Term
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Definition
| Adminiatration of ax. based on the practioner's judgement of the pathogens more likely to be causing the infection |
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Term
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Definition
| Ax. Taken before exposure to an infectious organism to prevent the infection |
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Term
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Definition
| The administration of ax. based on known results of culture and sensitivity testing identifying the pathogen causing the infection |
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Term
| What is the procedure the nurse must follow before initiation of antibiotic therapy when cultures have also been ordered? |
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Definition
Specimen must be begun before the tx has begun.
Can put pt. on broad spectrum ax. as you wait for culture/sensitivity to come back. |
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Term
| What are general patient teaching points regarding the use of antibiotics? |
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Definition
Take as directed
Take with water
Avoid caffeine, citrus fruits,cola, juices and tomato juice (decreases effectiveness)
Report diarrhea, flu-like symptoms, blistering or peeling, hearing loss, SOB, seizures, foul smelling loose, frequent bloody stools |
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Term
| What is the purpose of adding probenicid when administering penicillin? |
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Definition
| It increases the penicillin reaction in the body. |
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Term
| What is the purpose of clavulanic acid in the combination med of Augmentin(a penicillin)?SHORT ANSWER |
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Definition
Clavulanic acid combines with amoxacillin to create augmentin. This reaction inactivates penicillinase and acts as a body guard to the beta-lactam ring!!!
The specific action of Clavulanic acid is that it binds with the betalactamase enzyme to prevent the enzyme from breaking down the penicillin molecule. |
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Term
| What are the two components of Augmentin? |
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Definition
| Amoxicillin and clavulanic acid |
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Term
| Which drugs are used in treatment of STD's? |
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Definition
Macrolides: Clarithromycin, Azithromycin, Erythromycin
Quinolones: Levofloxacin (Levaquin)
Cephalosporins: Rocephine -drug of choice for gonorrhea
Tetracyclines-Doxycycline-drug of choice for chlamydia/gonnorhea |
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Term
| What drug classification can be used as a penicillin substitute? |
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Definition
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Term
| What are 2 important nursing implications regarding Gentamicin? |
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Definition
It is a very nephrotoxic and ototoxic drug-a baseline kidney, liver and hearing function must be assessed before administering the medication and kidney functions (serum creatinine lvls) and hearing loss need to be assessed throughout therapy
Due to the severity of the side effects, informed consent is very important. |
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Term
| What is important to know about the dosaging of Gentamycin? |
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Definition
| Peak and tough levels must be monitored every 3 days. If once daily dosing is being taken, trough levels need to be monitored once daily. A dosage above 2mcg/L is TOXIC |
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Term
| What is a bacteriostatic antibiotic? |
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Definition
| antibiotics that do not actually kill the bacteria, but rather inhibit their growth. |
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Term
| What is a bacteriocidal antibiotic? |
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Definition
| Antibiotic that kills the bacteria. The best choice for an immunocompromised patient |
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Term
Drug Category: Penicillins
Name the drugs you need to know for this category |
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Definition
Amoxicillin
Augmentin (po)
Cloxacillin
Penicillin V (po) & G (procaine-IM) |
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Term
Drug Category: Penicillins
Indications |
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Definition
| syphilis, acute otitis media, hospital acquired infections such as pneumonia, sepsis, and intraabdominal infections |
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Term
Drug Category: Penicillins
Contraindications/ Precautions |
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Definition
| Anaphylactic reaction to penicillin--ALWAYS ask b/c there is a high incidence of allergies. |
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Term
Drug Category: Penicillins
Interactions |
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Definition
*Oral Contraceptives: render it ineffective
Probenecid: increase lvls in the body
*Fruit juices and other acidic fluids: decrease lvls in body
*Clavulanic acid: protects beta-lactam ring from bac. entry
*Aminoglycosides increase bacterial death if given spaced at least one hour apart.
NSAID’s: increase cillin lvls in body |
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Term
Drug Category: Penicillins
Side Effects |
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Definition
P.O.: N/V, diarrhea, hypersensitivity, rash
IM/ IV: hypersensitivity, diarrhea, thrombophlebitis (IV)
note: IM cillin called procain contains anesthetic agents |
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Term
Drug Category: Penicillins
When should they be administered?
can they be taken with meals? |
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Definition
Should be administered 1 hr. before meals or 2 hrs. after meals.
