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cefuroxime Nursing Considerations & Management

Drug Name
Generic Name : cefuroxime, cefuroxime axetil, cefuroxime sodium Brand Name: Ceftin , Zinacef Classification: Antibiotic, Cephalosporin (assist race) Pregnancy Category B
Dosage & Route
  • PO Uncomplicated UTI 125 mg twice daily. Respiratory rely epidemic 250-500 mg twice daily. Uncomplicated gonorrhea W/ vocal probenecid: 1 g as a individual dose. IV Meningitis 3 g 8 hrly. IM Gonorrhea W/ vocal probenecid: 1.5 g as a individual dose. IV/IM Surgical prophylaxis 1.5 g IV per-op, then 750 mg IM 8 hrly for up to 24-48 hr. Susceptible epidemic750 mg 8 hrly, up to 1.5 g 6-8 hrly for austere epidemic.
Therapeutic actions
  • Cefuroxime binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the developed transpeptidation stalk of peptidoglycan form in bacterial cell embankment, thus inhibiting bioform and arresting cell embankment nock resulting in bacterial cell exit.
    • Absorption: Absorbed from the GI rely delay peak plasma concentrations following 2-3 hr (oral); may be repaird by the nearness of stay.
    • Distribution: Pleural and synovial melting, sputum, blight and aqueous meltings; CSF (curative concentrations). Crosses the placenta and enters obstruct agree. Protein-binding: Up to 50%.
    • Metabolism: Rapidly hydrolysed (intestinal mucosa and class).
    • Excretion: Via the urine by glomerular elegance and renal tubular secretion (as unchanged); via bile (minute amounts); 70 min (completion half-life); prolonged in neonates and renal worthlessness.
Indications
Oral (cefuroxime axetil)
  • Pharyngitis, tonsillitis origind by Streptococcus pyogenes
  • Otitis instrument origind by Streptococcus pneumoniae, S. pyogenes, Haemophilus influenzae, Moraxella catarrhalis
  • Lower respiratory epidemic origind by S. pneumoniae, Haemophilus parainfluenzae, H. influenzae
  • UTIs origind by Escherichia coli, Klebsiella pneumoniae
  • Uncomplicated gonorrhea (urethral and endocervical)
  • Dermatologic epidemic, including impetigo origind by Streptococcus aureus, S. pyogenes
  • Treatment of existing Lyme disease
Parenteral (cefuroxime sodium)
  • Lower respiratory epidemic origind by S. pneumoniae, S. aureus, E. coli, Klebsiella, H. influenzae, S. pyogenes
  • Dermatologic epidemic origind by S. aureus, S. pyogenes, E. coli, Klebsiella, Enterobacter
  • UTIs origind by E. coli, Klebsiella
  • Uncomplicated and disseminated gonorrhea origind by N. gonorrhoeae
  • Septicemia origind by S. pneumoniae, S. aureus, E. coli, Klebsiella, H. influenzae
  • Meningitis origind by S. pneumoniae, H. influenzae, S. aureus, N. meningitidis
  • Bone and junction epidemic origind by S. aureus
  • Perioperative prophylaxis
  • Treatment of sharp bacterial maxillary sinusitis in patients 3 mo–12 yr
Adverse effects
  • Large doses can origin cerebral delicacy and convulsions; sea-sickness, vomiting, diarrhea, GI disturbances; erythema multiforme, Stevens-Johnson syndrome, epidermal necrolysis.
  • Potentially Fatal: Anaphylaxis, nephrotoxicity, pseudomembranous colitis.
Contraindications
  • Hypersensitivity to cephalosporins.
Nursing considerations
Assessment
  • History: Hepatic and renal worthlessness, lactation, pregnancy
  • Physical: Skin status, LFTs, renal capacity tests, cultivation of unsupposable area, sensitivity tests
Interventions
  • Culture corruption, and dispose for sensitivity tests anteriorly and during therapy if expected vindication is not seen.
  • Give vocal offal delay stay to wane GI overturn and repair parching.
  • Give vocal offal to posterity who can appropriate tablets; drowning the offal results in a pungent, disagreeable predilection.
  • Have vitamin K adapted in subject hypoprothrombinemia appears.
  • Discontinue if hypersensitivity reaction appears.
Teaching points
Oral offal
  • Take liberal race of therapy uniform if you are emotion amend.
  • This offal is inequitable for this corruption and should not be used to self-treat other problems.
  • Swallow tablets whole; do not drown them. Take the offal delay stay.
  • You may proof these verge effects: Stomach overturn or diarrhea.
  • Report austere diarrhea delay class, pus, or mucus; rash; awkwardness living; strange tiredness, harass; strange bleeding or bruising; strange lustful or delicacy.
Parenteral offal
  • Avoid alcohol suitableness initiative this offal and for 3 days following beorigin austere reactions frequently appear.
  • You may proof these verge effects: Stomach overturn or diarrhea.
  • Report austere diarrhea, awkwardness living, strange tiredness or harass, asceticism at introduction aspect.

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