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52 Cards in this Set

  • Front
  • Back
Examples of Aminoglycosides? (5)
1. Gentamicin (Garamycin)
2. Neomycin
3. Streptomycin
4. Tobramycin (Tobrax)
5. Amikacin (Amikin)
Aminoglycoside actions
1. bacteriocidal
2. inhibits protein synthesis in GRAM - bacteria
Aminoglycoside indications
1. severe CNS inf
2. respiratory, GI, UT, bone, skin, soft tissue, PID
3. TB (streptomycin)*
Aminoglycoside side effects
1. ototox* (CN VIII)
2. nephrotox*
3. anoresia, N, V, D
Aminoglycoside nursing considerations
1. check hearing (CN VIII)
2. check renal fxn (BUN, CR)
3. rx for 7-10 days
4. encourage fluids
5. small, frequent meals
6. photosensitivity
What should you teach pt receiving aminoglycosides in relation to their ototoxic potential effects?
Immediately report: tinnitis, vertigo, nystagmus, ataxia
To make sure an aminoglycosid eis at a therapeutic level, what should you check?
1. peak: 2 h after med given
2. trough: at time of dose/prior to med
What should you do if an aminoglycoside is given long term?
Which aminoglycoside has opthalmic considerations? Describe admin
Neomycin sulfate (Neobiotic): remove infective exudate around eyes before admin of ointment
What is the potential side effect for opthalmic aminoglycoside?
hypersensitivity rxn
Give an example of each generation of cephalosporins (4)
1st gen: Cephalexin (Keflex)
2nd gen: Cefaclor (ceclor)
3rd gen: Ceftriaxone (Rocephin)
4th gen: Cefepime (Maxipime)
MOA of cephalosporins (2)?
1. bacteriocidal
2. inhibit syn of bacterial cell wall
Cephalosporin indications?
1. pharyngitis, tonsilitis
2. otitis media
3. upper and lower RTI
4. derm inf
6. septicemia
7. meningitis
8. periop prophylaxis
9. UTI
Side effects of cephalosporins?
1. ab pain, N, V, D
2. increased risk of bleeding, hypoprothombinemia
3. rash
4. superinfection
5. thrombophlebitis (IV), abcess formation (IM, IV)
Nursing considerations for cephalosporins?
1. take w/ food*
2. admin in liquid form to kids (don't crush)
3. have vitamin K available for hypoprothrobinemia
4. cross allergy w/ PCN***
5. monitor renal and hepatic fxn
6. monitor for thrombophlebitis
7. may cause a false + Coombs' test: looks for antibodies that may bind to your RBCs to cause premature hemolysis
3 examples of Fluroquinolones?
1. Ciprofloxacin (Cipro)
2. Levofloxacin (Levequin)
3. Norfloxacin (Noroxin)
Actions of fluroquinolones?
1. bactericidal
2. interferes w/ DNA replication of GRAM - bacteria
Indications for fluroquinolones (4)
1. tx of e. coli infections
2. chronic bacterial prostatitis
3. acute sinusitis
4. postexposure inhalation anthrax
Side effects of fluroquinolones?
1. seizures, headache
2. GI upset: N,D
3. rash
4. photosensitivity
5. achilles tendon rupture*
6. High: BUN, AST, ALT, serum CR, alkaline phosphate
7. low: WBC, Hct
Fluroquinolone nursing considerations?
1. culture & sensitivity before therapy begins
2. take 1 hr before or 2 hr after meals w/ water*
3. encourage fluids
4. if needed give antacids or Fe prep 2 hr after meds
5. take full course
6. avoid caffeine
7. CI in kids less than 18*
Example of a glycopeptide?
Vancomycin (Vancocin)
MOAs of glycopeptide (Vancomycin)
1. bacteriocidal
2. binds to bacterial cell wall and stops synthesis
Indications for vancomycin (a glycopeptide)
1. resistant staph inf
2. pseudomembranous enterocolitis r/t c. diff
Glycopeptide side effects?
1. liver tox
2. thrombophlebitis, abcess formation
3. nephrotox
4. ototox
Nursing considerations for glycopeptides?
1. monitor renal fxn & hearing
2. poor absorption orally**
3. administer IV*: peak 5 min, doa 12-24 hr
4. avoid extravation during therapy (it may cause necrosis)
5. give anti-histamine if RED MAN SYNDROME devo*
6. contact HCP if signs of superinfection
S&S of red man syndrome?
low BP, flusing of face & neck
Give an example of the Lincosamides
Clindamycin HCl Phosphate (Cleocin)
MOA of lincosamides like clindamycin
1. BOTH bacteriostatic & bactericidal *
2. suppresses protein syn by preventing peptide bond formation
Lincosamide indications?
1. staph
2. strep
Side effects of Lincosamides?
