antibacterials MINUS cephalosporins Flashcards
what is the MOA of penicillins, cephalosporins, carbapenems, vancomycin
inhibits cell wall synthesis, weakens cell wall, influx of fluid into the cell, the cell swells and bursts and then dies
adverse effects of penicillin
urticaria
pruritis
angioedema
what does penicillin interact with
NSAIDs, warfarin, oral contraceptives
what is a natural penicillin
Penicillin G &V
what does penicillin G & V treat
gram+
gram- cocci
anaerobic bacteria
spirochetes
IM to treat STDs
what is the least toxic penicillin
penicillin G & V / Natural PCNs
what drug is a penicillanse resistant PCN
nafcillin
indications for nafcillin
for people with who secrete penicillinase enzyme
-most common in patients who have staph bacteria
what is the route for nafcillin
IV only
what drugs are aminopenicillins
ampicillin
amoxicillin
what does amoxicillin most commonly treat
ear, nose, throat, GI, skin infections
SE of ampicillin
diarrhea and rash
less common in amoxicillin
what is the most intense (broadest spectrum) penicillin
piperacillin
what does piperacillin work against
pseudomonal bacteria
what is an adverse effect of piperacillin
affect platelet function
nursing considerations for piperacillin
always given with beta lactamase inhibitors
watch for patients with renal dysfunction
Carbapenem drugs
imipenem/cilastin
meropenem
what are imipenem/cilastin and meropenem used for
complicated infections
adverse effects of carbapenems
drug induced seizure (more imipenem)
meropenem - rash and diarrhea
nursing considerations for impenem/cliastin and meropenem
broadest spectrum
last resort med
MONITOR FOR SEIZURE
IV infused OVER 60 min
MOA of vancomycin
inhibit cell wall synthesis (weaken cell wall) –> cell lysis and death
indications for vancomycin
c.diff
pseudomembranous colitis
adverse effects of vancomycin
decrease dose for renal dysfunction
ototoxicity with high levels
immune mediated thrombocytopenia
nephrotoxic
Red man syndrome - flushing, rash, pruritus, urticaria, tachycardia, hypotension
infuse slowly
what drugs are in the aminoglycoside class
gentamycin
amikacin
tobramycin
indications for aminoglycosides
potent antibiotics that work well on gram (-) bacteria
-if using it for gram (+) need other antibiotic for synergistic effect
MOA of aminoglycosides
antimicrobial antibiotics that inhibit bacterial ribosomes (organelles that make proteins)
side effects of aminoglycosides
nephrotoxicity
ototoxicity
nursing considerations for aminoglycosides
therapeutic drug monitoring –> peak/trough levels
gentamycin considerations
if combining with neuromuscular blockade –> can cause profound respiratory distress
gentamycin adverse effects
CNS: confusion, depression, disorientation, numbness, tingling
cochlear damage - ototoxicity, high-frequency hearing loss, high-pitched tinnitus
what drug is in the lincosamide group
clindamycin
MOA of clindamycin
binds to ribosomes and inhibits protein synthesis
indications for clindamycin
chronic bone infection, GU tract infection, intraabdominal infections, anaerobic pneumonia, septicemia, serious skin infections; prophylaxis for endocarditis
nursing considerations for clindamycin
monitor use with neuromuscular blockade medications
very toxic - monitor levels
can cause deadly pseudomembranous colitis
what drugs are in macrolide class
erythromycin
azitromycin
MOA of macrolides
inhibit protein synthesis by binding to ribosomes
erythromycin and azithromycin
indications for macrolides
various infections of upper and lower respiratory
skin infections
soft tissue infections; STIs
what intense side effect do macrolides have
GI side effects
erythromycin
azithromycin
Nursing considerations for erythromycin
IV is painful; oral absorption isnt great
DO NOT TAKE ON EMPTY STOMACH - lots of GI upset
lots of drug interactions
nursing considerations for azithromycin
less GI upset, still some
try to take WITHOUT FOOD, food decreases absorption
what drugs are in tetracyclines
tetracycline, doxycycline, minocycline
MOA of tetracyclines
bacteriostatic drugs that inhibit protein synthesis by binding to ribosomes
contraindications of tetracyclines
NO FOR: pregnant and nursing women and children younger than 8
adverse effects of tetracycline
discoloration of permanent teeth and enamel, photosensitivity, n/v/d
rare: anaphylaxis and angioedema
what drugs are in fluoroquinolones class
ciprofloxacin
levofloxacin
MOA of ciprofloxacin & levofloxacin
destroy bacteria by altering their DNA
what are ciprofloxacin & levofloxacin used to treat
UTIs, some STIs, upper and lower respiratory tract infections, gonorrhea, and other infections, anthrax
adverse effects of ciprofloxacin
arthropathy (joint disease)
nursing considerations for ciprofloxacin
avoid in patients under 18 and over 60, prolonged post antibiotic effects, works well on rapid and slow growing organisms
adverse effects of levofloxacin
CNS disorders that predispose to seizures, kidney failure, can cause prolongation of QT interval, photosensitivity
MOA of metronidazole
inhibits DNA synthesis, similar to fluroquinolones
adverse effects of metronidazole
n/v, xerostomia (dry mouth), vaginal candidiasis
nursing considerations for metronidazole
DO NOT TAKE WITH ALCOHOL