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CEFEPIME
U.S. Brand Name (Maxipime)
Therapeutic Category:
1.Antibiotic
2.Cephalosporin(fourth
generation)
Pregnancy Risk Factor (B)
Prototype:
Cefotaxime Sodium.
Availability:
500mg,1g,2g vials
Lactation:
Enters breast milkuse
caution.
Therapeutic Effects:
1.Treats pneumonia.
2.Skin and soft tissue .
Therapeutic Effects.cont.
3.Respiratory tract.
4.intra-abdominal infections.
5.Urinary tract infection by
Eliminating SS of infection.
Use:
1.Treatment of respiratory
tract infection including
(brochitis and pneumonia).
2.Cellulitis, skin and soft
tissue infections.
Use .Continued.
3.Urinary tract infection.
Mechanism of Action:
Inhibits bacterial cell wall
synthesis by binding to one or
more of the penicillin-binding
proteins (PBPs).
Contraindications:
Hypersensitivity to cefepime
Any component ,or other
Cephalosporins .
Warnings /precaution:
1.Prolonged use may result in
Cont.
Superinfection .
2.cross-sensitivity to penicillins
exists (~10%).
3.Use in patients less than 2
months of age has not been
established.
Drug Ineractions:
1.Increased Effect/ toxicity :
High –dose probenecid
decreases clearance and
increases effect of
cefepime.
Adverse Reaction:
>10%: hematologic:
Positive coombs‘test without
hemolysis 1%to10%:
1.dermatologic:rash,pruritus.
2.GI:diarrhea,nausea,vomiting.
Cont.
3.C.N.S.:fever(1%)headache
(1%).
4.Local:pain,erythema at
injection site, phlebitis,
inflammation, urticaria.
5.Urogenital:
Vaginitis .
Other reaction cephalosporins
include:toxic epidermal
necrolysis,erythema multiforme,renal
Dysfunction,aplastic anemia,
hemolytic anemia,hemorrhage…ect
Over dose:
Include:
1.Neuromusclar hypersensitivity.
2.Convulsions.
Pharmacodynamics:
Protein binding:plasma:16%to19%.
Distribution :
20%protien bound,widely dist.,may
Cross in flamed meninges ;crosses
Placenta,secreted into breast milk.
Absorption:
After IM administration serum levels
significantly lower than
aftereqivalent IV dose.
Metabolism:
It‘s very little and metabolized in
the liver.
Elimination:
Excreted in urine .
Half –life elimination:2hours
Formulation:
Powder for injection as hydrochloride
:500mg,1g,2g.
Route and dosage:
1.Mild to moderate infections:
Adult: IV/IM 0.5-1g q12h times 7-10d
2.Moderate to severe infections:
Adult:IV 1-2g q12h time 10d.
3.Febrile neutropenia:
Adult :IV 2g q8h for 7d or until resolu-
Tion of neutropenia.
Elderly :IV/IM should be based on renal
function and severity of infection.
Administration:
1.(IM):
Inject deep I.M. into large muscle
mass.
2.(IV):
Inject direct I.V. over 5min.
Stability:
1.monitoring laboratory tests:
Prothrombin time ;peform culture and
sensitivity studies prior to initiating
drug therapy.
2.compatibility:
Discontinue other solution at the same
site to avoid compatibility problems.
Cont.
C.Monitor for S/S of hypersensitivity.
D.Assess bowel function (severe diarrihea)
E.Monitor urine output (if decreased,notify
prescriber).
F.Assess for opportunistic infection(fever,
Malaise,rash,itching,redness,chills,or
increased cough)
Additional Nursing lssues:
1.Physical assessment:
A. Determine history of hypersensitivity
reaction to cephalosporins, penicillins,or
other drug before therapy is initiated.
B.Lab tests perform culture and sensitivity
tests before initiation of therapy. Dosage
may be started pending test results.
2.Geriatric Consideration:
Adjust dose for changes in renal function.
3.Patient and Family Education:
A.Promptly report any S/S hypersensitivity
,superinfection and pseudomembranous
colitis.
B.Do not breast feed while taking this drug
without consulting physician.
Additional Information:
Each gram contain 2 mEq of
Sodium.
PH:4-6
THINK YOU
FOR GIVING ME
YOUR ATTANTION
References
1.Pharmacology,2nd edition-Mary J.Mycek,
ph.D.and Richard.D.,Harvey ,ph.D.
2.Drug information hand book for nursing.
Including
assessment,administration,monitoring
guidelines and patient education.
3.Prentice hall (nurses drug guide 2006)
WWW.antibiotic guide .com
WWW.cefepime drug information.com
‫كوم‬ ‫دوت‬ ‫طبيب‬–‫الحيوية‬ ‫المضادات‬
WWW.drugs.com
WWW.search.drug.com
Presented by:
SAMIAH MASLUM AL- JAHANY.
2005

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