Anti-Infectives (81) Flashcards
- MINOCYCLINE
- DOXYCYCLINE
- TRIMETHOPRIM/
SULFAMETHOXAZOLE - AMOXICILLIN, AMPICILLIN, PENICILLIN
- ERYTHROMYCIN
- CLARITHROMYCIN
- AZITHROMYCIN
- CLINDAMYCIN PHOSPHATE
- VANCOMYCIN
- LEVOFLOXACIN
- CIPROFLOXACIN
- CEFEPIME
- CEFDINIR
- CEFUROXIME
- CEPHALEXIN
- ZIDOVUDINE
- VALACYCLOVIR
- OSELTAMIVIR PHOSPHATE
- ACYCLOVIR
- ISONIAZID
- METRONIDAZOLE
- QUININE SULFATE
- HYDROXYCHLOROQUINE
- FLUCONAZOLE
- AMPHOTERICIN B
- AMOXICILLIN/CLAVULANATE
- AMIKACIN, GENTAMICIN, TOBRAMYCIN
MINOCYCLINE: Nursing Considerations
- Peak 2–3 hours
- If GI symptoms occur, administer with food EXCEPT milk products or other foods high in calcium (interferes with absorption)
- Take with full glass of water; do NOT take within 1 hour of bedtime
- Avoid during tooth and early development periods (4th month prenatal to 8 years of age)
- Rx; Preg Cat D
MINOCYCLINE: Side Effects
- Photosensitivity
- GI upset, diarrhea
- Renal, hepatic, hematologic abnormalities
- Dental discoloration of deciduous (baby) teeth
- Dizziness
- Hepatotoxicity
- Urticaria, rash
MINOCYCLINE: Purpose
Treatment of syphilis, gonorrhea, chlamydia, periodontitis, acne, bronchitis, and meningitis
DOXYCYCLINE: Nursing Considerations
- Peak 1.5–4 hours
- If GI symptoms occur, administer with food EXCEPT milk products or other foods high in calcium (interferes with absorption)
- Take with full glass of water; do NOT take within 1 hour of bedtime or reclining
- Avoid during tooth and early development periods (4th month prenatal to 8 years of age)
- Increases effects of anticoagulants
- Rx; Preg Cat D
DOXYCYCLINE: Side Effects
- Photosensitivity
- GI upset, diarrhea
- Renal, hepatic, hematologic abnormalities
- Dental discoloration of deciduous (baby) teeth
- Rash
DOXYCYCLINE: Purpose
Treatment of syphilis, gonorrhea, chlamydia, chronic periodontitis, acne, and anthrax; prophylaxis of malaria
TRIMETHOPRIM/SULFAMETHOXAZOLE: Nursing Considerations
- PO: with full glass water; if upset stomach occurs, take with food
- PO: take at equal intervals around the clock
- IV: infuse slowly over 60–90 minutes; flush lines at end of infusion to remove residue
- Monitor for hypersensitivity reaction; stop med at first sign of skin rash
- Never administer IM, rapidly IV, or by bolus injection
- Encourage fluids to 8–10 glasses/day
- Rx; Preg Cat C
TRIMETHOPRIM/SULFAMETHOXAZOLE: Side Effects
- Hypersensitivity reaction
- Blood dyscrasias
- Photosensitivity
- Nausea, vomiting, anorexia
- Stomatitis, abdominal pain
- Headache, fatigue
- Bone marrow suppression
- Increased BUN/creatinine
TRIMETHOPRIM/SULFAMETHOXAZOLE: Purpose
Treatment of urinary tract infections, otitis media, chronic prostatitis, shigellosis, chancroid, and traveler’s diarrhea
AMOXICILLIN, AMPICILLIN, PENICILLIN: Nursing Considerations
- Take careful history of penicillin reaction; observe for 20 minutes post IM injection
- PO for penicillin and ampicillin: take 1 hour ac or 2 hours pc to reduce gastric acid destruction of drug; not true for amoxicillin
- Take equally divided doses around the clock
- Continue medication for entire time prescribed, even if symptoms resolve
- Check for hypersensitivity to other drugs, especially cephalosporins
- Rx; Preg Cat B
AMOXICILLIN, AMPICILLIN, PENICILLIN: Side Effects
- Allergic reactions: fever, difficulty breathing, skin rash
