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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 1-1 1/3 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
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