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Pharmacology - NCLEX > Anti-Infectives (81) > Flashcards

Anti-Infectives (81) Flashcards

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1
Q
  1. MINOCYCLINE
  2. DOXYCYCLINE
  3. TRIMETHOPRIM/
    SULFAMETHOXAZOLE
  4. AMOXICILLIN, AMPICILLIN, PENICILLIN
  5. ERYTHROMYCIN
  6. CLARITHROMYCIN
  7. AZITHROMYCIN
  8. CLINDAMYCIN PHOSPHATE
  9. VANCOMYCIN
  10. LEVOFLOXACIN
  11. CIPROFLOXACIN
  12. CEFEPIME
  13. CEFDINIR
  14. CEFUROXIME
  15. CEPHALEXIN
  16. ZIDOVUDINE
  17. VALACYCLOVIR
  18. OSELTAMIVIR PHOSPHATE
  19. ACYCLOVIR
  20. ISONIAZID
  21. METRONIDAZOLE
  22. QUININE SULFATE
  23. HYDROXYCHLOROQUINE
  24. FLUCONAZOLE
  25. AMPHOTERICIN B
  26. AMOXICILLIN/CLAVULANATE
  27. AMIKACIN, GENTAMICIN, TOBRAMYCIN
A
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2
Q

MINOCYCLINE: Nursing Considerations

A
  • 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
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3
Q

MINOCYCLINE: Side Effects

A
  • Photosensitivity
  • GI upset, diarrhea
  • Renal, hepatic, hematologic abnormalities
  • Dental discoloration of deciduous (baby) teeth
  • Dizziness
  • Hepatotoxicity
  • Urticaria, rash
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4
Q

MINOCYCLINE: Purpose

A

Treatment of syphilis, gonorrhea, chlamydia, periodontitis, acne, bronchitis, and meningitis

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5
Q

DOXYCYCLINE: Nursing Considerations

A
  • 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
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6
Q

DOXYCYCLINE: Side Effects

A
  • Photosensitivity
  • GI upset, diarrhea
  • Renal, hepatic, hematologic abnormalities
  • Dental discoloration of deciduous (baby) teeth
  • Rash
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7
Q

DOXYCYCLINE: Purpose

A

Treatment of syphilis, gonorrhea, chlamydia, chronic periodontitis, acne, and anthrax; prophylaxis of malaria

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8
Q

TRIMETHOPRIM/SULFAMETHOXAZOLE: Nursing Considerations

A
  • 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
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9
Q

TRIMETHOPRIM/SULFAMETHOXAZOLE: Side Effects

A
  • Hypersensitivity reaction
  • Blood dyscrasias
  • Photosensitivity
  • Nausea, vomiting, anorexia
  • Stomatitis, abdominal pain
  • Headache, fatigue
  • Bone marrow suppression
  • Increased BUN/creatinine
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10
Q

TRIMETHOPRIM/SULFAMETHOXAZOLE: Purpose

A

Treatment of urinary tract infections, otitis media, chronic prostatitis, shigellosis, chancroid, and traveler’s diarrhea

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11
Q

AMOXICILLIN, AMPICILLIN, PENICILLIN: Nursing Considerations

A
  • 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
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12
Q

AMOXICILLIN, AMPICILLIN, PENICILLIN: Side Effects

A
  • Allergic reactions: fever, difficulty breathing, skin rash
  • Renal, hepatic, hematologic abnormalities
  • Nausea, vomiting, diarrhea
  • Urticaria, rash
  • Bone marrow suppression
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13
Q

AMOXICILLIN, AMPICILLIN, PENICILLIN: Purpose

A

Treatment of respiratory, skin, gastrointestinal, and urinary infections and of otitis media and gonorrhea

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14
Q

ERYTHROMYCIN: Nursing Considerations

A
  • 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
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15
Q

ERYTHROMYCIN: Side Effects

A
  • Abdominal cramps
  • Pain at injection site
  • Nausea, vomiting, diarrhea
  • Rash
  • Anaphylaxis
  • Vaginitis
  • Dysrhythmias
  • Hepatotoxicity
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16
Q

ERYTHROMYCIN: Purpose

A

Treatment of mild to moderate respiratory and skin infections, chlamydia, and syphilis

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17
Q

CLARITHROMYCIN: Nursing Considerations

A
  • 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
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18
Q

CLARITHROMYCIN: Side Effects

A
  • Nausea, vomiting, diarrhea
  • Headache
  • Taste abnormalities
  • Ventricular dysrhythmias
  • Vaginitis
  • Leukopenia
  • Rash
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19
Q

CLARITHROMYCIN: Purpose

A

Treatment of respiratory, skin, and sinus infections

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20
Q

AZITHROMYCIN: Nursing Considerations

A
  • 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
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21
Q

AZITHROMYCIN: Side Effects

A
  • Nausea, vomiting, diarrhea
  • Hearing loss
  • Dizziness, vertigo
  • Rash
  • Photosensitivity
  • Hepatotoxicity
  • Increased liver function tests
  • Vaginitis
  • Angioedema
  • Anemia
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22
Q

