Ofloxacin

INTRODUCTION

Indications

PO: Treatment of the following bacterial infections: Urinary tract and gynecologic infections, including cystitis, gonorrhea, nongonococcal urethritis and cervicitis, acute pelvic inflammatory disease, and prostatitis; Respiratory tract infections, including acute exacerbations of chronic bronchitis and communityacquired pneumonia; Uncomplicated skin and skin structure infections.

Action

Inhibits bacterial DNA synthesis by inhibiting DNA gyrase enzyme. Therapeutic Effects: Death of susceptible bacteria. Spectrum: Active against gram-positive pathogens, including Staphylococcus aureus, S. epidermidis, Streptococcus pyogenes, S. pneumoniae. Gram-negative spectrum notable for activity against Escherichia coli, Klebsiella pneumoniae, Enterobacter aerogenes, Proteus mirabilis, Haemophilus influenzae, Neisseria gonorrhoeae, Moraxella catarrhalis. Additional spectrum includes Chlamydophylia pneumoniae, Legionella pneumoniae, Mycoplasma pneumoniae.

Adverse Reactions/Side Effects

CNS: SEIZURES, dizziness, drowsiness, headache, insomnia, agitation, confusion. GI: PSEUDOMEMBRANOUS COLITIS, abdominal pain, diarrhea, nausea, vomiting. GU: vaginitis. Derm: photosensitivity, rash. Endo: hyperglycemia, hypoglycemia. MS: tendinitis, tendon rupture. Neuro: peripheral neuropathy. Misc: HYPERSENSITIVITY REACTIONS, INCLUDING ANAPHYLAXIS.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Watch for seizures; notify physician immediately if patient develops or increases seizure activity.

• Monitor signs of hypersensitivity reactions and anaphylaxis, including pulmonary symptoms (tightness in the throat and chest, wheezing, cough, dyspnea) or skin reactions (rash, angioedema, pruritus, urticaria). Notify physician or nursing staff immediately if these reactions occur.

• 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 any tendon pain or joint pain. Tendinopathy and rupture can occur, especially in large, weight-bearing tendons (Achilles, patellar tendons). Risk of tendon damage is greater in patients >65 yr old, transplant recipients (i.e., kidney, heart, lung), patients with preexisting tendon damage, and patients taking corticosteroids concurrently.

• Monitor signs of peripheral neuropathy (numbness, tingling). Perform objective tests (nerve conduction, monofilaments) to document any neuropathic changes.

• Assess dizziness and drowsiness 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.

• Be alert for confusion, agitation, or other alterations in mental status. Notify the physician promptly if these symptoms develop.

• Monitor signs of hypoglycemia (weakness, malaise, irritability, fatigue) or hyperglycemia (drowsiness, fruity breath, increased urination, unusual thirst). Patients with diabetes mellitus should check blood glucose levels frequently.

Interventions

• If tendon symptoms occur, notify the physician and protect the affected area to avoid tendon ruptures. Do not stretch or exercise the affected tendon, and provide crutches, walker, or other assistive devices if lower extremities are involved.

• Always wash hands thoroughly and disinfect equipment (whirlpools, electrotherapeutic ...