Antibiotics Flashcards
Difference of aerobic and anaerobic bacteria
Aerobic - requires O2 to multiply and survive
Anaerobic - doesn’t require O2 to survive Eg. E.coli (commensal) - harder to eliminate
Antibacterial classes
Penicillin - amoxicillin, flucloxacillin
Cephalosporin - cefuroxime, ceftrixone, cefaclor
Macrolide - erythromycin, azithromycin, roxithromycin, clindamycin
Tetracycline - doxycycline, minocycline
Sulfonamide - trimethoprim +/- sulfamethoxazole
Aminoglycoside - gentamicin, streptomycin
Fluoroquinolone - ciprofloxacin, norfloxacin
Others: vancomycin, metronidazole
Antibacterial agents inhibits/ interfere with:
bacterial cell wall synthesis
DNA/RNA replication
folic acid synthesis
protein synthesis
difference of Bacteriacidal and Bacteriostatic actions
Bactericidal action - interfere with cell membrane and bacterial DNA synthesis of the microbe leading to its death Eg. beta-lactams
Bacteriostatic action - inhibits growth and spread of microbes by interfering with protein synthesis or metabolic processes Eg. tetracycline, trimethoprim
test to determine the type of bacteria
Culture test
test to determine what kind of antibiotics will work
Sensitivity test
Always obtain _____________ before adm an antibiotic
cultures
Nursing reminders for Antibiotics
Antibiotics are used for bacterial infections only
Complete the entire antibiotic prescription even if the pt is feeling better
DO NOT take alcohol while on antibiotics (antibiotics are extreme in the liver, alcohol can contribute to more nausea)
Always take cultures before prescribing and adm antibiotics
Acute, spreading bacterial infection of the dermal tissue causing localised pain, swelling, erythema (skin rash/redness) and heat
Cellulitis
caused by a rheumatic fever which is an inflammatory disease affecting connective tissues in the heart, joints, skin or brain. Heart valves get inflamed and scarred overtime.
Rheumatic Heart Disease
Pharmacodynamics of Sulfonamides
Bacteriostatic action by inhibiting folic acid metabolism. Slows growth of the bacteria allowing the body to take over its own immunity (WBCs)
Used for:
UTIs (caused by E.coli)
Sulfonamides meds
trimethoprim
sulfamethoxazole (bactrim)
sulfadiazine
sulfasalzine
Adverse effects of Sulfonamides
GI upset - N&V, anorexia, diarrhoea, abdominal pain, stomatitis
Chills and fever
Crystalluria (crystals in urine)
Photosensitivity (risk of sunburn)
Nursing considerations for Sulfonamides
increase FLUID intakes as sulfas can dry out the body
USE sunblock as sulfas cause photosensitivity
Take folic acid daily
Pt can bruise easily - monitor skin
Pharmacodynamics of Fluoroquinolones
Bactericidal - Interferes with bacterial DNA synthesis leading to bacterial death
used for:
Lower respiratory infections
Bone and joints infections
UTIs
STIs
skin infections
eye infections
Fluoroquinolone meds
Ciprofloxacin
gemifloxacin
ofloxacin
moxifloxacin
levofloxacin
Adverse effects of Fluoroquinolones
GI upset - Nausea, diarrhoea, abdominal pain
Dizziness
Photosensitivity
Increased risk of tendonitis & tendon rupture (older adults taking corticosteroids)
Nursing considerations for pts taking fluoroquinolone
USE sunblock for Photosensitivity
TAKE IT WITH EMPTRY stomach with full glass of water
Pharmacodynamics of Penicillin
Broad spectrum antibiotic inhibiting the integrity of the bacterial cell wall
Used for:
Prophylaxis (prevention against diseases or secondary infections)
UTIs
Septicaemia (blood poisoning)
Meningitis
Intra-abdominal infections
STIs (syphilis)
Respiratory infections (pneumonia)
Penicillin meds
Amoxicillin
Penicillin G and V
Ampicillin
Piperacillin
Oxacillin
Penicillin contradictions
Allergic reactions to Cephalosporins or Penicillin
Renal disease
Asthma
Bleeding disorders
GI disease
Adverse effects of Penicillin
GI upset: Stomatitis (inflamed and sore mouth), dry mouth, gastritis, N&V and abdominal pain
Glossitis (inflamed tongue)
Nursing considerations for Penicillin
Safety precautions for pregnancy and breastfeeding
Disables oral contraceptives
Educate pt to take it WITH FOOD to decrease GI discomfort
Penicillin allergy is common!
