infection Flashcards
penicillin prototype and other drug names
amoxicillin (Amoxil)
Penicillin G, nafcillin, piperacillin
penicillin therapeutic use
broad spectrum (G-) tx of infection OR as prophylaxis. Some G+ skin, soft tissue, resp, GI, GU
penicillin EPA
inhibits bacterial cell wall synthesis -> interruption in normal cell wall synthesis -> bacteria death
penicillin administration
PO, IM, IV
penicillin ADRs
hypersensitivity, anaphylaxis, GI effects. Long term - renal and hepatic impairment, thrombophlebitis w/ IV admin
penicillin contraindications and interactions
Allergy to penicillin or cephalosporin
Use caution with severe renal impairment
Generally safe in pregnancy/lactation
penicillin RN intervention and client education
Monitor for GI symptoms
Have client report several diarrhea stools per day
Monitor for candida infection of mouth and vagina
Epinephrine for anaphylaxis
Monitor BUN and serum creatinine
cephalosporins prototype and other drug names
cefazolin (Ancef) and cephalexin (Keflex)
Other drugs: - know what generation each is
Cefoxin (2)
Ceftazidime (3)
Ceftriaxone (3)
Cefepime (4)
cephalosporins therapeutic use
surgical prophylaxis, skin, soft tissue, resp, bones/joints, GU, brain, blood
cephalosporins EPA
inhibits bacterial wall synthesis
cephalosporins adminsitration
PO, IM, IV
cephalosporins RN intervention and client education
Same as penicillin
Generally safe in pregnancy/lactation
Disulfiram like rxn when taken with alcohol
- Nausea, vomiting, flushing, dizziness, throbbing HA, general hangover sensation
monobactams prototype
aztreonam (Azactam)
monobactams therapeutic use
urinary and lower resp tract. Some abdominal and gynecologic infections. G- infections only NO G+
monobactams EPA
inhibits bacterial wall synthesis
monobactams administration
IV or IM, sometimes inhalation for clients w/ cystic fibrosis
monobactams ADRs
pain, phlebitis, inflammation of IV site. Superinfection. Seizures. GI effects, hypersensitivity, renal.liver, c diff. Inhalation route: wheezing, nasopharnygeal pain, chest discomfort/bronchospasm
monobactams contraindications and interactions
Use caution with allergy to cephalosporin or penicillin
Safety not established for pregnancy or lactation
monobactams RN intervention and client education
Monitor BUN/creatinine
Monitor bowel function
IV form is incompatible with many other drugs - verify compatibility using a chart
Furosemide can increase blood levels
aminoglycosides prototype and other drug names
gentamicin
Other drugs: tobramycin, neomycin
aminoglycosides therapeutic use
narrow spectrum antibiotic. Treats G- infections such as e coli, k pneumoniae, and p aeruginosa. When uses in combo therapy, can tx G+
aminoglycosides EPA
disrupts protein synthesis, thereby altering function/replication
aminoglycosides administration
PO (poor absop), IV (preferred), IM, ocular
aminoglycosides ADRs
nephrotoxicity: polyuria, dilute urine, proteinuria, elevated BUN/creatinie. Ototoxicity: tinnitus, HA, ataxia, vertigo. GI effects
aminoglycosides contraindications and interactions
Avoid: vancomycin, cephalosporin, penicillin, neuromuscular blockers
Use caution in those with hearing loss
Avoid with client who have tinnitus and vertigo
Avoid with renal disease
Avoid in pregnancy d/t risk for congenital deafness
aminoglycosides RN intervention and client education
Monitor BUN/CRE
Monitor serum levels (through)
Monitor for nephrotoxicity and ototoxicity
If client is dehydrated, rehydrate prior to initiating therapy
Encourage client to drink plenty of fluids
Encourage client to call MD if they develop s/sx of ototoxicity or nephrotoxicity
fluoroquinolones prototype and other drug names
ciproflaxin (Cipro)
Others: ofloxacin, levofloxacin)
fluoroquinolones therapeutic use
treats wide range of infection. Resp, GU, GI, bone, joint, skin, soft tissue. Tx anthrax exposure
