Pharmacologic: first-generation cephalosporins
Treatment of the following infections due to susceptible organisms: Skin and skin structure infections (including burn wounds), Pharyngitis and/or tonsillitis, Urinary tract infections. Not suitable for the treatment of meningitis.
Bind to bacterial cell wall membrane, causing cell death. Therapeutic Effects: Bactericidal action against susceptible bacteria. Spectrum: Active against many gram-positive cocci, including Streptococcus pneumoniae, group A beta-hemolytic streptococci, penicillinase-producing staphylococci. Not active against methicillin-resistant staphylococci, Bacteroides fragilis, Enterococcus. Active against some gram-negative rods, including Klebsiella pneumoniae, Proteus mirabilis, Moraxella catarrhalis, Escherichia coli.
Adverse Reactions/Side Effects
CNS: SEIZURES (VERY HIGH DOSES). GI: PSEUDOMEMBRANOUS COLITIS, diarrhea, nausea, vomiting, dyspepsia. Derm: rashes, pruritus, urticaria. Hemat: agranulocytosis, thrombocytopenia. Misc: allergic reactions, including anaphylaxis and serum sickness, superinfection.
PHYSICAL THERAPY IMPLICATIONS
Examination and Evaluation
Watch for seizures; notify physician immediately if patient develops or increases seizure activity.
Monitor signs of pseudomembranous colitis, including diarrhea, abdominal pain, fever, pus or mucus in stools, and other severe or prolonged GI problems (nausea, vomiting, heartburn). Notify physician or nursing staff immediately of these signs.
Monitor signs of allergic reactions and anaphylaxis, including pulmonary symptoms (tightness in the throat and chest, wheezing, cough dyspnea) or skin reactions (rash, pruritus, urticaria). Notify physician or nursing staff immediately if these reactions occur.
Assess muscle aches and joint pain (arthralgia) that may be caused by serum sickness. Notify physician if these symptoms seem to be drug related rather than caused by musculoskeletal injury or if muscle and joint pain are accompanied by allergy-like reactions (fever, rashes, etc.)
Monitor signs of agranulocytosis (fever, sore throat, mucosal lesions, signs of infection) or thrombocytopenia (bruising, nose bleeds, bleeding gums). Report these signs to the physician.
Always wash hands thoroughly and disinfect equipment (whirlpools, electrotherapeutic devices, treatment tables, and so forth) to help prevent the spread of infection. Employ universal precautions or isolation procedures as indicated for specific patients.
Instruct patient to notify physician immediately of signs of superinfection, including black, furry overgrowth on tongue, vaginal itching or discharge, and loose or foul-smelling stools.
Instruct patient and family/caregivers to report other troublesome side effects such as severe or prolonged skin problems (rash, hives, itching) or GI problems (nausea, vomiting, diarrhea, heartburn).
Absorption: Well absorbed after oral administration.
Distribution: Widely distributed. Crosses the placenta and enters breast milk in low concentrations. Minimal CSF penetration.
Metabolism and Excretion: Excreted almost entirely unchanged by the kidneys.
Half-life: 1–2 hr (increased in renal impairment).
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