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54 Cards in this Set
- Front
- Back
Bactericidal
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Destroy microorganism. Ie: Penicillins, Cephalosporins, Aminoglycosides
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Bacteriostatic
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Inhibit the microorganism growth, usually by inhibiting protein synthesis. ie: Tetracyclines, Erythromycin, Chloramphenicol
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Nursing Implications for Antibiotics: Intravenous (IV) Route
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-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 |
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Nursing Implications for Antibiotics: Intramuscular (IM) Route
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-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) |
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Nursing Implications for Antibiotics: Oral Route (PO)
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-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 |
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Anaphylaxis
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Causes hypotension, bronchoconstriction, laryngeal edema, possible cardiovascular collapse
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Cephalosporins: Prototypes
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Cefazolin (Kefzol) -1st Gen
Cefamandol (Mandol) -2nd Gen Cefotaxine -3rd Gen |
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Cephalosporins: Action
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Bactericidal; interfere with bacterial cell wall synthesis
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Cephalosporins: Therapeutic Uses
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Broad Spectrum. Kill most Staph and Strep organisms; Some Gram- (E. Coli, Klebselia, Proteus)
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Cephalosporins: Contraindications
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Allergy or life-threatening penicillin allergy
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Cephalosporins: Nursing Implications
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Eliminated through kidney; must have good renal function!! Push fluids.
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Cephalosporins: Adverse Effects
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Nausea, vomiting, superinfection, diarrhea, anaphylaxis
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Cefazolin
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1st gen Cephalosporin; alias "Kefzol"
For Gram+ and Gram- Don't cross blood brain barrier Given IV or IM (poorly absorbed in GI) |
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Cefamandol
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2nd gen Cephalosporin; alias "Mandol"
Similar to Kefzol with action |
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Cefotaxine
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3rd gen Cephalosporin; more expensive
Gram+ and Gram- and some anaerobes Given IV and IM |
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Penicillin: Action
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Bactericidal; inhibition of bacterial cell wall synthesis
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Penicillin: Therapeutic Uses
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Kill a wide range of bacteria, mostly gram positive+. Used to treat many common infections such as pneumonia, syphilis, and endocarditis.
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Penicillin: Adverse Effects
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Nausea, vomiting, diarrhea, superinfection, anaphylaxis
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Superinfection
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Ex: Vaginal candidiasis or candidiasis (thrush in mouth)
Pseudomembranous colitis: Fungal infection > Bowel. Causes severe, watery diarrhea from overgrowth of Clostridium difficile. |
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Penicillins: Nursing Priorities
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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. |
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Aminoglycosides: Prototype
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Gentamicin ("Garamycin")
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Aminoglycosides: Action
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Bactericidal; prevent protein synthesis
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Aminoglycosides: Therapeutic Uses
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Gram- and Gram+ but MOSTLY Gram Negative-. (Ie: Pseudomonas, E. Coli). Very powerful but dangerous drugs.
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Aminoglycosides: Contraindications
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Allergy, pregnancy unless necessary (can cause deafness of child), renal patients
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Aminoglycosides: Adverse Effects
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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 |
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Aminoglycosides: Nursing Implications
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-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 |
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Tetracyclines: Prototype
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Tetracycline
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Tetracyclines: Action
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BacterioSTATIC by inhibiting protein synthesis. Readily distributed to all tissues but brain; binds to newly formed bones and teeth
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Tetracyclines: Therapeutic Uses
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Acne vulgaris, Rickettsia, Chlamydia, Rat Bite Fever, Lyme Disease
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Tetracyclines: Contraindications
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1. Liver impairment
2. Renal disease 3. Pregnant and nursing mothers: child may have permanently stained teeth |
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Tetracyclines: Interactions
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1. Dairy (reduce absorption)
2. Antacids (reduce absorption) 3. Potentiates anticoagulants* |
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Tetracyclines: Adverse Effects
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1. Mostly GI (stomatits)
2. Hepatotoxicity 3. Nephrotoxicity 4. Black hairy tongue 5. Superinfection --> candida (thrush), diarrhea 6. Photosensitivity |
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Tetracyclines: Nursing Implications
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Given on an empty stomach with water if oral form - better absorbed
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Macrolides: Prototype
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Erythromycin
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Erythromycin: Action
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Bacteriostatic by inhibiting protein synthesis
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Erythromycin: Therapeutic Uses
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Best for Gram Positive+ bacteria, often for respiratory tract infections.
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Erythromycin: Adverse Effects
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Gastric upset and GI irritating. One of the least toxic ABX.
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Erythromycin: Nursing Implications
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-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 |
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Sulfonamides: Prototype
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Sulfisoxazole (Gantrisin)
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Sulfonamides: Action
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Bacteriostatic by inhibiting growth
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Sulfonamides: Therapeutic Uses
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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 |
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Sulfonamides: Contraindications
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1. Allergy; cross-sensitivities include thiazide diuretics and oral diabetic meds
2. Pregnancy |
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Sulfonamides: Adverse Effects
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1. Allergic reaction common - fever, rash
2. Photosensitivity 3. RENAL complications; poorly soluble in urine and crystallizes in renal tubules --> kidney stones. |
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Sulfonamides: Nursing Implications
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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 |
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Quinolines: Prototype
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Ciprofloxin (“Cipro”) or Ofloxacin (“Floxin”)
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Quinolones: Action
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Bactericidal by inhibition of enzyme needed for DNA
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Quinolones: Therapeutic Uses
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Broad spectrum, especially Gram Negative-. Prevention of inhaled anthrax. UTIs.
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Quinlones: Interactions
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1. Antacids, iron, or multivitamins reduce absorption
2. Oral anticoagulants 3. Asthma drugs |
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Quinlones: Adverse Actions
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Few. Nausea, yeast infections
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Quinlones: Nursing Implications
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Keep pt well hydrated!
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Vancomycin: Action
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Bactericidal
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Vancomycin: Therapeutic Uses
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Gram Positive+ Bacteria
1. Rx for Staph infections, esp if PCN allergy 2. MRSA |
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Vancomycin: Adverse Effects
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1. Ototoxicity
2. Nephrotoxicity 3. Allergy 4. Hypotension may be caused by rapid infusion (then, give over 2-3 hours) |
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Vancomycin: Nursing Implications
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1. PUSH FLUIDS
2. Given diluted IV, never IM! |