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54 Cards in this Set

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Bactericidal
Destroy microorganism. Ie: Penicillins, Cephalosporins, Aminoglycosides
Bacteriostatic
Inhibit the microorganism growth, usually by inhibiting protein synthesis. ie: Tetracyclines, Erythromycin, Chloramphenicol
Nursing Implications for Antibiotics: Intravenous (IV) Route
-Must be given on time to keep serum blood levels up
-Cannot skip doses
-Drug incompatabilities are a problem w/ multiple IV ATB (minimized by flushing IV line with IV soln or NS between drugs)
-Many cause phlebitis; could become very serious; therefore, often diluted with 50-100 mL of NS or D5W
-Extreme caution w/ calculating safe dosages
Nursing Implications for Antibiotics: Intramuscular (IM) Route
-Less convenient and more unpleasant for the pt
-Irritate the muscle tissue
-Some ATB will say to NEVER give IM route b/c necrosis of muscle tissue
-Be sure to rotate sites for injection
-Avoid if poor perfusion (ie with shock)
Nursing Implications for Antibiotics: Oral Route (PO)
-Used for many common infections (ie respiratory tract and UTI)
-Convenient, less expensive, less pain
-Disadvantages: bad taste, GI upset, occasional diarrhea, poor compliance w/ completing all doses
Anaphylaxis
Causes hypotension, bronchoconstriction, laryngeal edema, possible cardiovascular collapse
Cephalosporins: Prototypes
Cefazolin (Kefzol) -1st Gen
Cefamandol (Mandol) -2nd Gen
Cefotaxine -3rd Gen
Cephalosporins: Action
Bactericidal; interfere with bacterial cell wall synthesis
Cephalosporins: Therapeutic Uses
Broad Spectrum. Kill most Staph and Strep organisms; Some Gram- (E. Coli, Klebselia, Proteus)
Cephalosporins: Contraindications
Allergy or life-threatening penicillin allergy
Cephalosporins: Nursing Implications
Eliminated through kidney; must have good renal function!! Push fluids.
Cephalosporins: Adverse Effects
Nausea, vomiting, superinfection, diarrhea, anaphylaxis
Cefazolin
1st gen Cephalosporin; alias "Kefzol"
For Gram+ and Gram-
Don't cross blood brain barrier
Given IV or IM (poorly absorbed in GI)
Cefamandol
2nd gen Cephalosporin; alias "Mandol"
Similar to Kefzol with action
Cefotaxine
3rd gen Cephalosporin; more expensive
Gram+ and Gram- and some anaerobes
Given IV and IM
Penicillin: Action
Bactericidal; inhibition of bacterial cell wall synthesis
Penicillin: Therapeutic Uses
Kill a wide range of bacteria, mostly gram positive+. Used to treat many common infections such as pneumonia, syphilis, and endocarditis.
Penicillin: Adverse Effects
Nausea, vomiting, diarrhea, superinfection, anaphylaxis
Superinfection
Ex: Vaginal candidiasis or candidiasis (thrush in mouth)

Pseudomembranous colitis: Fungal infection > Bowel. Causes severe, watery diarrhea from overgrowth of Clostridium difficile.
Penicillins: Nursing Priorities
a. Watch for white patches on tongue or vaginal discharge. Give good oral hygiene / check skin closely.

