Term
| What are disease producing-organisms? |
|
Definition
|
|
Term
| What are the 2 types of bacteria? |
|
Definition
|
|
Term
| What is the difference between the - and +? |
|
Definition
| The bacterial cell wall structure |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Are bacteria single or multi cell organisms? |
|
Definition
|
|
Term
| What is the smallest and toughest pathogen? |
|
Definition
|
|
Term
| What are yeasts or molds? |
|
Definition
|
|
Term
|
Definition
| The skin or subcutaneous tissue |
|
|
Term
| What are the 2 types of antibiotics? |
|
Definition
Bacteriostatic
Bacteriocidal |
|
|
Term
| What do bacteriostatic drugs do? |
|
Definition
Inhibit growth of bacteria
Inhibits Protein synthesis |
|
|
Term
| What do bactericidal drugs do? |
|
Definition
| Kill bacteria by affecting cell wall |
|
|
Term
| What are the 5 mechanisms of antibacterial action? |
|
Definition
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 |
|
|
Term
| What are some factors in determining the effectiveness of one's body defenses? |
|
Definition
| Age, nutrition, immunocompromised, circulation, WBCs, organ function |
|
|
Term
| What are the 4 types of resistance? |
|
Definition
1.) Natural/inherent
2.) Acquired
3.) Nosocomial
4.) Cross-resistance |
|
|
Term
| What is acquired resistance? |
|
Definition
the bacteria evolves (mutant) and becomes resistant
caused by prior exposure to the antibacterial: staphylococcus aureus was once sensitive to PCN G, repeat exposure has caused this organism to evolve and become resistant to PCN G.
Penicillinase- resistant PCNs are currently available that are effective against S. aureus. |
|
|
Term
| What is nosocomial resistance? |
|
Definition
bacterial infections acquired in hospitals
MRSA used to be but is now community required |
|
|
Term
| What is cross-resistance? |
|
Definition
| antibiotics susceptibility testing (C&S) |
|
|
Term
| What is natural resistance? |
|
Definition
| occurs w/o previous exposure to the antibacterial drug: gram-negative (non-gram staining) bacterium Pseudomonas aeruginosa is naturally resistant to pencillin G. |
|
|
Term
| What is antibiotic resistance? |
|
Definition
- public health problems.
Bacteria resistant to antibiotics has increased in the last decade. |
|
|
Term
|
Definition
| kill sensitive bacteria, but resistant germs may be left to grow and multiply. |
|
|
Term
| What does improper use of antibiotics cause? |
|
Definition
| increase in drug-resistant bacteria. |
|
|
Term
| What causes failure of antibiotics to work? |
|
Definition
longer-lasting illnesses,
more doctor visits or extended hospital stays, and the need for
more expensive and toxic medications.
Some resistant infections can even cause death. |
|
|
Term
|
Definition
Vanc. Resistant Enterococci
can cause death in person with weakened immune system. Resistant to: PCN, aminoglycosides, Vanco |
|
|
Term
|
Definition
| Methocillin Resistant Stapholococcus Aureus |
|
|
Term
|
Definition
| effective against MRSA, VREF, and Penicillin-resistant-streptococci |
|
|
Term
|
Definition
| used against life-threatening infections caused by VREF and treatment of bacteremia, S. aureus, and streptococcus pyogenes. |
|
|
Term
| How are antibiotics misused? |
|
Definition
Viral infections
Taken incorrectly
Patient demands antibiotics |
|
|
Term
| What is the nurses role in misuse of antibiotics? |
|
Definition
| to teach clients proper use of antibiotics to prevent situations that promote drug resistance to bacteria. |
|
|
Term
| What can we do to prevent misuse? |
|
Definition
Culture and sensitivity (C&S)-detects the microorganism present in a sample and what drug can kill it.
