Infection Flashcards
amoxicillin (Amoxil): class
Penicillin for infection
amoxicillin (Amoxil): other
penicillin G, nafcillin, Piperacillin
amoxicillin (Amoxil): Use
broad spectrum (G-) treatment of infection or as prophylaxis, some G+, soft tissue, respiratory, GI, GU
amoxicillin (Amoxil): EPA
inhibits bacterial cell wall synthesis which causes cell death
amoxicillin (Amoxil): ADR
hypersensitivity, anaphylaxis, GI effects, long term: renal & hepatic impairment, thrombophlebitis with IV administration
amoxicillin (Amoxil): contraindications
allergy to penicillin or cephalosporin, use caution with severe renal impairment, usually safe in pregnancy
amoxicillin (Amoxil): RN intervention
monitor for GI symptoms, report if lots of diarrhea, monitor for candida infection, epinephrine for anaphylaxis, monitor BUN and serum creatinine
cefazolin (Ancef) and cephalexin (Keflex): class
cephalosporins
cefazolin (Ancef) and cephalexin (Keflex): other drugs KNOW THESE!
cefoxitin (2nd)
ceftazidime (3rd)
ceftriaxone (3rd)
cefepime (4th)
cefazolin (Ancef) and cephalexin (Keflex): Use
surgical prophylaxis, skin, soft tissue, respiratory, bone/joints, GU, brain, blood infection
cefazolin (Ancef) and cephalexin (Keflex): EPA
inhibits bacterial wall synthesis
cefazolin (Ancef) and cephalexin (Keflex): RN interventions
monitor for GI symptoms, report if lots of diarrhea, monitor for candida infection, epinephrine for anaphylaxis, monitor BUN and serum creatinine
cefazolin (Ancef) and cephalexin (Keflex): contraindications
do not take with alcohol, may cause disulfiram- like reaction if combined: N/V, flushing, dizzy, throbbing headache, hangover sensation
aztreonam (Azactam): class
Monobactams
aztreonam (Azactam): use
urinary and lower respiratory tract infection, some abdominal and gynecologic infections, G- infections only, NO G+
aztreonam (Azactam): EPA
inhibits bacterial wall synthesis
aztreonam (Azactam): administration
IV or IM, sometimes inhalation for clients with cystic fibrosis
aztreonam (Azactam): ADRs
pain, phlebitis, inflammation of IV site. Superinfection. Seizures. GI effects, hypersensitivity, renal/liver, clostridium difficile. Inhalation route: wheezing, nasopharyngeal pain, chest discomfort/bronchospasm
aztreonam (Azactam): contraindications
use caution with allergy to cephalosporin or penicillin, may not be safe during pregnancy
aztreonam (Azactam): RN interventions
monitor BUN/creatinine, monitor bowel function, incompatible with many other drugs, furosemide can increase blood levels
What causes Cdiff?
it is transmitted through the fecal-oral route, recent antibiotic use/hospital admission, normally flora destroyed
What are the signs and symptoms of Cdiff?
Mild-Moderate
- Watery diarrhea >3x/day
- Abdominal cramping/tenderness
Severe
- Watery diarrhea 10-15x/day
- Severe cramping
- Increased WBC
- Kidney Failure
- Dehydration
How should people wash hands with Cdiff?
soap and water only, no alcohol sanitizer, contact isolation
gentamicin: class
aminoglycosides
gentamicin: other
tobramycin, neomycin
gentamicin: use
narrow spectrum antibiotic, treats G- infections such as Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. When used in combo therapy, can tx G+.
