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84 Cards in this Set
- Front
- Back
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Carbapenems
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Beta-lactam antibiotics
Broad spectrum antimicrobial spectrum IV or IM Types: Imipenem (Primaxin) [prototype] Meropenem (Merrem IV) Doripenem (Doribax) Ertapenem (Invanz) |
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Carbapenem Pharmacological Action
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Destroy bacterial cell walls causing destruction of microorganisms
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Carbapenems Therapeutic Uses
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Serious infections
Pneumonia Peritonitis UTIs |
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Carbapenems Adverse Effects
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Allergy/hypersensitivity (rashes, pruitis, drug fever)
GI effects Suprainfection |
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Carbapenems Nursing Interventions
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Monitor for rashes, pruritus, and drug fever
Observe for symptoms, notify HCP Monitor I&Os Monitor for signs if colitis (diarrhea, oral thrush, or vaginal yeast infection) |
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Cephalosporins Nursing Interventions
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I&Os
Instruct client not to consume alcohol Instruct client to take with food Instruct client to take full dose Administer IM deep in large muscle IV administration can be a bolus or IV push (over 3-5 min) |
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Penicillin Action
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Alter cell permeability
Inhibit synthesis Block RNA & DNA transfer Interfere with metabolism Inhibit protein synthesis |
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Penicillin Prototype
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Penicillin G (Bicillin LA)
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Broad-spectrum Penicillins
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Amoxicillin-clavulanate (Augmentin)
Ampicillin (Principen) |
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Antidtapgylococcal Penicillins
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Nafcillin (Unipen)
Methicillin |
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Antipseudomonas Penicillins
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Carbenicillin (Geocillin)
Ticarcillin-clavulanate (Timentin) Piperacillin tazobactam (Zosyn) |
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Broad Spectrum Antibiotics
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Effective against a wide variety if microorganisms
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Narrow Spectrum Antibiotics
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Effective against a few species of microorganisms including gram positive or gram negative
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Penicillin Therapeutic Uses
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Otitis media
Sinusitis UTIs Pneumonia Meningitis Gonorrhea Syphillis Bacterial endocarditis |
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Penicillin Nursing Interventions
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Interview client for allergy
Advise clients to wear allergy ID Observe client for 30 min after administration of Parenteral penicillin |
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Monobactams
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Prototype: Vancomycin (Vancocin)
This is a potentially toxic drug used only for serious infections Aztreonam (Azactam) Fosdimycin (Monuroo) |
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Penicillins Side Effects
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Superinfection (normal microbial flora disturbed)
Renal impairment Hyperkalemia/dysrhythmias |
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Nursing Actions for Penicillin Side Effects
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Instruct client to ingest buttermilk or yogurt
Monitor I&O Monitor cardiac and electrolyte levels |
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Monobactams Therapeutic Uses
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MRSA
Staph epidermidis |
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Monobactams Adverse Effects
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Ototoxicity
Infusion reactions (rashes, flushing, and hypotension) Red man syndrome Theombophlebitis |
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Monobactam Nursing Interventions
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Monitoring for hearing changes
Monitor vanco levels Administer vanco slowly over 60 min Rotate injection sites Monitor for redness, swelling, and inflammation |
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Cephalosporins
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Bactericidal with actions similar to penicillin
Prototype: Cephalexin (Keflex) (1st gen.) 2nd gen. Cenfaclor (Ceclor), Cefotetan (Cefotan) 3rd gen. Ceftriaxone (Rocephin), Cefotaxime (Claforan), Cefoperazone (Cefobid) 4th gen. Cefepime (Maxipime) |
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Chepalosporins Therapeutic Action
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Approximately 10% of people allergic to penicillin can be allergic to cephalosporins
Used for: UTIs Postop infections Pelvic infections Meningitis Ear infections Bone and joint infections |
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Cephalosporin Administration
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Cannot be absorbed through GI
Administer IM or IV Only 10 drugs can be given orally |
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Cephalosporins Adverse Effects
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(Usually well tolerated, one of the safest antimicrobial groups)
Allergic reactions Bleeding Thrombophlebitis Pain at site of IM injection |
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Cephalosporins Interactions
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Probenecid - delays renal excretion
Alcohol - Cefotetan causes intolerance to alcohol |
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TB Drugs
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Prototype: Isoniazide (INH)
Pyrazinamide (PZA) Ethambutol (Myambutol) bacteria static only to M. tuberculosis |
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TB Drugs
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Prototype: Isoniazide (INH)
Pyrazinamide (PZA) Ethambutol (Myambutol) bacteria static only to M. tuberculosis |
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Mycobacterial (TB) Action
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Inhibits growth by preventing synthesis of mycolic acid in cell wall
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Mycobacterial (TB) Therapeutic Uses
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Active and latent TB
Active phase (multiple med therapy that includes INH) Latent phase (INH only) |
