wala ko tulog karon!!!!!
Thursday, July 30, 2009
common misconception in digestive system diseases
Myth # 1 Ulcers: Spicy food and stress cause stomach ulcers.
False - The truth is, the majority of stomach ulcers are caused either by infection with a bacterium called Helicobacter pylori (H. pylori) or by use of pain medications such as aspirin, ibuprofen, or naproxen, the so-called nonsteroidal antiinflammatory drugs (NSAIDs). Most H. pylori-related ulcers can be cured with antibiotics. NSAID-induced ulcers can be cured with time, stomach-protective medications, antacids, and avoidance of NSAIDs. Now that it is appreciated that H. pylori and NSAIDs are the cause of most ulcers and patients are being managed appropriately, the ulcers that are coming to medical attention are increasingly likely to be unrelated to H. pylori or NSAIDs. Spicy food and stress (except when associated with extreme medical conditions) may aggravate ulcer symptoms in some people, but they do not cause ulcers. Ulcers can also be caused by cancer.
Myth # 2 Heartburn: Smoking a cigarette helps relieve heartburn.
False - Actually, cigarette smoking may contribute to heartburn. Heartburn occurs when the lower esophageal sphincter (LES) - a muscle between the esophagus and stomach - relaxes, allowing the acidic contents of the stomach to splash back (reflux) into the esophagus. People who smoke more frequently have inflammation of the esophagus (esophagitis), presumably caused by increased reflux of acid, that is the basis of heartburn. The increased reflux is believed to be due to the fact that cigarette smoking causes the LES to relax
Myth # 3 Celiac Disease: Celiac disease is a rare childhood disease.
False - Celiac disease affects both children and adults. About 1 in 200 people in the United States have the genetic predisposition for celiac disease although not all of them have the disease. Sometimes celiac disease first causes symptoms during childhood, usually diarrhea, growth failure, and failure to thrive. But the disease can also first cause symptoms in adults of any age. These symptoms may be vague and therefore attributed to other conditions. Symptoms can include bloating and abdominal distention, flatulence, diarrhea, and abdominal pain due to the involvement of the small intestine as well as skin rash, anemia, and thinning of the bones (osteoporosis) due to malabsorption of nutrients by the diseased intestine. Celiac disease may cause such nonspecific symptoms for several years before being correctly diagnosed and treated.
People with celiac disease should not eat any foods containing gluten, a protein in wheat, rye, and barley, whether they have symptoms or not. In celiac disease, gluten provokes an inflammatory reaction by the body that destroys the lining of the small intestine, which interferes with the absorption of nutrients. Even a small amount of gluten can cause damage, and sometimes no symptoms will be apparent.
Myth # 4 Bowel Regularity: Bowel regularity means a bowel movement every day.
False - The frequency of bowel movements among normal, healthy people varies from three a day to three a week, and some perfectly healthy people fall outside both ends of this range. Nevertheless, even three bowel movements a day can be abnormal in someone who usually has one bowel movement a day. People with irritable bowel syndrome (IBS) may have fluctuating numbers of stools each day as well as fluctuating consistency of their stools.
Myth # 5 Constipation: Habitual use of enemas to treat constipation is harmless.
False? - It is not clear whether or not habitual use of enemas is harmless since there has been very little study of the effects of enemas or laxatives over the long term. Early studies showed that laxatives might injure the colon if taken chronically by impairing contraction of the colonic muscles, and this finding was extrapolated to include enemas. The data from the studies is not strong, however. In fact, some physicians feel that enemas are preferred over laxatives since they are a more "natural" means of stimulating a bowel movement. (Enemas mimic a large amount of stool in the rectum, the usual stimulus for a bowel movement.) An ongoing need for enemas is not normal; you should see a doctor if you find yourself relying on them or any other medication to have a bowel movement.
Myth # 6 Diverticulosis: Diverticulosis is an uncommon and serious problem.
False - Actually, the majority of Americans over age 60 have diverticulosis, but only a small percentage have symptoms or complications. Diverticulosis is a condition in which little sacs or out-pouchings, called diverticula, develop in the wall of the colon. These sacs tend to appear and increase in number as individuals age. Most people have no symptoms and learn that they have diverticula after an X-ray or intestinal examination (for example, colonoscopy or barium enema) that is being done for a purpose unrelated to the diverticulosis. Less than 10 per cent of people with diverticulosis ever develop complications such as infection (diverticulitis), bleeding, or perforation of the colon.
Myth # 7 Inflammatory Bowel Disease (Ulcerative Colitis and Crohn's Disease): Inflammatory bowel disease is caused by psychological problems.
False - Inflammatory bowel disease is the general name for two diseases that cause inflammation in the intestines, Crohn's disease and ulcerative colitis. The cause of the disease is unknown, but researchers speculate that it may result from a virus or bacteria interacting with the body's immune system. No evidence has been found to support the theory that inflammatory bowel disease is caused by tension, anxiety, or any other psychological factor or disorder, although these can aggravate the discomfort caused by the disease.
Myth # 8 Cirrhosis: Cirrhosis is only caused by alcoholism.
False - Alcoholism is just one of many causes of cirrhosis. Cirrhosis is scarring and decreased function of the liver. In the United States, alcohol causes less than one-half of cirrhosis cases. The remaining cases are from diseases that cause liver damage. For example, in children, cirrhosis may result from cystic fibrosis, alpha-1 antitrypsin deficiency, biliary atresia, glycogen storage diseases, and other rare diseases. In adults, cirrhosis may be caused by hepatitis B or C, primary biliary cirrhosis, diseases of abnormal storage of metals (like iron or copper) in the body, severe reactions to prescription drugs, or injury to the ducts that drain bile from the liver. In adults, cirrhosis can also be caused by nonalcoholic steatohepatitis (NASH), which is becoming the most common liver disease in the United States, affecting 2 to 5 percent of Americans. NASH is associated with the increasing prevalence of obesity and diabetes.
Myth # 9 Ostomy Surgery: After ostomy surgery, men become impotent, and women have impaired sexual function and are unable to become pregnant.
False - Ostomy surgery does not, in general, interfere with a person's sexual or reproductive capabilities. Ostomy surgery is a procedure in which the diseased part of the small or large intestine is removed and the remaining intestine is attached to an opening in the abdomen. Stool is collected in a bag taped to the skin over the opening. Alternatively, an internal pouch that collects the stool may be formed from a portion of the intestine. The pouch then can be emptied by insertion of a catheter at regular intervals.
Although some men who have had radical ostomy surgery for cancer lose the ability to achieve and sustain an erection, most men do not, or, if they do, it is temporary. This is caused by damage to the nerves that supply the penis. If erectile dysfunction persists, a variety of solutions are available. A urologist, a doctor who specializes in such problems, can help find the best solution.
In women, ostomy surgery does not damage sexual or reproductive organs, so it is not a direct cause of sexual problems or sterility. Factors such as pain and the adjustment to a new body image may create temporary sexual problems, but they can usually be resolved with time and, in some cases, counseling. Unless a woman has had a hysterectomy to remove her uterus, she can still bear children.
More Reading on Digestive Diseases
False - The truth is, the majority of stomach ulcers are caused either by infection with a bacterium called Helicobacter pylori (H. pylori) or by use of pain medications such as aspirin, ibuprofen, or naproxen, the so-called nonsteroidal antiinflammatory drugs (NSAIDs). Most H. pylori-related ulcers can be cured with antibiotics. NSAID-induced ulcers can be cured with time, stomach-protective medications, antacids, and avoidance of NSAIDs. Now that it is appreciated that H. pylori and NSAIDs are the cause of most ulcers and patients are being managed appropriately, the ulcers that are coming to medical attention are increasingly likely to be unrelated to H. pylori or NSAIDs. Spicy food and stress (except when associated with extreme medical conditions) may aggravate ulcer symptoms in some people, but they do not cause ulcers. Ulcers can also be caused by cancer.
Myth # 2 Heartburn: Smoking a cigarette helps relieve heartburn.
False - Actually, cigarette smoking may contribute to heartburn. Heartburn occurs when the lower esophageal sphincter (LES) - a muscle between the esophagus and stomach - relaxes, allowing the acidic contents of the stomach to splash back (reflux) into the esophagus. People who smoke more frequently have inflammation of the esophagus (esophagitis), presumably caused by increased reflux of acid, that is the basis of heartburn. The increased reflux is believed to be due to the fact that cigarette smoking causes the LES to relax
Myth # 3 Celiac Disease: Celiac disease is a rare childhood disease.
False - Celiac disease affects both children and adults. About 1 in 200 people in the United States have the genetic predisposition for celiac disease although not all of them have the disease. Sometimes celiac disease first causes symptoms during childhood, usually diarrhea, growth failure, and failure to thrive. But the disease can also first cause symptoms in adults of any age. These symptoms may be vague and therefore attributed to other conditions. Symptoms can include bloating and abdominal distention, flatulence, diarrhea, and abdominal pain due to the involvement of the small intestine as well as skin rash, anemia, and thinning of the bones (osteoporosis) due to malabsorption of nutrients by the diseased intestine. Celiac disease may cause such nonspecific symptoms for several years before being correctly diagnosed and treated.
People with celiac disease should not eat any foods containing gluten, a protein in wheat, rye, and barley, whether they have symptoms or not. In celiac disease, gluten provokes an inflammatory reaction by the body that destroys the lining of the small intestine, which interferes with the absorption of nutrients. Even a small amount of gluten can cause damage, and sometimes no symptoms will be apparent.
Myth # 4 Bowel Regularity: Bowel regularity means a bowel movement every day.
False - The frequency of bowel movements among normal, healthy people varies from three a day to three a week, and some perfectly healthy people fall outside both ends of this range. Nevertheless, even three bowel movements a day can be abnormal in someone who usually has one bowel movement a day. People with irritable bowel syndrome (IBS) may have fluctuating numbers of stools each day as well as fluctuating consistency of their stools.
Myth # 5 Constipation: Habitual use of enemas to treat constipation is harmless.
