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52 Cards in this Set

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Review
empiric therapy
Given to patients because
we don't know what's
really going on but
they have S+S of infection
so we give abx
Review
prophylactic therapy
Pt doesn't have infection
but given just in case
usually if pt is going to
be exposed to / or have
decreased immunity agains
for exp. the post op pt
General patient
teaching with abx
take exactly as rx until gone
better absorbed with h2o
allergy? wear medic alert
common side effects
super infection
c-diff
Sulfonamides
characterisitics
Broad spectrum abx (kills
both gram - and +)
inhibitor of metabolism
of bacteria
higher concentration
in kidney
synergistic
usually prescribe with UTI
Sulfonamides
MOA
bacteriostatic - inhibits
the growth, doesn't kill
bacteria
prevents synthesis of folic
acid - bacteria require
making folic acid
Sulfonamides
Indications
contraindications
I: UTI
C: preg, decreased/poor kidney
function, can interfere with
anti-coags and anti-diabetics
Sulfonamides
S/E and adverse rxn
Can be immediate - airway
compromise
Delayed - fever, rash
GI - n/v/d/
Hepatic and renal - may be
compromised
Hematologic - blood problems
describe
stevens-johnson
syndrome
s/e of abx
pt treated like burn victim
burn from inside out
if pt has s/e rash -
stop med immediately
Sulfonamides
nursing indications
admin with fluids
photosensitivity
take all meds
report any: fever, sore throat,
mouth sores, easy bruising, rash
monitor: leukopenia, renal
function, liver function,
integumentary
Sulfonamid: Bactrim
sulfamethoxazole/trimethroprim
combo
Sulfonamides are
useful in treatment of:
UTI's
Beta-Lactam
Chemical structure - prevents
beta ring from being
immobilized
4 classes
Beta-lactam:
Penicillin
from fungus/mold (bread, fruit)
has 4 subgroups
PCN - Indications
MOA
works against
Gram positive only
MOA - inhibition of bacterial
cell wall synthesis, prevents
cells from being able to grow
Kills bacteria:bacteriocidal
PCN - nursing
indications
monitor
do not drink caffeine, citrus
fruit, cola, fruit juices,
tomato juice=decreases effect
of PCN
take with h2o
IM - use large muscle mass-pn
anaphylactic rxn - airway
report: sore throat, fever,
muscle weakness, joint pn
PCN - s/e
adverse rxn
allergic rxn - 0.7-.08% pop
common - GI, rash
PCN allergy? more likely
to have allergy to same group
meds like cephalosporin
PCN - interactions
doses
compete with NSAIDS. Less
receptor sites for NSAIDS to
hook on to - leads to increase
in serum level of NSAIDS
Decreases BCP efficacy
increases Warafin metabolism
which makes it less available
increases risk of DVT
Amoxil po 250-500 mg q8h
Cephalosporin
Semi synthetic, fungus
structurally-pharmacologically
similar to PCN
BROAD SPECTRUM
take IV, PO, IM
Cephalosporin
nursing indications
cross-reactivity
monitor renal/liver function
prevent GI s/e
warn about antabuse type rxn
report: bruising, sore throat,
bleeding, joint pn
monitor: abd pn, n/v/d,
colitis, HA fever, chills,
rash, dyspnea
some types of
Cephalosporins
Keflex, Ancef
A drug interaction
occurs with PCN and
what:
NSAIDS
Aminoglycosides
For mean infections
bactericidal - kill
poor oral absorption
serious toxicity - not
reversible - renal failure
and hearing loss
Used against MRSA
Aminoglycosides
MOA
Prevent protein synthesis
cause baterial cell wall death
broad spectrum - and +
inactive against: fungi,
virus, and anaerobic bacteria
It is not metabolized -
excreted in original form in
urine (want good urine
function)
Aminoglycosides
indications
contraindications
I:MRSA, serious infections
C: pregnancy category C
No long term use
Aminoglycosides
nursing indications
caution about renal impairment
perform baseline hearing
tests and renal function tests
monitor serum peaks and troughs
Which of the following
properties are exhibited by
Aminoglycosides?
