Term
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Definition
Body defenses:
Age
Nutrition
Immunoglobulins
Circulation, WBCs
Organ function
Resistance to antibacterials:
Natural or inherent resistance
Acquired resistance
Nosocomial infections
Cross-resistance |
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Term
| Antibacterial General adverse reactions |
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Definition
Mild allergic reaction
Rash, pruritus, hives
Severe allergy: anaphylactic shock
Bronchospasm, laryngeal edema
Vascular collapse, cardiac arrest
Treatment
Antihistamine
Epinephrine
Bronchodilator |
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Term
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Definition
Bacteriostatic drugs
Inhibit growth of bacteria
Bactericidal drugs
Kill bacteria |
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Term
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Definition
- Effects
Additive: effect is doubled
Potentiative: one potentiates effect of other
Antagonistic: if one bactericidal and one bacteriostatic, desired effect is diminished |
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Term
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Definition
- Effect of a drug on a body including: ONSET, PEAK, DURATION of a medication
- Inhibition of bacterial cell wall synthesis
- Alteration of membrane permeability
Inhibition of protein synthesis
Inhibition of synthesis of bacterial RNA and DNA
- Interference with metabolism within the cell |
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Term
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Definition
| the action of drugs in the body over a period of time, The process by which a drug is absorbed, distributed, metabolized, and eliminated by the body. |
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Term
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Definition
-one type of organism, ie gram +
-very selective & more potent |
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Term
| Broad Spectrum Penicillin |
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Definition
-for gram + & gram - Escherichia coli
Salmonella
Influenzae
Bactericidal
Also known as aminopenicillins
Examples:
Amoxicillin (Amoxil)
Ampicillin (Omnipen) |
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Term
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Definition
secondary infection when normal flora killed
Sites: mouth, skin, respiratory tract, vagina, intestines
Usually occurs when treated more than 1 week |
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Term
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Definition
| determines drug to use to kill bacteria; also shows resistance or sensitivity |
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Term
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Definition
Structure of penicillins
Beta-lactam ring
Introduced to kill Staphyloccus
Inhibit bacterial cell wall synthesis
Narrow-spectrum
Examples: penicillin G Na/K, penicillin G procaine, penicillin V |
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Term
| Penicillin Nursing Interventions |
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Definition
Nursing interventions
Check culture and sensitivity before drugs are given.
Monitor for bleeding.
Monitor closely during first dose.
Increase fluids.
Take 1 hour before or 2 hours after meals.
Check for superinfection.
Consider safety issues. |
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Term
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Definition
| bacteria-produced enzymes that attack penicillins |
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Term
| Beta-lactamase inhibitors |
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Definition
Inhibits bacterial beta-lactamase enzyme, Amoxicillin-clavulanate (Augmentin) Given orally
Combination intensifies effect of amoxicillin
Piperacillin-tazabactam (Zosyn)
Ticarcillin-clavulanate (Timentin)
Ampicillin-sulbactam (Unasyn)
Given parenterally |
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Term
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Definition
Class-Beta-lactams Sub-class-penicillin, Mechanism-Inhibition of cell-wall synthesis, Broad Spectrum penicillin Target-Gram+, with gram -
Treats UTI, URI, OM, & sinusitis
-SE: n/v/d, rash, diarrhea, superinfection |
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Term
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Definition
Gram +, Gram -, & resistant to beta-lactamase -similar to PCN
Beta-lactam structure
Inhibit bacterial cell-wall synthesis
Bactericidal
Treat Respiratory, urinary, skin
Cross-sensitivity with penicillin
Cefepime - used a lot today |
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Term
| Cephalosporin Nursing Interventions |
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Definition
Assess for allergy.
Perform C & S before therapy.
Assess renal and liver function.
Administer IV over 30 min b.i.d.-q.i.d.
Monitor for superinfection.
For safety, keep out of reach of children. |
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Term
| Macrolides - Erythromycin |
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Definition
Binds to 50S ribosomal subunits and inhibits protein synthesis
Broad spectrum Most gram +, some gram – bacteria
Bacteriostatic: low to moderate doses
Bactericidal: high doses
Route: Oral, IV
Mostly used for Pneumonia, not many side effects |
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Term
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Definition
Side effects/adverse reactions
Tinnitus, ototoxicity
GI distress
Superinfection
Hepatotoxicity
Examples
Erythromycin (E-Mycin)
Clarithromycin (Biaxin, Biaxin XL)
Azithromycin (Zithromax) |
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Term
| Macrolides Nursing Interventions |
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Definition
Check culture and sensitivity (C&S) before therapy.
Monitor liver enzymes.
Advise client to take full regimen.
Administer antacids 2 hours before or 2 hours after macrolides.
Give azithromycin 1 hour before or 2 hours after meals with full glass of water. |
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Term
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Definition
Action: Inhibit bacterial protein synthesis, potent
Gram −, E. coli, Bactericidal
Drugs
Streptomycin
Gentamicin (Garamycin) most used
Kanamycin (Kantrex)
Tobramycin (Nebcin)
Route
IM, IV |
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Term
| Aminoglycosides side effects |
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Definition
Side effects/adverse reactions
Photosensitivity
Superinfection
Ototoxicity
Nephrotoxicity
Drug interactions
Penicillins decrease aminoglycoside effectiveness.
