Anti Biotics Flashcards
Adverse reactions
-hypersensitivity: Benadryl, corticosteroids, epinephrine
-cross sensitivity
-organ toxicity: liver, kidneys, CNS, GI
-hematotoxicity: causes aplastic anemia
Beta Lactam inhibitor
-protects PCN from destruction
-extends PCN’s spectrum of efficacy
Penicillin (beta lactamase)
-narrrow: penicillin G (IV/IM)
-broad: amoxicillin (PO)
-bac infection (tissue, resp, GI, GU)
-contraindications: hypersensitivity, cross sensitive cephalosporins
Cephalosporins (beta lactam)
-cep/cef
-AE: GI upset, superinfection, colitis, thrombocytopenia
-Antabuse with alcohol, furosemide increase nephrotoxicity
-full dose, report PCN allergy and diarrhea, monitor glucose
-cefazolin (Ancef)
Carbapenems (beta lactam)
-penem
-bone, joint, skin, tissue infections
-imipenem (cilastatin)
Monobactams (beta lactam)
-E. Coli, klebsiella, pseudomonas; mod-sev systemic infections and UTI
-AE: same as other beta lactams, localized thrombophlebitis
Aminoglycosides
-NEPHROTIXICITY & OTOTOXICITY!!!!!!***
-serious systemic infections
-micin/mycin/amikacin (gentamicin)
-monitor for tox no longer than 10 days
-AE: hypersensitivity, intense neuro blockade
-drug selection, monitor, treatment 10 days or less
Reducing Aminoglycoside toxicity
-identify high risk pt (high NSAID)
-keep hydrated
-caution with diuretics (low urine, high BUN/Cr)
-no longer than 10 days
-detect AE early and reduce dosage or D/C medication
Aminoglycosides peak and trough
-Peak: 30 minutes after administration
-trough: right before next dose
-draw 30 mins after peak
Fluoroquinolones/Quinolones
-floxacin (ciprofloxacin)
-good PO absorb (reduce with antacids)
-BBW: tendon rupture/tendinitis, peripheral neuropathy, CNS/Cardiac/Derm reactions
-contraindicated: hypersensitivity, pregnant, kids, pt with MG
Fluoroquinlolones/Quinolones AE
-CNS: HA, dizzy, insomnia, confuse, depress
-GI: constipation, diarrhea, N/V, superinfection (thrush)
-cardiac: prolonged QT
-integumentary: photosensitive
Tetracyclines
-cycline (tetracycline HCL)
-prevent from multiplying
-animal bites, Lyme, chlamydia, STD, anthrax, long term acne, sub for PCN
-contraindications: pregnant, kids less than 8
Tetracyclines AE
-GI: distress, esophagitis, N/V, flatulence
-yellow brown tooth discolor, hypoplasia tooth enemal
-hepatoxicity/ photosensitive/ superinfection
-dairy, calcium/iron, lax with mg, antacids reduce absorb
-empty stomach, separate 2hrs with diary etc.
Sulfonamides
-prevents synthesis of folic acid
-use:UTI, chronic bronchitis, ulcerative colitis, burn infect, soft tissue
-contraindication: allergy, thiazide/diuretic (stop if rash), pregnant, infants less than 2 months (jaundice, increase bilirubin)
Sulfonamides AE and interactions
-allergic, delayed cutaneous reactions (stevens johnson, necrolysis, photosensitive), blood/GI, sulfamylon (met acid, ABG)
-anti diabetic (hyperglycemia), decrease efficacy OCP, phenytoin (tox), warfarin (hemorrhage)
-IV needs to be over 60-90mins, never IM
Urinary antiseptics
-bactericidal from high concentrate in renal and urine
-UTI, no systemic infections
-nitrofurantoin (furadantin, macrodantin)
-AE: hypersensitivity, GI upset, blood dyscrasias, neuropathy
-edu: urine (rust-brown), stain teeth, with food, avoid pregnant
Miscellaneous antibiotics
-chloramphenicol: blood dyscrasias (aplastic anemia)
-clindamycin (cleocin): chronic bone infections,GU,intraabd, may cause pseudomembranous colitis
-linezolid (zyvox): VRE, skin; may cause hypotension, serotonin syndrome, reaction with tyramine food
-daptomycin (cubicin): skin by staph, strep,enterococcus, IV only, incompatible with dextrose
Metronidazole (flagyl)
-use: anaerobic organisms, intraabd, gynecological infect, protozal infect
-interact: Antabuse with ETOH, inactivation of warfarin
SE/AE: GI upset, metallic taste, CNS sx (paresthesia, ataxia, seizure—STOP med)
Vancomycin (vancocin)
-use: MRSA and gram + infect
-ototoxicity and nephrotoxicity
-additive neuromuscular blocking effects
-infuse over 60 mins or longer (rapid may cause hypotension)
Vancomycin flushing syndrome
-red man syndrome
-massive histamine release
-erythema; flush; pruritis of head, neck, face, upper trunk; tachycardia, hypotension
-HOLD and notify PCP
-give antihistamine
Nursing implications
-culture before antibiotic
-take exactly as prescribed
-s/s of superinfection (diarrhea with abd cramps and fever, perineal itching, cough, lethargy, unusual discharge)
-common AE N/V/D
Macrolide/ketolide
-thromycin
-Macrolide: resp tract infect, PCN sub, GU infect, bac sinusitis, H. Pylori
-Ketolide: community acquired pneumonia
-con: hypersensitivity, liver dx, gravis
-AE: GI, hepatox, otototox, superinfection, prolong QT**
-slow infusion
