CEFEPIME

U.S. Brand Name (Maxipime)

Therapeutic Category:

1.Antibiotic

2.Cephalosporin(fourth

generation)

Pregnancy Risk Factor (B)

Prototype:

Cefotaxime Sodium.

Availability:

500mg,1g,2g vials

Lactation:

Enters breast milk\use caution.

Therapeutic Effects:

1.Treats pneumonia.

2.Skin and soft tissue .

Therapeutic Effects.cont.

3.Respiratory tract.

4.intra-abdominal infections.

5.Urinary tract infection by

Eliminating S\S of infection.

Use:

1.Treatment of respiratory

tract infection including

(brochitis and pneumonia).

2.Cellulitis, skin and soft

tissue infections.

Use .Continued.

3.Urinary tract infection.

Mechanism of Action:

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs).

Contraindications:

Hypersensitivity to cefepime

Any component ,or other

Cephalosporins .

Warnings /precaution:

1.Prolonged use may result in

Cont.

Superinfection .

2.cross-sensitivity to penicillins exists (~10%).

3.Use in patients less than 2 months of age has not been established.

Drug Ineractions:

1.Increased Effect/ toxicity :

High –dose probenecid

decreases clearance and

increases effect of

cefepime.

Adverse Reaction:

>10%: hematologic:

Positive coombs‘test without

hemolysis 1%to10%:

1.dermatologic:rash,pruritus.

2.GI:diarrhea,nausea,vomiting.

Cont.

3.C.N.S.:fever(1%)headache

(1%).

4.Local:pain,erythema at injection site, phlebitis, inflammation, urticaria.

5.Urogenital:

Vaginitis .

Other reaction cephalosporins

include:toxic epidermal

necrolysis,erythema multiforme,renal

Dysfunction,aplastic anemia,

hemolytic anemia,hemorrhage…ect

Over dose:

Include:

1.Neuromusclar hypersensitivity.

2.Convulsions.

Pharmacodynamics:

Protein binding:plasma:16%to19%.

Distribution :

20%protien bound,widely dist.,may

Cross in flamed meninges ;crosses

Placenta,secreted into breast milk.

Absorption:After IM administration serum levels significantly lower than aftereqivalent IV dose.

Metabolism:

It‘s very little and metabolized in

the liver.

Elimination:

Excreted in urine .

Half –life elimination:2hours

Formulation:

Powder for injection as hydrochloride

:500mg,1g,2g.

Route and dosage:

1.Mild to moderate infections:

Adult: IV/IM 0.5-1g q12h times 7-10d

2.Moderate to severe infections:

Adult:IV 1-2g q12h time 10d.

3.Febrile neutropenia:

Adult :IV 2g q8h for 7d or until resolu-

Tion of neutropenia.

Elderly :IV/IM should be based on renal

function and severity of infection.

Administration:

1.(IM):

Inject deep I.M. into large muscle mass.

2.(IV):

Inject direct I.V. over 5min.

Stability:

1.monitoring laboratory tests:

Prothrombin time ;peform culture and

sensitivity studies prior to initiating

drug therapy.

2.compatibility:

Discontinue other solution at the same

site to avoid compatibility problems.

Cont.

C.Monitor for S/S of hypersensitivity.

D.Assess bowel function (severe diarrihea)

E.Monitor urine output (if decreased,notify

prescriber).

F.Assess for opportunistic infection(fever,

Malaise,rash,itching,redness,chills,or

increased cough)

Additional Nursing lssues:

1.Physical assessment:

A. Determine history of hypersensitivity

reaction to cephalosporins, penicillins,or

other drug before therapy is initiated.

B.Lab tests perform culture and sensitivity

tests before initiation of therapy. Dosage

may be started pending test results.

2.Geriatric Consideration:

Adjust dose for changes in renal function.

3.Patient and Family Education:A.Promptly report any S/S hypersensitivity

,superinfection and pseudomembranous colitis.

B.Do not breast feed while taking this drug without consulting physician.

Additional Information:

Each gram contain 2 mEq of

Sodium.

PH:4-6

THINK YOU

FOR GIVING ME YOUR ATTANTION

References

1.Pharmacology,2nd edition-Mary J.Mycek,

ph.D.and Richard.D.,Harvey ,ph.D.

2.Drug information hand book for nursing.

Including

assessment,administration,monitoring

guidelines and patient education.

3.Prentice hall (nurses drug guide 2006)

WWW.antibiotic guide .com

WWW.cefepime drug information.com

المضادات الحيوية–طبيب دوت كوم

WWW.drugs.com

WWW.search.drug.com

Presented by:

SAMIAH MASLUM AL- JAHANY.

2005