Antibiotics Part 1 Flashcards
Disinfectant
Used only on nonliving objects to kill organisms
Antiseptic
Applied exclusively to living tissue
Only inhibits the growth of microorganisms
Before beginning antibiotic therapy…
Suspected areas of infection should be cultured to identify the causative organism and potential antibiotic susceptibilities
Empiric Therapy
Treatment of an infection before specific culture information has been reported or obtained
Definitive Therapy
Antibiotic therapy tailored to treat organism identified with cultures
Prophylactic Therapy
Treatment with antibiotics to prevent an infection, as in intra-abdominal surgery or after trauma
Superinfection
Normal flora is wiped out and allows another infection
Preventing Resistance
Limit the use of antimicrobial agents to the treatment of specific pathogens sensitive to the drug being used
Make sure doses are high enough, and the duration of drug therapy long enough
Be cautious about the indiscriminate use of anti-infectives
Sulfonamides
Effective against both gram-positive and gram-negative bacteria
Treatment of UTIs, upper respiratory tract infections
Bactrim most commonly used
Adverse Effects of Sulfonamides
Blood adverse effects such as hemolytic and aplastic anemia, agranulocytosis, thrombocytopenia
Photosensitivity (prone to sunburn)
Crystalluria (prone to kidney stones)
Beta-Lactam Antibiotics
Penicillins, cephalosporins, carbapenems, monobactams
Penicillins
Amoxicillin, ampicillin, piperacillin/tazobactam
Indications for Penicillins
Prevention and treatment of infections caused by gram positive bacteria such as Staphs and Streps
Adverse Effects of Penicillins
Commonly an allergy (urticaria, pruritus, angioedema)
Interactions of Penicillins
NSAIDs, oral contraceptives, Warfarin
Cephalosporins
Semisynthetic antibiotics
Similar to penicillins
Bactericidal action
Broad spectrum
First Generation Cephalosporins
Cefazolin (Ancef)
Given IV or IM
Used for surgical prophylaxis and for susceptible staphylococcal infections
Second Generation Cephalosporins
Cefuroxime (Zinacef)
Better gram-negative coverage than first generation
Third Generation Cephalosporins
Most potent group against gram-negative bacteria
Less active against gram-positive bacteria
Ceftriaxone (Rocephin) IM and IV
Fourth Generation Cephalosporins
Broader spectrum of antibacterial activity than third generation, especially against gram-positive bacteria
Cefepime (Maxipime)
Adverse Effects of Cephalosporins
Nausea, vomiting, diarrhea
Potential cross-sensitivity to penicillins if allergies exist
Carbapenems
Reserved for complicated body cavity and connective tissue infections in acutely ill hospitalized patients
Broadest antibacterial action of any antibiotics to date
Meropenem (Merrem)
Monobactams
Aztreonam (Azactam)
Parenteral use only
Synthetics beta-lactam antibiotic; bactericidal
Used for moderately severe systemic infections and UTIs
Macrolides
Azithromycin (Zithromax) and Clarithromycin (Biaxin)
Fidaxomicin (Dificid) is the newest macrolide; indicated only for the treatment of C. difficile-associated diarrhea
Indications for Macrolides
Strep infections
Mild to moderate upper and lower respiratory tract infections
Spirochetal infections
Gonorrhea, Chlamydia, Mycoplasma
Adverse Effects of Macrolides
GI effects, primarily with erythromycin (nausea, vomiting, diarrhea)
Azithromycin and Clarithromycin have fewer GI adverse effects, longer duration of action, better efficacy, and better tissue penetration
Tetracyclines
Wide spectrum
Doxycycline (Doryx, Vibramycin)
Dairy products, antacids, and iron salts reduce oral absorption of tetracyclines
Should not be used in children under the age of 8 or in pregnant or lactating women because tooth discoloration will occur
Adverse Effects of Tetracyclines
Alteration in intestinal flora may result in superinfection, diarrhea, and pseudomembranous colitis
May also cause vaginal candidiasis, gastric upset, enterocolitis, maculopapular rash
Nursing Implications
It is ESSENTIAL to obtain cultures from appropriate sites BEFORE beginning antibiotic therapy
The most common adverse effects of antibiotics are nausea, vomiting, and diarrhea
All oral antibiotics are absorbed better if taken with 6-8 ounces of water
