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Pharmacology Day2
| Question | Answer |
|---|---|
| Bactericidal/Bacteriostatic | Bactericidal agents are those that have a killing action on the microbial agents. Bacteriostaticare microbial agents that inhibit growth of bacteria allowing defenses to complete the job of destroying the organism. |
| Administering Antimicrobial Agents | Several antimicrobials lower oral contracepticefficacy Increase dosages of contraceptives or an alternative form of birth control |
| Health Teaching | Always instruct clients to complete the prescription of antibiotics to avoid the increasing numbers of the antibiotic resistance. |
| Health Teaching | A drawback in the use of broad spectrum agents is that it destroys the body normal microbial population called normal flora and enabling super infection to develop. |
| Sulfonimides | First group of antibiotics General action Bacteriostaticeffect Inhibit para-aminobenzoicacid (PABA) PABA is essential for bacterial growth Broad spectrum |
| Sulfonamides: Therapeutic Uses | Treatment of urinary tract infections Otitismedia Certain vaginal infections Some respiratory infections |
| Sulfonamides: Adverse Effects | Hypersensitivity Renal dysfunction Hematological changes |
| Sulfonamides-Nursing Implications | 1.Monitor for development of hypersensitivity reactions especially for clients with severe allergies or bronchial asthma. 2.Instruct client to see the MD, ASAP if client has sore throat, fever and jaundice. 3.Must increase fluid intake, 4.Must complete |
| Sulfonamides: Nursing Implications | Consume at least 1 liter of fluid/day Avoid sunlight and tanning beds Reduce the effectiveness of oral contraceptives Monitor for hemologicalchanges Check for CBC Check for Blood sugar Avoid food that will acidify urine like Vit.C |
| Penicillins | Inhibit synthesis of the bacterial cell wall Most effective on newly forming and actively growing cell walls Some of the penicillinsare rapidly destroyed in the stomach. Given IM or IV |
| Penicillins: Therapeutic Uses | Prevention and treatment of gram (+) bacterial infections: Enterococcus, Streptococcus, and Staphylococcusbacteria |
| Penicillins: Adverse Effects | Hypersensitivity is the most common; likely to occur in persons with history of allergies, breathing difficulty or both. GI Symptoms Neurotoxicity Renal dysfunction Dermatological symptoms like pruritus, urticariaand/or rash. |
| Penicillins Nursing Implications | Administer oral penicillin 1-2 hours before meals or 2-3 hours after meals. Extreme caution to clients with history of allergic reaction to penicillin when administering cephalosporin |
| Cephalosporin | Chemically and pharmacologically related to penicillins Action: prevent bacterial cell wall synthesis Either bactericidal or bacteriostatic |
| Cephalosporin | Treat infections of: Skin Bone Heart Blood Respiratory tract Gastrointestinal tract Urinary tract |
| Cephalosporins: Adverse Effects | Hypersensitivity Cross-sensitivity reaction to penicillin Extreme caution to clients with history of allergic reaction to penicillin when administering cephalosporin. Thrombophlebitis(when given IV) Sterile abscess (when given IM) |
| Cephalosporin-Adverse Effects | Nephrotoxicity Cephalosporin is capable of causing nephrotoxicity, more likely to occur in clients with history of renal impairment and to those receiving other nephrotoxicdrugs like the aminoglycosideantibiotics and the loop diuretics. |
| Tetracycline | Action: inhibit protein synthesis in the bacterial cell; bacteriostatic Broad spectrum Bacteria: gram –and gram + Effective against: protozoa, Mycoplasma, Rickettsia, Chlamydia, syphilis, Lyme disease |
| Tetracyclines: Nursing Implications | Bind to Ca2+, Mg2+, and Al3+ions and form insoluble complexes Do not give tetracycline with: Dairy products, antacids, or iron salts Avoid use with calcium supplements for it may reduce tetracycline absorption |
| Tetracyclines: Toxic Effects | Do not give to children. Affects tooth development * Fourth month of fetal development to 8 yrs. Old * Avoid use in children under 8 because of possible interference with the development of teeth and bones; and staining their teeth * Temporary and |
| Macrolides | Action Bacteriostatic: inhibits protein synthesis in the bacterial cell Primarily used for respiratory, gastrointestinal, urinary, skin, and soft tissue infections |
| Treatment with Macrolides | Treat both gram + and some gram –organisms Erythromycin: preferred (pertussis) Primarily metabolized by the liver and excreted in the urine |
