no. But to make sure talk to your doctor; (a-mox-i-sill'in) amoxicillin, Amoxil, Apo-Amoxi , DisperMox, Novamoxin , Nu-Amoxi , Trimox, Wymox Func. class.: Antiinfective, antiulcer Chem. class.: Aminopenicillin Do not confuse: amoxicillin/amoxapine/Amoxil Trimox/Diamox/Tylox Wymox/Tylox Action: Interferes with cell wall replication of susceptible organisms; the cell wall, rendered osmotically unstable, swells and bursts from osmotic pressure; bactericidal, lysis mediated by bacterial cell wall autolysins Uses: Treatment of skin, respiratory, GI, GU infections; otitis media, gonorrhea. For gram-positive cocci (Staphylococcus aureus, Streptococcus pyogenes, Streptococcus faecalis, Streptococcus pneumoniae), gram-negative cocci (Neisseria gonorrhoeae, Neisseria meningitidis), gram-positive bacilli (Corynebacterium diphtheriae, Listeria monocytogenes), gram-negative bacilli (Haemophilus influenzae, Escherichia coli, Proteus mirabilis, Salmonella); prophylaxis of bacterial endocarditis; in combination with other drugs used for treatment of Helicobacter pylori Unlabeled uses: Lyme disease, anthrax treatment, and prophylaxis DOSAGE AND ROUTES Systemic infections • Adult: PO 750 mg-1.75 g daily in divided doses q8h • Child: PO 20-50 mg/kg/day in divided doses q8h Renal disease • Adult: PO CCr 10-30 ml/min 250-500 mg q12h; CCr <10 ml/min 250-500 mg q24h; do not use 875 mg strength if CCr <50 ml/min Gonorrhea/urinary tract infections • Adult: PO 3 g given with 1 g probenecid as a single dose; followed by tetracycline or erythromycin therapy Chlamydia trachomatis • Adult: PO 500 mg/tid × 1 wk Bacterial endocarditis prophylaxis • Adult: PO 2 g 1 hr prior to procedure • Child: PO 50 mg/kg/hr 1 hr prior to procedure; max 2 g Helicobacter pylori • Adult: PO 1000 mg bid, given with lansoprazole 30 mg bid, clarithromycin 500 mg bid × 2 wk or 1000 mg bid given with omeprazole 20 mg bid, clarithromycin 500 mg bid × 2 wk, or 1000 mg tid given with lansoprazole 30 mg tid × 2 wk Available forms: Caps 250, 500 mg; chew tabs 125, 200, 250, 400 mg; tabs 500, 875 mg; susp pediatric drops 50 mg/ml; susp 125, 200, 250, 400 mg/5 ml SIDE EFFECTS CNS: Headache, seizures GI: Nausea, vomiting, diarrhea, increased AST, ALT, abdominal pain, glossitis, colitis, pseudomembranous colitis HEMA: Anemia, increased bleeding time, bone marrow depression, granulocytopenia INTEG: Urticaria, rash SYST: Anaphylaxis, respiratory distress, serum sickness, Stevens-Johnson syndrome Contraindications: Hypersensitivity to penicillins Precautions: Pregnancy (B), lactation, hypersensitivity to cephalosporins, neonates, severe renal disease, acute lymphocytic leukemia PHARMACOKINETICS PO: Peak 2 hr, duration 6-8 hr; half-life 1-1⅓ hr, metabolized in liver, excreted in urine, crosses placenta, enters breast milk INTERACTIONS Increase: amoxicillin level—probenecid Increase: anticoagulant action—warfarin Increase: methotrexate levels—methotrexate Decrease: effectiveness of oral contraceptives Drug/Herb • Do not use acidophilus with antiinfectives; separate by several hours Decrease: absorption—khat; separate by 2 hr Drug/Lab Test False positive: Urine glucose, urine protein, direct Coombs' test NURSING CONSIDERATIONS Assess: • I&O ratio; report hematuria, oliguria, since penicillin in high doses is nephrotoxic • Any patient with a compromised renal system, since drug is excreted slowly in poor renal system function; toxicity may occur rapidly • Hepatic studies: AST, ALT • Blood studies: WBC, RBC, Hgb and Hct, bleeding time • Renal studies: urinalysis, protein, blood, BUN, creatinine • C&S before drug therapy; drug may be given as soon as culture is taken • Bowel pattern before, during treatment; diarrhea, cramping, blood in stools, report to prescriber; pseudomembranous colitis may occur • Skin eruptions after administration of penicillin to 1 wk after discontinuing drug • Respiratory status: rate, character, wheezing, tightness in the chest • Anaphylaxis: rash, itching, dyspnea, facial/laryngeal edema Administer: PO route • Shake suspension well before each dose; may be used alone or mixed in drinks; use immediately; discard unused portion of susp after 14 days • Give around the clock, caps may be emptied and mixed with liquids if needed Perform/provide: • Adrenaline, suction, tracheostomy set, endotracheal intubation equipment on unit • Adequate intake of fluids (2 L) during diarrhea episodes • Scratch test to assess allergy after securing order from prescriber; usually done when penicillin is only drug of choice • Storage in tight container; after reconstituting, oral suspension refrigerated for 14 days Evaluate: • Therapeutic response: absence of infection; prevention of endocarditis, resolution of ulcer symptoms Teach patient/family: • That caps ma
2016-05-24 03:06:07
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answer #9
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answered by Anonymous
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