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clindamycin (klin-da-mye-sin)
Cleocin, Cleocin T, Clinda-Derm, Clindagel, Clindesse, ClindaMax, Clindets, C/T/S, Dalacin C, Dalacin T, Evoclin
Classification
Therapeutic: anti-infectives
Pharmacologic: lincosamides
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PO, IM, IV: Treatment of Skin and skin structure infections, Respiratory tract infections, Septicemia, Intra-abdominal infections, Gynecologic infections, Osteomyelitis, Endocarditis prophylaxis. Topical: Severe acne. Vag: Bacterial vaginosis. Unlabeled Use: PO, IM, IV: Treatment of Pneumocystis carinii pneumonia, CNS toxoplasmosis, and babesiosis.
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Inhibits protein synthesis in susceptible bacteria at the level of the 50S ribosome. Therapeutic Effects: Bactericidal or bacteriostatic, depending on susceptibility and concentration. Spectrum: Active against most gram-positive aerobic cocci, including Staphylococci, Streptococcus pneumoniae, Other streptococci, but not enterococci. Has good activity against those anaerobic bacteria that cause bacterial vaginosis, including Bacteroides fragilis, Gardnerella vaginalis, Mobiluncus spp., Mycoplasma hominis, and Corynebacterium. Also active against P. carinii and Toxoplasma gondii.
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Adverse Reactions/Side Effects
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CNS: dizziness, headache, vertigo. CV: arrhythmias, hypotension. GI: PSEUDOMEMBRANOUS COLITIS, diarrhea, bitter taste (IV only), nausea, vomiting. Derm: rashes. Local: phlebitis at IV site.
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PHYSICAL THERAPY IMPLICATIONS
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Examination and Evaluation
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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.
Assess dizziness or vertigo that might affect gait, balance, and other functional activities (See Appendix C). Report balance problems and functional limitations to the physician and nursing staff, and caution the patient and family/caregivers to guard against falls and trauma.
Assess heart rate, ECG, and heart sounds, especially during exercise (See Appendices G, H). Report any rhythm disturbances or symptoms of increased arrhythmias, including palpitations, chest discomfort, shortness of breath, fainting, and fatigue/weakness.
Assess blood pressure periodically, and compare to normal values (See Appendix F). Report low blood pressure (hypotension), especially if patient experiences dizziness, fatigue, or other symptoms.
Monitor injection site for pain, swelling, and irritation. Report prolonged or excessive injectionsite reactions to the physician.
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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.
Because of the risk of arrhythmias and hypotension, use caution during aerobic exercise and other forms of therapeutic exercise. Assess exercise tolerance frequently (blood pressure, heart rate, fatigue levels), and terminate exercise immediately if any untoward responses occur See Appendix L).
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Patient/Client-Related Instruction
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Advise patient about the likelihood of GI reactions such as nausea, vomiting, diarrhea, and taste abnormalities. Instruct patient to report severe or prolonged GI problems.
Instruct patient and family/caregivers to report other troublesome side effects ...