Mosby's 2014 Nursing Drug Reference (99 page)
Read Mosby's 2014 Nursing Drug Reference Online
Authors: Linda Skidmore-Roth
Canada only Side effects:
italics
= common;
bold
= life-threatening 
Nurse Alert
(klin-da-my′sin)
Cleocin HCl, Dalacin C
palmitate (Rx)
Cleocin Pediatric, Dalacin C Flavored Granules
phosphate (Rx)
Cleocin Phosphate, Dalacin C Phosphate Sterile Solution
Func. class.:
Antiinfective—miscellaneous
Chem. class.:
Lincomycin derivative
Binds to 50S subunit of bacterial ribosomes, suppresses protein synthesis
Infections caused by staphylococci, streptococci,
Rickettsia, Fusobacterium, Actinomyces, Peptococcus, Bacteroides, Pneumocystis jiroveci
Unlabeled uses:
Acne rosacea,
Bacillus anthracis
, dental infections, folliculi
tis, malaria, pemphigus, periodontitis,
Pneumocystis jiroveci
pneumonia (PCP), toxoplasmosis
Hypersensitivity to this product or lincomycin, tartrazine dye; ulcerative colitis/enteritis
Black Box Warning:
Pseudomembranous colitis
Precautions:
Pregnancy (B), breastfeeding, geriatric patients, GI/renal/hepatic disease, asthma, allergy
Black Box Warning:
Diarrhea
Calculator
• Adult:
PO
150-450 mg q6-8hr, max 1.8 g/day;
IM/IV
1.2-2.7 g/day in 2-4 divided doses, max 4800 mg/day
• Child >1 mo:
PO
8-25 mg/kg/day in divided doses q6-8hr;
IM/IV
20-40 mg/kg/day in 3-4 equal divided doses q6-8hr
• Neonate:
IM/IV
15-20 mg/kg/day divided doses q6-8hr
• Adult:
IV
900 mg q8hr plus gentamicin
• Adult:
600 mg 1 hr before procedure
(unlabeled)
• Adult:
PO
1200-1800 mg/day in divided doses with 15-30 mg primaquine/day × 21 days
• Adult/adolescent:
Top gel, lotion, sol, apply a thin film to affected areas bid for up to 12 wk
• Adult/adolescents/child ≥2 yr:
Top (foam), apply to affected areas daily, if no improvement in 8 wk, discontinue
• Adult/adolescent females:
Intravaginal 1 applicator full (100 mg clindamycin/5 g cream) at bedtime × 7 days (CDC)
Available forms:
HCl:
caps 75, 150, 300 mg;
palmitate:
oral sol 75 mg/5 ml;
phosphate:
inj 150, 300, 600 mg base/4 ml; 900 mg base/ml; inj inf in D
5
300 mg, 600 mg, 900 mg; top pledget/foam/gel/lotion/solution/1%; Vag cream 2%; Vag suppository 100 mg
•
In equal intervals around the clock to maintain blood levels
•
Obtain C&S before use
•
EPINEPHrine, suction, tracheostomy set, endotracheal intubation equipment on unit available
•
Do not break, crush, chew caps
•
Orally with at least 8 oz of water
•
Do not refrigerate reconstituted product, store at room temperature ≤2 wk
•
Reconstitute granules with most of 75 ml of water, shake well, add remaining water, shake well (75 mg/5 ml)
•
IM deep inj; rotate sites; do not give >600 mg in single IM inj
•
By inf only; do not administer bolus dose;
dilute
300-mg or 600-mg doses/50 ml of D
5
W, NS;
give
over 10 or 20 min, respectively; 900-mg and 1200-mg doses/100 ml of compatible diluent and
give
over 30 or 40 min, respectively; final conc ≤12 mg/ml; if using ADD-Vantage vials, dilute containers with NS, D
5
W, give over 10-60 min, rate max 30 mg/min, max 1.2 g/h
•
Dilute as above, administer as rapid 1st dose only, then give at
cont inf
rate based on clindamycin levels
Syringe compatibilities:
Amikacin, aztreonam, gentamicin, heparin
Y-site compatibilities:
Acyclovir, alfentanil, amifostine, amikacin, aminocaproic acid, aminophylline, amiodarone, amphotericin B cholesteryl, amphotericin B lipid complex, amsacrine, anakinra, anidulafungin, ascorbic acid injection, atenolol, atracurium, atropine, aztreonam, benztropine, bivalirudin, bleomycin, bumetanide, buprenorphine, butorphanol, calcium chloride/gluconate, CARBOplatin, cefamandole, ceFAZolin, cefmetazole, cefonicid, cefo