AZITHROMYCIN: Purpose

A

Treatment of mild to moderate infections of the respiratory tract and skin and of nongonococcal urethritis, cervicitis, acute pharyngitis/tonsillitis, and community-acquired pneumonia

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23
Q

CLINDAMYCIN PHOSPHATE: Nursing Considerations

A
  • 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**
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24
Q

CLINDAMYCIN PHOSPHATE: Side Effects

A
  • Nausea, vomiting, diarrhea
  • Abdominal pain
  • Vaginitis
  • Rash
  • Jaundice
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25
Q

CLINDAMYCIN PHOSPHATE: Purpose

A

Treatment of infections caused by Staphylococcus, Streptococcus, and other bacteria

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26
Q

VANCOMYCIN: Nursing Considerations

A
  • 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
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27
Q

VANCOMYCIN: Side Effects

A
  • Nephrotoxicity
  • Headache
  • Ototoxicity
  • Dyspnea
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28
Q

VANCOMYCIN: Purpose

A

Treatment of C. difficile, resistant staph infections, colitis, and staph enterocolitis; prophylaxis for endocarditis and dental procedures

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29
Q

LEVOFLOXACIN: Nursing Considerations

A

Infused injection over 60–90 minutes, once every 24 hours
Monitor blood sugar; may cause hypoglycemia or hyperglycemia
Rx; Preg Cat C

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30
Q

LEVOFLOXACIN: Side Effects

A
  • 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
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31
Q

LEVOFLOXACIN: Purpose

A

Treatment of infections such as acute sinusitis, acute chronic bronchitis, pneumonia, and anthrax and of infections of the urinary tract, kidney, prostate, and skin

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32
Q

CIPROFLOXACIN: Nursing Considerations

A
  • 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
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33
Q

CIPROFLOXACIN: Side Effects

A
  • Seizures
  • Headache, restlessness
  • Nausea, vomiting, diarrhea, abd. distress, flatulence
  • Rash
  • Photosensitivity
  • Tendon rupture, muscle tear
  • Increased liver function test
34
Q

CIPROFLOXACIN: Purpose

A

Treatment of infections caused by E. coli and other bacteria and of chronic bacterial prostatitis, acute sinusitis, and postexposure inhalation anthrax

35
Q

CEFEPIME: Nursing Considerations

A
  • IV: peak 30 minutes
  • IM: peak 2 hours
  • May cause false positive for urine glucose
  • Possible cross allergy to penicillin
  • Rx; Preg Cat B
36
Q

CEFEPIME: Side Effects

A
  • Nausea, vomiting, diarrhea
  • Anorexia
  • Elevated liver function tests
  • Rash
  • Headache
  • Dyspnea
  • Nephrotoxicity
37
Q

CEFEPIME: Purpose

A

Treatment of respiratory tract, urinary tract, skin, and bone infections

38
Q

CEFDINIR: Nursing Considerations

A
  • 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
39
Q

CEFDINIR: Side Effects

A
  • Nausea, vomiting, diarrhea
  • Anorexia
  • Rash
  • Elevated liver function tests
  • Headache
  • Oral and vaginal candidiasis
  • Dizziness
  • Neurotoxicity
  • Thrombocytopenia
40
Q

CEFDINIR: Purpose

A

Treatment of acute exacerbations of chronic bronchitis, sinusitis, pharyngitis, otitis media, tonsillitis, and skin infections

41
Q

CEFUROXIME: Nursing Considerations

A
  • 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
42
Q

CEFUROXIME: Side Effects

A
  • Nausea, vomiting, diarrhea
  • Headache
  • Rash
  • Elevated liver function tests
  • Nephrotoxicity
  • Thrombocytopenia
43
Q

CEFUROXIME: Purpose

A

Treatment of lower respiratory tract, urinary tract, skin, bone, joint, and gonococcal infections and of septicemia and meningitis

44
Q

CEPHALEXIN: Nursing considerations

A
  • 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
45
Q

CEPHALEXIN: Side Effects

A
  • Diarrhea
  • Anaphylaxis
  • Nausea
  • Rash
  • Headache
  • Nephrotoxicity
  • Dyspnea
  • Thrombocytopenia
  • Elevated liver function tests
46
Q

CEPHALEXIN: Purpose

A

Treatment of upper and lower respiratory tract, urinary tract, skin, bone, and otitis media infections

47
Q

ZIDOVUDINE: Nursing Considerations

A
  • 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
48
Q

ZIDOVUDINE: Side Effects

A
  • Fever, headache, malaise
  • Nausea, vomiting, diarrhea
  • Dizziness
  • Insomnia
  • Dyspepsia
  • Rash
  • Hepatomegaly
49
Q

ZIDOVUDINE: Purpose

A

Management of HIV infection, postexposure prophylaxis of HIV foll

50
Q

VALACYCLOVIR: Nursing Considerations

A
  • Patients should drink plenty of fluids during treatment
  • Avoid sexual contact when lesions are visible
  • Rx; Preg Cat B
51
Q

VALACYCLOVIR: Side Effects

A
  • Nausea, vomiting, diarrhea
  • Abdominal cramps
  • Headache
  • Rash
  • Dizziness
  • Dysmenorrhea
  • Thrombocytopenic purpura
  • Increased AST
52
Q

