Penicillin G Benzathine

Drug Data

Classification

Generic Name Penicillin G Benzathine

Pharmacologic Classification Penicillin

Trade Name Penadur

Therapeutic Class Anti-infective, Antibiotic

Minimum Dose 300,000 units IM Maximum Dose 2.4 million units IM weekly for 3 weeks

Pregnancy Risk Factor B

Mechanism of Action Interferes with bacterial cell wall synthesis during active multiplication, causing cell wall death and resultant bactericidal activity against susceptible bacteria. Pharmacokinetics D: Crosses placenta; enters breast milk M: Hepatic E: Urine

Indication

Contraindications

General Indications - Severe infections caused by sensitive organisms (streptococci) - URTI caused by sensitive streptococci - Treatment of syphilis, bejel, congenital syphilis, pinta, yaws - Prophylaxis of rheumatic fever and chorea

Concentrations - Allergies to penicillins, cephalosporins, or other allergens

Drug Half Life 30-60 min

Contents Benzathine benzylpenicillin Availability and color

- Injection: 600,000, 1.2 million, 2.4 million units/dose

Precaution - Renal disorders - Pregnancy - Lactation Drug interaction Drug to drug - Decreased effectiveness with tetracyclines - Inactivation of parenteral aminoglycosides (amikacin, gentamicin, kanamycin, neomycin, tobramycin) Drug to food - none reported

Routes of administration Intramuscular

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, pp. 929

Adverse Reaction CNS: Lethargy, hallucinations, seizures GI: Glossitis, stomatitis, gastritis, sore mouth, furry tongue, black “hairy” tongue, nausea, vomiting, diarrhea, abdominal pain, bloody diarrhea, enterocolitis, pseudomembranous colitis, nonspecific hepatitis GU: Nephritis Hematologic: Anemia, thrombocytopenia, leukopenia, neutropenia, prolonged bleeding itme Hypersensitivity: Rash, fever, wheezing, anaphylaxis Local: Pain, phlebitis, thrombosis at injection site, Jarisch-Herxheimer reaction when used to treat syphilis Other: Superinfections, sodium overload leading to heart failure

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, pp. 929

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, pp. 929, http://www.merck.com/mmpe/print/lexicomp/ penicillin%20g%20benzathine.html

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, pp. 929

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, pp. 929

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, pp. 930

Nursing Responsibilities Before - Observe 15 rights of drug administration. - Reduce dosage with hepatic or renal failure. - Assess for hypersensitivity to drug. - Assess for any contraindications to the drug. - Educate about side effects of drug. During - Drug is not for IV use. Do not inject or mix with other IV solutions. - Give IM injection in upper outer quadrant of the buttock. - Avoid contact with the needle. - Withdraw needle as quickly as possible to avoid discomfort. - Stay with patient throughout whole duration of administration. After - Monitor client for at least 30 minutes. - Arrange for regular follow-up, including blood tests, to evaluate effects. - Instruct to report difficulty breathing, rashes, severe pain at injection site, mouth sores, unusual bleeding or bruising. - Instruct to take medication as directed for the full course of therapy, even if feeling better. - Do proper documentation.

Source: Karch, Amy: 2009 Lippincott’s Nursing Drug Guide, pp. 930