Multiantibiotic therapy- daily use of multiple antibacterials, delays development of resistance. |
|
|
Term
| When are antibiotics combined? |
|
Definition
For specific uncontrollable infections
Infection of unknown origin
Treatment was unsuccessful with single antibiotics
Obtain culture and sensitivity |
|
|
Term
| What are the 3 antibiotic combinations? |
|
Definition
1.) Additive
2.) Potentiative
3.) Antagonistic |
|
|
Term
| What is an additive antibiotic effect? |
|
Definition
|
|
Term
| What is a potentiative effect? |
|
Definition
|
|
Term
|
Definition
| If one bactericidal and one bacteriostatic - the desired effect is diminished |
|
|
Term
| What is a mild allergic reaction to antibiotics? |
|
Definition
Rash, pruritus, hives
Treatment: antihistamine |
|
|
Term
| What is a severe allergic reaction to antibiotics? |
|
Definition
Occurs within 20 min.
FIRST symptom is SOB
Bronchospasm, laryngeal edema, vascular collapse, cardiac arrest
Treatment: epinephrine, bronchodilator, and antihistamines |
|
|
Term
| What are the 3 general adverse rxns? |
|
Definition
1.) Allergic rxn
2.) Super infection
3.) ORgan toxicity |
|
|
Term
| What is a superinfection? |
|
Definition
normal flora are killed
Sites: mouth, skin, respiratory tract, vagina, intestines
Usually occurs when treated more than 1 week
Mouth –Candidas fungal infection- Give nystatin
GI- Clostridium difficile C diff- Tx: metronidazole (flagyl) or vancomycin by mouth |
|
|
Term
|
Definition
Liver- Hepatotoxic
Kidney-Nephrotoxic; aminoglycosides
Ear- Oto toxic; aminoglycosides |
|
|
Term
|
Definition
|
|
Term
| What is the problem with C.Diff? |
|
Definition
| norma flora are gone and Clostridium can then multiply. |
|
|
Term
| What is the treatment of C.Diff? |
|
Definition
stop the antibiotic which is killing the norma flora
Start- Flagyl (metronidazole) or Vanco
Start Probiotics similar to beneficial microorganisms found in the human gut
Hydration |
|
|
Term
| What are the 2 types of antibacterial spectrums? |
|
Definition
|
|
Term
| What are narrow spectrum antibacterials effective against? |
|
Definition
Primarily effective against one bacteria type
Examples: penicillin, erythromycin- against gram-positive bacteria |
|
|
Term
| What are broad spectrum antibacterials effective against? |
|
Definition
Effective against gram + and gram –
Examples: tetracycline, cephalosporins
Used when the offending microorganism has not been Identified by C&S |
|
|
Term
|
Definition
Bacteria can produce enzymes called beta-lactamases which can inactivate Penicillin and other antibiotics; cephalosporins
The beta-lactamases which attack penicillins are called penicillinases. |
|
|
Term
| What is the structure of penicillin? |
|
Definition
|
|
Term
| What are basic penicillins? |
|
Definition
Narrow-spectrum
Introduced to kill Staphyloccus
Bacteria die of cell lysis |
|
|
Term
|
Definition
BASIC
; given orally or by injection; painful |
|
|
Term
|
Definition
BASIC
less potent; use in mild to moderate infection |
|
|
Term
| What is the broad spectrum penicillin? |
|
Definition
|
|
Term
| What is the penicillinase-resistant penicillin? |
|
Definition
| Antistaphylococcal Penicillins |
|
|
Term
| What is the extended-spectrum penicillin? |
|
Definition
| Antipseudomonal Penicillins |
|
|
Term
| What is used instead of basic penicillin? |
|
Definition
|
|
Term
| What kinds of bacteria do broad spectrum penicillins kill? |
|
Definition
| Escherichia coli, Salmonella, Haemophilus influenzae, Shigella dysenteriae |
|
|
Term
|
Definition
respiratory infection, UTI, otitis media
Not penicillinase resistant thus ineffective against- S. Aureus |
|
|
Term
| Is penicillin bacteriastatic/cidal? |
|
Definition
|
|
Term
| What are 2 broad-spectrums penicillins? |
|
Definition
amoxicillin (Amoxil)
ampicillin (Omnipen) |
|
|
Term
| Who should not use penicillins? |
|
Definition
| Allergic to PCN, Severe renal dx, hypersensitivity to cephalosproins |
|
|
Term
| What are the side effects of penicillins? |
|
Definition
| N/V & diarrhea, rash, stomatitis |
|
|
Term
| What do penicillinase-resistant penicillins effective against? |