False? - It is not clear whether or not habitual use of enemas is harmless since there has been very little study of the effects of enemas or laxatives over the long term. Early studies showed that laxatives might injure the colon if taken chronically by impairing contraction of the colonic muscles, and this finding was extrapolated to include enemas. The data from the studies is not strong, however. In fact, some physicians feel that enemas are preferred over laxatives since they are a more "natural" means of stimulating a bowel movement. (Enemas mimic a large amount of stool in the rectum, the usual stimulus for a bowel movement.) An ongoing need for enemas is not normal; you should see a doctor if you find yourself relying on them or any other medication to have a bowel movement.
Myth # 6 Diverticulosis: Diverticulosis is an uncommon and serious problem.
False - Actually, the majority of Americans over age 60 have diverticulosis, but only a small percentage have symptoms or complications. Diverticulosis is a condition in which little sacs or out-pouchings, called diverticula, develop in the wall of the colon. These sacs tend to appear and increase in number as individuals age. Most people have no symptoms and learn that they have diverticula after an X-ray or intestinal examination (for example, colonoscopy or barium enema) that is being done for a purpose unrelated to the diverticulosis. Less than 10 per cent of people with diverticulosis ever develop complications such as infection (diverticulitis), bleeding, or perforation of the colon.
Myth # 7 Inflammatory Bowel Disease (Ulcerative Colitis and Crohn's Disease): Inflammatory bowel disease is caused by psychological problems.
False - Inflammatory bowel disease is the general name for two diseases that cause inflammation in the intestines, Crohn's disease and ulcerative colitis. The cause of the disease is unknown, but researchers speculate that it may result from a virus or bacteria interacting with the body's immune system. No evidence has been found to support the theory that inflammatory bowel disease is caused by tension, anxiety, or any other psychological factor or disorder, although these can aggravate the discomfort caused by the disease.
Myth # 8 Cirrhosis: Cirrhosis is only caused by alcoholism.
False - Alcoholism is just one of many causes of cirrhosis. Cirrhosis is scarring and decreased function of the liver. In the United States, alcohol causes less than one-half of cirrhosis cases. The remaining cases are from diseases that cause liver damage. For example, in children, cirrhosis may result from cystic fibrosis, alpha-1 antitrypsin deficiency, biliary atresia, glycogen storage diseases, and other rare diseases. In adults, cirrhosis may be caused by hepatitis B or C, primary biliary cirrhosis, diseases of abnormal storage of metals (like iron or copper) in the body, severe reactions to prescription drugs, or injury to the ducts that drain bile from the liver. In adults, cirrhosis can also be caused by nonalcoholic steatohepatitis (NASH), which is becoming the most common liver disease in the United States, affecting 2 to 5 percent of Americans. NASH is associated with the increasing prevalence of obesity and diabetes.
Myth # 9 Ostomy Surgery: After ostomy surgery, men become impotent, and women have impaired sexual function and are unable to become pregnant.
False - Ostomy surgery does not, in general, interfere with a person's sexual or reproductive capabilities. Ostomy surgery is a procedure in which the diseased part of the small or large intestine is removed and the remaining intestine is attached to an opening in the abdomen. Stool is collected in a bag taped to the skin over the opening. Alternatively, an internal pouch that collects the stool may be formed from a portion of the intestine. The pouch then can be emptied by insertion of a catheter at regular intervals.
Although some men who have had radical ostomy surgery for cancer lose the ability to achieve and sustain an erection, most men do not, or, if they do, it is temporary. This is caused by damage to the nerves that supply the penis. If erectile dysfunction persists, a variety of solutions are available. A urologist, a doctor who specializes in such problems, can help find the best solution.
In women, ostomy surgery does not damage sexual or reproductive organs, so it is not a direct cause of sexual problems or sterility. Factors such as pain and the adjustment to a new body image may create temporary sexual problems, but they can usually be resolved with time and, in some cases, counseling. Unless a woman has had a hysterectomy to remove her uterus, she can still bear children.
More Reading on Digestive Diseases
Wednesday, July 22, 2009
mmmm...
how can i discribe this day.. i dont know what i feel it seems like a bunch of hurt flaming up ...
tomorrow is another duty time but i'm quite anxious because my C.I is some what known to be strict and have a goal of not letting the student pass thats what i have heard but i'm hoping its just a rumor...
anyways i really what to arrange somethings in terms of relationship.. how i wish
tomorrow is another duty time but i'm quite anxious because my C.I is some what known to be strict and have a goal of not letting the student pass thats what i have heard but i'm hoping its just a rumor...
anyways i really what to arrange somethings in terms of relationship.. how i wish
Sunday, July 19, 2009
Friday, July 10, 2009
growth and development according to erik erikson
stagest of growth and development
1. Infancy: Birth to 18 Months
Ego Development Outcome: Trust vs. Mistrust
Basic strength: Drive and Hope
Erikson also referred to infancy as the Oral Sensory Stage (as anyone might who watches a baby put everything in her mouth) where the major emphasis is on the mother's positive and loving care for the child, with a big emphasis on visual contact and touch. If we pass successfully through this period of life, we will learn to trust that life is basically okay and have basic confidence in the future. If we fail to experience trust and are constantly frustrated because our needs are not met, we may end up with a deep-seated feeling of worthlessness and a mistrust of the world in general.
Incidentally, many studies of suicides and suicide attempts point to the importance of the early years in developing the basic belief that the world is trustworthy and that every individual has a right to be here.
Not surprisingly, the most significant relationship is with the maternal parent, or whoever is our most significant and constant caregiver.
2. Early Childhood: 18 Months to 3 Years
Ego Development Outcome: Autonomy vs. Shame
Basic Strengths: Self-control, Courage, and Will
During this stage we learn to master skills for ourselves. Not only do we learn to walk, talk and feed ourselves, we are learning finer motor development as well as the much appreciated toilet training. Here we have the opportunity to build self-esteem and autonomy as we gain more control over our bodies and acquire new skills, learning right from wrong. And one of our skills during the "Terrible Two's" is our ability to use the powerful word "NO!" It may be pain for parents, but it develops important skills of the will. (See Use of the Will from He Hit Me Back First!)
It is also during this stage, however, that we can be very vulnerable. If we're shamed in the process of toilet training or in learning other important skills, we may feel great shame and doubt of our capabilities and suffer low self-esteem as a result.
The most significant relationships are with parents.
3. Play Age: 3 to 5 Years
Ego Development Outcome: Initiative vs. Guilt
Basic Strength: Purpose
During this period we experience a desire to copy the adults around us and take initiative in creating play situations. We make up stories with Barbie's and Ken's, toy phones and miniature cars, playing out roles in a trial universe, experimenting with the blueprint for what we believe it means to be an adult. We also begin to use that wonderful word for exploring the world—"WHY?"
While Erikson was influenced by Freud, he downplays biological sexuality in favor of the psychosocial features of conflict between child and parents. Nevertheless, he said that at this stage we usually become involved in the classic "Oedipal struggle" and resolve this struggle through "social role identification." If we're frustrated over natural desires and goals, we may easily experience guilt.
The most significant relationship is with the basic family.
4. School Age: 6 to 12 Years
Ego Development Outcome: Industry vs. Inferiority
Basic Strengths: Method and Competence
During this stage, often called the Latency, we are capable of learning, creating and accomplishing numerous new skills and knowledge, thus developing a sense of industry. This is also a very social stage of development and if we experience unresolved feelings of inadequacy and inferiority among our peers, we can have serious problems in terms of competence and self-esteem.
As the world expands a bit, our most significant relationship is with the school and neighborhood. Parents are no longer the complete authorities they once were, although they are still important.
5. Adolescence: 12 to 18 Years
Ego Development Outcome: Identity vs. Role Confusion
Basic Strengths: Devotion and Fidelity
Up to this stage, according to Erikson, development mostly depends upon what is done to us. From here on out, development depends primarily upon what we do. And while adolescence is a stage at which we are neither a child nor an adult, life is definitely getting more complex as we attempt to find our own identity, struggle with social interactions, and grapple with moral issues.
Our task is to discover who we are as individuals separate from our family of origin and as members of a wider society. Unfortunately for those around us, in this process many of us go into a period of withdrawing from responsibilities, which Erikson called a "moratorium." And if we are unsuccessful in navigating this stage, we will experience role confusion and upheaval.
A significant task for us is to establish a philosophy of life and in this process we tend to think in terms of ideals, which are conflict free, rather than reality, which is not. The problem is that we don't have much experience and find it easy to substitute ideals for experience. However, we can also develop strong devotion to friends and causes.
It is no surprise that our most significant relationships are with peer groups.
6. Young adulthood: 18 to 35
Ego Development Outcome: Intimacy and Solidarity vs. Isolation
Basic Strengths: Affiliation and Love
In the initial stage of being an adult we seek one or more companions and love. As we try to find mutually satisfying relationships, primarily through marriage and friends, we generally also begin to start a family, though this age has been pushed back for many couples who today don't start their families until their late thirties. If negotiating this stage is successful, we can experience intimacy on a deep level.
If we're not successful, isolation and distance from others may occur. And when we don't find it easy to create satisfying relationships, our world can begin to shrink as, in defense, we can feel superior to others.
Our significant relationships are with marital partners and friends.
7. Middle Adulthood: 35 to 55 or 65
Ego Development Outcome: Generativity vs. Self absorption or Stagnation
Basic Strengths: Production and Care
Now work is most crucial. Erikson observed that middle-age is when we tend to be occupied with creative and meaningful work and with issues surrounding our family. Also, middle adulthood is when we can expect to "be in charge," the role we've longer envied.
The significant task is to perpetuate culture and transmit values of the culture through the family (taming the kids) and working to establish a stable environment. Strength comes through care of others and production of something that contributes to the betterment of society, which Erikson calls generativity, so when we're in this stage we often fear inactivity and meaninglessness.
As our children leave home, or our relationships or goals change, we may be faced with major life changes—the mid-life crisis—and struggle with finding new meanings and purposes. If we don't get through this stage successfully, we can become self-absorbed and stagnate.
Significant relationships are within the workplace, the community and the family.