- Renal, hepatic, hematologic abnormalities
- Nausea, vomiting, diarrhea
- Urticaria, rash
- Bone marrow suppression
AMOXICILLIN, AMPICILLIN, PENICILLIN: Purpose
Treatment of respiratory, skin, gastrointestinal, and urinary infections and of otitis media and gonorrhea
ERYTHROMYCIN: Nursing Considerations
- PO: give 1 hour before or 2 hours after meals
- PO: give with full glass of water; avoid citrus juice
- PO: onset 1 hour, peak up to 4 hours, duration 6–12 hours
- IV: onset rapid, peak end of infusion, duration 6–12 hours
- Take at equal intervals around the clock
- Can be used in patients with compromised renal function
- Monitor for signs of superinfection (sore throat, fever, fatigue)
- Rx; Preg Cat B
ERYTHROMYCIN: Side Effects
- Abdominal cramps
- Pain at injection site
- Nausea, vomiting, diarrhea
- Rash
- Anaphylaxis
- Vaginitis
- Dysrhythmias
- Hepatotoxicity
ERYTHROMYCIN: Purpose
Treatment of mild to moderate respiratory and skin infections, chlamydia, and syphilis
CLARITHROMYCIN: Nursing Considerations
- Treatment may be 7–14 days depending on organism and extent of infection
- Medication should be taken with food
- Be aware of possible increase in theophylline, carbamazepine, and digoxin levels
- Monitor for signs of superinfection (sore throat, fever, fatigue)
- Rx; Preg Cat C
CLARITHROMYCIN: Side Effects
- Nausea, vomiting, diarrhea
- Headache
- Taste abnormalities
- Ventricular dysrhythmias
- Vaginitis
- Leukopenia
- Rash
CLARITHROMYCIN: Purpose
Treatment of respiratory, skin, and sinus infections
AZITHROMYCIN: Nursing Considerations
- PO: rapid onset, peak 2.5–3.2 hours, duration 24 hours
- IV: rapid onset, peak end of infusion, duration 24 hours
- PO: don’t take with antacids; can take with or without food
- Monitor for signs of superinfection (sore throat, fever, fatigue)
- If treated for nongonococcal urethritis or cervicitis, sexual partners also need treatment
- Increases effects of oral anticoagulants
- Rx; Preg Cat B
AZITHROMYCIN: Side Effects
- Nausea, vomiting, diarrhea
- Hearing loss
- Dizziness, vertigo
- Rash
- Photosensitivity
- Hepatotoxicity
- Increased liver function tests
- Vaginitis
- Angioedema
- Anemia
AZITHROMYCIN: Purpose
Treatment of mild to moderate infections of the respiratory tract and skin and of nongonococcal urethritis, cervicitis, acute pharyngitis/tonsillitis, and community-acquired pneumonia
CLINDAMYCIN PHOSPHATE: Nursing Considerations
- PO: peak 45 minutes, duration 6 hours
- IM: peak 3 hours, duration 8–12 hours
- May cause increase in AST, ALT, CPK
- Do not break, crush, or chew capsules
- Rx; Preg Cat B**
CLINDAMYCIN PHOSPHATE: Side Effects
- Nausea, vomiting, diarrhea
- Abdominal pain
- Vaginitis
- Rash
- Jaundice
CLINDAMYCIN PHOSPHATE: Purpose
Treatment of infections caused by Staphylococcus, Streptococcus, and other bacteria
VANCOMYCIN: Nursing Considerations
- PO: poor absorption
- IV: peak 5 minutes, duration 12–24 hours
- Give at least 60 minutes (IV); do not infuse with other drugs
- Give antihistamine if “red man syndrome”: decreased blood pressure, flushing of face and neck
- Contact provider if signs of superinfection (sore throat, fever, fatigue)
- Check peak: 1 hour after infusion
- Check trough before next dose
- Encourage fluids to 2 L/day
- Rx; Preg Cat C
VANCOMYCIN: Side Effects
- Nephrotoxicity
- Headache
- Ototoxicity
- Dyspnea
