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Drugs for Bacterial Infections Pt. II
Pharmacology for Nurses: A Pathophysiologic Approach - Chapter: 34, pp. 478-505 http://goo.gl/xc0rD
Terms in this set (11)
Early Symptoms: Tinnitus, vertigo and persistent headaches. Symptoms include: dizziness, tinnitus, fullness in the ears and producesa loss of hearing and balance.
The following are symptoms of what organs failure: oliguria, proteinuria, elevated BUN & Creatinine levels, urinary casts (destroyed kidney cells), rash, N/V, and fatigue?
Therapeutic Effects of Antibiotics
Disappearance of fever, lethargy, drainage, and redness
Multidrug Resistance Organisms
MRSA (Methicillin-resistant Staphylococcus aureus), VRE (Vancomycin resistant Enterococcus), ESBL's (Extended spectrum betalactamases), KPC (Klebsiella pneumoniae carbapenemase)
Broad spectrum, Bactericidal. Action: Kills and prevents protein synthesis in bacteria. Gentamicin (Garamycin), Neomycin, Streptomycin, Tobramycin (Nebcin), Amikacin (Amikin). Usually given in conjunction with other antibiotics like Vancomycin and beta-lactam antibiotics to cause a synergistic effect (it is best to give the beta lactams (PCN or Cephalosporins, or Monobactams) first to break down the cell wall. Then give the Aminoglycosides to gain access to the ribosomes of the bacteria and then to later act as post-antibiotic effect to continue on suppression of the bacteria). Indications: Used to kill
bacteria (Pseudomonas, E. coli, Proteus, Klebsiella, Serratia), Urinary, respiratory, nervous or GI infections. Labs: Monitor for elevated Bilirubin, serum creatinine, BUN and Liver enzymes. Adverse: Ototoxicity and nephrotoxicity (Check kidney fx before giving) Implications: Monitor peak and trough blood levels of these agents to prevent nephrotoxicity and ototoxicity. Monitor renal fx test throughout therapy. Obtain a baseline eudiometry test. Increase fluid intake while on this drug. Do not take with other drugs (antibiotics) that cause Nephrotoxic effects. Do not take with Warfarin causes an increased effect of this drug. Monitor: This drug can kill (normal flora) intestinal bacterial flora and cause antibiotic induced Superinfections. Take yogurt or buttermilk to help prevent. Should be taken with at least 3 L of fluid per day, unless otherwise specified.
Natural and semi-synthetic drug. Produced from Streptomyces. Poor oral absorption; No PO forms. Given IM (painful) or IV. Very potent antibiotics with serious toxicities.
Action: Bactericidal, Alter DNA of bacteria, causing death by interfering with bacterial enzymes DNA. Does not affect human DNA. Ciprofloxacin (Cipro), enoxacin (Penetrex), Levofloxacin (Levaquin) (one day dosing), norfloxacin (Noroxin), moxifloxacin (Avelox). Therapeutic Uses: Lower respiratory tract infections / pneumonia. Sinusitis Gastrointestinal tract/Infectious diarrhea. Eye infections Serious Urinary tract infections Sexually transmitted diseases Skin, bone, joint and soft tissue infections. Implications: Should be taken with at least 3 L of fluid per day, unless otherwise specified. May be taken with food. Do not take concurrently with antacids, ferrous sulfate, multivitamins or mineral supplements since they contain CA, MG, Iron, or Zinc ions and reduces absorption by 90%. If taken with Warfarin it may increase anticoagulant effects and result in bleeding. Assess: Abdomen for bowel sounds, texture and patterns. Neuromuscular fx: due to a potential for dizziness, headaches and visual changes; renal and liver function tests: (BUN, Creatinine and Liver enzymes), as well out urinary output. blood glucose levels. (The Quinolones increase insulin release from pancreatic islet cells).Adverse: CNS: H/A, dizziness, fatigue, depression, seizures, and sleep disturbance. Cardiac: May involve prolongation of the QT interval. Seen more so if pt. is taking cardiac drugs in conjunction like Amiodarone (antiarrhythmic agent, medication used for irregular heart beat). GI: N/V, diarrhea, thrush, lab shows an increase in Liver enzymes Superinfections and anaphylaxis may occur. Report difficulty when walking, pain in feet or legs immediately.
Excellent oral absorption. Give IV. Absorption reduced by antacids when taken together. First oral antibiotics effective against gram-negative bacteria and some gram-positive organisms.Received extensive media attention because it was the only drug labeled as approved by the Food and Drug Administration (FDA) for both prophylaxis and treatment of inhalation anthrax.
Black box warning
d/c the drug if patient experiences pain or inflammation of a tendon, as tendon ruptures have been reported. Labs: Liver enzymes, creatinine and BUN may show increased levels when taken with ___.
Bacteriostatic depending on the dose and target organism.
Bactericidal (given in high doses). Azithromycin (Zithromax) (has a long half life - given for 5 days instead of 10 days), erythromycin (E-mycin), clarithromycin (Biaxin). Therapeutic Uses: Whooping cough - pertussis (used early in tx to reduce duration and symptoms), Diphtheria, Listeria, Legionnaire's disease, Lyme disease, Streptococcus infections (group A beta hemolytic strep), Haemophilus influenza, Mycoplasma pneumoniae, Chlamydia, Gonorrhea and Syphilis. Adverse: GI irritation is seen primarily with Erythromycin: Nausea, vomiting, diarrhea, abdominal cramping, flatulence, anorexia. Hepatotoxicity, Superinfections. Do not D/C the med complete the prescription. Do not take with or immediately before or after fruit juices. Do not take OTC or herbal products with this medication.
Adverse: Hearing loss / ototoxicity, vertigo and dizziness may be experienced with high doses especially in the elderly and those with impaired hepatic and renal excretion. Do not crush, chew, break, or open an ___ tablet or capsule. Swallow itwhole. Shake the oral suspension (liquid) well just before you measure a dose. The absorption of oral ___ is enhanced when taken on an empty stomach, but because of the high incidence of GI upset, many agents are taken after a meal or snack.
Bactericidal (binds to bacterial cell wall and causes inhibition of cell wall synthesis and death). Antibiotic of choice for treatment of severe infections(MRSA infection). Indicated for tx of gram positive infections. Parenteral form indicated for tx of bone and joint infections and bacterial bloodstream infections. (Staphylococcus and Streptococcus pneumoniae). IV Infusion over at least 60 minutes to prevent hypotension and flushing. Extravasation may cause local skin irritation and damage therefore monitor IV frequently. Monitor for: Nephrotoxicity (leading to uremia) and Ototoxicity. Provide adequate hydration at least 2 Liters of fluids/24 hours a day to prevent Nephrotoxicity. Monitor the vital signs - especially BP Monitor bowel sounds and patterns Monitor the lab values:BUN, Creatinine and Liver enzymes and a peak and trough usually after three doses have been given. Obtain a baseline eudiometry test. Redman's syndrome: Occurs from rapid IV infusion → (hypotension, flushing and itching). Causes a (release of histamine) of the upper body or head, neck and face; an antihistamine may need to be ordered.
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