8. Late Adulthood: 55 or 65 to Death
Ego Development Outcome: Integrity vs. Despair
Basic Strengths: Wisdom
Erikson felt that much of life is preparing for the middle adulthood stage and the last stage is recovering from it. Perhaps that is because as older adults we can often look back on our lives with happiness and are content, feeling fulfilled with a deep sense that life has meaning and we've made a contribution to life, a feeling Erikson calls integrity. Our strengt h comes from a wisdom that the world is very large and we now have a detached concern for the whole of life, accepting death as the completion of life.
On the other hand, some adults may reach this stage and despair at their experiences and perceived failures. They may fear death as they struggle to find a purpose to their lives, wondering "Was the trip worth it?" Alternatively, they may feel they have all the answers (not unlike going back to adolescence) and end with a strong dogmatism that only their view has been correct.
The significant relationship is with all of mankind—"my-kind
1. Infancy: Birth to 18 Months
Ego Development Outcome: Trust vs. Mistrust
Basic strength: Drive and Hope
Erikson also referred to infancy as the Oral Sensory Stage (as anyone might who watches a baby put everything in her mouth) where the major emphasis is on the mother's positive and loving care for the child, with a big emphasis on visual contact and touch. If we pass successfully through this period of life, we will learn to trust that life is basically okay and have basic confidence in the future. If we fail to experience trust and are constantly frustrated because our needs are not met, we may end up with a deep-seated feeling of worthlessness and a mistrust of the world in general.
Incidentally, many studies of suicides and suicide attempts point to the importance of the early years in developing the basic belief that the world is trustworthy and that every individual has a right to be here.
Not surprisingly, the most significant relationship is with the maternal parent, or whoever is our most significant and constant caregiver.
2. Early Childhood: 18 Months to 3 Years
Ego Development Outcome: Autonomy vs. Shame
Basic Strengths: Self-control, Courage, and Will
During this stage we learn to master skills for ourselves. Not only do we learn to walk, talk and feed ourselves, we are learning finer motor development as well as the much appreciated toilet training. Here we have the opportunity to build self-esteem and autonomy as we gain more control over our bodies and acquire new skills, learning right from wrong. And one of our skills during the "Terrible Two's" is our ability to use the powerful word "NO!" It may be pain for parents, but it develops important skills of the will. (See Use of the Will from He Hit Me Back First!)
It is also during this stage, however, that we can be very vulnerable. If we're shamed in the process of toilet training or in learning other important skills, we may feel great shame and doubt of our capabilities and suffer low self-esteem as a result.
The most significant relationships are with parents.
3. Play Age: 3 to 5 Years
Ego Development Outcome: Initiative vs. Guilt
Basic Strength: Purpose
During this period we experience a desire to copy the adults around us and take initiative in creating play situations. We make up stories with Barbie's and Ken's, toy phones and miniature cars, playing out roles in a trial universe, experimenting with the blueprint for what we believe it means to be an adult. We also begin to use that wonderful word for exploring the world—"WHY?"
While Erikson was influenced by Freud, he downplays biological sexuality in favor of the psychosocial features of conflict between child and parents. Nevertheless, he said that at this stage we usually become involved in the classic "Oedipal struggle" and resolve this struggle through "social role identification." If we're frustrated over natural desires and goals, we may easily experience guilt.
The most significant relationship is with the basic family.
4. School Age: 6 to 12 Years
Ego Development Outcome: Industry vs. Inferiority
Basic Strengths: Method and Competence
During this stage, often called the Latency, we are capable of learning, creating and accomplishing numerous new skills and knowledge, thus developing a sense of industry. This is also a very social stage of development and if we experience unresolved feelings of inadequacy and inferiority among our peers, we can have serious problems in terms of competence and self-esteem.
As the world expands a bit, our most significant relationship is with the school and neighborhood. Parents are no longer the complete authorities they once were, although they are still important.
5. Adolescence: 12 to 18 Years
Ego Development Outcome: Identity vs. Role Confusion
Basic Strengths: Devotion and Fidelity
Up to this stage, according to Erikson, development mostly depends upon what is done to us. From here on out, development depends primarily upon what we do. And while adolescence is a stage at which we are neither a child nor an adult, life is definitely getting more complex as we attempt to find our own identity, struggle with social interactions, and grapple with moral issues.
Our task is to discover who we are as individuals separate from our family of origin and as members of a wider society. Unfortunately for those around us, in this process many of us go into a period of withdrawing from responsibilities, which Erikson called a "moratorium." And if we are unsuccessful in navigating this stage, we will experience role confusion and upheaval.
A significant task for us is to establish a philosophy of life and in this process we tend to think in terms of ideals, which are conflict free, rather than reality, which is not. The problem is that we don't have much experience and find it easy to substitute ideals for experience. However, we can also develop strong devotion to friends and causes.
It is no surprise that our most significant relationships are with peer groups.
6. Young adulthood: 18 to 35
Ego Development Outcome: Intimacy and Solidarity vs. Isolation
Basic Strengths: Affiliation and Love
In the initial stage of being an adult we seek one or more companions and love. As we try to find mutually satisfying relationships, primarily through marriage and friends, we generally also begin to start a family, though this age has been pushed back for many couples who today don't start their families until their late thirties. If negotiating this stage is successful, we can experience intimacy on a deep level.
If we're not successful, isolation and distance from others may occur. And when we don't find it easy to create satisfying relationships, our world can begin to shrink as, in defense, we can feel superior to others.
Our significant relationships are with marital partners and friends.
7. Middle Adulthood: 35 to 55 or 65
Ego Development Outcome: Generativity vs. Self absorption or Stagnation
Basic Strengths: Production and Care
Now work is most crucial. Erikson observed that middle-age is when we tend to be occupied with creative and meaningful work and with issues surrounding our family. Also, middle adulthood is when we can expect to "be in charge," the role we've longer envied.
The significant task is to perpetuate culture and transmit values of the culture through the family (taming the kids) and working to establish a stable environment. Strength comes through care of others and production of something that contributes to the betterment of society, which Erikson calls generativity, so when we're in this stage we often fear inactivity and meaninglessness.
As our children leave home, or our relationships or goals change, we may be faced with major life changes—the mid-life crisis—and struggle with finding new meanings and purposes. If we don't get through this stage successfully, we can become self-absorbed and stagnate.
Significant relationships are within the workplace, the community and the family.
8. Late Adulthood: 55 or 65 to Death
Ego Development Outcome: Integrity vs. Despair
Basic Strengths: Wisdom
Erikson felt that much of life is preparing for the middle adulthood stage and the last stage is recovering from it. Perhaps that is because as older adults we can often look back on our lives with happiness and are content, feeling fulfilled with a deep sense that life has meaning and we've made a contribution to life, a feeling Erikson calls integrity. Our strengt h comes from a wisdom that the world is very large and we now have a detached concern for the whole of life, accepting death as the completion of life.
On the other hand, some adults may reach this stage and despair at their experiences and perceived failures. They may fear death as they struggle to find a purpose to their lives, wondering "Was the trip worth it?" Alternatively, they may feel they have all the answers (not unlike going back to adolescence) and end with a strong dogmatism that only their view has been correct.
The significant relationship is with all of mankind—"my-kind
acute gastritis
Gastritis is a term used to describe a group of conditions with one thing in common: inflammation of the lining of your stomach. The inflammation of gastritis is often the result of infection with the same bacterium that causes most stomach ulcers. However, other factors — such as traumatic injury, regular use of certain pain relievers or drinking too much alcohol — also can contribute to gastritis.
Gastritis may occur suddenly (acute gastritis) or it can occur slowly over time (chronic gastritis). In some cases, gastritis can lead to ulcers and an increased risk of stomach cancer. For most people, however, gastritis isn't serious and improves quickly with treatment
The signs and symptoms of gastritis include:
A gnawing or burning ache or pain (indigestion) in your upper abdomen that may become either worse or better with eating
Nausea
Vomiting
Loss of appetite
Belching or bloating
A feeling of fullness in your upper abdomen after eating
Weight loss
Acute gastritis occurs suddenly and is more likely to cause nausea and burning pain or discomfort in your upper abdomen.
Chronic gastritis develops gradually and is more likely to cause a dull pain and a feeling of fullness or loss of appetite after a few bites of food. For many people, though, chronic gastritis causes no signs or symptoms at all.
Occasionally, gastritis may cause stomach bleeding, although it's rarely severe. But be aware that bleeding in your stomach that causes you to vomit blood or pass black, tarry stools requires immediate medical care.
Gastritis usually develops when your stomach's protective layer becomes weakened or damaged. A mucus-lined barrier protects the walls of your stomach from the acids that help digest your food. Weaknesses in the barrier allow your digestive juices to damage and inflame your stomach lining.
A number of factors can contribute to or trigger gastritis, including:
.Bacterial infection.
People infected with Helicobacter pylori can experience gastritis — most commonly chronic gastritis. Half the world's population is thought to be infected with this bacterium, which passes from person to person. But the majority of those infected don't experience any complications of H. pylori infection. In some people, H. pylori may break down the stomach's inner protective coating, causing changes in the stomach's lining. The reason why some people experience complications from H. pylori infection and others don't isn't clear. However, doctors believe vulnerability to the bacterium could be inherited or it could be caused by lifestyle choices, such as smoking and high stress levels.
Regular use of pain relievers.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil, Motrin, others) and naproxen (Aleve), can cause both acute gastritis and chronic gastritis. Using these drugs regularly or taking too much of these drugs may reduce a key substance that helps preserve the protective lining of your stomach. Stomach problems are less likely to develop if you take NSAIDs only occasionally.
Excessive alcohol use.
Alcohol can irritate and erode your stomach lining, which makes your stomach more vulnerable to digestive juices. Excessive alcohol use is more likely to cause acute gastritis.
Stress. Severe stress due to major surgery, traumatic injury, burns or severe infections can cause acute gastritis.
Bile reflux disease.
Bile — a fluid that helps you digest fats — is produced in your liver and stored in your gallbladder. When it's released from the gallbladder, bile travels to your small intestine through a series of thin tubes. Normally, a ring-like sphincter muscle (pyloric valve) prevents bile from flowing into your stomach from your small intestine. But if this valve doesn't work properly, or if it has been removed because of surgery, bile can flow into your stomach, leading to inflammation and chronic gastritis.
