MOD 6 Antimicrobial Agents Flashcards
- Work by preventing the bacterial from
building a strong protective cell wall - Most effective against bacteria that
divide rapidly and are usually found in
skin and mucus membranes,
respiratory tract, ear, bone and blood. - Always discuss allergies with pt before
administering medication - Monitor patient for 30 minutes after
medication administration
Beta-Lactam Antibacterials
- First true antibiotics
- Very safe and effective
- Used to treat: ear infections, pneumonia, meningitis, UTIs, syphilis, gonorrhea, and prophylactic before surgery or dental procedures
- Refrigerate liquid forms of this medication
- Side effects and adverse effects: Urticaria, pruritis, angioedemaSkin reactions including maculopapular eruptions, Stevens-Johnson syndrome, exfoliative dermatitis
- Possible cross-sensitivity to cephalosporins (1-18%)
Penicillins
penicillin g and penicillin v (natural penicillins)
methicillin, cloxacillin, dicloxacillin, nafcillin, oxacillin (penicillinase-resistant)
amoxicillin, ampicillin, bacampicillin (aminopenicillins)
carbenicillin, piperacillin, ticarcillin, mezlocillin (extended spectrum penicillins)
Penicillin antibiotics
amoxicillin and clavulanic acid (Augmentin)
ticarcillin and clavulanic acid (Timentin)
Combination antibiotics
- structurally pharmacologically related to penicillins
- bactericidal: interferes with bacterial cell wall synthesis
- Broken down into generations – each progressive generation created to improve activity against bacteria.
- ceftriaxone (Rocephin) - very long half-life, can be given once a day as an IV or IM dose. One IM dose can sometimes eradicate the infection
- Don’t administer at the same time as antacids and or Iron supplements
- Refrigerate liquid forms of this medication
- Therapeutic uses: UTIs, respiratory infections, bacteremia, meningitis
Cephalosporins: ceftriaxone (Rocephin)
- Active against Aerobic gram-negative bacteria
- Preserves normal flora in the intestines
- Inhibits cell wall synthesis
- Therapeutic Uses: Influenza, UTI
- Side effects: Rash, d/n/v
Monobactams
- Bactericidal- Disrupts protein synthesis in bacteria
- Not usually given orally
- Very potent and have potentially serious toxicities, so they are reserved for more serious and life-threatening infections
- Side effects: nausea, vomiting, rash, ototoxicity, nephrotoxicity
- Used in the treatment of nosocomial infections: UTIs, Meningitis, burns, wound infections, septicemia
- Before administering, check labs: BUN, Creatinine, check hearing before and daily during administration
Aminoglycosides: tobramycin (Tobramycin), gentamicin (Garamycin)
- Inhibits reproduction of bacteria
- Excellent activity for gram-negative bacteria
- Excellent oral absorption
- Excreted in the kidneys
- Therapeutic uses: Lower respiratory tract infections, infectious diarrhea, urinary tract infections
- Side effects: Headache, dizziness, fatigue, insomnia, nausea, rash, photosensitivity
- Cautious use in elderly
- Check blood glucose levels frequently for pts who are diabetic
- Can raise blood pressure and cause arrhythmias in cardiac patients
- Give with plenty of fluids, recommended up to 3 liters a day
Fluoroquinolones (Quinolones) ciprofloxacin (Cipro), levofloxacin (Levaquin)
These medications prevent bacteria from using protein to reproduce
Tetracyclines
Sulfonamides
- Should only be given to patients with a healthy immune system
- Therapeutic Uses: acne, UTI, upper respiratory infections, pneumonia, meningitis, Rickettsia: Q fever, Rocky Mountain spotted fever, Lyme disease, Helicobacter pylori infections associated with peptic ulcer disease, gonorrhea and syphilis
- Side Effects: Superinfections, especially candida, diarrhea, photosensitivity
- Not to be given at the same time as Penicillin
- Give dairy products 1 hour before or 2 hours after medication administration
- Not to be used for children under the age of 8- causes teeth to discolor.
