Question

PN 105 Fundamentals of Nursing I Otitis Media - Amoxicillin SA, age 6 years, has otitis media. The health care provider ordered amoxicillin 250 mg. every 8 hours. The nurse asks SA's parent if SA is allergic to any drugs, and the parent says that SA is allergic to penicillin. 1. What are the similarities and differences in penicillin and amoxicillin? Explain your answer. 2. What nursing actions should the nurse take and why? The health care provider changed the amoxicin order to cefaclor (Ceclor) 250 mg every 8 hours. The therapeutic dose for children is 20-40mg/kg/dose in three divided doses. The child weighs 40 pounds 3. What are the similarities and differences in amoxicillin and cefaclor? Explain your answer. 4. Is the prescribed cefaclor dosage for SA within safe parameters? Explain your answer. 5. Explain the significance of the nurse asking about allergies to antibiotics such as penicillin. What is the relationship of penicillin and cefaclor in regard to allergies? 6. What should the nurse include in patient teaching for SA and her parents regarding cefaclor?

Answer 1

Otitis media

An inflammation of the middle ear is called Otitis media.

1. Similarities and differences between Amoxicillin and Penicillin:

Penicillin is a narrow spectrum antibiotic obtained from the Pencillium Nottatum molds.

Amoxicillin is a Moderate spectrum, bacteriolytic antibiotic used to treat bacterial infection.

Similarities: Both drugs are derived from Pencillium fungus and belong to Beta lactum antibiotics. Both act by stopping the bacterial multiplication and not effective in viral infections.

Differences: Only small differences are existing between these two drugs in terms of the kinds of bacterias they attack and the side effects.

Penicillin is produced synthetically and Amoxicillin is produced semi synthetically from Penicillin.

For an effective absorption Amoxicillin can be taken with food but Penicillin 1 hour before or 2 hour after meal.

2. Nursing Action

As the nurse got the information regarding penicillin allergy of the child from the parents, she can withdraw the medication without progressing into administration.

She can report regarding the history of drug allergy to the health care provider

Record the information regarding drug allergy in the past medical / allergic history

3. Amoxicillin and Cefaclor

Cefaclor: It is second generation Cephalosporin antibiotic used to treat a variety of bacterial infection.

Similarities: Both are antibiotics that stop the multiplication of bacteria. Both are not effective in viral infections

Difference: Amoxicillin is a Beta lactum antibiotic belongs to penicillin group and the Cefaclor is a type of Cephalosporin antibiotic.

Amoxicillin inhibit bacterial cell wall synthesis by binding with PBPs ( penicillin binding proteins) .Cefaclor inhibit bacterial cell wall synthesis by inhibiting peptidoglycan cross- linking.

4. Prescribed dose: 250 mg every 8 hour

Therapeutic dose 20 - 40 mg/ kg/ dose in three divided dose

Child's weight = 40 pounds = 18. 14kg (40÷ 2.205)

( 18× 20mg= 360 mg, 18× 40= 720 mg into three divided dose)

250 mg drug for every 8 hours is within the safe parameters.