VOL: 100, ISSUE: 48, PAGE NO: 33- Capsules: chloramphenicol....
- Capsules: chloramphenicol.
- Eye: chloramphenicol, Chloromycetin, Minims Chloramphenicol.
- Ear: chloramphenicol.
- Topical: Actinac.
- Functional: broad-spectrum antibiotic.
- Chemical: dichloroacetic acid derivative.
- Legal: prescription only.
- Interferes with protein synthesis in intact bacterial cells.
- Nurse prescriber: ophthalmic infections.
- Other: otitis externa; acne, rosacea (topical); severe infections (oral/IV); all preparations are active against a wide range of organisms including Salmonella typhi, Haemophilus influenzae, Neisseria meningitidis, Streptococcus pneumoniae, Mycoplasma spp, Chlamydia spp.
- All routes: hypersensitivity.
- Ear: perforated eardrum.
- IV: during labour.
- Oral/IV: previous toxic reaction, pregnancy, breastfeeding, porphyria, trivial infections.
- Ear: avoid prolonged use, high incidence of hypersensitivity reactions.
- Eye: overgrowth of non-susceptible organisms.
- Oral/IV: reduce dose in impaired hepatic/renal function, overgrowth of non-susceptible organisms, carry out blood studies.
- Topical: pregnancy.
- Ear: irritation, itching, rash, urticaria, contact dermatitis, burning.
- Eye: transient stinging/burning sensations.
- Oral/IV: blood disorders including aplastic/hypoplastic anaemia, bone marrow depression, peripheral/optic neuritis, erythema multiforme, nausea, vomiting, diarrhoea, stomatitis, glossitis, Grey's syndrome in newborn.
- Topical: severe erythema.
- Enhanced effects of acenocoumarol, warfarin, tolbutamide, phenytoin.
- Reduced effects of chloramphenicol with rifampicin, phenobarbitone.
- Half-life prolonged by paracetamol.
- Avoid myelosuppressive drugs.
- Ear: clean stopper and warm solution to body temperature.
- Eye: wash hands and cleanse eye before application, apply pressure to lacrymal sac for one minute to prevent systemic absorption. Apply topically inside lower eye lid.
- IV: injection over at least one minute as a solution containing 25mg/ml or 100mg/ml; infusion after further dilution in suitable quantity of fluid.
- Oral: on empty stomach with full glass of water.
- Ear: evaluate therapeutic response. Redness, swelling, pain in the ear indicates superimposed infection.
- Eye: evaluate therapeutic response. Itching, lacrimation, redness, swelling indicates allergy.
- IV/oral: assess allergies before treatment. Mark in bright red on chart. Alert all people giving medication. Monitor fluid balance, bowel patterns. Evaluate therapeutic response - decreased temperature, negative culture.
- Ear: method of instillation using aseptic technique. Dizziness may occur after instillation, be aware of possible side-effects, avoid prolonged use.
- Eye: use as prescribed, do not touch container tip to eye, use separate tip for each eye, wash hands between applications, do not use make-up, towels, face cloths of others; may cause blurred vision when applied; report itching, increased redness, stinging, swelling and discontinue use.
- IV/oral: complete entire course; report sore throat, fever, unusual bleeding or bruising, diarrhoea; take at equal intervals around the clock; wear/carry identification if allergic to this drug; be aware of side-effects.
- Nurses should refer to manufacturer's summary of product characteristics and to appropriate local guidelines.