Meds Flashcards
(7 cards)
Penicillin (action, what is specific about this drug, other drug names, works on what gram negative or positive bacteria, nursing considerations, prototype, adverse fx of prototype)
Prevent cell wall synthesis
Specific: has antibacterial: beta lactation ring; some bacteria secrete enzyme called beta-lactamase. Some ppl may develop superinfection: which causes inflammation to bowel wall followed by necrosis (C.DIFF)
Treats: pneumonia, meningitis, skin, bone, joint infection, stomach infection, heart valve and blood infection
Names:
narrow spectrum/penecilinase sensitive: penicillin G/V
Narrow spectrum/penicillinase resistant: cloxacillin
Broad spectrum: amoxillin, ampicillin
Most work effectively against gram positive bacteria
Monitor electrolyte, renal function, cardiac status (all have to do with increased lvls of sodium and potassium in penicillin) observe pt for first 30 mins, do not give cephalosporin if patient has penicillin allergy, take penicillin with meals, do not take with acidic juice, avoid use of penicillin in breastfeeding women, do not discontinue drug before prescription is done
Prototype: penicillin G- drug of choice for streptococci, pneumococci, and staphylococci
Adverse fx: anaphylaxis, pain at injection site, superinfection is possible, upset GI, renal disease can result to accumulation of drug, may decrease efficacy of oral contraceptives, potassium sparing diuretics may cause hyperkalemia if taken with penicillin g
Cephalosporin (action, what is specific about this drug, other drug names, works on what gram negative or positive bacteria, nursing considerations, prototype, adverse fx of prototype)
Inhibits cell wall synthesis
Specific: does nothing to MRSA or streptococcus pneumoniae, first gen is weak because it contains beta lactamase, second generation is broader in activity more resistant against lactamase, third gen is resistant to beta lactamase, third and fourth gen treats CNS infections by entering CSF
Names: first gen- cefadroxil, cephalexin. Second: cefotetan, cefaclor. Third gen: cefdinir, cefixime
Works on gram negative infection
Considerations: assess hx of bleeding disorders (cephalosporin reduces prothrombin lvls, thru interference of vit k metabolism) liver function should be monitored because it is responsible for vit k production, c&s, renal function because drug is excreted through the kidney (BUN and creatinine), intake and output, caution with pregnant/lactating women, eat cultured dairy products, avoid alcohol
Prototype: cefotaxime (third gen)- works against gram negative bacteria that have developed resistance to earlier gens of cephalosporin. Prescribed for severe lower respiratory tract infection, cns, genitourinary, bone, joint.
Adverse fx: pain at injection site, anaphylaxis, minor rash and itching, GI discomfort, cefotaxime interaction with probenecid reduces renal elimination of the drug, produces disulfiram rxn with alcohol, interacts with NSAIDS and increases platelet inhibition
Tetracycline (action, what is specific about this drug, other drug names, works on what gram negative or positive bacteria, nursing considerations, prototype, adverse fx of prototype)
Inhibits protein synthesis
Specific: treats Rocky Mountain spotted fever, Lyme disease, should be taken without food, causes GI distress- stays in GI longer so it destroys normal flora, do not take with milk or iron supplements, causes teeth discolouration
Drug: demeclocyline (declomycin), doxycycline (vibramycin), minocycline (miniocin)
Works on gram negative and gram positive, broad spectrum
Assess for history of acne vulgaris, actinomycosis, presence of diarrhea may indicate pseudomembranous colitis (PMC) by C.diff, c&s, decreases oral contraceptives, oral and perineal hygiene to decrease risk of superinfection development of candida
Prototype: tetracycline- works against gram negative and positive bacteria (chlamydiae, rikketsiae, and mycoplasma, short half life so given frequently
Adverse fx: disrupts oral, vaginal, intestinal flora. Irritates gastric mucosa causes GI distress and epigastric burning.
Macrolides (action, what is specific about this drug, other drug names, works on what gram negative or positive bacteria, nursing considerations, prototype, adverse fx of prototype)
Inhibits protein synthesis by binding to 50S ribosomal subunit, preventing movement of ribosome along messenger RNA, does not bind to human ribosome
Specific: treats streptococcus, H. Influenzae, mycoplasma pneumonia, chlamidya, considered to be one of the safest antibiotic drug class, causes less GI distress compared to ethrythromycin (macrolides were synthesized from this), have enteric coating (to be dissolved in intestine, fx of this drug is inactivated in stomach acid), metabolized by the liver, prevents the conversion of other drugs to its inactive form therefore causing toxicity of other drugs (dosage of their drugs should be reduced when taking macrolides)
Drug: azithromycin, clarithromycin
Works on gram positive bacteria
Warfarin drug interaction should be monitored (INR levels) may decrease excretion, should be used cautiously in ppl who are receiving cycloporine because it may cause nephrotoxcitiy, monitor enzyme tests for toxicity, do not take with fruit juices or OTC medication. Rashes
Erythromycin: enteric coated, works on gram positive bacteria, given to ppl with penicillin intolerance, for people with whooping cough and corynebacterium diphtheria
Adverse fx: abdominal cramping, GI distress, causes heptatotoxcity due to estolate form of drug
Aminoglycoside (action, what is specific about this drug, other drug names, works on what gram negative or positive bacteria, nursing considerations, prototype, adverse fx of prototype)
Inhibits protein synthesis by causing synthesis of abnormal proteins
Specific: treats TB, mycobacteria, protozoans, high risk of ototoxicity (tinnitus and hearing loss) and nephrotoxicity, may take up to 20 days after discontinuation to be excreted- remaining amounts may cause post antibiotic effect (antibody is still working), hearing impairment, vertigo, occurs in elderly adults and dehydrated clients, the most toxic
Drug: gentamincin, streptomincin
Works on aerobic gram positive bacteria
Assess for neuromuscular function, ototoxicity, nephrotoxicity, increase fluid intake, test for renal function and vestibular function, cautiously use for ppl taking anesthetic may cause neuromuscular blockage
Prototype:gentamicin- broad spectrum, used for serious urinary, respiratory, neurological, or GI infection. Parent ally or eyedrops
Adverse fx: hearing loss, balance issues, reduced kidney function (BUN and creatinine lvls)
Fluroquinolones (action, what is specific about this drug, other drug names, works on what gram negative or positive bacteria, nursing considerations, prototype, adverse fx of prototype)
Inhibits DNA replication
Specific: infections of respiratory, UTI, GI tracts, effective against tuberculosis
Drugs: ciprofloxacin, levoflaxin, moxifloxacin
Works on gram negative pathogen, new generations work more effectively against gram positive
Monitor WBC, liver and renal dysfunction, monitor urinary input and output of less than 1L in 24 hours, monitor signs of tendon pain or inflammation
Prototype: ciproflaxcin-inhibits bacterial DNA replication and repair, prescribed for respiratory infection, bone and joint infection, ophthalmic infection, sinusitis
Adverse fx: GI distress so give with food, caffeine should be restricting to avoid dizziness, do not take with antacids
Sulfonamides (action, what is specific about this drug, other drug names, works on what gram negative or positive bacteria, nursing considerations, prototype, adverse fx of prototype)
Inhibits folic acid synthesis in bacteria
Used to treat UTI, pneumonia,