| Macrolides-Adverse Effects | Hypersensitivity Gastrointestinal effects Hepatotoxicity Jaundice |
| Aminoglycosides | Poor oral absorption Given intravenously, not orally Action Bactericidal: inhibit cell wall protein synthesis Effective: gram –and some gram + Narrow therapeutic range Potent antibiotics with serious toxicities! |
| Aminoglycosides:Toxicities | Serious toxicities: caution Nephrotoxicity Ototoxicity Block neuromuscular action, which can lead to respiratory paralysis Monitor drug levels, both peak and trough |
| Fluoroquinolones | First oral antibiotics effective against gram-negative bacteria Excellent oral absorption |
| Treatment with Fluoroquinolones | Treat infections of: Lower respiratory tract Bone and joint Infectious diarrhea Urinary tract-genitourinary infections Skin Sexually transmitted diseases |
| Fluoroquinolones: Nursing Implications | Consume at least 1 liter of fluid/day Cinoxacin(Cinobac) is a urinary antiseptic and should be taken with meals to decrease incidence of GI side effects |
| Carbapenems | Action: Inhibit synthesis of the bacterial cell wall Broad spectrum Effective: Gram negative Gram positive Treat community acquired pneumonia |
| Carbapenems: Adverse Effects | Hypersensitivity Diarrhea Local reactions at intramuscular and intravenous sites |
| Carbapenems: Nursing Implications | Carbapenemsare contraindicated in clients with histories of anaphylactic reactions to penicillins, cephalosporinsand other beta-lactamantibiotics |
| Urinary Tract Anti-Infectives | Trimethoprim Most common Blocks the synthesis of folatein bacteria, thus inhibiting formation of nucleic acid and protein |
| Urinary Tract Analgesics | Phenazopyridinehydrochloride (Pyridium) is a urinary tract analgesic Must be taken after meals to reduce GI distress. It can cause reddish discoloration of urine and tears, and can stain undergarments and soft contact lens. |
| Urinary Tract Analgesics Nursing Implications | Nitrofurantoin Client must consume an acid ash diet. Advise client not to eat rhubarb for this will reduce the acidity of the urine. Urinary Retention Clients who are diagnosed with this and will be ordered to receive a subQdose of Bethanicolchloride |
| Isoniazid | INH Action: inhibits the synthesis of mycolicacid Adverse effects of INH Hepatotoxicity: jaundice Peripheral neuritis Use of pyridoxine (Vit.B6) prevents clients to develop peripheral neuropathy/peripheral neuritis. Nausea Skin rashes |
| Multiple Drug Therapy | Required: combination of two or three agents Helps prevent development of resistant strains Two meds are used to treat TB because clients tends to develop bacterial resistance when only one medication is used. |
| AntitubercularTherapy | Effectiveness depends on: Where Strain Effective drug combination Sufficient duration Effective drug compliance Most clients are non infectious following few weeks of therapy. Some individual metabolize isoniazidslowly and are known as slow a |
| Malaria | Malaria causes high morbidity and mortality Protozoa called Plasmodium Resides in the red blood cell of humans Signs and symptoms Fever, prostration, and recurrent chills |
| Transmission of Malaria | Malaria is transmitted by the bite of a female mosquito. Malaria is also transmitted via infected blood during blood transfusions. Injection/syringes infected with the organism. It enters the body and destroys blood cells. Has become more common |
| Other ProtozoalInfections | AmebiasisEntamoebahistolytica Contaminated food and drink Signs and symptoms: diarrhea Treatment: metronidazole(Flagyl) Trichomoniasis Sexually transmitted disease of the vagina Treatment: metronidazole(Flagyl) Clients should avoid alcohol w |
| Other Parasites | Lice and scabies are transmitted by infected articles, linens, bed, clothing and individual. Scabies is a highly contagious parasitic disorder caused by mites. Body lice is caused by pediculosiscorporis. Nits are louse eggs |
| Other Parasites | To irradicatelice and scabies: 1. Wash all clothes worn in hot water, Dry cleaned clothes must be placed in a plastic bag for 2 weeks. 2. Vacuum carpet and chairs 3. Wash and change all linens. Gamma Benzene Hexachlorideis another name for Lindane(Kw |
| Antiseptics and Disinfectants | Phenolicagents Alcohols and aldehydes Acids Iodine and iodophors Chlorine and chlorophors Mercury compounds Silver compounds Silver Sulfadiazine (silvadene) –treatment for burns. Surface-active agents Oxidizing agents Chlorhexidine |
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