**6.1.2.1 Methicillin**

In newborn,

304 Complementary Pediatrics

It is a salt of penicillin G which establishes quite low serum levels, which is water-insoluble and whose effect however remains for 3-4 weeks. In rheumatic fever prophylaxis, 600.000- 1.200.000 U/dose IM (each month) is applied. Penadur LA, Deposilin are its derivatives. It

*Monitoring*: Shall high doses be applied in patients with renal failure the serum sodium and potassium levels should be monitored. They should be monitored in terms of extravasation

*Caution:* The crystallized penicillin G should only be used IV. Procaine and benzathine

*Incompatible Drugs:* Amphotericin B, aminophylline, aminoglycosides, metoclopramide

*The things to be considered by nurse applying the drug:* Nurse should know whether child is

After the vial is diluted with sterile water the drug should be well dissolved before the

In case that high dose of Penicillin G is rapidly administered by IV route it can cause such electrolyte imbalances as potassium and sodium. So the drug should be administered very slowly. When administered by IM route, the injection area should be carefully selected; the drug should be administered deep and the area should be frequently changed (Kavakl et al,

After the drug is administered by parenteral route the children should at least be monitored for an hour especially in terms of allergy and anaphylaxis. The presence of erythema and pallor in the injection area of IV and IM can be a sign of sensitivity. And also in case that the child is observed with anxiety, nausea, vomiting, dyspnea, tremor, instant febrility, and rash it should be considered that it might be an allergic reaction. Allergic reactions should immediately be notified to doctor. Drug, tools and equipment should all be available for an

Toxicity symptoms should be closely monitored in newborns, infants and people with renal

In oral route the best is to administer the drug with water pre-meals. Administering the drug 1 hour before, or 2 hours later than the meals decreases the effect of gastric acid or the possibility that foods delay the absorption of drugs. Child should be prevented from drinking acid

Tablet drugs should be protected against light. Oral suspensions and syrups should be preserved in refrigerator. The infusion solutions of penicillin G can stay for 24 hours under

beverages 1 hour before and after the administration of drug (Kavakl et al, 1998).

In case of an extravasation hyaluronidase can be used (Kanmaz, 2010).

failure. Bleeding time should be monitored (Kavakl et al, 1998).

*Side effects*: Allergy, shock (Apak, 1996).

does not cause shock (Apak, 1996; Dökmeci, 2000; Eroğlu, 2002).

penicillin G should only be used IM (Kanmaz, 2010).

allergic to the drug or not (Kavakl et al, 1998).

desired dose is taken from the vial.

emergency (Kavakl et al, 1998).

room temperature (Kavakl et al, 1998).

*6.1.1.2.3 Benzathine penicillin G* 

(Kanmaz, 2010).

(Kanmaz, 2010).

1998).

IM, IV (15-30min.), <2000g <14 days: 50 mg/kg/day (every 12 hours),

<2000g >14 days: 75 mg/kg/day (every 8 hours),

>2000g <14 days: 75 mg/kg/day (every 8 hours),

>2000g >14 days: 100 mg/kg/day (every 6 hours),

For others: IV (15-30 min.), IM 100-200 mg/kg/day (every 4-6 hours), PO: 50-100 mg/kg/day (every 6 hours) (Eroğlu, 2002; Küçüködük 1994).

*Side effects*: It can cause interstitial nephritis. The dose should be adjusted in renal failure. Along with other penicillin it can produce cross allergic reaction (Apak, 1996).