Penicillins increase warfarin’s effect. |
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Term
| Aminoglycosides Nursing Interventions |
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Definition
Check C&S.
Monitor renal function, hearing loss.
Warn client to use sunblock.
Monitor for superinfection.
Monitor peak and trough levels. |
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Term
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Definition
Action
Inhibits cell wall synthesis
Fights gram +, S. aureus
Bactericidal
Uses
Serious infections:
Bone
Skin
Lower respiratory tract
Used agains M.R.S.A. |
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Term
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Definition
Side effects/adverse reactions
Red neck or red man syndrome
Occurs when IV too rapid
Severe hypotension
Red flushing of face, neck, chest, extremities
Ototoxicity
Pseudomembraneous colitis
Nephrotoxicity
Blood dyscrasias
Stevens-Johnson syndrome |
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Term
| Vancomycin Nursing Interventions |
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Definition
Check C&S before therapy.
Monitor vancomycin levels.
Administer over 1 to 2 hours IV.
Rotate sites.
Monitor BP.
Monitor IV site.
Monitor renal function tests and hearing.
Monitor client for superinfection. |
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Term
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Definition
Structurally related to macrolides
Action Blocks protein bacterial synthesis
Uses Acute chronic bronchitis, Acute bacterial sinusitis
Telithromycin (Ketek)
Route: Oral
Community-acquired pneumonia |
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Term
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Definition
Side effects/adverse reactions
Visual disturbances
GI distress, constipation
Drug interactions
Antilipids, antidysrhythmics, cisapride, midazolam
Rifampin, phenytoin, carbamazepine, phenobarbital |
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Term
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Definition
Action
Inhibits protein synthesis
Target-broad spectrum, however more active against gram+
Fights Helicobacter pylori
Treats acne (oral, topical)
Bacterial resistance
Route: Oral, IM,IV
Do not give to children younger than 8 years |
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Term
| Tetracyclines Side Effects |
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Definition
Photosensitivity
Discoloration of permanent teeth
Stomatitis, GI distress Pseudomembranous colitis
Blood dyscrasia
Superinfection
CNS toxicity, hepatotoxicity
Nephrotoxicity in high doses |
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Term
| Tetracycline Duration times |
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Definition
Short-acting
Tetracycline (Achromycin)
Intermediate-acting
Demeclocycline (Declomycin)
Long-acting
Doxycycline (Vibramycin)
May be taken with milk products and food |
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Term
| Tetracycline Nursing Interventions |
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Definition
Check C&S before drug.
Administer 1 hour before or 2 hours after meals.
Monitor kidney and liver function.
Store out of light and extreme heat.
Advise client to use sunblock.
Teach client to report superinfection.
Warn client to avoid milk, iron, antacids.
Tell client to use effective oral hygiene. |
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Term
Fluoroquinolones (Quinolones)
Not first Drug of choice |
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Definition
Action: Interfere with enzyme DNA gyrase Fight gram + and –
Broad spectrum: bactericidal
Uses: Streptococcus pneumoniae, Yellow Fever, typhoid, Legionaires, Salmonella, Bronchitis, GI, UTI
SE - Hematuria: blood in urine and
Crystalluria: inc. Uric Acid |
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Term
| Fluoroquinolones (Quinolones) (cont’d) |
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Definition
Routes
Oral
IV
Drugs
Ciprofloxacin (Cipro)
Levofloxacin (Levaquin)
Side effects/adverse effects
Rash, urticaria
Tinnitus, photosensitivity
GI upset, pseudomembranous colitis
Superinfection
Hematuria, crystalluria |
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Term
| Fluoroquinolones Nursing Interventions |
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Definition
Check C&S.
Infuse IV over 60 to 90 minutes.
Increase fluid intake to more than 2000 mL/d.
Tell client to avoid caffeine.
Check for superinfection. |
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Term
| Sulfonimades - 5cents a pill |
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Definition
Action: Inhibit bacterial synthesis of folic acid. Bacteriostatic
Fights gram – bacteria M.R.S.A.
Proteus, Klebsiella, E. coli, Chlamydia
Uses: Otitis media, respiratory infections, UTIs, prostatitis, gonorrhea
Route Oral, IV, topical, ophthalmic |
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Term
| Sulfonamides side affects |
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Definition
Side effects/adverse reactions
GI distress, stomatitis, photosensitivity
Crystalluria, renal failure
Blood dyscrasias, Stevens-Johnson syndrome |
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Term
| Sulfonamides Nursing Interventions |
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Definition
Administer with full glass of water 1 hour before meals or 2 hours after meals.
Increase fluid intake.
Monitor for sore throat, bruising, bleeding.
Monitor CBC.
Check for superinfection.
Advise client not to take with antacids.
Tell client to avoid direct sunlight. |
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