fluoroquinolones administration
PO and IV
fluoroquinolones EPA
inhibits DNA synthesis, cell growth and replication. Tx against many G- and G+ bacteria
fluoroquinolones ADRs
CNS symptoms: dizziness, HA, confusion, seizure, inc ICP, suicidal ideation. GI effects, rupture of achilles tendon. More common w/ older adults taking glucocorticoids. Photosensitivity. Hepatotoxicity, renal damage, C diff
fluoroquinolones contraindications and interactions
Use caution with clients who have seizure disorders, depression, or renal impairment
Use caution w/ warfarin (hepatotoxicity)
Use extreme caution in pregnancy or children <18
Antiarrhythmic drugs can increase QT interval
Aluminum-calcium-magnesium products decrease absorption. Take 2 hours after
fluoroquinolones RN intervention and education
Monitor for CNS symptoms
Monitor for C diff
Report achilles tendon pain
Cover skin to protect from sun
Drink 1500-2000mL fluids per day
tetracyclines prototype and other drug names
tetracycline
Other drugs: doxycycline
tetracyclines therapeutic use
chlamydia, chronic bronchitis, gonorrhea, syphilis (with PCN allergy), h pylori, small animal bites, lyme disease, acne bulgaris
tetracyclines adminsitration
PO and IV
tetracyclines EPA
inhibits protein synthesis in G- and G+ only when resistance does not develop (common)
tetracyclines ADRs
GI issues, superinfection, renal and hepatotoxicity, slowed bone growth, photosensitivity, discolored tooth enamel and gum hypoplasia in children <8
tetracyclines contraindications and interactions
Aluminum-calcium-iron-magnesium products decrease absorption
Dec effectiveness of oral contraceptives
Avoid dairy products within 2 hours
Avoid during pregnancy and kids <8
Use caution during lactation, renal and liver impairment
tetracyclines RN intervention and client education
Monitor BUN/CRE and liver function
Work best on empty stomach (1 hour before or 2 hours post meal)
Report watery stools
Report s/sx of liver damage (yellowing)
sulfonamides prototype
trimethoprim-sulfamethoxazole (TMP-SMZ) (Bactrim)
sulfonamides therapeutic use
UTIs 2/2 enterobacteriaceae, pneymocystis, ulcerative colitis, topically for burns and wounds
sulfonamides administration
PO, IV, topical
sulfonamides EPA
halt multiplication of new bacteria/inhibits folic acid
sulfonamides ADRs
GI effects: N/V/D, Gi bleeding, pacreatitis, aplastic anemia, agranulocytosis, thrombocytopenia, leukopenia, pruritis, urticarial, SJS, renal issues, hyperkalemia
sulfonamides contraindications and interactions
Do not use in children < 2 months, lactation, or pregnancy
Displaces bilirubin from binding to albumin -> hyperbilirubinemia -> toxicity
Inhibits CYP450 system -> MULTIPLE drug/herp interactions
sulfonamides RN intervention and client education
Monitor BUN/CRE, potassium, CBC (Hgb, Hct, WBC, RBC) discontinue drug at first sign of a rash
Monitor for s/sx of GI bleeding
Avoid concurrent use of NSAIDs/salicylates
Antitubercular: Isoniazid (INH) therapeutic use
active and latent TB
Active TB: given in combo with others
Latent TB: monotherapy
6-9 months
isoniazid EPA
inhibits mycobacterial cell wall synthesis
isoniazid ADrs
Hepatotoxicity
GI symptoms: N/V
Peripheral neuropathy d/t B6 deficiency
CNS effects (dizziness, ataxia, seizures, psychotic sx)
isoniazid RN intervention and client education
Monitor LFTs
Monitor for jaundice, abdominal pain, N/V, fatigue
Education on when to call provider
Educate client on medication adherence
Avoid ETOH
isoniazid contraindications and interactions
Separate 1hr from antacids
Avoid in clients w/ history of liver disease and/or ETOH abuse
antitubercular: rifamycins prototype
rifampin (Rifadin)
rifamycins therapeutic use
active and latent TB
Active TB: given in combo with others
Latent TB: monotherapy
6-9 months
Others: leprosy and meningitis
rifamycins EPA
broad spectrum antibiotic
