Drug Name Mechanism of Action Indication / Contraindications Adverse Effects Nursing Considerations

Generic Name Inhibits cell-wall synthesis, Indication:  watery or bloody Before:

Cefazolin promoting osmotic stools, stomach Dx:
instability; usually Cefazolin injection is a cramps or fever 1. Assess for possible
Brand Name bactericidal. cephalosporin antibacterial contraindications and known allergies
during treatment
Kefzol and Ancef indicated for preoperative thru patients' chart Evaluate the
prophylaxis. (1.1) Limitations of or for up to two client's health history of analgesic use
Pharmacologic effect Use: Use an alternative cefazolin or more months and substance abuse, tramadol is not
First generation product when lengthy surgical after stopping suggested for opioid-dependent
cephalosporin procedures require supplemental treatment individual or who have received
Therapeutic effect doses and when postoperative opioids in the past for more than one
Antibiotics dosing is required. (1.2) To  rash week.
reduce the development of drug- 2. Monitor the patient's level of pain
Route resistant bacteria and maintain  hives by allowing the patient to verbalize
Intravenous (IV) the effectiveness of Cefazolin their level of pain and by observing
 itching
injection and other antibacterial them.
Dose drugs, Cefazolin injection should  difficulty 3. Observe if patient is on other
500 mg be used only to prevent infections opioid analgesic as they cause
breathing or
that are proven or strongly excessive doses that would lead to
suspected to be caused by swallowing seizure.
bacteria Tx:
 blistering,
1. Provide precaution to pregnant
Contraindications: peeling, or patients that they are prohibited from
shedding skin taking this drug since it may lead to
Cefazolin for injection is neonatal respiratory depression.
 swelling in legs
contraindicated in patients who 2. Administered naloxone in case of
and feet toxicity or when patient respiratory
have a history of immediate
drops below 12 bpm it serve as an
hypersensitivity reactions (e.g.  decreased
antidote.
anaphylaxis, serious skin urination 3. Provide and review the purpose
reactions) to cefazolin or the and importance of the druc.
cephalosporin class of Edx:
antibacterial drugs, penicillins, or  dark urine 1. Educated about the adverse effects
other betalactams. Kidney, liver, of the drug.
or gastrointostinal disease  yellowing of 2. Advise and give precaution to
skin or eyes pregnant patients that they are
(ospocially colitis) pregnant, plan
prohibited from taking this drug since
to become pregnant. or are  pain in the upper it may lead to neonatal respiratory
breastfeeding. right part of depression.
stomach 3. Warn patient and caregivers of
Drug to drug interaction: patient taking tramadol to watch for
 fainting slow or shallow breathing, difficulty
Probenecid: The renal excretion or noisy breathing, confusion,
of cefazolin is inhibited by  a return of fever, excessive sleepiness, trouble
probenecid. Co-administration of sore throat, breastfeeding, or limpness. If any of
probenecid with cefazolin is not chills, or other these signs or symptoms occur, tell
recommended.. signs of infection them to stop. drug and seek
immediate emergency medical
Drug to food interaction: attention.

No interactions found.
During:
Dx:
1. Assess for level of pain relief and
administer prn dose as needed but not
to exceed the recommend total daily
dose.
2. Monitor and record regular weights
to monitor fluid changes.
3. Monitor continuously the vital
signs and assess for orthostatic
hypotension or signs of CNS
depression.
Tx:
1. Provide controlled environment
(temperature, lighting) if sweating or
CNS effects occur.
2. Administer with food or milk to
prevent GI upset.
3. Administer drug early in the day so
increased urination will not disturb
sleep.
Edx:
1. Encourage patient to cougha nd
breathe deeply every 2 hr to prevent
atelectesis and pneumonia.
2. Instruct patient to increase fluid
intake to prevent dry mouth and
constipation.
3. Advise and explain assessment and
monitoring process to patient and
family. Instruct the to immediately
report difficulty breathing or other
signs or ymptonms of a potential
adverse opioid-related reaction.

