Antiinfectives Flashcards
Penicillin Overview
MOA: inhibits bacterial wall synthesis
Indications: streptococcus and staphylococcus infections
Contraindications: drug allergy
Adverse Effects: allergic reaction in 0.7-4%, nausea, vomiting, diarrhea
Interactions: aminoglycosides, NSAIDs, oral contraceptives (reduce effectiveness- use different form of BC), warfarin
Nursing Considerations for Penicillin
Determine if patient is allergic to drug
Educate them about decreased effectiveness of birth control
Take drug with food to decrease GI upset
Finish entire course of antibiotics to reduce antibiotic resistance (no longer effective for MRSA)
Penicillin Key Drugs
penicillin G: given IV or IM, treats STD syphillis
amoxicillin: very common, treats infections in ears, nose, throat, GU tract, skin, and skin structures
Cephalosporin Overview
MOA: interfere with bacterial wall synthesis
Indications: effective BROAD spectrum antibiotic (covers both G+ and G- bacteria– makes it a good drug to start treating infection before lab results come back)
Contraindication: allergy to Penicillins
Adverse Effects: diarrhea, abdominal cramps, rash, edema
Interactions: alcohol, antacids (decrease oral absorption), oral contraceptives
Nursing Considerations for Cephalosporin
Determine if patient is allergic to penicillin, because of the potential for cross-susceptibility.
Wait two hours after taking antacid to take cephalosporin.
Use different BC method
Cephalosporin Key Drugs
cefazolin: prophylaxis in surgery to prevent surgical infection
cephalexin: streptococcus and staphylococcus infections (oral)
cefoxitin: abdominal surgeries d/t effectiveness against abdominal organisms
ceftriaxone: long acting; treats meningitis d/t ability to cross BBB, also be given IM (can be a painful injection, but may only need one dose!)
Macrolide Overview
MOA: bacteriostatic drugs which inhibit protein synthesis
Indications: wide variety of infections (somewhat broad spectrum)
Contraindications: known drug allergy
Adverse Effects: GI related- especially nausea and vomiting with bad diarrhea ***excel at bad GI effects
Interactions: competitive with many drugs because it is highly protein bound and metabolized in the liver
Nursing Considerations for Macrolides
Stay hydrated, do not drink alcohol, take with food to help the GI effects, take first dose at home (to see how it effects you), no juice (because it is acidic and can contribute to GI effects)
Macrolide Key Drugs
erythromycin: respiratory and GI infections (but a lot of patients cannot tolerate GI effects), topical for dermatological use
azithromycin: upper and lower respiratory infections (Z PACK)
clarithromycin- GU and respiratory infections
Overview of Tetracyclines
MOA: inhibit protein synthesis in susceptible bacteria
Indications: treatment of acne in adolescents and adults (most common use); but also, treatment of Chlamydia, Mycoplasma, & Rickettsia
Contraindications: avoid in pregnant and nursing women (potential for birth defects), and children younger than 8 years old (discoloration of teeth and reduction of tooth enamel)
Adverse Effects: photosensitivity, GI upset, hematologic abnormalities
Interactions: antacids, dairy products, calcium, enteral feedings, and iron preparations (reduce oral absorption)
Nursing Considerations for Tetracyclines
Use SUN PROTECTION, almost better off not going into the sun
Make sure patient is not pregnant or breast feeding
Schedule monthly blood work
Take milk, calcium, and iron at least two hours apart from medication!
Tetracycline Key Drugs
doxycycline: very common, treats Rickettsial infections, chlamydial infections, and mycoplasmal infections. Also used in treatment of acne– make sure to educate patients on adverse effects
Overview of Aminoglycosides
MOA: prevent protein synthesis in bacteria
Indications: serious infections due to toxicity
Contraindications: not for use in pregnant women d/t crossing placenta (potentially causes congenital deafness)
TOXICITIES: nephrotoxicity, ototoxicity, neurotoxicity
Interactions: other nephrotoxic drugs like vancomycin, cyclosporine & amphotericin B
Nursing Considerations of Aminoglycosides
This drug is ONLY used for SERIOUS infections because of potential adverse effects.
Watch for nephrotoxicity: Monitor I&Os, watch for increase in BUN and Creatinine, check GFR, check urine for albumin
Watch for ototoxicity: tinnitus, feeling of fullness in ears
Watch for neurotoxicity: balance issues, paresthesias (numbness/tingling) in arms/legs
Should get ready to stop medication and call the doctor if any of these signs or symptoms occur.
Do not restrict fluids because of possible nephrotoxicity.
Aminoglycosides Key Drugs
amikacin: treats infections which are resistant to gentamicin or tobramycin
gentamicin: most commonly used aminoglycoside; treatment of G+ and G- infections… make sure there are labs ordered to verify kidney function!