Fortum

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ceftazidime

Fortaz, Fortum (UK), Tazicef

Pharmacologic class: Third-generation cephalosporin

Therapeutic class: Anti-infective

Pregnancy risk category B

Action

Interferes with bacterial cell-wall synthesis and division by binding to cell wall, causing cell to die. Active against gram-negative and gram-positive bacteria, with expanded activity against gram-negative bacteria. Exhibits minimal immunosuppressant activity.

Availability

Powder for injection: 500 mg, 1 g, 2 g, 6 g

Premixed containers: 1 g/50 ml, 2 g/50 ml

Indications and dosages

Skin infections; bone and joint infections; urinary tract and gynecologic infections, including gonorrhea; respiratory tract infections; intraabdominal infections; septicemia
Adults and children ages 12 and older: For most infections, 500 mg to 2 g I.V. or I.M. q 8 to 12 hours. For pneumonia and skin infections, 0.5 to 1 g I.V. or I.M. q 8 to 12 hours. For bone and joint infections, 2 g I.V. or I.M. q 12 hours. For severe and life-threatening infections, 2 g I.V. q 8 hours. For complicated urinary tract infections (UTIs), 500 mg q 8 to 12 hours. For uncomplicated UTIs, 250 mg I.M. or I.V. q 12 hours.
Children ages 1 month to 12 years: 30 to 50 mg/kg I.V. q 8 hours
Neonates younger than 4 weeks: 30 mg/kg I.V. q 12 hours

Dosage adjustment

• Renal impairment

Off-label uses

• Febrile neutropenia
• Prophylaxis of perinatal infections

Contraindications

• Hypersensitivity to cephalosporins or penicillins

Precautions

Use cautiously in:
• renal impairment, hepatic disease, biliary obstruction, phenylketonuria
• history of GI disease
• elderly patients
• pregnant or breastfeeding patients
• children.

Administration

• Obtain specimens for culture and sensitivity testing as necessary before starting therapy.
• Reconstitute powder for injection with sterile water, following manufacturer's directions for amount of diluent to use.
• For I.V. injection, dilute in sterile water as directed, and give single dose over 3 to 5 minutes. Inject into large vein; rotate injection sites.
• For intermittent I.V. infusion, dilute further with 100 ml of sterile water or another compatible fluid, such as normal saline solution or dextrose 5% in water. Infuse over 30 minutes.
• Don't dilute with sodium bicarbonate.
• For I.M. injection, reconstitute with sterile water, bacteriostatic water, or 0.5% or 1% lidocaine hydrochloride.
• When giving I.M., inject deep into large muscle mass.

Adverse reactions

CNS: headache, confusion, hemiparesis, lethargy, paresthesia, syncope, asterixis, neuromuscular excitability (with increased drug blood levels in renally impaired patients), seizures, encephalopathy

CV: hypotension, palpitations, chest pain, vasodilation

EENT: hearing loss

GI: nausea, vomiting, diarrhea, abdominal cramps, oral candidiasis, pseudomembranous colitis

GU: vaginal candidiasis, nephrotoxicity

Hematologic: lymphocytosis, eosinophilia, bleeding tendency, hemolytic anemia, hypoprothrombinemia, neutropenia, thrombocytopenia, agranulocytosis, bone marrow depression

Hepatic: hepatic failure, hepatomegaly

Musculoskeletal: arthralgia

Respiratory: dyspnea

Skin: urticaria, maculopapular or erythematous rash

Other: chills, fever, superinfection, I.M. site pain, anaphylaxis, serum sickness

Interactions

Drug-drug.Aminoglycosides, loop diuretics: increased risk of nephrotoxicity

Chloramphenicol: antagonism of ceftazidime's effects

Probenecid: decreased excretion and increased blood level of ceftazidime

Drug-diagnostic tests.Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine, eosinophils, gamma-glutamyltransferase, lactate dehydrogenase: increased levels

Hemoglobin, platelets, white blood cells: decreased values
Coombs' test, urinary 17-ketosteroids, nonenzyme-based urine glucose tests (such as Clinitest): false-positive results

Drug-herbs.Angelica, anise, arnica, asafetida, bogbean, boldo, celery, chamomile, clove, danshen, fenugreek, feverfew, garlic, ginger, ginkgo, ginseng, horse chestnut, horseradish, licorice, meadowsweet, onion, papain, passionflower, poplar, prickly ash, quassia, red clover, turmeric, wild carrot, wild lettuce, willow: increased risk of bleeding

Patient monitoring

Monitor for extreme confusion, tonic-clonic seizures, and mild hemiparesis when giving high doses.
• Assess CBC and kidney and liver function test results.
• Monitor for signs and symptoms of superinfection and other serious adverse reactions.
• Be aware that cross-sensitivity to penicillins may occur.

Patient teaching

• Instruct patient to report reduced urine output, persistent diarrhea, bruising, and bleeding.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.

Fortum

A brand name for CEFTAZIDIME.
References in periodicals archive ?
Consolidated Electric Power Asia, and Imatran Voima Oy.
Finland's energy group Fortum's power unit Imatran Voima (IVO) has agreed with Eesti Energia AS to cut carbon dioxide (CO2) emissions at the Narva power plant in Estonia by about 50,000 tonnes a year.
Also in June, the huge Finnish generator Imatran Voima (IVO), part of the soon-to-be privatised Fortum energy group, was cleared to join forces with Finland's big oil and chemicals group Neste to set up a new electricity generation and distribution company IVO-Neste Yhtyma Oy.
A joint venture consisting of Imatran Voima Oy (IVO) of Finland, a subsidiary of Fortum Corp.
The Finnish Government has announced that the privatisation of Fortum, the company created by the merger of the Finnish public companies Neste (oil, gas, petrochemicals) and Imatran Voima (electricity), is to be deferred because of unfavourable market conditions.
The Finnish state-run power producer Imatran Voima (IVO) is to build a 450 million Markka gas power station in Thailand.
Telia, the Swedish national operator, is the majority shareholder in Telivo (75 %) and the Finnish energy company Imatran Voima holds the minority share (25 %).
Finnish Imatran Voima (IVO), part of state-owned energy holding company Fortum, said it has set up a speciality glass joint venture with French Saint-Gobain .
Announcing clearance on June 3 under the EU Merger Regulation for the fusion of the oil, natural gas, heat supply and chemicals activities of Neste Oy with the power and heat generating, trading and distribution, power station engineering and grid maintenance businesses of Imatran Voima Oy (IVO), the European Commission explained that the merged entity had agreed to relinquish its majority stake in Finnish natural gas monopoly holder Gasum in order to preserve fair competition in the energy sector.
The parent company is Imatran Voima Oy, a Helsinki-based electrical power company established in 1932.