ANTI INFECTIVE Flashcards
Antibiotics: Common AE
- Gi effects
- Skin effects
- Hypersensitivity rxn (true allergy or expected AE)
- Superinfections/ Secondary infection. Cdiff, yeast infection
Toxicities: How to prevent
More on IV antibiotics
1. AKI – prevent by hydration so teach patient
- Neurotoxicity- no preventative measure
- Liver toxicity –
- Nephrotoxicity – urine output (vancomycin )
Lifespan
Adults:
1. female on birth control pill use additional protection against pregnancy because birth control becomes less effective. As a nurse make sure you will do your assessment.
Pregnancy category c
- older adult ; risk for toxicity ( reduce liver , kidney function)
Nursing Administration
PRIOR:
- assessment and health hx
- obtain cultures indicated
- note s/s of current infection
- monitor pt/ inr because antibiotics can have
Nursing Administration
WHEN administering
Oral
1. oes / full glass water 1 hr before meals or 2-3 hrs. after meals
2. never take with fruit juice, soft drinks or milk
IV
1. observe for inflammation of veins (phlebitis)
2. check rate infusion (ivp)
3. check compatibility with meds / iv fluids
4. vancomycin is preferred on central line.
Nursing Administration
WHEN administering
Oral
1. oes / full glass water 1 hr before meals or 2-3 hrs. after meals
2. never take with fruit juice, soft drinks or milk
IV
1. observe for inflammation of veins (phlebitis)
2. check rate infusion (ivp)
3. check compatibility with meds / iv fluids
4. vancomycin is preferred on central line.
Throughout administration
- monitor /report therapeutic effects, adverse effects
- lab values cbc ,kidney functions, lft
- peak or through
- ensure hydration to reduce aki
Throughout administration
- monitor /report therapeutic effects, adverse effects
- lab values cbc ,kidney functions, lft
- peak or through
- ensure hydration to reduce aki
Patient education.
- TAD
- Females use another contraceptive
- Drink 3 l h2o
- Report ae to hcp.
Patient education.
- TAD
- Females use another contraceptive
- Drink 3 l h2o
- Report ae to hcp.
ANTIBIOTICS DRUGS
GENTAMICIN
1. AE: tinnitus, hearing loss, systemic routes high rf toxicities
2. BBW: nephrotoxicity, neurotoxicity
3. NURSING: draw peak (after 1 hr.)
ANTIBIOTICS DRUGS
GENTAMICIN
1. AE: tinnitus, hearing loss, systemic routes high rf toxicities
2. BBW: nephrotoxicity, neurotoxicity
3. NURSING: draw peak (after 1 hr.)
ERTRAPENEM
1. AE: systemic routes high rf toxicities
2. NURSING:
CIPROFLOXACIN
1. AE:
a. Photosensitivity (sun sensitive)
b. Tendon rupture possible with corticosteroid
c. Dysrhythmias with IV route need telemetry
2. NURSING:
a. telemetry if indicated
b. educate wear sunscreen
ERYTHROMYCIN
1. AE: IV route high risk for toxicities
2. NURSING
AMOXICILLIN
1. CONTRAINDICATION:
a. sensitivity to cephalosporin
b. renal disease
c. pregnancy category b
2. DRUG-DRUG INT: decrease effectiveness of oral contraceptives , increase anticoagulation effect of warfarin
3. AE:
4. NURSING:
CEFAZOLIN
1. CONTRAINDICATION:
a. allergy to penicillin
b. pregnancy category b
2. DRUG-FOOD: alcohol
3. AE:
4. NURSING:
CEFAZOLIN
1. CONTRAINDICATION:
a. allergy to penicillin
b. pregnancy category b
2. DRUG-FOOD: alcohol
3. AE:
4. NURSING:
SMZ
DOXYCYCLINE
1. AE: teeth discoloration, photosensitivity
2. CONTRAINDICATION: pregnancy
3. DRUG-DRUG: decreases effectiveness of oral contraceptives
4. NURSING: use sunscreen
DOXYCYCLINE
1. AE: teeth discoloration, photosensitivity
2. CONTRAINDICATION: pregnancy
3. DRUG-DRUG: decreases effectiveness of oral contraceptives
4. NURSING: use sunscreen
