ANTIBIOTICS Flashcards
(13 cards)
Penicillin
Broad Sprectrum Antibiotic (has beta-lactam in its structure)
Ear & Throat Infections
Prototype: Amoxicillin
Weakens and destroys cell walls
Adverse: GI (N/V), Superinfections, Allergic (Rash/Hives, ANAPHYLAXIS)
Take w/ meals, call 911 for breathing difficulty
Contraindications: Penicillin allergy, hypersens. to procaine or benzathine
MAY REDUCE EFFECTIVENESS OF ORAL CONTRACEPTIVES
KEEP THE CLIENT UNDER OBSERVATION FOR 30 MINS POST ADMIN
Cephalosporins
Beta-lactam, broad spectrum
5 generations: Cef-
Each gen = better resistance to beta-lactamase
Work similarly to penicillin
BACTERICIDAL
Adverse: GI (N/V), Superinfections (CDAD), Allergic (Rash/Hives, Anaphylaxis)
Thrombophlebitis
CROSS SENSITIVITY TO PENICILLIN
Look for diarrhea, (CDAD), history of allergies to penicillin, PT/INR for cefotetan (bleeding), renal function
Take before meals
Contraindications: Penicillin allergy (anaphylaxis), Cef. allergy
Monobactams
Beta-lactam, narrow spectrum
OPTION FOR THOSE W/ PENICILLIN ALLERGY
Prototype: Aztreonam (-am)
Only effective against aerobic gram-negative
BACTERICIDAL
Adverse: IV site issues (pain, thrombophlebitis), GI (N/V, D), Superinfection (C. Diff infection risk)
Monitor IV Side and for watery/bloody diarrhea (C. Diff)
Rotate injection sites / administer slowly
Increased risk of side-effects in older adults
Carbapenems
Beta-lactam, broad spectrum
ONLY USE WHEN OTHER ANTIBIOTICS AREN’T EFFECTIVE (reduce resistance)
BACTERICIDAL
Prototype: Imipenem + Cilastatin
Other: Meropenem
IM or IV administration only
Adverse: GI, Thrombophlebitis, Seizure (especially w/ renal impairment)
LIMIT TO 10 DAYS TO PREVENT SIDE EFFECTS
Administer slowly to reduce N/V, monitor IV site
MONITOR RENAL FUNCTION AND SEIZURE HX - lowers seizure threshold
Vancomycin
non-beta lactam, treats MRSA
Prototype: Vancomycin
BACTERICIDAL
Adverse: Renal failure, INFUSION REACTIONS (TACHYCARDIA, HYPOTENSION, FLUSHING), Ototoxicity, Site irritation (thrombophlebitis)
Renal failure is dose dependent - MONITOR PEAK/TROUGH of drug/creatinine
NEVER ADMINISTER FASTER THAN 60 MINUTES
Report flushing, dizziness during infusion
Hearing impairment - increased ototoxicity risk
Aminoglycosides, NSAIDs, and diuretics increase toxicity/ototoxicity risk
Lipoglycopeptides
USED ON VANCOMYCIN-RES (VRE) AND MRSA
Prototype: Telavancin
Adverse: PROLONGED QT, Nephrotoxicity, Infusion reaction (tachycardia, hypotension, flushing)
Increased mortality rate in clients with severe renal impairment
Report infusion reactions (slow if needed), check BUN and creatinine (before and after), monitor ECG, avoid pregnancy
IV ONLY - ONCE DAILY OVER 60 MIN
Contraindications: Long QT, Left Ven. Hypertrophy, Pregnancy, Heart Failure, Pregnancy
Prolonged QT may lead to fatal arrythmias
Avoid concurrent heparin use (affects aPTT)
Tetrocyclines
Treats syphilis in penicillin-allergic clients
DO NOT GIVE TO KIDS <8 - CAUSES PERM. STAINING AND DISCOLORATION OF TEETH
Prototype: Tetracycline | Others: -cycline
Bacteriostatic
Adverse: GI Distress, Liver Toxicity, Superinfections (C. Diff), Photosensitivity
CAN LEAD TO PHOTOSENSITIVTY AND SEVERE SUNBURN - use sunscreen
RISK TO FETUS IN PREGNANY CLIENTS
DAIRY AND CALCIUM DECREASE ABSORPTION
Reduces effectives of oral contraceptives
Macrolides
Treat’s legionnaires disease, whooping cough, diphtheria
