION

CONTRAINDICATION

ADVERSE REACTIONS

NURSING RESPONSIBILITIES

Generic Name: cefuroxime Trade Name: Ceftin, Zinacef Minimum Dose: 125 mg 1 cap BID PO Maximum Dose: 500 mg 1 cap BID PO Contents: cefuroxime axetil cefuroxime sodium Availability and Color: cefuroxime axetil Suspension: 125 mg/5ml, 250 mg/5ml Tablets: 125 mg, 250 mg, 500 mg cefuroxime sodium Infusion: 750 mg, 1.5 g premixed, frozen solution Injection: 750 mg, 1.5 g Route: PO, IV, IM Source: Brener, T., Rita, M.D., Nursing 2007 Drug Handbook. th Philadelphia (27 ed.) Lippincott Williams & Wilkins, p. 119-121

Pharmacologic: cephalosporins Therapeutic: anti-infectives Pregnancy Category: B

> pharyngitis, tonsillitis, infection of the upper or lower respiratory tracts, and skin or skinstructure infection > serious lower respiratory tract infection, UTI, skin or skin-structure infections, bone or joint infections, septicemia, meningitis, and gonorrhea > uncomplicated UTI > otitis media > pharyngitis & tonsillitis > perioperative prevention > early Lyme disease > secondary bacterial infection of acute bronchitis > uncomplicated gonorrhea

> contraindicated in pts hypersensitivity to drug or other cephalosporins Precaution: > use cautiously in pts with renal failure, lactation pregnancy Drug Interaction: > Drug-drug. Aminoglycosides: May cause synergistic activity against some organisms; May increase nephrotoxicity. Loop Diuretics: May increase risk of adverse renal reaction. Probenecid: May inhibit excretion & increase cefuroxime level. Probenecid may be used for this effect. > Drug-food. Any food. May increase absorption. Give drug with food.

CV phlebitis, thrombophlebitis GI pseudomembraneous colitis, nausea, anorexia, vomiting, diarrhea Hematologic transcient neutropenia, eosinophilia, haemolytic anemia, thrombocytopenia Skin maculopapular & erythema, urticaria, pain, sterile abscess, temperature elevation, induration, tissue sloughing Other anaphylaxis, hypersensitivity reactions, serum sickness

Before > Tell pt to report history of allergic reactions to penicillins and cephalosporins > Note reasons for therapy, baseline assessments > Assess for anemia, renal dysfunction Reduce dose with impaired renal function > Assess if the pt has taken drug that may decrease the medication effectiveness > Inform patient need and importance of the drug to him/her During > Administer medication with food to hasten absorption > If pt has difficulty swallowing, tell him that it may be crushed or dissolved but warn him about its bitter taste that is hard to mask, even with food > Inspect IM and IV injection sites frequently for signs of phlebitis > Monitor I&O rates and pattern: Especially important in severely ill patients receiving high doses. Report any significant changes > Observe 15 Rs of drug administration After > Report loose stools or diarrhea promptly. > Instruct pt not to breast feed while taking this drug > Educate pt of the possible adverse reactions of the drug > Tell patient to notify prescriber if rash, chills or fever develops > Document drugs name, time and date of administration on the patients chart