Ceftriaxone PDF
Ceftriaxone PDF
1 Half-life: 6– 9 hr.
TIME/ACTION PROFILE PDF Page #1
cefTRIAXone (sef-try-ax-one) ROUTE ONSET PEAK DURATION
Rocephin IM rapid 1–2 hr 12–24 hr
Classification IV rapid end of infusion 12–24 hr
Therapeutic: anti-infectives
Pharmacologic: third-generation cephalosporins Contraindications/Precautions
Pregnancy Category B Contraindicated in: Hypersensitivity to cephalosporins; Serious hypersensitivity
to penicillins; Pedi: Neonates ⱕ28 days (use in hyperbilirubinemic neonates may
lead to kernicterus); Pedi: Neonates ⱕ28 days requiring calcium-containing IV solu-
Indications tions (qrisk of precipitation formation).
Treatment of: Skin and skin structure infections, Bone and joint infections, Compli- Use Cautiously in: Combined severe hepatic and renal impairment (dose reduc-
cated and uncomplicated urinary tract infections, Uncomplicated gynecological in- tion/qdosing interval recommended); History of GI disease, especially colitis; OB,
fections including gonorrhea, Lower respiratory tract infections, Intra-abdominal in- Lactation: Pregnancy and lactation.
fections, Septicemia, Meningitis, Otitis media. Perioperative prophylaxis.
Adverse Reactions/Side Effects
Action CNS: SEIZURES (high doses). GI: PSEUDOMEMBRANOUS COLITIS, diarrhea, cholelithia-
Binds to the bacterial cell wall membrane, causing cell death. Therapeutic Ef- sis, gallbladder sludging. Derm: rashes, urticaria. Hemat: bleeding, eosinophilia,
fects: Bactericidal action against susceptible bacteria. Spectrum: Similar to that of hemolytic anemia, leukopenia, thrombocytosis. Local: pain at IM site, phlebitis at IV
second-generation cephalosporins, but activity against staphylococci is less, while site. Misc: allergic reactions including ANAPHYLAXIS, superinfection.
activity against gram-negative pathogens is greater, even for organisms resistant to
first- and second-generation agents. Notable is increased action against: Acinetobac- Interactions
ter, Enterobacter, Haemophilus influenzae (including -lactamase-producing Drug-Drug: Should not be administered concomitantly with any calcium-contain-
strains), Haemophilus parainfluenzae, Escherichia coli, Klebsiella pneumoniae, ing solutions.
Morganella morganii, Neisseria, Proteus, Providencia, Serratia, Moraxella catar- Route/Dosage
rhalis. Has some activity against anaerobes, includingBacteroides fragilis. Not active IM, IV (Adults): Most infections— 1– 2 g every 12– 24 hr Gonorrhea— 250 mg
against methicillin-resistant staphylococci or enterococci. IM (single dose). Meningitis— 2 g every 12 hr. Perioperative prophylaxis— 1 g
0.5– 2 hr before surgery (single dose).
Pharmacokinetics IM, IV (Children): Most infections— 50– 75 mg/kg/day (not to exceed 2 g/day)
Absorption: Well absorbed following IM administration; IV administration results divided every 12– 24 hr. Meningitis— 100 mg/kg/day (not to exceed 4 g/day) di-
in complete bioavailability. vided every 12– 24 hr or Uncomplicated gonorrhea— 125 mg IM (single dose).
Distribution: Widely distributed. CSF penetration better than with first- and sec- Acute otitis media— 50 mg/kg (not to exceed 1 g) IM single dose.
ond-generation agents. Crosses the placenta; enters breast milk in low concentra-
tions. NURSING IMPLICATIONS
Protein Binding: ⱖ90%. Assessment
Metabolism and Excretion: 33– 67% excreted in urine as unchanged drug; re- ● Assess for infection (vital signs; appearance of wound, sputum, urine, and stool;
mainder excreted in feces. WBC) at beginning of and throughout therapy.
⫽ Canadian drug name. ⫽ Genetic Implication. CAPITALS indicate life-threatening, underlines indicate most frequent. Strikethrough ⫽ Discontinued.
Name /bks_53161_deglins_md_disk/ceftriaxone 02/19/2014 09:43AM Plate # 0-Composite pg 2 # 2
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PDF Page #3
CONTINUED
cefTRIAXone
caspofungin, chloramphenicol, chlorpromazine, clindamycin, dantrolene, diaze-
pam, diazoxide, diphenhydramine, dobutamine, doxorubicin hydrochloride, epi-
rubicin, filgrastim, ganciclovir, haloperidol, hetastarch, hydralazine, hydroxyzine,
idarubicin, imipenem/cilastatin, irinotecan, labetalol, magnesium sulfate, mito-
xantrone, mycophenolate, pentamidine, pentazocine, pentobarbital, phenytoin,
prochlorperazine, promethazine, protamine, quinupristin/dalfopristin, tobramy-
cin, trimethoprim/sulfamethoxazole, vinorelbine, Calcium-containing solutions,
including parenteral nutrition, should not be mixed or co-administered, even via
different infusion lines at different sites in patients ⬍28 days old. In older patients,
flush line thoroughly between infusions.
Patient/Family Teaching
● Advise patient to report signs of superinfection (furry overgrowth on the tongue,
vaginal itching or discharge, loose or foul-smelling stools) and allergy.
● Instruct patient to notify health care professional if fever and diarrhea
develop, especially if diarrhea contains blood, mucus, or pus. Advise pa-
tient not to treat diarrhea without consulting health care professional.
Evaluation/Desired Outcomes
● Resolution of the signs and symptoms of infection. Length of time for complete res-
olution depends on the organism and site of infection.
● Decreased incidence of infection when used for prophylaxis.
Why was this drug prescribed for your patient?
⫽ Canadian drug name. ⫽ Genetic Implication. CAPITALS indicate life-threatening, underlines indicate most frequent. Strikethrough ⫽ Discontinued.