Pharmacodynamics of Cephalosporin
Bacteriocidal - kills bacteria entirely
Used for:
Prophylaxis for pre-opt, intra-opt, post-opt surgery infections
Otitis media (ear infection)
Respiratory infections
Bone infections
UTIs
Cephalosporin meds
Cefuroxime
Ceftriaxone
Cefaclor
Cephalosporin contradictions
Allergic reactions to cephalosporins and penicillins
Adm with caution for pts with:
renal disease
hepatic impairment
bleeding disorder
Adverse effects of cephalosporins
GI upset: N&V, diarrhoea
Dizziness
Malaise (feeling of weakness)
Heartburn
Fever
Nephrotoxicity (deterioration of kidney function due to toxicity of meds)
Nursing considerations for cephalosporin
Disables oral contraceptives
DO NOT drink alcohol while on cephalosporins
CONFIRM ALLERGIC REACTIONS to ______________ and _________________ abx before adm either of them
Penicillin and Cephalosporin
Pharmacodynamics of Tetracyclines
Used for:
Skin and soft tissue infections
Severe acne
Rocky mountain spotted fever (tick bites)
Tetracycline meds
Doxycycline
Minocycline
Demeclocycline
Tetracycline contradictions
Allergic reactions to tetracyclines
Lactation (toxic to developing foetus)
Nursing considerations for Tetracyclines
USE SUNBLOCK for photosensitivity (fluoroquinolone)
Disables oral contraceptives
TAKE WITH EMPTY stomach with full glass of water
CAUSES tooth discolouration (DO NOT GIVE to children < 9 yrs)
SIT UP (DO NOT LAY DOWN 30 mins after taking the medication) - causes heartburn and scarring of oesophagus)
AVOID calcium and dairy products (prevents absorption of the drug)
Pharmacodynamics of Aminoglycosides
Bactericidal - kills bacteria by blocking the ribosome from reading the mRNA resulting in the inability of bacteria to multiply
Used for:
Bowel preparation: decreases normal flora in the GI for pts having abdominal surgery
Hepatic coma: decreases ammonia in the intestines
Aminoglycoside meds
Gentamicin
Streptomycin
Kanamycin
Neomycin
Aminoglycosides contradictions
Allergic reactions to aminoglycosides
hearing loss
musculoskeletal disorders
location
Adverse effects of aminoglycosides
GI distress: N&V, anorexia
Rash and hives
Nephrotoxicity (proteinuria hematuria and increases BUN and creatinine)
Ototoxicity (tinnitus, vertigo, hearing loss)
Neurotoxicity (numbness, tumours, convulsions, muscular paralysis)
Unwanted effects of Antibiotics
Antimicrobial resistance
Superinfection
Hypersensitivity reactions
Examples of antimicrobial resistance factors
Mutation
Acquired resistance - Plasmids
Repeated exposure to antimicrobial agents creating more opportunity to become resistant
Bacterial resistance mechanism of action
Target modification - alter cell structure and their receptors
Efflux - use pumps to eject Abx from inside the cell
Immunity - attach a protein to Abx and prevent it to bind (making it ineffective)
Enzyme-catalysed destruction - bacteria develops enzymes that destroys Abx Eg. beta-lactamases
Bacterial resistance relevance
Economic and societal costs: mortality, length of hospital stay and cost of treatment
No new antimicrobial in pipeline
Diseases with bacterial resistance - TB, malaria, gonorrhoea, hospital-acquired pneumonia, MRSA
Causes another infections from Abx
Superinfection
Causes of superinfection
Broad-spectrum Abx
Some Abx can disable the efficacy of taking oral ___________
contraceptives
exaggerated or inappropriate immune response from Abx
Hypersensitivity
Abx Hypersensitivity S&S
Urticaria (skin rash)
Angioedema (swelling underneath skin)
Bronchospasm (wheezing and coughing)
Anaphylaxis (treat with adrenaline immediatley)
Characterised by rapid onset of life-threatening respiratory and cardiovascular symptoms
Anaphylaxis (dial 111 or get adrenaline)
Epinephrine or adrenaline pharmacodynamics
Non-selective agonist of adrenergic receptors
A1 receptor action - vasoconstriction
Beta1 receptor - increase HR and force of contraction
Beta2 receptor - provides bronchodilation, reduces the release of histamine and other inflammatory mediators
