Antibiotics Flashcards
Inhibit growth of bacteria
Bacteriostatic
Kills bacteria
Bactericidal
One bactericidal & one bacteriostatic (Desired effect is diminished)
Antagonistic
Primary effective against one type (+ or -)
- Penicillin
- Erythromycin
Narrow spectrum
Effective against gram (+ & -)
- Tetracycline
- Cephalosporin
Broad spectrum
- Allergy or hypersensitivity
- Superinfection
- Organ toxicity
- GI Distress
- Steven’s Johnson Syndrome
Side effects of what drug?
Antibiotics
Assessments for (Antibiotics)
- Assess renal function (<600ml/day UO = impaired renal function)
- Assess Baseline CBC
- Obtain culture & sensitivity before any antibiotics given
- Monitor bowel function
Implementation for (Antibiotics)
- Increase fluid intake with all antibiotics
- Complete entire course of antibiotics
- Report s/s of (superinfection)
- Notify HC professional if fever & diarrhea develops (Stools w/ pus, blood, or mucous)
Bacteriostatic
- Inhibits bacterial synthesis of folic acid
Sulfonamides
- Photosensitivity
- Crystalluria
- Blood dyscrasias
- Stomatitis
These are side effects of what drug?
Sulfonamides (Trimethoprim-sulfamethoxazole)
Implementations for (Sulfonamides)
- Administered with full glass of water
- Fluid intake (2000ml/day)
- Urine output (1200ml/day)
- Observe for hematologic reactions = (Life-threatening anemia)
Assessments for (Sulfonamides)
- ALT/AST Levels (Liver function)
- Drug interactions
- Blood sugar (Diabetics)
Teachings for (Sulfonamides)
- Avoid taking during the last 3 months of pregnancy
- Avoid direct sunlight’
- Oral contraceptives are less effective
What is never given alone and is added to penicillin to help prevent the inactivation of penicillin?
Beta-Lactamase
Beta-lactam ring interferes with bacterial cell-wall synthesis by inhibiting the bacterial enzyme that is necessary for cell division & cellular synthesis
Penicillin
Implementation for (Penicillin)
- Monitor closely during 1st & 2nd dose for allergic reaction
- Have epinephrine available
Teachings for (Penicillin)
- Taken with food to avoid gastric irritation
- Oral contraceptives are less effective
Inhibition of bacterial cell wall synthesis
- Causes cell death
(Bactericidal)
Cephalosporins
Implementation for (Cephalosporins)
- Infuse IV Cephalosporins over 30 minutes to prevent pain & irritation (Phlebitis)
- Use separate IV lines when administering Calcium salts
- or flush with a minimum of 10mL of saline before & after IV cephalosporins (when administering calcium salts)
Assessments for (Cephalosporins)
- Allergy to cephalosporins or penicillin
- ALT/AST levels
- Drug history (Loop diuretics & anticoagulants)
- Increases nephrotoxicity w/ (Loop diuretics)
- Increases bleeding w/ (Anticoagulants)
- Crystallization if administered w/ same IV as calcium salts (TPN & LR)
Caused by what drug interaction?
Cephalosporins
(-thromycin)
- Commonly used for patients with PCN allergy
- Broad spectrum
Macrolides
What route should you not administer Macrolides?
Intramuscularly
Implementation for (Macrolides)
- Monitor Liver enzymes & signs of liver damage
- Administer antacids 2 hours before or after macrolides
- Give (azithromycin) 1 hour before or 2 hours after meals with full glass of water
(Doxycycline)
- Broad spectrum
- Bacteriostatic or Bactericidal
- Can be used to treat acne
Tetracyclines
- Discoloration of permanent teeth & softening of bones & teeth
- Photosensitivity, hepatotoxicity, nephrotoxicity
Side effects of what drug?
