Generic Name/ Brand Name Ceftazidime (Zeptrigen)

Classification Antibiotic, Cephalosphorin (3rd Generation)

Mechanism of Action Interfere with a final step formation of the bacterial cell wall (inhibition of mucopeptide biosynthesis), resulting in unstable cell membranes that undergo lysis. Also, cell division and growth are inhibited. More activity against gram-negative organisms and resistant organisms and les activity against grampositive organisms than first-generation drugs (Spratto and Woods, 2008:1788).

Dosage & Frequency > Usual Dose: Adults: 1 g either IV or deep IM administration every 8-12 hrs depending on the type and severity of infection. >UTIs uncomplicated Adults: 250 mg IV or IM every 12 hrs >UTIs complicated Adults: 500 mg IV or IM every 8-12 hrs >Uncomplicated pneumonia, mild skin and skin structure infections Adults: 500 mg-1 g IV or IM every 8 hrs >Bone and joint infections Adults: 2 g IV every 12 hrs

Indication

Contraindications Patients with allergies to penicillins, cepahlosporins.

Side Effects CNS: Headache, dizziness, lethargies, paresthesias, malaise, fatigue, vertigo, confusion, precipitation of seizures, (especially in clients with impaired renal function) GI: nausea, vomiting, diarrhea, glossitis, abdominal cramps or pain, dyspepsia, anorexia, flatulence, cholestasis, pseudomembrano us colitis GU: Nephrotoxicity Hematologic: leukopenia, leukocytosis, lymphocytosis, neutropenia (transient), eosinophilia,

Nursing Responsibilities Before: 1. Assess for liver and renal dysfunction. 2. Obtain CBC, renal function studies; reduce dose with dysfunction. 3. Culture infection, and arrange sensitivity tests before and during therapy if expected response is not seen. During: 1. Do not mix with aminoglycoside solutions, administer these drugs separately. 2. Monitor prothrombin time in patients w/ renal or hepatic impairment, in a poor nutritional state or are on prolonged therapy. 3. Preparation of injectable solution, sites and methods of injection are treated with utmost care. Administer IV injection as slowly as possible. After:

Most active cephalosporin against gramnegative bacilli

>Serious gynecologic or intra-abdominal infections, meningitis, severe or life-threatening infections in immunocompromised clients Adults: 2 g IV every 8 hrs >Pseudomonal lung infections in cystic fibrosis clients with normal renal function Adults: 30-50 mg/kg body weight IV every 8 hrs. Maximum Dose: 6 g/day

thrombocytopeni, thrombocythemia, agranulocytosis, granulocytopenia, bone marrow depression, hemolytic anemia, pancytopenia, decreased platelet function, aplastic anemia, hypoprothrombinemia (may lead to bleeding) , thrombocytosis (transient) Hypersensitivity: urticaria, rashes (maculopapular, morbilliform, or erythematous), pruritis (including anal/genital areas), fever, chills, erythema, angioedema, serum sickness, joint pain, exfoliative dermatitis, chest tightness, myalgia, erythema multiforme, edema, itching, numbness, Stevens-Johnson

1. Store at temperatures not exceeding 30C. 2. Have Vit. K available in case hypoprothrombinemia occurs. 3. Discontinue if hypersensitivity occurs.

syndrome, anaphylaxis Hepatic: hepatomegaly, hepatitis Local: Pain, abscess at injection site, phlebitis, inflammation at IV site Other: Superinfections including oral candidiasis and enterococcal infections, hypotension, sweating, flushing dyspnea, interstitial pnuemonitis, disulfiram-like reactions with alcohol