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46 Cards in this Set
- Front
- Back
Penicillins - Side/Adverse Effects |
Hypersensitivity,
nausea/vomiting, diarrhea/GI disturbances, renal impairment |
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Penicillins - Drug Interactions
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Oral contraceptives, aminoglycosides
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Penicillins - NSG considerations/education for patients
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• Take with full glass of water 1 hour before or 2 hours
after meals – except for Amoxicillin, bacampicillin, pencillin V and Augmentin which may be taken with food • Monitor for superinfections (mouth ulcers, vaginitis) • Monitor for bleeding (high doses can decrease platelet aggregation) • Contraindicated in clients with allergies to cephalosporins • Instruct to take on time and to finish full course of medication • Report signs of allergic reaction such as hives, rash, itching, wheezing |
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Macrolides (Bacteriostatic Inhibitors) - Side/Adverse Effects
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GI discomfort (nausea,
vomiting, epigastric pain), thrombophlebitis |
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Macrolides - Drug Interactions
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Antihistamines,
theophylline, carbamezepine, warfarin |
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Macrolides - Nursing Implications/Client Education
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• Contraindicated in liver disease
• Infusion of erythromycin must be slow and in a dilute solution to prevent thrombophlebitis • Instruct client to complete entire course of therapy • Notify health care provider of GI upset or allergic reactions |
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Aminoglycosides - Drugs
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Gentamicin (Garamycin), Tobramycin
(Nebcin), Streptomycin (Neomycin) |
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Aminoglycosides - Side/Adverse Effects
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nephrotoxicity,
neurotoxicity, ototoxicity, hypersensitivity, nausea, vomiting, cramps, diarrhea, rash, tinnitus, pruritis |
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Aminoglycosides - Drug Interactions
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Coumadin, penicillin (will
inactivate aminoglycosides when mixed in same solution) |
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Penicillins - Drugs
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Penicillin G (Bicillin), Amoxil
(amoxicillin), Omnipen (ampicilin), Ticar (ticarcillin), Zosyn (piperacillin-tazobactam) |
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Macrolides - Drugs
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Erythromycin (E-mycin),
Clarithromycin (Biaxin), Azithromycin (Zithromax) |
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When should peak levels be collected?
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30 minutes after admin of medication
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When should trough levels be collected?
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Prior to next dose
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Tetracyclines - Drugs
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Tetracycline (Achromycin),
Doxycycline (Vibramycin) |
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Tetracylines - Side/Adverse Effects
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nausea, vomiting, diarrhea, photosensitivity, stomatitis, nephrotoxicity, hepatotoxicity, superinfection, yellow-brown tooth discoloration
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Tetracyclines - Medication Interactions
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milk products, calcium supplements, iron supplements, magnesium containing laxatives and most antacids (these will decrease effectiveness of tetracycline
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Tetracyclines - NSG Implications/Client Education
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• Take on an empty stomach with a full glass of water, except doxycycline and minocycline which may be taken with food.
• Administer at least 1 hour before and 2 hours after any food or supplements containing calcium and/or magnesium • Use of tetracycline during pregnancy can cause staining of the deciduous teeth – avoid administration to children under 8 years of age |
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Cephalosporins - Drugs
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cephalexin (Keflex), cefaclor (Ceclor),
ceftriaxone (Rocephin), cefepime (Maxipime) |
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Cephalosporins - Side/Adverse Effects
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Allergic/hypersensitivity,
bleeding tendencies, thrombophlebitis, pain with IM injection, cross allergy to penicillins, antibiotic associated pseudomembranous colitis |
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Cephalosporins - Medication Interactions
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Intolerance to alcohol
(Disulfiram reaction) and Probenecid |
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Cephalosporins - NSG Implicatoins/Client Education
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• Should not be given to clients who have a severe allergic reaction to penicillins
• Use cautiously with renal impairment • Monitor for bleeding if used with medications that promote bleeding (anticoagulants, NSAIDs) • Should be taken with food • Oral suspensions should be stored in refrigerator |
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Monobactams - Drugs
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Vancomycin (Vancocin),
azetreonam (Azactam) |
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Monobactams - Side/Adverse Effects
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Ototoxicity, infusion
reaction (rash, flushing, tachycardia, hypotension), thrombophlebitis |
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Monobactams - NSG Implications/Client Education
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• Use cautiously with renal impairment
