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Pharmacology Day2

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
Created by: 100000123616993



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