DRUG NAME

Clopidogrel bisulfate
Ceftriaxone
Clindamycin
sodium
hydrochloride
Thienopyridine
Third-Generation
derivative
Lincosamide
cephalosporin, 7 Platelet
Antibacterial
aggregation
and
aminocephalospora
antiprotozoal
inhibitor
nic acid
Pregnancy
Antibiotic category
antibiotic
B
Pregnancy category
B

MECHANISM OF
ACTION
Interferes
Inhibits
Binds
toprotein
adenosine
with bacterial
cell wall synthesis
synthesis
diphosphate
in susceptible
(ADP)by
inhibitingby
bacteria
receptors
cross-linking
onbinding
the
to
of peptidoglycan
50S
surface
subunits
of activated
of
strands. ribosomes
bacterial
platelets.
This action
Peptidoglycan
and
blocks
preventing
ADP, which
makes
peptide
the cell
bond
deactivates
formation,
membrane
nearby
which
rigid
and protective.
causes
glycoprotein
bacterial
IIb/IIIa
Without
cells
it, bacterial
to
receptors
die
and
cells
prevents
rupture and
fibrinogen
from
die.
attaching to receptors.
Without fibrinogen,
platelets cant
aggregate and form
thrombi.

INDICATION

To reduce
treat serious
infections of
the lower tract
respiratory
atherosclerotic
respiratory
infections
events,
such
caused
tract,
as by
skin, soft
anaerobes
stroke
andtissue,
such
MI, inas
urinarywith
occur
patients
tract,
with bones,
and joints
anaerobic
atherosclerosis
To
treat meningitis
pneumonitis,
documented
by
To treatstroke,
acute
empyema,
recent
andMI,
lung
or
bacterialand
otitis
abscess
peripheral
artery
those
media
caused by
disease
treat chancroid
To
reduce
rate of
pneumococci,
(Haemophilus
death,
reinfarction,
staphylococci,
and
Ducreyi
infection)
or
stroke in patients
streptococci
and uncomplicated
Serious
skin and
with
ST-segment
gonorrhea
soft
elevation
tissueacute
infections
MI
treat
gonococcal
To
reduce
caused by
conjunctivitis
atherosclerotic
anaerobes,
To
treat such asand
events,
staphylococci,
disseminated
stroke
and MI, in
streptococci
gonococcal
infection
Septicemis
caused
patients
with
acute
andanaerobes
pelvicsyndrome
by
coronary
inflammatory
Intra-abdominal
(unstable angina or
diseasewave
infections
caused
non-Q
MI) by
To
treat
gonococcal
anaerobes such as
meningitis
and
occur with intraendocarditis
abdominal
abscess
To
provide
surgical
and peritonitis
prophylaxis
Infection
of the
female pelvis and
genital tract caused
by anaerobes such
as occur with
endometritis,
nongonococcal
tubo-ovarian
abscess, pelvic
cellulitis, and
postsurgical vaginal
cuff infection

CONTRAINDICATION

Active pathological
Calcium
History
ofcontaining
regional
I.V. solutions
enteritis
bleeding,
including
Hyperbilirubinemic
Ulcerative
colitis
peptic
ulcer
and
Antibioticneonates
intracranial
Hypersensitivity
associated
colitisto
hemorrhage
Hypersensitivity
ceftriaxone, otherto
clindamycin
orits or
cephalosporines,
clopidogrel or
lincomycin
their components
components
Neonates who are
28 days old less if
they are expected
to need calciumcontaining solutions,
including parenteral
nutrition

