Final 14 Flashcards
mechanism of action of Penicillin
- affect cell walls
- bacteriocidal: inhibits construction of growing bacteria cell walls (kills by affecting cell walls)
- narrow spectrum: only treat gram +
- treat infection by susceptible organisms
- prophylaxis of bacterial endocarditis with prosthetic heart valve or prophylaxis of rheumatic fever
Penicillin is easily destroyed by _____
penicillinase
contraindications of Penicllin
- allergies (anaphylactic reaction to penicillin)
- kidney dysfunction/disease (due to high amt. of excretion that goes through kidneys)
- caution: cephalosporins
side effects of Penicillin
- itching
- skin reactions
nursing considerations for Penicillin
- inject deep IM
- hypersensitivity ranges from minutes to weeks
- decrease effectiveness to BC, so need to use another barrier method
- monitor neurotoxicity
- has distinct smell in urine
what to report with Penicillin
diarrhea
mechanism of action of ampicillin
- bacteriocidal: inhibits construction of growing bacteria cell walls (kills by affecting cell walls)
- broad spectrum: treats gram + & some -
- to treat infection by susceptible organism
contraindications of ampicillin
- allergy: especially if allergic to penicillin
- kidney probs
- caution: cephalosporins
side effects of amipicillin
- rash
- diarrhea
nursing considerations of ampicillin
- decreases effectiveness to BC, so use extra barrier method
- monitor kidney function
- want to try and take on empty stomach/glass of water for absorption, but can take c food for GI probs
mechanism of action & classification of Cefazolin
- 1st gen cephalosporin: beta-lactam ring, most effective against gram +, does not cross BBB (doesn’t enter CSF)
- small amt. gets in CNS
- bacteriocidal
- broad spectrum compared to penicillin
- not effective against MRSA
- used for prophylaxis in surgical procedures
what is Cefazolin sensitive to
beta lactamase
contraindications & side effects of Cefazolin
contraindication: cross allergy (penicillin)
side effects: rash, diarrhea
nursing considerations for Cefazolin
- inject really deep IM
- can be nephrotoxic: monitor kidney function
- monitor for superinfection because of broad spectrum
- can be given IM or IV
- secreted in breast milk
- start 30 min. before cut time for surgeries
mechanism of action & classification of Imipenem-cilastin
- carbapenems (penems)
- bacteriocidal
- broad spectrum: gram + & =, & anaerobic
- treat some strains of MRSA
- cilistatin: doesn’t do anything to help kill bacteria, so the Imipenem is antibiotic part
- excretion through kidneys
contraindications of Imipenem-cilastin
- kidney probs
- brain injuries: can increase risk for seizures
side effect of Imipenem-cilastin
- N, V, D
- rash
- pain at injection site
nursing consideration for Imipenem-cilastin
- admin. parentally: only IM or IV
- monitor for hypersensitivity (cross allergy with penicillins or cephalosporins)
- report diarrhea (C. Diff.)
mechanism of action of Tetracycline
- bacteriostatic: inhibits bacterial protein synthesis by binding to 30S ribosomes
- can be bacteriocidal
- super super broad spectrum: effective against aerobic, anaerboic, prophylaxis gram + & -
- limited usefulness due to resistance/penicillin resistant strains
- used to treat H. Pylori, acne (topically)
contraindications of Tetracycline
- allergy
- can not use in kids < 8
- can’t use in pregnancy/lactation: tendency to cause permanent discoloration of teeth (category D)
side effects of Tetracycline
- permanent teeth discoloration
- N, V, D
- epigastric burning
- photosensitivity
- black hairy tongue
- superinfection
nursing considerations for Tetracycline
- SUPERINFECTION!!
- usually given orally, but can be topical for acne
- can take with food for GI upset (but no milk because of calcium = decreased absorption)
- avoid taking c Ca+ or Fe+: these decrease absorption of drug
- monitor for yeast infection
- use another barrier method of BC
- keep upright after taking
- monitor for bleeding
mechanism of action & classification of Erythromycin
- macrolides: inhibits bacterial protein synthesis by binding to 50S ribosomes
- treats gram +
- drug of choice for pertusis & gonorhea
- used for neonatal eye infection prophylaxis
what drug is used in pt’s c allergy to penicillin
Erythromycin
contraindication of Erythromycin
- decreased hepatic function
side effects of erythromycin
- newer generations: less GI effects
- N, V
- abdominal cramping
nursing considerations for erythromycin
- encourage water & empty stomach, but can take with food for GI upset
- avoid acidic fruit juice: acidic environment destroys drug
- report diarrhea (for C. Diff) & yeast infections
- report s/s hepatotoxicity
- report s/s ototoxicity: problem hearing, tinnitus
mechanism of action & classification of Ciproflaxacin
- fluoroquinolones
- disrupts DNA synthesis & repair
- broad spectrum: more effective against gram -
- drug of choice for post-exposure prophylaxis of B. anthracs
- commonly used to treat UTIs, sinusitis, pneumonia
contraindications of Ciproflaxacin
- pregnancy
- children < 18
side effects of ciproflaxacin
- N, V, D
- rash
- tendon pain (rupture of achilles tendon)
- spontaneous retinal detachment
nursing considerations for ciproflaxacin
- limit caffeine intake: to limit CNS probs
- teach sudden joint pain: related to cartilage & tendon issue
mechanism of action & classification of Trimethoprim-sulfamethoxazole
- sulfonamidea & UTI meds
- bacteriostatic: inhibits folic acid production (doesn’t affect human cells since we don’t make folic acid)
- used for treatment & prophylaxis of UTIs
contraindications of Trimethoprim-sulfamethoxazole
- allergies to sulfas
- caution: kidney/liver dysfunction
- pregnancy/lactation
side effects of Trimethoprim-sulfamethoxazole
- N,V
- hypersensitivity
- crystal urea = encourage fluid intake
nursing considerations of Trimethoprim-sulfamethoxazole
- may have cross sensitivity to sulfonureas/thiazidiuretics (diabetes)
- monitor for Stephen Johnson’s syndrome = hypersensitvity
- monitor for allergies/asthma
- monitor for CBC & bleeding times
- avoid K+ supplements: to reduce increase of K+ build up in kidneys
mechanism of action for nitrofurantoin
- urinary antiseptic
- inhibits protein synthesis
- inhibits aerobic metabolism
- inhibits DNA & RNA synthesis
- inhibits cell wall formation
- treat gram + & -
- used for acute UTI
contraindications of nitrofurantoin
- renal impairment
- caution: pregnancy
- babies < 1 mo.
- pulmonary diseases
side effects of nitrofurantoin
- chronic use: side effects show up years & years later
- A,N,V
- hypersensitivity
nursing considerations for nitrofurantoin
- monitor pulmonary functions: flu-like s/s, dyspnea = discontinue med
- discourage antacids: because they decrease the absorption
- increase fluid intake = dilute urine & flush things through
- can give with food or milk
when the body creates an immune response to an antibody or its vaccine
active immunity
when actual pre-formed antibodies are given to someone, without the person’s own immune system creating them
passive immunity
4 types of passive immunity
- attenuated (live)
- inactivated (killed by heat or chemical, safer than attenuated)
- toxoid (make it so that body doesn’t effect organism itself so much that it attacks the toxins that the microorganism is giving out)
- recombinant (lab generated proteins = body will recognize as foreign substance & create antibodies)
contraindications to immunizations
- MMR or Rubella in pregnant women
side effects of immunizations
- pain or swelling at injection site
- low grade fever
what is VAERS
vaccine adverse effect reporting system: any effects that require medical treatment
