Invanz (ertapenem)

NURS 1566 Clinical Form 3: Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name Ertapenem Peak End of infusion

Trade Name Classification Dose Route Invanz Anti-infectives 1g IV Onset Duration Normal dosage range rapid 24 hr 1 g once daily

Why is your patient getting this medication To prevent infection after abdominal surgery

Time/frequency 2100/ q 24 hrs

For IV meds, compatibility with IV drips and/or solutions Administer in 50ml of 0.9% NaCl over 30 min Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity. Cross-sensitivity may occur with penicillins, cephalosporins and other carbapenems. Hypersensitivity to lidocaine (may be used as a dilutent for IM administration). Use cautiously in geriatric patients (age related ↓ renal function). Common side effects No common side effects. Potential dangerous side effects: seizures, pseudomembranous colitis, anaphylaxis

Mechanism of action and indications (Why med ordered) Bactericidal action against susceptible bacteria. Active against the following aerobic gram-positive organisms Staphylococcus aureus (methicillinsusceptible strains only), Staphylococcus epidermidis, Streptococcus agalactiae, S. pneumonia (penicillin-susceptible strains only), and S. pyogenes. Also active against the following gramnegative aerobic organisms Escherichia coli, Haemophilus influenza (beta-lactamase negative strains), Klebsiella pneumonia, and Moraxella catarrhalis Providencia rettgeri. Addition anaerobic spectrum includes Bacteroides fragilis, B. distasonis, B. ovantus, B. thetaiotamicron, B. uniformis, B. vulgatis Clostridium clostrioforme, Eubacterium lentum, Peptostreptococcus, Porphyromonas asaccharolytica, and Prevotella bivia. Interactions with other patient drugs, OTC or Lab value alterations caused by medicine herbal medicines (ask patient specifically) May cause ↑ AST, ALT, serum alkaline phosphatase levels. None known May cause ↑ platelet and eosinophil counts. Be sure to teach the patient the following about this medication Advise patient to report the signs of superinfection (black, furry overgrowth on the tongue; vaginal itching or discharge; loose or foul-smelling stools) and allergy. Consult healthcare professional before treating with antidiarrheals. Caution patient to notify health care professional if fever and diarrhea occur, especially if stool contains blood, pus, or mucus. Advise patient not to treat diarrhea without consulting health care professional. May occur up to several weeks after discontinuation of medication.

Nursing Process- Assessment (Pre-administration assessment) Assess for infection at beginning of and during therapy. Obtain history before initiating therapy to determine previous use of and reactions to penicillins, cephalosporins or carbapenems. Persons with a negative history of penicillin sensitivity may still have an allergic response. Obtain specimens for culture and sensitivity before initiating therapy. First dose may be given before receiving results. Observe patient for signs and symptoms of anaphylaxis.

Assessment Why would you hold or not give this med? Signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing).

Evaluation Check after giving Resolution of the signs and symptoms of infection. Prevention of infection.