Your own body attacking cells in your stomach
. Called autoimmune gastritis, this rare condition occurs when your body attacks the cells that make up your stomach lining. This produces a reaction by your immune system that can wear away at your stomach's protective barrier. Autoimmune gastritis is more common in people with other autoimmune disorders, including Hashimoto's disease, Addison's disease and type 1 diabetes. Autoimmune gastritis can also be associated with vitamin B-12 deficiency.
Other diseases and conditions.
Gastritis may be associated with other medical conditions, including HIV/AIDS, Crohn's disease, parasitic infections, some connective tissue disorders, and liver or kidney failure.
Factors that may increase your risk of gastritis include:
H. pylori infection. The most significant risk factor for gastritis is infection with H. pylori bacteria. Though it's thought to occur in half the world's population, H. pylori infection is most common in developing countries. Most people have no signs or symptoms of H. pylori infection.
Regular use of aspirin or other NSAIDs. If you regularly take aspirin to prevent a heart attack or stroke, you're at risk of developing gastritis. The same is true if you take anti-inflammatory pain relievers for arthritis or another chronic condition. That's because long-term use of aspirin and other NSAIDs can cause stomach irritation and bleeding.
Older age. Older adults have an increased risk of gastritis because the stomach lining tends to thin with age and because older adults are more likely to have H. pylori infection or autoimmune disorders than younger people are
Gastritis may occur suddenly (acute gastritis) or it can occur slowly over time (chronic gastritis). In some cases, gastritis can lead to ulcers and an increased risk of stomach cancer. For most people, however, gastritis isn't serious and improves quickly with treatment
The signs and symptoms of gastritis include:
A gnawing or burning ache or pain (indigestion) in your upper abdomen that may become either worse or better with eating
Nausea
Vomiting
Loss of appetite
Belching or bloating
A feeling of fullness in your upper abdomen after eating
Weight loss
Acute gastritis occurs suddenly and is more likely to cause nausea and burning pain or discomfort in your upper abdomen.
Chronic gastritis develops gradually and is more likely to cause a dull pain and a feeling of fullness or loss of appetite after a few bites of food. For many people, though, chronic gastritis causes no signs or symptoms at all.
Occasionally, gastritis may cause stomach bleeding, although it's rarely severe. But be aware that bleeding in your stomach that causes you to vomit blood or pass black, tarry stools requires immediate medical care.
Gastritis usually develops when your stomach's protective layer becomes weakened or damaged. A mucus-lined barrier protects the walls of your stomach from the acids that help digest your food. Weaknesses in the barrier allow your digestive juices to damage and inflame your stomach lining.
A number of factors can contribute to or trigger gastritis, including:
.Bacterial infection.
People infected with Helicobacter pylori can experience gastritis — most commonly chronic gastritis. Half the world's population is thought to be infected with this bacterium, which passes from person to person. But the majority of those infected don't experience any complications of H. pylori infection. In some people, H. pylori may break down the stomach's inner protective coating, causing changes in the stomach's lining. The reason why some people experience complications from H. pylori infection and others don't isn't clear. However, doctors believe vulnerability to the bacterium could be inherited or it could be caused by lifestyle choices, such as smoking and high stress levels.
Regular use of pain relievers.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil, Motrin, others) and naproxen (Aleve), can cause both acute gastritis and chronic gastritis. Using these drugs regularly or taking too much of these drugs may reduce a key substance that helps preserve the protective lining of your stomach. Stomach problems are less likely to develop if you take NSAIDs only occasionally.
Excessive alcohol use.
Alcohol can irritate and erode your stomach lining, which makes your stomach more vulnerable to digestive juices. Excessive alcohol use is more likely to cause acute gastritis.
Stress. Severe stress due to major surgery, traumatic injury, burns or severe infections can cause acute gastritis.
Bile reflux disease.
Bile — a fluid that helps you digest fats — is produced in your liver and stored in your gallbladder. When it's released from the gallbladder, bile travels to your small intestine through a series of thin tubes. Normally, a ring-like sphincter muscle (pyloric valve) prevents bile from flowing into your stomach from your small intestine. But if this valve doesn't work properly, or if it has been removed because of surgery, bile can flow into your stomach, leading to inflammation and chronic gastritis.
Your own body attacking cells in your stomach
. Called autoimmune gastritis, this rare condition occurs when your body attacks the cells that make up your stomach lining. This produces a reaction by your immune system that can wear away at your stomach's protective barrier. Autoimmune gastritis is more common in people with other autoimmune disorders, including Hashimoto's disease, Addison's disease and type 1 diabetes. Autoimmune gastritis can also be associated with vitamin B-12 deficiency.
Other diseases and conditions.
Gastritis may be associated with other medical conditions, including HIV/AIDS, Crohn's disease, parasitic infections, some connective tissue disorders, and liver or kidney failure.
Factors that may increase your risk of gastritis include:
H. pylori infection. The most significant risk factor for gastritis is infection with H. pylori bacteria. Though it's thought to occur in half the world's population, H. pylori infection is most common in developing countries. Most people have no signs or symptoms of H. pylori infection.
Regular use of aspirin or other NSAIDs. If you regularly take aspirin to prevent a heart attack or stroke, you're at risk of developing gastritis. The same is true if you take anti-inflammatory pain relievers for arthritis or another chronic condition. That's because long-term use of aspirin and other NSAIDs can cause stomach irritation and bleeding.
Older age. Older adults have an increased risk of gastritis because the stomach lining tends to thin with age and because older adults are more likely to have H. pylori infection or autoimmune disorders than younger people are
ampicillin/ drug study
Generic Name:
Ampicillin sodiumDosage Form: for Injection, USP
For Intramuscular or Intravenous Injection
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Ampicillin and other antibacterial drugs, Ampicillin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.
Ampicillin Description
OAS_AD('Middle');
Ampicillin for Injection, USP the monosodium salt of [2S - [2α,5α,6β(S*)]] - 6 - [(aminophenylacetyl)amino] - 3,3 - dimethyl - 7 - oxo - 4 - thia - 1 - azabicyclo[3.2.0]heptane - 2 - carboxylic acid, is a synthetic penicillin. It is an antibacterial agent with a broad spectrum of bactericidal activity against both penicillin-susceptible Gram-positive organisms and many common Gram-negative pathogens.
It has the following chemical structure:
The empirical formula is C16H18N3NaO4S, and the molecular weight is 371.39. Ampicillin for Injection, USP contains 2.9 milliequivalents of sodium per 1 gram of drug.
Ampicillin - Clinical Pharmacology
Ampicillin for Injection, USP diffuses readily into most body tissues and fluids. However, penetration into the cerebrospinal fluid and brain occurs only when the meninges are inflamed. Ampicillin is excreted largely unchanged in the urine and its excretion can be delayed by concurrent administration of probenecid. The active form appears in the bile in higher concentrations than those found in serum. Ampicillin is the least serum-bound of all the penicillins, averaging about 20% compared to approximately 60 to 90% for other penicillins. Ampicillin for Injection, USP is well tolerated by most patients and has been given in doses of 2 grams daily for many weeks without adverse reactions.
Microbiology
While in vitro studies have demonstrated the susceptibility of most strains of the following organisms, clinical efficacy for infections other than those included in the
INDICATIONS AND USAGE
section has not been demonstrated.
The following bacteria have been shown in in vitro studies to be susceptible to Ampicillin:
GRAM-POSITIVE ORGANISMS: Hemolytic and nonhemolytic streptococci, D. pneumoniae, nonpenicillinase-producing staphylococci, Clostridia spp., B. anthracis, Listeria monocytogenes, and most strains of enterococci.
GRAM-NEGATIVE ORGANISMS: H. influenzae, N. gonorrhoeae, N. meningitidis, Proteus mirabilis, and many strains of Salmonella, Shigella, and E. coli.
Ampicillin does not resist destruction by penicillinase.
Susceptibility Tests
Ampicillin Susceptibility Test Discs, 10 µg, should be used to estimate the in vitro susceptibility of bacteria to Ampicillin.
Indications and Usage for Ampicillin
Ampicillin for Injection, USP is indicated in the treatment of infections caused by susceptible strains of the designated organisms in the following conditions:
Respiratory tract Infections caused by S. pneumoniae (formerly D. pneumoniae). Staphylococcus aureus (penicillinase and nonpenicillinase-producing), H. influenzae, and Group A beta-hemolytic Streptococci.
Bacterial Meningitis caused by E. coli, Group B Streptococci, and other Gram-negative bacteria (Listeria monocytogenes, N. meningitidis). The addition of an aminoglycoside with Ampicillin may increase its effectiveness against Gram-negative bacteria.
Septicemia and Endocarditis caused by susceptible Gram-positive organisms including Streptococcus sp., penicillin G-susceptible staphylococci, and enterococci. Gram-negative sepsis caused by E. coli, Proteus mirabilis and Salmonella sp. respond to Ampicillin. Endocarditis due to enterococcal strains usually respond to intravenous therapy. The addition of an aminoglycoside may enhance the effectiveness of Ampicillin when treating streptoccoccal endocarditis.
Urinary Tract Infections caused by sensitve strains of E. coli and Proteus mirabilis.
Gastrointestinal Infections caused by Salmonella typhosa (typhoid fever), other Salmonella sp., and Shigella sp. (dysentery) usually respond to oral or intravenous therapy.
Bacteriology studies to determine the causative organisms and their susceptibility to Ampicillin should be performed. Therapy may be instituted prior to obtaining results of susceptibility testing.
It is advisable to reserve the parenteral form of this drug for moderately severe and severe infections and for patients who are unable to take the oral forms. A change to oral Ampicillin may be made as soon as appropriate.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Ampicillin and other antibacterial drugs, Ampicillin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
Indicated surgical procedures should be performed.
Contraindications
A history of a previous hypersensitivity reaction to any of the penicillins is a contraindication.
