CH 35: Antiinfectives Flashcards by Tyece Henry

Penicillin G action

bactericidal

Broad spectrum

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Penicillin G interactions

decrease oral contraceptives

no aminoglycosides false positive coombs test

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positive Coombs test

you have antibodies that act against your red blood cells

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Penicillin G adverse effects

diarrhea!!!
rash
pruritus
nausea
fever
anaphylaxis
nephrotoxic
superinfections

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Penicillin G nursing considerations

culture and sensitivities
rotate injection sites’
mouth care
yogurt for diarrhea!!
take missed meds asap

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Cephalosporin actions

bactericidal (faster)

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cephalosporin interactions

nephrotoxicity (1st gen)
increases anticoagulation (bleeding)
false positive Coombs test

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4th and 5th gen ceph use

resistance organisms

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ceph adverse effects

diarrhea!!
N/V
PMC (mucousy, prolyphic diarrhea)
nephrotoxic
anaphylaxis

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Ceph nursing considerations

1-7% of those allergic to pen are allergic to ceph
use with caution for CKD
pregnancy category B

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tetra action

bacteriostatic (slows growth)

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tetra interactions

iron supplements
magnesium
antacids reduce absorption
not administered with pen or ceph

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tetra adverse effects

N/V/D
permanent teeth discoloration

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tetra nursing considerations

take 1 hr before or 2-3 hr after meals
not with milk or iron supp (50% absorption)
oral with glass of water
pregnancy category D
protect from sunlight
2 forms of contraception

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tetra labs to monitor

creatinine
BUN
AST
ALT
amylase
bili
alkaline phosphate

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Erythromycin (Macrolides) action

bacteriostatic ( slows growth)

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Erythromycin therapeutic use

flu
pneumonia
chlamydia

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erytho adverse effects

N/V
Diarrhea!!!
anaphylaxis
ototoxicity
PMC
hepatotoxic
superinfection’

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erythromycin nursing considerations

culture and sensitivities
mouth care
yogurt for diarrhea
take missed asap
full glass of water
food to reduce GI
shake suspension - avoid bolus

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erythromycin labs to monitor

electrolytes

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erythromycin half-life

extended
5 days not 10

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erythromycin ROA

coated - do not crush

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High doses of erythromcyin may be

cardiotoxic

pose risk for potentially fatal dysrhrythmias

gentamicin (aminoglycoside) action

bactericidal

gentamicin therapeutic use

gram negatives E.coli pseudamonas

gentamicin adverse effects

nephrotoxicity ototoxicity anaphylaxis superinfections neuromuscular blockade and respiratory paralysis!!

gentamicin nursing considerations

yellow - send back to pharmacy test ears (8th) fluids small frequent meals monitor for dizziness signs of reduced kidney function (oliguria, proteinuria, BUN, creatinine) Avoid with CKD Pregnancy category C

hold gentamicin if serum level above normal range =

5-10 mcg/ml

gentamicin labs to monitor

bili creatine lactate BUN AST ALT

aminos synergistic with:

penicillins cephs vancomycin

aminogylcosides and the GI tract

poorly absorbed

Ciprofloxacin (Fluoroquinolones) action

bactericidal (fast)

cipro interactions

increases anticoagulants

Cipro therapeutic use

anthrax!! e.coli sinusitis pneumonia

cipro adverse effects

N/V/D tendon rupture!!!! muscle weakness MG phototoxicity headache dizziness

Cipro nursing considerations

culture and sensitivities 1hr before or 2hr after meals fluids 4 hr before antacids take full course

can reduce absorption of some fluoros by as much as 90%

multivitamins or minerals

risk of tendon rupture with fluoros increase in patients:

over age 60 and receiving concurrent corticosteroids

chronic autoimmune disorder in which antibodies destroy the communication between nerves and muscles

myasthenia gravis

unhealthy kidney lab values

high BUN high creatinine

sulfonamides action

bacteriostatic (slows growth)

sulfonamides interactions

enhance anticoagulants methotrexate toxicity potassium-sparing (hyperkalemia = cardiac arrest)

sulfonamides therapeutic use

UTI RA UC CD otitis media

sulfa adverse effects

crystalluria anaphylaxis SJS necrosis hyperkalemia N/V photosensitivity

sulfa nursing considerations

if rash forms stop immediately around the clock 8 glasses per water no sun exposure mouth care pregnancy C CKD renal dysfunction no potassium

sulfa labs

CMP BUN Creatinine CBC AST ALT

Clindamycin action

bacteriostatic or bactericidal

Clindamycin therapeutic use

acne septicemia abdominal, resp, gyno infections

Clindamycin adverse effects

PMC causes C. diff

Clindamycin nursing considerations

PO with water monitor for diarrhea monitor for PMC - causes c diff not with UC

Clindamycin labs

AST ALT CBC BUN Creatinine electrolytes stool studies

Vancomycin action

bactericidal

vancomycin interactions

ASA aminoglycosides loop diuretics

vancomycin adverse effects

red man syndrome!!! ototoxic nephrotoxic

red man syndrome

with rapid IV admin - release large amounts of histamines hypotension, flushing, red rash, slow down rate

vancomycin nursing considerations

caution with renal and hearing impairment evaluate hearing peak and trough after 3 doses monitor IV Monitor BP evaluate ears (8th) anaphylaxis superinfection