Medication Profile (to Be Completed On All Medications Listed In

Medication Profile (To be completed on all medications listed in syllabus and all medications administered to assigned patients in the clinical area. Must be handwritten neatly - photocopies are not acceptable. The act of writing this information facilitates memory.) Generic Name ciprofloxacin Trade Name: Cipro Uses/Action:

Classification:

Fluoroquinolones

(write all major uses/actions then be prepared to tell your instructor which use/action is pertinent to the patient receiving the med whenever you are administering it) Uses: Fluoroquinolones are broad-spectrum antimicrobials used for a wide variety of micro-organisms that are gram-negative or gram-positive bacteria, Klebsiella and E. coli Alternative to parenteral antibiotics for clients with severe infections Respiratory, urinary, & GI tract infections; infections of bones, joints, skin & soft tissues Med of choice for prevention of anthrax in clients who have inhaled anthrax spore Action: Fluoroquinolones are bactericidal (kill the bacteria) as a result of inhibition of the enzyme necessary for DNA replication Relevant Pre-Medication Assessment: (eg observation, VS, lab values, etc.) WBC, temperature prior to & periodically BUN, creatinine, AST, ALT I&O ratio, urine ph< 5.5 is ideal

Contraindications Should not be administered to children < 18 years of age (due to risk of Achilles tendon rupture) Hypersensitivity to quinolones Special Concerns/Nursing Implications: (eg overdose management, special method of administration, special storage/handling) Med/Food Interactions: Cationic cmpds (aluminum-magnesium antacids, iron salts, sucralfate, milk & dairy products) - ↓absorption of Cipro (Intervention: administer cationic cmpds 1 hr before or 2 hr after ciprofloxacin) Theophylline (Theo-Dur) – plasma levels of theophylline can be ↑ w/ concurrent use of Cipro (Intervention: monitor levels & adjust dosage accordingly) Warfarin (Coumadin) – plasma levels of warfarin can be ↑ w/ concurrent use of Cipro (Intervention: monitor prothrombine time & INR & adjust the dosage of warfarin accordingly) Pregnancy (C) Breast-feeding Geriatric patients Renal disease Epilepsy QT prolongation Tendon pain hypokalemia

Expected Outcome/Assessment: Improvement of symptoms (eg. Clear breath sounds, no S/S of inflammation, swelling, warmth, & erythema; no evidence of suprainfection (eg. Absence of cottage cheese or curd-like lesions in mouth & genital areas)

Side Effects: GI discomfort (eg. Nausea, vomiting, diarrhea) (Interventions: administer meds accordingly) Achilles tendon rupture (Intervention: instruct client to observe for S/S of pain, swelling, redness at Achilles tendon site & to notify primary care provider, stop Cipro & refrain from exercise until signs of inflammation subside) Suprainfection (eg. Thrush, vaginal yeast infection) (Intervention: instruct client to observe for S/S of yeast infection & to report to the primary care provider if symptoms occur) Adverse Effects: Seizures Pseudomembranous colitis Bone marrow depression Toxic epidermal necrolysis Anaphylaxis Stevens-Johnson syndrome

Routes/Administration:

Available in oral & intravenous forms (DO NOT break, crush, or chew XR product) Adjust dosage of ciprofloxacin by decreasing doses in clients w/ renal dysfunction Intravenous Cipro should be administered slowly over 60 min For inhalation anthrax infection, Cipro is administered every 12 hr for 60 days Safe Dosage Range: (cite usual then be prepared to tell your instructor which dose is appropriate for the individual patient based on use of drug and patient specifics for particular patient receiving the medication) Uncomplicated UTI: Adult PO: 100-250mg q12hr X 3 days or 500 mg X q24hr X3 days Complicated UTI: Adult PO: 500 mg q12hr or 1000 mg q24hr X 7-14 days; IV 400 mg q12hr Patient

Teaching: PLEASE USE BACK

Instruct client to complete the prescribed course of antimicrobial therapy, even though symptoms may resolve before the full course is complete Not to take any products containing Mg or Ca (such as antacids), iron or Al w/ this product or within 2 hr of product To use frequent rinsing of mouth, sugarless candy or gum for dry mouth Increase fluids to 3L/day to avoid crystallization in kidneys