Warnings
Serious and occasionally fatal hypersensitivity (anaphylactoid) reactions have been reported in patients on penicillin therapy. Although anaphylaxis is more frequent following parenteral therapy, it has occurred in patients on oral penicillins. These reactions are more apt to occur in individuals with a history of penicillin hypersensitivity and/or a history of sensitivity to multiple allergens.
There have been well-documented reports of individuals with a history of penicillin hypersensitivity reactions who have experienced severe hypersensitivity reactions when treated with a cephalosporin. Before initiating therapy with a penicillin, careful inquiry should be made concerning previous hypersensitivity reactions to penicillins, cephalosporins, and other allergens. If an allergic reaction occurs, the drug should be discontinued and appropriate therapy instituted.
SERIOUS ANAPHYLACTOID REACTIONS REQUIRE IMMEDIATE EMERGENCY TREATMENT WITH EPINEPHRINE, OXYGEN, INTRAVENOUS STEROIDS, AND AIRWAY MANAGEMENT, INCLUDING INTUBATION, SHOULD ALSO BE ADMINISTERED AS INDICATED.
Precautions
General
The possibility of superinfections with mycotic organisms or bacterial pathogens should be kept in mind during therapy. In such cases, discontinue the drug and substitute appropriate treatment.
A high percentage (43 to 100 percent) of patients with infectious mononucleosis who receive Ampicillin develop a skin rash. Typically, the rash appears 7 to 10 days after the start of oral Ampicillin therapy and remains for a few days to a week after the drug is discontinued. In most cases, the rash is maculopapular, pruritic, and generalized. Therefore, the administration of Ampicillin is not recommended in patients with mononucleosis. It is not known whether these patients are truly allergic to Ampicillin.
Prescribing Ampicillin in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.
Information for Patients
Patients should be counseled that antibacterial drugs including Ampicillin should only be used to treat bacterial infections. They do not treat viral infections (e.g., the common cold). When Ampicillin is prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed. Skipping doses or not completing the full course of therapy may: (1) decrease the effectiveness of the immediate treatment, and (2) increase the likelihood that bacteria will develop resistance and will not be treatable by Ampicillin or other antibacterial drugs in the future.
Laboratory Tests
As with any potent drug, periodic assessment of organ system function, including renal, hepatic, and hematopoietic, should be made during prolonged therapy.
Transient elevation of serum transaminase has been observed following administration of Ampicillin. The significance of this finding is not known.
Drug Interactions
The concurrent administration of allopurinol and Ampicillin increases substantially the incidence of skin rashes in patients receiving both drugs as compared to patients receiving Ampicillin alone. It is not known whether this potentiation of Ampicillin rashes is due to allopurinol or the hyperuricemia present in these patients.
Drug/Laboratory Test Interactions
With high urine concentrations of Ampicillin, false-positive glucose reactions may occur if Clinitest, Benedict's Solution, or Fehling's Solution are used. Therefore, it is recommended that glucose tests based on enzymatic glucose oxidase reactions (such as Clinistix or Tes-Tape) be used.
Carcinogenesis, Mutagenesis, and Impairment of Fertility
No long-term animal studies have been conducted with this drug.
Pregnancy - Category B
Reproduction studies have been performed in laboratory animals at doses several times the human dose and have revealed no evidence of adverse effects due to Ampicillin. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
Labor and Delivery
Oral Ampicillin-class antibiotics are poorly absorbed during labor. Studies in guinea pigs showed that intravenous administration of Ampicillin slightly decreased the uterine tone and frequency of contractions, but moderately increased the height and duration of contractions. However, it is not known whether use of these drugs in humans during labor or delivery has immediate or delayed adverse effects on the fetus, prolongs the duration of labor, or increases the likelihood that forceps delivery or other obstetrical intervention or resuscitation of the newborn will be necessary.
Nursing Mothers
Ampicillin is excreted in trace amounts in human milk. Therefore, caution should be exercised when Ampicillin-class antibiotics are administered to a nursing woman.
Pediatric Use
Guidelines for the administration of these drugs to children are presented in
DOSAGE AND ADMINISTRATION.
Adverse Reactions
As with other penicillins, it may be expected that untoward reactions will be essentially limited to sensitivity phenomena. They are more likely to occur in individuals who have previously demonstrated hypersensitivity to penicillins and in those with a history of allergy, asthma, hay fever, or urticaria.
The following adverse reactions have been reported as associated with the use of Ampicillin:
Gastrointestinal
Glossitis, stomatitis, black "hairy" tongue, nausea, vomiting, enterocolitis, pseudomembranous colitis, and diarrhea. (These reactions are usually associated with oral dosage forms.)
Hypersensitivity Reactions
Skin rashes and urticaria have been reported frequently. A few cases of exfoliative dermatitis and erythema multiforme have been reported. Anaphylaxis is the most serious reaction experienced and has usually been associated with the parenteral dosage form.
Note: Urticaria, other skin rashes, and serum sickness-like reactions may be controlled with antihistamines and, if necessary, systemic corticosteroids. Whenever such reactions occur, Ampicillin should be discontinued, unless, in the opinion of the physician, the condition being treated is life-threatening and amenable only to Ampicillin therapy. Serious anaphylactic reactions require the immediate use of epinephrine, oxygen, and intravenous steroids.
Liver– A moderate rise in serum glutamic oxaloacetic transaminase (SGOT) has been noted, particularly in infants, but the significance of this finding is unknown. Mild transitory SGOT elevations have been observed in individuals receiving larger (two to four times) than usual and oft-repeated intramuscular injections. Evidence indicates that glutamic oxaloacetic transaminase (GOT) is released at the site of intramuscular injection of Ampicillin sodium and that the presence of increased amounts of this enzyme in the blood does not necessarily indicate liver involvement.
Hemic and Lymphatic Systems– Anemia, thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukopenia, and agranulocytosis have been reported during therapy with the penicillins. These reactions are usually reversible on discontinuation of therapy and are believed to be hypersensitivity phenomena.
Overdosage
In cases of overdose, discontinue medication, treat symptomatically, and institute supportive measures as required. In patients with renal function impairment, Ampicillin-class antibiotics can be removed by hemodialysis but not peritoneal dialysis.
Ampicillin Dosage and Administration
Infections of the respiratory tract and soft tissues.
Patients weighing 40 kg (88 lbs) or more: 250 to 500 mg every 6 hours.
Patients weighing less than 40 kg (88 lbs): 25 to 50 mg/kg/day in equally divided doses at 6- to 8- hour intervals.
Infections of the gastrointestinal and genitourinary tracts (including those caused by Neisseria gonorrhoeae in females).
Patients weighing 40 kg (88 lbs) or more: 500 mg every 6 hours.
Patients weighing less than 40 kg (88 lbs): 50 mg/kg/day in equally divided doses at 6- to 8- hour intervals.
In the treatment of chronic urinary tract and intestinal infections, frequent bacteriological and clinical appraisal is necessary. Smaller doses than those recommended above should not be used. Higher doses should be used for stubborn or severe infections. In stubborn infections, therapy may be required for several weeks. It may be necessary to continue clinical and/or bacteriological follow-up for several months after cessation of therapy.
Urethritis in males due to N. gonorrhoeae.
Adults – Two doses of 500 mg each at an interval of 8 to 12 hours. Treatment may be repeated if necessary or extended if required.
In the treatment of complications of gonorrheal urethritis, such as prostatitis and epididymitis, prolonged and intensive therapy is recommended. Cases of gonorrhea with a suspected primary lesion of syphilis should have darkfield examinations before receiving treatment. In all other cases where concomitant syphilis is suspected, monthly serological tests should be made for a minimum of four months. The doses for the preceding infections may be given by either the intramuscular or intravenous route. A change to oral Ampicillin may be made when appropriate.
Bacterial Meningitis
Adults and children – 150 to 200 mg/kg/day in equally divided doses every 3 to 4 hours. (Treatment may be initiated with intravenous drip therapy and continued with intramuscular injections.) The doses for other infections may be given by either the intravenous or intramuscular route.
Septicemia
Adults and children – 150 to 200 mg/kg/day. Start with intravenous administration for at least three days and continue with the intramuscular route every 3 to 4 hours.
Treatment of all infections should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes asymptomatic or evidence of bacterial eradication has been obtained. A minimum of 10-days treatment is recommended for any infection caused by Group A beta-hemolytic streptococci to help prevent the occurrence of acute rheumatic fever or acute glomerulonephritis.
DIRECTIONS FOR USE
Use only freshly prepared solutions. Intramuscular and intravenous injections should be administered within one hour after preparation since the potency may decrease significantly after this period.
For Intramuscular Use– Dissolve contents of a vial with the amount of Sterile Water for Injection, USP, or Bacteriostatic Water for Injection, USP, listed in the table below:
NDC 0781
LabelClaim
RecommendedAmount ofDiluent
WithdrawableVolume
Concentration(in mg/mL)
3400-95
125 mg
1.2 mL
1.0 mL
125 mg
3402-95
250 mg
1.0 mL
1.0 mL
250 mg
3407-95
500 mg
1.8 mL
2.0 mL
250 mg
3404-95
1 gram
3.5 mL
4.0 mL
250 mg
3408-95
2 gram
6.8 mL
8.0 mL
250 mg
While Ampicillin for Injection, USP, 1 g and 2 g, are primarily for intravenous use, they may be administered intramusculary when the 250 mg or 500 mg vials are unavailable. In such instances, dissolve in 3.5 or 6.8 mL Sterile Water for Injection, USP, or Bacteriostatic Water for Injection, USP, respectively. The resulting solution will provide a concentration of 250 mg per mL.
Ampicillin for Injection, USP, 125 mg, is intended primarily for pediatric use. It also serves as a convenient dosage form when small parenteral doses of the antibiotic are required.
For Direct Intravenous Use– Add 5 mL Sterile Water for Injection, USP, or Bacteriostatic Water for Injection, USP to the 125, 250, and 500 mg vials and administer slowly over a 3- to 5- minute period. Ampicillin for Injection, USP, 1 g or 2 g, may also be given by direct Intravenous administration. Dissolve in 7.4 or 14.8 mL Sterile Water for Injection, USP, or Bacteriostatic Water for Injection, USP, respectively, and administer slowly over at least 10 to 15 minutes. CAUTION: More rapid administration may result in convulsive seizures.