|
Definition
Against most gram +
Staphylococcus
Bactericidal
Also known as antistaphylococcal penicillins |
|
|
Term
|
Definition
Oral preparation: dicloxacillin (Dynapen)
IM and IV preparations: Nafcillin (Unipen) and Oxacillin (Prostaphin) |
|
|
Term
| What is P-RP not effective against? |
|
Definition
Not effective against gram-negative organisms
Less effective than penicillin G against gram+ |
|
|
Term
| Who is P-RP contraindicated in? |
|
Definition
| allergic to PCN, hypersensitivity to cephalosporins |
|
|
Term
| What are the side effects of P-RP? |
|
Definition
|
|
Term
| What is important to note about dicloaxcillin? |
|
Definition
| Dicloxacillin is highly protein bound, toxicity may result when other highly protein bound drugs are used. |
|
|
Term
| What are extended-spectrum penicillins (antipseudomonals) effective against? |
|
Definition
Gram negative bacillus
Pseudomonas aeruginosa, Proteus, Klebsiella
pneumoniae |
|
|
Term
| What are E-SP used to treat? |
|
Definition
| bone, joint, skin, soft tissue, respiratory tract, UTI |
|
|
Term
| Is E-SP bacteriastatic/cidal? |
|
Definition
|
|
Term
|
Definition
Oral preparations: carbenicillin indanyl (Geocillin)
IV preparations: piperacillin-tazobactam (Zosyn), ticarcillin-clavulanate (Timentin) |
|
|
Term
| Who should not use Geocillin? |
|
Definition
| clients with hypertension or heart failure, r/t drug containing large amounts of sodium. |
|
|
Term
| What is Zosyn used to treat? |
|
Definition
| treat appendicitis, skin infections, pneumonia, beta-lactamase –producing bacterial. Tazobactam is a beta-lactamase inhibitor. |
|
|
Term
| What is timentin used for? |
|
Definition
| septicemia, lower respiratory tract, UTI, skin, bone, and joint infections. |
|
|
Term
| Are beta-lactamase inhibitors given alone? |
|
Definition
|
|
Term
| What are b-li combined with? |
|
Definition
| Broad-spectrum antibiotics combined with a beta-lactamase inhibitor: inhibits the bacterial beta-lactamases, makes the antibiotic effective and extends its antimicrobial effect. |
|
|
Term
| What are some examples of b-li? |
|
Definition
oral: amoxicillin-clavulanic acid (Augmentin)
IV: ampicillin-sulbactam (Unasyn)
piperacillin-tazobactam (Zosyn) |
|
|
Term
| What nursing interventions are involved with penicillin? |
|
Definition
C&S before drugs given
Monitor for N/V/D, bleeding disease (life threatening)
Monitor closely during first dose for allergic reaction (rash: mild to mod reaction; Laryngeal edema,etc.severe)
Increase fluids
Check for superinfection
Geriatrics- monitor BUN and Creatinine
Teach decreased effectiveness of oral contraceptives |
|
|
Term
| After administering the first dose of amoxicillin, a broad-spectrum penicillin, the client complains of shortness of breath and has audible stridor. What nursing action is priority? |
|
Definition
| The nurse suspects an anaphylactic reaction and notifies the physician. |
|
|
Term
|
Definition
Semi-synthetic- molecules were chemically altered
Beta-lactam structure-inhibit bacterial enzyme necessary to cell wall synthesis, cell lysis
Bactericidal- cell death
Treat
Respiratory, urinary, skin, bone, joint, and genital infections
Allergy to PCN, small likelihood may have an allergy to cephalosporin. |
|
|
Term
| What is a first generation cephalosporin? |
|
Definition
| Cephalexin (Keflex), cefazolin (Ancef) |
|
|
Term
| What is a second generation cephalosporin? |
|
Definition
| Cefaclor (Ceclor), cefOXitin (Mefoxin) |
|
|
Term
| What is a third generation cephalosporin? |
|
Definition
| Cefoperazone (Cefobid), cefTRIAXone (Rocephin) |
|
|
Term
| What is a fourth generation cephalosporin? |
|
Definition
|
|
Term
| What is 1st generation effective against? |
|
Definition
Gram +
streptococci & most staphylocci
Little Gram -
bacteria E. coli, Klebsiella |
|
|
Term
| What is 2nd generation effective against? |
|
Definition
Gram + bacteria as above but,
Broader spectrum against Gram –: Neisseria gonorrhorae,Haemophilus influenzae, Neisseria meningitidis |
|
|
Term
| What is 3rd generation effective against? |
|
Definition
Gram –: Psuedomonas aeruginosa
