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June 5, 20(RR3);1-137 Gonococcal conjunctivitis: 1 g IM once Disseminated gonococcal infection: 1 g/day IV/IM; continued for at least 24-48 hours after improvement is observed, then continued with cefixime 400 mg PO q12hr to complete at least 1 week of therapy Gonococcal endocarditis:1-2 g IV q12hr for 4 weeks Gonococcal meningitis: 1-2 g IV q12hr for 10-14 days Acute epdidymitis: 250 mg IM once with doxycycline Agranulocytosis Anaphylaxis Anemia Basophilia Bronchospasm Candidiasis Chills Diaphoresis Dizziness Dysgeusia Flushing Gallstones Glycosuria Headache Hematuria Hemolytic anemia Increased alkaline phosphatase or bilirubin Increased creatinine Jaundice Leukocytosis Lymphocytosis Lymphopenia Monocytosis Nausea Neutropenia Phlebitis Prolonged or decreased prothrombin time (PT) Pruritus Renal stones Serum sickness Thrombocytopenia Urinary casts Vaginitis Vomiting Pancreatitis, stomatitis and glossitis Oliguria, ureteric obstruction, post-renal acute renal failure Exanthema, allergic dermatitis, urticaria, edema; 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use with caution in patients with gallbladder, biliary tract, liver, or pancreatic disease and patients with history of penicillin hypersensitivity Inform patients that use of local anesthetics may cause methemoglobinemia, which must be treated promptly; advise patients or caregivers to stop use and seek immediate medical attention if they or someone in their care experience the following signs or symptoms: pale, gray, or blue colored skin (cyanosis); headache; rapid heart rate; shortness of breath; lightheadedness; or fatigue Use with caution in patients with history of GI disease (eg, colitis) Third-generation cephalosporin with broad-spectrum gram-negative activity; has lower efficacy against gram-positive organisms but higher efficacy against resistant organisms; highly stable in presence of beta-lactamases (penicillinase and cephalosporinase) of gram-negative and gram-positive bacteria; bactericidal activity results from inhibiting cell-wall synthesis by binding to 1 or more penicillin-binding proteins; exerts antimicrobial effect by interfering with synthesis of peptidoglycan (major structural component of bacterial cell wall); bacteria eventually lyse because activity of cell-wall autolytic enzymes continues while cell-wall assembly is arrested Distributed throughout body, including gallbladder, lungs, bone, bile, and CSF (higher concentrations achieved when meninges are inflamed); crosses placenta; enters amniotic fluid and breast milk Protein bound: 85-95% Vd: 6-14 L 10 mg/m L; compatible at 1 mg/m L) Additive: Aminophylline, clindamycin, linezolid, theophylline, metronidazole (at metronidazole 15 g/L with ceftriaxone 20 g/L; compatible at metronidazole 7.5 g/L with ceftriaxone 10 g/L) Syringe: Lidocaine (variable) Y-site: Alatrofloxacin, amphotericin B cholesteryl sulfate, amsacrine, filgrastim, fluconazole, labetalol, pentamidine, vinorelbine, vancomycin General: Calcium-containing drugs The above information is provided for general informational and educational purposes only. 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