ADVERSE REACTIONS
CNS
Confusion,
Chills, fever,
Fatigue,
headache
headache,
CV depression,
hypertonia,
fatigue,
dizziness,
Hypotension,
reversible
hallucinations,
thrombophlebitis
hyperactivity,
headache
EENT
seizures metallic or
CV Glossitis,
CV
unpleasant
Chest pain, taste,
edema,
Hypercholesterolemi
Edema
stomatitis
a, Hypertension,
EENT
GI
Hypotension,
Glossitis, hearing
Abdominal
pain,
Vasculitis
loss, stomatitis
diarrhea,
EENT
GI esophagitis, nausea,
Altered
taste;
Abdominal
cramps,
pseudomembranous
conjuctival,
ocular,
cholestasis,
colitis,
vomiting
or
retinal
bleeding;
GU diarrhea, elevated
rhinitis;
liver function
test
epistaxis;
Cervicitis,
vaginitis,
taste
disorders
results,
gallbladder
and vulvar irritation
GI
dysfunction, hepatic
HEME
Abdominal
pain,
failure
Agranuocytosis,
liver failure;
GU Acute
eosinophilia,
diarrhea;
colitis;
Elevated
BUN level,
leucopenia,
duodenal,
gastric, or
nephrotoxicity,
neutropenia,
peptic
ulcer
oliguria, renal
thrombocytopenic
GU failure,
purpuravaginal
SKIN
Elevated
serum
candidiasis
creatininepruritus,
level,
HEME
Irritation,
glomerulopathy,
rash,
Aplastic
anemia, UTI
urticaria
HEME
eosinophilia,
Agranuocytosis,
hemolytic anemia,
Aplastic
anemia,
hemorrhage,
neutropenia,
hypoprothrombinem
pancytopenia,
ia
MS prolonged bleeding
time
Arthralgia
MS
RESP
Arthralgia,
back
Allergic
pain,
myalgia
Pneumonitis,

NURSING
CONSIDERATIONS
Calcium-containing
Expect
Avoid
clopidogrel
to obtain ain
products who
specimen
patients
must
for have
culture
not a
be givan
and
genetic
sensitivity
variation
I.V. within
in
48 hours
testing
CYP2C19
before
of
or aregiving
ceftriaxone,
first
receiving
dose CYP2C19
Use
clindamycin
including
inhibitors.
solutions
Platelet
cautiously
in a
given through
inhibition
may
patients
who
have
a
differentincreasing
decline,
I.V. line
and
history
of
at arisk
the
different
ofasthma,
adverse
site
significant
because a allergies,
cardiovascular
or
GI disease;
ceftriaxone-calcium
effects
after MIin
Use
clopidogrel
those
with
renal or
salt may
precipitate
hepatic
cautiously
dysfunction;
inand
in the lungs
and
patients
in elderly
withcould
severe
or
kidneys
and
atopic
hepatic
patients
or renal
be fatal.
Dont
give
75Use
ceftriaxone
disease, risk
ofand
150mg capsules
to
cautiously
bleeding
from
in
tartarzine-sensitive
patientsor
trauma
who
surgery,
are
patients
hypersensitive
or
conditions that
to
Store
oral solution
penicillins
predispose
because
to
for
up to 2
weeks
at
cross-sensitivity
bleeding
(such
ashas
room
temperature
occurred
peptic
ulcer
in about
disease
reconstituted
1%thrombotic
or
to 3% of such
parenteral
patients. solution
thrompbocytopenic
If
forpossible,
up to 24obtain
hours at
purpura)
In
patients
room
temperature.
culture
andwith
Give
I.V.
dose
by
sensitivity
acute
coronary
results,
infusion
only:
dont
as ordered,expect
syndrome,
before to
bolus
dose.
giving
give
aspirin
drug.
with
Protect300
powder
from
Dilute
mg of
clopidogrel
Clopidogrel
prolongs
clindamycin
in
50ml
light
Monitor
BUN
and
of
diluents
and
give
bleeding
time;
serum
over
10creatinine
minutes.
expect
to
stop it 5
levelsbefore
Dilute
to
600
detect
mga
of
days
elective
early signs ofin 100
clindamycin
surgery
Monitor
patient
who
nephrotoxicity.
ml
of diluents
and
Also
monitor
give
takes
over
aspirin
fluid
20 closely
intake
and output,;
minutes.
because
risk
Dilute
for900
decreasing
mg
bleeding
of clindamycin
is urine