A patient has an infection caused by Pseudomonas aeruginosa. The prescriber has ordered piperacillin and amikacin, both to be given intravenously. What will the nurse do?
a. Make sure to administer the drugs at different times using different IV tubing.
b. Suggest giving larger doses of piperacillin and discontinuing the amikacin.
c. Suggest that a fixed-dose combination of piperacillin and tazobactam (Zosyn) be used.
d. Watch the patient closely for allergic reactions, because this risk is increased with this combination.
ANS: A
When penicillins are present in high concentrations, they interact with aminoglycosides and inactivate the aminoglycoside; therefore, these two drugs should never be mixed in the same IV solution. The drugs should be given at different times with different tubing. In the treatment of Pseudomonas infections, extended-spectrum penicillins, such as piperacillin, usually are given in conjunction with an antipseudomonal aminoglycoside, such as amikacin; therefore, suggesting a larger dose of piperacillin and discontinuation of the amikacin is incorrect. Zosyn is not recommended. The risk of allergic reactions does not increase with this combination of drugs.
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