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ATI PHARM Unit 2
Medications used to treat infections
| Question | Answer |
|---|---|
| Penicillins - therapeutic use | medication of choice for gram-positive cocci such as strep, pneumonia and meningitis. First choice for gram-negative cocci such as meningitis. Prophylaxis bacterial endocarditis. |
| Penicillins - Use | Destroys bacteria by weakening the bacterial cell wall. |
| Penicillins - medication/food interactions | Aminoglycosides ( penicillin inactivates aminoglycosides when mixed in the same IV solution.) Oral contraceptives (ampicillin reduces oral contraceptives efficacy. |
| Penicillins - Medications | (cillin) Amoxicillin, nafcillin, methicillin, geocillin, piperacillin |
| Penicillins - Adverse reactions | GI Distress, oral/vaginal candidiasis, generalized rash, anaphylaxis. |
| Cephalosporins - Medications | (ceph & cef)1st gen (cephalexin, cephapirin) 2nd gen(cefaclor, cefotetan) 3rd gen(ceftriaxone, cefotaxime) 4th gen(cefepime) |
| Cephalosporins - therapeutic uses | Broad spectrum bactericidal med w/high therapeutic index that treat urinary tract infections, post op infections, pelvic infections and meningitis. |
| Cephalosporins - Adverse Effects | hypersensitivity/anaphylaxis; bleeding tendencies; thrombophlebitis(administer slowly 3-5 mins & dilute solution); Pain w/IM injection; Cross allergy to penicillins; Antibiotic associated pseudomembranous colitis(observe for diarrhea and notify PCP) |
| Cephalosporins - Contraindications | not given to clts who have hx severe allergic reaction to penicillins. use cautiously w/clts w/renal impairment. Use cautiously in combo w/meds that promote bleeding.(anticoagulants, antiplatelets, thrombolytics, non-steroidal, anti-inflammatory agts) |
| Cephalosporins - Med/food interactions | Disulfiram reaction (intolerance to alcohol-instruct clt to not consume alcohol while taking cephalosporins) Probenecid (delays renal excretion - monitor I&O) |
| Cephalosporins - Patient teaching | Instruct clt to complete prescribed meds even if symptoms subside. Take with food. Store in fridge. |
| Carbapenems - Meds | Imipenem (primaxin), meropenem |
| Carbapenems - Therapeutic uses | Broad antimicrobial spectrum is effective for serious infections such as pneumonia, peritonitis, and urinary tract infections caused by gram-positive cocci, gram-negative cocci, gram-neg bacilli, and mixed aerobic and anaerobic bacteria. |
| Carbapenems - Adverse Effects | Allergy/hypersensitivity; GI symptoms(N/V diarrhea)monitor I&O; suprainfection (monitor for signs of colitis, diarrhea, oral thrush, vaginal yeast infection) |
| Carbapenems - Contraindications | Use cautiously in clts w/renal impairment. |
| Monobactams - Meds | Vancomycin (vancocin) Aztreonam, Fosfomycin. |
| Monobactams - Therapeutic uses | The antimicrobial of choice for serious infections caused by MRSA (Methicillin resistant staph aureus or staph. Used for antibiotic associated pseudomembranous colitis caused by (C Diff)Clostridium difficile. |
| Monobactams - Adverse effects | Ototoxicity (assess for hearing loss); infusion reaction(administer slowly over 60 minutes.); Thrombophlebitis (rotate sites, monitor for redness, swelling & inflammation.) |
| Monobactams - Client education | Peak blood level should be collected 1-2 hr after completion of IV infusion. Appropriate peak levels are b/w 30-40 ug/ml. |
| Tetracyclines - meds | (cycline)tetracycline hydrochloride, doxcycline |
| Tetracyclines - Therapeutic uses | First line med for rickettsia, infections of urethra or cervix caused by chlamydia, lyme disease. |
| Tetracyclines - Sided effects | GI discomfort includes cramping, n/v, diarrhea, and esophageal ulceration; yellow/brown tooth discoloration & hypoplasia of teeth enamel. hepatotoxicity (lethargy, jaundice); photosensitivity; Suprainfection of the bowel. |
| Tetracyclines - Medication/food interactions | Milk products, calcium supps, iron supp, magnesium-containing laxatives, and most antacids. Taken on empty stomach w/full glass of water. Administer 1 hr before or 2 hr after food and supps. Reduces effectiveness of Oral contraceptives |
| Bacteriostatic inhibitors - Meds | Erythromycin (E-Mycin), clindamycin, azithromycin, clarithromycin. |
| Bacteriostatic inhibitors - Therapeutic uses | Bacteriostatic inhibitors are used to treat infections in clients with a penicillin allergy. |
| Bacteriostatic inhibitors - Adverse effects | GI discomfort(n/v, epigastric pain- administer with meals) Thrombophlebitis (infusion of IV erythromycin should be admin slowly and in a dilute solution. |
| Bacteriostatic inhibitors - Med/food interactions | Antihistamines, theophylline(asthma med), carbamazepine(anticonvulsant) and warfarin(anticoagulant) concurrent use w/these meds results in toxicity. |
| Bacteriostatic inhibitors - Teaching | administer on empty stomach, IV erythromycin is rarely used, only for severe infections admin by continuous infusion. finish prescriptions. |