a. they are well absorbed
from GI tract
b. they're bacteriostatic
c. they achieve adequate
serum levels after oral admin
d. they are ineffective
against
anaerobic organisms
d. they are ineffective against
anaerobic organisms
Fluroquinolones
Potent broad spectrum - +
bactericidal
overall good oral absorption
EXCEPT with concurrent use of
antacids
excreted by kidneys
not recommended for children
Fluroquinolones
MOA
alter bacterial dna
Fluroquinolones
Indications
contraindications
Indications according to
body site
C: cardiac dysrythmias
if pt has cardiac problems
DO NOT GIVE
Fluroquinolones
S/E, adverse rxn,
interactions
S/E: ha, dizzy, fatigue, n/v/d,
depression, convulsions, fever,
chills, blureed vision
Interactions: antacids, iron,
zinc preparations - reduced
Fluroquinolones absorption
caution with anticoagulants
Fluroquinolones
nursing indications
use caution when giving with
seizure d/o, renal dz, preg,
geriatric pts, lactation
Drug-drug interactions:
antacis, anticoag
Increase fluid intake
may cause dizziness
report: rash, fever, sore
throat, ha, agitation,
confusion, phototoxic
HIGHEST OFFENDER OF HAVING
PATIENT HAVE POSSIBILITY
OF DEVELOPING CDIFF
C-diff
clostridium dificile
spore
fever, diarrhea, abd cramps
isolation, contact percautions
infection control measure
abx often eliminate normal
flora of GI tract - at risk
to develop cdiff
Macrolides
bacteriostatic
erythromycin most widely used
alternative to PCN allergy
Macrolides
MOA/indications
inhibit bacterial growth
upper/lower respiratory,
skin, soft tissue. used with
streptococcus, haemophilus,
syphillis, lyme dz, gonorrhea,
chlamydia, mycoplasma
Macrolides
S/E adverse rxn
palpitations, chest pn - adverse
ha, dizzy, vertigo, somnolence,
n/v/d, heartburn, rash, pruitis,
urticaria, hearing loss,
anorexia, jaundice
Macrolides
interactions
highly protein bound and
metabolized by liver - pt
has to have good liver function
potential for drug toxicity
may compete with other drugs
that are protein bound -
digoxin, warfarin,
carbamazipine, theophylline
Macrolides
nursing indications
use caution with pts with
impaired liver function
drug-drug interactions -
theophylline, antihistamines,
pcn, oral anticoag
elder - check albumin level
(protien bound)
herapeutic effects
associated
with abx include
which of the following?
a. decrease in Hgb
b. increase in WBC
c. increase in Hgb
d. decrease in WBC
c. a decrease in WBC
Macrolides -
Clarithromycin (biaxin)
semi-synthetic
macrolide
adult dose po 500 mg
x 1 dose then 250 mg
daily x 4 days
Bronchodilators
relax bronchial smooth
muscle bands
dilate bronchi and
bronchioles
2 classes - xanthine
derivative and beta-agonists
Bronchodilators
Beta-Adrenergic
agonist - MDI
acute phase of asthma attack
quick reduction of constriction
agonist sympathetic
nervous system receptors
imitate norepinephrine
receptor specific
Bronchodilators
Beta-Adrenergic
agonist
indication/contraindiation
relief of bronchospasm
C: allregy, uncontrolled
cardiac dysrhythmias
CARDIAC NOT NORM? DON'T GIVE
Bronchodilators
Beta-Adrenergic
agonist
Ventolin (albuterol,
proventil)
Brohchodilating beta 2 agonist
acute attacks/prvention
nausea, increased anxiety,
palpitations, tremors, increase
HR if overused
C: tachyarrhythmias,
severe cardiac dz
Dose: MDI 90 mg per spray,
2 puffs q4-6 hrs
Patients receiving
albuterol should know:
Avoid spraying eyes
proper med admin
potential S/E dizziness,
increase HR, anxious, jittery
Proper care of canister (clean
mouth piece)
subjective improvement
after 15 min.
Corticosteroids
relax smooth muscle in
bronchioles
used for asthma, obstructive
pulmonary d/o
exp. azmacort
Anti-inflammatory
does not relieve symptoms
prophylactic use
inhalation preferred method
Corticosteroids
MOA
reduces inflammation
ane enhances beta-agonists
Corticosteroids
indications
contraindications
I: allergy, part of treatent
used with beta-adrenergic
agonist
Corticosteroids
S/E adverse rxn
pharyngeal irritation
coughing
dry mouth
oral fungal infections
interactions are rare
Corticosteroids
azmacort, flovent
beclodisk
asthma prophylaxis and
maintenance
MDI 2 puffs tid-qid or 4 puffs
bid
Nursing indications
Beta agonists
contraindicated:
hx cardiac dz, dysrythmias,
angina, hyperthyroid dz, CAD,
HTN, DM, seizure d/o
Nursing indications
Corticosteroid
contraindicated:
hx of psychosis, fungal
infections, acquired
immunodeficiency
syndrome, TB, idiopathic
thrombocytopenia
Nursing indications
Use of inhalers
MDI - use spacer
gargle with h2o after use
instructions vary
f/u if tx ineffetive
check volume left in
canister
keep away from mouth
slow deep breath, hold
for 10 seconds