ATI Active Learning Template Medication Erythromycin Ophthalmic Eye Ointment Recommended by expert tutor

ATI Active Learning Template Medication Erythromycin Ophthalmic Eye Ointment Recommended by expert tutor Expected Pharmacological Action: Action: Suppresses protein synthesis at the level of the 50S bacterial ribosome. Therapeutic Effects: Bacteriostatic action against susceptible bacteria. Spectrum: Active against many gram-positive cocci, including: Streptococci, Staphylococci. Gram-positive bacilli, including: Clostridium, Corynebacterium. Several gramnegative pathogens, notably: Neisseria, Legionella pneumophila. Mycoplasma and Chlamydia are also usually susceptible. Therapeutic Use: IV, PO: Infections caused by susceptible organisms including: Upper and lower respiratory tract infections, Otitis media (with sulfonamides), Skin and skin structure infections, Pertussis, Diphtheria, Erythrasma, Intestinal amebiasis, Pelvic inflammatory disease, Nongonococcal urethritis, Syphilis, Legionnaires’ disease, Rheumatic fever. Useful when penicillin is the most appropriate drug but cannot be used because of hypersensitivity, including: Streptococcal infections, Treatment of syphilis or gonorrhea. Topical: Treatment of acne. Complications: CNS: seizures (rare). EENT: ototoxicity. CV: TORSADE DE POINTES, VENTRICULAR ARRHYTHMIAS, QT interval prolongation. GI: PSEUDOMEMBRANOUS COLITIS, nausea, vomiting, abdominal pain, cramping, diarrhea, hepatitis, infantile hypertrophic pyloric stenosis, pancreatitis (rare). GU: interstitial nephritis. Derm: rash. Local: phlebitis at IV site.Misc:allergic reactions, superinfection. Medication Administration: Contraindications/Precautions: Nursing Interventions: ● Assess for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at the beginning of and during therapy.● Obtain specimens for culture and sensitivity before initiating therapy. First dose may be given before receiving results. ● 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. ● Lab Test Considerations: Monitor liver function tests periodically on patients receiving highdose, long-term therapy. ● May cause ↑ serum bilirubin, AST, ALT, and alkaline phosphatase concentrations. ● May cause false ↑ of urinary catecholamines. Interactions: Drug-Drug: Concurrent use with pimozide may ↑ levels and the risk for serious arrhythmias (concurrent use contraindicated); similar effects may occur with diltiazem, verapamil, ketoconazole, itraconazole, nefazodone, and protease inhibitors; avoid concurrent use. May ↑ levels of ergotamine and dihydroergotamine and risk for acute ergot toxicity; concurrent use contraindicated. Concurrent use with amiodarone, dofetilide, or sotalol may ↑ risk of torsades de pointe; avoid concurrent use. May ↑ verapamil levels and the risk for hypotension, bradycardia, and lactic acidosis. ↑ blood levels and effects of sildenafil, tadalafil and vardenafil ; use lower doses. Concurrent rifabutin or rifampin may effect of erythromycin and ↑ risk of adverse GI reactions. ↑ levels and risk of toxicity from alfentanil, alprazolam, bromocriptine, carbamazepine, cyclosporine, cilostazol diazepam disopyramide, ergot alkaloids, felodipine, methylprednisolone, midazolam, quinidine, rifabutin, tacrolimus, triazolam, or vinblastine. May ↑ levels of lovastatin, and simvastatin and ↑ the risk of myopathy/rhabdomyolysis. May ↑ serum digoxin levels. Theophylline may ↓ blood levels. May ↑ colchicine levels and the risk for toxicity; use lower starting and maximumdose of colchicine. May ↑ theophylline levels and the risk for toxicity;↓ theophylline dose. May ↑ warfarin levels and the risk for bleeding Client Education: ● Educate parents on indications (and that it is mandated by the law) for use of the ophthalmic ointment following birth and adverse effects of the ointment. Evaluation of Medication Effectiveness: ● No contraction of gonorrhea/chlamydia infections (especially ophthalmic infections).