For Administration by Intravenous Drip– Reconstitute as directed above (For Direct Intravenous Use) prior to diluting with Intravenous Solution. Stability studies on Ampicillin sodium at several concentrations in various intravenous solutions indicate the drug will lose less than 10% activitiy at the temperatures noted for the time periods stated.
Room Temperature (25° C)
Diluent
Concentrations
StabilityPeriods
Sterile Water for Injection
up to 30 mg/mL
8 hours
Isotonic Sodium Chloride
up to 30 mg/mL
8 hours
5% Dextrose in Water
10 to 20 mg/mL
1 hour
5% Dextrose in Water
up to 2 mg/mL
2 hours
5% Dextrose in 0.45% NaCl
up to 2 mg/mL
2 hours
Lactated Ringer's Solution
up to 30 mg/mL
8 hours
Refrigerated (4° C)
Diluent
Concentrations
StabilityPeriods
Sterile Water for Injection
30 mg/mL
48 hours
Sterile Water for Injection
up to 20 mg/mL
72 hours
Isotonic Sodium Chloride
30 mg/mL
24 hours
Isotonic Sodium Chloride
up to 20 mg/mL
48 hours
Lactated Ringer's Solution
up to 30 mg/mL
24 hours
5% Dextrose in Water
up to 20 mg/mL
1 hour
5% Dextrose and 0.45% NaCl
up to 10 mg/mL
1 hour
Only those solutions listed above should be used for the intravenous infusion of Ampicillin for injection, USP. The concentrations should fall within the range specified. The drug concentration and the rate and volume of the infusion should be adjusted so that the total dose of Ampicillin is administered before the drug loses its stability in the solution in use.
Pharmacy Bulk Package– This glass vial contains 10 grams Ampicillin and is designed for use in the pharmacy in preparing IV additives. Add 94 mL Sterile Water for Injection, USP. The resulting solution will contain 100 milligrams Ampicillin activity per mL, and is stable up to one hour at room temperature. Diluting further within one hour from 5 mg to 10 mg per mL, the resulting solution will remain stable for 8 hours at room temperature or 72 hours under refrigeration.
CAUTION: NOT TO BE DISPENSED AS A UNIT.
How is Ampicillin Supplied
Ampicillin for Injection, USP for IM or IV Injection. Ampicillin sodium equivalent to 125, 250, 500 mg, 1, 2, or 10 grams Ampicillin per vial.
NDC 0781-3400-95 125 mg vial packaged in 10s NDC 0781-3402-95 250 mg vial packaged in 10s NDC 0781-3407-95 500 mg vial packaged in 10s NDC 0781-3404-95 1 gram vial packaged in 10s NDC 0781-3408-95 2 gram vial packaged in 10s NDC 0781-3409-95 10 gram Pharmacy Bulk Package packaged in 10s
Manufactured bySandoz GmbH, Kundl, Austriafor Sandoz Inc., Broomfield, CO 80020
Ampicillin Ampicillin sodium injection, powder, for solution
Product Information
Product Type
HUMAN PRESCRIPTION DRUG
NDC Product Code (Source)
0781-3400
Route of Administration
INTRAVENOUS
DEA Schedule
INGREDIENTS
Name (Active Moiety)
Type
Strength
Ampicillin Sodium (Ampicillin)
Active
125 MILLIGRAM In 1 VIAL
Product Characteristics
Color
NDC
Package Description
Multilevel Packaging
1
0781-3400-95
10 VIAL In 1 PACKAGE
contains a VIAL, GLASS (0781-3400-78)
1
0781-3400-78
1 VIAL In 1 VIAL, GLASS
This package is contained within the PACKAGE (0781-3400-95)
Ampicillin Ampicillin sodium injection, powder, for solution
Product Information
Product Type
HUMAN PRESCRIPTION DRUG
NDC Product Code (Source)
0781-3402
Route of Administration
INTRAVENOUS
DEA Schedule
INGREDIENTS
Name (Active Moiety)
Type
Strength
Ampicillin sodium (Ampicillin)
Active
250 MILLIGRAM In 1 VIAL
Product Characteristics
Color
Score
Shape
Size
Flavor
Imprint Code
Contains
Packaging
#
NDC
Package Description
Multilevel Packaging
1
0781-3402-95
10 VIAL In 1 PACKAGE
contains a VIAL, GLASS (0781-3402-78)
1
0781-3402-78
1 VIAL In 1 VIAL, GLASS
This package is contained within the PACKAGE (0781-3402-95)
Ampicillin Ampicillin sodium injection, powder, for solution
Product Information
Product Type
HUMAN PRESCRIPTION DRUG
NDC Product Code (Source)
0781-3407
Route of Administration
INTRAVENOUS
DEA Schedule
Ampicillin sodiumDosage Form: for Injection, USP
For Intramuscular or Intravenous Injection
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Ampicillin and other antibacterial drugs, Ampicillin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.
Ampicillin Description
OAS_AD('Middle');
Ampicillin for Injection, USP the monosodium salt of [2S - [2α,5α,6β(S*)]] - 6 - [(aminophenylacetyl)amino] - 3,3 - dimethyl - 7 - oxo - 4 - thia - 1 - azabicyclo[3.2.0]heptane - 2 - carboxylic acid, is a synthetic penicillin. It is an antibacterial agent with a broad spectrum of bactericidal activity against both penicillin-susceptible Gram-positive organisms and many common Gram-negative pathogens.
It has the following chemical structure:
The empirical formula is C16H18N3NaO4S, and the molecular weight is 371.39. Ampicillin for Injection, USP contains 2.9 milliequivalents of sodium per 1 gram of drug.
Ampicillin - Clinical Pharmacology
Ampicillin for Injection, USP diffuses readily into most body tissues and fluids. However, penetration into the cerebrospinal fluid and brain occurs only when the meninges are inflamed. Ampicillin is excreted largely unchanged in the urine and its excretion can be delayed by concurrent administration of probenecid. The active form appears in the bile in higher concentrations than those found in serum. Ampicillin is the least serum-bound of all the penicillins, averaging about 20% compared to approximately 60 to 90% for other penicillins. Ampicillin for Injection, USP is well tolerated by most patients and has been given in doses of 2 grams daily for many weeks without adverse reactions.
Microbiology
While in vitro studies have demonstrated the susceptibility of most strains of the following organisms, clinical efficacy for infections other than those included in the
INDICATIONS AND USAGE
section has not been demonstrated.
The following bacteria have been shown in in vitro studies to be susceptible to Ampicillin:
GRAM-POSITIVE ORGANISMS: Hemolytic and nonhemolytic streptococci, D. pneumoniae, nonpenicillinase-producing staphylococci, Clostridia spp., B. anthracis, Listeria monocytogenes, and most strains of enterococci.
GRAM-NEGATIVE ORGANISMS: H. influenzae, N. gonorrhoeae, N. meningitidis, Proteus mirabilis, and many strains of Salmonella, Shigella, and E. coli.
Ampicillin does not resist destruction by penicillinase.
Susceptibility Tests
Ampicillin Susceptibility Test Discs, 10 µg, should be used to estimate the in vitro susceptibility of bacteria to Ampicillin.
Indications and Usage for Ampicillin
Ampicillin for Injection, USP is indicated in the treatment of infections caused by susceptible strains of the designated organisms in the following conditions:
Respiratory tract Infections caused by S. pneumoniae (formerly D. pneumoniae). Staphylococcus aureus (penicillinase and nonpenicillinase-producing), H. influenzae, and Group A beta-hemolytic Streptococci.
Bacterial Meningitis caused by E. coli, Group B Streptococci, and other Gram-negative bacteria (Listeria monocytogenes, N. meningitidis). The addition of an aminoglycoside with Ampicillin may increase its effectiveness against Gram-negative bacteria.
Septicemia and Endocarditis caused by susceptible Gram-positive organisms including Streptococcus sp., penicillin G-susceptible staphylococci, and enterococci. Gram-negative sepsis caused by E. coli, Proteus mirabilis and Salmonella sp. respond to Ampicillin. Endocarditis due to enterococcal strains usually respond to intravenous therapy. The addition of an aminoglycoside may enhance the effectiveness of Ampicillin when treating streptoccoccal endocarditis.
Urinary Tract Infections caused by sensitve strains of E. coli and Proteus mirabilis.
Gastrointestinal Infections caused by Salmonella typhosa (typhoid fever), other Salmonella sp., and Shigella sp. (dysentery) usually respond to oral or intravenous therapy.
Bacteriology studies to determine the causative organisms and their susceptibility to Ampicillin should be performed. Therapy may be instituted prior to obtaining results of susceptibility testing.
It is advisable to reserve the parenteral form of this drug for moderately severe and severe infections and for patients who are unable to take the oral forms. A change to oral Ampicillin may be made as soon as appropriate.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Ampicillin and other antibacterial drugs, Ampicillin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
Indicated surgical procedures should be performed.
Contraindications
A history of a previous hypersensitivity reaction to any of the penicillins is a contraindication.
Warnings
Serious and occasionally fatal hypersensitivity (anaphylactoid) reactions have been reported in patients on penicillin therapy. Although anaphylaxis is more frequent following parenteral therapy, it has occurred in patients on oral penicillins. These reactions are more apt to occur in individuals with a history of penicillin hypersensitivity and/or a history of sensitivity to multiple allergens.
There have been well-documented reports of individuals with a history of penicillin hypersensitivity reactions who have experienced severe hypersensitivity reactions when treated with a cephalosporin. Before initiating therapy with a penicillin, careful inquiry should be made concerning previous hypersensitivity reactions to penicillins, cephalosporins, and other allergens. If an allergic reaction occurs, the drug should be discontinued and appropriate therapy instituted.
SERIOUS ANAPHYLACTOID REACTIONS REQUIRE IMMEDIATE EMERGENCY TREATMENT WITH EPINEPHRINE, OXYGEN, INTRAVENOUS STEROIDS, AND AIRWAY MANAGEMENT, INCLUDING INTUBATION, SHOULD ALSO BE ADMINISTERED AS INDICATED.
