Antibacterial, Antitubercular, Antifungals Flashcards
Antibacterial adverse rxns
Mild: rash, hives
Severe: anaphylactic shock
Superinfection: infection from the antibiotic (CDiff)
GI disturbances = dietary management (probiotics)
Organ toxicity: ear, liver, kidneys
Penicillins adverse rxns
Immediate 20-30m Accelerated 1-72hr Late days - weeks Laryngeal edema Bronochoconnstriction Severe hypotension Rash Treat with epinephrine, resp support, skin testing
Nursing interventions for penicillin
Get c&s before giving meds, then admin
Assess for allergy
Note GI limits (give w food if irritation)
Super infection: CDif and candida (yeast infection)
Decreases effect of oral BC
Increase fluid intake
Amoxicillin
Penicillin/beta-lactam
Broad spectrum
Inactivated by beta-lactamase enzyme
Use for resp infections, UTIs, sinusitis, otitis media
Can cause a rash or superinfection
Eliminated by kidneys = monitor renal function
Amoxicillin-Clavulanate
Beta-lactamase inhibitor
Inactivated bacterial enzyme
Protects penicillin from breaking down
Contains fixed amt of clavulanate
Cephalosporins
Ceftrixone Perioperative prophylaxis Gram (+) and (-) Avoid alcohol = muscle cramps Increase uric acid in ruin = decreased cef excretion Allergy is same as penicillin Steven-Johnson’s syndrome
Azithromycin
Z-pack
Macrolide: erythromycin
Low: bactorostatic
High: bacteriocidal
50 S ribosomal = inhibits protein synthesis
Use: mod-severe infections, resp & GI tract, STIs, mycoplasma pneumonia, legionnaires disease
Give to patients w penicillin allergy
Fewer side effects
CDiff and hepatotoxicity
Levels decrease with antacids (mess up absorption, 2hr be/af zpack)
Increases levels of warfarin
1hr b/2 hr after meals with full glass of water
Vancomycin
Glycopeptides Use as last resort and severe infections Infections of bone, skin (mrsa), low resp tract Redman syndrome (toxic rxn) - turn off IV Bactericidal Oral used to fight CDiff Monitor trough lvls to avoid toxicity Monitor IV site: extravasation Monitor renal function and hearing tests
Tetracyclines
High bacterial resistance Broad spectrum Fights H. pylori (peptic ulcers) Active against anthrax Treats acne SE: photosensitive, discoloration of permanent teeth, nephrotoxic in high doses Long acting: doxycycline = CAN take with milk products Decrease oral BC Increase warfarin and digtoxicity 1 hr b/ 2 hr a meals Wear long sleeves, sunscreen, hats
Aminoglycosides
Gentamicin sulfate Can be very toxic SE: ototoxicity and nephrotoxicity Penicillins decreases aminoglycosides Increase effects of warfarin Monitor renal function Monitor peak and trough to adjust meds
Fluroquinolones
Levofloxacin Interfere with bacterial dna synthesis Broad spectrum bactericidal SE: tendinitis and tendon rupture Community acquired pneumonia and UTIs Antacids decrease effect Increased effect of hypoglycemics NSAIDs may lead to seizures Avoid caffeine Increase fluid intake to more than 2,000 mL/day
Sulfonamides
Inhibit bacterial synthesis of folic acid
Bac-static
Use for UTIs and prostatitis
Alternate for penicillin
SE: crystalluria & SJ syndrome
Avoid during 3rd trimester (increased bilirubin levels)
Avoid antacids
Trimethoprim-sulfamethoxazole
TMP-SMZ (Bactrim) Allows for resistance to build slowly Treats gonorrhea, UTIs Prevents aids acquired pneumonia SE: crystalluria & photosensitivity Interacts with alcohol 1 hr b/ 2 hr a meal w full glass of water Sore throat, bruising, bleeding
Tuberculosis
Person to person droplet
At risk = alcoholics, immunocomp and aids
Cough, sputum
Prophylaxis: close contact, AIDS with + test, or - to + test
Drug sensitive INH regimen: 1 phase = 2mo, 2phase + 4-7 months w daily/biweekly
Multi-Drug resistant: 1-2 years w other types of meds
Isoniazid (INH)
Close contact prevention and treatment
Bac-cidal
AE: peripheral neuropathy (prevent w b6), blurred vision, anemia, photosensitivity
Treats and prevents TB