Gram + bacteria: less effective against |
|
|
Term
| What is 4th generation effective against? |
|
Definition
Resistant to most beta-lactamase bacteria
Gram – and Gram + :E. coli, Klebsiella, Streptococci, staphylococci |
|
|
Term
| How are cephalosporins administered? |
|
Definition
Oral: cefaclor (Ceclor)
IM, IV: cefazolin (Ancef) |
|
|
Term
| What are the side effects of cephalosporins? |
|
Definition
GI distress, weakness, pruritus
With high doses: increased bleeding, seizures, nephrotoxicity |
|
|
Term
| Who should not use cephalosporins? |
|
Definition
| hypersensitivity to cephalosporins or PCN, renal disease, lactation |
|
|
Term
| What are the drug interactions of cephalosporins? |
|
Definition
Alcohol: may cause flushing, dizziness, HA, n, v, muscular cramps
Uricosurics: decrease cephalosporin excretion= increasing serum levels of cephalosporins |
|
|
Term
| What are the nursing interventions involved with cephalosporins? |
|
Definition
Assess for allergy
C&S before therapy
Assess renal and liver function
Administer IV over 30 min b.I.d.-q.I.d.
Monitor for superinfection
Safety: keep out of reach of children |
|
|
Term
Which nursing intervention is a higher priority
for the client who is taking cefepime
(Maxipime)? |
|
Definition
| Monitor the client for signs and symptoms of a superinfection. |
|
|
Term
| What teaching is important with cephalosporins? |
|
Definition
- Report signs of superinfection
- Probiotics
-Take the complete course of medication
-Report IV site irritation
-Report hypersensitivity
- Take w/ food to avoid GI upset
-Avoid alcohol |
|
|
Term
|
Definition
Inhibits protein synthesis
Broad spectrum
Most gram +, some gram – bacteria
Bacteriostatic: low to moderate doses
Bactericidal: high doses |
|
|
Term
| What are the 2 routes for Macrolides? |
|
Definition
|
|
Term
| What are macrolides used for? |
|
Definition
Use if allergy to PCN
Moderate to severe infections
Respiratory, GI tract, skin, and soft tissue infection
Treat mycoplasmal pneumoniae, Legionnaire’s disease |
|
|
Term
| What is legionnaire's disease? |
|
Definition
| fatal disease; pneumonia, dru cough, myalagia, GI symptoms. Progression leads to other organ dysfunction and eventually cardiovascular collapse. |
|
|
Term
| What are the side effects of Macrolides? |
|
Definition
GI distress
Tinnitus (ototoxic with high dose)
Superinfection
Hepatotoxicity |
|
|
Term
| What are some Macrolides? |
|
Definition
Erythromycin (E-Mycin)
Clarithromycin (Biaxin, Biaxin XL)
Azithromycin (Zithromax) |
|
|
Term
| What are the drug interactions of Macrolides? |
|
Definition
Serum levels of warfarin, digoxin, theophylline, carbamazepine increase
Erythromycin levels increase with fluconazole (Diflucan), ketoconazole (nizoral), verapamil (Calan), diltiazem (Cardizem), clarithromycin (Biaxin)
Risk of sudden cardiac death
Azithromycin levels may be reduced by antacids |
|
|
Term
| What nursing interventions are related to Macrolides? |
|
Definition
Culture and sensitivity before therapy
Monitor vital signs, urine output, and lab values (liver enzymes)
Advise client to take full regimen
Administer antacids 2 hrs before or 2 hrs after macrolides
Give azithromycin 1 hr before or 2 hrs after meals with full glass of water (may give with food if GI upset occurs)
Monitor PT/INR- warfarin |
|
|
Term
| What is the action of Lincosamide? |
|
Definition
Inhibit bacterial protein synthesis
Fight gram + staph aureus
Bacteriostatic and bactericidal
Dependent upon dosage
Examples
Clindamycin (Cleocin)
Lincomycin (Lincocin) |
|
|
Term
| What are the side effects of lincosamides? |
|
Definition
| GI distress, rash, colitis, stomatitis, anaphylactic shock |
|
|
Term
| What are the drug interactions of lincosamides? |
|
Definition
| Incompatible with aminophylline, phenytoin (Dilantin), barbiturates, and ampicillin |
|
|
Term
| What is the action of glycopeptides? |
|
Definition
Inhibits cell wall synthesis
Fights gram +, staph aureus
Bactericidal |
|
|
Term
| What is glycopeptide used to treat? |
|
Definition
Serious infections of bone, skin, lower respiratory tract
