Bacterial Infections/Antibiotics - CH. 35 Flashcards
Cephalosporins (Cefazolin(1), Cefotetan(2), Ceftriaxone(3), Cefepime(4)
Action- bacteriocidal
Primary use-prophylaxis of bacterial infections, particularly gram- positive organisms; there are 4 generations
Common side effects-rash and diarrhea
Serious adverse effects-superinfections, colitis, nephrotoxicity, allergic reaction
Nursing- may cross-react with pcn
Penicillins (Penicillin G)
Action-kill bacteria by weakening their cell walls, allowing water to enter, killing the organism (bacteriocidal)
Serious adverse effects-superinfections and anaphylaxis
Common adverse effects-diarrhea, nausea, vomiting
Nursing- take with food, decreases effects of oral contraceptives Watch for allergic reaction during first 30 min with first dose
Tetracyclines (Tetracycline, Doxycycline, Demeclocycline)
Action- bacteriostatic
Use- used topically and orally for acne
Side effects-affects the vaginal, oral, and intestinal flora and can cause *suprainfections, irritates the GI mucosa, nausea, vomiting, diarrhea, *discoloration of the teeth (age 4 mos-8y), *photosensitivity
Nursing- empty stomach unless GI upset; do not lie down after taking- may cause esophageal ulcer
Interactions- milk products, calcium, antacids, & iron decrease effectiveness; drug decreases effectiveness of oral contraceptives
Labs- liver
Macrolides (Erythromycin, Azithromycin, Clarithromycin)
Action- bacteriostatic, bacteriocidal at higher doses; gram +
Primary use-for patients unable to tolerate penicillin
Adverse effects- GI symptoms, colitis; high doses-ototoxicity, vertigo, dizziness, dysrhythmias
Nursing- empty stomach unless GI upset
Drug- increases toxicity of antihistamines, theophylline, warfarin, digoxin
Aminoglycosides (Gentamicin, Amikacin, Neomycin)
Action- bacteriocidal
Primary use: serious urinary, respiratory, nervous, or GI system infections used IV, or as drops , for eye infections
Adverse effects: rash, nausea, vomiting, fatigue
BBW: *ototoxicity, *nephrotoxicity, neurotoxicity
Nursing- drug level 5-10 mcg/ml; watch other ototoxic meds- loop diuretics
Labs- BUN, creatinine
Fluoroguinolones (Cyproflaxacin, Levofloxacin, Moxifloxacin)
Action- bacteriocidal
Primary use: UTIs; respiratory, skin, bone, joint, and GI infections; pneumonia; sinusitis; infectious diarrhea, anthrax*
Side effects: nausea, vomiting, diarrhea, phototoxicity, headache, dizziness, suprainfection
Black Box Warning- Achilles tendon rupture
Nursing- administer at least 4 hours before iron or antacids; increased risk of c. diff
Drug- may increase effects of warfarin
Herbal/food- dairy , antacids decrease absorption of drug; restrict caffeine to prevent nervousness, tachycardia, anxiety
Sulfonamides (Trimethoprim-sulfamethoxazole (Bactrim)
Action- inhibit bacterial growth, prevents synthesis of folic acid
Primary use: UTIs, PCP pneumonia, shigella infections of the small bowel, acute episodes of chronic bronchitis
Adverse effects: rashes (SJS), nausea, vomiting, thrombocytopenia, leukopenia, nephrotoxic, hepatotoxic
Drug- increases effects of warfarin, phenytoin & DM meds
Nursing- avoid with sulfa allergy, diuretics; hyperkalemia when taken with ACE/ARBs
Labs- hyperkalemia
Overdose- leucovorin (folic acid) for bone marrow suppression
Antitubercular Drugs (Isonaizid, Rifampin, Pyrazinamide, Ethambutol)
Action- bacteriocidal for actively growing organisms but bacteriostatic for dormant mycobacteria
First-line drug for: tuberculosis
Adverse effects: numbness of the hands and feet, rash, fever; *dark
First-line drug for: tuberculosis
Adverse effects: numbness of the hands and feet, rash, fever; *dark urine, *neurotoxicity,
Black Box Warning- hepatotoxicity (watch for jaundice, loss of appetite, fatigue, elevated liver enzymes), nephrotoxic, neurotoxic
Nursing- see next page
Labs- liver enzymes, increased bg in DM