VANCOMYCIN: Purpose
Treatment of C. difficile, resistant staph infections, colitis, and staph enterocolitis; prophylaxis for endocarditis and dental procedures
LEVOFLOXACIN: Nursing Considerations
Infused injection over 60–90 minutes, once every 24 hours
Monitor blood sugar; may cause hypoglycemia or hyperglycemia
Rx; Preg Cat C
LEVOFLOXACIN: Side Effects
- Headache, nausea, vomiting, diarrhea
- Stomach pain
- Dizziness
- Vaginal itching and/or discharge
- Tendon rupture or tendinitis
- Insomnia
- Photosensitivity, rash
- Hallucination, paranoia
- Hepatotoxicity
- Suicidal thoughts
- Encephalopathy
- Chest pain, palpitations
LEVOFLOXACIN: Purpose
Treatment of infections such as acute sinusitis, acute chronic bronchitis, pneumonia, and anthrax and of infections of the urinary tract, kidney, prostate, and skin
CIPROFLOXACIN: Nursing Considerations
- Contraindicated in children less than 18 years of age
- Take 2 hours before or 6 hours after antacid or iron preparation
- Avoid caffeine
- Encourage fluids to 2–3 L/day
- May cause false positive in opiate screening tests
- Do not infuse with other medications
- Rx; Preg Cat C
CIPROFLOXACIN: Side Effects
- Seizures
- Headache, restlessness
- Nausea, vomiting, diarrhea, abd. distress, flatulence
- Rash
- Photosensitivity
- Tendon rupture, muscle tear
- Increased liver function test
CIPROFLOXACIN: Purpose
Treatment of infections caused by E. coli and other bacteria and of chronic bacterial prostatitis, acute sinusitis, and postexposure inhalation anthrax
CEFEPIME: Nursing Considerations
- IV: peak 30 minutes
- IM: peak 2 hours
- May cause false positive for urine glucose
- Possible cross allergy to penicillin
- Rx; Preg Cat B
CEFEPIME: Side Effects
- Nausea, vomiting, diarrhea
- Anorexia
- Elevated liver function tests
- Rash
- Headache
- Dyspnea
- Nephrotoxicity
CEFEPIME: Purpose
Treatment of respiratory tract, urinary tract, skin, and bone infections
CEFDINIR: Nursing Considerations
- Take for 10–14 days to prevent superinfection
- Do not give antacids or iron supplements within 2 hours
- May cause false positive for urine glucose
- Possible cross allergy to penicillin
- Rx; Preg Cat B
CEFDINIR: Side Effects
- Nausea, vomiting, diarrhea
- Anorexia
- Rash
- Elevated liver function tests
- Headache
- Oral and vaginal candidiasis
- Dizziness
- Neurotoxicity
- Thrombocytopenia
CEFDINIR: Purpose
Treatment of acute exacerbations of chronic bronchitis, sinusitis, pharyngitis, otitis media, tonsillitis, and skin infections
CEFUROXIME: Nursing Considerations
- Take for 10–14 days to prevent superinfection
- May cause increased BUN and serum creatine
- May cause false positive urine glucose
- Possible cross allergy to penicillin
- Rx; Preg Cat B
CEFUROXIME: Side Effects
- Nausea, vomiting, diarrhea
- Headache
- Rash
- Elevated liver function tests
- Nephrotoxicity
- Thrombocytopenia
CEFUROXIME: Purpose
Treatment of lower respiratory tract, urinary tract, skin, bone, joint, and gonococcal infections and of septicemia and meningitis
CEPHALEXIN: Nursing considerations
- Peak 1 hour, duration usually 6 hours, but may be up to 12 hours with decreased renal function
- Take for 10–14 days to prevent superinfection
- Possible cross allergy to penicillin
- May cause false positive of urine glucose
- Rx; Preg Cat B
CEPHALEXIN: Side Effects
- Diarrhea
- Anaphylaxis