VALACYCLOVIR: Purpose

A

Treatment of herpes zoster (shingles), genital herpes, herpes labialis (cold sores), and varicella

53
Q

OSELTAMIVIR PHOSPHATE: Nursing Considerations

A
  • 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
54
Q

OSELTAMIVIR PHOSPHATE: Side Effects

A
  • Nausea
  • Vomiting
  • Dizziness
  • Headache
  • Fatigue
  • Cough
55
Q

OSELTAMIVIR PHOSPHATE: Purpose

A

Prevention and treatment of influenza

56
Q

ACYCLOVIR: Nursing Considerations

A
  • 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
57
Q

ACYCLOVIR: Side Effects

A
  • Headache
  • Blood dyscrasias
  • Nausea, vomiting, diarrhea
  • Thrombocytopenia purpura
  • Nephrotoxicity
  • Tremors
  • Lethargy
58
Q

ACYCLOVIR: Purpose

A

Treatment of herpes and varicella

59
Q

ISONIAZID: Nursing Considerations

A
  • 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
60
Q

ISONIAZID: Side Effects

A
  • Peripheral neuropathy
  • Liver damage
  • Nausea, vomiting
61
Q

ISONIAZID: Purpose

A

Treatment and prevention of tuberculosis

62
Q

METRONIDAZOLE: Nursing Considerations

A
  • 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
63
Q

METRONIDAZOLE: Side Effects

A
  • Headache
  • Dizziness
  • Nausea, vomiting, diarrhea
  • Abdominal cramps
  • Metallic taste
  • Darkened urine
  • Depression
  • Blurred vision
  • Neurotoxicity
64
Q

METRONIDAZOLE: Purpose

A

Treatment of a wide variety of infections including trichomoniasis, giardiasis, and bacterial vaginosis

65
Q

QUININE SULFATE: Nursing Considerations

A
  • 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
66
Q

QUININE SULFATE: Side Effects

A
  • Eye disturbances
  • Nausea, vomiting
  • Anorexia
  • Tachycardia
  • Hypotension
  • Thrombocytopenia
  • Tinnitus
67
Q

QUININE SULFATE: Purpose

A

Treatment of malaria

68
Q

HYDROXYCHLOROQUINE:
Nursing Considerations

A
  • 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
69
Q

HYDROXYCHLOROQUINE: Side Effects

A
  • Eye disturbances
  • Nausea, vomiting
  • Anorexia
  • Photosensitivity
  • Dizziness
  • Headache
  • Hypotension
  • Skin changes
  • Ototoxicity
70
Q

HYDROXYCHLOROQUINE: Purpose

A

Management of lupus erythematosus, rheumatoid arthritis, and malaria

71
Q

FLUCONAZOLE: Nursing Considerations

A
  • 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
72
Q

FLUCONAZOLE: Side Effects

A
  • Nausea
  • Headache
  • Abdominal pain
  • Diarrhea
  • Hepatotoxicity
73
Q

FLUCONAZOLE: Purpose

A

Treatment of vaginal, esophageal, and systemic candidiasis and of cryptococcal meningitis

74
Q

AMPHOTERICIN B: Nursing Considerations

A
  • 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
75
Q

AMPHOTERICIN B: Side Effects

A
  • Blood, kidney, heart, liver abnormalities
  • GI upset
  • Hypokalemia
  • Skin irritation and thrombosis if IV infiltrates
  • Rash
  • Fever, chills
  • Malaise
  • Hypotension
  • Headache
  • Nephrotoxicity
  • Ototoxicity
76
Q

AMPHOTERICIN B: Purpose

A

Treatment of invasive fungal infections

77
Q

AMOXICILLIN/CLAVULANATE: Nursing Considerations

A
  • 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
78
Q

AMOXICILLIN/CLAVULANATE: Side Effects

A
  • Headache, agitation
  • Insomnia
  • Nausea, diarrhea, vomiting
  • Increased liver enzymes
  • Oliguria
  • Vaginitis
  • Bone marrow suppression
  • Hypo/hyperkalemia
  • Hypernatremia
  • Respiratory distress
79
Q

AMOXICILLIN/CLAVULANATE: Purpose

A

Treatment of lower respiratory infections, sinus and skin infections, otitis media, pneumonia, and impetigo

80
Q

AMIKACIN, GENTAMICIN, TOBRAMYCIN: Nursing Considerations

A
  • 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
81
Q

AMIKACIN, GENTAMICIN, TOBRAMYCIN: Side Effects

A
  • Use during pregnancy can result in bilateral congenital deafness
  • Ototoxicity
  • Nephrotoxicity
  • Neurotoxicity
  • Allergic reaction: fever, difficulty breathing, rash
  • Vertigo, tinnitus
82
Q

AMIKACIN, GENTAMICIN, TOBRAMYCIN: Purpose

A

Treatment of severe systemic infections of CNS, respiratory system, GI tract, urinary tract, bone, skin, and soft tissues

Pharmacology - NCLEX (20 decks)

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