*Do not take with food. (except Penicillin V and Augmentin) |
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Term
Drug Category: Penicillins
what is something important to do after a cillin injection? |
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Definition
| *Pt. should be watched for 30 min. after injection. Emergency equipment should be nearby. |
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Term
| *Beware that not all penicillin products do not end in “cillin”. Give 3 examples: |
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Definition
| Unasyn, Zosyn and Augmenin |
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Term
Drug Category: Cephalosporins
What are the drugs you need to recognize? |
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Definition
Cefazolin (Kefzol)—1st
Cefoxitin (Mefoxin)—2nd
Ceftriaxone (Rocephin)-3rd
Cefepime (Maxipime)-4th
Ceftaroline (Teflaro)-5th |
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Term
Drug Category: Cephalosporins
Indications |
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Definition
Upper and lower resp. Infections;
**Rocephin is drug of choice for gonorrhea and CNS infections (meningitis) |
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Term
Drug Category: Cephalosporins
Contraindications/ Precautions |
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Definition
| Anaphylactic reactions to penicillin or cephalosporin. |
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Term
Drug Category: Cephalosporins
What is something very important to know about this category? |
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Definition
| they are cousins to penicillin, so there is a 1-4% possibility that the pt will be allergic to both. Check cross sensitivity. |
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Term
Drug Category: Cephalosporins
Drug/Food interations |
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Definition
Concurrent use with loop diuretics (lasix) may cause renal toxicity
Oral contraceptives-decrease lvls
*ETOH: disulfirum-like reaction with some sporins (anabuse) |
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Term
Drug Category: Cephalosporins
Side Effects |
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Definition
P.O.: N/V, diarrhea, H/A, increased bleeding, dizziness
**disfulfiram-like reaction w/ ETOH
nephrotoxicity
superinfection
IM: pain at injection site-Do NOT give in arm |
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Term
Drug Category: Cephalosporins
Special notes |
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Definition
*Administer with food or milk
*Administer IM deeply.
*Do not give with antacids.
*Avoid alcohol |
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Term
Drug Category: Cephalosporins
Which drug is used in the tx of gonorrhea?
What is the dosage? |
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Definition
Rocephin
250mg IM + PO 1000mg |
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Term
Drug Category: Tetracyclines
What are the drugs you need to recognize? |
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Definition
Tetracycline
Doxycycline
(Vibramycin) |
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Term
Drug Category: Tetracyclines
Indications |
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Definition
eradicates H. pylori associated with PUD
Chlamydia |
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Term
Drug Category: Tetracyclines
What is the drug of choice to tx chlamydia? |
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Definition
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Term
Drug Category: Tetracyclines
Contraindications/ Precautions |
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Definition
Previous anaphylactic reaction
*Pregnancy/nursing mothers, children under the age of 8 years of age |
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Term
Drug Category: Tetracyclines
Drug/Food Interaction |
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Definition
*Antacids, milk products,or iron interfere with absorption.**Do not give multivitamins with iron containing drugs
*Oral contraceptives-decrease lvls |
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Term
Drug Category: Tetracyclines
Side Effects |
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Definition
| GI upset, teeth discoloration in very young, photosensitivity, ; fetal skeletal growth retardation |
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Term
Drug Category: Tetracyclines
Special Notes |
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Definition
*Usually given po
*Do not give with dairy products
*Use sunscreen; sunglasses |
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Term
Drug Cataagory: Sulfonamides
What are the drugs you need to recognize? |
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Definition
| Co-Trimoxazole/SMX-TMZ:(Bactrim, Septra) |
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Term
Drug Cataagory: Sulfonamides
Indications |
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Definition
Co-trimoxazole:
Pneumocystis carinii pneumoniatreatment of community acquired MRSA |
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Term
Drug Cataagory: Sulfonamides
Contraindications/ Precautions |
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Definition
*Previous anaphylactic reaction
*Late pregnancy, Infants under 2 months |
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Term
Drug Cataagory: Sulfonamides
Drug/Food Interaction |
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Definition
* Oral contraceptives:
decrease lvls |
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Term
Drug Cataagory: Sulfonamides
Side Effects |
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Definition
Stevens -Johnson syndrome, hypersensitivity reactions
photosensitivity
nephrotoxicity
crystalluria |
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Term
Drug Cataagory: Sulfonamides
Special Notes |
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Definition
*Must maintain adequate fluid intake (2000 -3000 ml/day for adults)-so crystals won't develop
Notify care provider if rash develops (could be Steven-Johnson's syndrome) |
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Term
Drug Category: Aminoglycosides
what is the one drug? |
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Definition
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Term
Drug Category: Aminoglycosides
Indications |
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Definition
Serious infections with
Gram (-) organism such as E. Coli, Pseudomonas, & Klebsiella |
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Term
Drug Category: Aminoglycosides
Contraindications/Precautions |
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Definition
Liver or kidney damage
pregnancy (may cause bilateral congenital deafness)
any meds that have potential ototoxicity.(ASA, Lasix)-don't use ototoxic drugs together |
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Term
Drug Category: Aminoglycosides
Side Effects |
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Definition
Nephrotoxicity and ototoxicity (irreversible 8th nerve impairment)
muscular weakness and paralysis (reversible). |
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Term
Drug Category: Aminoglycosides
Special notes |
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Definition
*Very toxic drug category--Trough levels are monitored if once daily dosing is used—should be maintained below 2mcg/L (anything above 2mcg/L is TOXIC)