Prototype: Erythromycin
Bacteriostatic
Adverse: GI Upset, QT Prolongation, Ototoxicity,
INCREASES RISK OF CARDIAC ARRYTHMIAS (TORSADES DE POINTES)
Assess ECG
Take on an empty stomach w/ 8 oz of water
Report palpitations, fainting, dizziness
Contraindicated in patients with long QT syndrome
Precautions: Liver disease and electrolyte imbalance
Increases levels of warfarin, theophylline, and digoxin
Aminoglycosides
Narrow spectrum
Prototype: Gentamicin
Bactericidal (higher dose -> faster killing)
Adverse: Ototoxicity, Thrombophlebitis, Neuromuscular Blockage (-> Paralysis), NEPHROTOXICITY
OTOTOXICITY AND NEPHROTOXICITY IF BLOOD LEVEL EXCEEDS THERAP. RANGE
Monitor peak and trough level, kidney function, tinnitus / hearing loss, ensure adequate hydration
Administer via IM or IV (slow: 30-60min), monitor peak (30min) and trough (1 hr)
Contra: hearing loss, tinnitus, neuromuscular disorders
Risk of deafness in fetus for pregnant clients
Interactions: Ototoxic and nephrotoxic drugs (vancomycin, NSAIDs, diuretics)
Oxazolidinones
Broad spectrum
Treats MRSA and VRE (vancomycin and penicillin resistant)
Prototype: Linezolid
Adverse: ANEMIA, peripheral neuropathy, serotonin syndrome
Do NOT give to clients taking MAO inhibitors (-> hypertensive crisis)
MONITOR CBC FOR ANEMIA
WATCH FOR SEROTONIN SYNDROME (AGITATION, CONFUSION, SWEATING), check for neuropathy (tingling, numbness), monitor NA levels (hyponatremia)
Oral: Monitor in clients with PKU
Avoid foods high in tyramine, monitor blood sugar if diabetic
Contraindications: Uncontrolled hypertension
Precautions: Older adults and renal / liver impairment
Fluoroquinolones
Treats serious bacterial infections (severe UTI, anthrax)
AVOID IN CHILDREN UNDER 18 - ACHILLES TENDON RUPTURE
Prototype: Ciprofloxacin, other: -floxacin
Adverse: CNS (dizziness, headache), ACHILLES TENDON RUPTURE, photosensitivity (severe sunburn), QT prolongation,
ASSESS FOR TENDON PAIN, avoid sun exposure, test for CNS effects (confusion, suicidal idealation), monitor ECG for QT prolongation
IV - infuse over 60 minutes
Contraindication: Tendon pain, QT prolongation, possible exacerbation in clients with CNS disorders (seizures / depression)
Sulfonamides
Broad spectrum synthetic antibiotics
Treats UTIs
Prototype: Bactrim (Sulfamethoxazole-trimethoprim), other: Sulfadiazine
Bacteriostatic
Adverse: Hypersensitivity (STEVEN JOHNSON’S SYNDROME), blood disorders, crystalluria, photosensitivity
Steven Johnsons: Painful rash with blisters, fever and skin peeling
DRINK A LOT OF FLUIDS (1200-1500 ml), monitor for rash or hives, monitor CBC for blood disorders (pallor, fatigue, easy bruising)
Contraindications: pregnancy, breastfeeding, infants <2 mo, (can cause brain damage due to bilirubin accumulation), severe renal or liver impairment, anemia
Precautions: Sulfa allergy or allergy to similar drugs (thiazide diuretics, celecoxib), bone marrow suppression
Urinary Tract Antiseptics
Treats UTIs
Prototype: Nitrofurantoin (Macrobid, Macrodantin)
Bacteriostatic OR bactericidal depending on dose
Adverse: Urine discoloration - brown / orange (HARMLESS)
Pulmonary reactions (fever, cough, dyspnea) can cause permanent damage (fibrosis) if drug is not stopped
Encourage adequate hydration
Contraindicated in pregnancy (last 4 weeks), or newborns <1 mo (risk of anemia)
Precautions: Liver disease / electrolyte imbalance
