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Pharmacology: Antiinfectives
2 months; 4-7 months - ANSDuration of administration of first line line TB drugs; duration of second line TB drugs 6 months to 1 year - ANSduration of prophylaxis for TB alcohol, rifampin, phenytoin - ANSdrugs that increase effect of isoniazid (INH) Alcoholics, debilitated individuals, immunocompromised, living in close quarters - ANSRisk factors for TB allergy to sulfa, allergy to thiazides, kidney disease - ANSContraindications for sulfonamides Aminoglycoside - ANSGentamycin, Tobramycin, Kanamycin sulfate, Neomycin sulate, Steptomycin Sulfate antacids - ANSFluroquinolones should not be taken with what? Antihelmintic - ANSUsed to treat worms (roundworms, pinworms, tapeworms, etc.). Mebendazole (Vermox). Antimuscarinic, antisposmodic - ANSClass of Tolterodine tartrate. Antiretroviral therapy (ART) - ANSinhibit viral replication by interfering with HIV viral ........... Antitubercular drugs - ANSdrugs used to treat infections caused by Mycobacterium bacterial species Bacitracin - ANSinterferes with the transport of peptidoglycan precursors across the cytoplasmic membrane Bacitracin - ANStopical application; works against gram-positives Bacitracin - ANSUsed to differentiate Streptococcus pyogenes from other streptococcal species (usually Streptococcus agalactiae) S. pyogenes is sensitive (BS) to bacitracin, while other strep are resistant (BR) backup birth control method - ANSWhat should women on birth control medication do when taking antibiotics, especially fluroquinolones
blood, semen, vaginal secretions, breast milk - ANSbody fluids that transmit HIV CD4 T helper cells - ANSDestruction of what cells by HIV results in immune deficiency? Cefoxitin, Cefalexin - ANSCephalosporin trade names cephalosporin - ANS-broad spectrum -ceph/cefs -Similar to PCN/ don't give if PCN allergy -Interactions-alcohol taken with med causes N/VContraindications-allergy to PCN; renal failureNursing Implications-review allergiesCommonly used names-Cef-ox-i-tin, Cef-a- lex-in Cephalosporins - ANSinhibit cell wall synthesis; broad spectrum antibiotic- treats gram positive and gram negative bacteria check for allergies, monitor BUN/creatine, peak and trough levels - ANSNursing implications for aminoglycosides (gentamycin, amikacin, tobramycin, streptomycin Colistimethate - ANSColy-Mycin M; used to treat bacterial infection, especially Pseudomonas aeruginosa, CRE, Klebsiella, Shigella crystalluria, proteinuria, hematuria - ANSSide effects of sulfonamides culture and sensitivity test - ANSLaboratory technique for finding out which, if any, microbes are present and which antibiotic will be effective against a specific pathogen Cystitis - ANSinflammation of the urinary bladder droplets - ANSHow is TB transmitted? E. coli, Klebsiella, Proteus, Psudomonas, Staph....... - ANSCausitive agents of cystitis egg allergy - ANSCI influenza and yellow fever vaccine; egg protein in these vaccine cause immediate type hypersensitivity reactions. empty stomach, full glass of water, avoid sunlight - ANSPatient teaching points for tetracycline Erythromycin - ANSan antibiotic used in the treatment of infections caused by Gram- positive bacteria. It is similar in its effects to penicillin. Belongs to macrolide group. facial flushing, sweating, severe headache, slurred speech, dark urine - ANSside effects of metronidazole
Metronidazole (Flagyl) - ANSclass: anti-infectives, antiprotozoals, antiulcer agents Indication: intra-abdominal infections, gynecological infections, skin infections, bone and joint infections, CNS infections, septicemia, endocarditis, amebic liver abscess, peptic ulcer disease Action: Inhibits DNA and protein synthesis in bacteria, bactericidal Nursing Considerations:
- do not take with alcohol-disulfiram reaction
- assess for infection before and during treatment
- obtain cultures before therapy
- monitor neurologic status: parasthesia, weakness, ataxia, or seizures
- monitor intake and output, daily weights
- may alter liver enzyme tests metronidazole (flagyl) - ANS1. Used to treat anaerobic infections
- DO NOT USED ALCOHOL (antabuse effect will be nauseous) microlides - ANSInhibit protein synthesis, bacteriostatic, derived from streptomysis erythromycin most common microlide can kill penicillin resistant pneumonia milk, iron, antacids - ANStetracyclines should not be taken with what? myalgia, pharyngitis, fever, fatigue, arthralgia, night sweats, lymphdenopathy - ANSHIV early symptoms Mycobacterium tuberculosis - ANSacid-fast bacillus that causes Tuberculosis Nitrofurantoin (Macrobid) - ANSEffective against many gram-positive and gram-negative organisms, especially E. coli. Side effects/adverse reactions: anorexia, nausea, vomiting, abdominal pain, diarrhea Clostridium difficile-associated diarrhea Peripheral neuropathy, brown urine discoloration nitrofurantoin, methenamine, Trimethoprim-sulfamethoxazole, fluroquinolones - ANSUrinary Antiseptics/Antiinfectives and Antibiotics no alcohol, take on empty stomach - ANSTeaching for cephalosporins nystatin - ANSAntifungal agent; used to treat oral candidiasis and diaper rash Oral, IM - ANSadministration routes of isoniazid ototoxcity, renal function - ANSside effects of streptomycin Ototoxicity, Hepatotoxicity, Neprotoxicity - ANSSide effects of aminoglycosides
Ototoxicity, Nephrotoxicity - ANSSerious side effects of vancomycin Oxybutynin (Ditropan) - ANSGenitourinary Medication, Anticholinergic (reduces bladder spasms) peak - ANSBlood serum level of a drug 30 minutes to 1 hour after administration Penicillin allergy, Renal failure - ANSContraindications for cephalosporins Penicillin, cephlosporin allergies - ANScontraindications for penicillins Penicillins - ANSGroup of antibiotics that are often used to treat infections by gram- positive bacteria. Phenazopyridine (Pyridium) - ANSmay discolor urine orange (red-orange) Phenazopyridine (Pyridium) - ANSUrinary Tract Analgesic photosensitivity - ANSdermatological side effect of tetracycline Polymixins - ANSthis type of polypeptide antibiotic binds phospholipids and disrupts outer and inner membranes of gram negative bacteria (topical because of more general mode of action = toxic!) Polymyxins - ANSreplaced by aminoglycosides (less nephrotic) but now rediscovered for treating drug resistant strains. Treats Pseudomonas aeruginosa, Escherichia coli, Klebsiella, Shigella Postexposure prophylaxis (PEP) - ANSRecommended procedures to help prevent the development of blood-borne diseases after an exposure incident such as a needlestick injury. PPE for TB - ANSmask, gown, gloves, hepa filter pregnancy, lactating, children under 18 - ANSgroups who should not take fluoroquinolones pregnant women, children under 8; tooth staining - ANSContraindicated groups for tetracyclines. Why? red-orange body fluids - ANSside effect of rifampin report joint pain, avoid caffeine - ANSPatient teaching indications for fluoroquinolones sexual contact, direct blood contact, mother to child - ANSmodes of transmission of HIV
Zithromax, E-mycin, clarithromycin - ANSCommonly used types of microlides
