| Term | Definition |
|---|
| blood dyscrasias | disease of blood and bone marrow |
| Helicobacter pylori | causes ulcers |
| myasthenia gravis | a chronic progressive disease characterized by chronic fatigue and muscular weakness (especially in the face and neck) |
| Tetracyclines, Macrolides, and Lincosamides | groups of broad-spectrum antibiotics |
| tetracyclines | include doxycycline (Vibramycin), minocycline (Minocin), and tetracycline (Sumycin). |
| macrolides | include azithromycin (Zithromax), clarithromycin (Biaxin), and erythromycin (E-Mycin). |
| lincosamides | include clindamycin (Cleocin) and lincomycin (Lincocin). |
| The tetracycline | are a group of anti-infectives composed of natural and semisynthetic compounds. They are useful in select infections when the organism shows sensitivity |
| to the tetracyclines, | such as cholera, Rocky Mountain spotted fever, and typhus. |
| tetracycline actions | The tetracyclines exert their effect by inhibiting bacterial protein synthesis (reproduction of the microorganism.( for reproduction) |
| tetracycline uses | These antibiotics are effective in the treatment of infections caused by a wide range of gram-negative and gram-positive microorganisms.broad-spectrum antibiotics when penicillin is contraindicated |
| The tetracycline treat treat | # Rickettsial diseases (Rocky Mountain spotted fever, typhus fever, and tick fevers) # Intestinal amebiasis # Some skin and soft tissue infections # Uncomplicated urethral, endocervical, or rectal infections caused by Chlamydia trachomatis # Severe acne as an adjunctive treatment (therapy used in addition to a primary treatment) |
| The tetracycline Adverse Reactions | Gastrointestinal Reactions * Nausea or vomiting * Diarrhea * Epigastric distress * Stomatitis * Sore throat |
| Infection with Helicobacter pylora | (a bacterium in the stomach that can cause peptic ulcer) in combination with metronidazole and bismuth subsalicylate.# Skin rashes # Photosensitivity reaction (demeclocycline seems to cause the most serious photosensitivity |
| tetracycline Contraindications | The tetracyclines are contraindicated in the patient known to be hypersensitive to any of the tetracyclines; during pregnancy because of the possibility of toxic effects to the developing fetus (pregnancy category D); and during lactation and in children younger than 9 years. |
| Nursing Alert children | The tetracyclines are not given to children younger than 9 years of age unless their use is absolutely necessary because these drugs may cause permanent yellow-gray-brown discoloration of the teeth. |
| Nursing Alert children 2 | The use of the tetracyclines, especially prolonged or repeated therapy, may result in overgrowth of nonsusceptible bacterial or fungal organisms. |
| The tetracycline Precautions | Tetracyclines should be used cautiously in patients with impaired renal function (when degradation of the tetracyclines occurs, the agents are highly toxic to the kidneys) |
| The tetracycline Precautions 2 | those with liver impairment (doses greater that 2 g/day can be extremely damaging to the liver). |
| Chronic Care Alert toxicity | Tetracyclines may increase the risk of toxicity in patients who take digitalis drugs for heart disease.The effects of toxicity could last for months after tetracycline administration discontinues. |
| tetracycline Interactions | antacids containing aluminum, zinc, magnesium, or bismuth salts, oral anticoagulants Blood thinner Increased risk for bleeding, oral contraceptives |
| Chronic Care Alert diabetes | Tetracyclines may reduce insulin requirements in patients with diabetes. |
| Macrolides Actions | The macrolides are bacteriostatic or bactericidalin susceptible bacteria. The drugs act by causing changes in protein function and synthesis. |
| Macrolides Uses | as prophylaxis before dental or other procedures in patients allergic to penicillin |
| Macrolides Uses 2 | * A wide range of gram-negative and gram-positive infections * Acne vulgaris and skin infections * Upper respiratory infections caused by Hemophilus influenzae (with sulfonamides) |
| Macrolides Adverse Reactions | Gastrointestinal reactions include the following: * Nausea * Vomiting * Diarrhea * Abdominal pain or cramping |
| Macrolides Adverse Reactions 2 | pseudomembranous colitis may occur, ranging in severity from mild to life-threatening. Visual disturbances (associated with telithromycin) may also occur. |
| Macrolides Contraindications | in patients with a hypersensitivity to the macrolides preexisting liver disease. Telithromycin (Ketek) should not be ordered if a patient is taking cisapride (Propulsid) or pimozide (Orap). |
| Macrolides Precautions | Macrolides should be used cautiously in patients who have liver dysfunction or myasthenia gravis (a disease that affects the myoneural junction in nerves and is manifested by extreme weakness and exhaustion of the muscles), or who are pregnant or lactating (azithromycin and erythromycin |
| Macrolides Precautions 2 | are in pregnancy category B; clarithromycin, dirithromycin, troleandomycin, and telithromycin are in pregnancy category C). |
| Macrolides Interactions | antacids (kaolin, aluminum salts, or magaldrate) anticoagulants |
| Macrolides Interactions 2 | clindamycin, lincomycin, or chloramphenicol Anti-infective agent Decreased therapeutic activity of the macrolide |
| Macrolides Interactions 3 | theophylline Management of respiratory problems, such as asthma Increased serum theophylline level |