After:
Dx:
1. Monitor ambulation and employ
appropriate safety precautions,
especially seizure precautions, as
seizures.
2. Assess patient for possible adverse
effects. (Nausea, vomiting,
constipation, lightheadedness etc.)
3. Monitor serum electrolytes,
hydration, and liver function during
long-term therapy.
Tx:
1. Administered naloxone in case of
toxicity or when patient respiratory
drops below 12 bpm it serve as an
antidote.
2. Provide diet rich in potassium or
give supplemental potassium.
3. Assist patient when rising up out of
bed slowly and dangle feet for few
minutes before standing up.
Edx:
1. Encourage patient to increase fluit
intake and fiber intake during meal
rounds to help prevent constipation.
2. Instuct patient to do deep
breathing exercises to prevent
atelactasis, pneumonia since this
medication is CNS depressants which
sedates the body.
3. Advised patient to ambulate when
tolerated to help move peristalsis.
Drug Name Mechanism of Action Indication / Contraindications Adverse Effects Nursing Considerations

Generic Name Inhibits cell-wall synthesis, Indication: ADVERSE REACTIONS NURSING CONSIDERATIONS
Cefepime Hydrochloride promoting osmotic • Monitor patient for superinfection,
instability; usually Used to treat infections caused by CNS: fever, headache. CV: including CDAD and
Brand Name bactericidal. bacteria such as pneumonia;
phlebitis. pseudomembranous colitis, which can
Suprax bronchitis; gonorrhea; and car, lung,
Gl: diarrhea, nausea, occur more than 2 months after f-nal
Cefepime is a throat, and urinary tract infections.
Pharmacologic effect bactericidal Antibiotics will not work for colds, vomiting. dose. Drug may cause overgrowth of
Fourth generation cephalosporin with a flu, or other viral infections. Skin: rash, pruritus. Other non-susceptible bacteria or fungi.
cephalosporin mode of action similar anaphylaxis, pain, • Drug may alter PT and increase
to other beta-lactam Contraindications: inflammation, bleeding risk. Patients at risk include
Therapeutic effect antibiotics.5,6 Cefepi hypersensitivity reactions. those with renal or hepatic
Antibiotics me disrupts bacterial Cefixime is contraindicated in Genitourinary: vaginitis, impairment or poor nutrition and
cell walls by binding patients with known allergy to renal injury. those receiving prolonged therapy.
Route
and inhibiting the cephalosporin group of Monitor PT and INR in these
Intravenous (IV)
transpeptidases antibiotics; contraindicated in patients. Give vitamin K, as
known as penicillin-
Dose conditions like hypersensitivity indicated. • Look alike-sound alike:
500mg, 1g, 2g; pwd for IV binding proteins
Don't confuse drug with other
infusion or IM injection after (PBPs), which are
Drug to drug interaction: cephalosporins that sound alike.
reconstitution enzymes involved in
the final stages of
Aminoglycosides: May increase
peptidoglycan layer risk of nephrotoxicity. Monitor
synthesis. This results renal function closely. Estrogen- PATIENT TEACHING
in the lysis and death based contraceptives: May • Warn patient receiving drug IM that
of susceptible decrease contraceptive absorption pain may occur at injection site.
microorganisms and effectiveness. Patient should • Advise patient to promptly report all
avoid use together or use non- adverse reactions, including rash, and
hormonal contraception for signs and symptoms of superinfection
duration of antibiotic (or 14 days,
(such as recurring fever, chills,
whichever is longer) and for 7
days after completion of malaise, and diarrhea).
antibiotic. Live-virus vaccines:
May decrease effectiveness of
live-virus vaccines. Concurrent
use isn't recommended. Potent
diuretics: May increase risk of
nephro-toxicity. Monitor renal
function closely. Probenecid:
May inhibit renal excretion of
cefepime. Monitor patient for
adverse reac-tions. Warfarin:
May enhance anticoagulant
effects. Monitor therapy.

