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Penetrex
Class: Antibiotic/Fluoroquinolone

 Action Interferes with microbial DNA synthesis.

 Indications Treatment of urinary tract infections caused by susceptible organisms; treatment of sexually transmitted disease caused by Neisseria gonorrhoeae.

 Contraindications Hypersensitivity to fluoroquinolones.

 Route/Dosage

Urinary Tract Infections

ADULTS: PO 200–400 mg q 12 hr for 7–14 days.

Sexually Transmitted Diseases

ADULTS: PO 400 mg as single dose.

 Interactions

Antacids, iron salts, zinc salts, sucralfate, bismuth subsalicylate: May decrease oral absorption of fluoroquinolone. Caffeine: Reduces clearance of caffeine. Digoxin: May increase digoxin levels. Theophylline: Can cause decreased clearance and increased plasma levels of theophylline, which may result in toxicity.

 Lab Test Interferences None well documented.

 Adverse Reactions

CNS: Headache; dizziness; insomnia; vertigo. DERM: Pruritus; photosensitivity. EENT: Tinnitus; unusual taste in mouth. GI: Diarrhea; nausea; vomiting; abdominal pain or discomfort; dyspepsia; heartburn.

 Precautions

Pregnancy: Category C. Lactation: Excreted in breast milk. Children: Contraindicated in children. CNS disorders: Use drug with caution in patients predisposed to seizures or with other CNS disorders. Convulsions: CNS stimulation can occur; use drug with caution in patients with known or suspected CNS disorders. Hypersensitivity: Serious and potentially fatal reactions have occurred. Discontinue drug if allergic reaction occurs. Pseudomembranous colitis: Consider possibility in patients in whom diarrhea develops subsequent to administration of antibacterial agents. Renal impairment: Reduced clearance may occur; dosage adjustment may be required. Superinfection: Use of antibiotics may result in bacterial or fungal overgrowth of nonsusceptible microorganisms.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • Do not administer with antacids.
  • Administer medication at least 1 hr before or 2 hr after meal.
  • Encourage patient to increase fluid intake.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Determine baseline WBC and BUN.
  • Assess renal and liver function.
  • Monitor temperature.
  • Monitor patient for signs and symptoms of hypersensitivity.
  • Inform physician of signs and symptoms of superinfection (eg, black furry tongue, white patches in mouth, foul-smelling stool).
  • If GI disturbances develop, withhold drug and notify physician.
  • If photosensitivity occurs, withhold drug and notify physician.
OVERDOSAGE: SIGNS & SYMPTOMS
  Renal failure

 Patient/Family Education

  • Instruct patient to take drug at least 1 hr before meals or 2 hr after meals.
  • Advise patient not to take medication with antacids.
  • Caution patient to avoid exposure to sunlight and to use sunscreen or wear protective clothing to avoid photosensitivity reaction.
  • Instruct patient to increase fluid intake and to restrict or eliminate caffeine intake.
  • Advise patient to report any visual changes, agitation, or rash to physician.
  • Instruct patient to report any additional infections after completion of medication to physician.
  • Tell patient to notify physician if diarrhea develops.
  • Advise patient that drug may cause dizziness and lightheadedness and to use caution while driving or performing other tasks requiring mental alertness.

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