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NUR151-Antiinfective
NUR151 - Anti-Infectives
| Question | Answer |
|---|---|
| Aminoglycosides Action | Bactericidal - Effective against aerobic gram-negative infections and protozoal infections |
| Aminoglycosides uses | Bowel prep for surgery, Prevent absorption of ammonia in hepatic encephalopathy |
| Preferred route of aminoglycosides is | IV – oral is poorly absorbed |
| Never piggy back or mix Aminoglycosides with | other meds because it can interfere |
| Bleeding may increase because the aminoglycosides | decrease synthesis of vitamin K in the intestinal tract – normal flora are disrupted |
| How does Aminoglycosides interfere with synthesis of vit k? | kills off bacteria in the colon and this reduces amount of vit k |
| Adverse effects/toxicity of aminoglycosides | Nephrotoxicity and ototoxicity – wouldn’t want to mix with vancomyocin because they are both nephrotoxic |
| Superinfection | secondary infection caused by destruction of normal flora – Candidiasis, Pseudomembranous colitis – due to aminoglycosides |
| peak and trough levels are drawn from blood to make sure | they are receiving therapeutic levels of the drug. |
| Peak drug level | blood specimen drawn 15 – 30 min. after IV infusion is completed – drawn after |
| Trough drug level | blood specimen drawn immediately prior to next IV infusion |
| Serum creatinine and blood urea nitrogen (BUN) to monitor | renal function |
| WBC count | tells if infection is being controlled or not |
| Differential | neutrophils are monitored as well as bands – should decline |
| Empiric therapy | propholactic – broad spectrum is started until causative organism identified |
| How much water to drink daily with aminoglycosides? | 2-3 liters per day |
| Cephalosporins Action | Bactericidal, Structurally and chemically related to penicillins, Cross-sensitivity may occur between the penicillins and cephalosporins |
| First through third generations of cephalosporins good against | gram-negative organisms |
| Fourth generation of cephalosporins good for | increased activity against gram-positive cocci and gram negative bacilli |
| Uses for cephalosporins | STDs, Respiratory infections, Urinary tract infections and skin/tissue infections, Used prophylactically and therapeutically in ortho disorders, Endocarditis |
| Administer cephalosporins how? | Administer PO with food or milk if complains of gastric irritation |
| Monitor what side effects of cephalosporins | lethargy, hallucinations, anxiety, depression, N/V, anemia, - Pseudomembranous colitis (super infection) |
| Biggest side effect of cephalosporins | renal toxicity |
| Monitor for superinfections | thrush in mouth, yeast infections |
| What delays absorption of cephalosporins orally | If patient receiving H2, iron supplements, antiacids - 2 hrs before or after – same with bread |
| Fluoroquinolones Action | Broad-spectrum bactericidal antibiotics, Used against gram – and gram + organisms |
| Use of Fluoroquinolones | Lower respiratory infections, sinusitis, bone & joint infections, soft tissue infections, abdominal infections |
| Fluoroguinolones are not given with | food – better on empty stomach |
| Best absorption of fluoroguinolones | PO and IV are same |
| Fluoroguinolones interact with | Oral antacids, iron, zinc preparations |
| What do you want to monitor when giving antibiotics due to dead flora | Monitor PT, INR |
| Antibiotic that causes photosensitivity | Fluoroguinolones -Wear sunglasses, long-sleeves and long legged garments – protect from direct sunlight |
| Macrolides and Lincosamides Action | Bacteriostatic (inhibiting the growth of bacteria) but can be bactericidal in high doses |
| Uses for Macrolides and Lincosamides | Lower respiratory tract infections, skin and soft tissue infections, syphilis, gonorrhea |
| Macrolides and Lincosamides side effects | Erythromycin – tears up stomach, NV, thrombophlibitis tendency (infection of IV site) – monitor IV site for infiltration |
| Vancomycin (Vancocin) Action | Bactericidal |
| Antibiotic of choice for methicillin-resistant Staphlococcus aureus (MRSA) and other gram positive bacteria, yeast, and fungi | vancomycin – vancocin |
| Oral use of Vancomycin | C Difficile |
| IV Vancomycin (vancocin) used for | Bone and joint infections or septicemia caused by staphlococcal organisms |
| IV side effects of Vancomycin | IV administration should be through a central line, causes phlebitis and can cause necrosis if extravasates |
| What labs to monitor for giving Vancomycin | Peak and Trough, Liver enzymes – ALT, AST, bilirubin, Kidney function |
| “Red neck (or man) syndrome” | too rapid IV Vancomycin infusion results in profound hypotension and erythematous rash - Nausea, hypotension, flushing |
| Extravasates | when tissue becomes necrotic |
| Ototoxicity is adverse effect of | vancomycin and aminoglycosides |
| Penicillins Action | Bactericidal, bacteriostatic - Gram positive organisms - derived from fungus or mold evidenced on bread or fruit |
| Use of penicillins | Pneumonia, upper respiratory infections, STD’s, prophylactically against endocarditis for oral, GI, pulmonary procedures when bacteria may enter circulation, used in beta-hemolytic streptococci Group A infections |
| Why larger PO dose than IM for penicillins | hepatic first-pass effect and the instability of PCN in a acidic environment |
| Penicillin Drug interactions | Loop & thiazide diuretics may exacerbate hypokalemia & rash, Decreased efficacy of oral contraceptives |
| Sulfonamides Action | First effective group of antibiotics (1935) – bacteriostatic |
| Use of sulfonamides | UTI, pneumonia, brain abscesses, ulcerative colitis, rheumatoid arthritis |
| Bactrim is a | sulfonamide |
| Nursing Implications for sulfonamides | Increase oral intake to promote urine output to prevent crystalluria/stone formation - Empty bladder every 2 hours – C & S |
| Alkoline/Ash diet is good to use with | sulfonamide - Fruits, except for plums, prunes, or cranberries, vegeies, milk |
| Stevens/Johnson syndrome (SJS) | type of rash that looks like 2nd degree burn – common with sulfonamides |
Created by:
Ladystorm