Tetracyclines: doxycycline (Vibramycin)
- Achieve high concentrations in the kidneys
- May be combined with other antibiotics for enhanced potency (trimethoprim, erythromycin)
- Bacteriostatic, inhibits the synthesis of folic acid
- Therapeutic Uses: Upper respiratory infections, Urinary Tract infections
- Before administering, check liver function tests
- Side effects: Common cause of allergic reactions (fever followed by rash), photosensitivity
- Contraindicated in patients with an allergy to sulfa antibiotics
- Give with plenty of fluids
Sulfonamides: Bactrim Septra
- Bacteriostatic or bactericidal
- Therapeutic Uses: common infections of skin and mucus membranes, wound infections, ear infections, upper respiratory infections
- Used for patients allergic to penicillin
- Side effects: Headache, Nausea, vomiting, diarrhea, photosensitivity
- Many drug-drug interactions with Macrolides – Check medication list thoroughly
- Decreases action of oral birth control
- Take oral medication with food
Macrolides: Azithromycin, Erythromycin
- Similar in action to Macrolides
- Used to treat infections caused by multiple organisms
- Well absorbed orally
- Take with a full glass of water to avoid esophageal irritation
Clindamycin: Cleocin
- Antibiotic that also has some antiprotozoal and anthelmintic activity.
- Varied range of treatments for many diseases
- Available in oral and parenteral routes
- May leave a metallic taste in the mouth
- Do not drink alcohol with this medication. May cause severe nausea and vomiting. Some patients may avoid cough syrup and mouthwash
- Side effects: Nausea, vomiting, headache, dizziness, rash, leukopenia
- Give with food
- Urine may turn dark
Metronidazole (Flagyl)
- Used for severe infections such as Sepsis, endocarditis, abscesses, multiple bacteria infections
- Peak and Trough necessary for management of therapeutic index
- “red man syndrome”
Vancomycin
- used to suppress herpes simplex type 1 and 2 infections, Varicella- zoster virus (Chicken Pox and Shingles)
- Inhibits viral cell replication
- Available in oral, topical, and parenteral formulas
- Contraindicated in patients who are allergic
- Give with lots of water
- Side Effects: nausea, vomiting, diarrhea, headache, burning when applied topically.
Acyclovir (Zovirax)
Acyclovir
Anti Viral Agents
Macrolides
Miscilaious
Anti-Infectives
Nystatin (Nystat, Mycostatin)
Amphotericin B
Fluconazole (Diflucan)
Griseofulvin
Antifungal Agents
- Applied topically for candidal diaper rash
- Treats oral and vaginal candidiasis (thrush, yeast infections)
- Available in oral, topical, and powder
- Side effects: nausea, vomiting, diarrhea, cramps
- Local irritation may occur with topical ointment
Nystatin (Nystat, Mycostatin)
- The agent of choice for treatment of severe systemic mycoses
- Works synergistically with flucytosine to treat mycoses
- Most patients who are given this med IV experience fever, chills, hypotension, malaise, joint and muscle pain, nausea, vomiting, and headache (Shake and Bake)
- Because of side effects, most patients are pre-medicated with Tylenol (decrease fever), an antihistamine, and an antiemetic
- Available in topical and IV routes
Amphotericin B
- Less side effects of amphotericin B and works fairly well
- Available in oral and IV routes
- Side effects: Nausea, vomiting, diarrhea
Fluconazole (Diflucan)
- Avoid taking during Pregnancy
- Used to treat topical fungal infections,
tinea cruris, tinea corporis and tinea pedis - Available in oral and topical routes
- Side effects: headache, GI discomfort, rash, blurred vision, transient hearing loss
Griseofulvin
- Metronidazole (Flagyl)
Parasitic Infections
For prophylaxis, take once a week for 2 weeks before arriving in the malaria area, during the time spent in the area, and for 8 weeks after
- Immediate attention needs to be sought if symptoms occur
- Baseline Renal and Liver enzymes should be checked.
Antimalarial Agents
Chloroquine (Aralen)
Mebendazole
Permethrin (Elimite)
Antimalarial Agents
- Used to treat Malaria
- Available in parenteral and oral routes
- Side effects: diarrhea, nausea, alopecia, dizziness, rash, headache
Chloroquine (Aralen)
- Use for treatment of parasitic worms in the intestines
- Administered orally
- Vomiting may occur
Mebendazole
- First-line treatment of lice and scabies
- Patient may complain of rash or dry skin with the use
Permethrin (Elimite)
Nursing Considerations for All Antibiotics
Take for the time specified, exactly as prescribed
Take with water
Watch for signs of superinfection
The most common side effects are GI: nausea, vomiting, diarrhea
Always inquire about drug allergies
Not to be given in pregnancy or lactation without a doctor’s approval
If pt shows signs of an allergic reaction discontinue use immediately and contact prescriber
