cloxacillin

Generic Name: cloxacillin (klox

a SILL in)
Brand Names: Cloxapen,
Tegopen

Mechanism of Action
Cloxacillin is resistant to degradation by penicillinases. It is particularly useful against
penicillinase-producing staphylococci. Highly active against S aureus, S pyogenes, S viridans
and S pneumoniae.
Indication & Dosage

Oral
TREATMENT OF STAPHYLOCOCCAL INFECTIONS RESISTANT TO
BENZYLPENICILLIN
Adult: 250-500 mg 4 times daily.
Child: 50-100 mg/kg in divided doses every 6 hr.
Administration
Should be taken on an empty stomach (i.e. At least one hour before food or four hours after
food). (Take on an empty stomach 1 hr before or 2 hr after meals.)
Pregnancy Category (US FDA)

Category B: Either animal-reproduction studies have not

demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-
reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not
confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in
later trimesters).

Contraindications
Hypersensitivity to penicillins.
Precautions
Renal impairment; pregnancy and lactation. Porphyria.
Potentially Life-threatening Adverse Drug Reactions
Neuromuscular hypersensitivity; pseudomembranous colitis; anaphylaxis.

Adverse Drug Reactions

Neutropenia, agranulocytosis; GI upsets; rash. Sore mouth or tongue. Black hairy tongue.
Potentially Hazardous Interactions
Increased hypoprothrombinaemic effects of oral anticoagulants.

Interactions
Co-admin of probenecid or disulfiram may result in higher cloxacillin concentration.
Chloramphenicol and tetracycline antagonise bactericidal effect of penicillins.

Dopamine HCL
Brand Name: Dopamine
Generic Name: Dopamine Hydrochloride

(Intropin®)

Class: Sympathomimetic
Route: IV or intraosseous piggyback
Adult Dose: 2-10mcg/kg/minute - BioTel authorization only, as follows

• 400mg dopamine in 250mL NS (1600mcg/mL)

• 800mg dopamine in 500mL NS (1600mcg/mL)

Refer to the Drug Drip Chart in Protocol Appendix for the number of drops
per minute to deliver the BioTel authorized order
Pediatric Dose 10mcg/kg/minute - BioTel authorization only, as follows

• 400mg dopamine in 250mL NS (1600mcg/mL)

• 800mg dopamine in 500mL NS (1600mcg/mL)

Refer to the Drug Drip Chart in Protocol Appendix for the number of drops
per minute to deliver the BioTel authorized order
Drug Action: • At low doses, increases perfusion to kidneys and abdominal organs
 • At moderate doses, increases force and rate of ventricular contractions

• At high doses, peripheral vasoconstrictor

Onset: 2 minutes - 4 minutes
Duration: 10 minutes - 15 minutes
Indications: • Cardiogenic shock with systolic blood pressure between 70mmHg-
90mmHg

• Symptomatic bradycardia unresponsive to atropine or TCP

Precautions: • Start IV’s in the antecubital fossa to lower risk of infiltration, and while
administering, continually check IV site for patency and signs/symptoms
of infiltration.

• Do not mix with sodium bicarbonate; flush tubing well between drugs

• Continually monitor ECG, heart rate and blood pressure.

Side Effects: • Tissue necrosis with infiltration

• Hypertension

• Tachycardia

• Arrhythmias
Contraindications: Hypovolemic shock
dobutamine Hcl
Dobutrex

Uses
Dobutamine Hcl is used to treat heart conditions. The medication provides
additional pumping strength by stimulating the heart muscle.

Storage

• Dobutamine diluted in IV solutions should be used within 24 hours.

• Freezing should be avoided.
• Refrigerate IV solutions until use.
• Pink discoloration is harmless if medication is used within proper
time limits.
• Store away from moisture and light.

Overdose

• If overdose is suspected, contact your local poison control center or

emergency room immediately.
• Symptoms of overdose may include loss of appetite, nausea,
vomiting, tremor, headache, shortness of breath, and chest pain.

How To Use

• Dobutamine Hcl is given by IV infusion under the supervision of

 your doctor, nurse and/or pharmacist.
• The medication is diluted to at least 50 ml fluid before use.

Side Effects

• Headache, nausea or vomiting and restlessness may occur.

• Notify your doctor if any of these effects continue or become
bothersome.
• Notify your doctor if any of the following effects occur: muscle
cramps or weakness, chest pain, trouble breathing, dizziness,
palpitations, rash.
• If you notice other effects not listed above, contact your doctor or
pharmacist.

Precautions

• Tell your doctor if you have: liver disease, any allergies,

pheochromocytoma, irregular heartbeat/arrhythmias.
• Dobutamine Hcl should be used only when clearly needed during
pregnancy.
• Discuss the risks and benefits with your doctor.
• It is not known whether Dobutamine Hcl is excreted into breast milk.
• Consult your doctor before breast-feeding to review risks.

Missed Dose

• Follow instructions from your health care provider if you have

problems with your IV infusion, or if treatment is interrupted.

Drug Interactions

• Tell your doctor of any nonprescription or prescription medicines

you take, especially of: antidepressants (esp.
• tricyclics), maprotiline, beta-blockers, digoxin, reserpine, MAO
inhibitors (e.g., furazolidone, linezolid, phenelzine, selegiline,
tranylcypromine), methyldopa, guanethidine.
• Dobutamine cannot be mixed with alkaline solutions such as sodium
bicarbonate.
• Several other advisories apply to mixing or administering
Dobutamine Hcl.
• The pharmacist can assist with any questions or further information.
• Do not start or stop any medicine without doctor or pharmacist
approval.