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Nursing Notes and Community

Drug Name cefuroxime (se fyoor ox' eem) cefuroxime axetil Ceftin cefuroxime sodium Zinacef Pregnancy Category B Drug classes Antibiotic Cephalospori n (second generation)

Dosages PO Uncomplicated UTI 125 mg twice daily. Respiratory tract infections 250-500 mg twice daily. Uncomplicated gonorrhea W/ oral probenecid: 1 g as a single dose. IV Meningitis 3 g 8 hrly. IM Gonorrhea W/ oral probenecid: 1.5 g as a single dose. IV/IM Surgical prophylaxis 1.5 g IV per-op, then 750 mg IM 8 hrly for up to 24-48 hr. Susceptible infections 750 mg 8 hrly, up to 1.5 g 6-8 hrly for severe infections.

Therapeutic Actions Cefuroxime binds to one or more of the penicillinbinding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death. Absorption: Absorbed from the GI tract with peak plasma concentrations after 2-3 hr (oral); may be enhanced by the presence of food. Distribution: Pleural and synovial fluid, sputum, bone and aqueous fluids; CSF (therapeutic concentrations). Crosses the placenta and enters breast milk. Proteinbinding: Up to 50%. Metabolism: Rapidly hydrolysed (intestinal mucosa and blood). Excretion: Via the

Indications Oral (cefuroxime axetil) Pharyngitis, tonsillitis caused by Streptococcus pyogenes Otitis media caused by Streptococcus pneumoniae, S. pyogenes, Haemophilus influenzae, Moraxella catarrhalis Lower respiratory infections caused by S. pneumoniae, Haemophilus parainfluenzae, H. influenzae UTIs caused by Escherichia coli, Klebsiella pneumoniae Uncomplicated gonorrhea (urethral and endocervical) Dermatologic infections, including impetigo caused by Streptococcus aureus, S. pyogenes Treatment of early Lyme disease Parenteral (cefuroxime sodium) Lower respiratory infections caused by S. pneumoniae, S. aureus, E. coli, Klebsiella, H. influenzae, S. pyogenes

Adverse effects Large doses can cause cerebral irritation and convulsions; nausea, vomiting, diarrhea, GI disturbances ; erythema multiforme, StevensJohnson syndrome, epidermal necrolysis. Potentially Fatal: Anaphylaxis, nephrotoxicit y, pseudomem branous colitis.

Contraindicatio ns Hypersensitivity to cephalosporins.

Nursing considerations Assessment History: Hepatic and renal impairment, lactation, pregnancy Physical: Skin status, LFTs, renal function tests, culture of affected area, sensitivity tests Interventions Culture infection, and arrange for sensitivity tests before and during therapy if expected response is not seen. Give oral drug with food to decrease GI upset and enhance absorption. Give oral drug to children who can swallow tablets; crushing the drug results in a bitter, unpleasant taste. Have vitamin K available in case hypoprothrombinemia occurs. Discontinue if hypersensitivity reaction occurs. Teaching points Oral drug Take full course of therapy even if you are feeling better.

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urine by glomerular filtration and renal tubular secretion (as unchanged); via bile (small amounts); 70 min (elimination halflife); prolonged in neonates and renal impairment.

Dermatologic infections caused by S. aureus, S. pyogenes, E. coli, Klebsiella, Enterobacter UTIs caused by E. coli, Klebsiella Uncomplicated and disseminated gonorrhea caused by N. gonorrhoeae Septicemia caused by S. pneumoniae, S. aureus, E. coli, Klebsiella, H. influenzae Meningitis caused by S. pneumoniae, H. influenzae, S. aureus, N. meningitidis Bone and joint infections caused by S. aureus Perioperative prophylaxis Treatment of acute bacterial maxillary sinusitis in patients 3 mo12 yr

This drug is specific for this infection and should not be used to self-treat other problems. Swallow tablets whole; do not crush them. Take the drug with food. You may experience these side effects: Stomach upset or diarrhea. Report severe diarrhea with blood, pus, or mucus; rash; difficulty breathing; unusual tiredness, fatigue; unusual bleeding or bruising; unusual itching or irritation. Parenteral drug Avoid alcohol while taking this drug and for 3 days after because severe reactions often occur. You may experience these side effects: Stomach upset or diarrhea. Report severe diarrhea, difficulty breathing, unusual tiredness or fatigue, pain at injection site.

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