- Nausea
- Rash
- Headache
- Nephrotoxicity
- Dyspnea
- Thrombocytopenia
- Elevated liver function tests
Treatment of upper and lower respiratory tract, urinary tract, skin, bone, and otitis media infections
ZIDOVUDINE: Nursing Considerations
- GI upset and insomnia resolve after 3–4 weeks
- PO: peak 30–90 minutes
- Check with provider before taking aspirin, acetaminophen, or indomethacin
- Rx; Preg Cat C
ZIDOVUDINE: Side Effects
- Fever, headache, malaise
- Nausea, vomiting, diarrhea
- Dizziness
- Insomnia
- Dyspepsia
- Rash
- Hepatomegaly
ZIDOVUDINE: Purpose
Management of HIV infection, postexposure prophylaxis of HIV foll
VALACYCLOVIR: Nursing Considerations
- Patients should drink plenty of fluids during treatment
- Avoid sexual contact when lesions are visible
- Rx; Preg Cat B
VALACYCLOVIR: Side Effects
- Nausea, vomiting, diarrhea
- Abdominal cramps
- Headache
- Rash
- Dizziness
- Dysmenorrhea
- Thrombocytopenic purpura
- Increased AST
VALACYCLOVIR: Purpose
Treatment of herpes zoster (shingles), genital herpes, herpes labialis (cold sores), and varicella
OSELTAMIVIR PHOSPHATE: Nursing Considerations
- Used to treat uncomplicated acute flu symptoms in patients that are symptomatic for 2 days or less
- Should not be used as a substitute for influenza vaccinations
- May be taken without regard to meals
- Rx; Preg Cat C
OSELTAMIVIR PHOSPHATE: Side Effects
- Nausea
- Vomiting
- Dizziness
- Headache
- Fatigue
- Cough
OSELTAMIVIR PHOSPHATE: Purpose
Prevention and treatment of influenza
ACYCLOVIR: Nursing Considerations
- IV: onset immediate, peak immediate
- PO: absorbed minimally, onset unknown, peak 90 minutes
- Do not break, crush, or chew capsules
- PO: take without regard to meals with a full glass of water
- If dose is missed, take as soon as remembered, up to 1 hour before next dose
- Contact provider if sore throat, fever, and fatigue; could be signs of superinfection
- Rx; Preg Cat B
ACYCLOVIR: Side Effects
- Headache
- Blood dyscrasias
- Nausea, vomiting, diarrhea
- Thrombocytopenia purpura
- Nephrotoxicity
- Tremors
- Lethargy
ACYCLOVIR: Purpose
Treatment of herpes and varicella
ISONIAZID: Nursing Considerations
- PO/IM: onset rapid, peak 1–2 hours, duration up to 24 hours
- Contact provider if signs of hepatitis: yellow eyes and skin, nausea, vomiting, anorexia, dark urine, unusual tiredness, or weakness
- Contact provider if signs of peripheral neuropathy: numbness, tingling, or weakness
- Monitor liver tests
- Do not skip or double doses
- Rx; Preg Cat C
ISONIAZID: Side Effects
- Peripheral neuropathy
- Liver damage
- Nausea, vomiting
ISONIAZID: Purpose
Treatment and prevention of tuberculosis
METRONIDAZOLE: Nursing Considerations
- IV: immediate onset, PO: peak 1–2 hours
- Treatment of both partners is necessary in trichomoniasis
- Do not drink alcohol or preparations containing alcohol during and 48 hours after use; disulfiram-like reaction can occur
- Rx; Preg Cat B
METRONIDAZOLE: Side Effects
- Headache
- Dizziness
- Nausea, vomiting, diarrhea
- Abdominal cramps
- Metallic taste
- Darkened urine
- Depression
- Blurred vision
- Neurotoxicity
METRONIDAZOLE: Purpose
Treatment of a wide variety of infections including trichomoniasis, giardiasis, and bacterial vaginosis
QUININE SULFATE: Nursing Considerations
- Peak 1–3 hours
- Take at the same time each day to maintain blood level
