Week 4 antiinfectives Flashcards
Carbapenems
imipenem are used to treat what?
serious bacterial infections and pneumonia
what are side effects of imipenem
Superinfections.
C-diff
N/V
What drugs will interact with carbapenems
What conditions would contraindicate carbapenems
Do not give to patients on PCN and cephalosporins
This should not be given in pregnancy
.
What are the nursing implications of carbapanems
probiotic yogurt.
C&S, Pregnancy tests, PCN allergies.
Cephalosporin’s examples
Cephalexin
Cefazolin
Cefaclor PO
Ceftriaxone IV
Cephalosporins MOA
interfere with cell wall synthesis
Cephalosporins indication
UTI
Surgery infection prevention
Cephalosporins SE/AE
GI track upset
C-diff
Renal insufficiency
bleeding
Cephalosporins
interactions/Contraindication
ETOH
PCN allergies
liver/kidney problems,
aminoglycosides
Cephalosporins
interactions/Contraindication
ETOH
PCN allergies Aminoglycosides
liver/kidney problems {PCN}
Nsg implication when taking cephalosporins, what would you want to assess? what about explain?
assess C&S
Get a renal function test Creatine (.5-1.1)
Get a liver function ALT (10-55)
-cephalosporins are harsh on the liver/kidneys
Avoid ETOH 72hrs after therapy because of Antabuse effect.
Penicillin
amoxicillin piperacillin
MOA
MOA: stops cell wall syth
Penicillin is used to treat?
strep throat
prevent endocarditis
sinus infection
peritonitis
Penicillin SE/AE
anaphylaxis, Hives, angioedema
itching, renal impairment
-hyperkalemia, dysthymias hypernatremia
Penicillin contraindicating and interactions
Cephalosporins, aminoglycosides
renal disease
NSAIDS, contraceptives
warfarin
What drugs does PCN interact with?
cephalosporins and aminoglycosides
Warfarin, NSAIDS, birth control
cephalosporins reduce what vitamin causing what effect?
vitamin K
reduce coagulation
what should a nurse know of PCN?
Asses for any allergies to cephalosporins, and PCN
are they on cephs or aminoglycosides
pt edu of penicillin
PCN will reduce Vit K and coagulative effects
take PCN 1 hr before food or 2 hrs after
do not take with juice-inhibits drug
it will interact with B/C “child care cillins and cyclines”
take w/ a glass of water
watch pt for 30 min p admin
Sulfonamides examples
sulfadiazine
sulfamethoxazole
Sulfonamides MOA
Drugs will inhibit folic acid syth for nucleic acids
Sulfonamides is used to treat what?
UTI,
E coli,
klebsiella
staph infections, CA MRSA
Sulfonamide se/ae
Sun avoidance due to photosensitivity
Steven Johnsons syndrome Skin peeling
N/V, diarrhea, renal effects
Sulfonamides interactions/contraindications
thiazide diuretics,
oral hypoglycemic-will drop blood sugar even more
Sulfonamides pt edu
wearing sunscreen/avoid sun
drinking 8-10 glasses of water
-will lower renal damage and crystal formation
Tetracyclines
examples
doxycycline
tetracycline
minocycline
tetracycline MOA
stops protein synthesis preventing replication of pos a neg
tetracycline treatment
chlamydia
acne vulgaris
pneumonia
Lyme disease
Side effects/AE of tetracyclines
photosensitive “Fun in The Sun”
N/V, diarrhea
superinfections
bone discoloration and damage
harmful to baby
contraindications of tetracycline
Pregnancy category D
dont use if under 8 yrs
discolors teeth by binding to Ca
what does tetracycline interact with?
