Wk 2 Anti-infective Meds Flashcards
Key Terms Pathogen Antimicrobials/Antimicrobial drug Antibiotic Bactericidal Bacteriostatic spectrum Generation
Pathogen Antimicrobials/Antimicrobial drug Antibiotic Bactericidal Bacteriostatic spectrum Generation
Key Terms Broad spectrum Narrow spectrum Superinfections Cross-Sensitivity Secondary Infection Opportunistic Infection
Broad spectrum Narrow spectrum Superinfections Cross-Sensitivity Secondary Infection Opportunistic Infection
General Nursing Implications for Antimicrobial Drug Therapy Box 5.1- p. 67 Assessment Planning & Intervention Evaluation
Assessment- History Obtain Specimens-C&S Focused Assessment Check Allergies Female & Oral Contraceptive Use
Planning & Intervention-
Monitor for Side Effects-Diarrhea
Monitor for Adverse Reactions
Take as prescribed
Evaluation-
Is med effective?
Follow-up Labs?
General Teaching Points for Patients & Families during antimicrobial Drug Therapy
Box 5.2- p. 68
- Diarrhea
- Take as prescribed-around the clock-even doses
- Report difficulty breathing/swelling lips STAT
- Rash/Hives-Stop taking-Call Doc
- Take until gone/as prescribed-don’t save for later
Penicillins (PCN) Action Uses Expected Side Effects Adverse Reactions Drug Interactions Examples of Common Penicillin Drugs
Action Uses Expected Side Effects Adverse Reactions Drug Interactions Examples of Common Penicillin Drugs
- Antacids may decrease absorption of penicillin.
- Laboratory results may change when penicillin is used.
- Ampicillin use may decrease the effectiveness of oral contraceptives, making the woman at increased risk for pregnancy.
Penicillins (2 of the 5 Generations)
Natural Penicillins - -penicillin V (pen-Vee K) Aminopenicillins - -amoxicillin (Amoxil) -ampicillin sodium and sulbactam sodium (Unasyn)
Penicillins
Nursing Implications
Nursing Implications
- Dosage depends on type and severity of infection
- Penicillin interferes with the accuracy of many lab tests
- Avoid giving ineffective doses since this may lead to the development of resistant strains
- Use with caution in patients with multiple allergies (cross-sensitivity occurs with many categories of antibiotics)
Penicillins
Why do organisms become resistant to antibiotics?
Before administering IM penicillin injections, the nurse should obtain the patient’s blood pressure and pulse. Following administration, the patient should be advised to wait 30 minutes before leaving the clinic. Why?
What signs and symptoms would the patient experiencing an allergic reaction to penicillin exhibit?
?
Penicillins
Patient Teaching
Patient Teaching
Take all meds as prescribed
Watch for s/s of superinfection (overgrowth of other organisms)
Notify Dr. if rash, hives, decreased urination, diarrhea, or other unusual symptoms occur (allergic reaction)
Go to ER right away if become SOB after taking med (anaphylaxis is the most serious adverse reaction)
Examples of Common Penicillin’s & Cephalosporin’s Table 5.1, p. 70-71
Penicillin's Cephalosporin's -1st generation cephalexin (Keflex) -2nd generation cefaclor (Ceclor) cefoxitin (Mefoxin) -3rd generation ceftriaxone (Rocephin) Vancomycin Carbapenems
Broad Spectrum Antibiotics
Action
Uses
Action
Attack a bacterium’s internal cell processes
May destroy the external cell wall
Therefore can be either bactericidal or bacteriostatic
Uses
Used to treat infections caused by certain susceptible organisms
These organisms must be identified by a culture and sensitivity test
To prevent/treat a secondary bacterial infection following a viral infection
Broad Spectrum Antibiotics
Adverse Reactions
Adverse Reactions
Superinfection
–May show up in the oral (thrush) , vaginal (yeast), or rectal (diarrhea) areas
–Treat with antifungals
–Mild to life threatening effects
Organ Damage
–Ototoxicity, nephrotoxicity, hepatotoxicity
Hypersensitivity (allergy)
–May develop within minutes of taking the drug or appear days after stopping the medication
–Anaphylaxis
–Cross sensitivity
Broad Spectrum Antibiotics
Ex. Serious Adverse Reactions
Ex. Serious Adverse Reactions
erythromycin (EES)
–Ototoxicity, hepatotoxicity
clindamycin (Cleocin)
–Severe and fatal colitis (may not occur until after tx is completed)
vancomycin (Vancocin)
–Nephrotoxicity, ototoxicity
Broad Spectrum Antibiotics
Categories:
(generations)
Categories: cephalosporins -1st generation cephalexin (Keflex) -2nd generation cefaclor (Ceclor) cefoxitin (Mefoxin) -3rd generation ceftriaxone
Cephalosporin’s
Action
Action
Cephalosporin’s
Uses
Uses
Cephalosporin’s
Expected Side Effects
Expected Side Effects
Cephalosporin’s
Adverse Reactions
Adverse Reactions
Cephalosporin’s
Drug Interactions
Drug Interactions
Severe disulfiram reaction resulting in severe flushing, vomiting, and collapse.