Against drug-resistant S. aureus and prophylaxis use for cardiac surgery patients allergic to PCN |
|
|
Term
| What is an example of a glycopeptide? |
|
Definition
Vancomycin (Vancocin)
Vancomycin is now ineffective for treating enterococci (VREF), which leads to staphylococcal endocarditis |
|
|
Term
| What is used to treat VREF? |
|
Definition
| Quinupristin/dalfopristin is used to treat life-threatening vancomycin-resistant enterococci (VREF) infections |
|
|
Term
| What are the side effects/adverse reactions of glycopeptides? |
|
Definition
Red neck or red man syndrome
Occurs when IV too rapid
Severe hypotension, red flushing of face, neck, chest, extremities
Nephrotoxicity
Ototoxicity- damage to CN VIII (auditory and balance may be permanent)
Chills, dizziness, fever, rash, N/V, thrombophlebitis |
|
|
Term
| What is oral glycopeptide used to treaT? |
|
Definition
|
|
Term
| What is IV vanc used to treat? |
|
Definition
| : treatment of severe infection due to MRSA, septicemia, bone, skin, and lower respiratory tract infections |
|
|
Term
| What interventions should be made with glycopeptides? |
|
Definition
Culture and sensitivity prior to therapy
Monitor vancomycin levels (peaks and troughs)
Administer over 1-2 hrs IV, rotate sites
Monitor BP, renal function, superinfection, hearing, IV site |
|
|
Term
| What do you do before administering glycopeptides? |
|
Definition
|
|
Term
|
Definition
| Closely related to macrolide |
|
|
Term
| What is the action of a ketolide? |
|
Definition
| Blocks protein bacterial synthesis |
|
|
Term
| What are the uses of ketolides? |
|
Definition
| Acute /chronic bronchitis, acute bacterial sinusitis, community-acquired pneumonia |
|
|
Term
| What is an example of the ketolide? |
|
Definition
|
|
Term
| What is the route of administration of ketolides? |
|
Definition
|
|
Term
| What are the side effects of ketolides? |
|
Definition
| Visual disturbances, HA. dizziness, GI distress (N/V/D) |
|
|
Term
| What are the drug interactions involved with ketolides? |
|
Definition
Antilipids, antidysrhythmics, cisapride, midazolam
Rifampin, phenytoin, carbamazepine, phenobarbital
Digoxin levels are increased |
|
|
Term
| What is the action tetracycline? |
|
Definition
Inhibits protein synthesis and have a bacteriostatic effect
Broad spectrum
Fights gram + and – bacteria
Fights Mycoplasma pneumoniae, Helicobacter pylori in peptic ulcer disease, & severe acne vulgaris
Treats acne (oral, topical)
Bacterial resistance |
|
|
Term
| What are the routes of tetracycline? |
|
Definition
|
|
Term
| What are the side effects of tetracyclines? |
|
Definition
GI distress, photosensitivity, stomatitis
Discolors permanent teeth
Do not give to children less than age 8
Blood dyscrasia, superinfection
Pseudomembranous colitis, CNS toxicity
Hepatotoxicity- with high doses
Nephrotoxicity: in high doses; tetracycline with aminoglycoside
Pregnancy category D |
|
|
Term
| What is a short acting tetracycline? |
|
Definition
| Tetracycline (Achromycin) |
|
|
Term
| What is an immediate acting tetracycline? |
|
Definition
| Demeclocycline (Declomycin) |
|
|
Term
| What is a long acting tetracycline? |
|
Definition
Doxycycline (Vibramycin)
May be taken with milk products and food |
|
|
Term
| What are the drug/food interactions of tetracyclines? |
|
Definition
Milk products, antacids
Decreases effects of oral contraceptives
Digoxin absorption is increased, leading to toxicity |
|
|
Term
| What nursing interventions should be made with tetracyclines? |
|
Definition
Culture and sensitivity prior to drug
Administer 1 hr before or 2 hr after meals
Monitor kidney and liver function
Store out of light and extreme heat
Advise client to use sun block
Teach client to report superinfection
Warn client to avoid milk, iron, antacids (inhibit absorption) exception: doxyclycline & monocycline
Tell client to use effective oral hygiene
Oral contraceptives actions lessened. |
|
|
Term
| What is the action of amino glycosides? |
|
Definition
Inhibit bacterial protein synthesis
Gram -, E. coli, Proteus pseudomonas,
Bactericidal |
|
|
Term
| What are some amino glycosides? |
|
Definition
Streptomycin highly toxic drug