- May increase digoxin levels
- Do not crush
- OTC, Rx; Preg Cat X
QUININE SULFATE: Side Effects
- Eye disturbances
- Nausea, vomiting
- Anorexia
- Tachycardia
- Hypotension
- Thrombocytopenia
- Tinnitus
QUININE SULFATE: Purpose
Treatment of malaria
HYDROXYCHLOROQUINE:
Nursing Considerations
- Peak 1–2 hours
- Take at the same time each day to maintain blood level
- Give with meats to decrease GI distress
- For malaria, prophylaxis should be started 2 weeks before exposure and continue for 4–6 weeks after leaving exposure area
- Rx; Preg Cat C
HYDROXYCHLOROQUINE: Side Effects
- Eye disturbances
- Nausea, vomiting
- Anorexia
- Photosensitivity
- Dizziness
- Headache
- Hypotension
- Skin changes
- Ototoxicity
HYDROXYCHLOROQUINE: Purpose
Management of lupus erythematosus, rheumatoid arthritis, and malaria
FLUCONAZOLE: Nursing Considerations
- Prothrombin time is increased after warfarin usage
- Take missed dose as soon as noticed, but do not double dose
- Monitor glucose levels, especially in diabetics
- Rx; Preg Cat C
FLUCONAZOLE: Side Effects
- Nausea
- Headache
- Abdominal pain
- Diarrhea
- Hepatotoxicity
FLUCONAZOLE: Purpose
Treatment of vaginal, esophageal, and systemic candidiasis and of cryptococcal meningitis
AMPHOTERICIN B: Nursing Considerations
- Do not mix with other drugs
- Monitor vital signs; report fever or change in function, especially nervous system
- Meticulous care and observation of injection site
- Potential benefits must be balanced against serious side effects
- Rx; Preg Cat B
AMPHOTERICIN B: Side Effects
- Blood, kidney, heart, liver abnormalities
- GI upset
- Hypokalemia
- Skin irritation and thrombosis if IV infiltrates
- Rash
- Fever, chills
- Malaise
- Hypotension
- Headache
- Nephrotoxicity
- Ototoxicity
AMPHOTERICIN B: Purpose
Treatment of invasive fungal infections
AMOXICILLIN/CLAVULANATE: Nursing Considerations
- Shake suspension before administering each dose
- Can be mixed with drinks
- Give with meal to increase absorption and reduce GI effects
- Give at equal intervals around to the clock to maintain blood levels
- Discard unused suspension after 14 days
- Nephrotoxic with high doses
- Rx
AMOXICILLIN/CLAVULANATE: Side Effects
- Headache, agitation
- Insomnia
- Nausea, diarrhea, vomiting
- Increased liver enzymes
- Oliguria
- Vaginitis
- Bone marrow suppression
- Hypo/hyperkalemia
- Hypernatremia
- Respiratory distress
AMOXICILLIN/CLAVULANATE: Purpose
Treatment of lower respiratory infections, sinus and skin infections, otitis media, pneumonia, and impetigo
AMIKACIN, GENTAMICIN, TOBRAMYCIN: Nursing Considerations
- IV over 30 minutes to 1 hour; IM by deep, slow injection, never subQ
- Careful monitoring of blood levels
- Check peak—2 hours after med given
- Check trough—at time of dose/prior to med
- Monitor for signs of superinfection (diarrhea, URI, coated tongue)
- Immediately report hearing or balance problems
- Encourage fluids to 8–10 glasses/day
- Rx; Preg Cat D
AMIKACIN, GENTAMICIN, TOBRAMYCIN: Side Effects
- Use during pregnancy can result in bilateral congenital deafness
- Ototoxicity
- Nephrotoxicity
- Neurotoxicity
- Allergic reaction: fever, difficulty breathing, rash
- Vertigo, tinnitus
AMIKACIN, GENTAMICIN, TOBRAMYCIN: Purpose
Treatment of severe systemic infections of CNS, respiratory system, GI tract, urinary tract, bone, skin, and soft tissues