| Lincosamides | anti-infectives with a high potential for toxicity, are usually used only for treating serious infections in which penicillin or erythromycin (a macrolide) is not effective. |
| Lincosamides actions | The lincosamides act by inhibiting protein synthesis in susceptible bacteria, causing cell death. |
| Lincosamides Uses | wide range of gram-negative and gram-positive microorganisms.may be used in conjunction with other antibiotics. |
| Lincosamides Adverse Reactions | GI Reactions * Abdominal pain * Esophagitis * Nausea * Vomiting * Diarrhea |
| Lincosamides Adverse Reactions 2 | * Skin rash * Blood dyscrasias (an abnormality of the blood cell structure or function) These drugs also can cause pseudomembranous colitis, |
| Lincosamides Contraindications | infants younger than 1 month , * Hypersensitive to the lincosamides * Taking cisapride (Propulsid) or the antipsychotic drug pimozide (Orap) * With minor bacterial or viral infections |
| Lincosamides Precautions | GI disorders, renal disease, liver impairment, or myasthenia gravis (lincosamides have neuromuscular blocking action). |
| Lincosamides Interactions | kaolin-or aluminum-based antacids Relief of stomach upset Decreased absorption of the lincosamide neuromuscular blocking drugs (see Chapter 21) Anesthesia Increased action of neuromuscular blocking drug, possibly leading to severe and profound respiratory depression |
| Preadministration Assessment | signs and symptoms of an infection in various areas of the body are pain, drainage, redness, changes in the appearance of sputum, general malaise, chills and fever, cough, and swelling. |
| Preadministration Assessment | It is important to establish an accurate database before the administration of any antibiotic.The nurse obtains a thorough allergy history,take and record vital signs before the first dose of the antibiotic is given. |
| Ongoing Assessment | An ongoing assessment is important during therapy with the tetracyclines, macrolides, and lincosamides. The nurse should take vital signs every 4 hours or as ordered by the primary health care provider |
| notify the primary health care provider | if there are changes in the vital signs, such as a significant drop in blood pressure, an increase in the pulse or respiratory rate, or a sudden increase in temperature. |
| Nursing Diagnosis Checklist | Impaired Comfort: Increased Fever related to ineffectiveness of anti-infective therapy Risk for Injury related to visual disturbances from telithromycin treatment Diarrhea related to superinfection secondary to anti-infective therapy, adverse drug reaction |
| Planning | The expected outcomes for the patient may include an optimal response to therapy, which includes control of the infectious process or prophylaxis of bacterial infection |
| Implementation Promoting an Optimal Response to Therapy | These drugs are of no value in the treatment of infections caused by a virus or fungus.its purpose is for preventing (prophylaxis) or treating a secondary bacterial infection that could potentially develop after the primary fungal or viral infection. |
| Tetracyclines It is important to give the tetracyclines on an empty stomach. | Tetracyclines It is important to give the tetracyclines on an empty stomach. The exceptions are minocycline (Minocin) and oxytetracycline (Terramycin), which may be taken with food. |
| Nursing Alert 1 | Nursing Alert The nurse should not give tetracyclines along with dairy products (milk or cheese), antacids, laxatives, or products containing iron. 2 after or before |
| Macrolides | Macrolides The nurse gives clarithromycin, troleandomycin, and telithromycin without regard to meals, and clarithromycin may be taken with milk, if desired. Azithromycin is given 1 hour or more before a meal or 2 hours or more after a meal. |
| Lincosamides | Food impairs the absorption of lincomycin. The patient should take nothing by mouth (except water) for 1 to 2 hours before and after taking lincomycin. |
| Parenteral Administration | When these drugs are given intramuscularly, the nurse inspects previous injection sites for signs of pain or tenderness, redness, and swelling. |
| Risk for Injury | Telithromycin (Ketek) is a drug related to the macrolides. It can cause the patient's eyes to have difficulty focusing and accommodating to light. |
| Diarrhea | Diarrhea may be an indication of a superinfection or pseudomembranous colitis, both of which can be serious The nurse should inspect all stools for blood or mucus. If diarrhea does occur and blood and mucus appear to be in the stool |
| A patient asks the nurse why the primary health care provider prescribed an anti-infective when she was told that she has a viral infection. The correct response by the nurse is that the antibiotic may be used to prevent a | secondary bacterial infection |
| A patient is receiving erythromycin for an infection. The patient's response to therapy is best evaluated by | comparing initial and current signs and symptoms |
| When asked to describe a photosensitivity reaction, the nurse correctly states that this reaction may be described as a(n) | aversion to bright lights and sunlight |
| When giving one of the macrolide antibiotics, the nurse assesses the patient for the most common adverse reactions, which are | a related to the GI tract |
Combine with other sets
Share on Facebook
Share on MySpace