VANCOMYCIN
- AE:
- NURSING: assessment priority ( urine output)
**Through draw( before ) to make sure patient is getting enough medications and to avoid toxicities
**Note about superinfection via iv vancomycin cdiff , cdiff has to be oral vancomycin because it gets to the gi tract
**Administer over at least 1 hr to reduce redman syndrome
METRONIDAZOLE (antibiotic/ antiprotozoal)
- CONTRAINDICATION:
a. Renal / liver dysfunction
b. Pg / lactation - DRUG-DRUG: anticoagulants (warfarin)
- AE:
a. CNS effects
b. Metallic taste (that’s normal)
c. Severe n/v with alcohol intake - NURSING: don’t take alcohol
METRONIDAZOLE (antibiotic/ antiprotozoal)
- CONTRAINDICATION:
a. Renal / liver dysfunction
b. Pg / lactation - DRUG-DRUG: anticoagulants (warfarin)
- AE:
a. CNS effects
b. Metallic taste (that’s normal)
c. Severe n/v with alcohol intake - NURSING: don’t take alcohol
TB Treatment (antibiotic/ antimycobacterial)
- AE (major)
a. GI effects nvd ( orange tint body fluids
b. Neuropathy
c. Bone marrow suppression
d. Liver toxicity - DRUG- DRUG
- NURSING:
a. Monitor ae
b. Monitor labs
c. Educate TAD
d. Do not stop meds
e. Treatment 6 months to 2 years
TB Treatment (antibiotic/ antimycobacterial)
- AE (major)
a. GI effects nvd ( orange tint body fluids
b. Neuropathy
c. Bone marrow suppression
d. Liver toxicity - DRUG- DRUG
- NURSING:
a. Monitor ae
b. Monitor labs
c. Educate TAD
d. Do not stop meds
e. Treatment 6 months to 2 years
ANTIVIRAL
Need to know specific indications, what virus
OSELTAMIVIR (tamiflu)
1. INDICATIONS: treatment or prophylaxis to decrease the s/s of flu
2. CONTRAINDICATIONS: pg / bf
3. AE: gi effects nvd
4. NURSING:
a. Treatment should be initiated within 48 hrs of symptoms
b. Do not administer 46 hrs before flu vaccine or 2 weeks after
c. May take with food to decrease GI intolerance
ANTIVIRAL
Need to know specific indications, what virus
OSELTAMIVIR (tamiflu)
1. INDICATIONS: treatment or prophylaxis to decrease the s/s of flu
2. CONTRAINDICATIONS: pg / bf
3. AE: gi effects nvd
4. NURSING:
a. Treatment should be initiated within 48 hrs of symptoms
b. Do not administer 46 hrs before flu vaccine or 2 weeks after
c. May take with food to decrease GI intolerance
ACYCLOVIRAL
1. INDICATIONS: herpes , variceralla zoster
2. ROUTES : oral ,topical ,iv( short duration)
3. AE:
a. Oral; malaise headache , nvd
b. IV: rf toxic
4. NURSING:
a. oral: amin around the clock (atc) with food; use gloves when applying
b. iv ; infuse over 1hr to decrease renal damage ;ensure patient hydrated
ANTI-RETROVIRAL
1. AE:
a. Gi effects
b. Cns effects
c. Flu like syndrome
d. Rf toxicity
2. NURSINF:
a. TAD
b. Do not skip dose
c. Take at the same time everyday
d. Refill meds before they run out
e. Report: rashes, severe di/vo, drowsiness . dizziness , difficulty breathing (sob)
f. Keep schedule lab and hcp appts
ANTI-FUNGAL
NYSTATIN (topical) given about 6 weeks.
1. AE:
a. Topical: contact dermatitis
b. Oral: nvd
2. NURSING
a. Topical: apply to affected area using gloves
b. Oral: direct patients to swish 2 mins , and swallow ,
c. Oral: children – swab
ANTI-FUNGAL
NYSTATIN (topical) given about 6 weeks.
1. AE:
a. Topical: contact dermatitis
b. Oral: nvd
2. NURSING
a. Topical: apply to affected area using gloves
b. Oral: direct patients to swish 2 mins , and swallow ,
c. Oral: children – swab
FLUCONAZOLE sometimes pt needs this meds long term so they need liver check / labs monitor like if they are in 6 mos treatment they need to have 3 month check
- AE: nvd , long duration , liver toxicity
- CONTRAINDICATIONS:
a. liver disease
b. pg
