GENERIC NAME: cefixime Classification: Antibiotic Dosage: 200 g Route: 1 tab Freq: BID Mechanism of Action: Like all

beta-lactam antibiotics, cefixime binds to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, causing the inhibition of the third and last stage of bacterial cell wall synthesis. Cell lysis is then mediated by bacterial cell wall autolytic enzymes such as autolysins; it is possible that cefixime interferes with an autolysin inhibitor. PRESCRIBED FOR: Cefixime is effective for infections of the middle ear (otitis media), tonsillitis, throat infections (pharyngitis), laryngitis, bronchitis, and pneumonia caused by susceptible bacteria. It also is used for treatingurinary tract infections and gonorrhea as well as acute bacterial bronchitis in patients with chronic obstructive pulmonary disease (COPD)..

For use in the treatment of the following infections when caused by susceptible strains of the designated microorganisms: (1) uncomplicated urinary tract infections caused by Escherichia coli and Proteus mirabilis, (2) otitis media caused byHaemophilus influenzae (beta-lactamase positive and negative strains), Moraxella catarrhalis (most of which are beta-lactamase positive), and S. pyogenes, (3) pharyngitis and tonsillitis caused by S. pyogenes, (4) acute bronchitis and acute exacerbations of chronic bronchitis caused by Streptococcus pneumoniae and Haemophilus influenzae (betalactamase positive and negative strains), and (5) uncomplicated gonorrhea (cervical/urethral) caused by Neisseria gonorrhoeae(penicillinase- and nonpenicillinase-producing strains).

Reported side effects include diarrhea, nausea, abdominal pain, vomiting, skin rash, fever, joint pain and arthritis, abnormal liver tests,vaginitis, itching, headaches, and dizziness. Adverse Effects: seizures, cholelithiasis, urticaria, agranulocytosis, eosinophilia, hemolytic anemia.

Cefixime is contraindicated in patients with known allergies to the cephalosporin or penicillin antibiotics

Nursing Responsibilities: Asses for infection at beginning of and throughout therapy. Obtain specimens for culture and sensitivity before initiating therapy. Observe patient for signs and symptoms of anaphylaxis ( rash, pruritus, laryngealedema, wheezing)

GENERIC NAME: Potassium Citrate BRAND NAME: Acalka CLASSIFICATION: Antiurolithic DOSAGE: 10 mEqq Freq: TID Route: PO MECHANISM OF ACTION: The aim of the treatment is to restore the level of the urinary citrate and to increase the pH of urine to 6-7, and to this end, the dosage pattern are: - In patients with slight hypocitraturia start the treatment with a dose of 30mEq (3 tabs/day, divided into 3 takings daily. It is recommended to take the tablets 30 minutes after meals. Approx 24 hrs after having started the treatment, make a determination of urinary citrate and pH, and adjust the dose in accordance with the needs of the patient. If necessary, the dose can be increased, though it is not advisable to exceed the dose of 100 mEq (10 tablets)/day. INDICATION: -Treatment of patients with renal lithiasis and hypocitraturia, chronic formers of calcium oxalate, phospate calculia. - Uric acid lithiasis alone or accompanied by calcium lithiasis CONTRAINDICATIONS: - Renal insufficiency Persistent alkaline urinary infections - Obstruction of the urinary tract - HyperpotassemiaAdrenal insufficiency - Respiratory or metabolic alkalosis - Active peptic ulcer - Intestinal obstruction

- Patients submitted to anticholinergic therapy - Patients with slow gastric emptying. SIDE EFFECTS/ ADVERSE EFFECTS: - Slight gastrointestinal disorders may appear which can be palliated by means of the joint administration of food. NURSING IMPLICATIONS/RESPONSIBILITIES: - The tablets must not be masticated or diluted. The active component of Acalka is contained with a porous wax matrix. As this was matrix is insoluble, it can be eliminated in visible form in the feces. The active component, however, has been released in the gastrointestinal tract. - Must not be administered to patients receiving potassium-sparing diuretics (traimterene, spirolactone, or amyloride). - It is advisable to carry out an evaluation of electrolytes (Na-K-Cl) and CO2, creatinine and hemogram every 4 hrs. - It is recommended that the patients in treatment with Acalka follow a diet w/o salt and increase the intake of fluids. - The recommended treatment in case of hyperpotassemia is: IV administratioin f 10% dextrose solution, containing 10-12 units of insulin/1000ml. Correction of the possible acidosis with IV sodium bicarboate and hemodialysis or peritoneal dialysis.