"Official medicines" is the best online drugstore.

World’s leading meds delivered to your door – and you don’t even need a prescription! Only certified, first class drugs on offer! Buy more and spend less with our great discount system.

The meds you need, reliable and hassle free! Top products of top brands.

The only pharmacy shop you will ever need! Approved drugs available without prescription. Best deals, unmatched service and shipping. 100% safe!

(PIH-per-uh-SILL-in SO-dee-uhm)
Pipracil
Powder for injection
(contains 1.85 mEq [42.5 mg] sodium/g) 2 g
Powder for injection: 3 g
Powder for injection: 4 g
Powder for injection: 40 g
Class: Antibiotic
Penicillin

 Actions Inhibits bacterial cell wall mucopeptide synthesis.

 Indications Treatment of intra-abdominal, urinary tract, gynecologic, lower respiratory tract infections, septicemia, skin and skin structure infections, bone and joint infections and gonococcal urethritis; surgical prophylaxis; treatment of infection due to susceptible microorganisms including infections caused by Streptococcus and Pseudomonas species.

 Contraindications Hypersensitivity to penicillins or cephalosporins.

 Route/Dosage

ADULTS: IM/IV 3 to 4 g q 4 to 6 hr (max 24 g/day).

CHILDREN: IM/IV 200 to 500 mg/kg/day divided q 4 to 6 hr.

NEWBORNS: IM/IV 100 mg/kg/dose q 12 hr.

 Interactions

Aminoglycosides, parenteral: May inactivate aminoglycosides in vitro; do not mix in same IV solution. May be used in combination for synergy. Anticoagulants: May increase bleeding risks by prolonging bleeding time. Chloramphenicol: Synergism or antagonism may develop. Contraceptives, oral: May reduce efficacy of oral contraceptives. Use additional form of contraception during piperacillin therapy. Erythromycin: Synergism or antagonism may develop. Heparin: May increase bleeding risks of heparin by prolonging bleeding time. Tetracyclines: May impair bactericidal effects of piperacillin.

 Lab Test Interferences May cause false-positive urine glucose test results with Benedict’s solution, Fehling’s solution, or Clinitest tablets but not with enzyme-based tests (eg, Clinistix0, Tes-tape); false-positive direct Coombs’ test result in certain patient groups; positive direct antiglobulin tests (DAT); false-positive protein reactions with sulfosalicylic acid and boiling test, acetic acid test, biuret reaction and nitric acid test but not with the bromphenol blue test (Multi-Stix).

 Adverse Reactions

CNS: Neurotoxicity (eg, lethargy, neuromuscular irritability, hallucinations, convulsions, seizures) especially with large dose or patient with renal failure; dizziness; fatigue; insomnia; reversible hyperactivity; prolonged muscle relaxation. DERMATOLOGIC: Ecchymosis. EENT: Itchy eyes. GI: Nausea; vomiting; abdominal pain or cramping; epigastric distress; diarrhea or bloody diarrhea; rectal bleeding; flatulence; enterocolitis; pseudomembranous colitis; anorexia. GU: Interstitial nephritis (oliguria, proteinuria, hematuria, hyaline casts, pyuria); nephropathy; elevated creatinine or BUN; vaginitis; moniliasis. HEMATOLOGIC: Anemia; hemolytic anemia; thrombocytopenia; thrombocytopenic purpura; eosinophilia; leukopenia; granulocytopenia; neutropenia; bone marrow depression; agranulocytosis; reduced Hgb or Hct; prolongation of bleeding and prothrombin time; decrease in WBC and lymphocyte counts; increase in lymphocytes, monocytes, basophils and platelets. HEPATIC: Elevated AST or AST and bilirubin; transient hepatitis; cholestatic jaundice. METABOLIC: Elevated serum alkaline phosphatase; hypernatremia; hypokalemia, reduced albumin, total proteins and uric acid. OTHER: Hypersensitivity reactions (ie, urticaria, angioneurotic edema, laryngospasm, bronchospasm, hypotension, vascular collapse, death, maculopapular to exfoliative dermatitis, vesicular eruptions, erythema multiforme, serum sickness, laryngeal edema, skin rashes, prostration); vaginitis; hyperthermia; pain at site of injection; deep vein thrombosis; hematomas; vein irritation; phlebitis; hyperthermia; sciatic neuritis.

 Precautions

Pregnancy: Category B. LACTATION: Excreted in breast milk. Bleeding abnormalities: Hemorrhagic manifestations associated with abnormalities of coagulation tests (bleeding time, prothrombin time, platelet aggregation) may occur. Abnormalities should revert to normal once drug is discontinued. Cystic fibrosis patients: May experience higher incidence of side effects when treated with piperacillin. Hypersensitivity: Reactions range from mild to life-threatening. Administer cautiously to cephalosporin-sensitive patients due to possible cross-reactivity. Pseudomembranous colitis: May occur due to overgrowth of clostridia. Renal failure: Dosage adjustment required. Superinfection: May result in bacterial or fungal overgrowth of nonsusceptible organisms.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • Obtain culture and sensitivity before administering first dose.
  • IM or IV route.
  • For IM use, dilute to 1 g/2.5 mL. Lidocaine (0.5% to 1%) may be used to dilute (for IM use only).
  • Do not give > 2 g IM at any one site.
  • For IV injection, reconstitute each gram with ³ 5 mL compatible diluent.
  • IV infusion is diluted further with 50 to 100 mL of D5W or normal saline and infused over 20 to 30 min.
  • Time doses for even distribution throughout 24 hours.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Assess for drug reactions especially in patients with asthma, hay fever, urticaria, or allergy to cephalosporins.
  • Assess baseline CBC and liver and renal function study results prior to initiating therapy and monitor throughout therapy.
  • Monitor results of diagnostic cultures and sensitivity tests.
  • Monitor patient for ³ 20 min after administering penicillin to observe for signs or symptoms of anaphylaxis. Notify health care provider if skin rash, hives, wheezing, nausea, or vomiting occur.
OVERDOSAGE: SIGNS & SYMPTOMS
  Agitation, confusion, asterixis, hallucinations, stupor, coma, seizures, hyperexcitability

 Patient/Family Education

  • Instruct patient to notify health care provider if symptoms of potential superinfection (eg, nausea/vomiting, diarrhea, black tongue, swollen joints, unusual bleeding or bruising) occur.
  • Explain signs and symptoms of allergic reaction (eg, hives, wheezing, skin rash, itching) and importance of seeking medical supervision as soon as possible.
  • Emphasize need for good hygiene to avoid superinfections.
  • If patient develops allergy to piperacillin, advise patient to notify future caregivers of penicillin allergy and patient should wear Medi-Alert identification.

Popularity: 3% [?]


If you're still unable to find appropriate information in the article, please use search form below