3.

Opiates or diphenoxylate with

atropine may aggravate the

Clindamycin Drug Study

Generic Name: Clindamycin hydrochloride
Brand Name: Dalacin-C, Cleocin

condition.
4. Reserve for serious infections.
Side-Effects:

Classification: Antibiotic, lincosamide

1. Diarrhea
2. Pseudomembranous colitis

Uses:

3. Tinnitis
1. Treatment of serious respiratory tract
infections caused by anaerobes
2. Treatment of serious skin and soft

4. Nausea and vomiting

5. Slin rashes
6. Dry skin

tissue infections, septicemia and

7. Burning

abdominal infections

8. Itching

3. Serious infections caused by

9. Skin erythema

Streptococci/ Staphylocicci/

10.Peeling

Pneumococci

11.Oily skin

4. Adjunct to surgery for chronic

bone/joint infections

12.Cardiopulmonary arrest
13.Anaphylaxis

5. Treatment of acne vulgaris

14.Agranulocytosis

6. Treatment of bacterial vaginosis

15.Aplastic anemia
Dosage:

Actions:
1. Suppresses protein synthesis by

Per Orem: 150-300mg q6h. For severe

microorganisms by binding to

infections: 300-450mg q6h.

ribosomes

Life-threatening infections: 4.8 grams/IV

2. Prevents peptide formation

Topical: Apply a thin film on the affected area.

3. Does not diffuse adequately to the

CSF

Nursing Considerations:

Contraindications:
1. Use parenteral form for anaerobic
1. Hypersensitivity
2. Use in treating minor bacterial
infections
3. Use in clients with a history of
regional enteritis, ulcerative colitis,

infections
2. Reduce dosage in severe renal
impairment
3. Give parenteral dosage for
hospitalized clients only

meningitis, antibiotic-associated

4. Administer IV over 20-60 minutes

colitis

5. Assess for diarrhea and possible

4. Use for treating viral infections

5. Lactation
Special Concerns:

colitis
6. Assess extent of infections and if
improvement occurs
7. Monitor liver and renal function

1. Systemic use may cause severe and

possibly fatal colitis.
2. Diarrhea and pseudomembranous
colitis may occur up to several
weeks.

8. With IV, keep in bed for 30 min.

following infusion to prevent
hypotension
9. Take orally with a full glass of water
to prevent stomach distress

10.If diarrhea occurs, do not use

Route & Dosage

antiperistaltic agents
11.If using vaginal cream, it weakens
latex-containing condoms due to the

Intraabdominal Infections

Adult: IV 1 g q8h
Child: IV 3 mo, 20 mg/kg q8h (max: 1 g q8h)

mineral oil content

12.Do not use peeling agents on
affected acne areas

MEROPENEM
(mer-o'pe-nem)
Merrem
Classifications: ANTIINFECTIVE; CARBAPENEM
ANTIBIOTIC

Prototype: Imipenem
Pregnancy Category: B

Availability
500 mg, 1 g injection

Actions
Broad-spectrum carbapenem antibiotic that inhibits
the cell wall synthesis of gram-positive and gramnegative bacteria by its strong affinity for penicillinbinding proteins of bacterial cell wall.

Therapeutic Effects
Effective against both gram-positive and gramnegative bacteria. High resistance to most bacterial
beta-lactamases. Do not use to treat methicillinresistant Staphylococci (MRSA).

Uses
Complicated appendicitis and peritonitis, bacterial
meningitis caused by susceptible bacteria,
complicated skin infections.

Unlabeled Uses
Other intraabdominal infections, skin/soft tissue
infections, febrile neutropenia.

Contraindications
Hypersensitivity to meropenem, other carbapenem
antibiotics including imipenem, penicillins,
cephalosporins, or other beta-lactams; lactation.

Cautious Use
History of asthma or allergies, renal impairment,
epileptics, history of neurologic disorders, older
adult, pregnancy (category B). Safety and
effectiveness in infants <3 mo not established.

Bacterial Meningitis

Adult: IV 2 g q8h
Child: IV 3 mo, 40 mg/kg q8h (max: 2 g q8h)
Complicated Skin Infection

Adult: IV 500 mg q8h

Child (>3 mo): IV 10 mg/kg q8h (max: 500 mg
q8h)
Renal Impairment

Clcr 2650 mL/min: 1 g q12h; 1025 mL/min: 500

mg q12h; <10 mL/min: 500 mg q24h

Administration
Intravenous

Note: Dosage reduction is recommended

for older adults.

PREPARE: Direct: Reconstitute the 500-mg or 1-g

vial, respectively, by adding 10 or 20 mL sterile

water for injection to yield approximately 50
mg/mL. Shake to dissolve and let stand until clear.
IV Infusion: Further dilute in 50100 mL of D5W,
NS, or D5/NS.
ADMINISTER: Direct: Give over 35 min. IV
Infusion:

Give over 1530 min.

INCOMPATIBILITIES Solution/additive: Ringer's

lactate, mannitol, amphotericin

B, metronidazole, multivitamins. Y-site: Amphot
ericin B, diazepam, metronidazole.

Store undiluted at 1530 C (5986 F),

diluted IV solutions should generally be
used within 1 h of preparation.

Adverse Effects ( 1%)

GI: Diarrhea, nausea, vomiting,
constipation. Other: Inflammation at injection site,

phlebitis,
thrombophlebitis. CNS: Headache. Skin: Rash,
pruritus, diaper rash. Body as a Whole: Apnea,
oral moniliasis, sepsis,
shock. Hematologic: Anemia.

Interactions

Drug: Probenecid will delay meropenem excretion;

may decrease valproic acid serum levels.

Pharmacokinetics

Discontinue drug and immediately report

S&S of hypersensitivity (see Appendix F).

Report S&S of superinfection or

pseudomembranous colitis (see Appendix
F).

Monitor for seizures especially in older

adults and those with renal insufficiency.

Distribution: Attains high concentrations in bile,

bronchial secretions, cerebrospinal

fluid. Metabolism: Undergoes renal and extrarenal
metabolism via dipeptidases or nonspecific
degradation. Elimination:Excreted primarily in
urine. Half-Life: 0.81 h.

Nursing Implications

Patient & Family Education

Learn S&S of hypersensitivity,

superinfection, and pseudomembranous
colitis; report any of these to physician
promptly.

Do not breast feed while using this drug.

Assessment & Drug Effects

Lab tests: Perform C&S tests prior to

therapy. Monitor periodically liver and
kidney function.
Determine history of hypersensitivity
reactions to other beta-lactams,
cephalosporins, penicillins, or other drugs.