Augmenten(amoxicillin Clavulan)

NURS 1566 Clinical Form 3: Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name Trade Name Amoxicillin/clavulanate Augmenten Peak Onset Duration 1-2 hr 30 min 8-12 hr Why is your patient getting this medication Sinusitis

Mechanism of action and indications (Why med ordered) Binds to bacterial cell wall, causing cell death; spectrum of amoxicillin is broader than penicillin. Clavulanate resists action of beta-lactamase, an enzyme produced by bacteria that is capable of inactivating some penicillins

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) None for this patient

Classification Dose Anti-infectives 875 mg Normal dosage range

Route PO

Time/frequency BID /c meals

875 mg q 12 hr

For IV meds, compatibility with IV drips and/or solutions NA Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity to penicillins and clavulanate, Hepatic impairment (dose cautiously, monitor liver function)

Common side effects Diarrhea, rashes Lab value alterations caused by medicine May cause ↑ serum alkaline phosphatase, LDH, AST, and ALT concentrations. Elderly men and patients receiving prolonged treatment are at ↑ risk for hepatic dysfunction, May cause false-positive direct Coombs' test result (anit-globulin test)

Be sure to teach the patient the following about this medication Instruct patients to take medication around the clock and to finish the drug completely as directed, even if feeling better. Advise patients that sharing of this medication may be dangerous, Advise patient to report the 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 immediately if diarrhea, abdominal cramping, fever, or bloody stools occur and not to treat with antidiarrheals without consulting health care professionals, Instruct the patient to notify health care professional if symptoms do not improve or if nausea or diarrhea persists when drug is administered with food

Nursing Process- Assessment (Pre-administration assessment) Assess for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and throughout therapy, Obtain a history before initiating therapy to determine previous use of and reactions to penicillins or cephalosporins. Persons with a negative history of penicillin sensitivity may still have an allergic response, Obtain specimens for culture and sensitivity prior to therapy. First dose may be given before receiving results

Assessment Why would you hold or not give this med? Observe for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Notify the physician or other health care professional immediately if these occur, 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, signs of superinfection

Evaluation Check after giving Resolution of the signs and symptoms of infection. Length of time for complete resolution depends on the organism and site of infection