Precautions
General
The possibility of superinfections with mycotic organisms or bacterial pathogens should be kept in mind during therapy. In such cases, discontinue the drug and substitute appropriate treatment.
A high percentage (43 to 100 percent) of patients with infectious mononucleosis who receive Ampicillin develop a skin rash. Typically, the rash appears 7 to 10 days after the start of oral Ampicillin therapy and remains for a few days to a week after the drug is discontinued. In most cases, the rash is maculopapular, pruritic, and generalized. Therefore, the administration of Ampicillin is not recommended in patients with mononucleosis. It is not known whether these patients are truly allergic to Ampicillin.
Prescribing Ampicillin in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.
Information for Patients
Patients should be counseled that antibacterial drugs including Ampicillin should only be used to treat bacterial infections. They do not treat viral infections (e.g., the common cold). When Ampicillin is prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed. Skipping doses or not completing the full course of therapy may: (1) decrease the effectiveness of the immediate treatment, and (2) increase the likelihood that bacteria will develop resistance and will not be treatable by Ampicillin or other antibacterial drugs in the future.
Laboratory Tests
As with any potent drug, periodic assessment of organ system function, including renal, hepatic, and hematopoietic, should be made during prolonged therapy.
Transient elevation of serum transaminase has been observed following administration of Ampicillin. The significance of this finding is not known.
Drug Interactions
The concurrent administration of allopurinol and Ampicillin increases substantially the incidence of skin rashes in patients receiving both drugs as compared to patients receiving Ampicillin alone. It is not known whether this potentiation of Ampicillin rashes is due to allopurinol or the hyperuricemia present in these patients.
Drug/Laboratory Test Interactions
With high urine concentrations of Ampicillin, false-positive glucose reactions may occur if Clinitest, Benedict's Solution, or Fehling's Solution are used. Therefore, it is recommended that glucose tests based on enzymatic glucose oxidase reactions (such as Clinistix or Tes-Tape) be used.
Carcinogenesis, Mutagenesis, and Impairment of Fertility
No long-term animal studies have been conducted with this drug.
Pregnancy - Category B
Reproduction studies have been performed in laboratory animals at doses several times the human dose and have revealed no evidence of adverse effects due to Ampicillin. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
Labor and Delivery
Oral Ampicillin-class antibiotics are poorly absorbed during labor. Studies in guinea pigs showed that intravenous administration of Ampicillin slightly decreased the uterine tone and frequency of contractions, but moderately increased the height and duration of contractions. However, it is not known whether use of these drugs in humans during labor or delivery has immediate or delayed adverse effects on the fetus, prolongs the duration of labor, or increases the likelihood that forceps delivery or other obstetrical intervention or resuscitation of the newborn will be necessary.
Nursing Mothers
Ampicillin is excreted in trace amounts in human milk. Therefore, caution should be exercised when Ampicillin-class antibiotics are administered to a nursing woman.
Pediatric Use
Guidelines for the administration of these drugs to children are presented in
DOSAGE AND ADMINISTRATION.
Adverse Reactions
As with other penicillins, it may be expected that untoward reactions will be essentially limited to sensitivity phenomena. They are more likely to occur in individuals who have previously demonstrated hypersensitivity to penicillins and in those with a history of allergy, asthma, hay fever, or urticaria.
The following adverse reactions have been reported as associated with the use of Ampicillin:
Gastrointestinal
Glossitis, stomatitis, black "hairy" tongue, nausea, vomiting, enterocolitis, pseudomembranous colitis, and diarrhea. (These reactions are usually associated with oral dosage forms.)
Hypersensitivity Reactions
Skin rashes and urticaria have been reported frequently. A few cases of exfoliative dermatitis and erythema multiforme have been reported. Anaphylaxis is the most serious reaction experienced and has usually been associated with the parenteral dosage form.
Note: Urticaria, other skin rashes, and serum sickness-like reactions may be controlled with antihistamines and, if necessary, systemic corticosteroids. Whenever such reactions occur, Ampicillin should be discontinued, unless, in the opinion of the physician, the condition being treated is life-threatening and amenable only to Ampicillin therapy. Serious anaphylactic reactions require the immediate use of epinephrine, oxygen, and intravenous steroids.
Liver– A moderate rise in serum glutamic oxaloacetic transaminase (SGOT) has been noted, particularly in infants, but the significance of this finding is unknown. Mild transitory SGOT elevations have been observed in individuals receiving larger (two to four times) than usual and oft-repeated intramuscular injections. Evidence indicates that glutamic oxaloacetic transaminase (GOT) is released at the site of intramuscular injection of Ampicillin sodium and that the presence of increased amounts of this enzyme in the blood does not necessarily indicate liver involvement.
Hemic and Lymphatic Systems– Anemia, thrombocytopenia, thrombocytopenic purpura, eosinophilia, leukopenia, and agranulocytosis have been reported during therapy with the penicillins. These reactions are usually reversible on discontinuation of therapy and are believed to be hypersensitivity phenomena.
Overdosage
In cases of overdose, discontinue medication, treat symptomatically, and institute supportive measures as required. In patients with renal function impairment, Ampicillin-class antibiotics can be removed by hemodialysis but not peritoneal dialysis.
Ampicillin Dosage and Administration
Infections of the respiratory tract and soft tissues.
Patients weighing 40 kg (88 lbs) or more: 250 to 500 mg every 6 hours.
Patients weighing less than 40 kg (88 lbs): 25 to 50 mg/kg/day in equally divided doses at 6- to 8- hour intervals.
Infections of the gastrointestinal and genitourinary tracts (including those caused by Neisseria gonorrhoeae in females).
Patients weighing 40 kg (88 lbs) or more: 500 mg every 6 hours.
Patients weighing less than 40 kg (88 lbs): 50 mg/kg/day in equally divided doses at 6- to 8- hour intervals.
In the treatment of chronic urinary tract and intestinal infections, frequent bacteriological and clinical appraisal is necessary. Smaller doses than those recommended above should not be used. Higher doses should be used for stubborn or severe infections. In stubborn infections, therapy may be required for several weeks. It may be necessary to continue clinical and/or bacteriological follow-up for several months after cessation of therapy.
Urethritis in males due to N. gonorrhoeae.
Adults – Two doses of 500 mg each at an interval of 8 to 12 hours. Treatment may be repeated if necessary or extended if required.
In the treatment of complications of gonorrheal urethritis, such as prostatitis and epididymitis, prolonged and intensive therapy is recommended. Cases of gonorrhea with a suspected primary lesion of syphilis should have darkfield examinations before receiving treatment. In all other cases where concomitant syphilis is suspected, monthly serological tests should be made for a minimum of four months. The doses for the preceding infections may be given by either the intramuscular or intravenous route. A change to oral Ampicillin may be made when appropriate.
Bacterial Meningitis
Adults and children – 150 to 200 mg/kg/day in equally divided doses every 3 to 4 hours. (Treatment may be initiated with intravenous drip therapy and continued with intramuscular injections.) The doses for other infections may be given by either the intravenous or intramuscular route.
Septicemia
Adults and children – 150 to 200 mg/kg/day. Start with intravenous administration for at least three days and continue with the intramuscular route every 3 to 4 hours.
Treatment of all infections should be continued for a minimum of 48 to 72 hours beyond the time that the patient becomes asymptomatic or evidence of bacterial eradication has been obtained. A minimum of 10-days treatment is recommended for any infection caused by Group A beta-hemolytic streptococci to help prevent the occurrence of acute rheumatic fever or acute glomerulonephritis.
DIRECTIONS FOR USE
Use only freshly prepared solutions. Intramuscular and intravenous injections should be administered within one hour after preparation since the potency may decrease significantly after this period.
For Intramuscular Use– Dissolve contents of a vial with the amount of Sterile Water for Injection, USP, or Bacteriostatic Water for Injection, USP, listed in the table below:
NDC 0781
LabelClaim
RecommendedAmount ofDiluent
WithdrawableVolume
Concentration(in mg/mL)
3400-95
125 mg
1.2 mL
1.0 mL
125 mg
3402-95
250 mg
1.0 mL
1.0 mL
250 mg
3407-95
500 mg
1.8 mL
2.0 mL
250 mg
3404-95
1 gram
3.5 mL
4.0 mL
250 mg
3408-95
2 gram
6.8 mL
8.0 mL
250 mg
While Ampicillin for Injection, USP, 1 g and 2 g, are primarily for intravenous use, they may be administered intramusculary when the 250 mg or 500 mg vials are unavailable. In such instances, dissolve in 3.5 or 6.8 mL Sterile Water for Injection, USP, or Bacteriostatic Water for Injection, USP, respectively. The resulting solution will provide a concentration of 250 mg per mL.
Ampicillin for Injection, USP, 125 mg, is intended primarily for pediatric use. It also serves as a convenient dosage form when small parenteral doses of the antibiotic are required.
For Direct Intravenous Use– Add 5 mL Sterile Water for Injection, USP, or Bacteriostatic Water for Injection, USP to the 125, 250, and 500 mg vials and administer slowly over a 3- to 5- minute period. Ampicillin for Injection, USP, 1 g or 2 g, may also be given by direct Intravenous administration. Dissolve in 7.4 or 14.8 mL Sterile Water for Injection, USP, or Bacteriostatic Water for Injection, USP, respectively, and administer slowly over at least 10 to 15 minutes. CAUTION: More rapid administration may result in convulsive seizures.
For Administration by Intravenous Drip– Reconstitute as directed above (For Direct Intravenous Use) prior to diluting with Intravenous Solution. Stability studies on Ampicillin sodium at several concentrations in various intravenous solutions indicate the drug will lose less than 10% activitiy at the temperatures noted for the time periods stated.