Dairy, antacids, and Fe, Ca, Mg supplements
Oral contraceptives
Child with penicillin and tetracyclines
tetracycline patient education
The sun protection needed
avoid milk/dairy and antacids by 2hrs because iron and antacids inhibit cyclines
take with water and food to ease GI upset
alt BC
Macrolides examples
clindamycin
erythromycin
azithromycin
(thromycin)
macrolides MOA
prevent protein syth, bactericidal and bacteriostatic
Macrolides indication
used for patients with PCN allergies
to treat strep, gonorrhea, chlamydia
Macrolides erythromycin SEAE
CNS and GI uset
hepatotoxicity and superinfections
Azithromycin SEAE
longer duration of action, better efficacy, fewer GI AE
Clindamycin SEAE
c-diff
macrolides interactions contraindications
hepatic impairment, warfarin, and digoxin
Aminoglycosides
mysin drugs
new gentleman tobra
gentamycin
neomycin
tobramycin
Aminoglycosides most serious adverse effects are? the most common?
my sin
ototoxicity and nephrotoxicity
dizzy
Aminoglycosides contraindications are
renal and hepatic disease, hearing loss
aminoglycosides biggest interactions include which types of drugs and should NEVER be mixed with this drug in an IV solution?
interacts with loop diuretics increasing otoxicity
do not mix aminoglycosides with PCN in the same IV EVER
What are the nurisng implications of aminoglycosides
monitor peak and trough
peak is 30 min p admin
trough is right before next does
-this is in order to prevent toxicity
-always perform renal function tests, hematuria, bun, and creatine.
aminoglycosides pt ed
drink lotta water
report tinnitus ringing of ototoxicity
aminoglycosisdes interacts with
ceph and PCN
aminoglycosisdes interacts with
ceph and PCN
Fluroquinolones examples
ciproflaxin
levofloxacin
Fluroquinolones MOA
interferes with DNA replication
Fluroquinolones treats what?
Cipro anthrax UTI
Levaquin respiratory track
Fluroquinolones SE AE Black box
Achilles tendon rupture
Fluroquinolones SE AE
Achilles tendon rupture
GI- N/V diarrhea
superinfection thrush
photoxicity
c-diff cipro
Fluroquinolones contraindicated by…
anyone under 18 unless they have anthrax or a E. Coli
Fluroquinolones interactions
Antacids-absorption
Ca, Mg, Fe, Zinc interactions
Fluroquinolones as a nurse,, you should know
C&S
any meds that may interact with Fluroquinolones, like antacids should be taken 1 hr before
Vancomycin
very toxic
MOA
destroy bacterial cell wall
Vancomycin
very serious
indication
MRSA,
C-diff
Vancomycin
SE//AE
ototoxic, nephrotoxic
red man syndromes (rash, flushing)
tachy-antihistamines can reduce the side effects
Vancomycin
very serious
is interacted/contraindicated by
loop diuretics
aminoglycoside
both with increase otoxicity
Vancomycin nursing implications
assess I&O
-renal function test BUN Creatine
trough level of 10-20mcg/mL
hearing loss
Because vancomycin is so irritating what can you do as a nurse to help reduce AE
admin slowly over 60min
rapid infusion can cause hypotension
Nursing implications of ABT
getting cultures
risk of superinfections c-diff, yeast, thrush, kills our flora
white discharge, yellow, on tongue, fould odor, redness in folds
C-diff: watery frequent foul smelling diarrhea, pain cramps,
Take med as prescribed
N/V, diarrhea is common
Nursing implications of ABT theraputic effects
improved s/sx
decreased WBC
normal vitals
negative culture and sensitive test
no fever, lethargy drainage, redness
Nursing implications of ABT adverse reactions
hypersensitvity
anaphylaxis wheezing SOB swollen tongue hives
pt edu for all ABT
druk fuluid
take as prescribed
report SOB, dyspnea, hives/urticaria, Headache, changes in urine output
Antitburcular
isoniazid
rifampin
rifabutin
rifapentine
pyrazinamide
MOA antiTB
TARGET dna of bacteria
Isoniazid SE/AE
peripheral neuropathy, hepatotoxicity
Antitubercular contraindication
renal or hepatic failure/issues
Interactions antitubercular
Rifampin + isoniazid = hepatotoxicity
isoniazid and phenytoin= increased phenytoin effect
Nursing implication of AnitTB
therapeutic effect
decrease s/sx
better chest XRT
negative C&S
Pt edu of antiTB
rifampin-orange
Avoid alcohol
report fever, diarrhea, peripheral neuropathy, bloody stool, jaundice
tx can be 12 mo
affect BC efficacy
Puriifed protein derivative mantoux
screenign for tb
resutls indicated by skin, the chest x-ray, then culture
10mm tall
Bacille Calmette Guerin BCG is against TB causes false postivies 60-80%