Gentamicin (Garamycin), kanamycin (kantrex), tobramycin (Nebcin) |
|
|
Term
| What are the routes of aminoglycosides |
|
Definition
|
|
Term
| What are amino glycosides used for? |
|
Definition
| serious infections, pre-op bowel antiseptic, tx intestinal amebiasis and tapeworm infestation |
|
|
Term
| What are the side effects of amino glycosides? |
|
Definition
Photosensitivity
Superinfection
Ototoxicity
Nephrotoxicity |
|
|
Term
| What are the drug interactions associated with aminoglycosidess? |
|
Definition
Penicillins decrease aminoglycoside effectiveness
Penicillins increase warfarin’s effect |
|
|
Term
| What are the nursing interventions related to amino glycosides? |
|
Definition
Culture and sensitivity
Monitor renal function, hearing loss
Warn to use sun block
Monitor for superinfection; stomatitis, vaginitis, itching
Monitor peak and trough levels
I & O, urinary output at least 600mL/day
Vital signs, note decreased body temp
Report N/V, tremors, tinnitus, pruritis, and muscle cramps |
|
|
Term
| What is the action of fluoroquinolones? |
|
Definition
Interfere with enzyme DNA gyrase
Fight gram + and –
Broad spectrum: bactericidal |
|
|
Term
| What are fluoroquinolones used in treating? |
|
Definition
Streptococcus pneumoniae, Haemophilus influenazep, salmonella, Shigella
Treat UTI, bone, and joint infections, bronchitis, pneumonia, gonorrhea, gastroenteritis
Drug of choice for anthrax prevention |
|
|
Term
| What are the routes for fluoroquinolones? |
|
Definition
|
|
Term
| What are examples of fluoroquinolones? |
|
Definition
| Ciprofloxacin (Cipro), levofloxacin (Levaquin) |
|
|
Term
| What are the s/e of fluoroquinolones? |
|
Definition
GI upset, rash, urticaria, tinnitus, photosensitivity
Superinfection
Hematuria, crystalluria
Psudomembranous colitis |
|
|
Term
| What are the drug interactions of fluoroquinolones? |
|
Definition
Antacids decrease absorption rate
Levofloxacin increase effect of oral hypoglycemics, theophylline, caffeine, warfarin |
|
|
Term
| What nursing interventions are important in fluoroquinolones? |
|
Definition
Culture and sensitivity
Infuse IV over 60-90 min
Increase fluid intake to >2000 ml/d
Check for superinfection; avoid caffeine
Levofloxacin (Levaquin) should be taken before meals, food slows the absorption rate |
|
|
Term
Which teaching has highest priority for the
client taking azithromycin (Zithromax) a macrolide? |
|
Definition
Instruct the client to report any loose stools or diarrhea
The client should be instructed to report loose stools or diarrhea because of possible pseudomembranous colitis. Photosensitivity during sun exposure is common with tetracyclines, which should not be given to children less than 8 years of age; the drugs are affected by light and extreme heat. |
|
|
Term
| What is the action of sulfonamides? |
|
Definition
Bacteriostatic-Inhibit bacterial synthesis of folic acid
Fights gram – bacteria
Proteus, Klebsiella, E. coli, Chlamydia |
|
|
Term
| What is sulfonamides uses? |
|
Definition
alternative for clients allergic to PCN
Otitis media, respiratory infections, rheumatic fever
UTIs, prostatitis, gonorrhea |
|
|
Term
| What are the routes for sulfonamides? |
|
Definition
Oral, IV,
Topical- Silvadene for burns
Ophthalmic- newborn eye prophylaxis |
|
|
Term
| What are the 2 types of sulfonamides? |
|
Definition
Short-acting
Sulfisoxazole (Gantrisin)
Intermediate-acting
Sulfamethoxazole (Gantanol)
Trimethoprim-sulfamethoxazole (Bactrim) |
|
|
Term
| What are the side effects of sulfonamides? |
|
Definition
GI distress, stomatitis, photosensitivity
Crystalluria, renal failure
Blood dyscrasias, Stevens-Johnson syndrome
Allergic response: skin rash itching
Cross-sensitivity-sensitivity to one may lead to another |
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Term
| What are the nursing interventions r/t sulfonamides? |
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Definition
Increase fluid intake
Monitor renal function, CBC
Monitor for rash, superinfection
Avoid during third trimester
Avoid antacids |
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Term
