MOD 6 Antimicrobial Agents Flashcards by Michael Price

Work by preventing the bacterial from
building a strong protective cell wall
Most effective against bacteria that
divide rapidly and are usually found in
skin and mucus membranes,
respiratory tract, ear, bone and blood.
Always discuss allergies with pt before
administering medication
Monitor patient for 30 minutes after
medication administration

Beta-Lactam Antibacterials

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First true antibiotics
Very safe and effective
Used to treat: ear infections, pneumonia, meningitis, UTIs, syphilis, gonorrhea, and prophylactic before surgery or dental procedures
Refrigerate liquid forms of this medication
Side effects and adverse effects: Urticaria, pruritis, angioedemaSkin reactions including maculopapular eruptions, Stevens-Johnson syndrome, exfoliative dermatitis
Possible cross-sensitivity to cephalosporins (1-18%)

Penicillins

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penicillin g and penicillin v (natural penicillins)

methicillin, cloxacillin, dicloxacillin, nafcillin, oxacillin (penicillinase-resistant)

amoxicillin, ampicillin, bacampicillin (aminopenicillins)

carbenicillin, piperacillin, ticarcillin, mezlocillin (extended spectrum penicillins)

Penicillin antibiotics

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amoxicillin and clavulanic acid (Augmentin)
ticarcillin and clavulanic acid (Timentin)

Combination antibiotics

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structurally pharmacologically related to penicillins
bactericidal: interferes with bacterial cell wall synthesis
Broken down into generations – each progressive generation created to improve activity against bacteria.
ceftriaxone (Rocephin) - very long half-life, can be given once a day as an IV or IM dose. One IM dose can sometimes eradicate the infection
Don’t administer at the same time as antacids and or Iron supplements
Refrigerate liquid forms of this medication
Therapeutic uses: UTIs, respiratory infections, bacteremia, meningitis

Cephalosporins: ceftriaxone (Rocephin)

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Active against Aerobic gram-negative bacteria
Preserves normal flora in the intestines
Inhibits cell wall synthesis
Therapeutic Uses: Influenza, UTI
Side effects: Rash, d/n/v

Monobactams

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Bactericidal- Disrupts protein synthesis in bacteria
Not usually given orally
Very potent and have potentially serious toxicities, so they are reserved for more serious and life-threatening infections
Side effects: nausea, vomiting, rash, ototoxicity, nephrotoxicity
Used in the treatment of nosocomial infections: UTIs, Meningitis, burns, wound infections, septicemia
Before administering, check labs: BUN, Creatinine, check hearing before and daily during administration

Aminoglycosides: tobramycin (Tobramycin), gentamicin (Garamycin)

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Inhibits reproduction of bacteria
Excellent activity for gram-negative bacteria
Excellent oral absorption
Excreted in the kidneys
Therapeutic uses: Lower respiratory tract infections, infectious diarrhea, urinary tract infections
Side effects: Headache, dizziness, fatigue, insomnia, nausea, rash, photosensitivity
Cautious use in elderly
Check blood glucose levels frequently for pts who are diabetic
Can raise blood pressure and cause arrhythmias in cardiac patients
Give with plenty of fluids, recommended up to 3 liters a day

Fluoroquinolones (Quinolones) ciprofloxacin (Cipro), levofloxacin (Levaquin)

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These medications prevent bacteria from using protein to reproduce

Tetracyclines
Sulfonamides

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Should only be given to patients with a healthy immune system
Therapeutic Uses: acne, UTI, upper respiratory infections, pneumonia, meningitis, Rickettsia: Q fever, Rocky Mountain spotted fever, Lyme disease, Helicobacter pylori infections associated with peptic ulcer disease, gonorrhea and syphilis
Side Effects: Superinfections, especially candida, diarrhea, photosensitivity
Not to be given at the same time as Penicillin
Give dairy products 1 hour before or 2 hours after medication administration
Not to be used for children under the age of 8- causes teeth to discolor.

