Details About Generic Salt ::  Cefamand

Main Medicine Class::    

(SEFF-uh-MAN-dahl NA-fate)
Mandol
Class: Antibiotic/cephalosporin

 

Drugs Class ::

 Action Inhibits mucopeptide synthesis in bacterial cell wall.

Indications for Drugs ::

 Indications Treatment of infections of lower respiratory tract, urinary tract, skin and skin structures, bone and joint; treatment of mixed infections; treatment of septicemia and peritonitis due to susceptible strains of specific microorganisms; perioperative prophylaxis.

Drug Dose ::

 Route/Dosage

ADULTS: IV/IM 500 mg 1 g q 4–8 hr (life-threatening infections or infections due to less susceptible organisms: up to 2 g q 4 hr) (maximum 12 g/day). CHILDREN > 1 MO: IV/IM 50–150 mg/kg/day in equally divided doses q 4–8 hr (maximum 12 g/day). PERIOPERATIVE PROPHYLAXIS: ADULTS: IV/IM 1–2 g ½-1 hr prior to surgical procedure followed by 1–2 g q 6 hr for 24–48 hr. CHILDREN ³ 3 MO: IV/IM 50–100 mg/kg/day in equally divided doses q 6 hr for 24–48 hr.

Contraindication ::

 Contraindications Hypersensitivity to cephalosporins.

Drug Precautions ::

 Precautions

Pregnancy: Category B. Lactation: Excreted in breast milk. Children: Safety and efficacy in children < 1 mo not established. Coagulation abnormalities: Cefamandole nafate may interfere with hemostasis. There is increased risk of bleeding abnormalities associated with hepatic and renal dysfunction, thrombocytopenia and concomitant use of anticoagulants or other drugs that affect hemostasis (eg aspirin). Pseudomembranous colitis: Should be considered in patients in whom diarrhea develops. Renal impairment: Use drug with caution. Dosage adjustment based on renal function may be required. Superinfection: Drug may cause bacterial or fungal overgrowth of nonsusceptible microorganisms.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

GI: Nausea; vomiting; diarrhea; anorexia; abdominal pain or cramps; flatulence; colitis, including pseudomembranous colitis. GU: Pyuria; renal dysfunction; dysuria; reversible interstitial nephritis; hematuria; toxic nephropathy. HEMA: Eosinophilia; neutropenia; lymphocytosis; leukocytosis; thrombocytopenia; decreased platelet function; anemia; aplastic anemia; hemorrhage. HEPA: Hepatic dysfunction and cholestatic jaundice; abnormal liver function tests. OTHER: Hypersensitivity, including Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis; candidal overgrowth; serum sickness—like reactions (eg, skin rash, polyarthritis; arthralgia, fever); phlebitis, thrombophlebitis and pain at injection site.

Drug Mode of Action ::  

 Action Inhibits mucopeptide synthesis in bacterial cell wall.

Drug Interactions ::

 Interactions

Alcohol: May cause acute alcohol intolerance (disulfiram-like reaction); reaction may occur up to 3 days after last dose of cefamandole nafate. Aminoglycosides: May increase risk of nephrotoxicity. Anticoagulants, oral: May increase anticoagulant effect; may cause bleeding complications. Probenecid: Inhibition of renal excretion of cefamandole. INCOMPATIBILITIES: Aminoglycosides: Do not add aminoglycosides to cefamandole solutions because inactivation of both drugs may result; administer at separate sites if concurrent therapy is indicated.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note allergy to cephalosporins and penicillins.
  • Obtain specimens for culture and sensitivity before beginning therapy.
  • Monitor renal function.
  • Monitor for coagulation abnormalities. Elevated prothrombin time or abnormal platelet count may occur. If bleeding occurs and PT is prolonged, vitamin K may be indicated.
  • Monitor for signs of infection, especially fever, and for positive response to antibiotic therapy.
  • Assess for signs and symptoms of anaphylaxis (shortness of breath, wheezing, laryngeal spasm). Have resuscitation equipment available.
  • Assess for signs of superinfection, such as vaginitis or stomatitis.
  • Assess for diarrhea with blood or pus, which may be symptom of pseudomembranous colitis. Symptoms may occur after antibiotic treatment.
  • Monitor IV site for infiltration, infection, and thrombophlebitis.
OVERDOSAGE: SIGNS & SYMPTOMS
  Seizures

Drug Storage/Management ::

 Administration/Storage

  • For IM administration, dilute in ratio of 1 g/3 ml of Sterile Water for Injection, Bacteriostatic Water for Injection, 0.9% Sodium Chloride for Injection or Bacteriostatic Sodium Chloride. Shake well until dissolved.
  • For IV administration, reconstitute in ratio of 1 g/10 ml of Sterile Water for Injection, D5W or 0.9% Sodium Chloride for Injection.
  • Administer intravenously or inject deep into large muscle mass to minimize pain.
  • Store open vials at room temperature.
  • May store drug at room temperature for 24 hr after reconstitution. Do not administer if solution is cloudy or precipitate is present.
  • May refrigerate reconstituted drug for 96 hr.
  • When drug is administered for perioperative prophylaxis, administration is usually discontinued 24–48 hr after surgical procedure but can be continued for up to 3–5 days postoperatively following complicated surgical procedures.

Drug Notes ::

 Patient/Family Education

  • Instruct patient to check body temperature daily. If fever persists for more than a few days or if high fever (> 102°F) or shaking chills are noted, physician should be notified immediately.
  • Advise patient to maintain normal fluid intake while using this medication.
  • Advise patient not to drink alcoholic beverages or take alcohol-containing medications while taking this medication and for several days after discontinuing it.
  • Instruct patient to report any increase in ecchymoses, petechiae, nose bleeds.
  • Advise patient to report signs of superinfection: black “furry” tongue, white patches in mouth, foul-smelling stools, vaginal itching or discharge.
  • Instruct patient in good personal hygiene (especially mouth and perineal area care).
  • Instruct patient to eat/drink 4 oz of yogurt or buttermilk a day as a prophylaxis against intestinal superinfection.
  • Advise diabetic patient to use enzyme-based tests (eg. Clinistix, Testape) for monitoring urine glucose because drug may give false results with other tests.
  • Instruct patient to report these symptoms to physician: nausea, vomiting, diarrhea, skin rash, hives, sore throat, bruising, bleeding, muscle or joint pain.
  • Warn patient that diarrhea that contains blood or pus may be a sign of serious disorders. Tell patient to seek medical care and not to treat at home.
  • Instruct patient to seek emergency care if wheezing or difficulty breathing occurs.

Disclaimer ::

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