KRISTI WRAY DRUG NAME CLASS/FAMILY MECHANISM OF ACTION INDICATIONS WHY IS YOUR PATIENT GETTING THIS MEDICINE ROUTES

PATIENT DOSAGE COMMON DOSAGE PHARMACOKINETICS Generic:cefepime hydrochloride Trade Name:maxipime Antibiotic; 4th-generation cephalosporin Binds to one or more of the penicillin-binding proteins located on cell walls of susceptible organisms. This inhibits the third and final stage of bacterial cell wall synthesis, thus killing the bacteria. Uncomplicated and complicated UTI, skin and soft tissue infections, pneumonia. Empiric monotherapy for febrile neutropenic patients. Pneumonia and UTI

IV and IM 1gm IV q12h IV/IM 0.5-1 g q 12h for 7-10 days Absorption: well absorbed after IM administration; serum levels significantly lower than after equivalent IV dose. Distribution: Widely distributed, may cross inflamed meninges; crosses placenta, secreted into breast milk Metabolism: liver Elimination: Urine Half-life: 2h Intermittent: Dilute with 50-100ml of one of the following: NS, d5W, D5/NS or other capatibile solution. Administer: Intermittent: Infuse over 30 min; with Y-type administration set, discontinue other compatible solutions while infusing cefepime Incompatibilites: Solution/additive: Aminoglycosides, aminophylline, metronidazole Positive Coombs/ test without hemolysis. May cause false-positive urine glucose test with Clinitest. Hypersensitivity to cefepime, other cephalosporins, severe reaction to penicillins, or other beta-lactam antibiotics

FOR IV MEDS, COMPATIBILITY WITH IV DRIPS AND OR SOLUTIONS

LAB VALUE ALTERATIONS CAUSE BY THIS MED CONTRAINDICATIONS/ PRECAUTIONS

INTERACTIONS

AMINOGLYCOSIDES may increase risk of nephrotoxicity and have additive/synergistic effects. May decrease efficacy or ORAL CONTRACEPTIVES. Probenecid may increase levels.

ADVERSE/SIDE EFFECTS

IMP NURS RESPONSIBILITIES

PT/FAMILY TEACHING

Body as Whole: Eosinophilia GI: antibiotic-associated colitis, diarrhea, nausea, oral moniliasis, vomiting, elevated liver function test (ALT, AST) CNS: headache, fever SKIN: Phlebitis, pain, inflammation, rash, pruritus, uticaria UROGENTIAL: vaginitis Determine hx of hypersensitivity reactions to cephalosporins, penicillins, or other drugs before therapy is initiated. Lab Tests: Perform culture and sensitivity tests before initiation of therapy. Monitor for S&S of hypersensitivity. Report their appearance promptly and discontinue drug. Monitor for S&S of superinfection or pseudomembranous colitis; immediately report either to physician. With concurrent high-dose aminoglycoside therapy, closely monitor for nephrotoxicity and ototoxicity Promptly report S & S of hypersensitivity (eg:rash) or superinfection, especially unexplained diarrhea.