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50 Cards in this Set
- Front
- Back
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Anti-Infective's
- What they do, other types? |
- Fight infection
- Antibiotic, antiviral, anti-fungal all types - Not all infections require antibiotics, infections can also be caused by virus, fungus, parasites |
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Antibiotics
How do they work? |
-Med's that help your body fight infection
- some directly kill, some weaken, some are bacteriocidal, others are bacteriostatic. |
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Bacteriocidal
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kill bacteria
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Bacteriostatic
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inhibit growth
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Antibiotic Resistance
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-bacteria and viruses can learn how to survive an attack by antibiotics
- genetic material mutates to become stronger, normal flora gets used to med over/under used, bacteria may be attacked by virus, then as it multiplies it spreads the genetic material and passes resistance on. |
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Antiviral resistance
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- same issue as antibacterial
- has become a big problem in HIV therapy - develops in people who don't finish taking meds or their bodies can't help clean them out. |
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Resistant Organisms
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MRSA/VRSA- methicillian/vancomycin-resistant
VRE- vancomycin-resistant Enterococcus ORSA- oxacillin-resistant Staphylococcus aureus |
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Culture Sensitivity ( C & S)
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culture- growth of pathogen
Sensitivity- seeing what drug kills pathogen C&S is both, you must get sample first and then treat if no growth=nothing |
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General Adverse Effects to
Antibacterial Drugs |
Hypersensitivity
super-infection- over growth of bacteria: C. diff Organ Toxicity- Nephro and hepatotoxicity Anaphylaxsis- life threatening |
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Sulfonamide
* many bacteria are now resistant to sulfa agents |
- man made, used in combo with other antibiotics usually
- prevents synthesis of folic acid which stops bacteria from growing, but can't actually kill it. - Has more of tendency to produce allergic reactions |
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Therapeutic Uses of Sulfonamides
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- treatment of UTI - sulfa/trimethoprin-septra
- Otitis Media- ear infections - Certain vaginal infections - some respiratory infections - conjunctivitis |
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Nursing Implications of Sulfonamides
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-Consume at least 1 liter of fluid/day to avoid cyrstalluria
- Avoid sunlight and tanning beds- photo-sensitivity - Reduces effectiveness of oral contraceptives |
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Sulfonamide Side Effects
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Nausea
Vomiting Diarrhea Watch for allergic reaction, RASH |
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Sulfonamide Adverse Effects
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Renal toxicity
Stevens Johnson's syndrome- REALLY WATCH FOR!!! Blood dyscrasias- anemia, thrombocytopenia, leukopenia |
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Sulfonamides Contraindications/Precautions
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-lead to the development of other sulfa drugs
- Thiazide diuretics, sulfonylurea, loop diuretics, if allergic do not give other sulfa based drugs |
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PCN (Penicillin's )
* what are the different types |
- All end in "cin" & "mycin"
-Ampicillian - Amoxicillin - Penicillin V ( penn-Vee K) - Dicloxacillin - Augmentin (Amoxicillan and Clavilanate) |
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Treatment with Penicillin (PCN)
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- beta-lactum antibiotics
- used to treat common infections - destroy cell wall - oldest and least expensive - many people are allergic |
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How does PCN Work
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- beta lactum, most bacterial cells have double layers on there outside, our human cells dont have this.
- the outer layer of cell must grow along with the cell or the cell will burst and die - PCN and Cephalosporin work by messing up cell wall |
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PCN Specific Side Effects
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-Fewer side effects than others
- rash (but not a true allergy) more of reaction - diarreha - nausea - vomiting |
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Patient Teaching with PCN
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-Penicillin V, amoxicillin- amox-clav. may be taken w/meal
- All others should be taken with a full glass of water 1 hour before or 2 hours after a meal - ALL PCN- cross sensitivity/cross re-activity, allergic to one, allergic to all |
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Cephalosporin
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- many start with " cef"
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Treatment with Cephalosporin
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skin, bone, heart, blood, respiratory tract, gastrointestinal tract, urinary tract
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How does cephalosporin work?