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Isoniazid (INH) Adverse Effects
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Peripheral neuropathy (tingling, numbness, and pain resulting from deficiency in pyridoxine and Vit. B)
Hepatotoxicity (anorexia, malaise, fatigues, nausea, and yellowish skin/eyes) |
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INH Nursing Interventions
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Instruct client to take 50-200mg of Vit. B6 daily
Monitor liver function tests Avoid alcohol Discontinue if liver tests are elevated |
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INH Interactions
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Inhibits metabolism of phenytoin (can lead to toxicity)
Concurrent use of alcohol, rifampin, and ptrazinamide increases the risk of Hepatotoxicity Monitor phenytoin levels Avoid alcohol |
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INH Administration
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Take 1 hr before meals or 2 hrs after
If GI discomfort take with meals Take full corse, don't skip a dose |
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Antimycobacterial
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Prototype: Rifampin (Rifadin)
Therapeutic Uses: Broad spectrum antibiotic |
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Rifadin Nursing Interventions
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Tell client to expect orange colored urine, saliva, sweat, and tears
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Rifampin Considerations
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Accelerate metabolism of: Coumadin, oral contraceptive, and HIV meds
Monitor PT and INR |
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Antiprotozoals
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Prototype: Metronidazole (Flagyl)
Impairs DNA function Therapeutic Uses: Intestinal amebiasis Trich Inflammatory bowel Prophylaxis for surgery Treat H. pylori |
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Flagyl Complications
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GI discomfort (dry mouth, metallic taste)
Dark urine CNS symptoms (numb extremities, seizures, ataxia) |
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Flagyl Nursing Interventions
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Tell client dark urine is harmless
Stop if CNS symptoms are present |
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Flagyl Interactions
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Alcohol - disulfiram reaction:
Facial flushing, sever headache, tachycardia, palpitations, hypotension, slurred speech Warfarin: monitor Pt and INR |
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Antifungals
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Prototype: Amphotericin B deoxycholate (Fungizone)
Ketoconazole (Nizoral) an azole Action: destroys fungus Uses: Histoplasmosis Blastomycosis Candidias Tinea pedis Fungal infection of nails |
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Antifungals
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Prototype: Amphotericin B deoxycholate (Fungizone)
Ketoconazole (Nizoral) an azole Action: destroys fungus Uses: Histoplasmosis Blastomycosis Candidias Tinea pedis Fungal infection of nails |
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Amphotericin B Complications
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Infusion reaction (fever, chills, rigors, headache)
Thrombophlebitis Nephrotoxicity Hypokalemia Bone marrow suppression |
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Antifungals
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Prototype: Amphotericin B deoxycholate (Fungizone)
Ketoconazole (Nizoral) an azole Action: destroys fungus Uses: Histoplasmosis Blastomycosis Candidias Tinea pedis Fungal infection of nails |
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Amphotericin B Complications
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Infusion reaction (fever, chills, rigors, headache)
Thrombophlebitis Nephrotoxicity Hypokalemia Bone marrow suppression |
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Amphotericin B Nursing Interventions
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Pretreat with diphenhydramine, Tylenol, and hydrocortisone
Monitor IV or IM site for pain, erythema, swelling Monitor kidney function (BUN and creatinine) Infuse normal saline Monitor lab, electrolytes, CBC, and Hct. |
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Antifungals
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Prototype: Amphotericin B deoxycholate (Fungizone)
Ketoconazole (Nizoral) an azole Action: destroys fungus Uses: Histoplasmosis Blastomycosis Candidias Tinea pedis Fungal infection of nails |
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Amphotericin B Complications
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Infusion reaction (fever, chills, rigors, headache)
Thrombophlebitis Nephrotoxicity Hypokalemia Bone marrow suppression |
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Amphotericin B Nursing Interventions
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Pretreat with diphenhydramine, Tylenol, and hydrocortisone
Monitor IV or IM site for pain, erythema, swelling Monitor kidney function (BUN and creatinine) Infuse normal saline Monitor lab, electrolytes, CBC, and Hct. |
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Ketoconazole Complications
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Hepatotoxicity
Effects on sex hormones: Males - gynecomastia, decreased libido, ED Females - irrgular menstrual flow |
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Antifungals
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Prototype: Amphotericin B deoxycholate (Fungizone)
Ketoconazole (Nizoral) an azole Action: destroys fungus Uses: Histoplasmosis Blastomycosis Candidias Tinea pedis Fungal infection of nails |
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Amphotericin B Complications
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Infusion reaction (fever, chills, rigors, headache)
Thrombophlebitis Nephrotoxicity Hypokalemia Bone marrow suppression |
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Amphotericin B Nursing Interventions
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Pretreat with diphenhydramine, Tylenol, and hydrocortisone
Infuse over 2-4 hrs Monitor IV or IM site for pain, erythema, swelling Monitor kidney function (BUN and creatinine) Infuse normal saline Monitor lab, electrolytes, CBC, and Hct. |
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Ketoconazole Complications
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Hepatotoxicity
Effects on sex hormones: Males - gynecomastia, decreased libido, ED Females - irrgular menstrual flow |
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Ketoconazole Nursing Interventions
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Monitor baseline liver tests
If symptoms occur, DC and notify HCP |
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Antiviral Medications
