Antibiotics Flashcards by sydney hines

Prophylactic Therapy

Prevention; do it before

Giving a antibiotic even though you don’t have a infection to try and prevent it. It could be done before surgery

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Empiric Therapy

Best guess for the choice of antibiotic ; confirmed by C&S

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ATB Resistance

General cause : OVERUSE of antibiotics

Bacteria learn to fight antibiotics so it doesn’t work for bacteria anymore

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Superinfection

Infection that usually happens when you are grating one infection and you get something else. Normal flora can’t fight

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Nosocomial infection

Hospital acquired

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Broad spectrum

Antibiotic that kills a lot of different bugs

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Narrow spectrum

Usually used for specific drugs or classes

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Compliance

How well you follow medication instructions

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Anti-Bacterial Agents classes

Sulfonamides
Penicillins
Cephalosporins
Macrolides
Tetracyclines
Aminoglycosides
Fluoroquinolones
Miscellaneous agents

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Where do Sulfonamides achieve high concentration

In the kidney

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One of the first groups of ATBs

Many organisms susceptible, now resistant

Sulfonamides

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Indications of Sulfonamides

UTIs

URIs

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Contraindications of Sulfonamides

Allergies of Sulfa

Allergies to like drugs: Sulfonylureas, thiazides and loop diuretics

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Side effects of Sulfonamides

Common cause of allergic reactions

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Interactions with Sulfonamides

Potentials the effect of Sulfonylureas=hypoglycemia
Sulfonylureas are used in diabetics. If you make them work even better then hypoglycemia is a major side effect to watch for

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Nursing considerations for Sulfonamides

Increase fluid intake to 1500-3000 ml/day unless otherwise contraindicated
Caution with liver or renal impairment patients

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Bactrim

Sulfonamides

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Where are Penicillins synthesized

From molds, so a lot of allergic reactions

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Penicillins and Cephalosporins are also known as “__________” antibiotics. Why?

BetaLactam antibiotics because these agents have a center “beta lactam” ring

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Why were Cephalosporins developed

Were developed for those who couldn’t take PCN d/t allergies…they have a broader spectrum

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Bacterial resistance to PCN

Some bacteria produce penicillinase or beta-lactamase
beta-lactamase inhibitors and penicillinase inhibitors developed: added to PCNs, improve effectiveness, decrease resistance

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Indications of Penicillins

Strep, Staph, and Enterococcus

Commonly gram positive bacteria

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Side effects of Penicillins and Cephalosporins

Both well tolerated
Penicillins= frequent allergy
Cephalosporins= GI distress
***some cross sensitivity between PCN and Cephalosporins

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Nursing considerations for penicillins and cephalosporins

Always check for allergy
Caution with neonates and pregnancy
Caution with history of ASTHMA and MULTIPLE ALLERGENS

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Keflex

Oral | Cephalosporins

Safe alternative to PCN

Macrolides

Mechanism of action of Macrolides

Prohibits protein synthesis

Indications of Macrolides

``` Streptococcus infections Lower respiratory infections Syphilis and Lyme disease STDs Diabetic gastroparesis Helicobacter pylori ```

Side effects Macrolides

Basically GI; Zithromax and Biaxin are less irritating

Nursing considerations Macrolides

Caution with neonates and pregnancy, caution with history of asthma and multiple allergens, take with food

-mycin=

Macrolides

What is Zithromax (azithromycin)? Used for?

Macrolides | Used for pneumonia and sometimes strep

Inhibits the action of ADH; useful in SIADH (syndrome of inappropriate anti diuretic hormone)

Declomycin

Indications of Tetracyclines

``` STDs Lyme disease Helicobacter pylori SIADH Persistent of chronic pneumothorax Acne ```

Contraindications of Tetracyclines

Drug allergy; avoided in pregnancy and in children less than 8!!!!

What should you not give a Tetracycline with? Why?

Dairy products because it won't be absorbed

Side effects of Tetracyclines

Teeth discoloration in children still developing and photosensitivity

Why do is teeth discoloration a side effect of Tetracyclines is children still developing

It's chemical ability to bind with Ca, Mg, and Al to form insoluble complexes causes tooth discoloration in children under 8

Nursing considerations of Tetracyclines

NOT to be used in children under 8 or pregnant women | Caution with renal or hepatic disease

Vibramycin (doxycycline)

Tetracyclines

What way should you give Aminoglycosides

All IV antibiotics, or IM | NOT orally

Why should you not give Aminoglycosides orally

Poor GI absorption

Serious toxicities of Aminoglycosides

Renal failure | Hearing loss

How are Aminoglycosides usually used

Synergistic (in combination) | Rarely used as a 1st line drug due to toxicity

Contraindications of Aminoglycosides

Allergy | Renal disease

Side effects of Aminoglycosides

Ototoxicty, renal toxicity, both reversible if caught early

Nursing considerations Aminoglycosides

Monitor renal function test = BUN and Creatinine Increase fluid intake Peak and trough levels regularly used Immediately report hearing loss or tinnitus

Garamycin (gentamicin)

Aminoglycosides

Excellent oral absorption | Can give once to twice a day

Fluoroquinoloness

Fluoroquinoloness have a _________ spectrum

Broader spectrum, covers a wide variety of gram - and a selected gram +

Indications of Fluoroquinoloness

Respiratory, skin, and urinary tract infections | Anthrax (post exposure)

Contraindications of Fluoroquinoloness

Not used with patients receiving certain anti-arrhythmic drugs=altered cardiac function

Side effects of Fluoroquinoloness

CNS: headache, dizziness, restlessness GI: nausea, vomiting, constipation

Who should you not recommend Cipro to?

Children used 18- some cartilage development studies shown in animals Cipro=Fluoroquinoloness

Nursing considerations Fluoroquinoloness

No Cipro in children under 18 Immediately report signs of tendon pain and inflammation. Immediately report signs of dizziness, restlessness, stomach distress, and fast heart rate Don't take with multivitamins or mineral supplements because Ca, Mg, iron, and zinc decrease absorption up to 90%

Cipro (ciprofloxacin)

Fluoroquinoloness

Levaquin (levofloxacin)

Fluoroquinoloness

Flagyl (metronidazole)

Good for Anaerobic organisms Widely used for intrabdominal and and gynecological infections. Also used for protozoal infections

Macrodantin (nitrofurantonin)

**UTIs | Indicted primarily for UTIs caused by Ecoli, S.aureus, Klebsiella, Enterbacter

Vancomycin

Only IV. Natural bactericidal antibiotic. ATB of choice for C-diff

How is MRSA now being treated

Combination of Sulfonamide and Cephalosporin. | Bactrim and Keflex