There are several precautions that must be taken when administering peni-
cillin. If penicillin is given PO, avoid giving this medication an hour before and
an hour after the patient has eaten. However, food doesn’t have any effect on
amoxicillin, amoxicillin and clavulanate, and bacampicillin. Give penicillin with
a full glass of water and not with acidic fruit juices.
If penicillin is administered IV, give it slowly because penicillin contains a large
amount of potassium that can cause heart failure in patients with renal insufficiency.
Before penicillin is administered, the patient must be assessed for a number
of conditions. One of the most important is allergies. An allergic reaction to
penicillin can be anywhere from a mild rash to anaphylactic shock and death.
Furthermore, don’t administer penicillin to patients who have:- A tendency to bleed.
- Ulcerative colitis and other GI diseases.
- Mononucleosis (a skin rash may develop with use of ampicillin or
bacampicillin). - A low-salt diet (parenteral carbenicillin and ticarcillin have high sodium
content - Impaired renal function (a lower dose may be given in such cases).
After penicillin is administered, monitor the patient for:- Serum electrolytes for hyperkalemia (elevated potassium) and/or hyperna-
turemia (elevated sodium) - Unusual weight loss (especially in the elderly)
- Vital signs
- WBC
- Cultures
- Prothrombin Time (PT) (bleeding times)
Descriptions of medication throughout this chapter use the following
abbreviations:(^210) CHAPTER 13 Antimicrobials—Fighting Infection
PB protein-binding IV intravenous
t^1 ⁄ 2 half-life IM intramuscular
UK unknown A adult
PO by mouth C child