Drug to food interaction:

No interactions found.
Drug Name Mechanism of Action Indication / Contraindications Adverse Effects Nursing Considerations

Generic Name Inhibits cell-wall synthesis, Indication: ADVERSE REACTIONS  Assess for infection
Ceftaroline fosamil promoting osmotic (vital signs; appearance
Brand Name instability; usually Ceftaroline fosamil is an skin rash, hives, of wound, sputum,
bactericidal. antibacterial drug. neutropenia, urine, and stool; WBC)
Teflaro, Zinforo Treatment of acute thrombocytopenia, and
at beginning of and
Binds to bacterial cell bacterial skin/skin anemia
throughout therapy.
Pharmacologic effect wall membrane, structure infections and
Fourth generation  Before initiating therapy,
causing cell death. community-acquired
cephalosporin obtain a history to
pneumonia. Gastrointestinal
Broad-spectrum semi- determine previous use
Therapeutic effect synthetic third-generation
Pseudomembrano of and reactions to
Antibiotics Contraindications: 
cephalosporin antibiotic.
us colitis (life- penicillins,
Preferentially binds to one or cephalosporins, or
Route more of the penicillin- Contraindicated in: Known threatening)
serious hypersensitivity to diarrhea carbapenems. Persons
Intravenous (IV) binding proteins (PBP) 
 located on cell walls of cephalosporins.  nausea with a negative history
Dose susceptible organisms. This Use Cautiously in: Known of sensitivity may still
500mg, 1g, 2g; pwd for IV inhibits third and final stage Dermatologic
of bacterial cell wall
hypersensitivity to other beta- have an allergic
infusion or IM injection after
synthesis, thus killing the lactams;Renal impairment response.
reconstitution  rash
bacteria. Generally active (dosage ↓ required for CCr  Obtain specimens for
against a wide variety of ≤50 culture and sensitivity
gram-negative hacteria mL/min); Geriatric: Dose Hematologic before initiating therapy.
including most of the adjustment may be necessary First dose may be given
Enterobacteriaceue. Also
for age-related ↓ in renal  hemolytic anemia before receiving results.
active against some
organisms resistant to first- function; Obstetric: Use only  Observe patient for
Local
and second-generation if potential benefit outweighs signs and symptoms
cephalosporins, and currently potential risk to  phlebitis at of anaphylaxis (rash,
available aminosIveoside fetus; Lactation: Use pruritus, laryngeal
antibiotics and penicillins. injection site
cautiously if breast edema, wheezing).
feeding; Pediatric: Safety Miscellaneous Discontinue the drug
and effectiveness not and notify health care
established.  hypersensitivity professional
reactions immediately if these
including symptoms occur.
Known serious anaphylaxis (life- Keep epinephrine, an
hypersensitivity to threatening) antihistamine, and
ceftaroline, other resuscitation
members of the equipment close by in
the event of an
cephalosporin class, or
anaphylactic reaction.
any component of the  Monitor bowel
formulation. function. Diarrhea,
abdominal cramping,
Drug to drug interaction:
fever, and bloody
 stools should be
Ceftaroline has previously been reported to health care
reported to cause an increased
risk of bleeding in patients taking professional promptly
warfarin as a sign of
pseudomembranous
Drug to food interaction: colitis. May begin up
to several mo
No interactions found.
following cessation of
therapy.
 Lab Test
Considerations: May
cause seroconversion
from a negative to a
positive direct Coombs'
test. If anemia develops
during or after therapy,
perform a direct
Coombs' test. If drug-
induced hemolytic
anemia is suspected,
discontinue ceftaroline
and provide supportive
care.

 Explain the purpose of

ceftaroline to patient.
Emphasize the importance
 of completing therapy,
even if feeling better.
 Instruct patient to notify
health care professional
if fever and diarrhea
develop, especially if
stool contains blood, pus,
or mucus. Advise patient
not to treat diarrhea
without consulting health
care professional.