Room Temperature (25° C)
Diluent
Concentrations
StabilityPeriods
Sterile Water for Injection
up to 30 mg/mL
8 hours
Isotonic Sodium Chloride
up to 30 mg/mL
8 hours
5% Dextrose in Water
10 to 20 mg/mL
1 hour
5% Dextrose in Water
up to 2 mg/mL
2 hours
5% Dextrose in 0.45% NaCl
up to 2 mg/mL
2 hours
Lactated Ringer's Solution
up to 30 mg/mL
8 hours
Refrigerated (4° C)
Diluent
Concentrations
StabilityPeriods
Sterile Water for Injection
30 mg/mL
48 hours
Sterile Water for Injection
up to 20 mg/mL
72 hours
Isotonic Sodium Chloride
30 mg/mL
24 hours
Isotonic Sodium Chloride
up to 20 mg/mL
48 hours
Lactated Ringer's Solution
up to 30 mg/mL
24 hours
5% Dextrose in Water
up to 20 mg/mL
1 hour
5% Dextrose and 0.45% NaCl
up to 10 mg/mL
1 hour
Only those solutions listed above should be used for the intravenous infusion of Ampicillin for injection, USP. The concentrations should fall within the range specified. The drug concentration and the rate and volume of the infusion should be adjusted so that the total dose of Ampicillin is administered before the drug loses its stability in the solution in use.
Pharmacy Bulk Package– This glass vial contains 10 grams Ampicillin and is designed for use in the pharmacy in preparing IV additives. Add 94 mL Sterile Water for Injection, USP. The resulting solution will contain 100 milligrams Ampicillin activity per mL, and is stable up to one hour at room temperature. Diluting further within one hour from 5 mg to 10 mg per mL, the resulting solution will remain stable for 8 hours at room temperature or 72 hours under refrigeration.
CAUTION: NOT TO BE DISPENSED AS A UNIT.
How is Ampicillin Supplied
Ampicillin for Injection, USP for IM or IV Injection. Ampicillin sodium equivalent to 125, 250, 500 mg, 1, 2, or 10 grams Ampicillin per vial.
NDC 0781-3400-95 125 mg vial packaged in 10s NDC 0781-3402-95 250 mg vial packaged in 10s NDC 0781-3407-95 500 mg vial packaged in 10s NDC 0781-3404-95 1 gram vial packaged in 10s NDC 0781-3408-95 2 gram vial packaged in 10s NDC 0781-3409-95 10 gram Pharmacy Bulk Package packaged in 10s
Manufactured bySandoz GmbH, Kundl, Austriafor Sandoz Inc., Broomfield, CO 80020
Ampicillin Ampicillin sodium injection, powder, for solution
Product Information
Product Type
HUMAN PRESCRIPTION DRUG
NDC Product Code (Source)
0781-3400
Route of Administration
INTRAVENOUS
DEA Schedule
INGREDIENTS
Name (Active Moiety)
Type
Strength
Ampicillin Sodium (Ampicillin)
Active
125 MILLIGRAM In 1 VIAL
Product Characteristics
Color
NDC
Package Description
Multilevel Packaging
1
0781-3400-95
10 VIAL In 1 PACKAGE
contains a VIAL, GLASS (0781-3400-78)
1
0781-3400-78
1 VIAL In 1 VIAL, GLASS
This package is contained within the PACKAGE (0781-3400-95)
Ampicillin Ampicillin sodium injection, powder, for solution
Product Information
Product Type
HUMAN PRESCRIPTION DRUG
NDC Product Code (Source)
0781-3402
Route of Administration
INTRAVENOUS
DEA Schedule
INGREDIENTS
Name (Active Moiety)
Type
Strength
Ampicillin sodium (Ampicillin)
Active
250 MILLIGRAM In 1 VIAL
Product Characteristics
Color
Score
Shape
Size
Flavor
Imprint Code
Contains
Packaging
#
NDC
Package Description
Multilevel Packaging
1
0781-3402-95
10 VIAL In 1 PACKAGE
contains a VIAL, GLASS (0781-3402-78)
1
0781-3402-78
1 VIAL In 1 VIAL, GLASS
This package is contained within the PACKAGE (0781-3402-95)
Ampicillin Ampicillin sodium injection, powder, for solution
Product Information
Product Type
HUMAN PRESCRIPTION DRUG
NDC Product Code (Source)
0781-3407
Route of Administration
INTRAVENOUS
DEA Schedule
erceflora/ bacillus clausii
Brand Name: Erceflora
Classification: Antidiarrheals
Suggested Dose:
Adults 2-3 vials of 2 billion/5 mL susp
Children 2-11 years 1-2 vials of 2 billion/5 mL susp
Infants >1 month 1-2 vials of 2 billion/5 mL susp.
Mode of Action:
Contributes to the recovery of the intestinal microbial flora altered during the course of microbial disorders of diverse origin. It produces various vitamins, particularly group B vitamins thus contributing to correction of vitamin disorders caused by antibiotics & chemotherapeutic agents. Promotes normalization of intestinal flora.
Indication:
Acute diarrhea with duration of ≤14 days due to infection, drugs or poisons. Chronic or persistent diarrhea with duration of >14 days.
Contraindication:
Not for use in immunocompromised patients (cancer patients on chemotherapy, patients taking immunosuppressant meds)
Drug Interaction:
No known drug interactions.
Side Effects/Adverse Reactions:
No known side effects.
Adverse Effects:
No known adverse effects.
Nursing Responsibility:
1.) Shake drug well before administration.
® Allows equal distribution of the drug in the fluid it is in.
2.) Monitor patient for any unusual effects from drug.
® Monitoring allows detection of possible side effects of the drug since there has been no known side effect of the drug.
3.) Administer drug within 30 minutes after opening container.
® To avoid contamination of the drug.
4.) Dilute drug with sweetened milk, orange juice or tea.
® To allow easy administration of the drug.
5.) Administer drug orally.
® Proper administration allows better effects of the drug and prevent possible complications
Classification: Antidiarrheals
Suggested Dose:
Adults 2-3 vials of 2 billion/5 mL susp
Children 2-11 years 1-2 vials of 2 billion/5 mL susp
Infants >1 month 1-2 vials of 2 billion/5 mL susp.
Mode of Action:
Contributes to the recovery of the intestinal microbial flora altered during the course of microbial disorders of diverse origin. It produces various vitamins, particularly group B vitamins thus contributing to correction of vitamin disorders caused by antibiotics & chemotherapeutic agents. Promotes normalization of intestinal flora.
Indication:
Acute diarrhea with duration of ≤14 days due to infection, drugs or poisons. Chronic or persistent diarrhea with duration of >14 days.
Contraindication:
Not for use in immunocompromised patients (cancer patients on chemotherapy, patients taking immunosuppressant meds)
Drug Interaction:
No known drug interactions.
Side Effects/Adverse Reactions:
No known side effects.
Adverse Effects:
No known adverse effects.
Nursing Responsibility:
1.) Shake drug well before administration.
® Allows equal distribution of the drug in the fluid it is in.
2.) Monitor patient for any unusual effects from drug.
® Monitoring allows detection of possible side effects of the drug since there has been no known side effect of the drug.
3.) Administer drug within 30 minutes after opening container.
® To avoid contamination of the drug.
4.) Dilute drug with sweetened milk, orange juice or tea.
® To allow easy administration of the drug.
5.) Administer drug orally.
® Proper administration allows better effects of the drug and prevent possible complications
Bacillus clausii is Gram-positive, motile, spore-forming and like most of the Bacillus bacteria, it is rod-shaped. Colonies of B. clausii form filamentous margins that appear cream-white in color. B. clausii is alkaliphilic and produces a class of subtilisins known as high-alkaline proteases. The protease from Bacillus clausii strain 221, the H-221 protease, was the first enzyme to be identified in an alkaliphilic Bacillus. The alkaliphilic nature of the organism has also proved it to be useful in preventing and treating various gastrointestinal disorders as an oral bacteriotherapy. This organism can be found in many alkaline environments, including soil and marine habitat.
The B. clausii strain KSM-K16 was obtained from soil samples, and its phylogenic position as a member of B. clausii was identified using Bacillus clausii DSM 8716 as a reference strain- also isolated from a soil sample. DSM 8716 was identified as a novel Bacillus species by Nielsen et. all, with unique characteristics detailed in Cell Structure and Metabolism. The techniques used to determine the classification of KSM-K16 included 16S rRNA sequencing, which directly compares two or more strains of rRNA sequences to determine sequence homology- in this case the sequence of KSM-K16 with that of DSM 8716. Other classification techniques including fatty acid analysis, which identifies fatty acids in the membrane, and carbohydrate utilization tests, which establish the metabolic characteristics of the organism. Growth of KSM-K16 was observed in the temperature range of 15-50°C and the pH range of 7-10.5, with optimal growth at 40°C and pH 9.0. The KSM-K16 strain produces the high-alkaline protease, M-protease, which is hyperproduced by a mutant used in industrial scale compact heavy-duty laundry detergent. This protease, among other enzymes used by B. clausii organisms, are being extensively studied to understand their ability to function in such alkaline conditions for possible biotechnology use, making the genome of B. clausii a necessary tool
The B. clausii strain KSM-K16 was obtained from soil samples, and its phylogenic position as a member of B. clausii was identified using Bacillus clausii DSM 8716 as a reference strain- also isolated from a soil sample. DSM 8716 was identified as a novel Bacillus species by Nielsen et. all, with unique characteristics detailed in Cell Structure and Metabolism. The techniques used to determine the classification of KSM-K16 included 16S rRNA sequencing, which directly compares two or more strains of rRNA sequences to determine sequence homology- in this case the sequence of KSM-K16 with that of DSM 8716. Other classification techniques including fatty acid analysis, which identifies fatty acids in the membrane, and carbohydrate utilization tests, which establish the metabolic characteristics of the organism. Growth of KSM-K16 was observed in the temperature range of 15-50°C and the pH range of 7-10.5, with optimal growth at 40°C and pH 9.0. The KSM-K16 strain produces the high-alkaline protease, M-protease, which is hyperproduced by a mutant used in industrial scale compact heavy-duty laundry detergent. This protease, among other enzymes used by B. clausii organisms, are being extensively studied to understand their ability to function in such alkaline conditions for possible biotechnology use, making the genome of B. clausii a necessary tool
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