rifamycins ADRs
hepatotoxicity, GI symptoms, bodily fluids turn reddish/orange
rifamycins RN intervention and client education
Monitor LFTs
Monitor for jaundice, ab pain, N/V. fatigue
Educate on when to call provider
Educate client on medication adherence
Avoid ETOH
rifamycins contraindications and interactions
Interferes with oral contraceptions! Warfarin
Avoid in clients w/ hx of liver dx and/or ETOH abuse
antiparasitic azole antibiotic prototype
metronidazole (Flagyl)
azole antibiotics therapeutic use
many forms/uses
Bacterial infections: c diff, bacterial vaginosis, abdominal/colorectal sources
Protozoal infections: trich, giardiasis
Adjuvant for H. pylori
azole antibiotics EPA
broad specturm antibiotic - damages DNA of anaerobic bacteria
azole antibiotics ADRs
GI most common. CNS (HA, vertigo, ataxia) SEVERE = seizures and peripheral neuropathy
azole antibiotics RN intervention and client education
Can take iwth food if GI distress
Monitor for CNS effects - if seizures or neuropathy = discontinue
Harmless darkening of urine
AVOID ETOH - causes disulfiram like reaction
azole antibiotics contraindications and interactions
Avoid: CNS disease, severe blood disorder, pregnant
MANY drug interactions
antiparasitic antimalarial prototype
chloroquine
antimalarial therapeutic use
treatment/prevention of malaria
antimalarial EPA
exact unknown
antimalarial ADRs
none in low doses
Higher doses - active malaria = GI symptoms, HA, visual disturbances
antimalarial RN intervention and client education
Monitor for and report visual disturbances immediately
Sunglasses - help minimize
Call provider if severe GI distress
Can take with food
antimalarial contraindications and interactions
No food/drug interactions
antifungal polyene prototype and other drug names
amphotericin B
Other: Nystatin - PO, topical
polyene therapeutic use
superficial (topical) AND systemic fungal infections -> candida, yeast, yeast-like fungi
IV form = amphotericin = very toxic! Only given w/ severe, systemic, fungal infections
polyene EPA
interrupt the integrity of fungal cell wall
polyene ADRs
Amphotericin - CLOSELY MONITOR
Common reaction during infusion = fever, chills, tachycardia, hypotension, HA, nausea
- Premedicate: tylenol, benadryl
Bone marrow suppression - RBCs - anemia
Nephrotoxicity - BUN/CRE - IV fluids
Thrombophlebitis - monitor IV site
polyene RN intervention and client education
Nystatin for oral candidas (thrush) = swish and swallow
antifungals azole prototype and other drug names
ketoconazole
Others: miconazole (Monistat), clotrimazole (Lotrimin)
azoles adminsitration
PO and topical
azoles therapeutic use
superficial and systemic fungal infections. Candida and tinea
Tinea pedis = athletes foot
Tinea crudis = jock itch
Systemic = disseminated coccidioidomycosis histoplasmosis
azoles EPA
interrupt integrity of fungal cell wall
azoles ADRs
Topicals: burning, itching, redness
Systemic: hepatotoxicity, GI symptoms, drowsiness/dizziness
azoles RN intervention and client education
If systemic -> monitor LFTs - educate client on s/sx of liver failure and when to call provider
MUST take with food = better absorption
azoles contraindications and interactions
antacids, PPIs, H2 blockers
antiviral prototype
acyclovir (Zovirax)
antivirals therapeutic use
infections from herpes simplex virus, varicella, herpes zoster
antivirals EPA
inhibits replication of viral DNA
antivirals ADRs
topical : burning/itching
PO: GI sx, HA/vertigo
IV: renal toxicity, thrombophlebitis
Rare: CNS toxicity = restlessness, tremors, psychosis, seizures
antivirals RN intervention and client education
Monitor for/report adverse effects
If IV - monitor BUN, CRE, give IV hydration, monitor IV site closely
Topical form: wear gloves when applying
antivirals contraindications and interactions
Caution: dehydration, renal insufficiency, neurological disorders