perazone, cefotaxime, cefoTEtan, cefOXitin, cefpirome, cefTAZidime, ceftizoxime, ceftobiprole, cefuroxime, cephalothin, cephapirin, chloramphenicol, cimetidine, cisatracurium, CISplatin, codeine, cyanocobalamin, cyclophosphamide, cycloSPORINE, cytarabine, DACTINomycin, DAPTOmycin, dexamethasone, dexmedetomidine, digoxin, diltiazem, diphenhydrAMINE, DOCEtaxel, DOPamine, doxacurium, DOXOrubicin, DOXOrubicin liposomal, doxycycline, enalaprilat, ePHEDrine, EPINEPHrine, epirubicin, epoetin alfa, eptifibatide, esmolol, etoposide, famotidine, fenoldopam, fentaNYL, fludarabine, fluorouracil, folic acid, foscarnet, furosemide, gatifloxacin, gemcitabine, gemtuzumab, gentamicin, glycopyrrolate, granisetron, heparin, hydrocortisone, HYDROmorphone, ifosfamide, imipenem-cilastatin, indomethacin, insulin (regular), irinotecan, isoproterenol, ketorolac, levofloxacin, lidocaine, linezolid, LORazepam, LR, magnesium sulfate, mannitol, mechlorethamine, melphalan, meperidine, metaraminol, methicillin, methotrexate, methoxamine, methyldopate, methylPREDNISolone, metoclopramide, metoprolol, metroNIDAZOLE, mezlocillin, miconazole, milrinone, morphine, moxalactam, multiple vitamins injection, nafcillin, nalbuphine, naloxone, nesiritide, netilmicin, niCARdipine, nitroglycerin, nitroprusside, norepinephrine, octreotide, ondansetron, oxacillin, oxaliplatin, oxytocin, PACLitaxel, palonosetron, pamidronate, pancuronium, pantoprazole, PEMEtrexed, penicillin G potassium/sodium, pentazocine, perphenazine, PHENobarbital, phenylephrine, phytonadione, piperacillin, piperacillin-tazobactam, potassium chloride, procainamide, propofol, propranolol, protamine, pyridoxine, ranitidine, remifentanil, Ringer’s, ritodrine, riTUXimab, rocuronium, sargramostim, sodium acetate/bicarbonate, succinylcholine, SUFentanil, tacrolimus, teniposide, theophylline, thiamine, thiotepa, ticarcillin, ticarcillin-clavulanate, tigecycline, tirofiban, TNA, tobramycin, tolazoline, TPN, trimetaphan, urokinase, vancomycin, vasopressin, vecuronium, verapamil, vinCRIStine, vinorelbine, vitamin B complex/C, voriconazole, zidovudine, zoledronic acid
GI:
Nausea, vomiting, abdominal pain, diarrhea
,
pseudomembranous colitis,
anorexia, weight loss, increased AST/ALT, bilirubin, alk phos; jaundice
GU:
Vaginitis
, urinary frequency
INTEG:
Rash, urticaria, pruritus, erythema, pain, abscess at inj site
SYST:
Stevens-Johnson syndrome, exfoliative dermatitis
PO:
Peak 45 min, duration 6 hr
IM:
Peak 3 hr (adult), 1 hr (child); duration 8-12 hr; half-life 21/2 hr; metabolized in liver; excreted in urine, bile, feces as inactive metabolites; crosses placenta; excreted in breast milk
•
May block clindamycin effect: erythromycin, chloramphenicol
Increase:
neuromuscular blockade—neuromuscular blockers
Decrease:
absorption—kaolin
Increase:
alk phos, bilirubin, CPK, AST, ALT
•
Infection:
C&S before product therapy; product may be given as soon as culture is taken
•
VS, urine, stools, sputum
•
Hepatic studies: AST, ALT if on long-term therapy
•
B/P, pulse in patient receiving product parenterally
Black Box Warning:
Pseudomembranous colitis:
bowel pattern before, during treatment; if severe diarrhea occurs, product should be discontinued, may occur several wk after therapy is terminated
•
Respiratory status: rate, character, wheezing, tightness in chest
•
Serious skin reactions:
Stevens-Johnson syndrome, exfoliative dermatitis
•
Therapeutic response: decreased temp, negative C&S
•
To take oral product with full glass of water; that antiperistaltic products may worsen diarrhea
•
About all aspects of product therapy; to complete entire course of medication to ensure organism death (10-14 days); culture may be taken after medication course completed
To report sore throat, fever, fatigue; may indicate
superinfection
•
To take with food to reduce GI symptoms
•
To notify nurse or prescriber of diarrhea with pus, mucous
•
Withdraw product; maintain airway; administer EPINEPHrine, aminophylline, O
2
, IV corticosteroids