| What else is important to know about sulfonamides? |
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Definition
| Poorly soluble in urine and can cause crystallization, which could damage the kidneys if there is insufficient fluid and water intake. Current sulfonamides have greater water solubility; therefore crystal formations in the urine and renal damage are unlikely. |
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Term
| What is Trimethoprim/sulfamethoxazole |
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Definition
Bactrim, Septra
Interferes with bacterial folic acid synthesis
Urinary tract antiinfective
Effective against gram –
Proteus, Klebsiella, E. coli
Synergistic effect |
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Term
| What is a combination sulfonamide? |
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Definition
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Term
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Definition
Blocks bacterial protein synthesis
Bactericidal effect |
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Term
| What is TMP/SMZ used to treaT? |
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Definition
| UTI, intestinal, otitis media, lower respiratory, prostatitis, gonorrhea, prevents Pneumocystis carinii in client with AIDS. |
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Term
| What is route of TMP/SMZ? |
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Definition
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Term
| What is the drug interaction of TMP/SMZ? |
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Definition
Warfarin
Increases anticoagulation effect
Oral hypoglycemic
Increases hypoglycemia effect |
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Term
| What are the side effects of TMP/SMZ? |
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Definition
Mild to moderate rash, photosensitivity
GI distress, stomatitis, crystalluria
Fatigue, depression, headache, dizziness |
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Term
| What are the life threatening effects of TMP/SMZ? |
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Definition
Blood dyscrasias/ anemias
Stevens-Johnson syndrome
Renal failure |
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Term
| What is Steven Johnson's Syndrome? |
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Definition
| systemic skin disease that produces fevers and lesions of the oral conjunctival, and vaginal mucous membranes. Marked by a cutaneous rash that is often widespread and severe. Skin loss may lead to dehydration, infection or death. |
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Term
| What nursing interventions are r/t TMP/SMZ? |
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Definition
Increase fluid intake - Administer with full glass of water 1 hr before meals or 2 hrs after meals
Monitor for sore throat, bruising, bleeding
Monitor CBC-bleeding? Warfarin? PT/INR?
Check for superinfection- stomatitis, black tongue, anal/genital discharge, and itching
Advise client not to take with antacids
Tell client to avoid direct sunlight
Monitor VS, make sure Temp decreased |
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Term
| Why increase fluids with TMP/SMZ? |
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Definition
| Increase fluid intake is highly recommended to avoid complication such as crystallizaton in urine. |
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Term
Which of the following is a higher priority for
teaching the client who is taking TMP-SMX? |
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Definition
Encourage an increase in fluid intake.
Fluid intake should be increased to at least 2000 ml/day when taking sulfonamides to prevent crystalluria. Ototoxicity is not a common adverse effect of sulfonamides. Photosensitivity is a side effect. Dairy products or antacids should not be taken at the same time as sulfonamides because they decrease absorption. |
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