gentamicin: EPA
disrupts protein synthesis, thereby altering function/ replication
gentamicin: ADR
Nephrotoxicity: polyuria, dilute urine, proteinuria, elevation BUN/ Creatinine
Ototoxicity: tinnitus, headache, ataxia, vertigo, GI effects
gentamicin: contraindications
- avoid: vancomycin, cephalosporin, penicillin, neuromuscular blockers
- caution with hearing loss
- Avoid with people who have tinnitus or vertigo
- Avoid with renal disease
- Avoid in pregnancy, risk for congenital deafness
gentamicin: RN interventions
monitor BUN/CRE, serum levels, monitor for nephrotoxicity and ototoxicity, hydrate before, drink plenty of fluids, call if developing symptoms^
ciprofloxacin (Cipro): class
Fluoroquinolones
ciprofloxacin (Cipro): other medications
ofloxacin, levofloxacin
ciprofloxacin (Cipro): Use
wide range of infections, respiratory, GU, GI, bone, joint, soft tissue, treatment anthrax exposure, treatment against G- and G+
ciprofloxacin (Cipro): EPA
inhibits DNA synthesis, cell growth and replication
ciprofloxacin (Cipro): ADRs
CNS symptoms: dizzy, headache, confusion, seizures, increase ICP, suicidal ideation. GI effects, rupture of Achilles tendon, photosensitivity, hepatoxicity, renal damage, Cdiff
ciprofloxacin (Cipro): contraindication
caution with seizure disorder, depression, or renal impairment, caution in pregnancy, antiarrhythmic drug can increase QT interval, aluminum-calcium-iron-magnesium products decrease absorption, take 2 hours after
ciprofloxacin (Cipro): RN Intervention
monitor CNS symptoms, monitor for Cdiff, report achilles tendon pain, protect from sun, drink 1500-2000mL fluids per day
tetracycline: class
tetracyclines for infection
tetracycline: other medications
doxycycline, “-cycline”
tetracycline: Use
chlamydia, chronic bronchitis, gonorrhea, syphilis, helicobacter pylori, small animal bites, Lyme diseases, acne Bulgaris
tetracycline: EPA
inhibits protein synthesis in G- and G+ only when resistance dose not develop (common)
tetracycline: ADR
GI issues, super infections, renal and hepatotoxicity, slowed bone growth, photosensitivity, discolored tooth enamel and gum hypoplasia in children under 8
tetracycline: contraindication
- aluminum-calcium-iron-magnesium products decrease absorption
- decrease effectiveness of oral contraceptives
- avoid dairy products within 2 hours
- teratogenic
- caution during lactation, renal and liver impairment
tetracycline: RN Intervention
- monitor BUN/ CRE and liver function
- work best on empty stomach (1 hr before or 2 hrs after)
- report watery stools
- Report s/sx of liver damage (yellowing)
trimethoprim-sulfamethoxazole (TMP-SMZ) (Bactrim): class
sulfonamides
trimethoprim-sulfamethoxazole (TMP-SMZ) (Bactrim): Use
UTIs, 2/2 enterobacteriaceae, pneumocystis, ulcerative colitis, topically for burns and wounds
trimethoprim-sulfamethoxazole (TMP-SMZ) (Bactrim): EPA
halt multiplication of new bacteria/ inhibits folic acid
trimethoprim-sulfamethoxazole (TMP-SMZ) (Bactrim): ADR
GI effects (N/V/D), GI bleeding, pancreatitis, aplastic anemia, agranulocytosis, thrombocytopenia, leukopenia, pruritis, urticarial, stevens-Johnson syndrome, renal issues, hyperkalemia
trimethoprim-sulfamethoxazole (TMP-SMZ) (Bactrim): contraindication
- do not use in children less than 2 months
- teratogenic
- displaces bilirubin from binding to albumin -> hyperbilirubinemia -> toxicity
- inhibits CYP450 system -> multiple drug/herb interaction
trimethoprim-sulfamethoxazole (TMP-SMZ) (Bactrim): RN Interventions
- monitor BUN/CRE, postassium, CBC
- discontinue drug at first sign of a rash
- monitor for GI bleeding
- avoid concurrent use of NSAIDS/salicylates
erythromycin: class
macrolides
other macrolides
azithromycin (Zithromax) Z-pack
erythromycin: Use
PCN substitute, Legionnaires disease, upper resp. infections 2/2 group B strep, dental procedures for those with mechanical heart valves and allergy to PCN
erythromycin: EPA
inhibits microbial protein synthesis -> cell death
erythromycin: ADR
GI effects, hepatotoxicity, colitis, CNA effects, ototoxicity, cardiac effects such as ventricular dysthymias, superinfection, cdiff
erythromycin: Contraindication
- USE CAUTION with liver insufficiency or disease, many drug on drug interactions
- caution with pregnancy and lactation
erythromycin: RN intervention
- monitor liver function (jaundice)
- assess cardiac status and CNS effects
- report changes in hearing or watery diarrhea