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- similar molecular structure ans action to PCN
- useful for people who cant tolerate PCN - organized into generations, 4 groups - because they are chemically similar to PCN, there is a potential for cross-sensitivity /allergy |
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Side Effects/Adverse Effects of Cephalosporin
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- rash, diarrhea, nausea, vomiting, same as PCN
- 10% chance of allergy if allergic to PCN - if allergic to one cephalosporin, should not take any others - Thrombophelitis when given IV - Sterile abscess when given IM |
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Carbapenem
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Imipenem/cilastin (Primaxin)
- beta-lactum antibiotic - bacteriocidal - used for organisms resistant to other antibiotics - similar SE/AR as other antibiotics - Side effects are similar to others, cross with PCN about 6-8% |
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Glycopeptide
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-Vancomycin (vancocin), similar to beta-lactum
- potent against staph aureus - can be result in vancomycin resistant group D entercoccus - Peak and trough need monitored - can cause ototoxicity (ringing in the ears) - Red man Syndrome |
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Macrolide
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- like erythromycin, usually end in " mycin"
- azithromycnin ( Z-pack, Zithromycin) - clarithromycin (biaxin) - Erythromycin (E-mycin) |
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How Macrolide's Work
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-blocks protein making machinery of certain bacteria
- Bacterostatic - usually substitute for people allergic to PCN - may be bactericidal depending on dose, E-mycin stops bacteria from multiplying in higher doses it kills bacteria - primary used for Respiratory, GI, urinary, skin, soft tissue infections |
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Side Effects of Macrolides
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-Stomach upset, N/V/D, cramps
- better with clairthromycin and azithromycin - always take with food or milk!!! |
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Adverse Effects of macrolides
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-hypersensitivity
- hepatotoxicity - Superinfection - Jaundice - Anaphylaxis |
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Lincosomide
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-Clindanycin (Cleosin)
- blocks protein making machinery of certain bacteria - bacteriocidal or bacteriostatic depending on dose - used to treat severe anaerobic infections - combined with aminoglycosides for use of penetrating wounds of the gut - SE/AR- N/V/D, colitis, anaphylaxsis |
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Tetracyclines
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-Tetracycline- take it 4/day pt compliance is an issue
- PO only Doxycycline(vibramycin)- usually 2/day, also PO - Minocycline (minocin)- 2/day, PO -can cause vertigo temporary, and bluish discoloration of the skin permanent. |
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How Tetracycline's Work TCN
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- blocks protein making machinery of certain bacteria
- bacterisostatic, Broad spectrum, gram + /- - Common uses- chlamydia, acne, skin disorders - Best for tx life threatening conditions such as anthrax and cholera - Bound to calcium in newly formed teeth and bone in young children and pregnant women |
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Things to know about TCN
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- not to be taken with antacids, milk due to absorption issues
- TCN increases digoxin absorption, which may result in digoxin toxicity - take on an empty stomach, meaning 1 hour before or 2 hours after mealtime - Except for minocycline and doxycycline there absorption actually improves if taken with food |
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TCN Toxic Effects
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- Do not give to children- effects tooth development
- photosensitivity - Superinfection - Nephrotoxiticy |
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Side Effects/Adverse Reactions of TCN
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SE- nausea, vomiting, diarrhea, photosensitivity
AE- tetragenic in the first trimester of pregnancy less than 8 tooth discoloration, ototoxicity, nephrotoxicity, may impair hepatic function |
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Aminoglycoside
-gentamycin (garamycin) - tobramycin ( Nebcin) - Amikacin (amikin) |
- block proteins of certain bacteria's
- Bactericidal, effective gram -/some +, dont work on all anaerobes - poor oral absorption IV or IM - Narrow therapeutic range, monitor peak and trough * Potent med with serious toxicities!!! |
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Aminoglycoside's Used for
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- More for pt that does not respond to home tx
- infectious dirrhea and HIV induced diarrhea - bacterial overgrowth syndrome - hepatic encephalopathy - pre-op setting for bowel, effective against amoeba, giardia, tapeworms |
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SE/ AE for Aminoglycoside's
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- watch for otoxicity- ringing, hearing loss, balance problems
- Nephrotoxicity- monitor urine output, BUN, creatinine, and clearance , effect is does dependent - Can have interaction with coumadin, watch bleeding |
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Fluroquinolones
-ciprofloxacin (cipro) - Gatifloxacin (Tequin) - levofloxacin (levaquin) - ofloxacin(floxin) |
-Bactericidal alter DNA, Broad Spectrum gram +/-
- prevent crystalluria- hydrate - not to be used in children under 18- cartilage - contradicted pregnancy and nursing mothers\ - treat- lower resp, bone/joint, infectious diarrhea, urinary tract, skin, sexually transmitted diseases and anthrax |
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Side effects/ Adverse Effects from Fluroquinolones
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SE- N/V/D, fatigue, HA, photsensitivty
AE- Stevens Johnson's Syndrome, Seizures, Dysrhytmias |
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Metronidazole (Flagyl)
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-Impairs DNA Function, have the best anaerobe drug!!!
- treats anaerobes present in mouth colon, vagina - Is also a anti-protozoa - treats amoeba, cause of colitis, giardia, trichomonas, H. Pylori - Sever vomiting if taken with alcohol, don't drink and take or 48 after stopping - SE: HA, confusion, Depression, irritability, weakness, insomnia, dark/reddish brown urine |
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Nitrofurantoin (Macrobid)
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- Just used for UTI's,
- Don't confuse with neurontin, nitroglycerin - can be safely used in pregnancy Cat B - evaluate drug effectiveness - may turn urine a harmless brown |
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Fungi
Mycotic Infections |
Contracted - by air and skin to skin
Due to normal flora being killed off- antibiotics, corticosteroid therapy, antineoplastic agents, suppressed immune system - three general types: cutaneous, subcutaneous, systemic (can be life threatening) |
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Antifungal Agents
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Action: kill the fungus or inhibit fungal growth
Amphotericin B- systemic infections Nystatin- candida infections Ketoconazole (Nizoral), Fluconazole (Difucan)- candidiasis, tinea infections |
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Antifungal Agents Adverse Effects
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Topical- irritation and redness
Oral - N/V/D May potentiate antihistamines IV- hepatotoxicity, renal toxicity, phlebitis IV drugs must be diluted and admin slowly: amphotericin B |
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Antiviral Agents
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Viruses may cause many infection disorders; acute, chronic, slow growing
Available Vaccines: polio, rabies, smallpox |
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Things to know about Antivirals
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- a virus cannot replace it's own
- it must attach to and enter a host cell - inhibits viral replication by interfering with viral nucleic acid synthesis and or regulation, ability of virus to bind to cells - Interferon- stimulates immune system |
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Treatment with Antiviral Agents
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influenza A-within 24-72hrs
herpes complex- dont treat, suppresses outbreaks RSV- children under 2 AID's HIV |
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Adverse Effects of Anitviral Agents
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bone marrow supression
nephrotoxicity hepatotoxicity GI effects CNS effects |
