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|Cephradine

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Cephradine

Pronouncation: (SEFF-ruh-deen)
Class: Antibiotic, Cephalosporin

Trade Names:
Velosef
- Capsules 250 mg
- Capsules 500 mg
- Powder for Oral Suspension 125 mg/5 mL
- Powder for Oral Suspension 500 mg/5 mL

Mechanism of Action

Pharmacology

Inhibits mucopeptide synthesis in bacterial cell wall.

Pharmacokinetics

Absorption

Cephradine is rapidly absorbed. C _max is about 9 mcg/mL (250 mg) to 24.2 mcg/mL (1 g). T _max is 1 hr. Food delays absorption.

Distribution

8% to 17% protein bound.

Elimination

More than 90% is excreted unchanged in the urine. The t _½ is 48 to 80 min.

Special Populations

Renal Function Impairment

The t _½ is prolonged. Dosage adjustment is recommended.

Indications and Usage

Treatment of infections of respiratory tract, urinary tract, skin and skin structure; treatment of otitis media caused by susceptible strains of microorganisms.

Contraindications

Hypersensitivity to cephalosporins.

Dosage and Administration

Adults

PO 250 mg to 1 g q 6 to 12 hr.

Children

PO 25 to 100 mg/kg/day in equally divided doses q 6 to 12 hr (max, 4 g/day).

General Advice

May administer without regard to meals. Administer with food or milk if GI upset occurs. Food slows but does not decrease absorption.

Storage/Stability

Reconstituted oral suspension may be stored at room temperature for up to 7 days or in refrigerator for 14 days. Shake well before pouring. When drug is stored at room temperature, protect from light.

Drug Interactions

Probenecid

Inhibition of renal excretion of cephradine.

Laboratory Test Interactions

May cause false-positive urine glucose test results with Benedict"s solution, Fehling"s solution, or Clinitest tablets but not with enzyme-based tests (eg, Clinistix , Testape ); false-positive test results for proteinuria with acid and denaturization-precipitation tests; false-positive direct Coombs" test result in certain patients (eg, those with azotemia); false elevations in urinary 17-ketosteroid values; false-positive reactions in urinary protein tests that use sulfosalicylic acid.

Adverse Reactions

GI

Nausea; vomiting; diarrhea; colitis, including pseudomembranous colitis.

Genitourinary

Renal dysfunction; pyuria; dysuria; reversible interstitial nephritis; hematuria; toxic nephropathy.

Hematologic

Eosinophilia; neutropenia; lymphocytosis; leukocytosis; decreased platelet function; anemia; aplastic anemia.

Hepatic

Hepatic dysfunction; abnormal LFT results.

Miscellaneous

Hypersensitivity, including Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis; candidal overgrowth; serum sickness–like reactions (eg, skin rashes, polyarthritis, arthralgia, fever).

Precautions

Monitor

Response to therapy

Monitor patient"s response to therapy. Notify health care provider if infection does not appear to improve or worsens.

Side effects

Monitor patient for GI, DERM, and general body side effects, and signs of superinfection. Inform health care provider if noted and significant. Immediately report severe diarrhea, diarrhea containing blood or pus, or severe abdominal cramping.

Pregnancy

Category B .

Lactation

Excreted in breast milk.

Children

Safety and efficacy for infants under 9 mo not established.

Hypersensitivity

Reactions range from mild to life-threatening. Administer drug with caution to penicillin-sensitive patients because of possible cross-reactivity.

Renal Function

Use drug with caution in patients with renal impairment. Monitor renal function and dosage adjusted.

Superinfection

Drug may result in bacterial or fungal overgrowth of nonsusceptible microorganisms.

Pseudomembranous colitis

Consider in patients in whom diarrhea develops.

Overdosage

Symptoms

Seizures.

Patient Information

Instruct patient to complete full course of therapy.
Advise patient to take with food or milk if GI distress occurs.
Remind patient to check body temperature daily. If fever persists for more than a few days or if high fever (higher than 102°F) or shaking chills are noted, notify health care provider immediately.
Advise patient to maintain normal fluid intake while using this medication.
Remind diabetic patient to use enzyme-based tests (eg, Clinistix or Testape ) for monitoring urine glucose because drug may give false results with other tests.
Instruct patient to report these symptoms to health care provider: nausea, vomiting, diarrhea, skin rash, muscle or joint pain.
Advise patient to report signs of superinfection: black “furry” tongue, white patches in mouth, foul-smelling stools, vaginal itching or discharge.
Warn patient that diarrhea that contains blood or pus may be sign of serious disorders. Tell patient to seek medical care and not to treat at home.
Instruct patient to seek emergency care immediately if wheezing or difficulty in breathing occurs.

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