Cephalosporin’s
Nursing Implications and Patient Teaching
Nursing Implications and Patient Teaching
Must be given IV or IM
Patients with a severe reaction to penicillin should not take these products.
Broad Spectrum Antibiotics
Generations: meds that are developed from other meds
Generations: meds that are developed from other meds
- 2nd and 3rd generation meds are more effective against a broad group of gram – organisms, however they are less effective against gram +.
- 3rd generation meds are more effective against resistant organisms and have increased resistance to inactivation by beta-lactamase
- 3rd generation meds are newer, cost more, and have more side effects
- 1st generation meds are more effective against gram + organisms
Broad Spectrum Antibiotics
Categories (cont…)
Categories (cont…) -Aminoglycoside gentamicin (Garamycin) -Fluoroquinolones ciprofloxacin (Cipro) -Macrolides erythromycin (EES) -Miscellaneous vancomycin (Vancocin)
Broad Spectrum Antibiotics
Other Cell Wall Synthesis Inhibitors
Other Cell Wall Synthesis Inhibitors
Vancomycin & carbapenems
-used for infections caused by multidrug-resistant (MDR) bacteria
-given intravenously by IV push or by infusion over an hour or more in an acute care setting
-Nausea, vomiting, diarrhea, headache, rash, fever, and chills can occur
Broad Spectrum Antibiotics
Nursing Responsibilities
Nursing Responsibilities Assess for allergies Administer per orders and policy Assess for therapeutic effects Monitor for adverse effects Monitor for common drug interactions that: Decrease effectiveness of antibiotic Alter effect of other med
Broad Spectrum Antibiotics
Patient Teaching
Patient Teaching
Take at proper time; full course of therapy
Take with or without food as order (tetracyline and lincomycin are better absorbed on an empty stomach)
Increase fluid intake (minimum of 1500c per day) to decrease renal toxicity
Tetracyclines Table 5.2, p. 73-75 Action Uses Expected side effects Adverse effects Drug interactions
Action- Protein synthesis inhibitors
Uses- Broad Spectrum Drugs
Expected side effects- N//V/D, yeast infection, skin sensitivity/sunburn
Adverse effects- Liver toxicity, decreased renal/kidney function
Drug interactions- Milk, dairy, and calcium
Macrolides p. 74 Actions Uses Expected Side Effects Adverse Effects Drug Interactions Nursing Implications Patient Teaching
Actions Uses Expected Side Effects Adverse Effects Drug Interactions Nursing Implications Patient Teaching
Sulfonamides p. 76-77
Action
Uses
Bactrim or Septra (sulfamethoxazole & trimethoprim) Action Bacteriostatic effect against a wide range of gram + & gram - micro-organisms by inhibiting folic acid synthesis Uses Acute and chronic UTIs Ulcerative colitis Pre- and post-op bowel surgery Otitis media
Sulfonamides
Adverse Reactions
Adverse Reactions Headache Drowsiness Fatigue Dizziness Vertigo Tinnitus Anaphylactic shock
Sulfonamides
Drug Interactions
Drug Interactions
Potentiate the effects of anticoagulants, methotrexate, sulfonylureas, thiazides, phenytoin
Decrease the effect of penicillin
Antacids decrease absorption of sulfonamides