| Aminoglycosides - Medications | Gentamicin (garamycin)amikacin, tobramycin sulfate, neomycin, streptomycin, paromomycin(oral) |
| Aminoglycosides - therapeutic uses | med of choice against aerobic gram-negative bacilli. |
| Aminoglycosides - Adverse effects | Ototoxicity; nephrotoxicity (monitor I&O, BUN, and creatinine levels, clt rpts decrease in urine output, intensified neuromuscular blockade resulting in respiratory depression. Hypersensitivity (streptomycin - neurologic disorder/numbness of hand or feet) |
| Aminoglycosides - contraindications | use cautiously in clts w/renal impairment, pre-existing hearing loss, clts w/myasthenia gravis, clts on ethacrynic acid, cephalosporins, vancomycin, neuromuscular blocking agts. Clts renal impairment should receive reduced doses of aminoglycosides. |
| Aminoglycosides - interactions | Penicillin - will inactivate aminoglycosides when mixed inthe same IV solution. |
| Aminoglycosides - client education | Measure levels based on dosing schedule. Samples for peak levels collected 30 min after admin IM or IV. Trough levels for clients receiving divided dosing. Sample should be collected prior to next dose. Once-a-day dosing 2 samples 2&12hr after admin. |
| Sulfonamides/Trimethoprim - Meds | Bactrim, septra, cotrim |
| Sulfonamides/Trimethoprim - Therapeutic uses | Med of choice for urinary tract infection caused by E. Coli and other infections. |
| Sulfonamides/Trimethoprim - Adverse effects | Hypersensitivity including Stevens-Johnson syndrome; blood dyscrasias(hemolytic anemia); crystalluria(instruct fluid intake 8-10 glasses a day.); kernicterus (jaundice); photosensitivity |
| Sulfonamides/Trimethoprim - Medication/food interactions | Warfarin, dilantin, Orinase |
| Sulfonamides/Trimethoprim - Teaching | Take on empty stomach w/full glass of water. |
| Urinary tract antiseptics - Meds | Nitrofurantoin (macrodantin |
| Antimycobacterial-meds | Isoniazid (INH); streptomycin, ethambutol, pyrazinamide |
| Antimycobacterial - Adverse effects | Peripheral neuropathy(tingling, numbness administer 50 to 200 mg of vit b6 daily.)Hepatotoxicity(anorexia, malaise, fatigue-monitor liver function) |
| Antimycobacterial - Contraindicated | INH is contraindicated for clts with liver disease. |
| Antimycobacterial - Med/food interactions | Phenytoin(interferes w/metabolism) Alcohol, rifampin and pyrazinamide (increases risk for hepaatotoxicity. |
| Antimycobacterial - patient teaching | Take on empty stomach. Take w/meals if develops gastric discomfort |
| Anti-hansen's disease - Med | dapsone |
| Anti-hansen's disease - medication/food interaction | Coumadin, oral contraceptives protease inhibitors and NNRTIs (meds for HIV); Oral contraceptives. |
| Antiviral - Meds | Acyclovir (Zovirax), ganciclovir, interferon alfa, ribavirin, amantadine, lamivudine |
| Antiviral- Use | Acyclovir prevents the reproduction of viral DNA. |
| Antiviral - adverse effects | Phlebitis and inflammation of infusion site, Nephrotoxicity(administer acyclovir infusion slowly over 1 hr, ensure adequate hydration), Mild discomfort with oral therapy, granulocytopenia and thrombocytopenia (Obtain CBC); Reproductive toxicity; |
| Antiviral - Patient education | wear gloves to avoid transfer of virus, never admin acyclovir by IV bolus. acyclovir diminishes symptoms, not cure. wash w/soap and water 3-4x day, refrain from sexual contact when lesions present, |
| Fluoroquinolones- Meds | Ciprofloxacin (Cipro) |
| Fluoroquinolones - Adverse affects | GI discomfort, Achilles tendon rupture, surpainfection |
| Fluoroquinolones - Med/food interactions | cationic compounds(aluminum, magnesium antacids, iron salts, sucralfate, milk and dairy products)Theophylline (Theo-dur), Warfarin(coumadin) |
| Fluoroquinolones - Patient education | available in oral and IV, IV admin slowly over 60 mins. |
| Antiprotozals - Meds | Metronidazole (Flagyl) |
| Antiprotozals - Adverse effects | GI discomfort, metallic taste, Darkening of urine(harmless effect), CNS symptoms(numbness sizures) |
| Antiprotozals - med/food interactions | Disulfiram-like reaction w/alcohol ingestion; Metronidazole - inhibits inactivation of warfarin. |
| Antifungals - Meds | Amphotericin B deoxycholate(fungizone), ketoconazole(nizoral), nystatin(clotrimazole) |
| Antifungals - Adverse effects | Infusion reactions 1-3hr after initiation, thrombophlebitis(rotate injection sites); nephrotoxicity, Hypokalemia(monitor electrolyte)bone marrow suppression, KETOCONAZOLE-Hepatotoxicity, sex hormones: males-gynecomastia, females irregular period. |
| Antifungals - Med/food interactions | Aminoglycosides (gentamicin, streptomycin, cyclosporine)flucytosine |
| Antifungals - patient teaching | Antifungals are highly toxic and should be reserved for sever life-threatning fungal infections. amphotericin B infused slowly over 2-4hrs by IV. Renal damage lessened w/admin of 1L saline on day of Amphotericin B infusion. complete med. |
Created by:
krislynn
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