ampicillin (am-pi-sil-in)

Classification
Therapeutic: anti-infectives
Pharmacologic: aminopenicillins

Indications: Treatment of the following infections: Skin and skin structure infections, Soft-tissue
infections, Otitis media, Sinusitis, Respiratory infections, Genitourinary infections, Meningitis, Septicemia.
Endocarditis prophylaxis. Unlabeled Use: Prevention of infection in certain high-risk patients undergoing
cesarean section.
Action: Binds to bacterial cell wall, resulting in cell death. Therapeutic Effects: Bactericidal action;
spectrum is broader than penicillin. Spectrum: Active against: Streptococci, nonpenicillinase-producing
staphylococci, Listeria, Pneumococci, Enterococci, Haemophilus influenzae, Escherichia coli,
Enterobacter, Klebsiella, Proteus mirabilis, Neisseria meningitidis, N. gonorrhoeae, Shigella, Salmonella.
Pharmacokinetics Absorption: Moderately absorbed from the duodenum (3050%). Distribution:
Diffuses readily into body tissues and fluids. CSF penetration isqin the presence of inflamed meninges.
Crosses the placenta; enters breast milk in small amounts. Metabolism and Excretion: Variably
metabolized by the liver (1250%). Renal excretion is variable (2560% after oral dosing; 5085% after
IM administration). Half-life: Neonates: 1.74 hr; Children and Adults: 11.5 hr (qin renal impairment).
Contraindications/Precautions Contraindicated in: Hypersensitivity to penicillins. Use Cautiously in:
Severe renal insufficiency (dose prequired if CCr _10 mL/min); Infectious mononucleosis, acute
lymphocytic leukemia or cytomegalovirus infection (qincidence of rash); Patients allergic to
cephalosporins; OB: Has been used during pregnancy; Lactation: Distributed into breast milk. Can cause
rash, diarrhea, and sensitization in the infant.
Adverse Reactions/Side Effects CNS: SEIZURES (high doses). GI: PSEUDOMEMBRANOUS
COLITIS, diarrhea, nausea, vomiting. Derm: rash, urticaria. Hemat: blood dyscrasias. Misc: allergic
reactions including ANAPHYLAXIS and SERUM SICKNESS, superinfection
NURSING IMPLICATIONS Observe patient for signs and symptoms of anaphylaxis (rash, pruritus,
laryngeal edema, wheezing). Discontinue the drug and notify health care professional immediately if
these occur. Keep epinephrine, an antihistamine, and resuscitation equipment close by in the event of an
anaphylactic reaction.
-Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to
health care professional promptly as a sign of pseudomembranous colitis. May begin up to several weeks
following cessation of therapy.
-Caution patient to notify health care professional if fever and diarrhea occur, especially if stool contains
blood, pus, or mucus. Advise patient not to treat diarrhea without consulting health care professional. May
occur up to several weeks after discontinuation of medication.