b. Diarrhea needs to be tested

c. Some of the PCNs have a high Sodium content and Cardiac pts cannot tolerate this.
Aminoglycosides: Prototype
Gentamicin ("Garamycin")
Aminoglycosides: Action
Bactericidal; prevent protein synthesis
Aminoglycosides: Therapeutic Uses
Gram- and Gram+ but MOSTLY Gram Negative-. (Ie: Pseudomonas, E. Coli). Very powerful but dangerous drugs.
Aminoglycosides: Contraindications
Allergy, pregnancy unless necessary (can cause deafness of child), renal patients
Aminoglycosides: Adverse Effects
1. Nephrotoxicity (renal damage) → Pt. would need dialysis for rest of life or kidney transplant
Sx: Proteinuria, increased BUN and serum creatinine levels
2. Ototoxicitiy (hearing loss) → Irreversible damage to CN VIII.
Sx: Dizziness, tinnitus (ringing ears), hearing loss
Aminoglycosides: Nursing Implications
-Poorly absorbed orally
-Serum levels measured and dosage is based on this.
-TESTS: BUN (blood urea, N+ level) and Serum Creatinine Values to show kidney function
-Push fluids, monitor Input & Output
-Pre-hearing test, especially in children
Tetracyclines: Prototype
Tetracycline
Tetracyclines: Action
BacterioSTATIC by inhibiting protein synthesis. Readily distributed to all tissues but brain; binds to newly formed bones and teeth
Tetracyclines: Therapeutic Uses
Acne vulgaris, Rickettsia, Chlamydia, Rat Bite Fever, Lyme Disease
Tetracyclines: Contraindications
1. Liver impairment
2. Renal disease
3. Pregnant and nursing mothers: child may have permanently stained teeth
Tetracyclines: Interactions
1. Dairy (reduce absorption)
2. Antacids (reduce absorption)
3. Potentiates anticoagulants*
Tetracyclines: Adverse Effects
1. Mostly GI (stomatits)
2. Hepatotoxicity
3. Nephrotoxicity
4. Black hairy tongue
5. Superinfection --> candida (thrush), diarrhea
6. Photosensitivity
Tetracyclines: Nursing Implications
Given on an empty stomach with water if oral form - better absorbed
Macrolides: Prototype
Erythromycin
Erythromycin: Action
Bacteriostatic by inhibiting protein synthesis
Erythromycin: Therapeutic Uses
Best for Gram Positive+ bacteria, often for respiratory tract infections.
Erythromycin: Adverse Effects
Gastric upset and GI irritating. One of the least toxic ABX.
Erythromycin: Nursing Implications
-Allergies rare, but may not tolerate if GI problems
-Short serum half life (given q.i.d)
-If oral, must be given enteric coated or capsule
Sulfonamides: Prototype
Sulfisoxazole (Gantrisin)
Sulfonamides: Action
Bacteriostatic by inhibiting growth
Sulfonamides: Therapeutic Uses
1. Broad spectrum, Gram+ and Gram-
2. Drug of choice for UTI (Urinary Tract Infection) caused by E. coli, Klebsiella, Proteus, Staph aureus, Enterobacter
3. Also used for ear infections
Sulfonamides: Contraindications
1. Allergy; cross-sensitivities include thiazide diuretics and oral diabetic meds
2. Pregnancy
Sulfonamides: Adverse Effects
1. Allergic reaction common - fever, rash
2. Photosensitivity
3. RENAL complications; poorly soluble in urine and crystallizes in renal tubules --> kidney stones.
Sulfonamides: Nursing Implications
1. Take on an empty stomach
2. Push fluids
3. Watch for toxic effects by lab tests that reflect bone marrow (WBC counts and bleeding)
4. Avoid sun or use sunscreens/covering
Quinolines: Prototype
Ciprofloxin (“Cipro”) or Ofloxacin (“Floxin”)
Quinolones: Action
Bactericidal by inhibition of enzyme needed for DNA
Quinolones: Therapeutic Uses
Broad spectrum, especially Gram Negative-. Prevention of inhaled anthrax. UTIs.
Quinlones: Interactions
1. Antacids, iron, or multivitamins reduce absorption
2. Oral anticoagulants
3. Asthma drugs
Quinlones: Adverse Actions
Few. Nausea, yeast infections
Quinlones: Nursing Implications
Keep pt well hydrated!
Vancomycin: Action
Bactericidal
Vancomycin: Therapeutic Uses
Gram Positive+ Bacteria
1. Rx for Staph infections, esp if PCN allergy
2. MRSA
Vancomycin: Adverse Effects
1. Ototoxicity
2. Nephrotoxicity
3. Allergy
4. Hypotension may be caused by rapid infusion (then, give over 2-3 hours)
Vancomycin: Nursing Implications
1. PUSH FLUIDS
2. Given diluted IV, never IM!