Name CefuroximeIV 50mg q6 ANTIINFECTIVE;A NTIBIOTIC; SECONDGENERATIONCEP HALOSPORIN

MOA Cefuroxime is a second generation cephalosporin with a broad antimicrobial activity against both Gram-positive and Gram-negative organisms. It has excellent in vitro activity against staphylococcal strains, streptococcal strains (other than enterococci), N. gonorrhoeae, H. influenzae and N. meningitidis. It also has excellent in vitro activity against members of the Enterobacteriaceae with the exception of Serratia and indole-positive Proteus. Ps. aeruginosa and B. fragilis are resistant.

Adverse Effect Body as a Whole: Thrombophlebitis(IV site); pain,burning, cellulitis(IM site);superinfections,p ositive Coombs'test. GI: Diarrhea, nausea, antibioticassociated colitis. Skin: Rash,pruritus, urticaria. Urogenital: Increased serumcreatinine andBUN, decreasedcreatinineclear ance

Indication It is effective forthe treatment of penicillinaseproducing Neisseriagonorrhoea (PPNG).Effectively treatsbone and jointinfections,bronc hitis,meningitis,gono rrhea, otitismedia,pharyngit is/tonsillitis, sinusitis, lowerrespiratory tractinfections, skin andsoft tissueinfections, urinarytract infections, andis used for surgicalprophylaxis,r educing oreliminatinginfectio n

Contraindication Hypersensitivity t ocephalosporins and relatedantibiotics ; pregnancy(categ ory B), lactation ADVERSE Adverse Reactions: Vomitin g, abdominal pain, colitis, vaginiti s including vaginalcandidiasis, toxic nephropathy, hepatic dysfunction including cholestasis, aplastic anemia, hemolytic anemia, and hemorrhage. Several cephalosporins, including cefuroxime (cefuroxime (cefuroxime injection) injection) , have been implicated in triggering seizures,

Nursing Responsibility Determine history of hypersensitivi tyreactions tocephalosporin s,penicillins, and historyof allergies,particul arly to drugs,before therapy isinitiated. Inspect IM and IVinjection sitesfrequently for signs of phlebitis. Report onset of loosestools or diarrhea.Althou ghpseudomemb ranouscolitis. Monitor I&O rates andpattern: Especiallyimport ant in severelyill patients receivinghigh doses. Reportany significantchang es

particularly in patients with renal impairment when the dosage was not reduced (see DOSAGE AND ADMINISTRATION) . If seizures associated with drug therapy should occur, the drug should be discontinued. Antico nvulsant therapy can be given if clinically indicated.

DRUG INTERACTIONS Drug/Laboratory Test Interactions A false-positive reaction for glucose in the urine may occur with copper reduction tests (Benedict's or Fehling's solution or with Clinitest tablets) but not with enzyme-based tests for glycosuria. As a false-negative result

may occur in the ferricyanide test, it is recommended that either the glucose oxidase or hexokinase method be used to determine blood plasma glucose levels in patients receiving cefuroxime (cefuroxime injection) . Cefuroxime (cefuroxime (cefuroxime injection) injection) does not interfere with the assay of serum and urine creatinine by the alkaline picrate method.

Name Dobutamine

MOA Stimulatesheats beta1receptors toincreasemyocardialcontracti lity andstroke

Adverse Effect CNS:headache CV:hypertension,increasedhea rt rate

Indication ncrease cardiacoutput in short-terntreatment of cardiacdecompensationcause by

Contraindication Contraindicatedin patientshypersensitiv e todrug or itscomponents andin

Nursing Responsibility Before startingtherapy, give a plasma volumeto correcthypovolemia ana cardiacglycoside

volume.At therapeuticdosage s, drugincreasescardiac output by decreasing peripheralvascular resistance,reducingventricul ar filling pressure,and facilitatingAV nodeconduction

depressedcontractility, suc has during refractoryheart failure;adjunctive therapyin cardiac surgery

those w/idiopathichypertrop hicsubaortic stenosis

Continuouslymonitor ECG, blood pressure, pulmonaryarter y wedge pressure,cardiac outputand urineoutput

Tell patientto reportadversereactions p romptly,especiallylabore d breathing anddruginducedheadache Instruct pati8ent toreportdiscomfort atI.V. insertionsite