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alter viral replication
ineffective when virus is dormant HIV is a retovirus antiretroviral agents treat HIV infections |
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Entery/Infusion Inhibitors
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Prototype: Enfuvirtide (Fuzoen) (subcutaneous)
Action: limits spread of HIV Uses: HIV |
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Entry/Infusion Inhibitors Adverse Effects
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Reaction (localized)
Bacterial pneumonia Fever, chills, rash, hypotension |
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Entry/Infusion Inhibitors Nursing Interventions
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Rotate sites
Assess breath sounds before Monitor for fever, cough, shortness of breath, and rash (notify HCP) |
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Nuceloside Reverse Transcriptase Inhibitors (NRTIs)
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Prototype: Zidovudine (Retrovir)
Others: Didanosine (Videx) Stavudine (Zerit) Lamivudine (Epivir) Abacavir (Ziagen) Action: inhibits DNA synthesis Uses: HIV |
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NRTIs Adverse Effects
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Suppressed bone marrow
lactic acidosis hepatomegaly/fatty liver |
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NRTIs Nursing Interventions
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Monitor CBC and platelets
Monitor symptoms of lactic acidosis (hyperventilation, nausea, abdominal pain) Take with food Monitor I&O Monitor liver enzymes |
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Non-nuceloside Reverse Transcriptase Inhibitors (NNRTIs)
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Prototype: Delavirdine (Rescriptor), Efavirenz (Sustiva)
Others: Nevirapine (Viramune), Etravirine (Intelence) Action: act directly on RNA to HIV replication Uses: HIV |
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NNRTIs Adverse Effects
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Rash which may be serious and lead to Stevens-Johnson Syndrome
Flu-like symptoms, headache, fatigue |
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NNRTIs Nursing Interventions
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Monitor for rash (treat with benadryl)
Notify HCP of fever or blistering Monitor for adverse reactions, encourage rest and adequate oral fluid intake |
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Protease Inhibitors
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Prototype: Ritonavir (Norvir)
Others: Saquinavir (Invirase), Indinavir (Crixivan), Amprenavir (Agenerase), Nelfinavir (Viracept) Action: acts against HIV-1 and HIV-2 to alter and inactivate virus Uses: HIV Oral route |
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Antiviral Prototype
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Acyclovir (Zovirax): Oral, topical
Ganciclovir (Cytovene): Oral, IV Other meds: Inteferon alpha-2b Lamivudine (Epivir) Oseltamivir (Tamiflu) Ribavirin (Rebetol) Amantoadine (Symmetrel) |
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Protease Inhibitors Adverse Effects
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Hyperglycemia
Hypersenitivity Elevated serum lipids Thrombocytopenia |
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Protease Inhibitors Nursing Interventions
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Monitor serum glucose
Monitor for rash, notify HCP take with food to reduce GI effects and increase absorption Monitor CBC Monitor for signs of infection (fever, sore throat) Monitor for bleeding (blood in stool, bruising) |
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Antiviral Expected Action
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prevents reproduction of viral DNA, which results in interruption of cell replication
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Antiviral Therapeutic Uses
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Herpes Simplex
Varicella-zoster viruses Cytomegalovirus (CMV) Hepatitis Influenze A & B RSV and inluenza |
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Acyclovir Adverse Effects
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Phlebitis and inflammation
nephrotoxicity mild discomfort associated with oral therapy (nausea, headache, diarrhea) |
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Acyclovir Nursing Interventions
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Rotate IV sites
Monitor IV for welling and redness Administer slowly Provide adequate hydration for client during infusion and 2hr after Increase fluid intake Monitor symptoms of discomfort and notify HCP |
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Ganciclovir Adverse Effects
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Granulocytopenia
Thrombocytopenia |
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Ganciclovir Nursing Interventions
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Obtain baseline CBC and platelet count
Administer granulocyte colony-stimulating factors Monitor WBC |
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Acyclovir Administration
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Wear gloves with topical
Administer IV slowly Inform client that medication will only relieve not cure symptoms Wash infected area with soap ad water 3-4 daily Refrain from sexual contact while lesions are present |
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Ganciclovir Administration
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Administer slowing IV
Oral with food Complete prescribed course |
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Drugs to treat UTIs
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Sulfonamides
Teimethiprim Urinaty antiseptics Penicillins Amino glycosides Cephalosporins Fluoroquinolones Prototype: Trimethoprim-sulfamethoxazole (TMP-SMZ, Bactrim) Co-trimoxozole (Cotrim, Septra) |
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UTI med adverse effects
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Hypersenitivity
Seven-Johnson syndrome |
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UTI med adverse effects
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Hypersenitivity
Seven-Johnson syndrome Kernicterus (jaundice, increased bilirubin) Photosensitivity |
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UTI med Nursing Interventions
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Do not administer TMP-SMZ to clients allergic to:
Sulfonamides Thiazides diuretics (HCTZ) Sulfunylurea-type oral hypoglycemics (tobutamide) Lois diuretics (Lasix) Stop TMP-SMZ at the first indication of hypersensitivity such as rash |
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Cirprofloxacin uses
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Urinary
Respiratory GI Bone, joint Skin and soft tissue Prevents anthrax in client who inhale it |
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Cipro Adverse Effects
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GI
Achilles' tendon rupture Supra infection (thrush, yeast) |