1. D, N
2. rash
3. liver tox
4. vaginitis
5. colitis may occur 2-9 days or several weeks after starting meds
Nursing considerations for Lincosamides?
1. admin PO med w/ full glass of water to prevent esophageal ulcers
2. monitor for persistent V, D, fever, ab pain, cramping, superinfections
Give 2 examples of Macrolides?
1. Erythromycin (Erythrocin)
2. Azethromycin (Zithromax)
Actions of Macrolides?
1. bacteriostatic AND bactericidal
2. binds to cell membrane and causes change in protein fxn
Macrolide Indications?
1. acute infection
2. acne, skin inf
4. prophylaxis before dental procedures for pt allergic to PCN and w/ valvular heart disease*
Macrolide side effects?
1. GI: ab cramps, D, N
2. CNS: confusion, uncontrollable emotions
3. hepatotox
4. superinfections
Macrolide nursing considerations?
1. can be used in pt w/ renal dysfxn because they are primarily excreted through the bile
2. monitor liver fxn
3. take around the clock to max effectiveness
4. take PO 1 hr before or 2-3 hr after meals w/ full glass of water
Give examples of PCNs (6)
1. Amoxicillin (Amoxil)
2. Ampicillin (Omnipen)
3. Methicillin
4. Nafcillin (unipen)
5. PCN G
6. PCN V
PCN actions
1. bactericidal
2. inhibit cell wall syn
indications for PCN?
1. effective against GRAM + orgs
2. moderate-severe inf tx
5. lyme dz
PCN side effects
1. glossitis, stomatitis
2. gastritis, D
3. superinfection
4. hypersensitivity, skin rashes
5. renal, hepatic, heme abnormalities
PCN nursing considerations.
1. obtain C&S before first dose
2. take careful hx of PCN rxn
3. observe for 20 min post-inj
4. give 1-2 hr ac or 2-3 h pc to reduce gastric acid during drug destruction
5. monitor for loose, foul-smelling stool & change in tongue
6. check for hypersensitivity to ther drugs, esp cephalosporins!
7. monitor serum electrolytes & cardiac status if given IV
8. monitor and rotate injection sites
9. good mouth care
10. yogurt or buttermilk helps D
3 examples of Sulfonamides?
1. Sulfisoxazole (Gentrisin)
2. Sulfasalazine (Azulfidine)
3. Trimethoprim/Sulfamethoxazole (Bactrim, Septra)
Actions of Sulfonamides
1. bacteriostatic
2. competitively antagonizes paraminobenzoic acid (essential component of folic acid synthesis)-->causes cell death
Indications for Sulfonamides (7)
1. UC, Chron's dz
2. otitis media
3. conjunctivitis
4. meningitis
5. toxoplasmosis
6. UTIs
7. rheumatoid arthritis
Sulfonamide side effects
1. peripheral neuropathy
2. crystalluria, proteinuria
3. photosensitivity
4. GI upset
5. stomatitis
NC for Sulfonamides
1. C&S before therapy
2. take on EMPTY stomach w/ a full glass of water
3. take around the clock
4. encourage fluid intake (8 glasses of water/day--3000mL/day)
5. protect from sun exposure
6. good mouth care
7. avoid vitamin C (which acidifies urine)--bicarbonate may be indicated to elevate urine pH
Special considerations for Bactrim in terms of administration?
IV solution must be given slowly over 60-90 minutes

3 examples of Tetracyclines
1. Doxycycline (Vibramycin)
2. Minocycline (Minocin)
3. Tetracycline HCl (Panmycin)
Actions of Tetracyclines (2)
1. bacteriostatic
2. inhibits protein synthesis of susceptible bacteria
Indications for Tetracyclines
1. STIs: syphilis, chlamydia, gonorrhea
2. malaria prophylaxis
3. chronic peridontitis
4. acne
5. tx of anthrax (Vibramycin)
6. part of combo therapy for H. pylori inf
7. tetracycline: drug of choice for stage 1 Lyme dz
Side effects of tetracyclines:
1. photosensitivity
2. discoloration of deciduous *baby* teeth, enamel hypoplasia, discoloration and inadequate calcification of primary teeth of fetus if taken during pregnancy
3. glossitis, dysphagia
4. D, renal, hepatic, hematological abnl
5. rash, superinfections
NC for tetracyclines
1. take 1 h before or 2-3 h after meals
2. do NOT take w/ antacids, milk, iron preps (give 3 hr after med)--foods high in ca interfere w/ absorption
3. good oral hygiene
4. avoid during tooth and early devo periods (4th mo prenatal to 8 years of age)
5. monitor I&O
6. avoid sun exposure
7. look at expiration date: nephotoxic w/ age and exposure to sun light
8. topical applications may stain clothes