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INTRODUCTION

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cefazolin (sef-a-zoe-lin)

Ancef, Kefzol

Classification

Therapeutic: anti-infectives

Pharmacologic: first-generation cephalosporins

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Indications
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Treatment of the following infections due to susceptible organisms: Skin and skin structure infections (including burn wounds); Pneumonia; Urinary tract infections; Biliary tract infections; Genital infections; Bone and joint infections; Septicemia; Bacterial endocarditis prophylaxis for dental and upper respiratory procedures. Perioperative prophylaxis. Not suitable for the treatment of meningitis.

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Action
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Binds 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 Proteus mirabilis, Escherichia coli.

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Adverse Reactions/Side Effects
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CNS: SEIZURES (HIGH DOSES). GI: PSEUDOMEMBRANOUS COLITIS, diarrhea, nausea, vomiting, cramps. Derm: rash, pruritus, urticaria, Stevens-Johnson syndrome. Hemat: leukopenia, neutropenia, thrombocytopenia. Local: pain at IM site, phlebitis at IV site. Misc: allergic reactions, including anaphylaxis and serum sickness, superinfection.

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PHYSICAL THERAPY IMPLICATIONS

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Examination and Evaluation
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  • 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). Skin reactions may indicate serious hypersensitivity reactions (Stevens-Johnson syndrome). 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.).

  • Instruct patient to report signs of leukopenia and neutropenia (fever, sore throat, signs of infection) or thrombocytopenia (bruising, nose bleeds, and bleeding gums). Report these signs to the physician.

  • Monitor injection site for pain, swelling, and irritation. Report prolonged or excessive injection site reactions to the physician.

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Interventions
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  • 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.

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Patient/Client-Related Instruction
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  • Instruct patient to notify physician 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, cramps).

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Pharmacokinetics
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