Anti-infectives (fluoroquinolones, glycopeptides, lincosamides, macrolides, penicillins, sulfonamides, tetracyclines) Flashcards
Ciprofloxacin
Anti-infectives, fluroquinolones
purpose: tx of infections caused by E.coli and other bacteria & of chronic bacterial prostatitis, acute sinusitis and postexposure inhalation anthrax
SE: seizures, headache, restlessness, N, V, D, abd distress, flatulence, rash, photo-sensitivity, tendon rupture, muscle tear, increased liver function test
Nurs con:
- 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 2-3L/day
- may cause false positive in opiate screening tests
- do not infuse with other medications\
Levofloxacin
Anti-infectives, fluroquinolones
purpose: tx of infections such as acute sinusitis, acute chronic bronchitis, pneumonia & anthrax & infections of the urinary tract, kidney, prostate & skin
SE: headache, nausea, vomiting, diarrhea, stomach pain, dizziness, vaginal itching/discharge, tendon rupture or tendinitis, insomnia, photosensitivity, rash, hallucination, paronoia, hepatoxicity, suicidal thoughts, encephalopathy, chest pain, palpitations
Nurs con:
- infused injection over 60-90 min, once every 24 hours
- monitor blood sugar, may cause hypoglycemia or hyperglycemia
Vancomycin
Anti-infectives, glycopeptides
Purpose: tx of C. difficle, resistant staph infections, colitis & staph enterocolitis; prophylaxis for endocarditis & dental procedures
SE: neprhtoxicity, headache, ototoxicity, dyspnea
Nurs con: PO: absorption
- IV peak 5 mins, duration 12-24 hours
- give at least 60 min (IV) do not infuse with other drugs
- give antihistamine if “red man syndrome”: decreased blood pressure, flushing of face & neck
- contact provider if signs of superinfection (sore throat, fever, fatigue)
- check peak: 1 hour after infusion
- check trough before next dose
- encourage fluids 2L/day
Clindamycin HCL phosphate
Anti-infectives, Lincosamides
purpose: tx of infections caused by staphylococcus, streptococcus & other bacteria
SE: N, V, D, abd pain, vaginitis, rash, jaundice
Nurs con:
- PO: peak 45 mins, duration 6 hrs
- IM: peak 3 hours, duration 8-12 hours
- may cause an increase in AST, ALT, CPK
- do not break, crush or chew capsules
Azithromycin
Anti-infectives, Macrolides
purpose: tx of mild to moderate infections of the respiratory tract & skin & of nongonococcal urethritis, cervicitis, acute pharyngitis/tonsillitis & community acquired pneumonia
SE: N, V, D, hearing loss, dizziness, vertigo, rash, photosensitivity, hepatotoxicity, increased liver function tests, vaginitis, angioedema, anemia
Nurs con:
- PO: rapid onset, peak 2.5-3.2 hours, duration 24 hours
- IV: rapid onset, peak end of infusion, duration 24 hours
- PO: dont take with antacids; can take with or without food
- monitor for signs of superinfection (sore throat, fever, fatigue)
- increases effects of oral anticoagulants
Clarithromycin
Anti-infectives, Macrolides
purpose: tx of resp, skin & sinus infections
SE: N, V, D, headache, taste abnormalities, ventricular dysrhythmias, vaginitis, leukopenia, rash
Nurs con: -tx may be 7-14 days depending on organism & extent of infection
- medication should be taken with food
- be aware of possible increase in theophylline, caramazepine and digoxin levels
- monitor for sings of superinfection (sore throat, fever, fatigue)
Erythromycin
Anti-infectives, Macrolides
purpose: tx of mild to moderate resp & skin infections, chlamydia & syphilis
SE: abdominal cramps, pain at injection site, N, V, D, rash, anaphylaxis, vaginitis, dysrhythmias, hepatotoxicity
Nurs con: -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)
Amoxicillin, ampicillin, penicillin
Anti-infectives, Penicillins
Purpose: treatment of resp, skin, gastrointestinal & urinary infections & otitis media & gonorrhea
SE: Allergic Rx: fever, difficulty breathing, skin rash,
-Renal, hepatic, hematologic abnormalities, N, V, D, urticaria, rash, bone marrow suppression
Nurs con: -take careful history of penicillin rx: observe for 20 mins post I injection
- PO for penicillin & 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
Trimethorpim/Sulfamethoxazole
Anti-infectives, Suldonamides
purpose: tx of UTI, otitis media, chronic prostatitis, shigellosis, chancroid & traveler’s diarrhea
SE: hypersensitivity reaction, blood dyscarasias, photosensitivty, N, V, anorexia, stomatitis, abdominal pain, headache, fatigue, bone marrow suppression, increased BUN/creatinine
Nurs con: -PO with full glass water, if upset stomach occurs, take with food
- PO: take at equal intervals around the clock
- infuse slowly over 60-90 minutes: flush lines at end of infusion to remove residue
- monitor for hypersensitivty rx; stop med at first sign of skin rash
- never admin IM, rapidly IV or by bolus injection
- encourage fluids 8-10 glasses/day
Doxycycline hyclate
Anti-infectives, Tetracyclines
purpose: tx of syphillis, gonrrhea, chlamydia, chronic periodontitis, acne, & anthrax; prophylaxis of malaria
SE: photosensitivity, GI upset, diarrhea, renal, hepatic, hematologic abnormalities, dental discoloration of deciduous (baby) teeth, rash
Nurs con: -peak 1.5-4 hours
- if GI symptoms occur, admin 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 & early developmental periods (4th month, prenatal to 8 years of age)
