Brand Name: 

UNASYN

CLASSIFICATIONS
Therapeutic: 
Anti-infectives
Pharmacologic:
Aminopenicillins/ beta lactamase inhibitors
ACTIONS
Physiologic Mechanism
• Bactericidal action. Active against: Streptococci, Penumococci, Enterococci, Haemophilus
influenzae,
• Use should be reserved for infections caused by beta-lactamase-producing strains.
Pharmacologic Mechanism
• Binds to bacteria cell wall, resulting in cell death, spectrum is broader than that of penicillin.
Addition of sulbactam increases resistance to beta-lactamase, enzymes produced by bacteria
that may inactivate ampicillin.
INDICATION
• Treatment of respiratory infections
NURSING CONSIDERATIONS
• Assess patient for infection (vital signs, wound appearance, sputum, urine, stool, and WBCs)
at beginning and throughout therapy.
• Obtain a history before initiating therapy to determine previous use of and reactions to
penicillins or cephalosporins. Persons with a negative history of penicillin sensitivity may still
have an allergic response.
• Obtain specimens for culture and sensitivity before therapy. First dose may be given before
receiving results.
• Observe patients for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema,
wheezing). Discontinue the drug and notify the physician immediately if these occur. Keep
epinephrine, an antihistamine, and resuscitation equipment close by in the event of an
anaphylactic reaction.
• Caution patient to notify physician if fever and diarrhea occur, especially if stool contains
blood, pus, or mucus. Advise patient not to treat diarrhea without consulting health care
professional. May occur up to several weeks after discontinuation of medication.
•Instruct patient to notify physician if symptoms do not improve.
CEFUROXIME AXETIL
Ceftin
Classifications: antiinfective; antibiotic; second-generation cephalosporin
Prototype: Cefonicid sodium
Pregnancy Category: B
NURSING IMPLICATIONS
Assessment & Drug Effects
 Determine history of hypersensitivity reactions to cephalosporins,
penicillins, and history of allergies, particularly to drugs, before therapy
is initiated.
 Lab tests: Perform culture and sensitivity tests before initiation of
therapy and periodically during therapy if indicated. Therapy may be
instituted pending test results. Monitor periodically BUN and creatinine
clearance.
 Inspect IM and IV injection sites frequently for signs of phlebitis.
 Report onset of loose stools or diarrhea. Although
pseudomembranous colitis (see Signs &Symptoms, Appendix F) rarely
occurs, this potentially life-threatening complication should be ruled out
as the cause of diarrhea during and after antibiotic therapy.
 Monitor for manifestations of hypersensitivity (see Appendix F).
Discontinue drug and report their appearance promptly.
 Monitor I&O rates and pattern: Especially important in severely ill
patients receiving high doses. Report any significant changes.
Patient & Family Education
 Report loose stools or diarrhea promptly.
 Report any signs or symptoms of hypersensitivity (see Appendix F).
 Do not breast feed while taking this drug.