The Incidence Of Nephrotoxicity With Concomitant Use Of Vancomycin And Zosyn? How Can It Be Prevented And Or

Azithromycin (Zithromax) 500 mg IVPB q24h for~ 2 days then 500 mg PO for~ 7 days

Are there any contraindications for this drug? Hypersensitivity, cross-sensitivity with other NSAID’s such as aspirin, history of allergic reactions, asthma, advanced renal disease, hepatic dysfunctions, perioperative pain.

Amoxicillin can interact with medications such as Diuretics, oral contraceptives, Probenecid, Tetracyclines, and Warfarin (Woo, 2012).

A twenty-five-year old Caucasian female presented to the office with burning with urination. External inspection of the patient’s labia majora revealed genital herpes. Herpes simplex virus infections associated with the genitals are usually deemed type two (Uphold & Graham, 2013). The patient was placed on acyclovir for her outbreak. The current dosage that she is being placed on is 400 mg orally every eight hours for ten days (Medscape, n.d.). There are no medication contraindications for this drug; however, one should not use neomycin orally due to an increase in nephrotoxicity and or otoxicity if the two are taken together (Medscape, n.d.). Other medications such as bacitracin and cidofovir should also not be used with acyclovir due to an increase in nephrotoxicity and or otoxicity if these are

Cultures are an effective way of guiding the Infectious Disease specialist to which antibiotics that are to be used to treat the patient with MRSA by looking at the type of strain that the patient has. The culture can also be tested for susceptibility to a variety of antibiotics. Surgery may be required to debride and drain the pus filled skin from the infected area, while antibiotics, such as vancomycin, linezolid, daptomycin, quinupristin/dalfopristin, clindomycin (as well as many other sulfa drugs and tetracyclines) could be prescribed to help eradicate the infection. Some antibiotics that are used to treat MRSA are only available intravenously. Unfortunately, some high-powered antibiotics are developing resistance to MRSA infections. Because of this, Vancomycin is no longer a sure treatment for MRSA due to questions surrounding its effectiveness. Patients that are prescribed antibiotics should never stop taking their antibiotics, even if they are starting to feel better. These infections are extremely dormant and are prone to reoccur if they develop resistance to the

Because of this rise of selection for vancomycin-resistant bacteria, finding an alternative antibiotic treatment for this strain of bacteria is imperative. There has been some consideration of alternatives to vancomycin treatment of bacteria as sensitivity toward the drug decreases. Though vancomycin is still the treatment standard for methicillin-resistant bacteria, other compounds such as linezolid have proven to be more effective. Linezolid is a currently FDA approved compound that disrupts protein synthesis in the ribosomes of bacteria. The result of this disruption is

Other than slowing down the infusion rate, antihistamines can relieve and prevent the effects of red man syndrome. Antihistamines such as diphenhydramine and hydroxyzine administered before the vancomycin dose can help to reduce symptoms of pruritus and erythema. Pretreatment is usually given in IV form with 50 mg of diphenhydramine over the course of one hour. By pretreating with either diphenhydramine or hydroxyzine, red man syndrome can be prevented when the patient receives their first dose of vancomycin. Other than these pretreatments, a combination of an H1 receptor blocker with an H2 receptor blocker such as cimetidine can also reduce the risk of developing red man syndrome.7 In our patient, the IV vancomycin dose should have been discontinued because of the incorrect route and instead, she should have been given oral vancomycin. JZ should also have been given a pretreatment of 50 mg of diphenhydramine to avoid red man syndrome when given vancomycin.

Age plays an important factor when considering prescribing drugs as the very young and the elderly will have difficulty with the metabolism and excretion of drugs. Even the healthiest of the ageing population will have a degree of renal impairment which delays excretion through the kidneys, increasing the duration of action. However when dealing with an acute illness, which are the patients I encounter, a further and rapid reduction in clearance will exacerbate this process. Liver function may also be impaired during acute illness resulting in delayed drug metabolism (Beckworth & Franklin, 2007). Therefore, before any prescribing can take place a diagnosis must be accurately made and underpinned by an understanding of basic pathophysiology eg, a recent review of bloods to assess renal

Adverse reactions to this medication are migraine, speech disorders, rhinitis, sinusitis, hyperglycemia, elevated liver function, elevated serum creatinine level, pancytopenia, bronchitis, dyspnea, toxic epidermal necrolysis, anaphylaxis, elevated creatine kinase, generalized pain, and infection. Nursing considerations with this medication is to have the patient swallow the whole tablet and not to chew. Watch for aspiration while watching the patient take the medication. Educate the patient about the medication and inform them to notify a physician if bleeding

As the nurse you must hold for elevated levels, over 100-400 ng/mL; and monitor for Nephrotoxicity, hypertension, hepatotoxicity, tremors, and seizure (Urden, Stacy, & Lough, 2014, p. 963).

Absence of circulatory shock, treatment with nephrotoxic drugs, absence of gastrointestinal or renal fluid losses, and on-going bacterial infection.

Medications that can cause interactions include anticoagulants, probenecid, bisphosphonates, angiotensin-converting enzyme (ACE) inhibitors, anticoagulants (Warfarin), antiplatelet medicines (Clopidogrel), aspirin, corticosteroids (Prednisone), heparin, other NSAIDs (Ibuprofen), Rivaroxaban, or Selective Serotonin Reuptake Inhibitors (SSRIs) (Fluoxetine) due to the risk of stomach bleeding may be increased. Bisphosphonates (Alendronate), Cyclosporine, Hydantoins (Phenytoin), Lithium, Methotrexate, Quinolones (Ciprofloxacin), Sulfonamides (Sulfamethoxazole), and Sulfonylureas (Glipizide) side effects may be increased by Naproxen. The effectiveness of Angiotensin-converting enzyme (ACE) inhibitors (Enalapril), Beta-blockers (Propranolol), or diuretics (Furosemide, Hydrochlorothiazide) may be decreased by Naproxen (Lexi-Comp,

The prognosis of nephrotic syndrome depends the sensitivity to the corticosteroid treatment, the underlying cause and the patient factors. Patients who are sensitive to corticosteroid treatment have a good prognosis and their risk to develop renal failure is small, while in the other hand patients who are resistant to corticosteroid treatment have a poor prognosis and they have a high risk up to 50% to develop renal failure. The second factor is the cause of nephrotic syndrome for example idiopathic membranous nephropathy is one of the primary form of the NS and the most common type, it has an appropriate prognosis in general and the prognosis can follow one of three pathways, one is a good course with high rate of cure from the disease, another one the patient may develop edema with normal renal function and the last one may progress to renal failure within 10

What is your conclusion with regard to the effect of the drug on curing the infection? What is the odds ratio using the CMH method?

bacterial urinary tract infection, which is the most common side effect, may occur.21 Other patients