1. Assess for allergic reactions; if reaction occurs, stop drug immediately. Allergic reactions are more likely to occur with a history of asthma, hay fever, urticaria, or allergy to cephalo-sporins.

2. The elderly may be more sensitive to the effects of penicillin than younger people. Use care when calculating the dose based on weight and height.

3. Most penicillins are excreted in breast milk and should be prescribed cautiously to nursing mothers. Client/Family Teaching

1. Review drugs prescribed, method and frequency of administration, side effects, and expected outcome/goals of therapy.

2. Report any S&S of allergic reactions, i.e., rashes, fever, joint swelling, angioneurotic edema, intense itching, and respiratory distress (during therapy and in some cases 7—12 days after therapy). Stop medication when noted and call for help immediately.

3. Oral penicillins may cause GI upset (N&V and diarrhea). Take oral penicillin with a glass of water 1 hr before or 2 hr after meals to minimize binding to foods.

4. Complete the entire prescribed course of therapy, even if feeling well. Incomplete therapy will predispose client to development of resistant bacterial strains. With alpha-he-molytic Streptococcus infection, must continue with penicillin therapy for a minimum of 10 days, and preferably 14 days, to prevent development of rheumatic fever or glomeruloneph-ritis.

5. Report S&S of superinfections (furry tongue, vaginal or rectal itching, diarrhea).

6. Notify provider if S&S do not improve or get worse after 48—72 hr of therapy.

7. For patients taking oral contraceptives, use a back-up method of birth control for the remainder of the current cycle.

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