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(oh-FLOX-uh-SIN)
Floxin Ocuflox
Class: Antibiotic/fluoroquinolone

 Action Interferes with microbial DNA synthesis.

 Indications Treatment of infections of lower respiratory tract, skin and skin structure and urinary tract caused by susceptible organisms; treatment of STDs; treatment of prostatitis caused by E. coli.

Ophthalmic: Treatment of superficial ocular infections caused by susceptible organisms.

 Contraindications Hypersensitivity to fluoroquinolones, quinolone antibiotics, or any product component; tendonitis or tendon rupture associated with quinolone use.

Ophthalmic: Epithelial herpes simplex keratitis; vaccinia; varicella; fungal disease of ocular structure; mycobacterial infections of the eye.

 Route/Dosage

UTIs

ADULTS: PO/IV 200 mg q 12 hr.

Prostatitis

ADULTS: PO/IV 300 mg q 12 hr for 6 wk.

Respiratory Tract, Skin and Skin Structure Infections

ADULTS: PO/IV 400 mg q 12 hr.

Acute, Uncomplicated Gonorrhea

ADULTS: PO/IV 400 mg as single dose.

Acute Pelvic Inflammatory Disease

ADULTS: PO/IV 400 mg q 12 hr for 10 to 14 days.

Cervicitis/Urethritis

ADULTS: PO/IV 300 mg q 12 hr.

Epididymitis

ADULTS: PO 300 mg twice daily for 10 days.

Ocular Infection

ADULTS: Ophthalmic 1 to 2 gtt as directed.

 Interactions

Antacids, iron salts, zinc salts, sucralfate, didanosine: May decrease oral absorption of ofloxacin. Antineoplastic agents: Serum ofloxacin levels may be decreased. Theophylline: Decreased clearance and increased plasma levels of theophylline may result in toxicity.

 Lab Test Interferences None well documented.

 Adverse Reactions

CNS: Chest pain. CNS: Headache; dizziness; fatigue; lethargy; drowsiness; insomnia; nervousness. DERM: Rash; pruritus. EENT: Visual disturbances; transient burning, itching, stinging, inflammation, angioneurotic edema, urticaria and dermatitis (ophthalmic use). GI: Diarrhea; nausea; vomiting; abdominal pain or discomfort; dry or painful mouth; flatulence; dysgeusia. GU: Vaginal discharge; genital pruritis. HEPA: Increased ALT, AST. HEMA: Eosinophilia; lymphocytopenia. OTHER: Vaginitis; fever; decreased appetite. Ophthalmic use may possible cause same adverse reactions seen with systemic use because of absorption.

 Precautions

Pregnancy: Category C. Lactation: Excreted in breast milk. Children: Do not use in children < 18 yr. Elderly: Half-life may increase. Convulsions: CNS stimulation can occur; use drug with caution in patients with known or suspected CNS disorders. Photosensitivity: Moderate-to-severe reactions may occur; avoid excessive sunlight and ultraviolet light. Pseudomembranous colitis: Consider possibility in patients who develop diarrhea. Renal impairment: Reduced creatinine clearance may occur; decrease dose accordingly. Syphilis: Not effective for treating syphilis.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

IV:

  • Store at room temperature.
  • IV solution is stable after dilution for 72 hr at room temperature and 2 wk if refrigerated.
  • Discard unused portion of IV preparation.
  • Do not give as IV push or bolus. To reduce likelihood of hypotension, infuse over 60 min.
  • Dilute to concentration of 4 mg/mL.
  • Do not infuse in IV line with any other drug.

Oral:

  • Store at room temperature.
  • Administer 1 hr before or 2 hr after meals.
  • Do not administer concurrently with antacids.
  • Administer with full glass of water.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Obtain baseline CBC, renal and liver function tests, and electrolytes.
  • Assess for any skin rashes. Notify physician if skin rash occurs.
  • Obtain baseline vital signs. Monitor vital signs at least bid while administering medication.
  • Monitor patterns of elimination and stool consistency.
  • Monitor for signs of superinfection.
  • Encourage fluid intake.
  • Notify physician if vomiting, fatigue, lymphocytopenia, increased liver function test results, seizures, or visual disturbances occur.
  • Notify physician if extreme burning, angioneurotic edema, or dermatitis occurs with ophthalmic use.
OVERDOSAGE: SIGNS & SYMPTOMS
  Nausea, headache, dizziness, crystalluria, vomiting, drowsiness, seizures

 Patient/Family Education

  • Advise patient to take on empty stomach 1 hr before or 2 hr after meals.
  • Instruct patient to avoid taking antacids within 4 hr before or 2 hr after dose.
  • Caution patient to avoid exposure to sunlight, and to use sunscreen or wear protective clothing to avoid photosensitivity reaction.
  • Advise patient to notify physician of signs of superinfection.
  • Caution patient to report the following symptoms to physician: seizures, nausea, rash, itching, diarrhea, shortness of breath, dizziness, headache.
  • Demonstrate and observe return demonstration of correct technique for instillation of ophthalmic drops.
  • Advise patient using ophthalmic solution to discontinue medication and notify physician of rash or allergic reaction.
  • Instruct patient to complete full course of therapy, even if symptoms have resolved.
  • Instruct patient to stop treatment and inform physician if experiencing pain, inflammation, or rupture of tendon, and to rest or refrain from exercise until diagnosis of tendonitis or tendon rupture is excluded.

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