Doxycycline (Tetracyclines)
Implementation of (Tetracyclines)
-Do not administer to pregnant women or children under the age of 8
- Administer drug 1 hour before or 2 hours after meals for best absorption
- Given with full glass of water to prevent GI effects
Teaching for (Tetracyclines)
- Avoid sunlight
- Inform the patient that taking this drug while pregnant can cause teratogenic effects
- Oral contraceptives less effective (use nonhormonal drugs)
- Avoid milk products, iron, & antacids
(-mycin)
- Gram (-)
- Bactericidal
Aminoglycosides
Implementation of (Aminoglycosides)
- Monitor intake & output (<600ml/day), BUN, & Creatinine (To identify nephrotoxicity)
- Monitor hearing & balance (Ototoxicity)
- Check therapeutic range (peak & trough for IV Aminoglycosides should be drawn every 3rd or 4th dose)
Teaching for (Aminoglycosides)
- Report tinnitus or decrease urine output (Normal <600ml/day)
- Use sun block & wear protective clothing
(-floxacin)
- Broad spectrum w/ bactericidal
Fluoroquinolones (Quinolones)
Implementation for (Fluoroquinolones)
- Monitor intake & urine output (normal output: 750ml/day)
- Monitor blood sugar (Diabetics taking hypoglycemic agents)
- Monitor Theophylline levels (Risk of Theophylline toxicity)
- Monitor HR & Rhythm (Causes QT prolongation)
- Apply cardiac monitor
Teaching for (Fluoroquinolones)
- Encourage pt to drink 2000ml of water per day to prevent (Crystalluria)
- Avoid sunlight
- Report pain in their heel or tendon location (risks of Tendonitis & tendon rupture)
Drug used for treatment of MRSA
- Treats gram (+)
- Bactericidal
Vancomycin
- Red neck or Red Man Syndrome
- Ototoxicity & Nephrotoxicity
Side effects of what drug?
Vancomycin
How should you administer (Vancomycin)?
Slowly
- Given 60-90 minutes
- 500mg diluted in 100ml
- 1g diluted in 200ml
What causes red neck or red man syndrome?
Giving IV vancomycin too rapidly
- Severe hypotension
Contraindications for (Vancomycin)
- Renal impairment (Creatinine clearance <80mL/min dosage reduction required)
When should trough levels be checked when on (Vancomycin)?
Every 3-4 doses
- Request trough levels to be drawn after 4 doses
(Ideal trough lvls: 10-20mcg/ml)
(Nitroimidazoles)
- Used for vaginal infections (Bacterial vaginosis)
- Bactericidal, Amoebicidal, & Trichomonacidal
Metronidazole
- Headaches
- Dizziness
- Urine discoloration
- Peripheral neuropathy
Side effects of what drug?
Metronidazole
- Circulatory collapse
- Confusion
- Visual disturbance
- Syncope
(Alcohol hand gel can cause these reaction)
What is it called when this reaction occurs with alcohol?
Disulfiram
Route (Oral, Tropical, IV)
Indications: (Herpes simplex-1 & 2)
(IV for Shingles)
(Side effects): Phlebitis & pain at injection site
- Headache, nausea, diarrhea
(IV given slowly to prevent phlebitis)
Acyclovir
(Routes): PO
(Indications): Influenza A & B
- Started within 48hrs of onset of symptoms
(Tamiflu)
Oseltamivir
HAART Goal
(CD4 Count): >200cells/mm 3
Ideally (>500cells/mm 3)
(Viral Load): (<50 copies/mL) = Undetectable (No risk of transmitting infection)
- Hepatotoxicity
- Peripheral neuropathy (Caused by depletion of B6)
Side effects of what drug?
Isoniazid
- Isoniazid
- Rifampin
Antitubercular drugs
- Hepatotoxicity
- Red-Orange discoloration of body fluids (Staining of clothes & contact lenses)
Side effects of what drug?
Rifampin
- Potent antifungal & dangerous
- Administered IV in ICU
- Slowly infused (2-6hours)
Amphotericin B
- Cardiac dysrhythmias
- Hypokalemia
- Hypomagnesemia
Side effects of what drug?
Amphotericin B
(Routes): Oral, Tropical
- Powder (Used in skin folds)
- Ointment (Skin or Vaginally)
- Oral (Swish & Swallow)
Nystatin
- Amphotericin B
- Nystatin
Antifungal drugs
Teaching for (Nystatin)
If given orally
- Shake 1st
- Swish medication thoroughly around mouth (Coating all areas)
- Gargle before swallowing
- Do not drink for 30 minutes after
How is Nystatin administered for infants?
- Swab medication with swab stick on the inside of both cheeks, across tongue & roof of mouth
