Chloramphenicol and Drug-Drug Interactions
Chloramphenicol can have an adverse interaction with alfentanil (Alfenta) by
increasing alfentanil levels in the patient. Chloramphenicol is known to increase
bone marrow depression when given with anticonvulsants.
Patients who are taking antidiabetic medication may see an increase in the
level of that medication when taken with chloramphenicol resulting in hypo-
glycemia. Therefore, diabetics who take chloramphenicol must closely monitor
their blood glucose level.
Chloramphenicol also causes a decrease in the therapeutic effect of clin-
damycin, erythromycin, or lincomycin. Chloramphenicol increases the drug
serum levels of phenobarbital (Luminal), phenytoin (Dilantin), or warfarin
(Coumadin) which can lead to toxicity.Chloramphenicol, Nursing Diagnosis,
and Collaborative Problems
Patients who take chloramphenicol may also experience rash, fever, and dysp-
nea. Neonates experience gray syndrome.
Here are the common nursing diagnoses that are related to a patient who is
taking chloramphenicol.- Fluid volume deficit related to anorexia, nausea, and vomiting
- Altered protection related to dose-related bone marrow depression
- Altered bowel elimination (diarrhea)
- Altered thought processes (confusion, delirium) related to neurotoxic reac-
tions; sensory-perceptual disturbances related to optic neuritis (blurred
vision, loss of vision, eye pain); and to peripheral neuritis (tingling, numb-
ness, and burning pain of the hands and feet)
FLUOROQUINOLONES
Fluoroquinolones are a broad spectrum, synthetic antibiotic that stop bacterial
growth in bone and joint infections, bronchitis, gastroenteritis, gonorrhea, pneu-(^236) CHAPTER 13 Antimicrobials—Fighting Infection