• Assess for hearing loss • Administer slowly over at least 60 minutes • Peak blood levels should be collected 1-2 hours after completion of IV infusion. Therapeutic peak level – 30 to 40 micrograms/ml. |
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Sulfonamides - Drugs
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trimethoprim-sulfamethoxazole
(TMP-SMZ, Bactrim) |
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Sulfonamides - Side/Adverse Effects
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Hypersensitivity, blood
dyscrasias, crystalluria, kernicterus, photosensitivity • Medication Interactions: Coumadin, Dilantin, sulfonylurea oral hypoglycemics |
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Sulfonamides - NSG Implications/Client Education
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• Contraindicated in clients with folate deficiency
• Avoid use in pregnancy and lactation • Use cautiously if renal dysfunction • Take on an empty stomach with a full glass of water • Stop medication at first indication of hypersensitivity such as rash • Observe for bleeding, sore throat or pallor (signs of blood dyscrasia) • Increase fluid intake to prevent crystalluria • Avoid prolonged exposure to sunlight |
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Fluoroquinolones - Drugs
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ciprofloxacin (Cipro)
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Fluoroquinolones - Side/Adverse Effects
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GI discomfort, Achilles
tendon rupture, suprainfection |
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Fluoroquinolones - Medication/Food Interaction
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aluminummagnesium, antacids, iron salts, sucralfate,
milk and diary products (decrease absorption of Cipro); Theophylline (can lead to theophylline toxicity); Warfarin (can lead to warfarin toxicity) |
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Fluoroquinolones - NSG Implications/Client Education
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• Do not administer to children <18 years of
age due to increased risk of Achilles tendon rupture • Dosage is decreased for renal dysfunction • Administer cationic compounds 1 hr before or 2 hrs after Cipro • Instruct to complete entire course of therapy |
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Antiprotozoals - Drugs
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metronidazole (Flagyl)
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Antiprotozoals - Side/Adverse Effects
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GI discomfort,
darkening of urine, CNS symptoms such as numbness of extremities, ataxia, seizures |
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Antiprotozoals - Medication Interactions
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Alcohol ingestion
may cause a Disulfiram-like reaction, warfarin |
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Antiprotozoals - NSG Implications/Client Education
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• Use cautiously in clients with renal dysfunction
• Avoid use in first trimester of pregnancy and use cautiously thereafter as it can pass through the placenta • Advise clients to avoid alcohol consumption during therapy • If taking warfarin, monitor PT/INR closely |
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Antifungals - Drugs
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amphotericin B (Fungizone)
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Antifungals - Side/Adverse Effects
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Infusion reactions,
thrombophlebitis, nephrotoxicity, hypokalemia, bone marrow suppression |
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Antifungals - Medication Interactions
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Aminoglycosides
(additive nephrotoxic risk), Flucytosine (potentiates effect) |
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Antifungals - NSG Implications/Client Education
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• Commonly pretreated with Benadryl and Demerol as ordered to diminish infusion
reactions • Monitor for thrombophlebitis • Obtain baseline renal function tests, notify health care provider if urine output decreases • Administer additional IV saline as ordered • Monitor potassium levels |
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Antimycobacterials (Antituberculosis) - Drugs
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Isoniazid (INH), streptomycin,
ethambutol, pyrazinamide |
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Antimycobaterials - Side/Adverse Effects
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peripheral neuropathy, hepatotoxicity
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Antimycobaterials - Medication Interactions
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Phenytoin (can cause toxicity); alcohol, rifampin and pyrazinamide (increases risk for
hepatotoxicity) |
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Antimycobaterials - NSG Implications/ Client Education
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• INH is contraindicated in liver disease
• For active TB, direct observation therapy (DOT) is done to ensure compliance • Take INH on empty stomach (1 hr before meals or 2 hrs after) • Monitor for tingling, numbness, burning pain related to pyridoxine (vitamin B6) deficiency – treatment is 50-200 mg of B6 daily • Monitor liver function tests and instruct client to avoid alcohol |
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Antivirals - Drugs
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Acyclovir (Zovirax), ganciclovir
(Cytovene), lamivudine (Epivir), amantadine (Symmetrel) |
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Antivirals - Side/Adverse Effects
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phlebitis/inflammation
at infusion site, nephrotoxicity, nausea, headache, diarrhea (with oral therapy), granulocytopenia, thrombocytopenia, reproductive toxicity |
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Antivirals - NSG Implications/Client Education
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• Administer acyclovir slowly over 1 hr
• Ensure adequate hydration to minimize nephrotoxicity • Obtain baseline CBC and platelet count • Ganciclovir is teratogenic – avoid pregnancy and teach risk of sterility |