Clarithromycin

Clarithromycin
Date and Time ordered: April 10, 2023 @ 8:00 AM

Ordering Physician: Dr. Lopez
Generic Name: Clarithromycin
Classification: Macrolide Antibiotic
Dosage, Frequency, and Route of Administration: 500 mg/tab x 10 days BID, PO
Mechanism of Action: Cefuroxime inhibits bacterial protein synthesis by binding to the bacterial
50S ribosomal subunit, causing cell death
Desired Effect: This is given to the patient to treat bacterial infection (H. pylori) and prevent
infection complications like stomach ulcer.
Nursing Responsibilities Rationale
1. Verify the doctor’s written order  To identify patients, know the dosage,
frequency and route of administration,
and to prevent medical error
2. Observe the 12 R’s in medication  To promote safe and accurate

administration. administration of the medication.
3. Review the allergic history of the  To prevent hypersensitivity reaction to

patient to clarithromycin, the medication
erythromycin, or any macrolide
antibiotic
4. Explain the indication and possible  To provide knowledge and give

side-effects (e.g., diarrhea, nausea and assurance that the medication is safe
vomiting) of the drug
5. Monitor for renal, hepatic, and  To provide timely intervention and

hematopoietic functions during prevent further complications like
prolonged therapy nephrotoxicity
6. Watch out and monitor for the  To identify and quantify the risks
following adverse effects: associated with the use of drugs and
a. CNS: dizziness, headache, and fatigue help to timely reduce the harmful
effects of therapeutic products.
b. Skin: anaphylaxis
c. GI: diarrhea, abdominal pain,
vomiting, melena, flatulence, and
pseudomembranous colitis
d. Others: superinfection, decreased
WBC
7. Monitor fluid intake and output, BUN  To ensure that the patient has proper
and serum creatinine intake of fluid and other nutrients
because the medication can cause
diarrhea. To detect signs of
nephrotoxicity
8. Encouraged the patient to take the  This is to decrease GI upset when GI

drug with food effects occur
9. Advised to not drink grape juice and  Grapefruit increase side effects of this
eat grapefruit-containing foods while dug
taking the drug
10. Shake suspension before use; do not  To have a longer potency and will not
refrigerate. Store at room temperature have side effects to the patient.
between 68°F and 77°F (20°C and 25°C).
11. Do not cut or crush, and ensure the  To avoid the release of all the drug at
patient does not chew the tablet once, which tend to increase the risk of
side effects.
12. Provide health teaching to patient and  To enhance patient and significant
significant others: other’s knowledge on drug therapy, to
a. Explain the drug's effect to the body raise awareness of how and when to take
the medication and to recognize side
and manifestations that would need effects and know what to do if they occur,
reporting. and promote adherence
b. Emphasize the importance of strict
adherence to drug therapy. To
ensure maximum therapeutic
effects.
c. Provide information to address the
adverse effects:
i. CNS: dizziness, headache, and
fatigue
1. Encourage to take some rest
2. Do some relaxation techniques to
avoid fatigue
3. If dizziness happens, instruct to
move slowly when sitting up or
standing and dangle feet briefly
before getting out of bed.
4. If symptoms persist, consult
primary health care provider
immediately
ii. Skin: anaphylaxis
1. Discontinue the drug and report
it immediately to doctor
iii. GI: diarrhea, abdominal pain,
vomiting, melena, flatulence, and
pseudomembranous colitis
1. For diarrhea: Encouraged to have
a diet known as BRAT may also
quickly relieve diarrhea. BRAT
stands for bananas, rice,
applesauce, and toast.
2. Increase fluid intake to prevent
dehydration.
3. Take anti-diarrheal and pain
medication as prescribed.
4. For vomiting: Encourage to eat dry
crackers; eat slowly and eat smaller,
more frequent meals.
5. Pseudomembranous colitis: Report
to the attending physician or any
primary healthcare provider
immediately if there is watery,
black stool even after 2 months
of drug therapy ended
iv. Others: superinfection and
decreased WBC
1. Instruct to notify physician or
any primary healthcare provider
immediately including black,
furry overgrowth on tongue, and
loose or foul-smelling stools.

Clarithromycin

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Clarithromycin

Date and Time ordered: April 10, 2023 @ 8:00 AM

Nursing Responsibilities Rationale

2. Observe the 12 R’s in medication  To promote safe and accurate

3. Review the allergic history of the  To prevent hypersensitivity reaction to

4. Explain the indication and possible  To provide knowledge and give

5. Monitor for renal, hepatic, and  To provide timely intervention and

8. Encouraged the patient to take the  This is to decrease GI upset when GI

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