***Monitor kidney function (serum creatinine levels) and assess for hearing loss through out therapy.
*Keep pt. well hydrated—to prevent kidney damage |
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Term
Drug Category: Macrolides
Drugs |
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Definition
Clarithromycin
Azithromycin (Zithromax)
Erythromycin |
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Term
Drug Category: Macrolides
Indications |
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Definition
Chlamydia; community acquired pneumonia
H. pylori
penicillin substitute** QOT |
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Term
Drug Category: Macrolides
Contraindications/Precautions |
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Definition
*Known drug allergy to macrolides
*Oral Contraceptives: decreases lvl |
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Term
Drug Category: Macrolides
Drug/Food Interaction |
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Definition
| do not take with fruit juice |
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Term
Drug Category: Macrolides
Side Effects |
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Definition
| H/A, dizziness, GI upset; hepatotoxicity; photosensitivity; cardiac arrhythmias with high dose erythromycin; rash; hearing loss |
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Term
Drug Category: Macrolides
special notes |
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Definition
*Foods interfere with absorption of erythromycin —take one hour before or two hours after meals.
*Use sunscreen; sunglasses
*Baseline cardiac function (for erythromycin=dysrhythmias) |
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Term
Drug Category: Quinolones
Drugs |
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Definition
| Levofloxacin (Levaquin)--used commonly for UTIs |
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Term
Drug Category: Macrolides
Indications |
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Definition
|
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Term
Drug Category: Macrolides
Contraindications/ precautions |
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Definition
Not recommended for prepubertal children--but will see kids with cystic fibrosis take this med
May affect cartilage development.
Hypersensitivity |
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Term
Drug Category: Macrolides
Drug/Food Interaction |
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Definition
| Antacids, iron preparations decrease lvls |
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Term
Drug Category: Macrolides
Side Effects |
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Definition
psychosis
tendonitis and tendon rupture>65yoa(Achilles tendon) BLACK BOX WARNING
prolongation of QT interval-sudden cardiac death |
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Term
Drug Category: Macrolides
Special Notes |
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Definition
*Instruct to drink 8 glasses of H20/day and report decrease in urine output
*Use sunglasses and sunscreen. |
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Term
Drug Category: Vancomycin
Drugs |
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Definition
| Vancomycin (Vancocin, Vancoled |
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Term
Drug Category: Vancomycin
Indications |
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Definition
MRSA infections QOT
C.diff |
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Term
Drug Category: Vancomycin
Contraindications/Precautions |
|
Definition
Use with caution in patients with hearing loss or renal dysfunction.
Ototoxic/nephrotoxic |
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Term
Drug Category: Vancomycin
Drug/Food Interaction |
|
Definition
| Added neuromuscular blockade in patients taking neuromuscular blockers |
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Term
Drug Category: Vancomycin
Side Effects |
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Definition
| Ototoxicity and nephrotoxicity; red man syndrome: Histamine reaction= Flushing/puritis of head, neck and chest=IV too fast-should be given over an hour-may pre-treat with benadryl or vistadryl |
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Term
Drug Category: Vancomycin
Special Notes |
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Definition
*Reserved for severe infections b/c it is very toxic
*Maintain adequate hydration (2-3L/24 hours) |
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