Timentin

Ti·men·tin (tmntn)

A trademark for the drug ticarcillin disodium.

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ticarcillin disodium and clavulanate potassium

Timentin

Pharmacologic class: Penicillin (extended-spectrum)

Therapeutic class: Anti-infective

Pregnancy risk category B

Action

Ticarcillin disodium inhibits bacterial cell-wall synthesis during replication; clavulanic acid extends ticarcillin's antibiotic spectrum by inactivating beta-lactamase enzymes (which otherwise would degrade ticarcillin).

Availability

Injection: 3 g ticarcillin and 100 mg clavulanic acid in 3.1-g vials

⊘Indications and dosages

➣ Systemic and urinary tract infections caused by susceptible organisms

Adults weighing more than 60 kg (132 lb): 3.1 g (30:1 fixed-ratio combination of 3 g ticarcillin and 100 mg clavulanic acid) by I.V. infusion q 4 to 6 hours

Adults weighing less than 60 kg (132 lb): 200 to 300 mg/kg/day (based on ticarcillin content) by I.V. infusion in divided doses q 4 to 6 hours

➣ Gynecologic infections caused by susceptible organisms

Adults weighing more than 60 kg (132 lb): For moderate infections, 200 mg/kg/day (based on ticarcillin content) by I.V. infusion in divided doses q 6 hours. For severe infections, 300 mg/kg/day (based on ticarcillin content) by I.V. infusion in divided doses q 4 hours.

Adults weighing less than 60 kg (132 lb): 200 to 300 mg/kg/day by I.V. infusion q 4 to 6 hours

➣ Mild to moderate or severe infections in children caused by susceptible organisms

Children weighing more than 60 kg (132 lb): For mild to moderate infections, 3.1 g (30:1 fixed-ratio combination of 3 g ticarcillin and 100 mg clavulanic acid) by I.V. infusion q 6 hours. For severe infections, 3.1 g (30:1 fixed-ratio combination of 3 g ticarcillin and 100 mg clavulanic acid) by I.V. infusion q 4 hours.

Children ages 3 months to 16 years weighing less than 60 kg (132 lb): For mild to moderate infections, 200 mg/kg/day (based on ticarcillin content) by I.V. infusion in divided doses q 6 hours. For severe infections, 300 mg/kg/day (based on ticarcillin content) by I.V. infusion in divided doses q 4 hours.

Dosage adjustment

• Renal impairment

Contraindications

• Hypersensitivity to drug or other penicillins

Precautions

Use cautiously in:
• cystic fibrosis, renal or hepatic disease
• pregnant or breastfeeding patients.

Administration

• Ask patient about penicillin allergy before giving.
• Add 13 ml of sterile water or normal saline solution to vial; shake gently. Dilute further to 10 to 100 mg/ml of ticarcillin; infuse I.V. over 30 minutes.
• Give at least 1 hour before I.V. aminoglycosides (such as amikacin or gentamicin).

Route	Onset	Peak	Duration
I.V.	Immediate	Immediate	Unknown

Adverse reactions

CNS: headache, giddiness, dizziness, lethargy, fatigue, hyperreflexia, neuromuscular excitability, asterixis, hallucinations, stupor, seizures

GI: nausea, vomiting, diarrhea, flatulence, pseudomembranous colitis

Hematologic: eosinophilia, transient neutropenia and leukopenia (with high doses)

Skin: urticaria, rash

Other: unpleasant taste; fever; overgrowth of nonsusceptible organisms; pain, vein irritation, erythema, phlebitis, and thrombophlebitis at I.V. site; hypersensitivity reactions including anaphylaxis

Interactions

Drug-drug. Aminoglycosides: physical incompatibility, causing aminoglycoside inactivation when mixed in same I.V. solution

Aminoglycosides, tetracyclines: additive activity against some bacteria

Lithium: altered lithium elimination

Probenecid: increased ticarcillin blood level

Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, eosinophils, lactate dehydrogenase, sodium: increased levels

Bleeding time: prolonged

Granulocytes, hemoglobin, platelets, white blood cells: decreased levels

Liver function tests: transient increases

Urine glucose, urine protein: false-positive results

Patient monitoring

• Monitor liver function tests and CBC with white cell differential.
• Watch closely for signs and symptoms of superinfection and severe allergic reactions.
• Assess neurologic status, and stay alert for seizures.

Patient teaching

☞ Advise patient to report skin reactions and severe diarrhea right away.
☞ Tell patient drug may increase risk of other infections. Advise him to promptly report signs and symptoms of new infection.
• Instruct patient to limit sodium intake (drug contains sodium).
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

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Timentin

AIDS A parenteral antibacterial used to manage skin infections. See AIDS.