Tetracyclines: doxycycline (Vibramycin)

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Achieve high concentrations in the kidneys
May be combined with other antibiotics for enhanced potency (trimethoprim, erythromycin)
Bacteriostatic, inhibits the synthesis of folic acid
Therapeutic Uses: Upper respiratory infections, Urinary Tract infections
Before administering, check liver function tests
Side effects: Common cause of allergic reactions (fever followed by rash), photosensitivity
Contraindicated in patients with an allergy to sulfa antibiotics
Give with plenty of fluids

Sulfonamides: Bactrim Septra

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Bacteriostatic or bactericidal
Therapeutic Uses: common infections of skin and mucus membranes, wound infections, ear infections, upper respiratory infections
Used for patients allergic to penicillin
Side effects: Headache, Nausea, vomiting, diarrhea, photosensitivity
Many drug-drug interactions with Macrolides – Check medication list thoroughly
Decreases action of oral birth control
Take oral medication with food

Macrolides: Azithromycin, Erythromycin

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Similar in action to Macrolides
Used to treat infections caused by multiple organisms
Well absorbed orally
Take with a full glass of water to avoid esophageal irritation

Clindamycin: Cleocin

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Antibiotic that also has some antiprotozoal and anthelmintic activity.
Varied range of treatments for many diseases
Available in oral and parenteral routes
May leave a metallic taste in the mouth
Do not drink alcohol with this medication. May cause severe nausea and vomiting. Some patients may avoid cough syrup and mouthwash
Side effects: Nausea, vomiting, headache, dizziness, rash, leukopenia
Give with food
Urine may turn dark

Metronidazole (Flagyl)

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Used for severe infections such as Sepsis, endocarditis, abscesses, multiple bacteria infections
Peak and Trough necessary for management of therapeutic index
“red man syndrome”

Vancomycin

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used to suppress herpes simplex type 1 and 2 infections, Varicella- zoster virus (Chicken Pox and Shingles)
Inhibits viral cell replication
Available in oral, topical, and parenteral formulas
Contraindicated in patients who are allergic
Give with lots of water
Side Effects: nausea, vomiting, diarrhea, headache, burning when applied topically.

Acyclovir (Zovirax)

Acyclovir

Anti Viral Agents

Macrolides
Miscilaious

Anti-Infectives

Nystatin (Nystat, Mycostatin)
Amphotericin B
Fluconazole (Diflucan)
Griseofulvin

Antifungal Agents

Applied topically for candidal diaper rash
Treats oral and vaginal candidiasis (thrush, yeast infections)
Available in oral, topical, and powder
Side effects: nausea, vomiting, diarrhea, cramps
Local irritation may occur with topical ointment

Nystatin (Nystat, Mycostatin)

The agent of choice for treatment of severe systemic mycoses
Works synergistically with flucytosine to treat mycoses
Most patients who are given this med IV experience fever, chills, hypotension, malaise, joint and muscle pain, nausea, vomiting, and headache (Shake and Bake)
Because of side effects, most patients are pre-medicated with Tylenol (decrease fever), an antihistamine, and an antiemetic
Available in topical and IV routes

Amphotericin B

Less side effects of amphotericin B and works fairly well
Available in oral and IV routes
Side effects: Nausea, vomiting, diarrhea

Fluconazole (Diflucan)

Avoid taking during Pregnancy
Used to treat topical fungal infections,
tinea cruris, tinea corporis and tinea pedis
Available in oral and topical routes
Side effects: headache, GI discomfort, rash, blurred vision, transient hearing loss

Griseofulvin

Metronidazole (Flagyl)

Parasitic Infections

For prophylaxis, take once a week for 2 weeks before arriving in the malaria area, during the time spent in the area, and for 8 weeks after - Immediate attention needs to be sought if symptoms occur - Baseline Renal and Liver enzymes should be checked.

Antimalarial Agents

Chloroquine (Aralen) Mebendazole Permethrin (Elimite)

Antimalarial Agents

- Used to treat Malaria - Available in parenteral and oral routes - Side effects: diarrhea, nausea, alopecia, dizziness, rash, headache

Chloroquine (Aralen)

- Use for treatment of parasitic worms in the intestines - Administered orally - Vomiting may occur

Mebendazole

- First-line treatment of lice and scabies - Patient may complain of rash or dry skin with the use

Permethrin (Elimite)

Nursing Considerations for All Antibiotics

Take for the time specified, exactly as prescribed Take with water Watch for signs of superinfection The most common side effects are GI: nausea, vomiting, diarrhea Always inquire about drug allergies Not to be given in pregnancy or lactation without a doctor's approval If pt shows signs of an allergic reaction discontinue use immediately and contact prescriber